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12.12.08 Issue #353 Forward This Newsletter To A Colleague

Nancy Caudill
Senior Consultant
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Scheduling Traps That Trip You Up!

Dr. George Graham—Case Study #224

Dr. Graham’s Practice Statistics:

  • 1 doctor and 2 assistants working 4 days a week
  • 20-year-old practice at the same location
  • 7 hygiene days per week
  • 2 business assistants working 4 days a week
  • Doctor daily gross production currently—$2,800
  • Doctor daily gross production last year—$3,300
  • Collections at 98% of net production

Dr. Graham enjoyed a slower pace and dedicated time to chat with his patients. His patients liked him and paid for their dental services. Everything appeared to be normal, including his schedule, which at first glance was "full." The entire left column was filled from 8:00 until 5:00 with an hour for lunch and the adjacent column had patients sporadically scheduled throughout the day. Upon further scrutiny, however, there were many scheduling mishaps that were probably the root of Dr. Graham's feelings of being trapped. They are identified below.

Scheduling Traps:

  1. The combined practice goal of $6,000 did not include a specific goal for Dr. Graham.
  2. “Doctor Only” procedures were scheduled in both columns.
  3. Too much time scheduled for procedures resulted in unused time units.
  4. Too many non-productive appointments were scheduled in one day.
  5. There was an apparent need for more dental assistants!

What was discovered in Dr. Graham's practice was that Sharon, his Schedule Coordinator for seven years, had resigned to start a family. Dr. Graham then hired Kathy, who had 3 years of dental experience. Dr. Graham assumed that she knew how to orchestrate a productive schedule, so therefore spent no time giving Kathy the proper training that she needed. How hard could it be to put names on a schedule and keep the holes filled? Kathy certainly knew how to do that!

Unfortunately for the doctor, Kathy was getting caught in these scheduling traps, because she didn’t even know what she didn’t know.

How to Avoid these Dangerous Scheduling Traps:

  1. Set a daily production goal for the doctor. This goal can be based on many different criteria, such as a general overall increase of 20%, establishing a 55% overhead, gross wages overhead of 20%, etc. Remember that the hygiene goals must be established first (after the practice goal is established). The remainder of the production must be achieved by the doctor.
  1. Understand doctor procedures versus assistant procedures. Most dental software programs allow you to set up default times for procedures, as well as designate each unit of time as doctor time or assistant time. Set up your procedures with the accurate assistant/doctor time to make it easier for the Schedule Coordinator to properly utilize both columns of the schedule. Educate your scheduler about why it is impossible to perform a root canal procedure in one treatment room and simultaneously prep a quadrant of composites in the other treatment room.
  1. Schedule the proper amount of time for each procedure. How would the Schedule Coordinator know? Because the information is provided on the routing slip by the assistant when the patient is "passed off" to her at the front desk. Yes, default times can be set up in the computer to make it easier but it is important that customized time be assigned to each patient. Only the doctor and assistant know how difficult the 1-surface resin filling is going to be on Mrs. Jones or how quick and easy a 3-surface posterior restoration will be for Mr. Smith. Sometimes the default time is not applicable to a patient. This information is crucial to proper and productive scheduling.
  1. Limit the number of non-productive appointments per day. Dr. Graham had one day with 4 crown cementations. When the doctor says, "Mrs. Jones, Kathy will schedule an appointment for you in two weeks to get that new crown placed for you," it’s just a guideline. If he prepped 4 crowns that day, don't give him 4 crown seats in exactly two weeks—spread them out a day or two apart. Pre-determine how many crown seats you are willing to do in a day, as well as other non-productive appointments, such as wax try-ins, final impressions, etc. All these procedures eat up doctor time and do not create additional production. The daily goal will not be reached with too many of these appointments.
  1. If the schedule is properly managed, there is no need for additional assistants. Doctors sometimes feel that they can produce more if they have one more assistant and can open up one more treatment room. Wrong! No matter how many treatment rooms and assistants you have, YOU can only be in one place at one time.

Dr. Graham was happy to call recently to report that after professionally training his new Schedule Coordinator, his daily production is reaching almost $4,000 a day and he is only seeing 8 to10 patients instead of 15 to 17. He is now working smarter instead of harder.

Please contact McKenzie Management to learn how to rescue your business team from scheduling traps.

If you would like more information on how McKenzie's Practice Enrichment Programs can help you IMPLEMENT proven strategies, email

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