The Alarms Bells Are Ringing, But You Can’t Hear A Thing
“Dr. Tami’s” favorite patient is the one sitting in the chair. Spoken like a true politician, but she’s sincere. Her practice has come a long way in terms of its patient numbers, but a little over a year ago it was a different story. It goes without saying that patients are the lifeblood of a growing practice, and this practice was anemic - but Dr. Tami was blissfully unaware.
Her crowded schedule belied the reality; patient numbers were falling off. She sort of had a feeling that something was off, but she was pretty busy. So what did she have to worry about? Plenty. On any given day, there would be at least two no-shows or cancellations in her schedule and likely one or more in the hygiene schedule. But she dismissed it as a temporary situation and figured it would resolve in time.
Shortly thereafter she was chatting with friends at a dinner party when one of them joked about how lucky she must be not to need new patients. Dr. Tami was puzzled. She learned that her friend had tried to schedule a new patient appointment with the hygienist, but was told that the schedule was full for several months. Her friend apologized that he just couldn’t wait months for an appointment. Dr. Tami was disappointed and embarrassed. She couldn’t help but think about the no-shows and cancellations, yet new patients couldn’t get in?
Something was off here. Something didn’t add up. The signals were present, but there weren’t any blaring alarms - until they were deafening. Dr. Tami got the ultimate wake-up call. She was forced to cut her own pay. The practice was losing money. How could she be losing money if the schedule was full and she had hundreds of patient records in her system? Yet again, the illusion of busy was the shrieking alarm of inefficiency. The “hundreds of records” are merely that - data on a computer system. The records don’t pay the bills. And that was just the beginning.
It was a classic case of practice erosion. Little breakdowns in system infrastructure here or there, inefficiencies virtually everywhere, and very quickly the practice is sliding off the financial cliff. Before she realized it, Dr. Tami’s management systems - if you can call them that - had sustained a series of damaging blows.
What happened? She didn’t care for the business of dentistry. Her passion, like so many of her counterparts, is the art and science of the profession. She wanted to help patients. Consequently, she didn’t pay much attention to “the numbers” until she was forced to.
was at a crossroads. Her attitude toward the business side of her practice spelled disaster unless she took action. If she wanted to remain in practice for herself, she had a couple of choices:
Dr. Tami chose to become CEO of her practice. It didn’t happen overnight, and she didn’t do it alone. She had to embrace what she believed she didn’t care for - the “business” of dentistry. She came to understand profit and loss, marketing, human resources, hiring and firing. She learned how to efficiently monitor the 22 business systems that directly affected her profitability.
Most importantly, she realized that running a profitable business and serving her patients as a caring dentist weren’t mutually exclusive. She now had the financial means to improve patient care. She could afford more than the required continuing education units. She could offer more advanced patient services. She could train her team to provide the very best customer service. All of which made her a more effective practitioner and a highly successful business owner.
She recognized that each patient, new and existing, brought opportunities that went well beyond the treatment chair. They enabled the practice to consider how well the marketing and patient education efforts are working, measure the efficiency of the scheduling system, and consistently fine-tune patient protocols, treatment presentation procedures, and financing options - systems that she once disregarded as being distractions to her “real work.”
Practice systems don’t break down overnight. It is a gradual process that can be caught before significant damage occurs, if you pay attention. Sign up today for the Dentist CEO Business Training and take the first step in getting your practice back on track.
Next week, can you count on your staff to uphold your systems?
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
Your Adjustments Can Break Your Bank!
Your first question may be: “what is an adjustment?” And a reasonable question it is! Let’s briefly review production and collection adjustments that may take place in your office every day.
There is also the dreaded but accepted “PPO” adjustment, but I won’t go into detail about that one here. Other production adjustments come in the form of a “bad debt” write-off, “small balance” write-off, “uncollectible” write-off, etc. I would like to focus on the “bad debt” and “uncollectible” adjustments below.
You just hired Susie, who has never worked in a dental office before. She is unfamiliar with how PPO adjustments are handled, besides being told that the patient doesn’t pay the difference between the practice fee and the allowable fee. Your fee for a service was $100, and the PPO allowable fee was $80 and covered at 80%. Susie, not knowing any better due to lack of proper training, receives the insurance check for $64 (80% of the $80 PPO fee). She proceeds to adjust the remaining balance of $36, leaving the patient with either a $0 balance or a credit balance of $16, which was the 20% patient portion of the reduced fee of $80 IF it had been collected at the time of service. You are given a request for a refund for $16, at which time you send a refund check.
Another example is an inexperienced business coordinator, having not been taught how to make collection calls to delinquent accounts, sees an adjustment code called “uncollectible” and feels that it’s appropriate to write this balance off. She has sent five monthly statements with no response so it must be “uncollectible” at this point. In this scenario, the posts could add up to thousands of dollars a year.
It is also suggested that if your practice management allows, set up an adjustment code that more accurately describes the adjustment that is being posted. Examples would be: 10% Cash Courtesy, Employee Family, Employee, Posted in Error (Credit), Posted in Error (Debit), Small Credit Balance Adjustment, ABC Insurance Adjustment, Small Uncollectible Adjustment, Finance Charge Adjustment, Old Balance over 1 Year Adjustment, etc. The more categories there are, the easier it is to review the adjustments for accuracy.
Keep your production adjustments to a minimum. Monitor the percentage of adjustments compared to your gross production monthly. It should not vary much from month-to-month if properly posted.
For more information about receiving an analysis of your Business Operational Systems, contact McKenzie Management today.
How to Sell Dentistry When No One Wants It
Selling a beautiful piece of jewelry or a vacation in Hawaii is a lot easier than selling an implant supported bridge, right? The jewelry makes you feel beautiful and rich. The Hawaiian vacation is an opportunity to get away to an amazing place with great weather, wonderful food, flower scented trade winds and breathtaking beaches backed by the greenest of tropical mountains. How can a dental bridge top that? It can’t - at least not at the same positive emotional level.
When there is need for dentistry or a perceived value of the service, the ease of patient acceptance is much higher. Need is triggered by pain, a broken tooth in an unsightly location, or an uncomfortable feeling that something unhealthy is imminent because of bad breath or bleeding gums. Once need is established, the patient must accept the fact that there will be a process to go through to get rid of the pain or other problem. There is emotion attached to this process and it is usually not positive. This is where selling dentistry is challenging - because no one wants the process of delivering care, no matter how good it is going to look in the end.
Fear of more pain, needles and other sharp instruments in a very sensitive mouth all create emotions not akin to a nice piece of jewelry or a tropical vacation. If the Hawaiian vacation was contingent upon you rowing to Hawaii in a small boat, it would not have the same positive emotion connected to it. Presenting treatment to patients with the thought of planting a seed for when there is need is more realistic than trying to create a need where, at this point in time, there is no want or desire for procedures that the patient thinks they can have a normal life without.
Focus on the emotion attached to the purchase of dental care. Think of the patient’s emotional state when thinking of the process, not the outcome. Sooner or later everyone needs a dentist and that is when you become a want or a dire necessity. If you have communicated positive information in a caring way to your patient, they will want you.
So how do you market to them prior to that triggering event? How do you ensure that when the dental event occurs or they decide it’s time to get that implant supported bridge, they know about your practice and your services, and you are on their short list of potential dentists?
Marketing is everything you do. Your knowledge, experience, empathy, fairness, professionally trained staff, dedication to customer service, track record of satisfied patients who have received the same type of treatment proposed, excellent media reviews, patient centered hours and financial options are just a few of the components of your brand. Be someone who is hard to forget because of the extra kindness and concern demonstrated. In other words, create a positive emotional connection to your patients. Envision how you will help your patient get over the very thing they’re afraid of. This means truly understanding the psychology of your patients at the time of presenting treatment.
Sit down with your team and focus on how you deliver dental care. Discuss what each of you can do to make the process more comfortable, emotionally calming and positive for the patient. Everyone has their own ways of achieving relaxation and comfort, and these ways can be shared to create a standard of care for patients that is offered at the time the treatment options are being discussed.
Years ago I worked in a practice for a very kind and thoughtful dentist. Many patients would literally fall asleep in the dental chair during procedures because they were so at ease. When it came to wanting the dental care there was no hesitation based on the process, as they knew they were in good hands.
If you want to explore better ways of presenting treatment to patients and learn what you can do to gain more treatment acceptance, sign up for the Treatment Acceptance Course or the Front Office Business Training Course.
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