Does Your Practice Need A Reality Check?
“Ellen” is a hard worker. She is a dedicated 12-year employee in “Dr. Mike’s” office. She was the first employee he hired, and she has held many positions within the practice. She has assisted the doctor, worked as the receptionist, been “in charge” of marketing, served as scheduling coordinator, office trainer, and the list goes on. Ellen views herself as very versatile and valuable to the practice. She knows the patients, their families, their interests. She loves people, and they love her…except for those people who must work with Ellen.
Her colleagues will tell you that the reason she has held so many different positions within the practice is because she’s excelled at none. Their assessment of her performance is that it is poor to average at best, so she’s a floater and helps out wherever she can. Meanwhile, critical details fall through the cracks. Staff cringe when Ellen comes to help. She means well, but she suffers from serious priority confusion, which is a charitable way of saying that she’s scattered.
For example, practice collections are down, and accounts receivables are creeping upward. Dr. Mike has asked Ellen to follow-up. She promises to do so right after she is done with this month’s handwritten birthday cards to patients. Yes, you read that correctly. Handwritten cards are very important, asserts Ellen. From her perspective, if you do something nice for the patients, like send them a handwritten note, the freeloaders will be more likely to pay. Not. As you might expect, Ellen’s temperament is such that for her, making collection calls is about the most painful “chore” to do. Add to the fact that she has not been trained on how to effectively make these calls, but that’s another article entirely.
The doctor tries to appreciate her dedication and commitment to practice/patient relations, but he doesn’t hold her accountable. He reasons that if she’s busy doing something, she must be doing it for the good of the practice. He doesn’t like to think about the drain on overhead. The rest of the team have stopped asking questions. They no longer gape in disbelief at what Ellen “gets away with.” They reason that if they want to keep their jobs for now, Dr. Mike’s preferential treatment of Ellen must be tolerated. So they settle into a state of “functional stupidity.”
What is functional stupidity? According to Andre Spicer, a professor of organizational behavior at Cass Business School, City University London, it is when otherwise smart people stop using their intelligence at work. He has co-written a study about the functional stupidity of employees, which was published last fall in the Journal of Management Studies.
On the surface it appears that functional stupidity can be a good thing, after all the study reveals that it can reduce conflict. No one is questioning procedures or decisions. Go along to get along. Don’t make waves. In the case of Ellen, the staff have resigned themselves to navigating around her because the doctor has not and apparently will not address the problems. Why? Look no further than the first sentence of this article. Ellen isn’t just a staff member; she is the first employee he hired. And in Dr. Mike’s eyes, she’s practically family.
For his part, Dr. Mike says he has tried to address the issues with Ellen. In the occasional staff meeting, he brings up his concerns about mistakes, important details lost in the shuffle, problems here and there. Naturally, nothing changes. His comments are usually general in nature, along the lines of “We should be doing this better or that more effectively.”
Beyond the obvious reality check that Dr. Mike desperately needs, as well as clearly defined management systems and staff accountability, I would venture to assert that he also needs a healthy dose of conflict. As you might imagine, the situation with Ellen is merely the tip of the iceberg. But Dr. Mike just wants to keep the peace, so he engages in his own form of functional stupidity and glosses over Ellen’s ineptitude and the negative impact it is having on his practice, his team, and his profitability. But the patients love her, so Ellen is allowed to muddle along making busy work for herself and offering little to no real value to the team or the office as a whole.
Next week, beyond the illusion, what’s really happening in Dr. Mike’s office?
For more information on this topic, visit my blog: The Lighter Side
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Activate Dormant Revenue before Marketing
The focus on attracting new patients to the dental practice is seldom overlooked. When dentists are asked what they want most for their practice, the number one answer is more new patients. Advertising campaigns and marketing strategies can be expensive and unsuccessful if the expectations of the target market are not matched to the services of the dental practice.
Before embarking on a marketing strategy, it is recommended to have a complete chart audit (paper charts) or computer generated reports to determine how many active patients you have and how many open treatment plans exist. The definition of an active patient is one who has had dental services in your practice (other than transient care) from today to one year ago. If the patient is in recall or scheduled for follow-up care then you know acceptance of your practice is current. If the audit reveals patients who have not returned for recall and/or have unscheduled treatment, a plan to reactivate is necessary. If you are using patient management systems such as Sesame, Demandforce, or Eaglesoft and Dentrix systems then you can use these programs to send out surveys and reminders to contact the practice for an appointment. If patients do not respond to automated prompting, pick up the phone and call them.
Research has shown that people who are dissatisfied with the services of a dental practice seldom voice the reason. When a patient does not want to schedule in your practice or is now a patient in another practice, it is important to ask why they left your practice. The script would be as follows: “Hello, Mrs. Brown? This is Mary from Dr. Dee’s dental office and I am calling to invite you to schedule for your past due professional cleaning and examination. I have Wednesday, July 10th at 2:00 available, would that work for you?”
If the patient says they are not interested or have chosen another dentist, the following response is recommended. “I am sorry to hear that Mrs. Brown. We strive to improve our patient care. May I ask the reason that you are not returning to our practice? It will be kept confidential.”
Write the reason in the patient’s chart note area and also record on a separate spreadsheet to quantify the reasons patients have left the practice. This can be used to improve practice systems prior to marketing. The next response would be, “If I can correct this issue for you, would you return to our practice?
If you do not correct what makes patients leave your practice, there will be more of the same in the future. Save money and audit patient records before your new marketing strategy. I interviewed a patient recently who felt that his dentist of 15 years was overcharging and decided to visit another dentist down the street. The new dentist was late in seating him and the business staff did not have his insurance information, so they were not able to give him an estimate. They said they would email the treatment plan to him. He decided to return to his former dentist because they were far more prepared. Money was no longer the obstacle. Good customer service and having the information patients need to make a decision equals good dental care. The two cannot be separated as far as patients are concerned.
Contacting unscheduled patients has shown to improve practice production by 20-30%. Patients often equate lack of interest from the provider as lack of importance to the services they provide. Reactivation is to be performed daily from unscheduled treatment lists, past due recall lists and other tickler file lists. Be sure you are making at least 5 phone calls a day to contact the patient. You can leave a message that says the following:
“Hi, this is____from Dr.____’s dental office. We have missed you and I am calling to schedule a convenient time for you to return for your care. We are here Monday through Thursday from 8:00 to 5:00 or you can email us at ____ for an appointment request. We look forward to hearing from you soon. Our phone number is__________.”
If you are losing more patients out the back door than new ones are coming in the front door, your practice is in decline. Want to identify and fix the broken systems affecting your practice growth? Contact McKenzie Management today for professional business training or dental practice consulting services.
Business Employee vs. Assistant. Who to Hire First?
You could say it’s a bit like the chicken or the egg analogy - which comes first, the business employee or the doctor’s assistant? For dentists early in their careers, few can afford to hire multiple employees, so they typically must choose between hiring an assistant and hiring a business employee initially.
Certainly, there are advantages and disadvantages to hiring either employee at the outset. It may make more sense for a dentist to look for an assistant with front desk experience. In addition, if the new practice has computers in the operatories, many of the front desk duties can be handled chairside, such as scheduling appointments and collecting payments. There are benefits to hiring a front desk person who can assist when necessary and benefits to hiring an assistant who can handle the front desk duties. Presumably, if the doctor has an assistant s/he can work out of two rooms and that helps to increase production.
However, the decision also depends on how long a dentist has been practicing. Recent graduates typically have not worked with an assistant. Therefore, in a new practice, it makes more sense for the doctor to seriously consider hiring someone who can make a good first impression. The practice is likely to have a greater need for someone who can answer the phones and represent the practice well to patients. This person will probably have to assist somewhat chairside, but being able to help establish critical business systems early is essential, which leads me to my next point.
If the dentist is hiring an employee to perform both jobs temporarily, s/he should hire for the business skills. That person needs to be nurturing and friendly, but they also need an analytical and logical side because they will be handling insurance, asking patients for money, and organizing the schedule. A new dentist wants to look for someone that they would like to keep on staff for many years. Not just any employee will work out well in a new practice.New dentists need a staff member who brings the “whole package.” This person needs to be able to multi-task, they need enthusiasm, and they need almost an ownership mentality. Those with a strong work ethic and an excellent attitude tend to succeed the most in this kind of an environment because you can train for skill but you can’t train attitude and commitment.
If you are trying to choose the right employee for the two positions, the doctor needs to consider far more than simply “is the candidate likable?” The individual’s temperament/personality profile should be considered. For example, someone with a more extroverted personality will typically be more comfortable in a position in which s/he must work with people all day. Assistants generally may be more emotionally based in what Myers-Briggs refers to as a “feeling” temperament, as opposed to what Myers-Briggs calls “thinking” types in that they are more analytical and logical. Clinical assistants tend to be more feeling in nature. If this person is also responsible for the business duties, she might have to stretch beyond her comfort zone particularly when handling collections, scheduling, and those areas of the practice that require more assertive practice/patient communication skills.
Temperament testing as well as employee assessment tests are recommended, so the doctor can determine if the candidate is a good fit for the dual role position and the prospective employee can understand where s/he may need additional training. Additional training will be essential to help this employee know what to say to patients when discussing financial arrangements, following up on unscheduled treatment, confirming appointments, etc. Moreover, if the doctor is relying on one person to perform both jobs, the expectation should be that the other position will be filled in 3-6 months and definitely no longer than one year.
But which position is going to have greater impact on overhead expenses? Consider a few other essential variables besides cost when hiring an employee, in particular, quality of staff. You want to hire someone who is going to reflect the level of quality dentistry that you deliver to your patients. That will then help the dentist to be more productive and more efficient, and enable them to pay a higher wage and grow the practice. The two do go hand-in-hand. In the short-term, a highly credentialed assistant will likely demand a higher wage than a business employee, unless that person is a business manager.
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