Plug These Cash-Draining Holes in Your Practice
It’s not a happy day when you realize that there’s not enough money for you to pay yourself…again. Or maybe you can take a partial payment, but there’s nothing left for retirement. Or you are putting off continuing education as long as possible because you’re not sure you can afford it. Why? Practice expenses are dictating your every move. Yet, you still have the “helper” at the front desk. She’s a nice person who greets the patients warmly but is equally good at merely warming the chair most of the time. Hygiene continues to lose money, and on top of it all some of the employees are asking about annual raises.
When money is tight, there are 3 areas - staff, hygiene, and salaries - that are often the ones draining practice resources. It is critical that you carefully assess each for inefficiencies, starting with staff. When things get a little rushed, a little harried, and a little busy, too many dental teams think that's an indication that another employee is needed. Wrong. Determining the need for more staff must be based on actual numbers, not on a little stress.
For front desk staff, look at check-in and check-out. Typically, these administrative tasks take approximately 10 minutes per patient. If your practice is seeing 15-22 patients per day, which would total 150-220 minutes of patient contact, one person should be able to effectively manage the front desk duties. If that person is spending more than 240 minutes handling patients, or half the day, the practice should consider hiring an additional employee.
As for assistants, if the procedures are streamlined, one assistant can efficiently maintain two treatment rooms for a general dentist using two operatories and seeing 13 or fewer patients a day. This would include setting-up the room, seating the patient, assisting the dentist, dismissing the patient, and cleaning-up.
Another common contributor to inflated overhead is low hygiene production. Before you take out your financial frustrations on your hygienist, look closely at the recall system. Typically, weaknesses in hygiene production can be traced to inefficiencies in this system. An effective recall system ensures that patients are in the chair. And if they are in the chair, the hygienist should be expected to produce 33% of total practice production. Moreover, the hygienist's salary should be no more than 33% of her/his production (excluding doctor's fees). If the hygienist receives a guaranteed salary, the expectation must be that s/he produces three times her/his wages. Again, the key to achieving that is the hygiene schedule.
Hygiene schedules frequently appear to be overbooked. But practices commonly dismiss holes and no-shows that creep in. If patients aren’t in the chair, the hygienist can’t meet production goals, plain and simple. The practice should designate a Patient Coordinator. This is the point person who is responsible for keeping a steady flow of patients streaming into the hygiene treatment rooms through a solid recall system. This job has an enormous impact on production/overhead. Just be careful that the person doesn’t get dumped on with all the “menial” tasks that no one else wants to do. Their primary focus must be keeping the schedule full, using all of today’s modern communication tools including text messaging, email, in some cases social media and of course the phone to reach patients in order to maintain a solid schedule.
In addition, take a good look at perio. This is a critical factor in improving hygiene production. There are several ways to incorporate an interceptive periodontal program into the practice. I recommend the business assistant greets the patient upon arrival and mentions the program. She hands the patient a questionnaire and a brochure educating them on the importance of addressing the signs and symptoms of gum disease, such as Periodontal Disease - What you Need to Know.The patient checks any symptoms s/he has experienced, which opens the door for discussion in the treatment room.
Finally, address the issue of staff raises. Guidelines must be clearly established for when raises are discussed and under what conditions they are given. Make certain your employees know what is expected of them. Job descriptions are a must for everyone. Use performance measurements to determine raises. And remember the Cardinal Rule of Raises - if the practice is losing money, employees do not get more. Check out my Employee Salary Review form HERE. This form will help you mathematically determine how much of a raise you can afford and still keep your salary overhead in line with the industry.
Be consistent. Monitor the systems. Controlling overhead requires constant vigilance or before you know it, high overhead will pull you under…again.
For more information on this topic and for additional Dental Practice Management info, visit my blog: The Lighter Side.
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