12.25.09 Issue #407 Forward This Newsletter To A Colleague

Nancy Caudill
Senior Consultant
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Job Descriptions - Why Does It Really Matter?

Dr. Jamey Gleason – Case Study #332

“I didn’t do it... I have no idea who did!”
“I wasn’t working that day so I don’t know who scheduled that patient.”
“I didn’t know that you wanted me to do that.”

These were very familiar comments made by Dr. Gleason’s team. Dr. Gleason felt like his practice was out of control and he was unable to hold anyone accountable for his or her performance. The interesting fact is that these comments were true. No one was trying to hide anything and because of the lack of specific job descriptions, no one in the office knew what the doctor expected of them, except the typical “just do your job and do it well.” 

Dr. Gleason’s practice needed the following job descriptions: Patient Coordinator, Schedule Coordinator, Financial Coordinator, Treatment Coordinator, Hygienist and Assistants.  While Dr. Gleason has only 4 employees, he needs 6 positions filled.  Someone apparently is going to wear two hats.

Hygiene Coordinator Tasks:
This position is responsible for the growth of the practice through the Hygiene Department. If there are 30 new patients being seen in hygiene each month, but 35 are not coming back on average through hygiene, the practice is not growing. This is the “Dialing for Dollars” position. The Hygiene Coordinator has a 5-step follow-up process that she performs every month to maintain the integrity of the Hygiene Department. The Coordinator schedules the Hygienist to a pre-determined goal set by the doctor, based on either 3x the hygiene salary or 1/3 of the total practice production goal.

Schedule Coordinator Tasks:
This position is responsible for scheduling the doctor to a predetermined daily gross production goal. In this office, this position will also check out all the patients (post their charges and payments and schedule the next appointment). She/he also follows up on unscheduled treatment plans.

Financial Coordinator Tasks:
This person is responsible for outstanding insurance claims, outstanding account balances and weekly statements. The Financial Coordinator generates claims daily, verifies patient insurance eligibility and confirms that all insurance information in the computer is correct.

Treatment Coordinator Tasks:
This position presents to the patient what their clinical needs are.

Hygienists and Assistants Tasks:
These positions perform specific duties that are associated with their clinical training.

Dividing up the Workload
With the understanding that every office is different and the design of the business area can influence the decision of who does what, typically the Hygiene and Financial Coordinator are one person. The Schedule Coordinator is in the “hot seat” so this is all this person can manage. The Treatment Coordinator position is carried out by all the clinical team, including the doctor. The treatment that is needed by the patient should be explained chairside by the doctor and supported by the assistant and/or hygienist.

Dr. Gleason didn’t want to hear “I don’t know who did it.” He wanted the problem addressed and resolved. Why is this so difficult? Because there was a lack of job descriptions in his practice. Everyone does a little bit of everything, so there were “too many spoons in the soup” and he didn’t know who was holding the saltshaker!

During the morning meeting, Dr. Gleason expressed his concern to his entire team. Due to lack of accountability, he didn’t know which person to be directing this conversation to. As a result, they all heard his comments and dismissed them because they were thinking, “Sure glad that he is not talking about me.” Having a specific job description attached to his employees will allow him to direct his concerns to the person who is responsible for that department. Even if they didn’t do the deed, they are responsible for correcting it and making sure that it doesn’t occur again. It also keeps his concern from falling on those team members that aren’t involved.

Example:  Mrs. Jones was scheduled on the doctor’s schedule for 2 hours for a crown on Tooth #3, according to the computer.  When she came in that morning and the assistant seated Mrs. Jones, it was determined by the assistant that Mrs. Jones didn’t need a crown, she actually needed a root canal and THEN a crown on her next appointment. Dr. Gleason was unhappy!  At the end of the day he asked everyone what had happened. How did the appointment get scheduled as a crown?  No one knew. The computer indicated that the Hygiene Coordinator scheduled the appointment two months ago, but she doesn’t remember. Now everyone is upset, including the doctor.

The Solution
The Schedule Coordinator is ultimately responsible for Dr. Gleason’s schedule. When a patient is scheduled incorrectly, he goes to her/him. End of the line!  As the Schedule Coordinator, it is her responsibility to confirm that the appointments are correct in the computer by reviewing the clinical notes prior to the morning meeting.  It is also recommended that the Schedule Coordinator “solicit” assistance from the assistant the day before to review the patient records and double-check for errors.

Dr. Gleason invited his team to determine which job descriptions best fit their temperament types and experience, and implemented these specific responsibilities to those team members. Now instead of “fussing” at everyone, he directs his concerns to those that are responsible, with the expectation that they will resolve the issue and avoid it in the future.

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

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