Dental Career or Daily Drudgery? You Decide.
Case File #214 - Dr. Lin Wu
After many years as an associate dentist in a general practice, Dr. Lin Wu decided that he wanted to start up his own practice. The decision to leave was fueled by an increasingly hostile environment created by the deteriorating relationship with the owner dentist, Dr. Smith. Dr. Wu had confidence in his abilities to be an excellent dentist and, over the years, had built a loyal following of about a thousand patients that were supposed to be his, according to the loosely drawn agreement with the owner dentist. One last dispute ended the relationship and sent Dr. Wu in a tailspin as to what to do now: accept an offer to join another established practice as an associate, or take the big leap and open his own practice. He chose to open his own practice. The first step was to enroll in McKenzie Management’s Practice Start Up program for 2 days. There was a lot to be done but he knew that he needed the guidance of an expert to make it all come together.
The hunt for a location using a real estate specialist yielded a smaller but doable space within a few miles of his previous practice. Dr. Wu knew the demographics and psychographics of the neighborhood and was pleased with the practice location and availability of parking. Luckily he was within the ruling of the “non-compete” clause in his associate contract and would be able to take his established patient records without too much resistance. He would still be held to the agreement of giving Dr. Smith a percentage of the collections on work pending with insurance companies.
Working out the new lease with the current tenant, broker and landlord was challenging to do quickly and with the same goal in mind. The previous tenant had invested in beautiful flooring, painting and artwork which would be part of the lease agreement. The dental chairs were in very good condition, the plumbing and electrical were installed correctly and with a few alterations, they would be ready soon. Getting the new computers, software, digital x-ray and televisions installed took a team of about ten people from several sources working in tandem or in sequence.
Dr. Wu was able to avoid one of the biggest hurdles facing new start-up dentists. His staff was willing to come with him, understanding that they would not have as many hours or benefits in the beginning. Deciding to go chartless with the new set-up and getting a new software program met with some resistance, but when it was explained to Dr. Wu and his staff how much time would be saved and how much more efficient they would be, everyone was open to learning the new program. So as hammers banged putting up shelves and running cables, the team learned the new software program and prepared to see patients the next day.
Unlike many start-up scratch practices, Dr. Wu had many scheduled patients that wanted to be seen as soon as possible. Would it be possible to work on patients while the office was being built up around them? It was deemed possible but only with the cooperation of an incredible team of people. Much like the television show Extreme Makeover, where a brand new home is built within a week, the process of putting a working practice together required many people to do their jobs quickly and correctly.
Dental supplies started coming in with a parade of boxes and the staff scrambled to organize the work area and put the supplies in containers and labeled shelves so that they could be found without much time lost. Dr. Wu needed a sterilizer, new handpieces, instruments, burs, endo supplies, trash bags, paper towels, drawer organizers, alginate, impression materials, composite materials, etc. The list seemed endless and just when the staff thought they had everything, they were adding more to the list. In the business area, getting the phones set up and the merchant services for credit cards along with getting the sign pad for the health history forms and the credit card receipts took time on the phone doing installations. Signing up for electronic claims and electronic statements involved uninterrupted time on the phone and on the computer.
Within a week Dr Wu and his team were seeing patients. Sure it was rocky and had its challenges, but they made it work. It has now been three weeks and although they are still working through the daily bumps in the road, every day is exciting and fulfilling with the knowledge that teamwork has paid off in creating the start of a dream practice. Want to start-up your own practice? Learn what to do to get started and what not to do to avoid pitfalls by taking McKenzie Management’s Dentist Start-Up Program.
If you would like more information on Treatment Acceptance Training to improve the performance of your team, email firstname.lastname@example.org.
Dr. Barry Bronson – Case Study #216
Dr. Bronson, a general family practictioner was constantly annoyed every day by his team. Not surprising, his team struggled with the same challenges – how to communicate with one another!
What annoys Dr. Bronson:
What annoys the team about Dr. Bronson:
These lists could go on indefinitely from both parties. It was organized chaos in Dr. Bronson’s office. Temperament types indicated that his employees liked organization, following the same protocols daily without unnecessary changes, and a little recognition from him. He was spontaneous, ambitious and always planning ahead for the next move. Different planet, different universe! These annoyances were not “earth-shattering” issues. However, sometimes it is the little things that cause doctors to call and say “Help! My office is out of control.”
Morning meetings – Dr. Bronson and his clinical team would gather in the hall while the hygiene patients were being walked between them to briefly “chat” about the day. The meeting was non-productive and did not completely cover the areas that needed to be covered in order to have an efficient and productive day.
Morning meetings should include but not be limited to the following:
In conjunction with the morning meeting, the hygienists and assistants should have access to their patients’ records for the next day by lunch time in order to have time to review the information prior to the morning meeting the next day.
“Walkie Talkies” could be used by all team members and doctors to improve inter-office communication. Team members were running around the office trying to find other team members to ask questions or share information with. Team members were constantly playing hide and seek with the doctor or each other.
Questions for the Doctor – Many times the team doesn’t realize that the doctor has a lot of clinical concerns rolling around in his mind when he is moving from one patient to another. Catching him in the hall between hygiene patients is NOT a good time to approach him about any management issues, let alone a personal issue. Unless the building is on fire, wait until the end of the day or before lunch to approach him. Doctor, in order to avoid answering yes or no to a question without giving it any thought, I give you permission to respond with, “Susie, I need to think about that. Come to me in the morning and I will have an answer for you.”
Sick! You can’t be sick! – A system was implemented for the team to use when they were ill. The doctor was notified by phone as soon as the team member recognized that they were not going to be able to work. Dr. Bronson’s response was to be, “Susie, I am sorry to hear that. Take care of yourself and unless I hear from you, I will see you tomorrow.” The team member that is sick also contacts her working “partner” to inform them of her condition and fills her in on anything that she might need to know regarding the day.
Dr. Bronson must keep the doors of communication open so the team members don’t feel intimidated by his responses to certain situations. It is also necessary to have a mechanism in place to be able to express concerns without fear of being reprimanded: a suggestion box, whiteboard, etc. Remain open-minded about your team’s concerns and comments. Remember – Men are from Mars and Women are from Venus! Success is when you can all come together on Earth.