Fire the Performance Reviews
These days it seems to be popular for the management pundits and business commentators to proclaim that performance reviews are bad and they should be abandoned. I have to say - when I read the articles, I tend to agree. I certainly wouldn’t want to be part of the employee reviews that they describe. And if they’ve personally experienced the disastrous exchanges they detail in these articles, well, no wonder they’ve got an axe to grind.
I’ll be the first to tell you that old school reviews in which you sit down with your employees individually once a year and tell them what they’ve done right or wrong over the past 12 months don’t work, and frankly I doubt they ever did. Effective performance reviews, or coaching encounters or whatever you want to call them, should be structured to be positive interactions that are part of an ongoing system of performance measurement, employer/employee feedback, and system monitoring.
The boss doesn’t pull out a list of all the things the employee has done wrong during the past 12 months and slap it on the desk before them. Nor is this the only time the doctor praises the team members’ performance. If that’s how employee reviews work in your practice, then there’s certainly cause for you and your staff to despise the ritual. And let me be the first to recommend that you fire it.
But let’s be clear, while poor performance review systems should be shelved, it’s not an excuse to abandon them entirely, which is too often the case. Dentists commonly profess that they don’t need “a system” for performance measurement/review among their employees. They believe that they would be aware if there were a problem. They will say, “I think Erin is doing a great job.” But they don’t really know. They confidently assert, “If there were a serious problem I would see it.”
They also cling to this belief. “Everyone knows that they are expected to do a good job.” And when I ask them what exactly do the words “good job” mean? They squirm and their eyes go to the ceiling, searching for an answer in the crown molding, and they say, “Well … you know. Do what they’re supposed to do. Take care of the patients and stuff.” Nice try, but it won’t fly.
What many doctors don’t realize is that employees want a system as well. They see details slip through the cracks. They are uncertain about who is responsible for what. When there is a problem or issue, staff members commonly respond with comments such as, “Is that my job? I thought it was hers. When was I supposed to have time to take care of that? Oh, is that important?”
It is the disconnect that occurs between the performance/results that the doctor desires and the performance/results the employees deliver. Dentists know what they want, but they don’t know how to guide employees down the path to achieve it. Consequently, both become frustrated and discontented with the other. The doctor sees a team of non-performers who can’t do their jobs. The team sees a doctor who can’t lead and doesn’t know how to communicate what s/he wants. Both are wrong. But both are lacking the fundamental ingredient necessary for success: clearly established performance measurements.
Performance measurement begins with performance management. If you’ve wanted to improve patient retention or scheduling or treatment financing/collections, etc. you’ve touched on performance management. These are all systems in your practice, and properly managing the performance of each means appropriately measuring the performance of the individuals who oversee those systems.
But where do you begin? Certainly, many dedicated practitioners have given up in frustration when trying to implement performance measurement systems. They neither knew where or how to execute such a program. This isn’t the type of change that can be implemented overnight. Give yourself time, a period of months, to implement a working performance measurement system. Don’t reinvent the wheel. There are some excellent models out there that are designed specifically for dental practices.
And don’t put it off any longer. Invest some time and resources to shape a highly functioning team. You’ll be the first to enjoy the payoff of better performance and higher productivity. I guarantee it.
Next week, performance measurements step-by-step.
For more information on this topic and more, visit my blog: The Lighter Side
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‘Backfill’ Your Cancellations and No-Shows
“Doctor, Mr. Jackson just cancelled his prep appointment for those three crowns. He said he had something come up.” Poof. In less than 30 seconds there goes your production for the day, swallowed into that now gaping two-hour hole in your schedule. Every dentist in every practice experiences the seemingly endless frustrations associated with patient cancellations and no-shows. Broken appointments cost practices tens of thousands of dollars every year.
Have you considered just how much cash is siphoned from your practice in 10 minutes here and 10 minutes there of unfilled chair time? Let’s say your daily production goal is $3,500 or $437.50 per hour for an eight-hour day. Each 10-minute unit is valued at $73. Now you may feel that your schedule is pretty stable. On average, you may have a 30-minute opening in the morning and one in the afternoon. These might be the result of a cancellation, no-show, or a few open units here or there on any given day. In one month, working four days per week, your practice lost $7,008 and more than $80,000 for the year. Feel free to take a moment to catch your breath.
Now stifle the urge to call your business team in and demand that they do better. Rather, turn the mirror on yourself for a moment. Curbing cancellations and no-shows begins chairside. The schedule often depends on the clinical team’s ability to emphasize the value of the dental care provided during even the most “regular” dental visit as well as clearly explain to patients the importance of keeping their appointments.
Ironically, dentists frequently overlook the significant influence that they have on the patient’s perception of routine dental care. In a rush to return to their own patient, they often unwittingly minimize the value of care.
Consider this common scenario: The hygienist spends time explaining to Mrs. Patient that she is now showing signs of periodontal disease and may require more frequent oral hygiene appointments. The patient is concerned and is prepared to schedule oral hygiene visits once every four months. Then the doctor walks in to check Mrs. Patient. He comments on the “good job” she is doing with her oral healthcare. The doctor thinks he’s just being friendly, yet he has unintentionally given Mrs. Patient justification to skip her next oral hygiene appointment. “The doctor said I’m doing a great job; why would I book another appointment so soon?” Even more troubling, the doctor’s comments cause the patient to question both the doctor’s and the hygienist’s diagnostic abilities.
First and foremost, clinical teams must be on the same page. This situation is easily addressed if the hygienist takes just a moment to explain to the doctor what has been found and subsequently discussed with that patient. It is a simple solution, but it underscores the importance of the clinical team’s role in emphasizing the value of ongoing dental care.
If your practice is not stressing the importance of the next visit – be it for follow-up treatment or the next hygiene appointment – while the patient is sitting in the chair, you probably have many more broken appointments and cancellations than you should. In fact, it has been estimated that more than a quarter of your patients, about 28%, routinely cancel appointments largely because practices are not actively educating patients on the importance of keeping them.
In addition, avoid the tendency to schedule all appointments for larger treatment plans. Certainly, there is a strong desire to immediately schedule the patient for all necessary visits, as if that will guarantee they keep every appointment. However, booking the entire treatment plan does nothing to ensure the patient won’t change or cancel appointments. What it does do is cause the schedule to appear unnecessarily full and overwhelming. Simply avoiding the tendency to overbook patients will help reduce the number of cancellations and no-shows the practice has to routinely manage.
Finally, be patient with your patients and educate them. Oftentimes, they have no comprehension of the turbulence that their “little” cancellation or no-show can cause you and your team. They do not set out to create havoc or disruption in your day. They too are very busy and when something has to give in their demanding lives, it is often their personal appointments. However, educating them on the necessity and value of ongoing dental care is an essential step every practice can take in controlling cancellations and no-shows.
Interested in speaking to Gene about your practice concerns? Email firstname.lastname@example.org
Multi-Tasking Equals Multi-Mistakes
“Must be able to multi-task” was a required skill written in a job description for a Dental Office Business Coordinator position posted to an internet job board. The ability to do several tasks efficiently almost simultaneously is what most people understand as multi-tasking.
Based on years of observing dental office personnel, the conclusion drawn is that the term “multi-tasking” is a myth, or closer to a fantasy. A fantasy because when a person is performing a task and has to shift gears to do another activity seamlessly and without skipping a beat, it usually doesn’t happen with the accuracy intended. Even computers process one element at a time and then move on to the next element. For most humans there is not enough absolute memory for what we just did, as sometimes we forget steps in the thought process when trying to do more than one thing at a time.
It would be more reasonable to say: “Completing multiple tasks within a work day period will be required.” If there is just one person at the desk, that person will have critical work to be done that requires full focus and few distractions. Posting payments to patient’s accounts, especially insurance checks, can prove frustrating when the phone needs to be answered and patients need to be checked in and out. Bulk checks can prove challenging as it is easy to post the wrong amount, omit a payment or make an adjustment to the wrong account balance. At the end of the day, when the posted collections do not match the receipts, it may take several minutes or longer to find the errors and make corrections. This is one reason for overtime in dental practices.
Multi-tasking can also cause the following errors: scheduling the wrong patient because the names look similar, failing to identify an insurance check as a check and filing it away as an EOB, writing the wrong time on an appointment card, forgetting a patient on hold, forgetting to call a patient back, making errors on treatment plans by omitting procedures, making mathematical errors on treatment estimates, forgetting to relay a message or to even write it down… just to name a few. All of these errors were made while trying to do more than one task at a time.
Time management to ensure that all tasks are completed accurately at the end of the day must be strategized by the Business Coordinator. The priority is determined by the daily practice goals and the tasks associated with accomplishing these goals.
• Schedule all activities to stay on schedule
Being busy is not the same as being productive, so be aware of what is going on with the patients in the practice and whether the dental team is operating within the scheduled time allotted for patient care. In the myth of multi-tasking one is always busy doing something. If the business coordinator is doing five different things and nothing is finished or completed without error, is that what you want from an employee?
The most important activities would be the ones that bring more value to your patients and build your business. It is possible to complete several tasks accurately in a day’s work but it requires double checking your work, prioritizing tasks, managing the eight hour time block and sticking to your schedule.
We can teach you how to maximize time and complete all of your business tasks while staying on schedule. Call today for professional business training in Front Office skills and Dental Office Management.
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