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Dr. Jim Wilkins – Case Study #63
“My schedule is out of control! We are always working into lunch, patients are waiting and we work late. I have to work out of three operatories and I am conducting exams in two hygiene rooms. It makes me tired just thinking about it. I need an associate!”
Dr. Wilkins’ practice facts:
Dr. Wilkins, indicated that he is considering an associate or maybe even a partner, even though it was never his plan to work with another dentist. He felt that sharing the workload would reduce his stress and allow for improved customer service to his patients.
“Dr. Wilkins, it’s important to know that you do have options. You have numerous business systems that need to be repaired in order to get the practice working properly. Let’s refurbish your systems first and then see where you are.’
Dr. Wilkins is assuming that seeing the symptom of being booked out far in advance in his schedule would automatically mean an associate. However, areas such as scheduling and utilization of an assistant, by state law, has to be taken into consideration.
When possible, perform quadrant dentistry for the patients. Longer appointments are more productive than several short appointments. It is also better customer service because it reduces the number of visits for the patients..
Patients should be overlapped on the schedule according to what the assistant can do without a doctor and captured doctor time. The doctor must not be scheduled in more than one treatment room at any given time.
Daily production goals must be established for the doctor and the hygienists based on the practice overhead. By scheduling to a specific goal each day, it reduces the roller coaster effect and allows for productive days every day.
New Patients must be scheduled within one week for good customer service.
Those practices that schedule the new patient for what they are requesting have a higher rate of new patient retention than those offices that schedule the patient for something different than what they requested.
The Orthodontic patients should be scheduled together for time efficiency. Evaluate the amount of time that is taken per week for ortho and then condense this time into blocks of 1/2 day segments at diversified times and days. This eliminates the continual interruptions during the day.
The hygienists need to notify Dr. Wilkins as soon as they have taken x-rays or completed their visual assessment so he can perform his exam anytime while the patient is in the hygiene room. (Please check your state law.) Waiting until the end of the hygiene appointment is not good time management.
Extend his morning schedule until 1:00 to allow for more production prior to breaking for lunch. In many cases, the daily goal can be met prior to lunch. This allows the afternoon to be scheduled with non-productive appointments. However, customer service is the priority should the patient not be able to come in the morning.
In order for the day to run smoothly, it is imperative that Dr. Wilkins meet with the team in the morning prior to the start of the day. This 15-minute meeting allows everyone to review the schedule and discuss any “traffic jams” they foresee. Patient concerns are discussed as well as looking at the production for the previous day and today to see if the doctor and hygienists reached their daily goals. A morning meeting also gets everyone started off “on the same page” and focused on the day.
Two hour monthly meetings gives everyone the opportunity to understand the “mechanics” of the practice. Practice statistics are discussed, such as production, collections, adjustments, outstanding insurance claims, accounts receivables, lab and dental supply expenses and the overall practice overhead for the month. Team members want to be informed of how the practice is doing.
The practice cannot support two dentists with 22 new patients per month. Dr. Wilkins would need to be willing to “give up” some of his production to the associate in order to keep him/her busy. Yes….the associate would be busy initially, helping to “catch up” those patients that are being scheduled four weeks out. But, once the catch up is completed the reality of not enough new business sets in.
After six months of implementing the various changes in Dr. Wilkins’ systems, it was obvious that he would have made a mistake by incorporating an associate into his practice. As soon as his Schedule Coordinator started scheduling to a daily goal and learning how to schedule for Doctor/Assistant time, he took back control of his practice again…and his life.
Dr. Nancy Haller
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The Sun and the Wind made a bet. They challenged each other to see who could get the man to take off his coat faster. The Wind went first and blew fiercely, expecting to strip the man of his garment. However, the harder the Wind blew, the more the man clung to his overcoat. Ultimately the Wind gave up. The Sun smiled, and then warmed the air temperature so high that the man quickly removed the coat himself.
The moral of this little parable is that people don't resist change, they resist being changed. As a dental leader, you will be significantly more successful when you understand change and how to influence it in others.
Leadership is about influencing others…to think differently or to behave differently. It is the ability to consistently gain support for your views and opinions, and to achieve goals through the work of others.
There is no ‘right’ way to influence because leadership is contextual. For example, if there’s a fire in the office, ordering people to the nearest exit is quite effective not to mention necessary for survival. But taking a ‘Wind’ approach just doesn’t work in non-emergency situations. The days of the Do-As-I-Say boss are gone; even the military puts its top ranks through leadership training now. "Command and control" is no longer a way to influence people. If you lead that way, you’ll pay -- literally. You’ll have staff turnover and patient departures because nobody likes that style.
If you’re going to succeed in influencing change, find the carrot and put away the stick. People are motivated for their reasons, not yours. And your ability to understand what drives the people on your team is a key factor in productivity and profitability. If you want an employee to change, you have to help her/him decide the change is in their best interest. Just as the Sun convinced the man to remove his overcoat, you need to influence, not force change.
Influence starts by connecting with your employees. Learn about the person/people you want to influence. Try to understand their perspectives and beliefs. By knowing their concerns, fears and assumptions, you increase your ability to gain cooperation. This also enables you to counter any resistance by pointing out how it will help them. The real benefit in truly understanding their perspective, however, is that you make employees feel valued…and gain loyalty.
Even if you disagree with an employee’s view, acknowledge their perspective. You don’t need to point out the flaws in their thinking even if you can find 10 reasons why they’re wrong. Part of the reason people resist change is that they don’t feel validated or acknowledged.
Once you know more about their issues and you acknowledge their perspective, then – and only then – help them see a different point of view. Talk to them about the differences in your perspectives. Reduce their fears. Build a clearer picture of the future after the change, explaining the parts of it that will be of greatest interest and benefit to them.
Be aware of natural temperaments. Some people are more open and move more quickly to a new approach or system. Others are more cautious. Not everyone will move at the same rate.
Persevere with patience. Give people some time. Let them reflect on what you have asked of them. Give them time to adjust to a new perspective in their mind. By allowing some time to pass you also help them to 'save face' as they start to agree with a change that they had previously resisted.
Successfully influencing others is an invaluable skill you can learn to do more effectively. I assure you that the more adept you are at appealing to the needs of others, the sooner you’ll negotiate your way from confrontation to cooperation.
Stop being the Wind. Start acting like the Sun and help your team to warm up to the idea of change. It’s in your best interest to show them how it’s in their best interest.
To strengthen your ability to influence your team, contact Dr. Haller at firstname.lastname@example.org.