3.25.11 Issue #472 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Can You Afford to Give the Team a Raise Yet?
by Sally McKenzie CEO
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In my job, I hear from dentists all around the country. A few have skated through the recession with nary a financial bump or bruise, others have sustained serious financial beatings, and most have fallen somewhere in between. Virtually every dental practice has had to implement some cost cutting measures, and for many it meant curbing salary increases. Now as the economic tide is turning, practitioners are feeling pressure to thaw frozen wages.

mailto:info@mckenziemgmt.comCertainly, we have enjoyed some positive economic news recently, but the question you have to ask yourself is: Are you truly experiencing an economic recovery in your own office? If so, the next step is to consider the true impact of that “modest increase.”  
Dentists often look at a “small raise” and think to themselves, “What’s another buck-fifty an hour? She’s a loyal, hardworking staff member who has stayed with me through these difficult economic times.” That may well be the case, and you may sincerely want to give the raise. Just make sure you make a truly informed decision. Take 10 minutes to conduct an Employee Salary Review.

Here’s why - every increase in salary, no matter how seemingly small and insignificant, has a direct impact on your overhead. The Employee Salary Review is a clear and simple mathematical tool that you can access immediately to determine exactly how much more money you’ll need to collect each month to cover that “itty bitty” increase. To ensure that salaries do not exceed 22% of average monthly collections, which would tip your overhead costs into the danger zone, you must have a plan to increase revenues and balance the impact of the raise. If the team wants to make more money, then the practice must make more money, and every employee plays a vital role in accomplishing that.

Have you developed new strategies to boost hygiene production and treatment acceptance? What steps will you take to increase collections? Is rent going down anytime soon? Can you refinance your practice mortgage? Have you considered loan consolidation to increase cash flow? Don’t fool yourself into thinking that any raise is so small its impact won’t be felt. Without a clear plan to increase revenue, a little raise here and a minor wage adjustment there will come ripping through your profits, and I guarantee you’ll be stunned at the thundering impact.

First, take a look at collections. Make one employee accountable for collecting money, generating accounts receivable reports, and following up on delinquent accounts. Your financial coordinator should achieve daily collections of 45% or higher if you are accepting insurance assignment. If you don’t already have one, establish a collections policy and follow it. Expect full payment at the time of service for all procedures under $200. Additionally, in lieu of extending credit to patients, partner with a patient financing company, such as CareCredit, and require insured patients to pay a portion of their payment responsibility when services are rendered.

Monitor your money monthly. Review the aged accounts receivable report every 30 days. It should list each account with an outstanding balance and date of last payment. Total all monies over 90 days delinquent. The percentage should not exceed 15% of your total accounts receivable. If it does, delinquent account calls need to be accelerated. Reexamine benefits. Offer a set amount for benefits that can be budgeted and controlled by the doctor. Reinforce recall. Delegate responsibility for the recall system to the patient coordinator, and expect him or her to:

  • Establish a short-notice cancellation list of patients that would be willing to come in for treatment before their scheduled appointment
  • Confirm all appointments via text, email, and/or phone
  • Follow-up with patients who have diagnosed but unscheduled treatment
  • Schedule to ensure the hygienist achieves a specific daily or monthly financial goal - at 3x her/his daily wages

Consider your fees. While many practices may have forgone fee increases over the past couple of years, consider if the time may be right for an increase. Under normal economic circumstances, fees should be increased 3-5% each year. If your area is seeing its share of economic improvement, a 2-3% increase may be in order. Overlap patients during just the first 10 minutes and last 10 minutes of each appointment. This will increase income even before fees are adjusted. 

If you feel strongly that you want to raise employee compensation, by all means do so, but conduct a Salary Review so you know exactly how much it will cost your practice. 

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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Jean Gallienne RDH BS
Hygiene Consultant
McKenzie Management
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Is Your Periodontal Therapy Lost In Cyber Space?
By Jean Gallienne, RDH BS

We are going to look at a couple different scenarios that you may want to think about, to know if they are happening in your practice without anybody realizing it.

The office has a new patient come in and the patient insists on getting a cleaning, so the patient is added to the hygienist’s schedule. The hygienist does six point probings and finds that the patient needs four quadrants of root planing. However, the patient is scheduled for a cleaning and the financials have not been explained. The hygienist goes ahead and does the cleaning, the treatment plan is gone over by the financial coordinator, and the patient is scheduled for root planing. The patient returns for the four quadrants of root planing. When they leave, they do not schedule their periodontal maintenance appointment. They request to have a reminder sent to them.

This is great as long as the scheduling coordinator remembers to change the patient’s 6-month prophylaxis recall, which is linked to their continuing care in the computer, to a 3-month periodontal maintenance appointment. Otherwise, there are only two ways that this patient will return for the correct treatment of a periodontal maintenance in three months and not a prophylaxis appointment in six months.

 One is if the periodontal maintenance appointment was actually treatment planned into the computer when the root planing was treatment planned, and a staff member is working the treatment pending that is in the computer. We are not talking recall. The other way is if the software will actually allow the office to link the patient to the three-month periodontal maintenance appointment without the patient actually scheduling it. This may need to be done manually by the scheduling coordinator in the continue care area.

The next scenario is a returning patient that has been coming in every 3-6 months for several years to have their routine prophylaxis. Their mouth has not shown any signs of improving in health, and they refuse to go to a periodontist. So, the hygienist treatment plans four quadrants of root planing and in 3 months, a periodontal maintenance appointment. The treatment plan coordinator enters today’s procedures, the four quadrants of root planing, and the periodontal maintenance appointment into the computer.

It is important with existing patients to specifically treatment plan today’s procedures and the periodontal maintenance appointment in the computer so that the insurance benefits remaining are accurate. Make the patient aware of the increase in the fee that they will be paying, because they are now going to be seen as a periodontal maintenance and not a prophylaxis.

The patient is compliant and has the root planing done. When the patient leaves, the scheduling coordinator goes into automatic and schedules the patient for a cleaning in three months because they forgot to link the patient to a perio recall, instead of a prophy recall.

There are other ways periodontal maintenance appointments may be lost due to the patient not being linked correctly to not only the correct amount of monthly interval, but also to the correct perio recall. This may be the difference of a patient needing four appointments in a year compared to two appointments in a year. This only needs to happen approximately eight times in one year for the practice to lose possibly two days of scheduled hygiene time!

When it comes to lost revenue, if eight patients are scheduled at six month intervals as a prophylaxis, instead of three month intervals as a periodontal maintenance, this will result in a loss of $3104 a year. Looking at your production by provider based on the individual codes is a very good way to see if this may be happening in your practice.

Another way is to run a report that informs you of how many periodontal maintenance appointments you have returning one year from today, with and without appointments. If this number is really low, then your office needs to evaluate the periodontal therapy program they have in place and how it is utilizing the software in your computer.

Another number/report that is interesting to look at is how many periodontal maintenance appointments were done by each hygienist in your practice in the last year. You may also want to look at how much root planing was done and consider how many of those patients should be returning for periodontal maintenance appointments.

These are just a couple of areas where periodontal therapy programs can fall into the cracks of cyber space and be lost in the computer. These are production numbers that should be looked at on a regular basis. If they do not appear correct, then the office may want to look into the systems being utilized in the office and trends.

Interested in improving your hygiene department? Email hygiene@mckenziemgmt.com and ask us about our 1-Day Hygiene Training Program.

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Imprive your hygiene performance one day... in your office

Nancy Haller, P.h. D.
Leadership Coach
McKenzie Management
coach@ mckenziemgmt.com
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How Does Your Team Score?
Nancy Haller, Ph.D., Leadership Coach McKenzie Management

Take an inventory of your team. Do team members openly and readily disclose their opinions? Are team meetings compelling and productive? Does the team come to decisions quickly and avoid getting bogged down by consensus? Do team members confront one another about their shortcomings? Do team members sacrifice their own interests for the good of the team?

Although no team is perfect, the best dental practices constantly work to ensure that their answers are "yes." If you answered "no" to any of these questions, your team may need some work.

Dentistry is a service business. Although you may have excellent clinical skills, your success will be limited unless you have a high performing team. Patient retention and new referrals are dependent on how it “feels” to be in your office. And that feeling comes from how well your team is working together.

A team is not just a group of individuals. A team is what happens between individuals - how they communicate, resolve disagreements, and support one another. Everyone makes an important contribution to the practice. Team members trust each other enough to address problems openly and respectfully. There are minimal distractions from the primary focus, which is meeting patient needs.
Successful teams have better results because the combined knowledge and skill set of the group surpasses that of any one individual. Consequently, strong dental teams get more done in less time with less cost. This is a HUGE competitive advantage. Despite the benefits, good teamwork is hard to achieve. The book, Five Dysfunctions of a Team, continues to be highlighted on the business best-seller lists for good reason. In this leadership fable, author Patrick Lencioni illustrates the importance of strong teamwork. Here are the five functions that every team must address to succeed.   

1. Build Trust
Trust is the foundation of teamwork. In a team, trust is about vulnerability. Building trust takes time, but the process can be accelerated, such as with team retreats. Like a good relationship, trust must be maintained and fine-tuned over time.

 2. Master Conflict
To resolve differences requires direct and respectful communication. It is only after trust is established that teams are capable of engaging in constructive and sometimes heated dialogue. In dental offices where team members do not address important issues directly with one another, valuable energy and time are wasted with bickering and griping. Patient care suffers and so does your bottom line.

3. Achieve Commitment
Commitment requires buy-in and clarity. It is only when teams learn to handle conflict constructively that they can come to agreement on the most important practice goals and objectives. Commitment also means honestly supporting one another and the decisions of the team. Clear direction combined with unified effort yields accountability.

4. Embrace Accountability
When a team establishes trust, successfully resolves conflict, and honestly commits to a clear plan of action, the group will become responsible for itself. Team members willingly remind one another when they are not living up to the standards of the group. Accountability on strong teams occurs directly among co-workers. Of course, the dental leader must model a willingness to confront difficult issues.

5. Focus on Results
When everyone is focused on collective goals, the business thrives. Ego, personal career development, money and departmental desires become secondary to the primary mission of the team.

The first step toward solidifying the individuals in your office is to determine which of the five areas you need to develop. Start with the most basic and build on that. The rewards are plentiful. Functional teams don’t get bogged down by personalizing or blaming. The team avoids wasting time talking about the wrong issues and revisiting the same topics over and over again. Functional teams make higher quality decisions and accomplish more in less time and with less distraction and frustration. Finally, satisfied employees rarely leave offices where they are part of a larger goal and a cohesive team.

Does your team need a coach? Email Dr. Haller at coach@mckenziemgmt.com

Dr. Haller provides training for leadership effectiveness, interpersonal communication, conflict management, and team building. If you would like to learn more contact her at coach@mckenziemgmt.com

Interested in having Dr. Haller speak to your dental society or study club? Click here.

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