CEOs Ask the Tough Questions
As much as you may want to, the fact is: you alone can't do it all. The successful practice needs a team of people committed to achieving excellence in every practice system. In most cases, this won't happen without team training. But reaching the true pinnacle requires that each person feels a sense of ownership in the practice, as if each employee was the CEO of his/her respective area.
As the “CEOs” of their specific practice systems, employees can be a tremendously valuable resource and a major factor in total practice success. Part of creating a “CEO mentality” is seeking input from those on your team, and that requires asking more questions. Employees can be a powerful resource in identifying better ways to do things as well as where to save money.
One of my favorite questions to periodically ask the dental team is, “What is it time to get rid of?” As practices grow and mature through the years, procedures that were critical 10 years ago may be inefficient and antiquated today. For example, patient recall required far more paperwork in the past. Today, it should be a streamlined and efficient system that is largely achieved through email and text messaging. Patient forms that once needed to be printed and distributed to patients in person or through the mail can now be available on the practice’s website or sent to the patient via email - saving on printing and mailing costs.
Particularly for practices that have been in operation for 15-20 plus years, owners and team members can get settled into a “this is the way we do things” mentality. Looking at streamlining processes and updating technologies to improve practice efficiency and productivity can be a highly effective way to reduce costs over the long-term. Speaking of costs - another of my favorite questions for the “team of CEOs” is: “What would you change if you were paying the bills?”
Perhaps you have a situation in your practice in which someone different is always ordering supplies. Consequently, no single individual is accountable. As a result, items are ordered only to find that the office already had plenty of this or that product. Streamlining certain duties, such as ordering supplies, can help to ensure practice resources are used most effectively. Paying attention to specific budget targets will also encourage the team and the doctor to more closely evaluate the value of larger purchases. Look for ways in which unnecessary expenses can be eliminated. The more effectively the practice can manage and increase available revenues, the greater the likelihood that the entire team can benefit financially from the success of a practice that is well in the black. And that brings me to my final questions for the CEOs: “What systems are working well? How can they be improved? How can that success be replicated in other systems?”
Just as it is far too easy to complain and find fault, often in dental practices it is far too easy to focus on what isn't working and disregard those areas that experience consistent success. Look at those systems that function well. Discuss the attributes of each and what sets them apart. Then consider how similar approaches can be implemented in other areas. For example, if scheduling consistently runs like a well-oiled machine, what steps have been implemented to ensure consistent results? Perhaps the scheduling coordinator understands that s/he is scheduling for production. S/he has received training in how to direct patients to particular time slots. S/he has a well-prepared script so that s/he always knows exactly what to say to patients and how to say it. S/he receives regular feedback from the doctor and hygienist so s/he knows precisely what is working well and what needs to be adjusted.
Luck doesn't determine the success of practice systems any more than it determines the skill of the doctor. It is through specific procedures that are routinely evaluated and continually improved. It is through training and employee education. And it is in empowering the team to think like practice owners, so that at the end of the day, it is a total team effort that leads to total practice success.
Want more of me? Click here to visit my blog, The Lighter Side, for more Dental Practice Management info.
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A Sad Story with a Happy Ending
As a hygienist, I have had patients tell me amazingly personal things about themselves. It is surprising that with my instruments in their mouths for the better part of an hour, they are able to express so many thoughts and emotions to me. I have had patients burst into tears, recount fights with family members, and even confide secret wedding plans! I have always considered their statements to be confidential, but am sometimes a little bewildered as to what I should say in response to their revelations. Typically I try to look for a positive comment, but I think that many times they just want someone to listen.
A while back a new patient arrived at our office who stressed my ability to respond in a positive way. Since we did not have a mutual history, I didn't really know what to say during our initial conversation - but eventually we both found a way to land on solid footing. Here is what happened:
Mrs. Patient came to our office at the suggestion of a co-worker of hers. While going over her medical history it was evident that she had more than her share of medical problems. Her demeanor was combative. For first time patients we typically take a full mouth series of radiographs and full mouth perio charting along with an adult prophy and dentist's exam. If a patient arrives who needs more than a standard prophy, we perform whatever service can be accomplished during the time period, along with a detailed explanation of what actually needs to be done. An estimate is prepared for restorative and perio services and is presented by front desk staff at the end of the appointment.
Before she had even settled into the chair, Mrs. Patient told me that she hates dentists and has had terrible experiences in the past with hygienists who hurt her. She expressed that her previous dentist just wanted money and that she didn't trust the profession as a whole. She told me that she could not understand how anyone could scrape people's teeth for a living and suggested that anyone who would do such a thing must have a mean streak and enjoy the chance to hurt someone!
I was pretty shocked. I felt attacked, demeaned, and frankly, angry. My usual explanations about what we would be accomplishing at this first appointment seemed weak and inappropriate. Not really knowing what else to do, I told her that we would be doing our best not to hurt her, and that I would be starting with her radiographs. When I placed the sensor in her mouth she pushed my hand away and told me “that thing is too big” and that she “couldn’t stand to have it in her mouth.” Her facial expression reminded me of someone with road rage on the highway.
I took the sensor away and sat down in my operator chair at her eye level. I was actually shaking in the face from all of this hostility. I decided to try something different. I took her hand in my two hands and said as sincerely as I could: “You have had some horrible experiences with dentistry and expect the same will happen here. I am so sorry that you have had to put up with so much. It just isn’t right.”
Tears filled her eyes and she replied in a much softer voice, “I have been through so much lately. I am at my wit’s end.”
I told her again how sorry I was for her trouble. And then she started telling me about her life. She had recently become a widow after her husband was very ill for a long time. She described how heartbroken she was that he had to suffer for so long, and she expressed her anger at the entire situation. She told me about her long lonely nights and her sorrow at having to face the rest of her life alone. I listened to her and didn't say much. We were just two people talking about one of the hardest things a person might have to face in this world.
After a while I got her some tissues and a cup of water, and I asked her why she had decided to come to the dentist at this time. She told me that she knew she had a lot of dental problems, but had not cared about herself much over the previous few years while caring for her husband. Her daughters had encouraged her to have her teeth looked at, and her co-worker had told her about us. So - she decided to give our office a try. I told her that we would all do our best to take good care of her and thanked her for giving us a chance.
Not much dentistry was accomplished during this appointment, but I was able to take her x-rays and the dentist was able to complete a thorough exam. I rescheduled her for perio charting and a prophy, as it turned out that was all she required on my end. However, it was discovered that Mrs. Patient had extensive restorative needs. She decided to have all of the treatment completed, and during her future appointments she never expressed the negative, combative emotions she showed during her first visit.
I have two points with this story. First impressions can be absolutely wrong, and dentistry is often more than just restorative treatment and perio care. A person who seems to be “on the attack” may have other issues that are not really about the dentist, the hygienist, or the office. Sometimes taking a moment to respond as a human being can make all the difference.
An ability to make connections with patients is a valuable attribute for anyone working in dentistry. From the front desk staff to the dentist, when patients feel that you have their best interests at heart they will tend to accept your suggestions more readily. That is good for patients, in that they receive the treatment they need, and for the office, in that it is good for the financial bottom line.
Carol Tekavec RDH is the director of Hygiene for McKenzie Management. Carol can improve your hygiene department in just one day of training “in your office.” Interested in knowing more about how to improve your hygiene department? Email firstname.lastname@example.org.
Winning Against the Odds
I saw the movie Moneyball this week, an Academy Award nominee for Best Picture. Based on the book by Michael Lewis, it's an inspiring story about Billy Beane, the 2002 Manager of the Oakland A's. The team didn't take the World Series Championship that year, but they won 103 games and set the record for the longest winning streak in American League Baseball history with 20 games. The movie is about how they took a cast of undervalued players and created such a winning team.
There are many dental team parallels in the movie, but the most striking (pun intended) revolves around the importance of hiring and developing talent. Hiring is an important investment. The A's accepted the fact that they were a small market team. Rather than compete with the extravagant budget of the New York Yankees, they identified undervalued talent and developed their investment. Leveraging your hiring dollars is more important than ever if you want to position your practice for future profitability. Certainly there are no sure-bet methods to guarantee an applicant will be a peak performer in your practice, but there are ways you can increase the probability of success.
Review Job Descriptions
Standardize Your Interview
Look Beyond the Resume
Be Innovative in your Selection Process
Smart employment practices will ensure a more successful and productive office, better patient service, and new referrals. Challenging the status quo of your hiring process takes time, but the investment will yield large dividends. The pay-off is higher caliber employees who work harder and stay longer…and this ultimately helps you to succeed on a competitive playing field.
Dr. Haller is available for consultation and coaching. If you would like to receive a sample report of the Employee Assessment Test, contact her at email@example.comInterested in having Dr. Haller speak to your dental society or study club? Click here.
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