8.19.11 Issue #493 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Where Do You Rank Among CEOs?
by Sally McKenzie CEO

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A few months back, Barron's released its list of 30 Best CEOs. Naturally, such notables as Apple's Steve Jobs, Jeff Bezos of Amazon.com, and Warren Buffett made the list. Each of these men has led their companies to success in the extreme. Each has been in their respective business for many years, and each is well beyond the early years of their careers.

 I often talk about dentists being the CEOs of their own businesses and the many challenges and responsibilities that accompany that role. For the distinguished gentlemen listed above, they had years to cultivate their skills. After all, for those in the business world, becoming a great CEO is a process of growth and development that takes years to gather the knowledge, skill and experience for. They trudge through their failures and build on their successes to chisel out "greatness" over time.

Dentists on the other hand don't have the luxury of working behind the scenes and fine-tuning their CEO skills over a decade or two. Many are thrown into the role within a few short years of graduating from dental school, and some step into the position immediately with a start-up practice. For those that take the associate route, they are likely learning "CEO" skills from someone who never had any real training in practice management or human resources management and is passing on their personal experiences - for better or worse - from the school of hard knocks.

What does it take for a dentist to become an effective CEO? It is a combination of both tangible and intangible skills, but perhaps the most important is accepting the responsibility of your role as CEO. The old "I just want to do the dentistry" attitude will get you little more than a whole lot of frustration. Once you accept your critical role as the "big boss" a few character traits must be either already present or cultivated, starting with vision.

It is a word that is overused and has been trivialized over time, but the truth remains that the ability to articulate where you see the future of the practice is critical. Otherwise, why should your team care? They are merely going through the daily motions, rather than working toward clear and specific objectives.

Passion - If you do not love what you do, I guarantee that your team and your patients know. Passion is a huge motivator. It is the spark that creates the fire to set and accomplish goals. Seeing your passion for what you do convinces patients to pursue treatment. It excites and encourages your team to achieve the goals that might not have been possible without it.

Openness - Most dental practices are small operations. You work closely with one another and there is no room for backbiting, hidden agendas and the like. It's essential that the CEO of the practice set the tone. Praise openly, establish expectations clearly, and constructively redirect when necessary. Successful businesses are successful because employees understand the vision, are motivated by the passion, and know what is expected.

There are many more, but I believe those three are the foundation for excellence in the practice. However, they will only get you so far. For the truly successful CEOs, it comes down to practical skills and attention to key systems. In the McKenzie Management training program for the dentist/CEO, we commonly work with doctors who simply have no idea what they need to be focusing on in terms of the business side of the practice.

The most tragic situations are with those doctors who wait years to make the call for help. Oftentimes they say that they just wanted to give things time to resolve on their own, which they never do. Virtually without exception, the situations don't get better, they get worse. Why? Because if you continue to do the same thing, the same way, you will continue to get the same result. Production will continue to limp along. Treatment acceptance will continue to be unpredictable. Staff turnover will continue to stymie real progress, and the list goes on.

Next week, the dentist/CEO's #1 concern.

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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Performance-Based Reviews
By Nancy Caudill, Senior Consultant McKenzie Management

When consultants work with dentists, one question is almost always asked…"How do I conduct a fair annual review when I don't know what she/he does?"

What a great question! What we usually find is that there have been no reviews….ever. You as the dentist know that it would be appropriate. It is necessary to give feedback to your employees, and more importantly, they want feedback. One of the most common complaints, if you will, from team members is that the doctor seldom tells me when they do a good job or "I have never had a review and I have been here six years!"

There are two types of personnel reviews. The salary review and the performance review. This article addresses the performance review.

Performance Review
It is important to know that performance reviews have nothing to do with salaries. If you choose, you can combine them if you plan to increase salaries. The purpose of performance reviews is just that - to review the performance of an employee. So, the big question is this: How do you do it?

  • First - you must have specific job descriptions for each of your team members that lists the tasks that are expected of them.
  • Second - each team member must have a full understanding of their job description.
  • Third - they must know that their job performance reviews will be based on their performance relative to their job descriptions.

How do you write a job description? The easiest way is to ask each team member to write her own job description and then you review it. You may add tasks, clarify tasks or reallocate tasks to another team member whom you feel is more qualified.

A clinical assistant's job description would be much different from a schedule coordinator's. A hygienist's would be different from a patient coordinator's job description. Even two assistants that perform basically the same tasks could have a few tasks that vary. For instance, one is responsible for cleaning the traps and the other is responsible for making sure that the trash is removed from the premises at the end of each day.

Keep in mind that when you have overlapping tasks, someone must be ultimately responsible for seeing that the task is completed. The accountability is crucial as the job description is reviewed and the performance evaluation is discussed. Does Suzie make sure that the trash is removed every day? If she is on vacation, does she delegate the task to someone else to make sure that it is performed?

Positions in the business area of your practice have many overlapping tasks throughout the day, but again, ultimately only one person is responsible. They are the one who is held accountable if the task is not performed. Saying "Gosh doctor, I don't know, I didn't do it" is not an excuse when there are job descriptions and everyone knows who IS responsible.

Statistical Information is vital when reviewing the performance of hygienists and the business team. They perform tasks that can be monitored. For example, the hygienist's periodontal procedure percentage can be monitored on a monthly basis compared to a predetermined goal dependent on the type of practice you have. Her total production can be monitored monthly for improvement or no improvement.

For the business team, almost every task that they do can be evaluated based on statistics, such as accounts receivables, accounts over 90 days, outstanding insurance claim $, your daily production, unscheduled time units/day, etc.

In order to be able to conduct a Performance Review, these statistics must be monitored on a monthly basis. The employees must know how well they are doing. They are responsible for their performance when given the tools to perform their tasks. Once these statistics are readily available to the employees as well as you, it allows for a very decisive and fair performance review. Areas of concern can be discussed, additional assistance can be provided so the employee can improve, or maybe you determine that the employee is not the right "fit" for that position. This doesn't mean that they are not a good person, but just that they are not right for the position they are in.

Conduct your Performance Reviews more often for newer employees to help them learn about what you are expecting from them, encourage them and establish another time to review their areas of weakness for improvement. Other employees should be reviewed AT LEAST one time a year! They want to know how well they are doing, and even though it is hard to be critical when they look at you with tears in their eyes, they still want to know how they can be a better employee… really!

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 Management for the Business Coordinator
Belle DuCharme, CDPMA

Dear Belle,

 At the end of my day when everyone else is walking out the door to go home, I am still in the office trying to catch up on closing the day. What can I do to manage my time better and leave on time? 

Betty Business Coordinator

HygieneUpon questioning Betty (names have been changed) about her daily tasks and job description, a time and motion analysis, based on the real time it took to do her tasks to completion was done The following is a recommendation of the priority of her tasks.

Task Management for Betty:
Work-day is 8-9 hours with half hour to hour lunch and no scheduled breaks. Suggested chronological preferences to diminish priority confusion:

  1. The schedule meets the goal for today and all patients are confirmed for doctor and hygiene.
  2. The schedule for tomorrow and next day is to goal and confirmed.
  3. Confirm financial option commitments of all patients scheduled for the next 3 days.
  4. Review accounts receivable balances and outstanding insurance claims over 30 days old. Follow-up on late claims and overdue balances.
  5. Verify insurance benefits for all patients appointed and confirm eligibility for new patients prior to their arrival.
  6. Follow-up on unscheduled treatment and recall with 5 calls per day.
  7. Make 5 calls to inactive patients and invite them back to the practice.
  8. Post mail payments and bulk checks.
  9. Billing and collection follow-up.
  10. Follow-up on staffing issues and verify time sheets.
  11. Close day, balance deposits and print reports.

To save time and money for the practice, it is recommended to use technology to improve systems - such as sending e-statements instead of stuffing and mailing.  E-statements cost about .79 cents each, versus about $5 each for paper mailed statements.

Use the time clock software on the computer so that people can clock in and out with a password. This eliminates errors and omissions in tracking hours, which can cost hundreds if not thousands of dollars overtime. It was also recommended that a software program that confirms patients via email or text be considered to give Betty more time to spend with patients.

It was determined by the time management system that Betty spends an average of 10 minutes per patient on checking in and out.  When you factor in time for phone calls, it is estimated that she spends 5-6 hours of her day just doing these tasks. The above listed priority preferences must be worked into another 2-3 hours, and this leaves out lunch and breaks. If Betty does not carefully manage her time, she will not complete all of her work each day and it will roll over into the next day. It was suggested that she make it a goal to complete the first five of the list above before lunch every day.

The hard to measure factor is the number of inbound phones calls coming into the practice on any given day. Looking at the historical average, it was determined that most calls came in on Monday and Tuesday, so Betty had to make sure to be available and upbeat to receive calls and give the best customer service to current and new patients.

Betty has been called into the back office to help with set-up of treatment rooms and
sterilization tasks. It was recommended that she not be pulled into the back office at all, as it is far more important that she complete business tasks that affect the profitability of the practice.

A computer monitor was in place in each operatory so that the dental assistants and the dental hygienists could set appointments. Scheduling in the back office area eliminates the bottleneck effect at the front desk, and keeps patients from having to wait to get the next appointment. This system also allowed Betty more time to discuss treatment plans with patients and gain informed consent without being interrupted with outgoing patients.

Betty found more job satisfaction with the new organization of her daily tasks, and with careful time management of her daily tasks she was able to get out of work on time.

Want to learn more about making your day more profitable and less stressful? Sign up for a business training course with McKenzie Management today.

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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