A case study: Taking a practice from just OK to thriving

By Sally McKenzie, CEO Printer Friendly Version

A few years ago, a husband and wife dental team that seemingly had everything together reached out to McKenzie Management for help. While their 10-year-old Chicago-based practice was profitable and they were seeing roughly 40 new patients a month, they wanted more. They knew they were just scratching the surface of what they could achieve, and they were right.

When most dentists reach a certain level of success, they’re content to stay with the status quo. That wasn’t enough for this pair. They wanted to push themselves even further, and to take their practice from OK to thriving. It was important to them to develop consistent systems and to increase hygiene production. They were ready to improve patient communication as well as customer service, and to really focus on eliminating practice debt. And they wanted to do all this while enhancing their lives outside the office and reducing the stress that comes with owning a dental practice.

Before we dive into the areas that needed improvement, here are some of their key practice numbers:

Open days: 184 a year
Practice production: $1,396,686
Practice collections: $1,465,723
Hygiene production: $439,568
New patients per month: 44
Operatories: 6
Full-time dentists: 2
Hygienists: 2 full-time, 1 part-time
Full-time business staff: 3
Assistants: 3 full-time, 1 part-time

After visiting the practice, here’s what we found was holding this duo back:

There were no job descriptions. Because there weren’t detailed job descriptions, team members felt lost. No one really knew who was responsible for what, which also meant no one was held accountable. They’d often say things like “that’s not my job” or “I thought he took care of that.” This led to inefficiencies and even conflict from time to time, keeping the practice from meeting its full potential.

Production was stagnant. While the doctors were seeing plenty of new patients each month, many of their existing patients weren’t accepting treatment, or returning at all. Patient retention numbers were down, mostly because there wasn’t much of a focus on patient education or customer service.

After taking a deeper look, we found the practice had a lot of unscheduled treatment. The report told us they had nearly $1 million worth, in fact. Part of the problem? No one was following up with patients after initial case presentations. Why? The employees claimed they didn’t have time. The fact is, no one was responsible for these calls or held accountable for them, so they weren’t a priority. 

Case presentations didn’t get the job done. This was a huge problem. The doctors gave new patients their complete list of treatment recommendations at the very first visit. They briefly talked with them chairside about all the work they needed, then moved them on to the assistant to go over specifics. Once done there, patients were sent to the front desk where one of the business employees would talk about cost and attempt to close the sale.

Do you see the issue with this approach? First, one visit isn’t enough to establish the trust necessary for patients to agree to a long list of treatment recommendations. When dentists start the relationship this way, patients often wonder about their intentions—prompting them to schedule their next appointment at another practice. And none of the team members talking to patients about treatment had training in sales or even a script to follow. They’d often just wing it and hope patients would schedule. More often than not, they didn’t.

There were too many openings in the schedule. It quickly became clear that the practice’s schedule was not delivering the “three Ps”—patients, production and profit. Last minute cancellations and no-shows were common occurrences, and business employees didn’t know how to retrieve information on patients who missed appointments or those who hadn’t scheduled at all. No one was tasked with reaching out to past due patients, so they remained on the unscheduled treatment report.

Several employees managed the schedule, and none were trained to schedule producers to meet production goals. The schedule was a mess, which was causing stress for everyone on the team and holding the practice back.

While this practice seemed to be doing OK on the surface, we found there was definitely room for improvement. The doctors had plenty of employees on the payroll, but unclear job descriptions led to confusion and inefficiencies—and that meant tasks just didn’t get done. There were three different people answering telephones, scheduling appointments, and making financial arrangements, yet no one was ensuring the schedule was full or following up with patients after initial case presentations. There was no accountability, which led to frustration and conflict among team members.

After identifying areas that needed improvement, McKenzie Management sat down with these doctors to talk about how they could take their practice to the next level. Check out next week’s article to find out what advice we gave and to see the results, as well as learn how you can take the same steps to turn your practice from just so-so to thriving.

Next Thursday: The advice one practice followed to increase production and profits. Share this Newsletter

Interested in speaking to me about your practice concerns? Email sallymck@mckenziemgmt.com
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