Hoping, Dreaming, Wishing for Just One Good Hire
The busy season is upon us. Everyone is busy with family, busy with shopping, busy with cooking, busy with everything except practice goals and objectives. Frankly, for many doctors all that “busyness” is a good excuse to avoid those unpleasant tasks. You know the ones. They involve addressing staff issues.
Case in point, “Dr. Jim” called me this week. He’s exasperated. The assistant he hired three months ago, Margo, isn’t working out. He has a feeling that she will likely head for the exit after the holidays. In fact, he’s hoping that’s what will happen because he does not like dealing with “messy” employee situations. He’s found that avoidance works well for him, and eventually those he doesn’t like or those that don’t meet his standards leave. Margo is the third assistant he’s hired this year. “Sally,” he says, “good help is hard to find around here.”
I asked Dr. Jim to describe his hiring and selection process. “It’s the same thing everyone does,” he tells me. He places an ad for a dental assistant on a couple of online job boards and professional websites, reviews the resumes, does a few interviews, and hires the person he feels is the best candidate. What specifically does he look for when hiring a dental assistant? “Past experience, of course,” he asserts. As the conversation continues, I ask Dr. Jim about the job description that he gives to the candidates. “They don’t need job descriptions if they already have experience. They should know what to do.”Dr. Jim faces a host of challenges, and not just in his hiring systems. But since that is his most pressing problem, I offer some advice that could save him a fortune, if he chooses to implement it.
Many doctors set out on a course destined for perpetual discontent when they are trying to hire a new employee. They don’t have a plan and they desperately want to just fill the position and hope things work out. We see it again and again and again. In almost every case, the doctor does not get the employee s/he hoped and wished for. Why? Because hoping, dreaming, and wishing won’t get you what you want when it comes to employees…or much else for that matter. Consequently, the doctor will try to muddle through and make the best of the poor hiring decision, giving little or no thought to the ripple effect that this mediocre or poor employee has on the entire practice – not just the doctor. Like Dr. Jim, they assert that good help is hard to find, but they have done virtually nothing to ensure a different outcome.
With 2013 just around the corner, many doctors will be closing out 2012 and pledging to change things in the coming year. Since the quality of your team has a direct impact on the quality of your practice, the effectiveness of your production, and the percentage of your profits, creating a reliable system for staffing should be your number one focus for the New Year.
Think about the type of person you want working with you, your team, and your patients day in and day out. We’ve found that the best employees have a few characteristics that indicate a greater likelihood for success. These individuals take responsibility for their performance. They like to think of ways to help the patients, the practice, and their co-workers. They don’t need prodding to get the job done because they are self-motivated. They enjoy sharing their knowledge and experience with others. They get the greatest satisfaction from performing to the best of their ability, and they enjoy quality of life outside of work.
You may get lucky and think you’ve found someone that you believe has these characteristics, but remember that people are typically at their best in the interview process. They want you to want them. You need to confirm that they will measure up. In addition to knowing precisely what duties this person will perform and skills necessary to succeed in the job, you also must consider if this person will fit the job, both in skill and in personality type. There are three tests that we recommend all dentists administer with prospective applicants.
Next week, test your applicants to objectively determine if that seemingly perfect candidate really is.
For more information on this topic, visit my blog: The Lighter Side
Interested in speaking to me about your practice concerns? Email firstname.lastname@example.org
A New Year, a New Approach to Hygiene Recall?
During a recent staff meeting, the subject came up of how to lessen the number of cancellations and broken hygiene appointments. The same old flimsy, computer printed postcards were going out as usual, phone calls were made to confirm, and the added use of a computer software program that sends texts and emails was being utilized - but there was still an average of 1-2 broken hygiene appointments per day per hygienist. What’s a practice to do? “But we have always done it this way.” There lies the problem. How can you expect a different result when you keep doing the same thing?
Maybe it’s the message, not the manner in which it is delivered, that makes the difference. With a goal in mind of .5 cancellations a day for each hygienist, efforts to bring importance and urgency to the routine hygiene visit brings focus to the system of communication during the patient visit. The words spoken before, during and at the close of the visit make a difference in how the patient views the importance of promptly returning for the future visit.
“You are doing great, your oral hygiene is good, and we will see you in 6 months.” This is a positive statement, but brings no sense of importance or exactness to keeping the appointment. Most people make judgments on their oral health and often postpone the 6 month interval based on the last good report by the hygienist or doctor.Since the advent of the postcard reminder system as far back as the 1960s, the correlation between dental health and serious life threatening diseases including diabetes, cancer and heart disease have come to light. As health care providers, dental professionals can now detect and monitor the progression of these diseases with regular dental examinations. The best time to communicate your role in overall health care and disease management is when the hygienist or doctor is reviewing the patient’s medical history.
McKenzie Management has an updated line of recall postcards that have space to write a personal health-centered message to the patient, bringing importance to why they should return promptly. The verbiage pre-printed on the card also carries weight for health, and does not devalue the message as a cutesy cartoon card or landscape scene may do.
The patient will self-address a legal sized envelope at the close of their appointment, in which the recall card with the next appointment or a reminder to call will be placed. The hygienist or doctor will write the personal note. You may also insert an educational brochure relevant to the patient, a script for pre-medication, or a promotional offer or coupon for a new toothbrush, etc. Because it is an envelope, it is HIPAA compliant and is now first class mail. The envelope will then be placed in a calendar card file to be sent two weeks before the scheduled appointment or a month before an unscheduled appointment due date.
When the patient receives the self-addressed envelope they are reminded that they need to call for the appointment or make sure the scheduled appointment is confirmed. They read the customized clinical note to remember the appointment is for a routine cleaning and to check the areas of concern. Within the envelope, the patient can be reminded to bring their night guard, splint, retainers, nitrous mask, sleep apnea device or other applicable materials. You may also insert a reminder to use insurance benefits before they expire and a printed break down of insurance benefits to help the patient understand their plan and how it reimburses. A copy of your latest newsletter can also be inserted in the envelope.
For offices that are paperless and are thinking this is a step backward, think of it as a system to create focus on health, not a reminder for a pre-appointed hygiene visit. We are limited severely as to what message we can leave in an email or on a postcard by privacy laws. For some offices in areas where technology does not have as much impact yet or where the demographic is older or poorer, it is estimated that 50% of the population do not use email.
The results of this system can be tracked in the computer by making sure all patients are in the recall system and by indicating when the envelopes are sent, just like you are sending postcards. Yes, it takes more effort and a higher level of involvement and interest in the patients, but the rewards for the patient and the practice make it a worthwhile system to implement.
For more information, call McKenzie Management today and speak to one of our professional consultants on implementing this system into your Hygiene Department.
How Large is your Active Patient Pool?
“Dr. Brown, how many active patients do you have in your practice right now?” I asked. “Oh, I would say about 2,500” he replied. “Really?” But why would I second guess him? Because he tells me that his practice is 20 years old and he has one hygienist working four days a week and at times, it is hard to keep her busy. I suppose there is “safety in numbers” - number of patient records. But when the time comes that you no longer have any paper records on your shelves, will you know how many active patients you have? Why don’t we learn now what an active patient is and determine how large your active patient pool really is, opposed to assuming that all those records you see on the shelves are active.
Definition of “Active” Patient: A patient that has been seen for their recall appointment by you, your assistant or your hygienist in the past 12 months and are due to return in the next 12 months. Why do you want to use this definition? Because your practice grows as you add more hygiene days, and you add more hygiene days when you increase the number of active patients.
As an example, “Dr. Brown” mentioned that he had 2,500 active patients with one hygienist. There is no feasible way that a hygienist can see 2,500 patients every 6 months. Even if she is Wonder Woman and can see 12 patients/day, she is still only capable of 1,200 patients every 6 months so who is seeing the other 1,300 patients?What about the past due recall patients? They may still come in! Yes - they may, and probably some of them will. However, until they return, they are not active. Without some effort put forth by your Hygiene Coordinator, they may not be as motivated to call you and will wait. How do you determine your number of active patients? Run your recall report for the next 12 months (in case you have some patients on a 12-month recall interval) for patients with and without appointments. THESE are your active patients.
So let’s say you have 1,000 active patients. You need 222 days of hygiene to provide 6- month recall appointments for these patients if your hygienist sees 9 patients/day and you have 100% retention. My guess is that you don’t work 222 days/year. This also doesn’t allow for new patients, SRPs or room for your past due patients. With 1,000 active patients this month, how much does your active patient base fluctuate from month to month? This should be tracked monthly on your Business Management Spreadsheet, along with other practice statistics.
How Do I Track It?
Let’s assume you have 200 past due recall patients that are 1 - 365 days past due that you are actively pursuing with emails, phone calls, cards and letters. For every patient that is scheduled from the past due list, a REAC or some other in-office code that you would like to use is added to the appointment for this patient, so when they are seen, this code is posted to their ledger. At the end of the month, you can easily review the Production Report and see how many REAC patients were seen. Let’s say that you saw 15 patients. 1000 - 12 + 15 = 1,003 active patients now.
Or…you can simply run your recall report again!
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