Certification = Practice Loyalty
Jean Gallienne RDH BS
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“Can you offer any advice on how to help a patient accept one hour of hygiene when they have been able to have thirty-minute appointments for many years?”
McKenzie Management does not recommend a set appointment time for every patient. By this, I am saying that the hygienist requests the time that is needed for the individual patient. For instance, when doing an oral cancer exam, reviewing health history, blood pressure, periodontal maintenance, and full mouth series, the hygienist may need more time compared to performing an oral cancer exam, reviewing health history, blood pressure, prophylaxis, and bite wings, or even no bite wings. Therefore, the patient's appointment should be scheduled based on the actual amount of time needed, which is in turn based on how long it takes all of the procedures scheduled for that day.
In order to determine how long the hygienist needs for each procedure, a time and motion study can be done in your office with your hygienist. The procedures should be timed at least 10 times over the next 3 months. Keep in mind that we are looking for the correct time needed for each patient, based on the procedures being done at appointments. For example, the hygienist should be timed on how long it takes him/her to seat the patient, make them comfortable in the chair, introduce him/herself, review the medical history, ask the patient what changes or problems they are having dentally, and prepare the patient for what is going to be done that day based on their needs. Then the hygienist would be timed on how long it takes him/her to take a blood pressure, get x-rays if needed and do an oral cancer exam. Probings will need to be timed, as well as the periodic exam by the doctor if it is done in hygiene, and the actual prophylaxis or periodontal maintenance treatment.
The hygienist will know that the time and motion study is being done in the office. However, it is best if a person other than the hygienist does the timing in order to figure out how much time is needed for each procedure. It is also best if the hygienist is unaware of when the timing is actually being done. This will give a more accurate time for all of the procedures that are performed in the hygienist’s operatory during any one hygiene appointment.
However, if your practice policy is to have the patient scheduled for one hour no matter what, then the patient’s perception of what is being done in that time needs to be changed. For instance, if you have not been probing, then start probing all patients immediately. Explain periodontal disease to the patient, and the need for more time in order to remove all of the bacteria from under the gums. Educate the patient about the latest research when it comes to periodontal disease, and how your office is committed to treating and helping to prevent periodontal disease. Remember to talk at their level, and not use our dental terminology. Do an oral cancer exam and explain the importance of this.
If you are not comfortable with discussing periodontal disease the doctor may want to consider investing in a computer probing system. There are also many other audio media available when it comes to educating the patient. Intelligent Dental Marketing has TreatmentPro, which is a very affordable patient education system.
Our goal is to increase the amount of patients being seen per day, while allowing the hygienist enough time to provide quality care for each individual patient.
Interested in knowing more about how to improve your hygiene department? Email firstname.lastname@example.org.
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Dr. Nancy Haller
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More than any other article I have written for this newsletter, the Aspire to Inspire column generated the most feedback (December 15, 2006 http://www.mckenziemgmt.com/archives.htm)
Dental offices from coast to coast emailed to let me know that the movie activity generated enthusiastic and meaningful discussions in their office. Some dental leaders were especially savvy in facilitating discussions beyond film titles. They were able to evoke ‘teaching moments’ from their staff members. Regardless of the specific film, the most important ‘take-aways’ were the learnings that employees had about themselves, and how those translate into improved performance. Here are just a few examples.
The comments I received underscore the importance of going beyond the simple answers. If you want to be an effective leader, you need to be curious. Have an exploratory mindset. Take an interest in your employees’ comments and actions. What are the themes behind their words and behaviors? And how do those impact your most important practice goals?
You don’t need to have a Ph.D. in psychology to be an inspirational leader. You do need to have an interest in people and a willingness to put aside your beliefs and values to discover those of your staff members. When you connect with employees on this meaningful level, you build trust. Getting people to talk about what’s important to them is powerful in solidifying relationships and team cohesion. Plus it gives you a glimmer into who they are, and what they need for job satisfaction (i.e. longevity and commitment). Those kinds of discussions also give you opportunities to emphasize how those values make the practice strong.
The most beneficial outcome of building trust with and between your staff is that you enable them to engage in healthy conflict. Employees are more willing to disagree, to exchange ideas without reservation, because they know it is safe to express themselves. In those spirited but constructive discussions will be truth, not politics. When there is honesty, it propels the team forward. When there are politics, people argue to win…and everyone, including you, loses.
Find ways everyday to learn about your staff. Facilitate dialogues that move your staff from ‘either-or’ thinking to ‘and’ thinking. The more they expand their perspectives to accept and understand diverse views, the more cohesive they will be as a team…and the more efficient, productive and profitable your practice will become. Here’s another example I received.
The most strident discussion originated from the two assistants who could see no purpose for science fiction type movies. “They have no basis in reality”. Two of the hygienists took exception with this and there was a protracted and vociferous discussion with the assistants from the opposite point of view. I think it will be continuing………
Leveraging relationships into trusting partnerships is the foundation for an effective dental team. As their leader, you must help them to establish trust. Then you need to demand healthy debate. Set the example by modeling acceptance of conflict in real time. For example, when employees disagree, make a comment like, “I am so glad you are bringing this out. Let’s talk about it some more”. Handle conflict with confidence. Be willing to be uncomfortable for the moment. Keep in mind that the discussions need to be about ideas, not personality.
Dedicate time for team building activities. It might be an off-site retreat or just a portion of your weekly staff meeting. Here’s an activity that can enable your team to share, to be vulnerable, and to build a more trusting environment.
Each member of the team pairs up with someone they do not know well. In dyads, one at a time, they finish the following sentence stems about each other.
And congratulations on aspiring to be an inspirational leader!
Create the right environment that sustains profitability through employee commitment.
Contact Dr. Haller at email@example.com.
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