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  07.22.05 Issue #176

Is your Time on the Run or your Practice on a Roll?

Sally McKenzie, CEO
The McKenzie Company

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When you considered a career in dentistry, you probably didn't imagine that your life would eventually be driven by units. Units of time that is - 10-15 minute slots, 30-minute sections, two-hour blocks, etc. You probably thought about the people you would serve, the highly skilled, perfected techniques you would use to create magnificent restorations and gorgeous smiles, the expert care you and your team would provide. And when that first patient walked in the door it was cause for Champagne celebrations and hopes for several more as the early days were focused on simply filling the hours in the week.

My how things have changed. Today many dentists are suffocating under the crush of voluminous patient records. Just about any “thriving” practice has patients booked out for weeks and even months. Cancellation lists paper the walls. Doctors and teams spend their hours trying to outrun the schedule, head off the latest calamity, and reserve enough energy to make it home at the end of the day. Yet, in spite of the seemingly non-stop work, production revenues are disappointing, if not down right embarrassing.

The problem: your schedule has become practice enemy number one. When work and life are spiraling out of control, this is what we typically find:

  • The doctor is booked more than three weeks out, and patients have to wait several weeks for even the most routine procedures.
  • There is little if any consistency in the time booked for procedures – 30, 60, 90, minutes.
  • The objective is simply to keep the day full – just stick patients anywhere.
  • The hygiene schedule is loaded up for months.
  • Lunch “hour” is a food fantasy. The team typically catches 10 minutes to inhale fries and a burger or chug a power shake.
  • Patient retention is flimsy at best.
  • New patients can't be seen for a month.
  • Worst of all, revenues are flat.

Too often those who manage the schedule are given one, single sentence of training and instruction: “Keep the doctor busy.” Beyond that, they are on their own, and the clinical team is left to race the hallways, be in two places - sometimes three - at once, skip lunch, and remain calm at all times. When quitting time finally rolls around, everyone is ready to collapse in a heap.

It's time to shift the focus from busy to productive – big difference and it goes to the heart of controlling your day while increasing your profits.

Start by using your schedule to meet production objectives rather than survival training exercises. First, establish a goal . Let's say yours is to break $700,000 in clinical production. This calculates to $14,583 per week not including four weeks for vacation. Working forty hours per week means you'll need to produce about $364 per hour. If you want to work fewer hours, obviously per hour production will need to be higher.

A crown charged out at $900, which takes two appointments for a total of two hours, exceeds the per hour production goal by $86. This excess can be applied to any shortfall caused by smaller ticket procedures. Use the steps below to determine the rate of hourly production in your practice.

  1. The assistant logs the amount of time it takes to perform specific procedures. If the procedure takes the doctor three appointments, she should record the time needed for all three appointments.
  2. Next record the total fee for the procedure.
  3. Determine the procedure value per hourly goal. To do this, take the cost of the procedure, for example $900; divide it by the total time to perform the procedure, 120 minutes. That will give you your production per minute value - $7.50. Multiply that by 60 minutes - $450.
  4. Compare that amount to the doctor's hourly production goal. It must equal or exceed the identified goal.

Now you can identify tasks that can be delegated and opportunities for training that will maximize the assistant's functions. You also should be able to see more clearly how set up and tasks can be made more efficient.

Next week, creating daily order from hourly chaos .

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