Obstacles to Achieving the Ideal Practice.” This week…
one of the barriers likely to be interfering in your ability
to reach your goals. Next week I’ll discuss proven solutions.
#1 The Hygiene Heist
In many practices,
the hygiene department should entitle the doctor to some sort
of charitable tax write-off for all the money poured in and
the measly return realized. That’s a nice way of saying
that in most cases the doctor and the practice are being robbed.
Hygiene departments, which could be huge profit centers,
are yielding some pretty abysmal results. This isn’t
necessarily the fault of the hygienist, oftentimes they are
seemingly booked into eternity and single-handedly trying
to manage patient recall.
A number of factors
can undermine your hygiene department. The recall “system”
may be a spiral notebook with a few names of people who once
upon a time didn’t show or cancelled their appointments.
There’s no real ownership of this vital practice system
because, well, everyone is just too darn busy. Why do you
need to bother with it when hygiene is booked six months out?
Yet hygiene is probably producing well below the standard
of 33% of total practice production. Often if the
doctor steps back and really looks at what is happening, they
will find that the hygienist has far more down time than they
realized, patient retention is seriously lacking,
and periodontal treatment is minimal at best.
Think about your
own practice for just a minute. Have you increased the number
of hygiene days per week in the last two years? If not, you’re
If you have been
in practice for just 15 years and have kept a mere 50% of
the patients that have stepped into your practice, you should
have three or four hygienists. How’s that for a revelation!
So, what do you
do? Although improving hygiene is a multi-step process,
you can come a long way if you focus on one thing.
Next week, I'll give you my number one approach to improving
patient care and solving the Hygiene Heist.
VP of Professional Relations
for McKenzie Management
series of short weekly chores designed to keep the return
on investment in technology at its highest level.
If you missed any of the previous issues
Department Automation: Paper records = electronic pages
point, most of you will make the transition to a digital
clinical record. Maybe you already have, I don’t
know. But, ALL of you will have some reservations about
doing so. The most common perception out there is that
the computer is going to “slow me down”.
This is the fastest way to get over the fear and grasp
the reality that a digital clinical record is actually
more complete, easier to produce and review, and faster
(yes, I said faster) than a paper chart.
Here’s what I want you to do. This is going to
sound elementary at first, but do each step in order.
- The next
5 existing patients that come into your treatment
room, list the documents inside the paper chart that
you routinely reference before, during, and after
the patient visit. I want you to have a list. Your
list may look a lot like this:
recent med history
necessary treatment plan
front desk of work performed today
front desk of next appointment
the sequence of the list as steps
how many “pages” of paper you reference
to find and store information now
of your practice management system as “pages
of the same paper”
- Go to
your practice management system’s clinical management
In our example above... ...
You would bring up the patient record
”click” to see their most recent medical
”click” to see prior treatment
”click” to see their existing treatment
”click” to see their most recent xrays
”click” to chart necessary treatment
”click” to review and save the clinical
note that enters itself
”click” to post today’s procedures
performed (which 80% of the time are scheduled and
ready for posting anyway)
”click” to make the next appointment or
inform the front desk one is needed
I can almost guarantee you (this depends on the quality
of your practice management system’s design) that
the information you require prior to, during, and after
seeing a patient can be found faster, more easily, AND
MORE COMPLETELY than on a paper chart.
In order to get over that initial hurdle, just duplicate
your existing routine until using your practice management
system becomes faster than your paper system. Once you
are faster, here are some other things to consider incorporating
into your routine.
the patient’s portrait before they arrive so
you can recognize and greet them by name.
patient notes entered by the whole team so you can
be ready for any “surprises”.
any specific areas of clinical concern or “watches”
for the patient’s arrival by having their full
smile on the monitor just before arrival.
the image of the tooth or teeth you are going to work
on today immediately visible so you can review exactly
what you are going to do at today’s visit.
patient education loop ready to run to assist you
in preparing the patient for today’s treatment
(this works fabulously for building value in interceptive
Bottom line: The reason a paper chart is comfortable
is because you’ve been using them forever. Paper
charts are limited. If you think about electronic records
as “pieces of electronic paper” and know
how to retrieve them (like thumbing through a chart)
– doing so will become a new habit. Once the new
habit is in place, you will be much faster. Once you
are faster, adding new pieces (radiographs, digital
images, patient education, patient notes, etc) into
your routine will make the whole patient visit more
refined, more focused, more pleasant, and more memorable
to your patients. Oh, one more thing … you will
do all this in the same or less time.
Year Practice Resolutions 2003
Increase Production by 42%?
2. Set job descriptions for staff with performance measurements?
3. Reduce the accounts receivable by 15%?
4. Get a full one hour for lunch?
5. Bring on an associate dentist in the first quarter?
6. Increase perio treatment in the hygiene department by 28%?
7. Equip another operatory first quarter?
8. Increase fees 3% the first of March and October?
9. Teach dental assistants how to make temporary crowns?
10. Have 2 hour monthly meetings with system measurements?
will yours be?
out NOW how you can make your 2003
resolutions … REALITY!!!!
Pack Hygiene Special!!!!!
How To Have A Successful Recall System- Book
Telephone Effectiveness to Improve Patient Retention-Audio
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Breakdown: The Hidden Signals of Practice Erosion
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