Managing the Flood Waters of New Patients
There is no cookie cutter plan of action that fits all practices. Each has its own uniqueness, and those differences dictate how to set up and monitor systems. Starting up a new practice without a patient base can be frightening, and the expenses to operate coupled with the payback on loans can seem overwhelming. Attracting quality new patients is one of the top fears new dentists have when opening a new practice.
Demographics and psychographics play an important role in determining if there will be a large enough population and a population that seeks the care your practice will provide. Investing in the right marketing plan, branding your practice and getting the word out everywhere that you are there to serve the community is high priority.
General advice would include signing up for select Preferred Provider Networks of insurance companies. The practice of Dr. J thought it reasonable that if you accept all plans, you will have more than enough patients to treat. This really depends on the saturation of dentists accepting the PPOs in the area of the practice. What it does do is control what you can charge and collect for services. What about management of these patients when you are trying to control operational expenses?
Dr J’s practice showed favorable demographics and psychographics, but he decided to sign up for every PPO network available. Because this was generally a fee for service area, it seemed like a good idea. Some of the plans paid from a limited fee schedule and not the UCR or the usual contracted plan. The practice was writing off so much that there was no profitability in the patient’s visit. They made up for some of this loss by participating in the plans that paid from the UCR for the area. The doctor looked at the production reports on a daily basis and was pleased, but was shocked when he saw the adjustments on the end of the month report. Cramming more patients into the schedule seemed like the way to make more money.
To control overhead staffing issues, the practice had one business coordinator whose job was all front office duties and also presenting treatment and financial arrangements. There were three open phone lines that rang regularly. Since they could accept just about everybody, they did - and there was a “flood” of new patients wanting to get in for an appointment. Accepting so many plans called for checking eligibility and verifying benefits before the patient’s arrival. This was priority, as was fielding all the phone calls and making sure to collect all co-payments and deductibles at the time of service. The business coordinator’s main focus had become insurance driven, and the effort to educate patients and spend the time building relationships was replaced with booking treatment that the insurance would pay for, as it was easier and fit into the time restraints of a “busy” practice. Some patients got out the door with “I will bill your insurance and if there is a balance, I will send you a statement” from the business coordinator, who was too busy on the phone.
Monthly business meetings were thrown by the wayside because the patient demand outweighed the value received for the team to discuss practice goals. There were no goals, just get them in wherever you can. Morning huddles also became a thing of the past as the practice became focused on finding any open time to see a patient.
The demand to stay on time with a schedule that was impossible to manage caused the doctor and the team to drop the niceties that many patients expect, such as offering a cup of coffee, water or at least pleasant verbal exchange upon arrival. They often fell behind schedule when the opportunity arose to do more treatment that was covered by the insurance. Being seated late and with poor customer service was not acceptable to some patients, who soon left the practice.
After a few years operating at this pace, the practice had reached an adequate level but not close to its potential. There are staffing issues of burnout and the doctor spends less and less time communicating with the staff, causing an absence of teamwork. There is turnover among the staff and the “hiring panic” had caused the doctor to hire without verifying experience or references. The new hire was a problem, as he did not have the basic computer skills that were necessary to put in patient notes and treatment plans.
Upon looking at the practice reports, it was noted that the unscheduled treatment report was quite large, and no one had called the patients to follow-up. The practice had become insurance dependent, and the skills to motivate patients to accept treatment were rusty with neglect. Dr. J admitted that it was not the practice he envisioned, but he did not know what to do to change things.
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