Manpower, Materials, & Management Make or Break Your Practice
Do you hear the sirens going off in your head when you see the holes in the schedule? Are you heading for the basement because payroll is due and you don’t have enough to cover it? What is happening? You have four front office people to make sure the schedule is “full” and the money is collected. You thought you were safe.
This is a true story from the case files of McKenzie Management’s Advanced Training.Center The names and location have been changed to protect the privacy of those involved.
Dr. Goodtooth and his partner Dr. Grandstand have a beautiful office with all of the latest technology. They have spared no expense for computers and monitors in every operatory, digital x-ray, surgical microscope, intra-oral cameras, and ergonomically correct front office and treatment rooms. They have the WOW factor plus they are in a large city with plenty of opportunities to attract patients.
Dr. Goodtooth, a general and cosmetic dentist is booked solid and new patients have to wait four weeks to see him. He tends to run 15 minutes or more behind because he loves to talk and says that is what patients want from him. The Office Manager, Trudy Lovespeople, says that many new patients do not show up for their appointment and she doesn’t know why. Studies show that most people expect an appointment within one to two weeks of the time they call. They will make an appointment and then call another office and schedule something sooner and then not call you back.
Dr. Grandstand is a periodontist and feels that marketing is to blame for the lack of patients receiving on-going periodontal therapy The current active patient base is over 3,000 yet only a small percent are in periodontal maintenance. On top of that, they have three associate dentists that are on a percentage of production that spend too much time with empty chairs.
Upon examination of the latest reports produced by the software system, it was determined that key systems were in “crisis”. The recall system needed an overhaul and several recommendations were made, including changing from “cutesy” see you in 6 months cards to McKenzie Management’s system of professional cards in envelopes with a reason to return for the professional cleaning and exam. Insurance companies were dictating soft tissue management protocol and the hygienists were not being directed to promote periodontal care. Dr. Goodtooth expressed his concern that the hygienists never used the intra-oral cameras that he had installed “for them”. Dr. Grandstand was put in charge of getting the periodontal program back on track with all hygienists understanding the protocol, using the camera and learning the software.
Even though there were four front office people all with written job descriptions, several systems were in the red zone. The accounts receivables were beyond acceptable range with over 90 days at 45% of total AR when it should be 10% or less. Insurance claim filing was backlogged and no one on the staff knew how to do attachments of digital x-rays and periodontal charts. It was recommended that the software trainer return and also those who know the system are to have a designated time to train other team members.
Overdue collection calls, overdue recall patients, unscheduled treatment calls were being made “once in a while” when someone had time. Trudy expressed her concern that there were time management and absenteeism issues with staff. Trudy was given the direction to redo the job descriptions delegating more responsibilities to her team and instilling performance measurements so that they understood their areas of accountability. Creating daily tasks lists with completion by the end of the day was recommended.
It was discovered that all patients were being checked out at the front office. With the average of six patients coming to the desk to be checked out and six more showing up to be checked in the chaos at the desk was “crazy”. Recommendations were that all hygiene appointments were to be made at the hygiene chair and that all post-op, delivery or phased treatment plans were to be scheduled at the chair by the dental assistants. Financial arrangements were to have been made and any monies due collected by the Financial Coordinator prior to the patient being seated so that the patient did not have to wait at the desk to pay. It was also recommended that the dental assistant was to enter the treatment plan while the patient was in the chair and not have the front office do it at dismissal.
There is a lot of work to be done to get this office where it should be. Don’t wait for “storm warnings” to motivate you to seek help. Call us today.
For more information on McKenzie's Advanced Training for Dentists, Office Managers and front office team, email email@example.com, call 1-877-777-6151 or visit our web-site at www.mckenziemgmt.com
Jean Gallienne RDH BS
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Many offices have morning meetings. The hygienists’ report what is scheduled for the day in relation to their goal as well as their total production from the previous day. This is great as long as everybody in the practice understands what these numbers indicate and the goals for production are being scheduled accurately and are being met.
The daily totals that are given should be determined on the actual amount that is received from the patient as well as insurance companies that pay at reduced fee plans. By monitoring the hygiene department in this manner, it should be more aware of the actual amount the practice receives as payment as well as each hygienist’s actual production per day.
Many hygienists may discover that the practice is not producing nearly as much as originally anticipated. This is because of the insurance companies not paying the entire fee to the practice that he or she thought the doctor was collecting. Many hygienists may also find that they are not actually producing as much as they originally thought. The hygienist should be aware of his or her actual production as well as the production goal is per hour.
Where exactly did the goals come from when it comes to what the practice needs to produce? Did the doctor and possibly a consultant just pull these numbers from the air? Well, that could be the correct answer, but hopefully there has been an evaluation of the practice in order to determine where the goals should be set in order to pay the employee salaries including benefits such as retirement, medical, dental supplies, taxes, office supplies, lab cost, facility expenses, and miscellaneous expenses. All of these expenses represent overhead costs that the doctor must pay before she/he even gets a paycheck. Therefore, establishing budgetary targets based on industry standards are a great way to start. This will also help in setting hourly, daily, monthly, and yearly goals for the doctor and the hygienist.
However, it takes the entire team in order to obtain these goals. The Scheduling Coordinator needs to schedule accurately, the Financial Coordinator needs to collect the money, the Patient Coordinator needs to keep the schedule full, the Assistant needs to keep the doctor on schedule, and the Doctor and Hygienist need to provide the patient with quality care.
When staff members want raises, remember the numbers that are gone over every day at the morning business meeting and the numbers that are reported at the weekly business meeting. Are raises really possible? Have goals been met? This goes back to coming to work, doing your job to the best of your ability. Working hard is not the only thing that determines your salary and raises. There needs to be money in the checkbook in order to write the checks.
The hygienist’s salary should be no more than 33% of his or her production (excluding doctor’s fee.) What exactly does this mean? Let us say that the hygienist is producing $100 an hour on average. In order to stay at industry standard without going over, the most this hygienist should be paid is $33.00 an hour. Even with this figure, the hygienist gets thirty-three cents of every dollar he or she produces.
With that in mind let’s look at a couple of steps that will help build a hygiene department that is a full contributor to the success of the practice.
Hold all employees accountable for their systems. Either they will enable the practice to sail on to bigger and better achievements or they will attempt to sink every effort to improve systems and procedures. Setting goals and achieving these goals are imperative when it comes to the future of the practice, job security, and increases in income.
Interested in knowing more about how to improve your hygiene department? Email firstname.lastname@example.org.
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