The Paradox of Performance
It’s an interesting irony; the success of virtually every dental practice is wholly and completely dependent on the effectiveness of both the doctor and the team. Yet when it comes to establishing systems to measure that effectiveness, many are reluctant to do so. Dentists will say things like, “I’m sure Mary is doing the best she can.” But you don’t really know. Or, “If there were a serious problem I would see it.” Yes, and believe me, it’s about to hit you right between the eyes and square in the bank account. “Everyone knows they are expected to do a good job.” And what exactly do the words “good job” mean, doctor?
Details slip through the cracks, and when questioned about specific responsibilities, staff members commonly respond with comments such as, “Is that my job? I thought it was hers.” “When was I supposed to have time to take care of that?” “Oh, is that important?” Without clearly defined job responsibilities and performance measurements, dental teams experience far more conflict, staff turnover, patient attrition, and lost profits.
Performance measurement begins with performance management. If you’ve ever had an interest in improving patient retention, scheduling, treatment, financing, collections, etc. then you’ve touched on performance management. These are all systems in your practice, and properly managing the performance of each system means appropriately measuring the performance of each person who affects those systems.
Too often, however, there is a disconnect between the performance/results that the doctor desires and the performance/results the employees deliver. Dentists know what they want, but they don’t know how to guide employees down the path to achieve it. Consequently, both become frustrated and discontented with the other. The doctor sees a team of non-performers who “can’t do their jobs.” The team sees a doctor who “can’t lead and doesn’t know how to communicate what s/he wants.” Both are wrong. But both are lacking the fundamental ingredient necessary for success: clearly established performance measurements.
In working with thousands of practices over the years, we find that most employees - at least the ones you want on your team - sincerely want to perform well. They want to be challenged, and they need direction, guidance, and regular feedback.
But where do you begin? Certainly, many dedicated practitioners have given up in frustration when trying to implement performance measurement systems. They neither knew where or how to execute such a program. This isn’t the type of change that can be implemented overnight. Give yourself time, a period of months, to implement a working performance measurement system.
Choose a model that encourages, not discourages, excellence. Some well-intentioned systems are poorly designed and actually discourage outstanding performance. For example, some practices will mistakenly base the measurements solely on areas that are clearly and easily quantifiable, such as collections ratio, accounts receivables, production, number of new patients, etc. They also are inclined to establish group bonus plans based on the combined efforts of staff to reach specific production, collection, and overhead figures. Group participation implies equal contribution toward group objectives. Yet in reality, the business coordinator schedules production, the clinical assistant aids in production, the dentist and hygienist produce. These are not equal functions.
The most successful performance measurements are based on individual jobs. They focus on specific job-related goals and how those relate to improving the total practice. Used effectively, employee performance measurements and reviews provide dental teams and individuals with critical information and direction that is essential in making major decisions regarding patients, financial concerns, management systems, productivity, and staff.
Ultimately, it comes down to making a choice. If you want to maintain the status quo, continue to tell yourself that your practice really doesn’t need performance measurements. But if you want to feel good about coming to work every day and enjoy the quality of life and financial benefits of a highly functioning team, invest some time and resources in constructively directing them. You’ll be the first to enjoy the pay-off of better performance and higher productivity. I guarantee it. What’s more, you will learn very quickly if the employee(s) you perceive to be weak performers truly are lacking in competence, or merely need clear direction and guidance from you.
Next week, implement performance measurements step-by-step.
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When the Going Gets Tough the Tough Get Going
While attending a recent dental conference, I heard people in small groups talking about the recession, the national debt, the health insurance mess and other negative verbal exchange. Statistics say that dental offices are down in production an average of 10-30% across the country. The percentages are demographically driven, as some communities have not been affected as badly as others. Many doctors are concerned, and rightly so. What are we supposed to do with this information?
Buying into negativity can immobilize and foster a defeatist attitude. We can look around and say that we cannot do anything about it, or we can create a positive energy and work on improving office systems that will attract patients. People are saving more, reducing credit card debt and shopping for good deals - but it doesn’t mean that they aren’t seeing a dentist. What they are doing is seeing the dentists who do something to attract them and work on keeping them in the practice.
Contrary to what is happening in many offices, I learned from other practices that had been through our training programs that most have maintained or increased production, and one office was having a banner year and the best January ever. Taking notes from these different offices, I have created the following bullet points to consider when there are openings on the doctor’s schedule and the hygiene schedule has fallen apart. Instead of clocking out, going online or shutting down the office for the day, consider doing some of the following to create improved morale and better systems:
When you immerse yourself into a creative process and reach out to your patients and the community, it has a positive effect. People start calling you for information and making appointments, and soon you are busy doing what you do best - dentistry.
Need help, call us at McKenzie Management. We have been helping dental practices improve since the 1980’s.
Forms and More Forms
As part of the on-site consulting program, it is important that the printed forms, stationery, recall cards, business cards, thank you cards, etc. are reviewed for any necessary changes and/or recommendations.
Now, I think that Garfield is “cute” but I don’t think that Garfield is professional. Ask any hygienist how she feels about her profession being promoted by Garfield, compared to a professional recall notice with the practice and appointment information. It fits into a professionally printed envelope with the return address and logo on it, compared to being printed on a flimsy postcard with computer-generated information, which no human hands have touched other than to rip the 2x2 cards apart and run them through the postage machine.
Logo & Thank You Cards
Business or Appointment Cards
New Patient Information Form
It is important to include details on the form such as the release of information to the insurance company and the assignment of benefits (if applicable). If you take patient photos and wish to use them for marketing or training, include a release that allows you to do so. Inform the patient of any NSF fees that you will charge them should your bank charge you, as well as interest, service charges, collections fees, etc. that may be applicable to your practice. (State regulations vary so check with your state to see what you are allowed to charge the patient with their acknowledgement.)
Remember to include the practice logo on this form, too.
Consent and/or Post Op Forms
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