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  Sally McKenzie's
 Weekly Management e-Motivator
  7.25.03 Issue #74
   

Your Money or Your Practice?


Sally Mckenzie, CMC
President
McKenzie Management
sallymck@
mckenziemgmt.com

     “This is a stick up! More money or the practice gets it!” Hopefully, it’s not come to that in your office, but doctor after doctor will tell me they feel like the practice is at the mercy of “more money or else” employees. Many dentists say they are working just to meet payroll, which only continues to escalate while production is flat or, worse yet, decreasing. Wages should be no more than 22% of gross production, not including taxes/benefits or the doctor’s salary. Employees go along thinking they are performing just fine, but they have nothing to base that on. They show up every day,

by golly, they deserve more money. But, in many cases, they are not doing anything to increase production or improve systems. They’ve just come to expect that at a certain time every year they get a raise. Or they’ll periodically corner the doctor and convince him or her that they are deserving of a bigger slice of the pie than they’re getting. It’s time to tie raises to performance, and raise – or perhaps establish - performance standards.

First, take the emotion out of giving raises and protect yourself from the “I want more money or else” employee by establishing a compensation policy. The policy states that raises will be given based upon employee performance. Follow these guidelines when dealing with an employee who tells you they deserve a raise.

  • Don’t give raises because you feel sorry for an employee or are afraid they won’t like you if you don’t give in.
  • Don’t answer a request for more money with comments such as: “I can’t afford it right now.” “You haven’t been here long enough.” “I need to be fair to the others.”
  • Do ask the employee to provide sound business reasons for why they should be paid more.
  • Do ask the employee to prepare a written list of contributions they’ve made to the practice.
  • Do ask them to provide a report on recent problems/issues and how they addressed them or new responsibilities they’ve taken on since their last raise.
  • Do ask them to explain in writing what they have done to increase revenue, cut costs, and/or save time.
  • Do tell the employee what is expected of them. A job description is essential.
  • Do inform the employee of how you will measure their performance, for example: the employee is to secure treatment acceptance at a certain level, collections must meet established targets, or the supply budget is to be within established parameters.

Next week, establishing clear guidelines for when and under what circumstances raises are given.

If you have any questions or comments, please email Sally McKenzie at sallymck@mckenziemgmt.com.

Interested in having Sally speak to your dental society or study club?
Click here

Building On The Theory

How An Ailing Business Foundation Can Cause
“Digital Chaos”


Mark Dilatush
VP Professional Relations
McKenzie Management
mark@
mckenziemgmt.com

Technology Tool Box

Service Interruptus?

Last week I discussed professional communications from a specialist's viewpoint [see article]. That discussion prompted another email from a reader who shared his story about how their server went down and caused stress, loss of time, and a loss of money.

Our reader survey [take survey now] shows the vast majority of you own small computer networks in your dental offices. This week’s article is about one simple, inexpensive, ridiculously fast step you can take to protect yourself from Service Interruptus! As a matter of fact, if you already own a Windows network, I guarantee you have ZERO additional hardware to buy!

Remember, a downed server isn’t just a pain in the back side for you and your dental team. Having your network down does not allow you to service your patients the way they have grown accustomed to being serviced in your dental practice. So, when I say Service Interruptus, I am not just talking about your network – I’m talking about your patients!

My first instruction is to tell you that if you don’t know how to do this yourself, pay for a professional to do it. I cannot imagine this taking longer than 1 hour. The technical investment is very minimal

  1. If your file server (in a non-dedicated network) is at your check-in/check-out business location – move it to a different location. Having your file server at that location is the LEAST efficient way to operate and the most dangerous.
  2. Assuming your file server does not reside at your business desk, understanding how to do this should be relatively simple. The idea is to duplicate the patient data that resides on your server to the hard drive on one of the front desk workstations each night. This is called backing up through the network.
  3. Load a copy of your practice management system on one of your workstations at the front desk. Best results would be created by loading your system onto the machine that greets and/or checks out your patients. Make sure you create a new unique folder on the local hard drive. For instance, you might call the folder “Dentrix Front Desk Recover” – or something like that so you are familiar with what the folder is and what it does in the future.
  4. Create a command (this is where you might need help) to copy all of the patient data from your server to this folder each night. The command can have it’s own icon on your desktop. This makes it simple for someone on the team to do every evening, lunch, or morning. In a typical dental office, transferring files from the file server to a local drive should take less than 2 minutes to complete. YOU MUST DO THIS WHEN EVERYONE IS LOGGED OUT OF YOUR PRACTICE MANAGEMENT SOFTWARE!
  5. Now one workstation at the front desk has a complete duplication of all of your patient data every evening. This is good! THIS DOES NOT ELIMINATE THE NEED FOR AN OFF SITE BACKUP OF YOUR FILE SERVER! This exercise should be done in addition to having a portable backup of your server information.
  6. If you have multiple workstations at the front desk, or, multiple workstations used to administrate the business of your dental practice – you could get fancy. You could ask your technician to set up an alternate network just in case your server ever goes down. Temporarily, the front desk workstation would become a non-dedicated server and the rest of the administrative workstations would see your patient data from the front desk workstation. This creates a “mini” network just in case the main server goes down.

There’s an easy way to test this in your dental office. Unplug your server! JUST KIDDING – JUST KIDDING! Ok, don’t go unplug your server. But, pretend that you did.

What is your contingency plan to service your patients? If your contingency plan is a tape backup and your tape backup is in your server – what good is your contingency plan? If your tape backup is not in your server but you’ve never verified that your backup tapes are valid (actually working) – what is your contingency plan?

The bottom line is your network has all kinds of capabilities and your technician may or may not know the right way to set up the network for a dental practice. Print this article for them and tell them you want them to set up your Service Interruptus Contingency Plan. After they stop laughing, just hand them this article and have them read it. They’ll say “Ohhhh, no problem!”

If you have any questions or comments, please email Mark Dilatush at mark@mckenziemgmt.com.

Interested in having Mark speak to your dental society or study club?
Click here

Getting The Cold Shoulder


coach@
mckenziemgmt.com

Giving Dentists And Their Staff Different Perspectives On Day To Day Issues

Dear Coach,

I have worked with my doctor for three years now. He took over the practice back in 2000 and I have managed it with him since. We had a receptionist,

one RDA, one DA and me (office manager). Recently, we had to let our receptionist go due to lack of teamwork. We were in the process of looking for another receptionist, when the doctor saw how well I was doing with both jobs. He figured why hire anyone else. Now I am stuck with both jobs and feel obligated to do them since he gave a raise, “which I may add, I deserved anyway”. What do you think I should do or say?

Sincerely,
Ms. Overworked

Dear Ms. Overworked,

Let us begin by remembering that you are part of a business and the object of business is to make money. Cutting overhead expenses is one of the ways to ensure profitability. Profitability is the central concern of the owner of the business and this is reasonable.

As the office manager, your responsibilities involve keeping the staff machine running efficiently. As a good leader, you would be expected to be able to handle everyone's job. It is not surprising that your ability to handle two jobs would draw the attention of the owner of the business; however, there is another element to consider before addressing your personal feelings.

It is the volume of production which delegates the requirements for hiring employees. Is your practice so unproductive that one person can do two jobs? If your practice is not busy as it should be, then it is only natural for the doctor to want to save overhead. His solution is shortsighted; he should bring in a practice management team to assess the reasons for poor revenues. This decision would generate the funds necessary to return you to your former position and pay for a new receptionist.

If the practice is profitable and productive, then the issue becomes one of a matter of territory and prestige. If the new job description does not suit your temperament, then I think a request to alter your job description and a return to the former organizational chart would be reasonable.

While the doctor is trying to save money, he may also be shortsighted in terms of the actual workload involved in his decision. You were not specific about the workload. If the new workload is not overwhelming, then your decision to go back to the former organization chart would appear lazy. Even if you were to give back the raise in return for your old position, you might still look lazy and this is not an image that you want as a manager.

Should your request not merit a change, you will appear to be maneuvering in your own self-interest. This is easily misunderstood by other team members. The reason why this is easily misunderstood is that the doctor has placed you into a staff position from a management position. This can be observed as a step down and thus contaminates your overall reputation and effectiveness as a leader within the company. In addition, the desire to not have a staff position makes you appear snobby.

With the issue of practice productivity discussed, I think another aspect of your question hinges on the presence of resentment over the doctor's decision. If you are resentful, then it will affect your work. If you are not resentful but are inconvenienced, perhaps you can alter things by re-delegating some of your responsibilities to make the system work for you.

It is important that you go to work every day feeling that the effort you put out is adequately compensated and respected. Since he has given you a raise, has your prestige and reputation been tarnished? If so, then some kind of new arrangement would make sense, if you are to avoid long-term resentment.

Feelings of resentment that go unexpressed will stress you and diminish whatever pleasure you derive from your daily work. This is a very serious matter. Most people trivialize their inability to express how they feel. This is a big mistake in the long run.

If you are resentful then some kind of an adjustment must be made. Long-term resentment will manifest as low-grade stress which will wear away at your relationships with the team and the doctor. Resolution of any resentment requires expression, usually direct expression with the doctor. This is not a team problem.

In summary, if there is no resentment and it is simply a matter of workload, then, if business is poor, then your workload is not sufficiently stressed and his decision to save on overhead would make sense; however, if the business is building, expanding, and very busy, then your workload is sufficiently taxed to the point where your productivity will actually become diminished and in effect, it will cost the doctor money.

A realistic assessment of the business and personnel issues is necessary in order to know what to say in order to justify your own solution. Remember, if the doctor can justify changing your job description, you have to be able to justify changing it back.

The Coach

Want your issues answered? Ask the
coach@mckenziemgmt.com.

Missed Past Issues of Our e-Motivator Newsletter?

Is Your Overhead Rising and
Your Revenues Staggering?

Payroll – 19-22%
Dental Supplies – 5%
Miscellaneous – 10%
Dental Laboratory-10%
Payroll Taxes and Benefits
3% - 5%
Facility – 5%

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Sally's Mail Bag

Dear Sally,
I was wondering if you have some "rules of thumb" on when a practice is ready to hire an associate doctor?

Dr. Robert

Dear Dr. Robert,
There are no rules of thumb on when to hire an associate. You can have a solo dentist who is able to treat 2500 active patients and some that are overwhelmed at 1000. You have states where placement of restorative material is legal, therefore, more procedures can be delegated to auxiliaries allowing those dentists to treat more patients. It is true that when a dentist's schedule is booked more than 3 weeks solid with appointments spilling into the 4th week ... consistently, the situation needs to be evaluated. You can have a doctor scheduling on 15 min. units vs 10, 1 operatory vs 4 operatories. Your particular situation needs to be evaluated for what it is. If you bring on an associate dentist based on being booked out more than 3 weeks and working many hours, you will only be looking at a small snapshot. Many associates in the past were hired to find out a few months later, they were working below poverty level because the patient base wasn't there. If you would like for me to try and give you a clearer picture of your personal situation, let me know. sallymck@mckenziemgmt.com
877-777-6151

Sincerely,
Sally


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