1.13.12 Issue #514 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Four Steps for a Successful 2012
By Sally McKenzie, CEO

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Actually, there are several steps that you can take to ensure that your practice achieves the level of success that you desire in the coming year. I wrote about six others last week in what I consider to be the top 10 steps that practices can take in 2012 to enjoy greater prosperity and less stress. Below are the remaining four.

4. Stop Worrying About the Competition
Your problem is not the competition. Rather, your concern should be what you are doing to set your practice apart and deliver superior customer service. Train your team. Most business staff have no understanding of how to most effectively manage new patient phone calls, how to build rapport, how to make the prospective patient feel good about calling their office.  Additionally, rather than worrying about the dentists down the street, go visit them. Walk into their offices and introduce yourself. Check out the interior, pay attention to how staff and the doctors make you feel when you step through the door. If you don't feel welcome there, I can virtually guarantee that their patients don't either. Study your competition, get to know them, and offer to take their emergencies when they are away.

3. Face the Fire
Problem employees will ruin a practice. They need to be dealt with directly using clearly established policies. Work with a professional to create a policies and procedures manual that is specific to your individual practice needs. The manual may cover as many or as few issues as the doctor chooses, but should include the following key practice policies:

  • Equal opportunity statement - This states that the employee's religion, age, sex, or race will not influence hiring, promotion, pay, or benefits in any way.
  • Definition of the work schedule - This indicates that all employees are to be at their assigned work areas and ready to provide care for patients at a certain time.
  • Salary/payment policies - This details when the employee can expect to be paid, how wage increases are handled, overtime, etc.
  • Professional Code of Conduct - This section clarifies the practice's expectations regarding employee dress, punctuality, use of tobacco, alcohol, and drugs, as well as policies regarding personal phone calls, Internet usage, and personal visits.
  • Performance review policy - This section explains exactly how and when employee performance is evaluated, including samples of performance evaluation forms. It may also spell out the practice's policy on progressive discipline and unsatisfactory performance, and it may list those infractions that could result in termination of employment.  
  • Time off policies - This section explains policies on vacation, parental/maternity leave, illness, military, funeral, personal, jury duty, holidays, personal days, etc.

Preparation is critical. Waiting until employee behaviors are so problematic that they are damaging the practice or dealing with issues such as tardiness, family leave, unprofessional conduct, dress code, etc. inconsistently make the dentist and practice highly vulnerable to litigation.

2. Ensure that Patients Understand the True Value of “Routine” Hygiene Visits
Enhance patient perception of the hygiene appointment by explaining the impact of oral health on systemic health, periodontal health, and oral cancer. This increases the patient’s perceived value of routine care. If a periodontal co-examination is performed and the hygienist talks about the results and educates the patient - even healthy patients - they will have far greater appreciation and understanding when you must recommend that they be seen in four months rather than six.

1. Market your Practice
Recognize that effective marketing requires hard work, diligence, and a fully-funded budget. It's more than a few ads or occasional patient mailer. Marketing is an ongoing system, and everyone on your staff is marketing your practice for better or worse in every patient interaction. Effective marketing involves a series of fundamental steps and ongoing commitment. Most importantly, if you want long-term measurable marketing results, hire a professional dental marketing company. Visit McKenzie Management's Marketing Division HERE.

Certainly, running a dental office presents a host of challenges, and ongoing success requires focus and attention to multiple details. While frustrations and setbacks may occur, with guidance and solid, well-constructed business systems, dental practices can achieve unprecedented success. I know this because at McKenzie Management we have seen it again and again. If you believe your practice has greater potential than it is delivering, make 2012 the year that you achieve it. Give me a call, 877-777-6151 or email me, sallymck@mckenziemgmt.com and we'll make this your best year yet.

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 Haller, Ph.D.
Leadership Coach
McKenzie Management
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Want to Reduce Turnover? Conduct "Stay" Interviews
Nancy Haller, Ph.D.

Most people are familiar with “exit interviews.” The purpose is to find out why people have decided to leave. Makes sense in theory. Find out the cause(s) for employee dissatisfaction and fix it. But the traditional approach to understanding turnover is limited because the number of workers who leave represents a small percentage of the total employee population. In the long run, your practice will be more productive and profitable if you improve employee retention rather than reducing turnover.

The logical problem involved with exit interviews is that they give little information about why some people stay. Even in a weak economy, good workers are in demand and can find employment opportunities elsewhere. In fact workforce surveys indicate that 38 percent of employees are actively seeking a new job.

Stay-interviews are a preventive tool in employee retention. By conducting stay-interviews you can proactively address potential issues that impact morale and job satisfaction. In essence you have an opportunity to find out how to retain and engage your best workers. Additionally, stay-interviews enable you to develop stronger relationships with your team…and we all know what that does for engagement and productivity.

There is no secret formula for why people stay. It's just not that easy or exact. In general, the most common reasons are pride in the organization, a compatible and supportive boss, compensation and benefits, meaningful work and opportunities to learn, and affiliation with co-workers.

Still others stay just because they can't leave. Their spouse has a job in the community. They have family obligations. Worse, they have inertia. By conducting stay-interviews you can reinforce positive reasons for staying, and at the same time, make it easier for those who are staying for negative reasons to quit. In the latter case, turnover quality might really improve the things in your office. The point is that all people are different and your leadership goal should be to help each individual to meet their own needs as well as the needs of your practice.

Here is a list of possible questions to incorporate into your stay-interview. The interviews should be conducted with each employee individually over a one to two week period. Choose four or five of the following:

  • When you travel to work each day, what are you looking forward to?
  • What do you like best about your job? About working here?
  • How does working here compare to what you thought it would be like?
  • What is most energizing about your work?
  • Am I fully utilizing your skills?
  • What is it that keeps you here?
  • What makes for a great day at work?
  • How can I make your day better?
  • What's one thing you would like to change about your job?
  • What one thing would make your job more satisfying and rewarding?
  • What is something new you would like to learn this year?
  • Are there things you would like to change about the team?
  • What can I do to be a better boss?
  • Do you feel I recognize you? Value you?
  • What kind of recognition would be most meaningful to you?
  • What might entice you away? What would have to happen for you to consider leaving?
  • What can I do to make you stay longer?

As you solicit ideas from your employees about how to retain them, just listen. No matter what they say, do not evaluate their responses even if you cannot fulfill their wishes. Simply take notes and gather the information. To close the stay-interviews, promise that you will review the feedback and give them a timeline for further discussion. And follow-up no matter what!

There is an old adage that employees don't leave jobs, they leave bosses. Research findings are consistent with this. By conducting stay-interviews you will show each employee that you care about them…and you increase the probability that they will return the kindness. Even if some employees ultimately leave your practice, it won't be because you failed to do what you could.

Find out who wants to stay and figure out what to do with those who have to stay. This kind of information can’t be found in exit interviews. In fact, you may have” lost” many people who are still working in your practice.

Exit interviews tell you why good people are leaving, but rarely in time to prevent their departure. However, a stay-interview is an early warning system that shows your appreciation, identifies ways to reinforce employees' good will, and helps you keep star performers on your payroll vs. on someone else's.

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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Carol Tekavec, RDH
Hygiene Consultant
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Show, Tell, Do
By Carol Tekavec RDH

Communicating with patients can sometimes be a daunting task. We know that we don’t want to use overly technical language; but how do we convey a patient’s conditions accurately without it? We acknowledge that a patient will not commit to treatment s/he doesn’t understand; but how do we help him/her get the big picture? Our patients come to us with widely divergent dental “past histories.” How can we best address their fears and concerns?  And what about explaining fees and insurance limitations? These issues often throw a roadblock into our patient’s accepting our recommendations.

One good method is the “Show, Tell, Do” system. This system provides for using an intraoral camera, or at the very least, a hand mirror, to show patients what we are talking about; a “script” we are comfortable with to explain what we are seeing and what might be done to correct problems, and then and only then, doing the service. Many dentists and staff skip the “show” portion and go directly to simply telling patients what they need. This can be a mistake. If staff skips the “show” segment, a patient may not fully understand why a service is needed; so he may decide to skip the “do” segment!

Let’s look at an example of using Show, Tell, Do. Joan is a new patient who was scheduled for a “cleaning” and exam. When she arrives, Shari, the hygienist, goes over her medical history, performs an oral cancer screening (to be followed by the dentist’s oral cancer exam) and gets the camera ready for photos. This is before beginning any type of “cleaning” service.  As we all know, new patient cleaning and exam appointments bring with them many possible opportunities for misunderstandings.  Why is this? Because until the patient is in the chair, we have no idea if she is going to require a standard adult prophy, a debridement, or is a candidate for scaling and root planing. In addition, we have no history with her so we don’t know what she has been accustomed to receiving in the past.  Does she consider a polish with the prophy angle a “cleaning?” Has she ever had a periodontal probing and charting performed? The camera helps us introduce her to her mouth and lets her see what we see. 

First Shari takes a photo of thick, heavy calculus on the lingual and facial of the lower anteriors, as well as a picture of 3mm recession on mandidular and maxillary bicuspids. She notices that #30 has a large MODFL amalgam restoration and a crack on the mesial surface. She sees that #19 has a large resin restoration, with recurrent decay around the margins. Both of these teeth are photographed. Tooth #3 has a large amalgam restoration, but appears to be in decent shape. A photo of this tooth is also recorded. Finally, she snaps a picture of Joan's chipped and worn front teeth.

Next Shari probes several areas of the mouth. She notices that the posterior tissues are inflamed and probing depths are 5mm around several teeth. She takes a photo of an inflamed area, as well as one of #22, which is not inflamed. Now she is ready for the “show and tell” portion of the appointment.

She sits Joan upright and brings the monitor close enough for her to see. Shari brings up the photo of the thick, heavy calculus on the lower anteriors and tells Joan what the picture means. She explains that this calculus is acting like a “splinter under your fingernail” and is a focal point for inflammation and infection. She shows the photos of the inflamed tissues around some of the posterior teeth, and the non-inflamed tissue around #22. Joan can easily see how different the tissues appear. Shari talks about periodontal disease and what it can do to the supporting structures of the teeth and how the mouth and body systems are related. She also tells Joan how different her teeth would feel if the calculus was removed and how much healthier she would be without the toxins that are currently affecting her mouth.

Next Shari goes to the recession photos, and describes to Joan what is occurring. When she gets to #30 with the large amalgam and cracked surface, she shows both #30 and #3 (as a “non-cracked” example). Since #19 has decay around an existing resin, these dark areas show up like the Grand Canyon on the monitor. The chipped and worn front teeth are displayed, with Shari explaining how these might be altered for better appearance.

Shari takes radiographs as ordered by the dentist, and after explaining to Joan what the numbers mean, records all periodontal probing depths and extenuating issues (mobility, furcations, and recession).  Shari can see that Joan needs full mouth scaling and root planing.  Since Joan was expecting a “cleaning” today, Shari tells her that she will remove the calculus from one segment of the mouth (the lower anteriors) but that this service is not complete. Often this is an important step, because patients can be very unhappy if their perception is that “nothing” was done today.

When the dentist comes into the treatment room he can go over all of the data collection that Shari has gathered, go over the photos and probing depths, confirm (or put a “watch”) on restorative recommendations, confirm the need for full mouth scaling and root planing,  and then cause an estimate to be generated and presented by the treatment coordinator.

Although Joan is not happy that she needs periodontal therapy, restorative treatment on #19 and a crown on #30, because she has first been “shown” and then “told” about her conditions, she understands what is being presented to her. She agrees to “do” treatment, and schedules an appointment to begin.

Helping patients understand their oral conditions and treatment recommendations is an important function of a successful dental office. The Show, Tell, Do format can facilitate this.

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.

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