7.29.11 Issue #490 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

10 Point Plan for Practice Success - Part 2
by Sally McKenzie CEO

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For some it seems that success comes naturally. I dare say those are the independently wealthy, the few who really don’t have to make the effort. For the rest of us, the overwhelming majority, success requires commitment, focus, and clear action - not just some of the time, but all of the time. Practice success is no different. This is part 2 of my 10 Point Plan for Practice Success. I shared Points 1-5 last week.

mailto:info@mckenziemgmt.comPoint #6: Don’t Settle
It’s your vision and your leadership that will enable you to create your practice - not the hygienist’s, or the business assistant’s, or anyone else’s for that matter. What do you really want out of this career in dentistry? Knowing the answer to that is the cornerstone for every decision you make from here on out.  

Point  #7: Pay Attention
Pay attention to where you are going, not where you’ve been. No one is going to deny that the last few years have presented their share of challenges for virtually everyone. Rest assured that at any given point in anyone’s career, there will be difficult times. There are situations that knock you down, but it’s not just you, it’s your competitors as well. How you handle those challenges defines your success. Stop blaming the economy, the staff, the patients, this or that. Look in the mirror and take responsibility for your success. Then make the commitment to stay focused and develop a clear plan of action, which leads me to Point #8.

Point #8: Get Your Head Out Of the Sand
Solve the problems - stop ignoring the frustrations, the missed goals, the excuses. Lack of accountability in your ranks will sink your ship. I guarantee it. Take specific steps to ensure that everyone on your team is on the same page, namely yours, and knows exactly what you expect. This requires that you take a few key steps:

  • Provide clear job descriptions to employees, so they know exactly what is expected of them.
  • Train new employees, but don’t overwhelm them.
  • Give employees some form of personnel policy manual. This document spells out the office code of conduct, dress code, policies regarding tardiness, overtime, sick leave, office policies and procedures. All employees deserve to know the rules of the game.
  • Give ongoing direction and constructive feedback. Too many practices wait until there’s a problem or crisis before they give staff any feedback.
  • Be specific. Don’t candy-coat the feedback and don’t beat around the bush. Tell employees what they’re doing well and what needs to be corrected. 
  • Know when to cut your losses. And that brings me to Point #9…

Point #9: Know When to Quit
Killing projects, parting with seldom-used or aging equipment, terminating partnerships, firing staff, even dismissing difficult patients for good - these are all things nobody enjoys doing. Yet, they’re critical in cutting yourself from the deadwood that can be holding you and your practice back. They will drain your resources, consume your time, clobber your productivity and stymie your success at every turn - unless you take responsibility and make the hard decisions to advance your goals and create the practice that you desire.

Point #10: Don’t Go It Alone
Running a practice presents a host of challenges. I readily acknowledge that sometimes these can feel overwhelming. But there are a multitude of resources available including local dental societies, other dentists, fellow small business owners, and qualified practice management consultants that can help you at various stages throughout your career. The frustrations and challenges are temporary, if you take steps to address them. I often say that suffering is optional. If you are not happy in your practice, you do have the power to change that - but you have to choose to make the commitment, focus your attention on achieving specific goals, and develop clear plan of action to get there. Give me a call at 877-777-6151 and we’ll begin the process right now.  

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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Carol Tekavec, CDA RDH
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Staff Turnover - Should I Stay or Should I Go?
Carol Tekavec RDH

Many of us know of offices that are constantly in need of staff. These practices seem to have Craigslist and the “Want Ads” on around-the-clock alert. Even with so many job seekers out there, some offices can’t seem to hold on to their dental team members.  What’s wrong?

Red Flag Number One
Office staff need to have defined job duties and priorities. While cross-training is a plus for keeping an office running smoothly, having too many people responsible for the same tasks can create confusion and misunderstandings.

Jean and Susan are dental assistants in Dr. A’s dental office. When a case is designated to be sent to a lab, each assistant is responsible for making sure that the case for the patient she assisted with goes out that evening. When a case comes back to the office, whoever is available logs it in and places it in the proper place; ready for the patient’s return appointment. At least twice a week a crown or appliance patient is listed on today’s schedule and the case cannot be found. A mad search ensues. Often the case is not in the office and no one seems to know what happened or why.

Sometimes the case is discovered to be sitting in the proper place, but no one has logged it in. Staff time is wasted and tempers flare. Finger pointing and blame become the order of the day. Both assistants become resentful of one another and of Dr. A., who is always mad and upset about his lab cases. The discontent filters over to the front office staff, who often get put in the middle. Instead of a calm, professional atmosphere, tension prevails and starts to takes it’s toll. Susan goes home angry on many nights and because of this and other problems at the office, starts to think about looking for another position.

A simple solution to this situation is to designate one assistant as the “keeper of the cases.” When a case is returned to the office, that assistant is responsible for logging it in and placing it in the proper place. Each day that same assistant is responsible for checking the next day’s schedule to be sure that each patient’s case is ready. If one has not come in, the lab can be called to see if it will arrive on time and if not, the patient can be reappointed. One assistant has a job priority of case management, reducing the chance for confusion and problems.  

Red Flag Number Two
Running on time is presented as a priority for the entire office team. The appointment coordinator is given the task of setting up appointments for new and returning patients. Dr. A. has let it be known that he wants the assistants and hygienist to handle appointment times for their patients, and that he doesn’t want to be questioned about what to set up. He considers that the staff is experienced and professional and he should not be expected to direct these types of every-day decisions. Everyone should “know” how long procedures take and schedule appropriately. In addition, emergencies are allowed to be put in as patients call. The result? Most days the schedule does not run on time.

Annie is the full time hygienist for Dr. A.  During a recall appointment, it is discovered that Mr. Patient needs to have a crown on #30 and resins on #8M and #9M. She goes over what Mr. Patient can expect and generates an estimate. She is worried about how much time to schedule for these services because Dr. A. did not specify. He usually wants 90 minutes for a crown prep, but he did not say whether he would want to do #8 and #9 on the prep day, the cementation day, or at a completely separate appointment. 

She would have liked to ask Dr. A. these questions when he was in the treatment room during Mr. Patient’s appointment, but she knows that Dr. A expects her to know how much time to schedule and does not like questions. She guesses that he will want to do the crown prep alone and designates time for that only. When Mr. Patient comes for his appointment, it turns out Dr. A. wants to do #8 and #9 as well. The time allotment is too short, Dr. A. performs the services anyway, and the schedule runs behind.  To make matters worse, Patty at the front desk has scheduled two emergencies back to back after Mr. Patient’s appointment. Dr. A. is already stressed from having too little time for the procedures he wanted to perform, and now must address two emergencies. The schedule runs through the lunch hour. 

Dr. A is annoyed with Annie the hygienist and Patty the appointment coordinator for not putting in appointments correctly. Annie and Patty are unhappy because they feel they are doing the best they can, the patients are unhappy because they are kept waiting and feel their time is not being respected, and Jean and Susan, the dental assistants, are upset with everyone because they have missed lunch again. This situation is repeated several times a week. One day Annie has had enough. She gives notice and leaves for another office she knows is looking for an experienced hygienist.

A solution to this problem would be for Dr. A. to say how much time he wants for the patient’s next appointment, and what he will want to accomplish during that time. If he doesn’t mention it, Annie should feel comfortable asking. While certain time allotments can be expected for certain procedures, there are many circumstances where that allotment might be too little or too much. The dentist is in the best position to make the determination. In addition, first thing each day at least two emergency slots should be designated in the schedule by Dr. A. Now the appointment coordinator knows where to put emergency patients, and everyone knows where time may be a little tight and can help one another.

These are just two examples of why an office might find itself always looking for staff. When issues repeat themselves over and over, team members become unhappy. Practices with revolving doors often experience these types of problems, as well as many others. Conflicts of any kind wear away at office harmony. In addition, constant retraining and integrating new staff costs the practice money. Addressing the causes of conflicts can put the practice back on track. Dr. A. is a good dentist and the team members are competent. They can work together to make the practice a stable and happy place. 

Carol Tekavec RDH is the director of Hygiene for McKenzie Management.  Carol can improve your hygiene department in just one day of training “in your office”.  Interested in knowing more about how to improve your hygiene department?  Email hygiene@mckenziemgmt.com.

Carol is also a speaker on hygiene efficiency and profitability for McKenzie Management. Interested in having Carol speak to your dental society or study club?  Click here

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Nancy Haller, P.h. D.
Leadership Coach
McKenzie Management
coach@ mckenziemgmt.com
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How Much Does Conflict Really Cost?
Nancy Haller, Ph.D., Leadership Coach McKenzie Management

Consider this example. You have two employees whom you are paying $32,000 each per year. Over the past four weeks they have been engaged in a disagreement about who sterilizes more instruments. On the conservative side, they each spend about two hours a week of their time gossiping, recruiting people to one side or the other, planning defenses and navigating the drama. You think this is an insignificant matter and leave it to them to work it out. What started out as a petty issue has gone ‘viral’ and the entire office is now involved. Worse, this petty argument has impacted patient care (i.e. complaints), employee absenteeism, and potential turnover. Not to mention the risk of grievances and litigation. Might be amusing if it’s on a sitcom, but not when it’s happening in your business.

This simple conflict could cost the practice thousands of dollars. Staggering! Dental offices are filled with people who have differences of wants, needs, and expectations. So, of course conflicts will occur. The trouble isn't necessarily the fact that conflict exists. It's how you deal with those conflicts or what happens when they aren't resolved. The impact of unresolved conflict in the workplace can be devastating - to the parties involved, to colleagues and the team, to patients, and to the practice as a whole.

The Consulting Psychologist Press - publishers of the Myers-Briggs and the Thomas-Kilmann Conflict Mode Instrument - commissioned a study on workplace conflict. They found that in 2008, U.S. employees spent 2.8 hours per week dealing with conflict. This amounts to approximately $359 billion in paid hours (based on average hourly earnings of $17.95), or the equivalent of 385 million working days. And that’s not all.

The study found that 25% of employees said that avoiding conflict led to sickness or absence from work. Equally alarming, nearly 10% reported that workplace conflict led to project failure and more than one-third said that conflict resulted in someone leaving the company, either through firing or quitting. Those negatives translate into real financial losses, especially for small businesses.

If an employee uses five sick days a year to avoid conflict, that's a direct cost of over $700 to your practice (calculated using the above hourly earnings), not to mention the cost of covering the employee's missed work (e.g., overtime pay for another worker or hiring a temporary employee). Multiply that by 10 employees and you can immediately see the kind of money drain conflict creates.

Unresolved conflict represents the largest reducible cost in many businesses, yet it remains largely unrecognized. Tension and stress diminish motivation and disrupt concentration. If you’re a ‘wait-and-see’ dental leader, take heed and adjust your belief about conflict.

Whenever people work together, conflict is an inevitable result. Disagreements occur in even the best working relationships. But how you address conflict will either add to or take away from your bottom line. When conflicts are handled well, there’s a positive effect on work relationships. When they are not, these factors can deteriorate.
Conflict in your practice is a high but hidden expense item that is not in your budget. Learn to think strategically about conflict. Team assessments and interventions can resolve workplace conflicts successfully at a fraction of the cost.

Keep the attitude that holding different views is both normal and healthy to a group. Use patience, persistence and good people skills. Model open communication and feedback.  Encourage your employees to acknowledge, deal with, and appreciate their disagreements. Dealing with conflict up front leads to team cohesion and conscious cooperation among your employees, and increased productivity and profitability for you.

Need to resolve conflict in your office? Contact 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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