Under Pressure to Raise Salaries? Do This First
No question about it, money matters can make for messy business in any workplace that is dependent upon teamwork and trust - which would be virtually every dental practice. Reward some and you seemingly punish the rest. Reward all and you send the message that average effort pays the same as excellent. It’s a management minefield for most dentists who struggle with balancing the financial needs of the practice with the financial desires of the staff. How do you navigate this tricky issue? With clear leadership and specific salary guidelines.
Certainly, it’s imperative that employees understand how their roles fit into the overall success of the practice. And it’s critical they have a clear understanding of the financial health of the business. But above all else, effectively handling the matter of money with your staff requires that you manage their expectations from the outset. It starts day one - not six, eight, or twelve months after the employee comes to work for you. Explain when raises will be discussed and under what circumstances a raise will be given. Implement the following four rules of staff compensation and start managing payment expectations immediately.
Rule #1 - Establish a Clear Compensation Policy
Rule #2 - Conduct a Salary ReviewBefore you convince yourself that another buck-fifty an hour isn’t going to break your bank, check the balance sheet. The Salary Review is a clear and simple mathematical tool you can access immediately to determine exactly how much more money you’ll need to collect each month to cover that seemingly insignificant pay increase. It ensures that you are making an informed rather than emotional decision when it comes to salary increases. Your goal is to follow compensation benchmarks, which means wages should be in the 19-22% range of gross collections, not including the doctor’s salary or taxes/benefits.
Consider this example: If your current monthly collections are $48,325 per month and your existing salaries are $9353, then a $2 hourly raise for your assistant from $15 to $17 who is working a 36 hr. week will increase existing salaries to $9665, which is within the 20% industry benchmark. However, if your current monthly collections are $39,000 and existing salaries are $9353, that puts you at 24% of gross production and well above the standard.
Rule #3 - Make More before you Spend More
Rule #4 - Job Description
Finally, hold employees accountable for their systems. And remember, pay increases should reward excellence and dedication to advancing the practice - not another year on the calendar.For more information on this topic and for additional Dental Practice Management info, visit my blog: The Lighter Side.
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What Does a Hygienist Do?
What does a hygienist do? If you ask someone on the street they may say something like “helps the dentist” or “cleans teeth.” Due to an increase in consumer product advertising (as in “recommended by dentists and hygienists”) some people have become aware that a hygienist is a separate category of dental professional - one that might have knowledge of prevention and preventive dental products on par with a dentist.
Even so, when patients see the hygienist they usually believe that his or her focus is on “cleaning.” While providing professional cleaning is an important function for the hygienist, in a successful practice s/he does much more. So what else does a hygienist do? Identify and promote necessary dental treatment.
During the course of their patient care, hygienists have the opportunity to visually inspect every single tooth in a patient’s mouth. Issues with existing restorations, cracks and fractures, demineralized areas and decay are readily apparent. With the advent of easy to use intra-oral cameras, the hygienist can point out and photograph possible problems. Discussing these problems and giving potential solutions “sets the stage” for the dentist’s exam and diagnosis. The patient has time to digest the information and see what the problems look like before the dentist even enters the room.
The conversation between the patient and hygienist may go something like this:
Hygienist: “Mr. Patient, I am noticing a fracture next to a large silver filling you have in your lower right first molar. Has that tooth been bothering you at all?”
Patient: “I haven’t had any pain, but I can feel a sharp spot on that side.”
Hygienist: “That tooth has been in your mouth since you were six years old, and the filling you have in it may have been placed shortly after it erupted. So, it has been there a long time. Often a filling will become worn and break, or the filling may stay in place but the tooth structure next to it may crack or fracture. That’s what I think has happened here. Let me take a photo for us to look at.”
Hygienist (while showing the photo on the monitor): “Here is where I see the fracture. I think that Dr. M. will probably recommend a crown for that tooth. He can take away the fractured part of the tooth and place a crown to cover the entire top surface. That way the tooth will remain strong.”
Patient: “Can’t I just have another filling?”
Hygienist: “It might be possible, but I really doubt that it would be the best solution. When Dr. M. comes in for your exam, he can let us know what he recommends.”When Dr. M. enters the hygiene treatment room he can start the conversation, “Hi Mr. Patient. Good to see you again. How have you been getting along?”
Hygienist replies: “I took a photo and have it there on the screen. I told Mr. Patient that you could let him know what the best solution might be.”
Dr. M. examines the patient’s mouth, identifies the tooth in question, sets the patient’s chair so that the monitor can be clearly seen, points out the problems, and affirms the need for a crown. “I think that Ann is right. A crown would be the best and probably only solution for this fracture.”
Patient: “How much will a crown cost?”
Dr. M: “When we finish here I will let the treatment coordinator know what we have found and she can give you an estimate for your insurance and your portion. We now use computer milled crowns and can have yours ready for you the same day you come in for the preparation.”
Patient: “That’s great. It is hard for me to take time off from work.”
Dr. M. leaves the treatment room, Ann takes Mr. Patient to the front desk, an estimate is given and the appointment for the crown prep is made. The patient has been educated about his condition, he has seen a visual presentation (in the form of his own tooth on the monitor), has had (in his mind) two dental professionals agree on a course of action, has had an estimate presented, and has made an appointment that will enable him to leave the same day with his new crown. Success for everyone!
What happens if the dentist does not think a crown is the best solution? In that case he might say: “Good eye, Ann. That tooth definitely has a problem. The fracture is apparent. However, in this case I think I can restore the tooth with a white filling. I don’t think that a crown will be necessary.” Verbiage such as this affirms the hygienist’s credibility with the patient, and confirms Ann’s assertion that Dr. M. would be the “final word” on what should be done.
Working together in this manner is a professional way to handle a patient, whatever the dentist’s diagnosis and treatment recommendation. Hygienists are trained to apply a meticulous eye to their daily tasks, and if given adequate time during routine appointments, they can also forge lasting and trusting relationships with patients. When both the hygienist and the dentist agree that a course of action should be taken, patients also tend to agree. The hygienist is not “diagnosing” - s/he is identifying, educating and promoting necessary dental treatment. These are important aspects of “what hygienists do” and serve a vital function in a successful dental practice.
Next time: Educating patients and providing necessary periodontal care.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.
Validate Your Way to Practice Success
There’s a short film on YouTube called "Validation" - the story of an attendant who dispenses free parking and free compliments. Very quickly his validation process creates a line of people waiting to get into the garage. Everyone wants to get validated.
”Validation”has won several film awards and is definitely worth the 16 minutes it takes to watch it. Cute and fun, it packs a wallop of a message - the need to be acknowledged and appreciated. It is the foundation of human behavior. How we're feeling - and most especially whether or not we feel acknowledged and valued - influences our behavior, consumes our energy and affects our decisions all day long, whether we're aware of it or not.
Many naive employers operate on the mindset that “staff are lucky to have a job.” They erroneously assume that a paycheck or benefits make employees feel valued. Sure, those have an impact. But if you treat employees with a lack of respect, money will not compensate. The fundamental key for people to be excited about coming to work each day is that they feel valued and recognized for their unique contributions.
Unfortunately the struggle to feel valued is one of the least acknowledged issues in organizations, probably because it sounds like “touchy-feely” psychobabble. But it is correlated with retention rates, customer service, individual performance, team performance, business productivity, and even profitability. More important than money, people want to feel valued and respected, to be proud of the place where they work and to get satisfaction from what they are contributing. When they do, they are more engaged and committed.Fostering recognition in the workplace begins with you, the dental leader. Do you validate yourself? When you feel good about something you’ve done or said, perhaps an interaction with a patient…stop and acknowledge it.
After you complete a difficult treatment, find a way to reward yourself. Give yourself validation. If you aren’t validating yourself, it’s unlikely that you’ll validate others. Dental Leadership Coaching can help you to learn how.
Consider how things might be if you validated people every day…affirmed them for all the good things they do for you in your practice. Think about all the people who inspire and help you. In addition to your staff, there may be a vendor who goes out of his/her way when you need additional supplies. Or the mail carrier who has a great sense of humor and adds levity to stressful days. Patients who refer family members and friends. The employee who straightens out magazines in the waiting room. You may say “they know how I feel” but remember, people can’t read your thoughts so you need to verbalize what you’re thinking and validate them.
In addition to sincere compliments and words of appreciation, validation means being available to support others. It’s ok to demand results from your staff as long as you back that up with coaching, training and follow-up. Your job is to bring out the best in your employees. Make sure that you are available to help them. Be visible and spend time with them. Validate your patients by providing a pleasant office environment, being on time for their appointments and going the extra mile to deliver exceptional service.
It is human nature to want to grow and develop. Training and Team Building Retreats are other ways to validate your team. When the economy is tight or when business drops, the tendency is to cut skill-building. If your employees feel that you aren’t investing in them from an improvement perspective, they won’t feel valued. Without training and development, stagnation and complacency take hold.
True validation needs to be personal and genuine. Furthermore, it's not just noticing what people do, but connecting their actions to something meaningful. It’s easy to build up people and make them feel valuable. It’s just that we get so focused on our own “stuff” that we forget the people around us. Imagine how different your workday would be if your employees validated each other. Show the “Validation” film at your next staff meeting and see what happens. Be sure to let me know too.
Create the right environment that sustains employee commitment and patient loyalty. Contact Dr. Haller at email@example.com.
Dr. Haller provides training for leadership effectiveness, interpersonal communication, conflict management, and team building. If you would like to learn more contact her at firstname.lastname@example.orgInterested in having Dr. Haller speak to your dental society or study club? Click here.
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