7.29.11 Issue #490 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Carol Tekavec, CDA RDH
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Staff Turnover - Should I Stay or Should I Go?
Carol Tekavec RDH

Many of us know of offices that are constantly in need of staff. These practices seem to have Craigslist and the “Want Ads” on around-the-clock alert. Even with so many job seekers out there, some offices can’t seem to hold on to their dental team members.  What’s wrong?

Red Flag Number One
Office staff need to have defined job duties and priorities. While cross-training is a plus for keeping an office running smoothly, having too many people responsible for the same tasks can create confusion and misunderstandings.

Jean and Susan are dental assistants in Dr. A’s dental office. When a case is designated to be sent to a lab, each assistant is responsible for making sure that the case for the patient she assisted with goes out that evening. When a case comes back to the office, whoever is available logs it in and places it in the proper place; ready for the patient’s return appointment. At least twice a week a crown or appliance patient is listed on today’s schedule and the case cannot be found. A mad search ensues. Often the case is not in the office and no one seems to know what happened or why.

Sometimes the case is discovered to be sitting in the proper place, but no one has logged it in. Staff time is wasted and tempers flare. Finger pointing and blame become the order of the day. Both assistants become resentful of one another and of Dr. A., who is always mad and upset about his lab cases. The discontent filters over to the front office staff, who often get put in the middle. Instead of a calm, professional atmosphere, tension prevails and starts to takes it’s toll. Susan goes home angry on many nights and because of this and other problems at the office, starts to think about looking for another position.

A simple solution to this situation is to designate one assistant as the “keeper of the cases.” When a case is returned to the office, that assistant is responsible for logging it in and placing it in the proper place. Each day that same assistant is responsible for checking the next day’s schedule to be sure that each patient’s case is ready. If one has not come in, the lab can be called to see if it will arrive on time and if not, the patient can be reappointed. One assistant has a job priority of case management, reducing the chance for confusion and problems.  

Red Flag Number Two
Running on time is presented as a priority for the entire office team. The appointment coordinator is given the task of setting up appointments for new and returning patients. Dr. A. has let it be known that he wants the assistants and hygienist to handle appointment times for their patients, and that he doesn’t want to be questioned about what to set up. He considers that the staff is experienced and professional and he should not be expected to direct these types of every-day decisions. Everyone should “know” how long procedures take and schedule appropriately. In addition, emergencies are allowed to be put in as patients call. The result? Most days the schedule does not run on time.

Annie is the full time hygienist for Dr. A.  During a recall appointment, it is discovered that Mr. Patient needs to have a crown on #30 and resins on #8M and #9M. She goes over what Mr. Patient can expect and generates an estimate. She is worried about how much time to schedule for these services because Dr. A. did not specify. He usually wants 90 minutes for a crown prep, but he did not say whether he would want to do #8 and #9 on the prep day, the cementation day, or at a completely separate appointment. 

She would have liked to ask Dr. A. these questions when he was in the treatment room during Mr. Patient’s appointment, but she knows that Dr. A expects her to know how much time to schedule and does not like questions. She guesses that he will want to do the crown prep alone and designates time for that only. When Mr. Patient comes for his appointment, it turns out Dr. A. wants to do #8 and #9 as well. The time allotment is too short, Dr. A. performs the services anyway, and the schedule runs behind.  To make matters worse, Patty at the front desk has scheduled two emergencies back to back after Mr. Patient’s appointment. Dr. A. is already stressed from having too little time for the procedures he wanted to perform, and now must address two emergencies. The schedule runs through the lunch hour. 

Dr. A is annoyed with Annie the hygienist and Patty the appointment coordinator for not putting in appointments correctly. Annie and Patty are unhappy because they feel they are doing the best they can, the patients are unhappy because they are kept waiting and feel their time is not being respected, and Jean and Susan, the dental assistants, are upset with everyone because they have missed lunch again. This situation is repeated several times a week. One day Annie has had enough. She gives notice and leaves for another office she knows is looking for an experienced hygienist.

A solution to this problem would be for Dr. A. to say how much time he wants for the patient’s next appointment, and what he will want to accomplish during that time. If he doesn’t mention it, Annie should feel comfortable asking. While certain time allotments can be expected for certain procedures, there are many circumstances where that allotment might be too little or too much. The dentist is in the best position to make the determination. In addition, first thing each day at least two emergency slots should be designated in the schedule by Dr. A. Now the appointment coordinator knows where to put emergency patients, and everyone knows where time may be a little tight and can help one another.

These are just two examples of why an office might find itself always looking for staff. When issues repeat themselves over and over, team members become unhappy. Practices with revolving doors often experience these types of problems, as well as many others. Conflicts of any kind wear away at office harmony. In addition, constant retraining and integrating new staff costs the practice money. Addressing the causes of conflicts can put the practice back on track. Dr. A. is a good dentist and the team members are competent. They can work together to make the practice a stable and happy place. 

Carol Tekavec RDH is the director of Hygiene for McKenzie Management.  Carol can improve your hygiene department in just one day of training “in your office”.  Interested in knowing more about how to improve your hygiene department?  Email hygiene@mckenziemgmt.com.

Carol is also a speaker on hygiene efficiency and profitability for McKenzie Management. Interested in having Carol speak to your dental society or study club?  Click here

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