2.4.11 Issue #465 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Put an End to the Ultimate Time Waster
by Sally McKenzie CEO
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It is the most maligned ritual in our modern business culture. For too many, it is viewed as a waste of time and resources. For others, it’s a negative black hole that sucks the energy out of the team. For some, it’s seen as the chance to talk and talk about change, but no real change ever occurs. For a few, it’s merely a social hour. The dynamics of staff meetings are as varied as the teams themselves, but most agree that this routine custom is not nearly as effective as it could or should be. Typically, meetings can’t produce results that satisfy anyone because there isn’t a system or standard established.

Here’s the common scenario: Most of the group shuffles in at the appointed hour, a few others straggle in a few minutes late. Eventually, the meeting begins. Oops, whoever was supposed to prepare the agenda forgot. The group will have to wing it.  Caroline, the business manager, pipes up that she wants to give her report on collections and accounts receivables first because she has to leave the meeting early for an appointment. Caroline begins but is soon interrupted by Jennifer, the scheduling coordinator, who said she heard that the practice down the street raised fees. For the next 15 minutes the group discusses which businesses in town have the highest fees on everything from crowns to oil changes to happy hour drink prices. Caroline has to leave and can’t finish her report.

From there, the hygienist, Joe, reports on production in his area, noting that cancellations and no-shows seem to be fluctuating. One month they are up, the next month they are down. At that point, Ann, the assistant, reminds the group that Jennifer was supposed to develop a plan to fix those holes in the schedule. Jennifer bristles and reminds everyone that her maternity leave threw everything off schedule. She’s just now finding the time to take care of extra duties such as this one. As if on cue, Jennifer’s reference to maternity leave prompts everyone to start talking, sharing stories about the births of their children, their nieces and nephews, etc. Before you know it, time’s up. Once again, nothing has been accomplished.

The doctor silently vows never to have another meeting again. Yet she knows that meetings are critical to sharing information among the team. There has to be a better way, and there is. Staff meetings should be treated like any other practice system - with standards, roles and responsibilities, and expectations for specific outcomes. Too often meetings are called with no specific purpose or objective in mind.

Typically, in the dental office, there are two types of meetings - the daily meeting and the monthly meeting. The monthly meeting should be scheduled for at least two hours. This is the opportunity to review the various systems and focus attention on larger issues and topics that help move the practice toward achieving its goals. That being said, ensuring that your monthly meeting is not a time waster doesn’t just happen. It requires planning and preparation. 

First ask yourself, what is the purpose of the meeting? What is to be achieved before the meeting concludes? For example, the purpose of the meeting is to define what actions need to be taken to address the frequent no-shows and last minute cancellations. You might also have a portion of the meeting dedicated to a quick review of each system/area of the practice. But the key is that everyone goes into the meeting understanding what the purpose is, and they are prepared to help the group work toward that purpose.

Next, identify the specific outcomes that need to come out of the meeting. Ask yourself what must be accomplished before everyone walks out of the room. For example, you and your team have developed an action plan with specific steps to address the issue of no-shows and cancellations. You’ve determined who is responsible for each step, and deadlines have been established.

Knowing your purpose and what specific outcomes need to come out of your staff meetings is essential to improving their effectiveness immediately. But it doesn’t stop there.

Next week, 5 key strategies to keep the team on task and focused during every meeting.

Want more of me? Click here to visit my blog, The Lighter Side, for more Dental Practice Management info.

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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Nancy Caudill
Senior Consultant
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Show Me The Money!
By Nancy Caudill, Senior Consultant McKenzie Management

A call came in recently from a Schedule Coordinator in one of our client’s practices.  Susie shared with me her concern regarding the difficulty that she was experiencing in collecting patient payments prior to their departure. Let’s look at some statistics for this practice to help you see the obvious problems that they are having:

Practice Statistics:
Net Production: $90,000
Net Collections: $85,000
Total AR: $135,000 or 1.5x the net production
Collection to Production Percentage: 89.5%

If you have read enough of the McKenzie Management e-newsletters regarding healthy financial statistics, you know that the AR (Accounts Receivable NOT including credit balances) should be no more than one month’s NET production. You also know that the net collections to net production percentage should be 100% after you factor in the 2% bad debt write-offs.

These statistics were tracked monthly on the practice’s “scoreboard” and the doctor brought these continuing poor performance percentages to Susie’s attention. Susie called for help.

Inform Before You Perform!
This is nothing new to dentistry. The dentist, assistant and/or hygienist always review with their patients what is to be performed that day. Unfortunately, this can be a new concept for the financial team. How can we expect our patients to pay when we don’t tell them how much it is? Let’s walk through a scenario:

Mrs. Jones is escorted to the Schedule Coordinator, Susie, by the Hygienist. The Hygienist gives Susie the routing slip and verbally informs her that Mrs. Jones needs to return for two tooth-colored fillings on the upper left side. NOTE: The decision to schedule the tooth-colored versus a silver filling was decided chairside and not left to the Schedule Coordinator.

Susie now posts today’s charges for Mrs. Jones and generates her insurance claim.  She asks Mrs. Jones IF she would like to schedule her next appointment. Fortunately, she says “yes” and an appointment time is established. Susie bids her good-bye.

What was wrong with this scenario? 

Susie asked Mrs. Jones a “yes or no” question when she asked if she would like to make an appointment. Always assume that the answer is “yes” and move forward. A better question for Susie to ask Mrs. Jones would be: “Mrs. Jones, I have an appointment available with Dr. Brown next Wednesday at 10:00.”  Susie just had a “change in her schedule” for Wednesday and she wants to fill it. If she doesn’t offer it to Mrs. Jones, how would Mrs. Jones know to ask for it? Avoid allowing the patient to control the appointment schedule.

No financial arrangements were made for Mrs. Jones’ next appointment.  Because of this breakdown, it makes it more difficult to ask her for payment on the day that she is treated.

Recommendation:  “Mrs. Jones, you are fortunate enough to have dental benefits that will assist you with your next visit for the fillings. At this time, I am ‘guestimating’ that your portion will be $175. After I hear from the insurance company, if there is any difference, I will let you know. I will write this amount on the back of your appointment card for your convenience.”

Having this discussion with Mrs. Jones now, instead of surprising her on the day of her visit, eliminates the “deer in the headlights” expression that we are so familiar with!  This is a very subtle way of saying to the patient that you expect her to pay at her next visit.

By revealing Mrs. Jones’ expected portion, it also allows Mrs. Jones the opportunity to ask any questions she may have about the amount. She may question the amount. The response by Susie may be, “Mrs. Jones, since it is the first of the year, I have factored in your deductible for you.”

On Check-Out Day
Mrs. Jones is dismissed by the assistant to Susie, the Schedule Coordinator, who also checks out the patients. Susie made an “appointment note” in the computer indicating that Mrs. Jones was quoted $175 when her appointment was made. Now, all Susie has to say to Mrs. Jones is:  “Mrs. Jones, your portion today is $175.  Will you be paying by check, credit card or cash?” And here is the most important part of this presentation:  SMILE as you present this fee to her and continue to smile until she responds. Avoid looking down and mumbling the fee, as though you are afraid or ashamed to tell her.

One of the many “Golden Rules of Dentistry” is this: Whoever speaks next loses! This is a perfect example. After the fee is presented, don’t say a word until the patient does. Otherwise, you will make additional offers… like mailing the payment.

If your patients are not paying at the time of service, it is not because they aren’t reading the sign you have posted at the check out counter. They are not paying because when their appointment is made, no one is informing them how much to be prepared for, and as a consequence, no one is asking them to pay when they check out.

Remember - inform before you perform!

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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Belle DuCharme CDPMA
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Time to Consider Dental Consulting
By Belle DuCharme, CDPMA

Case #3454 Dr. M. Needshelp

Dear Belle,

“I have a small practice that has not been hit by the recession until just recently. I am blessed with wonderful patients who have been here with me for twenty plus years, but lately I have had whole mornings without patients and lots of holes in hygiene. I have had turnover in my practice and in the last two years terminated five employees. The team I have now is great but I still have to monitor their work every minute to make sure it gets done. I don’t do any advertising but I have a website that was designed by a friend and it looks good but needs work and updates. When I put in search words to bring up my practice I am at the bottom of the list. Recently I was quoted a fee to optimize my website and place me at the top on the list, but I thought it to be too expensive. I figure word of mouth is all I really need.

My patients ask me if I am considering signing up for their PPO plan and I say no, I am signed up for one and that is enough. There is a report from the computer that says I have about one thousand active patients in my practice, but that can’t be right, I have been here 22 years. Some patients have left but that is because of the front office person I had here previously who drove people away with her bad personality. The services I offer are fillings, crowns, implants, cleanings, bridgework, and veneers. My fees are pretty fair but I don’t know if I charge too much or not enough. There are a lot of dentists in this area but they are not of the caliber that I am and frankly I don’t know if they are busy or not. I just know that I am not and I am very concerned. What should I do?”  

Dr. M. Needshelp

Dear Dr. Needshelp,

From reading about your practice, there are several systems I would question as to whether they are working to build your practice. For instance, you say you have not been hit by the recession until recently. The effects of a downward spiral don’t just show up, the process started most likely a year or two ago or even longer.

The turnover in staff is not perceived as positive by patients unless you have taken some time to explain that it was for the better of the practice and to improve service to the patients. Patients tend to look at long term, caring staff as a sign that the practice is stable. A change of the entire team can be suspicious to patients.  If you feel that the current team is great, why do you have to monitor their work every minute?  Patients can feel tension and can tell if you are preoccupied with what the staff is doing.  The focus for all the team should be on the patient and their needs. If you have hired your staff with a system that includes job descriptions, performance appraisals and accountability you would not have to physically monitor their every move.

As far as the website is concerned, the updates and changes should be done on a regular basis.  People tend to go to websites first and then call or email your practice. If you do not offer email to patients, you are missing out on a valuable communication tool. Word of mouth is the best way to get new patients, but it is not the only way - and you should not limit access to your practice. 22 years ago, the demographics and psychographics of your practice area were very different than they are now and it is important to know how your neighborhood has changed so that you can continue to keep the patients you have and to attract new patients to your practice.

A big concern for you is that your practice is declining and shrinking. There are several signs that this is evident, but a thorough system analysis by a dental consultant would be the advisable thing to do at this stage of your practice. A hit and miss marketing attempt without a demographic overview of your zipcode would be a waste of money and time. It is important to offer services that meet the needs of your practice community. As your patient base ages and the demographics change from young families to predominately senior residents, you must adapt to this change or market to attract young families from nearby communities.

Dr. Needshelp, you are seeing and feeling symptoms of “system disease.” At this point, you are too close to see the causes. The best thing that I can recommend is to have one of McKenzie Management’s Consultant Coaches come into the pratice to provide you an “action plan” to move forward.  The symptoms have been there, but the recession has brought them to the surface. Call today, 877-777-6151 to speak to one of our experts and start improving your practice today.

If you would like more information on McKenzie Management’s Consulting Coaching Programs to improve the performance of your practice, email info@mckenziemgmt.com

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