3.18.11 Issue #471 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Is It Time To Consider A Raise?
by Sally McKenzie CEO
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As the economic tide slowly turns, employers are beginning to consider if it is time to thaw the salary freeze that the recession forced upon many businesses, small and large. Dental employees, like many workers across the country, have seen their salaries stagnate over the past couple years. The economic state of the union has taken its toll on practices, as evidenced by the recently released Dental Assistant National Board DANB Certificant Salary Survey issued by the Dental Assisting National Board (DANB).

mailto:info@mckenziemgmt.comNationwide, the median salary per hour is $18.50 for certified dental assistants (full-time and part-time) and $16.49 for non-certified assistants. Salaries are up just over 3% for certified dental assistants over those reported in 2008 when the survey results showed the median salary of $18.00. However, that percentage increase is significantly lower than two years before when survey results showed the median salary for certified dental assistants increased to $18.00 from $16.50 per hour, an 8% jump.

As would be expected, certified dental assistants with more experience earn higher wages. Those starting out in the profession with 0-5 years experience make $15 per hour on average. Those working in the field between 16 and 20 years earn $19 per hour. Assistants working in prosthodontic offices earn the highest salaries on average at $21.02. Assistants working in pediatric practices reported the lowest salaries on average at $16.77 per hour. General dentistry assistants came in at $18.18 on average. Dental assistant salaries are highest in the nation’s capital where the average hourly wage is reported at $23. Assistants earn the lowest wages in Kansas where the average rate is $14.95 per hour.

Although the assumption may be that large cities and metropolitan practices must pay more, the survey results don’t bear that out. The median salary for small city or suburb and large cities is $18.47 and $18.50 respectively, a modest difference between the two. Locations described as metropolitan pay $19.00 on average. With regard to benefits, 61% report having a pension/401(k) plan; 56% receive free dental care; 54% receive health insurance; 52% receive reimbursement for continuing education; and 30% report reimbursement for certification or state registration and renewal. The DANB survey results are based on a 17% response, and they were released in the winter 2011 issue of DANB Certified Press.

Certainly, many practice owners have been wrestling with whether they should increase compensation for employees. I recently heard from “Dr. Bill” who acknowledges that compensation for his team members is among the lowest in his area. It has been a struggle for Dr. Bill from day one. He opened his practice in 2008, which is when the worst of the recession began to unfold. Nonetheless, his practice has continued to grow thanks to the insurance plans that he accepts. However, that too is a double-edge sword because he must accept assignment of benefits, which means writing off 45% of his fees annually. Dr. Bill genuinely appreciates his staff, all of whom have stayed with him in spite of the fact that no one, including Dr. Bill, has seen a raise in some time. He sincerely wants to reward his team for their loyalty and hard work. The question is, can he afford it?

Next week, understanding the impact of that “little” pay increase.

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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Belle DuCharme CDPMA
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Should You Be In Charge? Qualifications to Manage a Dental Practice
Belle DuCharme, CDPMA

Dear Belle,

I have been out of the dental field for about ten years and would like to get a position as a dental office manager. Prior to my hiatus I was employed as a dental manager for ten years and thought I was a good one. Upon contacting a dental employment agency, I was told that my skills need to be updated and that the dental office has changed. What is expected from today’s dental office manager?

-Pati Needsajob


Dear Pati,

Today’s dental office manager needs to be savvy in ways that the old school or traditional manager never dreamed of. If you are employed in a small practice of four or less employees, your challenges will be different from those of a multi-doctor and or multi-specialty practice with ten or more employees. The skills you will need are directly related to your written job description,  which was not a standard hiring policy ten years ago. For instance, if you are in charge of scheduling, insurance, financial/collection, supplies for the office and internal marketing, then you are a systems manager not a staff manager. In practices such as this, you would be accountable for your area and the other staff members would be accountable for their work habits and would answer directly to the dentist for any human resource issues.

Today’s dental office manager needs to understand the overhead of the practice and how it directly affects the profitability of the practice. Old school was to fill the schedule holes without any knowledge of whether the practice was paying its bills and growing, or in the red and shrinking. Just showing up regularly and doing your job duties as understood was enough to continue receiving a paycheck.

Analyzing practice vital signs monthly and implementing policies to improve the financial health of the practice is a requirement of a dental office manager. Today’s dental office manager must be able to produce computer reports that can provide the following:

  • Accounts receivable aging reports
  • Unpaid insurance claims reports
  • Demographic reports
  • Practice analysis reports such as Production by Code per provider
  • Recall reports showing scheduled and unscheduled patients
  • New patient reports
  • Referral reports and production per referral
  • Practice goal reports including daily production and collection statistics

Depending on the practice, there may also be other figures that are necessary to make sure the practice is on target for growth. It becomes imperative to be accountable for tracking vital signs on a monthly, quarterly and annual basis, to show trends to recognize successful performance by staff members and to uncover problem areas in the practice before they cause deterioration of the practice.

Managing office systems that require the cooperation of other employees may be part of the dental manager’s job. For instance, the dental manager may have to supervise the work of the scheduling coordinator, seeing that the schedule is balanced and meeting the production goal for the day. Monitoring to make sure recall systems are producing productive hygiene schedules with limited changes and failed appointments is important as well. The dental manager may also be required to become involved in follow-up on difficult customer service issues such as complaints against a staff member or doctor or unpaid billing/insurance issues.

Handling most of the human resource issues may be a large part of a dental manager’s position, as well as scheduling vacation breaks and making sure the office is covered in times of staff illness or other reasons for absence. Hiring full-time or part-time personnel and overseeing orientation and training of these new staff members ensures that fewer errors or misunderstandings occur.

Delegation of tasks to underemployed personnel to see that areas of the practice are not ignored, such as having clinical staff help with reactivation of patients in recall or in unscheduled treatment plans, is often the office manager’s responsibility. Monitoring the website and overseeing changes and updates is a new requirement to today’s dental manager, as well as seeing that updates to the computer software are made and that the rest of the team learns and implements the changes into their daily routine. Being able to email digital images and PDF files to other professionals involved in the treatment of our patients is also necessary for credibility in today’s ever changing technology.

A successful dental office manager understands all practice systems and how they are interdependent upon the viability of the practice, and can be counted on to step up to the plate and take a leadership position if necessary to move the practice in a positive direction. Want to become an exceptional dental manager? Call McKenzie Management today for information on taking our dynamic interactive course.

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

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Frustrated with HIRING the WRONG people? Remove the guesswork. Employee Testing On-Line

Nancy Caudill
Senior Consultant
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You Must Have a Patient Coordinator
By Nancy Caudill, Senior Consultant McKenzie Management

A call came in from a doctor, concerned that their hygiene department was not producing. The doctor had not established a daily production goal for the hygienists, so there was not a way to measure their performance, but it “felt” like they weren’t posting enough charges compared to the rest of the practice. This is not an uncommon complaint from many dentists, and the state of the economy is irrelevant. I have been hearing this for 30 years!

When performing the initial evaluation of our clients, many reports are generated and reviewed. One of the primary reports printed is the Past Due Recall Report. It is not uncommon to see 400-500 names on this report.

mailto:info@mckenziemgmt.comLost Patients
The Past Due Recall Report indicates 450 names for the past 12 months. 450 / 12 months = 37.5 past due patients/month.

The Production Report for the number of Comprehensive Exams shows 350 patients.  350 / 12 months = 29 new patients/month.  This illustrates a potential loss of 8.5 active patients/month.

Lost Days of Hygiene
It is also important to determine how many hygiene days are needed to serve the active patient base of the practice, plus allowing for new and past due patients, as well as appointments for scaling and root planing. If these calculations are not performed at least every six months, the practice could be trying to keep the hygienists’ schedules filled when there are not enough patient appointments to accomplish this.

Patient Communication
It is imperative that patients are contacted regarding their upcoming appointments, as well as contacting those patients that are due but have not made their appointments.  Their appointments must also be “confirmed.” With the technology that is available today in the dental office, these contacts can be made via email, automated phone calls or text messages, as well as traditional communication with mail and employee-placed telephone calls.

There was a day when the attitude of the dental practice was that it is the patients’ responsibility to contact the practice or remember their appointments - no need to “baby-sit” the patient. If you still have this attitude, you either don’t need or want to increase your patient base!

Your Patient/Hygiene Coordinator
So, you ask - “Who is supposed to perform all these tasks?” The Patient Coordinator.  Now, you say - “I only have one business person at the front desk.” Okay, that is fine.  This person wears many hats:

  • Schedule Coordinator
  • Financial Coordinator
  • Treatment Coordinator
  • Insurance Coordinator
  • Patient/Hygiene Coordinator

The role of the Patient/Hygiene Coordinator carries the responsibility of managing the growth of the practice through increasing the active patient base in hygiene. By increasing your active patient base through hygiene, you also increase your “passive income.” It is important to recognize that 50% of your treatment is generated from your hygiene exams. Therefore, the more patients you see on a regular basis, the more opportunities you have for detecting, diagnosing and recommending needed treatment and reiterating outstanding treatment already presented.

Peak PerformanceWhat exactly does a Patient/Hygiene Coordinator do?

  • Maintains the Recall System
  • Implements the 5-Step Follow-Up Recall Program
  • Schedules to a specific daily hygiene goal
  • “Dials for Dollars” when necessary to maintain the schedule and pursue past due patients

The 5 Step Follow-Up Process is a systematic program to manage the patients that are due but not scheduled for their professional cleanings or periodontal maintenance appointments. The steps are as follows:

  1. Notify the patients that are due or have appointments for the upcoming month.
  2. Contact by phone, text or email those patients that are past due for the previous month.
  3. For patients that are 2 months past due, reach out using a friendly and informative letter on your office stationery. Your software should allow for mail merge to expedite this process.
  4. At 6 months past due, the patients should be contacted again by phone, text or email. As well, another letter should be remitted. This letter could include an informative brochure or a special offer.
  5. The final attempt to contact and schedule your past due patient is conducted when the patient is 12 months past due. Should the patient be on a 6 month interval, at this point they have not been seen by your hygienist in 18 months.

The point here is that a systematic protocol must be created to avoid continuous, repetitious and redundant attempts to contact patients. It is about a return on investment of time spent. At some point, it is time to stop the calls and your Patient Coordinator needs to understand when this time is.

When assigning job descriptions to your business team members, this position is the most important. There are no patients to schedule, no insurance claims to follow up on, no checks to post and no treatment to present IF there is a lack of patients in your practice. Think about the value of this position and the consequences if this position is not assigned. The 5 Step Follow-Up Process will never take place, as what typically happens in most dental offices is that the recall report gets “worked” only when there is nothing else to do. What is wrong with this picture?

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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