10.26.07 - Issue # 294 Forward This Newsletter To A Colleague

You Said What?
The Inside Scoop on Patient Communication
by Sally McKenzie CEO
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Wars are won or lost based on its effectiveness. Business arrangements fail or succeed and marriages flourish or wither because of it. Patients will love you or simply tolerate you depending how well you handle this. It’s the one characteristic that can almost instantly distinguish the excellent from the average. Communication. This is the bricks and mortar of every relationship you build with your colleagues, your team, your family, and, of course, your patients.

Today’s dentists have made huge strides in how they communicate with patients. The dental patient is recognized as a partner in the diagnostic process.  And volumes have been written about the importance of handling seemingly every communication situation from phone calls, to written correspondence, to email, to treatment presentations, to collections discussions, to patient financing conversations, to answering tough patient questions. But just when you think you’ve got the perfect script for every scenario, communications snafus come up in the most innocent and unlikely places and among the most well-meaning dental teams. 

Take the “insiders only” dental practices. They socialize together, share joys and sorrows about their children, their spouses, their pets, their hobbies, anything and everything in excruciating detail. The team members, including the doctor, can just sit and chat like old friends out for lunch. But their inside jokes, their “Oh, you had to be there,” conversations and other exchanges leave everyone but “those in the know” out of the loop.

And there’s Mrs. Patient, sprawled out on the chair, just watching these old chums chat away.  All the while, she is thinking, “Are they paying attention to what they’re doing? Is the anesthetic going to wear off before these two get to the last chapter of this epic discussion? I really wish someone would ask me if I need to spit.”  Now don’t get me wrong, good relationships among the team are crucial, but some of you enjoy each others’ company to the point that the patient can feel like an uninvited guest at your private party.

Then there are the teams with the entirely too talkative employees. Without even realizing it, they routinely discuss other patients’ personal situations. They’ll gossip about the doctor, fellow staff, and anyone else. They have the inside scoop on everything and in hushed whispers, they’ll be sure to tell you exactly what’s going on. 

At the other end of the spectrum are the tension-filled offices in which the stress is palpable. Disagreements and conflict among the team is as much a part of the daily routine as cancellations and no-shows. The doctors and staff will argue about specific treatment, how situations are to be handled or not, complain about so and so, and punctuate their exchanges with rolling eyes and frustrated sighs. Patients can sense problems from the moment they walk in the door. They are tuned in to everything that is said or not said, reading body language, and feeling the increasing stress of their own tension and anxiety.

Remember, most dental offices tend to be small spaces and casual conversations or tension filled exchanges can easily be heard in nearby operatories or even the reception area. Even if the patient is wearing earphones and listening to music or the television they may have quietly turned them off.

Always assume the patient can hear every word that is exchanged. Monitor your conversations and discussions and follow some basic rules for professional communication.

  1. Never have a disagreement in front of a patient. It makes the patient nervous and undermines confidence in the doctor and the staff.
  2. If one doctor or a member of the staff needs to discuss treatment with another doctor or another staff member, have the discussion in another room so the patient can’t hear you.
  3. Try not to disrupt the doctor while he is with a patient. The patient should feel like he/she is the most important person in the doctor’s life at that time.
  4. Doctors and staff should always be aware that the patient can see and/or hear you at all times as long as you are in the operatory or nearby hallway.
  5. Always show respect for your team members and other patients whether they are present or not.
  6. Save your personal stories for personal time. When the patient is in the chair, they are the center of attention, not you.
  7. Keep your opinions and “inside information” to yourself.

Next week, stop talking and start listening.

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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Bruce Bryen, CPA
Partner, The Snyde
Group, LLC
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An Employer Sponsored Qualified Retirement Plan.
It's the Best Investment Available For You and Your Dental Practice

The implementation of a sophisticated employer- sponsored qualified retirement plan is one of the most sound methods to generate wealth, ensure financial stability and optimize tax benefits that exists. Whether you have no employees or many, this type of plan will accelerate your contributions because of higher deductibility limits than boiler plate type plans such as individual IRAs. The type of legal structure that you have formed for your dental practice has no bearing on the format of the plan that you decide upon or the contribution level that is generated by the type of plan that you use.

What is the best type of plan for you?

There are only two types of plans available.  They are the defined benefit plan and the defined contribution plan. Of course there are many variations of each, but by definition, these are the only two plans in existence. Defined benefit plans are very complex and sophisticated but can be customized to your individual needs. This type of plan offers tremendous tax advantages such as an incredibly quick and large generation of deductible contributions and can be used as an effective tool in a pretax dental practice acquisition. The effective savings in this type of purchase can amount to hundreds of thousands of dollars for the buyer and the seller of the dental practice. Amounts paid into these plans tend to be larger amounts than those paid into defined contribution plans and therefore the balances tend to grow to larger sums on a much faster pace than those in the defined contribution plans.

Defined contribution plans restrict the employer or employee contribution level and these plans are less complex than defined benefit plans. Examples are 401ks, simple IRAs and profit sharing plans. Contributions and accumulations of wealth generally tend to grow less quickly than those available in defined benefit plans because of the restrictions in funding levels. These restrictions are based on percentage of salary levels and fixed levels of contributions based on amounts that cannot exceed certain published IRS guidelines.

In either type of plan, the employer’s contributions are pretax, your money is protected from creditors and you maintain control, if you wish, over all investment decisions concerning the funds generated by the contributions to the plan and the earnings on those funds.

The type of plan that one chooses is based upon a number of factors such as age at implementation, years of service in the practice, annual income and overall debt and asset diversification structure. Sometimes more than one plan is effective for an employer who may be interested in maximizing the contribution and growth level of the plan(s). Many dentists spend a great deal of money on attorney fees in order to create elaborate asset protection devices such as family limited partnerships and irrevocable trusts. Those legal structures do not offer the tax deductibility provision that an employer-sponsored qualified retirement plan affords. The irrevocable trust also does not offer the control of the investment fund available to the trustees (dental practice owner) of the employer-sponsored qualified retirement plan. Especially important to the practicing dentist is the ability to use the retirement plan for the explicit purpose of providing an opportunity for a prospective buyer to pay pretax dollars to acquire the dental practice and allow that buyer the ability to buy at a lower net cost for the acquisition. Of course this method allows the seller of the dental practice to have a much larger group of buyers available for the ultimate sale of the dental practice. It certainly makes it easier for a seller to transition the practice to a buyer. This is an exciting concept that creates hundreds of thousands of dollars in savings to the buyer and the seller.

An experienced professional advisor familiar with your practice and your personal financial position is in an important position to establish your ability to understand the guidelines that must be followed in the creation of this important vehicle for use in creating wealth through pre tax savings and also in affording the opportunity for a larger than normal pool of buyers for your dental practice. An advisor who has knowledge in the world of dentistry will have the ability to engage an actuary on your behalf for the formal approval from the IRS of the right retirement plan for you and your practice. Those with experience can design the plan that fits your needs and complies with all IRS regulations.

Meet with someone with experience in advising those in the dental world. Find out what you are missing and begin implementation of the best investment available for you and your dental practice.    

Bruce Bryen, CPA has successfully assisted dentists with their personal and financial matters for over thirty years. As a partner in The Snyder Group, he delivers creative strategies and prudent financial strategies to help dentists build and protect wealth at every stage of their careers. His extensive expertise includes financing, debt restructuring, retirement planning, and tax advising to help dentists keep more of what they earn.  He can be reached at bbryen@snydergroup.net. 1-800-988-5674.

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Dr. Nancy Haller
Dentist Coach
McKenzie Management
coach@ mckenziemgmt.com
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The Five (Dys)Functions Every Team Faces

How would you respond if I said, “Tell me about your Team”.

It’s likely that you’ll list the specific job categories in your practice (i.e. number of clinical and administrative staff) and/or the names of your employees.

However, I didn’t ask about the composition of jobs or the identity of individuals in your office. I asked about your “Team”.  You might say,

  • 'A sniveling group of complainers who are overpaid and still dont do the job right. They constantly have little tiffs with each other. Reminds me of junior high school. If I could, Id replace them all.'

Or would you give the following description?

  • Everyone on our team makes an important contribution to the practice. By addressing issues openly, honestly and respectfully we gain trust with each other. We work together to accomplish our goals and we dedicate ourselves to the needs of our patients. We make a difference in every smile. And we better ourselves by relaxing, having fun, supporting each other and being accountable for our actions.

These examples certainly are extremes yet they highlight a Gestalt Psychology principle: The whole is greater than the sum of its parts. A team is not just a group of individuals. A team is what happens between individualshow they communicate, work together, and support one another toward a common goal.

Successful teams have better results because the combined knowledge and skill set of the group surpasses that of any one individual. Consequently, strong dental teams get more done in less time with less cost. This is a HUGE competitive advantage.

Despite the benefits, good teamwork is hard to achieve. It requires courage and discipline. After all, teamwork is about individuals setting aside their needs for the good of the whole.

The book, Five Dysfunctions of a Team, continues to be highlighted on The New York Times, Business Week, Wall Street Journal and USA Today best-seller lists for good reason. In this leadership fable, author Patrick Lencioni illustrates the importance of strong teamwork. Here are the five functions that every team must address if it wants to succeed.

Build Trust
Trust is the foundation of teamwork. On a team, trust is about vulnerability. Building trust takes time, but the process can be accelerated. Like a good relationship, trust must be maintained and fine-tuned over time.

Master Conflict
To resolve differences requires direct and respectful communication. It is only after trust is established that teams are capable of engaging in constructive and sometimes heated dialogue. In dental offices where team members do not address important issues directly with one another, valuable energy and time are wasted with bickering and griping. Patient care suffers and so does your bottom line.

Achieve Commitment
Commitment requires buy-in and clarity. It is only when teams learn to handle conflict constructively that they can come to agreement on the most important practice goals and objectives. Commitment also means honestly supporting one another and the decisions of the team. Clear direction combined with unified effort yields accountability.

Embrace Accountability
When a team establishes trust, successfully resolves conflict, and honestly commits to a clear plan of action, the group will become responsible for itself. Team members willingly remind one another when they are not living up to the standards of the group. Accountability on strong teams occurs directly among co-workers. Of course the dental leader must model a willingness to confront difficult issues.

Focus on Results
When everyone is focused on collective goals, the business thrives. Egos, personal career development, money and departmental desires become secondary to the primary mission of the team.

The first step toward solidifying the individuals in your office is to determine which of the five areas you need to develop. Start with the most basic and build on that. The rewards are plentiful. Functional teams dont get bogged down by personalizing or blaming. The team avoids wasting time talking about the wrong issues and revisiting the same topics over and over again. Functional teams make higher quality decisions and accomplish more in less time and with less distraction and frustration. Finally, satisfied employees rarely leave offices where they are part of a larger goal and a cohesive team.

Does your team need to function better? Email Dr. Haller @ coach@mckenziemgmt.com

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

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