8.24.07 - Issue # 285 Forward This Newsletter To A Colleague
OSHA do’s and don’ts
Hygiene Openings
Office Manager?

Do’s and Don’ts When the OSHA Inspector Comes to Call
by Sally McKenzie CEO
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First, don’t panic. Ideally, you’ve prepared for the remote possibility that someday, you may receive a visit from the Occupational Safety and Health Administration. You have protocols in place, necessary records and documentation readily available as well as a designated OSHA safety officer/compliance officer.

Do introduce yourself to the inspector, welcome them, ask what the purpose is, convey concern, and take full responsibility for the practice’s OSHA program. Explain that the practice’s OSHA safety officer will escort the inspector through the practice. Inform them that you are with patients but, if necessary, you will be available.

Do request politely to see the inspector’s identification. Peculiar as it is, there have been cases in which salespeople attempting to sell lighting, alarms, or other equipment have actually posed as OSHA inspectors. So trust but verify, confirm that the person really is an OSHA inspector. 

While the practice is within its rights to refuse to let the OSHA inspector in, most experts do not recommend it. Demanding a warrant may get you another 24 hours, but it will likely buy you more problems as well. Practices can ask the inspector to schedule an appointment. However, they are not required to do so and most likely they will want to complete the inspection at that time. 

Do ask the inspector specifically what is the purpose of the visit and which records they will want to examine. You may be able to limit the inspection to only those areas related to the complaint. If the inspector has a written complaint, ask to see it and copy it for your records.

Do insist that your staff compliance officer stay with the visitor at all times. You really don’t want an OSHA inspector wandering around your practice unsupervised.

Don’t be too friendly. Inspectors are there to conduct government business. They won’t appreciate your efforts to socialize and that includes any offers of food or beverages.

Don’t get nasty. Don’t trivialize the visit. Don’t play the superiority card – I’m a busy doctor and I don’t have time for this. That will get you nowhere.

Don’t speak unless you are spoken to. The inspector has the right to interview staff. However, employees should be advised that they are not to engage in conversation with the inspector unless they are asked a question directly. Staff should be instructed to answer the specific question honestly and stop talking. Keep answers simple, truthful, and stick to the facts.

Don't admit to any violations. Don't agree with the inspector that a hazard or violation exists.

Don't argue with the compliance officer or become defensive. You can briefly explain why you don't agree but don’t push the issue.

Do take advantage of the closing conference. During the conference, the inspector will tell you what areas of the practice are not in compliance and what the practice will be cited for. The inspector will explain your rights for appeal.  At this time, if the inspector finds a violation that you believe is incorrect, you can politely explain extenuating circumstances for the violation, and possibly get it removed. Following the visit, the practice will receive a written report within approximately two weeks.

Do appeal the findings. Most regulatory experts urge practices in virtually every case to appeal the findings because that can significantly reduce the fines and penalties assessed, some of which can be as high as $70,000.

Do check out the American Dental Association’s Regulatory Compliance Manual on CD-ROM. This is a goldmine of information on OSHA and CDC regulations.

Interested in speaking to Sally about your practice concerns? Email her at sallymck@mckenziemgmt.com.

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

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Jean Gallienne RDH BS
Hygiene Consultant
McKenzie Management
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Say What… Another Change in The Schedule?

With the children going back to school, last minute vacations and so much going on in people’s lives, this is the time of year that seems to historically slow down for dentistry. Practices may find openings in their hygiene schedule and doctor’s schedule that they didn’t see in the beginning of the year.

Now is a good time to send a written form of communication to your patients and really concentrate on working the recall system.

One written form of communication that may be sent is a greeting card or letterhead from the office. This letter could have any or all of the following items in it:

  • Remind patients to maximize their insurance before the end of the year.
  • New products or procedures.
  • Introduce new staff.
  • New pre-med protocol.
  • Verbiage about periodontal disease and the commitment the practice has to prevent and slow the disease process down.

When the letter or newsletter is being created by the office, make sure to have it proof read by the entire staff and ask for input. This may be done at a staff business meeting.

Another option is to have a marketing company that specializes in dentistry such as ADA Intelligent Dental Marketing, create a marketing campaign specific for your office. Whether it is a direct mailer, local business flyer, print ads, or a referral brochure they are there to help you with marketing your practice. They can be found at www.adaidm.com

I know the recall system is worked in order to fill open time as it happens, but really ask your self, is it being worked as much as it should be? This is not an occasional job that the hygienist or whoever has time works on occasion or if there is a last minute cancellation. This is the heart and soul of the practice and should be worked on a continuous basis by one person that knows the pulse of the practice and the recall system at all times. Unfortunately this is also one of the most neglected systems in dentistry.

It is recommended that the person that works the recall system be hired specifically to work the recall. We will call this job description, patient coordinator. Their duties may include telephoning patients that are overdue for any professional hygiene service or may have treatment needing done by the doctor. Depending on how big the practice is and how many hours the patient coordinator is working, will make a difference as to what the actual job description involves. However, the number one priority should be the recall system and retaining the existing patient base. With this being the number one priority and having time to perform their responsibilities, they will greatly enhance the growth of the practice.

Even when there are not any openings in the hygiene schedule, overdue patients should be contacted and appointments made for them. At the same time, in order to help increase the people on your ‘as soon as possible list’ (ASAP list), the patient coordinator and the scheduling coordinator should ask every patient if they would like to be called if an earlier appointment becomes available.

The verbiage is very important when it comes to what is being said on the telephone and should be gone over at a staff business meeting. Of course this will continuously be modified until the Patient Coordinator finds the perfect verbiage that seems to motivate patients to make their appointments.

Avoid calling the ASAP list, “the cancellation list” and informing patients that there are always cancellations and that they may be moved to a sooner appointment if the office has one. This is telling the patient that it is appropriate for them to cancel their appointment, and that a lot of your patients do it.

It is much better to say, “Mr. Jones, if we have a change in our schedule would it be all right for us to call you in order to get you in even sooner.” Effective communication and education are an essential part of a well thought out and executed patient retention system.

If the overdue patient is unable to be reached by telephone, then letters will need to be sent by the Patient Coordinator. This letter should be professionally printed on stationery and not photocopied. Letters may be found in our book, Building A Successful Recall System, in addition to telephone retention monitor, and forms that may be used in order for the Patient Coordinator to show accountability for their work efforts.

Having a Patient coordinator in your practice may be priceless even though it may sound like an additional expense for an already overloaded budget. However, once you know the best time of day to call your patients, having a Patient Coordinator come in for even a minimum of three hours a day for three days a week; with a salary of $15.00 an hour, would cost the practice $135.00 a week, not including payroll taxes. Not many recall appointments would have to be scheduled to pay for this salary.

Interested in knowing more about how to improve your hygiene department? Email hygiene@mckenziemgmt.com.
Interested in having Jean speak to your dental society or study club Click Here.

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Belle DuCharme CDPMA
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What Job Duties Define A Dental Office Manager?

Without clearly defined job descriptions and areas of accountability, a title given to a job is up to interpretation.

“Dear Belle,
 I was given the title of “office manager” in a practice that I have worked at for five years as a treatment coordinator. Dr. Gordon (not his real name) wants to take the office to a higher level of productivity with more cosmetic treatment plans. I present all treatment but also have to do the AR and the AP, payroll, insurance and all financial arrangements, answer the phone and do some insurance follow-up.  I have tried to get some help in confirming appointments and follow-up to unscheduled treatment so that I can spend more time with “management duties” but everyone is “too busy” to help.  When I get assertive, the staff goes behind me to the doctor and then he tells me I am too mean.  I find myself running ragged while the rest of the staff including the doctor has long coffee breaks in the staff lounge.  What should I do?  Selina M.

Dear Selina M.,
First, arrange a meeting with Dr. Gordon and define your job description, practice accountability and authority to make decisions that affect the team.  With Dr. Gordon, create written job descriptions for each staff member including yourself. If Dr. Gordon wants you to direct staff in their daily tasks then he needs to formally  give you the authority and inform the staff of his decision.

If you are seeing more than twenty patients a day, working 8 hours a day, you will need another full time person at the front desk. This person will need a written job description with separate, yet sometimes overlapping, job responsibilities to ensure that all systems are being monitored and worked.  The systems often left to chance are unscheduled recall, unscheduled treatment and overdue payments on accounts. Chart audits to reactivate patients should be done on a daily basis yet this job is usually left to someone with “spare time”.  Making just five calls a day makes this job manageable and pleasant.” 

An Office Manager or Business Administrator definition changes with each office.  Some dentists want an office manager who is in charge of recruiting, training and conducting performance reviews of staff.  Being involved with terminating an employee is another role often performed by an office manager.  Another dental practice may not want the office manager to be involved with staff issues at all, leaving those duties to the CEO/Dentist. In those offices, the office manager has front office duties only and is actually a Business Administrator or Business Manager. Her/his duties would include:

  • Set Financial Policies
  • Collection System-Monitor AR –Meet collection goals
  • Telephone follow-up to unscheduled treatment
  • Present treatment and arrange financing
  • Insurance processing
  • Office Correspondence
  • Balance Day Sheets and other Bookkeeping tasks
  • Run Daily and Monthly reports
  • Some banking duties
  • Using QuickBooks or other software
  • Payroll
  • Front Office Supplies
  • Seeing that scheduling meets or exceeds production goals

If the dentist CEO has given the office manager authority to oversee the staff in the performance of daily tasks then he or she needs to take a supportive role toward the office manager when a staff member goes “over” her to get to the doctor.  By explaining to the staff that they must go to the office manager for things like requests for time off or vacation and sick time or other job performance issues.  Many dentists would love to stay out of the sometimes “petty” staffing issues that crop up at any time. Once the authority has been given the dentist must stand firm and not be swayed to listen to “gossip” and be drawn into office dramas.

 An office manager’s duty sometimes includes monitoring operational costs of the practice to keep these costs within industry standards and control total overhead expenditures.  Then again, many dentists do not want any staff member to know the financial details of their business.

The Advanced Business Training at McKenzie Management includes instructions to help you draw up job descriptions for front office staff along with instructions for implementing and monitoring all of the dental office systems that make a dental practice rewarding and profitable.

Clarify today whether you want an Office Manager or a Business Administrator and get professional training today.

For more information on McKenzie's Advanced Training Programs for Office Managers and Front Office, email training@mckenziemgmt.com, call 1-877-777-6151 or visit our web-site at www.mckenziemgmt.com.

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

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