12.24.10 Issue #459 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

What Kind of CEO Will You Be in 2011?
by Sally McKenzie CEO
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At last, we stand at the summit of 2010. Each of us a year older, and I hope wiser. Some are battle scarred and road weary from the lessons, trials, and tribulations that they have endured over the past year. Others are rejoicing in the newfound opportunities and victories that enabled them to achieve goals and realize long held dreams. While I do believe that each day is the opportunity to begin anew, there is nothing like the final days of December to cause us to take stock of the last 12 months.  And for most, we simply cannot help but consider what we want to change, improve, and achieve in the New Year.

For dentists, success is for the taking, and the opportunities are virtually limitless. You have the opportunity to improve clinically. You have the chance to achieve goals you never believed possible. You have the power to create a team of rock star performers. But most importantly, you have a choice: accept where you are and what you’ve achieved in your career as “good enough” and settle in for more of the same - or take a close look at yourself and what you can do differently to become the leader of your practice and the creator of your success. If you choose the latter, your journey begins with acknowledging your vitally important role as the CEO of your business. It is generally accepted that there are several important factors that impact the success of the dental practice CEO. Below are the top 6:

  1. Credibility
  2. Vision
  3. Communication
  4. Motivate and Inspire Employees
  5. Manage Conflict Effectively
  6. Build a Success-Oriented Culture

Consider the first factor - credibility. Do you walk the walk or merely talk the talk? You insist that your employees be ready for the morning huddle at 7:45, but most days you don’t pull into the parking lot until 7:50 a.m. Your Collections Coordinator is expected to meet specific collection goals, but you routinely undermine her/his efforts by giving “friends and family” discounts. You claim that you encourage your employees to take ownership of their responsibilities, to solve problems, and do what needs to be done. Yet, all the while you are criticizing, second guessing, and micromanaging virtually everything they do. You tell staff that the practice is hurting financially then wonder why they aren’t excited about your flashy new Jaguar.

How about communication - do you communicate clearly and specifically? It is said that some two-thirds of employees do not know their employers’ goals or business philosophy. Open the lines of communication with your team. Express your practice goals and objectives to your staff. Encourage ongoing discussion, feedback, and problem solving from everyone. Communicate your expectations clearly because if you don’t, no one can be held responsible except you when those expectations aren’t met.

Do you have a vision and do your employees know what it is? Vision is the ability to see your practice, not where it is today, but where you want it to be when you're done. If so, share your vision as well as your passion for achieving it. If you see the practice you want in your mind’s eye, and you share that with your team, you can develop the systems and strategies to make the vision your reality.

Motivate and inspire your employees - are you honest with your team and do you provide ongoing constructive feedback? Feedback is protein for your practice, creating high performance energy day-in and day-out. Be generous with your positive feedback, ensure that it is sincere, and if possible, give it in front of others. Be constructive with your negative feedback. Provide it in private and use it as a precise instructional tool in which you are carefully carving out your perfect employee, not as a hammer in which you’re going to smash both the problem and the employee’s self esteem to smithereens. Don’t mix positive and negative feedback. The employee will only focus on the negative and the positive will mean nothing.

Next week - creating a culture for success in your practice.

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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Belle DuCharme CDPMA
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Collection Tactics for 2011
By Belle DuCharme, CDPMA

“I have recently opened my practice and want to know what is the best type of collection agency to use? I have talked to one who will collect for a flat rate per account and I have talked to another who wants 60% of what they collect. What do you think?” 
-Dr. J. Paylater

Dear Dr. Paylater,

Don’t throw good money after bad. If you have exhausted all in-house attempts to collect and have failed, why pay someone else to essentially do the same thing? The collection agencies that work off a commission are more successful, but in the long run very little return is realized either way you choose.

Instead of focusing on who is going to do the job of collecting, now that we have failed, let’s look at how we can create a better system for collection practices to insure practice growth. Is collection success related to practice growth? Absolutely - and here is why that is true. If a patient owes you money, you have lost the patient. Patients do not return to have more treatment until they pay off their current obligation to you. A patient that has paid for services is happier with the outcome than a patient who still owes for the services. Practices that have large accounts receivables have fewer patients to fill the schedule for treatment or recall.

Sending patients to collections can be detrimental to a practice if not done correctly, because it will create ill-will toward the practice. One practice sent everyone to collections whether they owed $30 or $300. The Business Coordinator did not know how to estimate the patient’s co-payments, so she billed the insurance and billed the patient when the insurance paid. If the patient did not understand the reason for the co-payment, there was a delay in receiving the payment. After awhile, the time uncollected went from 30 to 90 days and more, and the Business Coordinator sent the accounts to collection.

The impact of this activity is not as negative if the practice is getting 30-50 new patients a month, but if it is a smaller practice with 15 or less new patients a month, the loss of patients that owe money can severely affect the profitability of the practice. Sending out a copy of the explanation of benefits along with the statement will increase cash flow more than just a statement with a balance due. It is far easier and more acceptable to collect at the time of service than to send a statement later.

Another important factor to consider is the good-will of the practice. If a patient owes you money, they are less likely to refer a friend or relative to your practice. If this patient is sent to collections, they are more likely to warn their friends and relatives about your practice. As unfair as this is, it is human nature to want to defend ones actions.

If you have been openly defrauded by a patient and this patient has skipped town with no forwarding address, then send them to collections. For patients who still live and work in town and are having a tough time, work something out with them until they get back on their feet. If a patient still owes for a co-payment but their recall services will be covered, then invite them back into the practice with the understanding that they make a payment toward the co-payment as best they can. You will keep these patients and still get paid for recall services. 

The best prevention is to calculate and collect all co-payments and deductibles at the time of service. Understanding the patient’s insurance plan benefits before they come in for treatment and being able to give them a printout showing the information that you obtained about the plan will be appreciated. If they don’t like what they have, they can contact their HR department or the insurance company before the treatment is rendered. In this credit sensitive time and with so many people struggling, take the time to consider the impact on the practice and on the people being sent to collections. Try sending a letter in a different color envelope that says something like this:

Dear Patient,

Your account has been red flagged by our accountant. I have sent you many statements and have called you with no response. I don’t want you sent to collections where you will be reported to the agencies that will affect your being able to buy a car, rent an apartment or even get a job. This report will be on your record for seven years.  So please pick up the phone today and call to set up a payment plan with us.

Bette, Business Coordinator

For more training on how to create better business systems for your practice, call McKenzie Management today and start the New Year off on a positive note.

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

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Nancy Caudill
Senior Consultant
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I Only Want My Teeth Cleaned!
By Nancy Caudill, Senior Consultant McKenzie Management

I think that every dentist should put this “wish” somewhere near the top of their “wish list” - “I wish that all my patients will accept and pay for ideal dentistry!”

Wouldn’t that be great? You go to dental school to become a dentist for several reasons, not in any specific order:

  • Be your own boss
  • Own your own business
  • Make an above average income
  • Help peoplemailto:info@mckenziemgmt.com

How can you help people when they dictate to you what they want? It is time for a reality check. 99.5% of dental patients don’t die as a result of refusing the perfect dental care. OK - there is the concern of certain bacterium that enters the bloodstream from neglected periodontal or other dental needs. But in general, dental treatment is not like “life or death” surgeries that patients undergo to treat medical issues.

80/20 Rule
This is nothing new to you. 80% of your treatment is performed on 20% of your patients.  Does this mean that the 80% that don’t accept treatment are “bad” patients? Absolutely not. We already know that the goal for your Hygiene Department is to retain 90% of your active patient base. This means that if you run your recall report for the next 12 months for patients with and without appointments, an average of 90% of those patients should come back or they are replaced with new patients. How do you handle those patients that don’t accept “ideal” treatment? Let’s start with the patients that need periodontal therapy.

Failure to accept Periodontal Therapy
It is recognized that I am treading on philosophical territory. My purpose is to give you a different version of the “I just want my teeth cleaned” response.

Here is the story:

Mr. Jones calls to make his “New Patient” appointment. It goes like this: “Hello, this is Bob Jones. Are you taking new patients?” Now, we have no idea why patients ask us this because we are ALWAYS taking new patients! “I would like to make an appointment to get my teeth cleaned.” Did you hear him say that he wanted to make an appointment for Scaling and Root Planing?  No.

A few days later (and I hope it is a few days opposed to weeks) Mr. Jones is greeted by your wonderful hygienist. She conducts her very thorough periodontal charting and “pre-assesses” that Mr. Jones MAY have Type II periodontal disease, with the understanding that you will make the diagnosis. Your hygienist continues to educate the patient about his potential disease and how it can be treated. “I understand,” Mr. Jones responds, “but I only want my teeth cleaned”.

Now what? Where do you go from here? Does she “clean” his teeth after your confirmed diagnosis, or dismiss him because he didn’t accept the treatment plan? And to make matters worse, he has several areas of decay that will require crowns.

Give the Patient What They Want
Bear with me… Mr. Jones is referred to you by a wonderful patient. Mr. Jones is not demanding or argumentative. He simply is expressing what he wants - he wants his teeth cleaned. The most important first step to a long relationship with any patient is to listen to what they have to say and attempt to accommodate them. Let’s play out this conversation from a marketing standpoint.  The point being to develop a rapport with Mr. Jones in hopes of “winning him over” as well as making his friend look good for referring him to you.

Your hygienist Suzie, in her expert manner, expresses her concern with Mr. Jones regarding his request to “clean his teeth.” In an effort to give him what he wants, she acknowledges his wishes with a caveat - “Mr. Jones, I understand your reluctance and I am willing to compromise with you as long as you promise me that you at least acknowledge that you have gum disease, but have elected not to treat it today. Is that a deal? In that case, I will do my best to “clean” the areas of your teeth above the gum that I can reach. With your permission, we will re-visit this when you come back next time, okay?” Mr. Jones is a happy patient. His wife insisted that he get his teeth cleaned… and he did!

And, he also returned for the 3 crowns that he needed. Suzie made a note in his clinical record that Type II periodontal disease was diagnosed, but the patient elected not to continue with SPRs and only wanted his teeth cleaned.

What Happens If You Don’t?
Let’s play this scenario again with a different approach. Mr. Jones is informed by you that he has periodontal disease and he indicates that he only wants his teeth cleaned.  Suzie discusses with the patient the consequences of not accepting periodontal treatment and Mr. Jones still declines. Suzie indicates that she can’t just “clean his teeth” - she can only treat his disease. He leaves the office without scheduling an appointment for the crowns, or the SRPs. He has nothing good to say to his friend about you, because all he wanted was his teeth cleaned and you wouldn’t do it.

Getting to “Yes”
Very often patients need to hear their diagnosis more than once before they say yes.  Patients need crowns more often than fillings, but you are willing to compromise and do the filling. Consider the same situation for your new or existing patients with periodontal disease. With proper education, a signed refusal form acknowledging that they know they have the disease but prefer not to be treated, some day in the future, they may say yes!  Keep them in your practice and give them the opportunity to say yes to you!

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

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