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1.13.06 Issue #201  
Ready! Fire! Aim! Why You Shouldn't Wait to Install Digital Radiography

Sally McKenzie, CEO
The McKenzie Company

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As I hope the title of this article indicates, I'm actually advocating that you follow a practice that is reputed to have been common in the Old West. I'm recommending that you "shoot first and ask questions later." This might not be what you'd expect to hear from a business consultant, but the financial benefits of installing digital radiography are so great that you simply can't afford to wait.

Installing digital radiography in your practice is so important that, even if you make a mistake initially, the benefits will far outweigh any mistakes you might make by choosing the wrong vendor. What's more, if you discover that you're not totally happy with the system you've purchased, you can generally opt out of your purchase and choose a vendor with a better product.

Make no mistake: I'm not quite telling you to just go out there and buy the first digital radiography system that's demonstrated in your office. There's no substitute for doing your homework. What I am saying, though, is, "Get out there and buy a digital radiography system for your practice now.” Let me explain why.

First, there are the financial rewards that accompany installing digital radiography in your practice. I've actually found that there are many dentists who don't realize how much money they are paying out each month to maintain their film X-ray systems. Film radiography has been the de facto standard of care for so long that many doctors have just come to accept the fact that such consumable supplies as film, chemicals, developer equipment and maintenance, and mounts are significant out-of-pocket expenses. I've come to recognize that these are "invisible" or "phantom" costs that many dentists have become so accustomed to that they simply don't question them.

I think it's high time they do start to question them. It’s time that dentists who are still taking film X-rays realize that not converting to digital radiography is costing them serious money. When I say "serious money," I'm talking about a minimum of $400.00 every month in film, chemicals, developer equipment service and maintenance, and mounts. If, for instance, your practice takes an average of 50 film X-rays a day (or 200 per four-day week), you're spending that much money every month with no chance to recoup your expenditure.

This is not to mention the time your team members spend developing film X-rays. It takes an average of 12 to 15 darkroom visits to develop and mount 50 film X-Ray images in a given day. This means that your practice is wasting two to two-and-a-half hours of staff time daily just to develop film X-rays. If you multiply that times $20.00 per hour, you’ll find it’s costing you as much as $50.00 a day. That translates to $800.00 to $1,000.00 a month in wasted staff time to develop film X-rays.

I call it "wasted" time because in the best digital radiography systems the X-ray image is displayed instantly in the operatory on a large-size computer screen. In other words, there is literally zero development time involved in producing a digital X-ray. Which means that there are zero dollars in lost staff time for your practice.

To put it bluntly, film radiography has become a Return-On-Investment nightmare. Even if you converted to Unknown Company Digital Radiography, you'd be better off financially than you are with film. But there are other digital radiography options out there that make even better sense.

If you add up the lost costs of film radiography for a practice that takes around 200 X-rays per week, you'll find that they amount to some $1,300.00 per month. These costs include the price of consumable supplies, system maintenance, and wasted staff time.

The typical lease cost for a digital radiography system is around $500.00 per month. If you subtract the $500 lease cost from $1,300.00, you’ll see that your return on investment is somewhere in the neighborhood of $800.00 per month, or just shy of $10,000.00 per year.

What's more, you can actually begin to realize a cash-flow benefit from converting to digital radiography within less than two weeks. That's because once you pass the point where your unrecoverable expenses for film radiography exceed the cost of your monthly digital radiography lease payment, you're realizing positive cash flow for your practice. For most practices, this point is reached after about five or six working days each month.

And so, my question to you is, if you haven't yet converted your practice from film to digital radiography, "What are you waiting for?" Ready! Fire! Aim!

Converting to digital radiography will provide you with one of the fastest returns you're ever likely to get for your money. By the end of the first month, when you make the first lease payment on your state-of-the-art digital radiography system, you'll be hundreds of dollars to the good. That's because you'll already have realized at least $1,300.00 in savings. The ROI for digital radiography starts early and never goes away. It's one of the best financial moves you can make.

Interested in having Sally speak to your dental society or study club? Click Here.

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Are you a Morale Booster?

Dr. Nancy Haller
Executive Coach
McKenzie Management

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Communication is the real work of leadership. In fact, "multi-modality" in communication is essential. What you say is only the beginning. Your behavior, your actions, and your decisions also are ways of communicating. If you are going to have a productive, loyal staff, you need to learn how to create a consistent message through all of these. It's been said many times - leaders lead by example.
Answer ‘yes’ or ‘no’ to the following statements.

  1. I inform employees how their contributions fit into the practice’s goals.
  2. I am aware of each staff member’s career goals and consider them when delegating responsibilities.
  3. I have canvassed my staff through a questionnaire or dialogue about the office morale.
  4. I concentrate on being enthusiastic, serving as a role model.
  5. I seek free exchange of communication with my staff.
  6. I think of examples to empower my staff, involving them in decision-making.

If you answered ‘yes’ fewer than three times, you need to step up to the leadership plate. Demands on your time become even more crucial when business is booming. It’s natural that you expect your staff to help you out when the pressure is on. But productivity and efficiency in your personnel team are the result of consistent training and coaching. Unfortunately, because developing employees takes time, it generally gets neglected…until problems arise. By then emotions can flare up and it feels like you’re putting out fires. 

Building a strong, cohesive office requires time upfront, but the investment yields long-term gains. The foundation of a good staff begins in the selection process - hiring the right people, matching their skills and work styles as closely as possible to the responsibilities of the job. Pre-employment assessment can be an invaluable tool to strengthen the processes you already have in place.  

Even if you hire the right people, that is just the first step.  Since there are no perfect job candidates, it is much more realistic to expect that your employees will have strengths and talents, as well as areas they need to improve.  Those are referred to as developmental needsOnce they are on-board, it is necessary for you to train your staff. In corporate America, employees are referred to as ‘Human Capital’ because they are your greatest asset. Just as your dental equipment needs servicing from time to time, so do your employees. Help them understand not only the concrete parts of their job, and even more importantly, how you expect them to do those tasks.  In turn, you are coaching your staff to assist you in achieving organizational objectives. 

Performance-based feedback is essential. It tells your employees that they are ‘on track’, or it gives them information that they are off-course. Be brief and objective. Stick to the matter at hand.  Ask them what kind of help they might need to perform better. Voice confidence in their ability to succeed. Give them encouragement. And remember to praise them. It is very important to notice even the smallest efforts they make toward their identified goal. Coaching may be helpful in training you to be a more effective leader for your staff.

Simultaneous with coaching the individuals in your office, you need to ‘coach’ your practice. That means treating it as if it were a living thing…which it is. Your practice evolves, changes, fluctuates from day to day. In essence, it breaths and it needs attention. Develop a clear mission statement. Accurately explain why your practice exists and what you hope to achieve in the future. A good mission statement articulates the essential nature of the practice, its values and its work. Then you need to communicate that vision everyday, every way.

Team retreats are an excellent way to build morale AND revenue in your practice. Contact Dr. Haller at to learn how to personalize our team programs to your office.

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Prepping Patients' for Periodontal Maintenance Appointments

Jean Gallienne RDH BS
Hygiene Consultant McKenzie Management

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You have root planed your existing or new patient and had them back for a periodontal re-evaluation and prophylaxis, referred them to the periodontist, and they have refused to go see the periodontist. Now, they need to return for their periodontal maintenance appointment. Educating your patients about the periodontal maintenance appointment has to start immediately.

You have already explained to them, “Mr. Jones, as you know we are still recommending that you go to see the periodontist. However, since you have refused to go, we may want to look at doing the root planing on a regular interval in order to continue to slow down the disease process. This is not the optimum care, but it may help you to keep your teeth longer. There is no guarantee on how long that may be. In the mean time, if you change your mind about seeing the periodontist here is a referral card to the periodontist we recommend. We will now start having you come back in for a periodontal maintenance appointment instead of a cleaning every three months to start.”

The patient may then ask, What is a periodontal maintenance appointment?” There are a couple of ways you may want to answer this question. Of course, it may be different for the existing patient compared to the new patient. Even then you may answer it differently based on how well you know the patient and how each individual patient likes to be approached. This takes us back to utilizing our communication skills. One way you may want to answer is, “Mr. Jones, a periodontal maintenance appointment is for patients, like yourself, that have completed periodontal therapy, (root planing and or surgery). Typically you will require this appointment at an interval of three months, but this can vary depending upon the clinical judgment of the dentist or hygienist. It involves the removal of the bacterial flora from the sulcus and pocket areas. We will review your medical history, and perform a clinical examination that will allow us to compare the new measurements with the previous baseline measurements we took at your first appointment and your re-evaluation appointment. We will then check for decay and probe. After the examination we will determine the best treatment for you that day. The treatment may include, hand and ultra sonic scaling with an antimicrobial agent. Depending on what we see, we may even decide to get an area numb and root plane an individual site. When new or recurring periodontal disease appears, additional diagnostic and treatment procedures must be considered. You will have periodontal maintenance appointments until the health of your gums stabilizes. If you continue to improve and your condition stabilizes, we may be able to extend the amount of time between visits. However, if your periodontal disease should relapse, further periodontal therapy may be necessary. Over the years we hope our professional care coupled with your good homecare will allow your immune system to become strong enough to keep the destructive germs under control. Our goal is to help you achieve and maintain your oral health.”

Another way to approach an existing patient is to explain to them, “Mr. Jones, now that we have completed the active phase of your interceptive periodontal therapy and you refuse to see the periodontist for further treatment, I am going to recommend you come in every three months for periodontal maintenance appointments. This appointment will seem very similar to what we used to bill as a professional cleaning (1110) however; it is much more involved than a professional cleaning. We are dealing with removing bacteria from the pocket area that has resulted in your mouth and a professional cleaning will not enable us to do what is necessary for the health of your mouth.”

In a future article, we will talk about the perceptions of the patient and how to change their perceptions of what is being done.
In addition to verbally reminding the patient after treatment is done what the next step is on their treatment plan, it is recommended that, when you send the patient their invitation style notice in an envelope reminding them of the need for a periodontal maintenance appointment, enclose a brochure having to do with periodontal maintenance appointments. The ADA and Stepping Stones To Success both have very good brochures about periodontal maintenance.

The other place a patient may be educated about your protocol is at the initial consult. When the Financial Coordinator in your office goes over the periodontal treatment plan it is a good idea to have pamphlets or an information sheet explaining the difference between a prophylaxis and a periodontal maintenance appointment that the patient can take home with them.

The final place a patient needs to be educated is when they are actually scheduling their next periodontal maintenance appointment by the Scheduling Coordinator.  That is right, periodontal maintenance appointment, not a prophylaxis appointment.  All of the energy that has gone into educating the patient may vanish if they go to make the appointment and it is called a cleaning appointment instead of a periodontal maintenance appointment. The verbiage must be consistent through out the entire office.

The scripts above are designed as a basis for you to modify and find the conversation and protocol that best suits your office.

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