10.26.12 Issue #555 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Signs of a “Sick” Practice - Part 1
By Sally McKenzie, CEO

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A friend of mine recently asked me to recommend a dentist for her. I was somewhat surprised because I knew she had been with her dentist for some years, and she isn’t the type of patient to shop around for a “dental deal.” So I asked if she was unhappy with her dentist’s care. Her response was, “No, but I don’t really think he wants to be doing dentistry.” I was intrigued. As the conversation continued, it became abundantly clear that this is a very “sick” practice. Let me explain.

For starters, I learned that the office is open only three days a week, making appointment scheduling inconvenient for patients - and that spells trouble for retention and disaster for growth. The doctor is in his 60s and remains a sole practitioner, which is a waving red flag that the practice is most assuredly losing more patients than it is retaining. The office manager, who has been with the doctor since day one, insists on six-month pre-scheduling for hygiene patients. If patients have to cancel, they are placed on the “cancellation call list,” meaning the patient will be contacted when an opening occurs. The phone calls from the practice trying to reschedule the patient usually begin the next day and continue every day the practice is open. What does that mean? Cancellations and no-shows are an issue, and not a small one.

Scheduling patients months out will not ensure a full schedule; it is a myth that has been disproven again and again and again. Yet, offices refuse to let go of this fallacy even though it’s costing them a fortune in time, inefficiency, and patients. If ever there were a perfect example of an office that, at a minimum, needs to try another approach, this is it. Clearly, many of the patients in this practice would respond better to receiving a professional notice via email or USPS two weeks in advance of their due date notifying them that it is time to schedule their professional dental hygiene appointment. An appointment that is made within a couple of weeks has a far higher compliance rate than one made six months ago.

But there’s more to this situation than merely the six-month scheduling issue. As the conversation continued, I learned that the office manager is friendly enough as long as you don’t have to reschedule an appointment. If an emergency arises and you have to cancel at the last minute, it will result in an “uncomfortable” conversation with her. She will remind the patient that the cancellation policy is clear: “The office requires two days notice for all cancellations.” If patients cannot or will not follow the manager’s “rules,” over time they will come to feel very unwelcome in the practice.

Unfortunately, the troubles don’t stop at the front desk. If the patient needs treatment, the good news is they can get an appointment to see the doctor within days. The bad news - for the practice, not the patient - there are multiple appointment openings to choose from. What’s happening here? It’s obvious. The doctor does not have enough new patients to support his schedule - even three days a week are difficult to fill.

Moreover, I learned that my friend had to practically beg the doctor to address the cosmetic issues that she wanted taken care of. During an appointment for a filling, he finally recommended six anterior crowns. They also briefly discussed the possibility of whitening as well as adult ortho. It went something like this: “You probably should consider crowns on those six front teeth. You might want to think about some adult ortho as well as whitening.”

This was a breakthrough. Finally, there was hope that she could get the cosmetic treatment she wanted. However, she realized this would be no small investment, and she wanted more information. The doctor completed the filling, left the room, and naturally, the patient began quizzing the assistant. “How much time would the treatment take? How much are the crowns? Does the doctor offer Invisalign or will I have to see an orthodontist?” As is so often the case, this unprepared staff member was thrown into “treatment presentation” mode. The assistant hastily dodged the questions and told the patient that she would share them with the doctor. The office would call her to schedule a treatment consultation visit soon, so that the doctor can further explain his recommendations.

Four weeks have passed and the patient has heard nothing from the practice. Next week, more signs of a “sick practice.”

For more information on this topic, visit my blog: The Lighter Side.

Interested in speaking to me about your practice concerns? Email sallymck@mckenziemgmt.com
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