07.24.09 Issue #385 Forward This Newsletter To A Colleague
Productive Staff Meetings
Branding Job Value
Improving Cash Flow

Staff Meetings - Worthwhile or Waste of Time?
by Sally McKenzie CEO
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The dreaded staff meeting. That tired business ritual established long, long ago by individuals who undoubtedly had the best of intentions. They likely wanted to educate, inform, communicate, direct, problem solve. Grand and glorious goals those early meeting masters had, how unfortunate that today the staff meeting is generally deemed by many as downright boring. Worst of all, the phrase typically used to describe staff meetings is total waste of time. According to a survey conducted by GroupSystems, which specializes in virtual meetings, the typical staff meeting is 50 minutes long, yet 16 minutes are wasted on inefficiencies. As for chronicling these oh so important gatherings - 59% do not even take meeting minutes, and 68% responded that input from meetings is used rarely if at all. Ouch.

The number one problem: lack of focus. The worst meetings have no plan and no agenda. With a set up like that, is it any wonder the staff meeting too often becomes an exercise in futility. For dental practices, the ritual can quickly turn into a gripe session or group therapy. The doctor may open up by asking general questions about how things are going. “So Mary, how are things in hygiene these days.” Mary responds with, “They’re fine, except I have more cancellations and no-shows than I’ve had in weeks.” At that point it becomes a free-for-all. The entire team starts complaining about the patients who don’t keep their appointments. The scheduling coordinator unleashes her fury.

From there, it’s no longer a meeting but a round-table rant in which team members share their personal anecdotes and imaginary scenarios about what they would like to do to those patients who routinely miss or cancel appointments. How quickly it spirals out of control. The meeting has no focus, no plan, and no hope of being productive. Is it any wonder that the doctor despises staff meetings?

In other cases, the staff meeting is just one more major headache for the doctor. The group gathers and the doctor starts reporting to the staff.  He/she feels pressured to have all the answers and all the details when the staff asks questions. Once again, is it any wonder that many doctors will go to great lengths to avoid staff meetings?

Stopping System Collapse

So the obvious question becomes, why bother with staff meetings? Because, contrary to popular perception, it is in staff meetings that the dental team identifies and solves problems, examines areas of responsibility/systems, establishes policies, presents information, motivates and educates one another, exchanges ideas, and finds untapped revenue streams -  at least that is what’s supposed to happen.

The next obvious question is how do you make that happen in your meetings? First, shift your attitude. Look at meetings not as production losers but as revenue generators. Next, treat meetings as you would any other system. Establish expectations and standards.

In addition to the daily huddle meeting, dental teams need a one to two hour meeting each month for in-depth discussion focused on addressing key practice issues. If possible, the meetings should be held off-site in a conference room with a conference table, and eliminate outside interruptions. Seek consensus from the staff as to the best time to hold staff meetings, and remember that meetings scheduled outside normal work hours should be paid.

In addition, make sure that staff meetings always have an agenda that includes standard items the practice is continuously monitoring. These are all areas affecting the profitability/success of the practice. For example: numbers of new patients, recall patients, collections, treatment acceptance, production, accounts receivables, unscheduled time units for doctor and hygiene, uncollected insurance revenues over 60 days, overhead, etc.

One person – not the doctor – is responsible for compiling and distributing the agenda to everyone in advance of the meeting. However, developing the agenda is the responsibility of the full team. Post the agenda in the break-room or other area where staff will see it regularly and can add items as they come up during the month. Issues that present themselves regularly in the daily huddle but require more involved discussion and analysis should be put on the monthly meeting agenda.

List the most critical issues highest on the agenda to ensure there is adequate time to talk about them. Determine how much time you will spend discussing each matter, avoid getting bogged down on unrelated topics, and insist that team members come prepared to discuss the items listed.

Next week, hold your most efficient staff meeting yet.

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

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In 30 days, you could be depositing more money. What are you waiting for?

Belle DuCharme CDPMA
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Branding Your Job Value in the Dental Office

It is undisputed that millions of people have lost their jobs in this recession and that it is affecting dental production. In some demographic locations, as much as 36% of patients are postponing dental recalls and treatment because of lack of insurance or money.  Layoffs, rare in dental offices in the past, are now possible if fewer patients force the practice to cut back on employees instead of cutting back patient hours.  Showing your employer that you will do what it takes to prevent being a recession statistic means stepping out of the box that you are comfortable in and reinventing yourself by learning new skills or becoming certified in a skill that will be of value to the practice.  

Knowing what is valuable to your employer means creating your own office “brand” so you are the key person that comes to mind to perform that skill. For instance, take the time to learn the dental software program well enough to quickly create and print treatment plans with photos and with the estimated insurance payment and patient participation. This skill is a must have to properly communicate payment options and prevent financial systems breakdown.

Become a “software trainer” of the program in your practice by taking the appropriate training and passing the examination. This will benefit the practice because you will be asked to train existing and new employees. Having the skills to be the best at taking and pouring impressions to insure a precise lab case will make a difference in the outcome of the final restoration. Taking intra-oral photos displaying the old and worn fillings or cracked teeth and open margins helps to get insurance claims paid promptly without resubmitting, resulting in improved cash flow. The team member that becomes known for taking great before and after photos for the treatment presentation book provides the patients with visual displays of the doctor’s best work, and gives patients the confidence to proceed with their own treatment.

Taking the extra time to get patient testimonials for the website or for the case book is another internal marketing necessity that is often overlooked in dental offices because the staff forgets to do it. Brand yourself as the one who will make sure to get the patient’s written testimonial, right when treatment is complete and the patient is admiring their new dentistry.

In one general practice, one of the certified dental assistants became a massage therapist and the practice was able to offer patients neck and shoulder massages for a minimum charge with dental services. This was a wonderful service and a great way for the dental assistant to establish her brand in the practice.

Is there an aquarium in the practice or have you thought of adding one?  Learn how to take care of it from professionals and offer to add the task to your job description. The same would apply to the care of live plants or water features in the office.

Finding ways to cut back on the overhead by comparison shopping for dental and office supplies will add value to your service in the practice and brand you as a money saver. Have a website? Offer to maintain it by learning how to change text, add and delete photos and provide downloadable forms or other features. Keep up to date on the latest way to market your practice.

Don’t have a logo for your dental practice? Now is the time to get creative. Have a contest to design a logo for the practice and have each team member submit a design. You may decide to get some ideas from the patients also. Logos are part of business branding and a way to become unforgettable to your patients. By updating your image you create a new excitement about the practice. Patients, like everyone else, are looking for positive people and businesses during this rough time.

Have a flair for marketing or advertising?  Design an ad with an offer to the patients to come in for treatment. It could say something like: Times are tough for all of us, but there is never a right time to neglect your health by postponing your professional cleaning and exam. To help you out, we are offering $30.00 off any service in our practice for the month of August 2009.

Interested in learning more about establishing your own “brand” and adding value to your practice? Call today for information about our advanced training programs.

If you would like more information on Treatment Acceptance Training to improve the performance of your team, email training@mckenziemgmt.com.

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Free Overhead Assessment

Nancy Caudill
Senior Consultant
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Get paid for what you do!

Dr. Brent Loftin– Case Study #410

Many dental offices are struggling right now with treatment acceptance from their patients. Dr. Loftin contacted McKenzie Management to indicate that not only was case acceptance down, but so were his collections.  Computer reports were generated and the following was reviewed:

Dr. Loftin’s practice statistics

  • Average monthly net collections = $76,000
  • Average monthly net production = $87,500
  • Accounts Receivables not including credit balances = $143,000
  • Accounts over 90 days old = $28,600
  • Over the counter collections = $23,625

Why Are these Statistics Important? A healthy practice should be collecting 98% of “net” production. Net production is your total charges to the patients less any adjustments that affect these charges, such as courtesy adjustments, insurance adjustments, bad debt write-offs, etc. Net collection is your total revenue paid from the insurance companies and the patients, less any refunds or NSF checks that are uncollectible.

Net Collections / Net Production = 98% or better. Dr. Loftin’s is 87%. A healthy practice should have an Accounts Receivable to Net Production Ratio of 1:1 or less. It is imperative that this report NOT include credit balances, as it inaccurately reduces the balance, illustrating a false total. Accounts Receivable / Net Production = 1.0 or less. Dr. Loftin’s is 1.63. Accounts Receivables over 90 days should be 12% or less. Dr. Loftin’s is 20%.

If the A/R Report is generated without the credit balances, the last line of the report should accurately “age” the balances, showing the percentage that is 90 days or more old. Over the Counter Collections – for a family practice that accepts insurance assignment, the revenue that is collected at the time of service should be around 45% of net production. 

To more specifically determine what Dr. Loftin’s practice should be collecting, he divided his total payments less the insurance payments by the total net production.  This reflects the amount that should be collected when the patient is in the office that the insurance does not pay. $23,625 / $87,500 = 27% - should be 45%. With this information, Dr. Loftin is now able to determine that his Schedule Coordinator is not collecting enough money at the time of service. Therefore, it is affecting all the benchmarks mentioned above.

When a practice elects to accept the “assignment of benefits,” it becomes necessary to determine to the best of the Financial or Schedule Coordinator’s ability how much the insurance is going to pay without wasting the time to send a pre-authorization. This step only delays the schedule process with the patient, and think about it, when is the patient going to be the most motivated to schedule a crown? The day they see the large crack on the intraoral camera or two weeks later when you call them with the insurance information?

With this understanding, placing calls or requesting the information from the insurance company’s website is necessary to determine the patient’s deductible, limitations, waiting periods, maximum, etc. Along with the fee that is allowed, if the plan is a PPO, an estimate can be made of how much the insurance will pay.

A Financial Arrangement Form must be completed for the patient’s next scheduled appointment.  This form should include the following information:

  • Patient’s name
  • Services to be completed at the appointment
  • Total fee for the appointment
  • Patient’s expected payment at the appointment
  • Patient/Parent signature and date

This signed form should be scanned or copied and placed in the patient’s chart. An appointment note should be made indicating how much the patient has agreed to pay and a note made in the Guarantor/Account notes in the computer for reference.

When the patient is dismissed to the Financial/Schedule Coordinator for their next scheduled appointment, a review of the procedures, fees and patient’s portion should be reviewed and the FA form should be completed at that time. In addition, the expected amount of payment from the patient should be written on the back of the appointment card as another reminder.

The use of the FA form eliminates any confusion over what the treatment is or how much the patient is to pay at the time of service. The patient also understands that this is only an estimate and once the insurance remits their payment, any additional balance will be requested or a refund check will be issued.  Therefore, when the patient is checked out the amount of payment has already been discussed and the patient understands how much they are responsible for.

Within six months, Dr. Loflin’s A/R was reduced to less than 1x his net production, his over 90 days accounts were reduced to 11% and his over the counter payments were increased to 42%. His collections to production percentage was over 100%, as his Financial Coordinator was now collecting past due balances as well as the appropriate amount from the patient at the time of service.

If you find that you are still staying productive chair-side but the revenue isn’t coming in as it should, look at the above statistics in your office and implement a Financial Arrangements Form for each patient visit. Watch your revenue skyrocket!

If you would like more information on how McKenzie's Practice Enrichment Programs can help you IMPLEMENT proven strategies, email info@mckenziemgmt.com.

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