McKenzie Newsletter 417

What’s Your True Value to the Practice?
by Sally McKenzie CEO
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The current economy aside, the fact is that many dental employees will walk into their employers’ offices expecting, requesting, and even demanding raises. “I’ve been here a year. I show up on time every day. I do my job. I deserve to make more money.” Unfortunately, too many dental employees are convinced that those are the only criteria they have to meet to receive a pay hike.

I recommend a little different approach to determining whether it’s time to receive that hard earned raise - calculate your true value in the practice by asking yourself a few key questions. What recent problems or critical issues have I resolved? You should have a list documenting your contribution as a team who is focused on finding solutions, not creating problems. What new responsibilities have I taken on since my last raise? Showing up with a smile on your face three out of four days a week is not enough. What have I done to increase practice revenues and/or cut costs or save time? Virtually every employee in the office is a frontline team member. You are responsible for carrying out key systems daily and you should have a good sense of what is working and what could be improved. It’s your job to recommend strategies to improve ineffective systems.

Next, you absolutely must consider the bottom-line financial realities of the dental practice that employs you. For example, if the practice’s current monthly collections are $48,325 per month and team salaries are $9,353 a month, a $2 hourly raise for the dental assistant from $15 to $17 working a 36 hr. week will increase existing salaries to $9,665, which is within the 20% industry benchmark. However, if current monthly collections are $39,000 and existing wages are $9,353 that puts salaries at 24% collections and well above the accepted standard. Meaning, you’ll need to do something to boost revenues before you can expect the doctor to increase expenditures on your behalf.

And there is plenty you can do. The fact is that employee productivity has a huge impact on the profitability of the practice and can directly improve your income potential provided you make one very important commitment: Focus on delivering measurable results daily. Follow these steps to make that happen.

Develop a clear, results-oriented job description.

Work with the doctor in establishing your own performance objectives/job expectations that are consistent with the doctor’s overall practice goals, such as scheduling to meet production goals, keeping the hygiene schedule full, eliminating the insurance backlog, improving the new patient process and materials, enhancing your assisting skills, etc.

At the monthly business meeting, be prepared to report to the entire team the status of your area of responsibility. If you are the scheduling coordinator and last minute cancellations and no-shows are pounding the production goals, what strategies and procedures will you propose to control the problem? Seek suggestions from your teammates. Don’t take the attitude that no-shows and cancellations are just a fact of life. You don’t have to have all the answers but you do have to be open to changing systems that aren’t working and to implementing new strategies to address challenges that are costing the practice money. Remember, your success is directly tied to the practice’s overall success.

Develop a list of specific steps you can take to be a valuable asset to the business. Monitor your progress and your accomplishments using concrete numbers whenever possible. For example, if you developed a new patient welcoming procedure and materials that increased the number of patients coming into the practice and pursuing recommended treatment plans, document your strategy, measure the outcomes, and report the results to the doctor and team.

Ultimately, although you may truly be consistently delivering results for your employer, the practice simply may not be able to increase your salary at this time. Squelch the urge to use threats or make demands. Requesting a raise with the attitude "if I don't get it, I'm leaving" will only tell the doctor and team that you are uncompromising and only out for yourself. Be professional, and if your job is worth keeping –you’ll know if it’s not – be willing to better the practice and you’ll likely better yourself as well.

Interested in speaking to Sally about your practice concerns? Email her at sallymck@mckenziemgmt.com. Interested in having Sally speak to your dental society or study club? Click here.

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Nancy Caudill
Senior Consultant
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The Bad Employee

This article is not about a particular practice, as I typically would write. You have probably either already experienced this topic and learned from your mistake, or you are experiencing it now but maybe don’t even know it. Ideally, you are reading this to avoid it from happening to you. What is it? The bad employee!

Great Employee Characteristics:
Your long-time chairside assistant moved away when her spouse was promoted to another state. It was a sad day and everyone cried on her last day. She was the best assistant you had ever worked with because:

She was only late for the morning meeting 5 days in 5 years
She was a team player, willing to help anyone in the office when she had a spare moment
She was trained by you and clinically skilled
The patients loved her because of her positive attitude
She always “had your back” and never whined
She participated in all the office functions with a smile
She said “please” and “thank you”
She was your “transportation director” and always knew where you were and where you needed to be

And now – it’s time to let the interviews begin! Because interviewing is your least favorite time-killer, when the 3rd resume arrived via email, you decided that this is the one. She has lived in the area for 6 years and has worked in 3 dental offices in town so she has a lot of experience. You call her and the answer machine says, “Hey you! This is Judy. Sorry you missed me. Leave me a message and maybe I will return your call if I like the sound of your voice.” Cute, you think to yourself. You leave a message to return your call.

Saturday afternoon you give Judy a call again. Since you were sure that she was “the one” you have not reviewed the other 26 resumes that are on your desk. Whew, she answers the phone. You introduce yourself, tell her that you are interested in having her come by the office on Monday at 5:15 and say good-bye. She was very excited to hear from you and is looking forward to meeting you. To make this story short – you hire her on the spot. No confirmations of previous employment, no working interview, simply, “you have the job.”

Now it’s Tuesday morning, 7:50 am, and no Judy. The morning meeting starts without her. At 8:05 she blows in, indicating that she didn’t realize that it would take so long to get there in the morning traffic. “I understand,” you respond.

For the next 6 months, Judy proves to be incapable of taking x-rays without cone-cutting them. She is left-handed, making her chairside assisting awkward for you. Hmmmmm… you forgot to ask her if she was left or right-handed. She has arrived late for work on 8 difference occasions and has already missed 4 days of work for various “reasons.” Sharon, your now “right hand” assistant, is concerned that this new employee is not going to be a team-player and expresses to you her concern. Actually, the remainder of your team expresses their concerns with you, as well. It just doesn’t register with you that they may have a point.

Finally, your hygienist who has been with you for 9 years indicates that either Judy goes or she goes. She feels that Judy is a bad fit for the practice because:

She is often late and always has an “excuse”
She never has time to help others because she tends to “disappear” during the day with her cell phone
She solicits others to take her x-rays because hers are unacceptable
She is not dependable, having already missed so many days of work
She is sarcastic and rude to other team members

After another painful 3 months and 5 more missed days of work and 8 days of tardiness, you dismiss her. Back to square one!

Summary
Don’t let this happen to you. If you have an employee right now that reminds you of Judy, let her go. Your existing employees will be so proud of you and you will be much happier. If you are looking for a new employee, do your homework. Review all the applications, check with previous employers for verification of employment, look for “red flags” such as multiple employers within a short time period, conduct a working interview, give her a personality and ability test, allow your team to take her to lunch and see what their feelings are about her. And most of all – LISTEN to what they are telling you. Your staff wants a happy, well-adjusted team player as much as you do. Don’t waste time on the bad employee. Dismiss her and start again. There are many outstanding employees in the work force right now - you will find that right person if you don’t waste time on the bad ones!

If you would like more information on how McKenzie's Practice Enrichment Programs can help you IMPLEMENT proven strategies, email info@mckenziemgmt.com.

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Belle DuCharme CDPMA
Instructor/Consultant
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Scheduling Special Needs and Emergency Patients

In calculating procedure times and mapping out scheduling to meet the practice goals, thought must be given to time management of the special needs and emergency patients. Obviously, it is difficult to plan for the emergency patient but demographics and practice philosophy can dictate the frequency of this patient. Some dentists will see only one or two emergency patients a day and others will see anyone that calls. Affluent neighborhoods on the average see fewer emergency patients than poor or poverty level neighborhoods because the affluent are more apt to seek regular routine care. If you run the practice analysis by code report and note how many D0140 or limited oral evaluations you have for the last year it will give you a prospective of what you will probably get this year. This code should be used to distinguish the emergency patient from the new patient comprehensive D0150.

In the initial interview of the new patient, their health history will give clues to their specific needs. Special needs would include those patients with dental phobias, bleeding disorders, physical or mental handicaps, heart conditions, the elderly in wheelchairs or with limited mobility of limbs, neck and torso, and patients requiring premedication to prevent endocarditis or for management of anxiety. Having the right comfort tools available in the set-up will save time at the chair, for instance, a blanket for the elderly and a neck pillow for the patient with neck problems or nitrous oxide for anxiety. Patients having special needs usually require additional units of time on the schedule. How much time should be added to the patient’s time block must be communicated to the Scheduling Coordinator, otherwise they may be assigned the standard time to do the procedure when making appointments.

Elderly patients, homemakers, and retired patients who are available during daytime hours should be scheduled to fill times usually between 10:00am and 2:00pm. Young children should be scheduled for morning appointments as they are generally more cooperative after a full night of sleep and breakfast. Diabetic patients should be scheduled early in the morning when their insulin levels tend to be more stable. Patients covered under the Americans with Disabilities Act may also have special needs and it is wise to be familiar with this information.

If not managed correctly, emergency patients can wreak havoc on an otherwise well planned schedule. During the morning meeting it is decided by the clinical staff or the dentist where it would be advantageous to place an emergency patient should one or more call that day. Do not allow the emergency patient to dictate when they will come in that day. Having a planned time unit and codes for this patient helps to manage time and keep the practice on schedule. The emergency visit could include a limited oral evaluation, a periapical x-ray or two and a palliative treatment. Quoting the fee for these services and asking the patient if they are prepared to pay is good practice management as emergency visits are the most common unpaid visit seen on overdue accounts receivable reports.

Screening the emergency patient would include the following questions:

After asking for the patient’s name, ask: “Are you a patient of record with our practice?”
Ask: “Are you having discomfort? Please describe the discomfort or the nature of the emergency.”
Ask: “How long have you had the pain/swelling?”( as described by the caller)
Ask: “Is the discomfort constant? Does is wake you up or prevent sleep?”
Ask: “Does the pain increase when exposed to heat, cold, sweets or pressure?”
Ask: “Are you under the care of a physician for a medical condition?”
Ask: “Are you taking any medications and do you have any drug allergies?”
Tell the patient: “The emergency visit today will be between $85 and $125. We accept cash, Visa or MasterCard. Will that be a problem for you today?”

Emergency patients are in crisis and must be handled with kindness and care. It is important to educate the patient on establishing regular routine care to prevent future emergency visits. Connecting and building rapport with this patient can make a difference in their future quality of life.

Want to learn more about managing your schedule and communicating with your patients? Come join us for advanced learning and take the Front Office Advanced Training at McKenzie Management.

If you would like more information on McKenzie Management’s Advanced Training Programs to improve the performance of your team, email training@mckenziemgmt.com

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