10.30.09 Issue #399 Forward This Newsletter To A Colleague
Asking for Your Help
Past Due Recall Report
Dental Practice Surveys

Dear Subscriber,

Each week over the past six years, I have written this newsletter to offer tips and guidance for you on a multitude of practice management topics. I have never requested anything in return, until now. Today I am asking you to help someone very close to me, my friend Risa Simon. Risa is in need of a kidney transplant and she’s having a difficult time finding a healthy blood type O donor. Through the power of this newsletter, I am able to reach thousands of individuals, all of us having the common bonds of dentistry and a sincere desire to help others. 

Kidney Kinships

Many of you may know Risa. She has spoken nationwide to dental groups throughout the country. She is one of dentistry’s leading experts on OSHA, ergonomics and operatory efficiency. Risa is a bubbly and passionate individual, and over the years we have devoted our lives to helping dentistry.  We both started our consulting careers as assistants doing time and motion studies in the treatment room. While we may have begun as competitors, as our speaking engagements intertwined, we eventually met and became “sisters.” 

Risa has hereditary polycystic kidney disease, which has already squelched 80% of her kidney function. This genetic disease has no treatment or cure. Only a kidney transplant or dialysis will sustain Risa's life. And while dialysis is designed to preserve life, it can be debilitating, demoralizing and extremely restrictive. Be it tethered to a machine in an outpatient setting three to four hours a day (three times a week), or exchanging fluids several times a day (every day) at home, the task is arduous to say the least. So while dialysis may seem like it's a viable option, experienced users have said that it feels like it's only postponing their death. 

Risa needs a kidney. Blood type O donor needed.

Right now, in addition to my friend Risa, there are more than 87,000 people waiting for a kidney. On average their wait for a deceased donor is five years. Yet almost any healthy individual can donate a kidney at any time! I am hopeful that Risa can receive a kidney transplant - before she is forced to go on dialysis. Transplant recipients can live a normal life with very few restrictions.

Will you please help me inspire good-hearted individuals who are already seeking extraordinary avenues to serve humankind to step forward on Risa's behalf? Perhaps you, personally, would like to help Risa but are concerned about the cost. I am pleased to tell you that her medical insurance will pay all medical expenses at Mayo Hospital in Phoenix, AZ.

You’ve wanted to make a powerful and profound impact on this world for many years. Learn what you can do to help Risa and others at www.kidneykinships.org, or contact me or Risa Simon directly at risasimon@cox.net. There are hundreds of thousands of people already searching for more purposeful service. Becoming a living kidney donor can be life changing for the recipient and the donor, particularly when this selfless gift can be celebrated by both parties. You can also help Risa by becoming a part of her team of advocates.

I am confident that we are just a click away from making an extraordinary difference in Risa’s condition. Please join me in forwarding this newsletter to colleagues, friends and family, and most importantly, please help me to save my friend's life. I truly believe that there is an army of angels – people just like you – who can make this happen for Risa and many, many others. Please do what you can now.

Thank you my friends,

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Help me to help my friend and others like her.

Nancy Caudill
Senior Consultant
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Run This Report It's Critical!

Dr. Jim Carrigan – Case Study #221

Your dental management software program provides you with numerous reports. This article is to teach you about one report that can make or break your Hygiene Department, which in turn, curtails the growth of your practice. This report is called the Past Due Recall Report. If you have seen this report in the past 30 days, good for you!  If you haven’t, then you need to. Dr. Carrigan had never seen this report, and he was concerned because the number of new patients coming into his general family practice dropped from 35 down to 21 in one month.  What he discovered was that his practice was the revolving door- new patients were coming in the top, and existing patients were dropping out the bottom.

Let’s take a look at Dr. Carrigan’s hygiene statistics:

  • Averaging over two 50-minute openings per day per hygienist
  • Perio production was only 11% of total hygiene production instead of 33%
  • Hygiene salary as a percentage of production was 43% instead of 33%
  • All hygiene appointments were booked 3-6 months in advance
  • No pre-blocking for new patients or scaling and root planing
  • No notices were being sent out to patients with or without appointments as reminders

Pre-appointing all Patients
Let’s take this scenario:  Mrs. Jones is dismissed to the Schedule Coordinator to be checked out.  She needs to return for her professional cleaning and exam in six months.  Suzie Coordinator says to Mrs. Jones:  “Let’s go ahead and schedule for your next six month cleaning and check-up.”  Mrs. Jones responds with, “Gosh Suzie, I am not sure what my schedule will be in six months.”  Suzie responds with, “Well, let’s make your appointment and if you can’t make it, it is fine to call and cancel.”  Reluctantly, Mrs. Jones says okay, thinking to herself that there is no way she will be able to keep this appointment but if that is what Suzie wants, okay.

Time is Running Out!

What has just happened?  Mrs. Jones now has an appointment six months from now that she probably is going to cancel, or worse, not appear and fail to cancel. Five months from now, there is a patient that wants an appointment soon but there is no place to put them, since the schedule is full with patients that scheduled six months ago, including Mrs. Jones, who said that she wasn’t sure what her schedule was. Statistically, about one-fourth to one-third of all patients that pre-schedule will either cancel or not show for their appointment!  That’s 2-4 patients per day per hygienist. The problem is, you don’t know which ones it will be until you call the day before or they don’t arrive at all. At the same time – it isn’t the patients’ fault when they plainly tell you that they don’t know what their schedule will be six months from now.

The Solution:  Don’t schedule those patients!  Suzie would respond with, “Mrs. Jones, that is perfectly fine. I understand. The envelope that you addressed to yourself in the hygiene room will be mailed to you about a month before you are due. You can call us then and schedule your appointment at a time that is convenient for you.”

The 12-month Past Due Recall Report
In addition to pre-appointing all the patients, Dr. Carrigan’s office was not sending out reminder notices to their patients with appointments. I suppose he thought that all of these patients were going to remember. How did I know that they weren’t?  The Past Due Recall Report revealed 252 patients that were past due for their recall appointments! What did this mean? If all the patients were pre-appointed at some point, 252 cancelled or failed their appointments and were never rescheduled! That is an average of 21 lost patients a month. Remember that he is now seeing an average of 21 new patients a month so he is “breaking even” at best.

Now What?
Methodically work through the list, reaching out to 10 patients per day instead of trying to contact 252 the first week. If a patient is contacted, the script would be something like this: “Mrs. Smith, this is Suzie at Dr. Carrigan’s office. Dr. Carrigan noticed that we failed to make an appointment for your six-month professional cleaning and exam. He was concerned about your tooth on the upper left side. Do you prefer a morning or an afternoon?” Notice that she didn’t ask if the patient wanted to schedule but rather when they wanted to schedule. This is very important.

Suzie was given the job description of Hygiene Coordinator, so it became her responsibility to maintain the Hygiene Department’s Recall System. The number of openings on each hygienist’s schedule has been reduced to only 1 per day – a big improvement.  Past due recall reports for 1, 2, 6 and 12 months are generated every month and these patients are contacted either by phone, mail, email or all three in an attempt to schedule their hygiene appointments. Dr. Carrigan feels comfortable now, knowing what his monthly patient retention rate was 89% last month, which is close to his goal of 90%.

Please run your Past Due Recall Report for the past 12 months. You may find that you don’t need more new patients, you just need a system to retain the ones that you already have!

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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Belle DuCharme CDPMA
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Survey Says! What Patients Look For in a Dental Practice

If you haven’t surveyed your patients recently or if it has been a year or more, now is the time - before you start the New Year. The recession is still upon us, but recovery is coming and we must determine how we will greet new patient expectations. Patients will be asking for more satisfaction, and have the choice of choosing another provider if your practice does not stack up. Ask patients that come into the office if they will take a couple of minutes to answer your survey and drop the answer sheet into a “suggestion box.” The comments can be anonymous or can be signed; it is up to the patient. Or you can do a more private mail-in survey. There is a patient survey offered on the McKenzie Management website that you can customize to fit your needs. A dental practitioner recently sent me the results of his survey, and the patients in his practice listed the following attributes as most desirable for them in a dental practice:

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  1. Friendly doctor and staff.
  2. Staff that go out of their way to show caring and concern, such as evening post-op calls.
  3. Painless injections or skilled trained staff members that are careful not to poke, stab or drop things on the patients.
  4. Cleanliness and a modern updated look.
  5. A location that is close to home and has ample parking places.
  6. Practitioners who are good with children and who treat them with respect.
  7. Staff that explain the procedures in language that the patient can understand.
  8. Fair and honest fees without surprises or hidden costs.
  9. A dentist that accepts the patients insurance and explains how the insurance works for their situation.
  10. An office that does not keep the patient waiting for long periods in the reception room.
  11. The availability of immediate emergency care.
  12. Payment options so that the patient can make monthly payments.

This list of desired practice qualities should already be part of your practice - and yet from what is observed in some practices, it may be lacking in consistency. From a survey of dentists, it is noted that many dentists do post-op calls to patients in the beginning of their practice career, but later it drops off to sporadic or the task is given to a dental assistant. Some dentists are referred to as “rough” because their technique in giving injections is uncomfortable to the patient, yet little is done to improve their skill.  The same goes for working in the patient’s mouth.  A dental hygienist in one practice got a reputation for being rough and cutting patient’s lips with her instruments to a point that several patients asked if someone else could do their cleanings.

A patient who had received a treatment proposal was dismayed that it changed quite radically when the treatment was begun. She wasn’t informed that there was a good possibility that the two fillings she needed would turn out to be crowns, so she had sticker shock at the front desk and was not able to pay the entire amount. She told the business coordinator that she would continue there as a patient, but she would not recommend the practice to her friends or family. Often doctors want to try to be conservative knowing very well that the tooth will fracture during the preparation. It is better to prepare the patient for the worst that could happen, and then if it doesn’t happen they are happier for the cost to be less than to be more than anticipated.

With fewer people seeking regular care because of the effects of the recession, it is imperative that the dental practice provides the best customer service possible for each patient that walks through the door. If you are designing some of the questions for a patient survey, you may want to consider asking some of the following:

  1. Which staff member(s) give the best customer service?
  2. What can our practice do to improve our service to you?
  3. Would you consider referring our practice to friends and relatives?
    1. If Yes, why?
    2. If No, why?
  4. Are there services or products that you would like our practice to provide to you and your family in the future?

Building positive relationships with your patients creates trust that you are the practice where the patients want to hang their hat for a lifetime. Let the patient know that you care about what they think, and that you will listen to their request to improve your service. 

If you would like more information on McKenzie Management’s Advanced Training Programsto improve the performance of your team, email training@mckenziemgmt.com.

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