10.25.13 Issue #607 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Becoming a Highly Effective Office Manager
By Sally McKenzie, CEO

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You have it all figured out. You are just waiting for your opportunity to tell everyone else. As the newly designated office manager, you are excited about the possibilities. You’ve been a long-term dedicated employee. You’ve worked hard, and you deserve this promotion. You are confident you can hit the ground running; after all you’ve worked as a member of the business team for three years now. What’s so different about becoming an office manager? A lot.

For some, moving from business employee to office manager is akin to jumping from the frying pan into the fire. It sounded like such a good idea, a great opportunity until they realize they are completely unprepared for the responsibilities suddenly heaped upon their shoulders. Their confidence is strong until they realize there’s no one to give them guidance or training.

Oftentimes “good” employees are elevated to the position of “office manager” because they have been simply that - “good employees.” The doctor wants to reward them, and his/her intentions are genuine. The only problem is that no one really considered what it means to be the “office manager.” The doctor hopes that by appointing someone to the role, the individual will take the management reins and address those sticky and annoying and troubling management headaches that the doctor really does not want to deal with.

The doctor thinks the appointment will ensure that the scheduling issues are resolved, the marketing plan is implemented, the collections policy is consistently carried out, overdue patients are drawn back into the practice, overhead is monitored, job descriptions are updated, and on, and on, and on. As the doctor and the newly appointed office manager will soon come to realize, there is a very expensive divide between “thinking” an employee can effectively serve as office manager and knowing s/he can. It’s usually thousands of dollars in practice revenues.

Consider one of the most fundamental practice systems: patient retention. Commonly, the designated “office manager” is unaware of this very fundamental and critical system. The pace of the practice lulls them into a false sense of security, but if this key area isn’t monitored regularly the practice is likely to quietly lose patients for months before serious scheduling/revenue troubles emerge and the manager takes notice. The truth is, most office managers aren't paying attention to the multitude of inactive records that are chewing up space on the computer system or the holes in the schedule because the office is busy...or so it seems. They are not monitoring key production indicators to ensure that the hygienist’s salary is not exceeding 33% of what s/he produces, and the list goes on.

Case in point...I received an email from an office manager on the East Coast who wanted to know how she could determine if the practice was losing patients. I sent “Megan” the formula for calculating patient attrition. Soon after, Megan contacted me again because she wasn't sure how to interpret her findings. She had discovered that patient retention in the practice where she is the designated “office manager” is at 53%, a figure she thought sounded alarming. She is correct. The practice retains little more than half the patients who walk through its doors. This finding alone should set off alarm bells in every corner of the office. But sounding the alarm isn’t enough. As the office manager, Megan needs to know how to put out the fire that is burning through practice profits.

She’s a bright woman, a few minutes into our conversation and she quickly recognized that critical business systems were lacking. Accountability and follow-through were weak, as was clear leadership. It didn’t take long for Megan to realize that nearly all the elements are present for this office to become a highly functioning team. However, the one essential element missing is training.

Time and again office managers are asked to take on huge amounts of responsibility, often with very little guidance. Most office managers across the country are doing the best that they can, but without receiving professional management training they simply don’t know what they don’t know. And most doctors don’t know how much it’s costing them until serious problems arise.

Next week, what does the office manager really need to know?

For more information on this topic, visit my blog: The Lighter Side

Interested in speaking to me about your practice concerns? Email sallymck@mckenziemgmt.com
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Belle DuCharme, CDPMA
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Demographics Reflect Older Patient Numbers on Rise
By Belle DuCharme, CDPMA

77 million people were born between 1946 and 1964. An American turns 50 every 7 seconds. The “baby boomers” or the “senior” age group is now, for the first time, the largest in terms of size and percentage of the U.S. Population. That translates to a lot of people who want to live healthy industrious lives as long as they can. Working with as many dental offices as I do, I am privy to their particular demographics and I have noticed that many practices have a large percentage of older and elderly patients. Age 60-100 can be upwards of 70% or more of the patient base. The number of older or elderly patients is expected to grow to 68 million by 2025 in this country. According to census data, this is an increase of 87% from the year 2000. Certainly these numbers suggest that there is an ever growing demand for dental services designed for the needs of the older population. Advancing ages puts many seniors at risk for a number of oral health related problems such as:

Dry mouth. Dry mouth is caused by reduced saliva flow from cancer treatments, medications, Sjogrens’s syndrome and other related diseases.

Staining and darkening of teeth caused by changes in dentin from eating foods that stain for many years.

Loss of teeth due to breakdown of existing restorations and loss of bone from other missing teeth, chipping and fracturing from bruxism.

Loss of sense of taste from aging and wearing dentures or ill-fitting partials.

Gum disease caused by plaque, ill-fitting prosthetics, poor diets, and not being aware of changes in mental and physical health leading to poor oral hygiene.

Root decay from exposed root surfaces due to erosion and ill-fitting prosthetics and not having the manual dexterity to be able to clean the area as well as they used to.

Diabetes, anemia and cancer increase as the population ages and can lead to dental problems for the elderly.

An uneven jawbone. This is caused by tooth loss and makes it more difficult to restore the mouth to function.

Denture induced stomatitis. Poor-fitting dentures, poor dental hygiene, or a buildup of the fungus Candida albicans cause this condition, which is inflammation of the tissue underlying a denture.

Thrush. Diseases or drugs that affect the immune system can trigger an overgrowth of the fungus Candida albicans in the mouth.

Age in and of itself is not a dominant or sole factor in determining oral health. However, certain medical conditions such as arthritis in the hands and fingers may make brushing or flossing teeth difficult or impossible to perform. As health care providers it is imperative that we see this demand and work to meet the needs of the aging population in the following ways:

1. Is handicapped parking available at your practice location? If not close by, have the patient or driver call you just before arrival so you can help the patient into the office. Have a wheelchair available also.

2. Is there a place to install a wheelchair ramp at the front or rear of your office?

3. Are the reception room chairs equipped with arm rests so the patient can use them to stand? Do you have chairs or sofas that are firm and easy to rise from?

4. Do you keep extra pairs of reading glasses handy for those who forget their glasses?

5. Do you have a wheelchair accessible table so the patient can write a check or read a treatment plan?

6. Do you have extra blankets and neck pillows available for patient comfort?

7. Do you sell electric tooth brushes or other electric devices that make it easier for seniors to brush their teeth and gums? It would be convenient for them to make a purchase at your office.

8. Do you carry mouth rinse products, tooth pastes for sensitive teeth, prescription fluoride gels or pastes designed for the particular oral health needs of the elderly?

9. Do you spend extra time with elderly patients to make sure they understand the treatment and their options?

10. Do you ask if there is anyone else you need to speak to in the family before embarking on a multiple phase treatment plan? Elderly patients often have an executor who will authorize treatment.

11. Would senior care centers or assisted living facilities in your area benefit from an educational program on dental care that you could present?

12. Do you offer water or a beverage to elderly patients? It is often difficult for them to get up or carry it without spilling.

A little extra TLC goes a long way with this special group of patients. Understanding patients at every age and giving them what they want is a key to treatment acceptance. If you want to learn more about your individual practice demographics and be able to motivate patients to accept treatment, sign up today for the Treatment Acceptance Training Course and improve your practice performance.

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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Gene St. Louis
VP Practice Solutions
McKenzie Management
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The #1 Practice Management Myth
By Gene St. Louis

“I think the doctor is happy with my performance. He hasn’t told me he isn’t.” And that is how the conversation began with a key employee in “Dr. Craig’s” practice. The staff member, “Kelly,” had been with the practice for about a year, and was trying to explain how Dr. Craig sets forth his expectations. She was struggling to clarify how the doctor provides feedback and direction to the staff both individually and as a whole.

When I inquired as to how often the doctor meets with employees individually to discuss their performance and his expectations of them, Kelly tried her best to put a good face on the situation. “Oh I’m sure Dr. Craig would if he had time. And really, he’s pretty good about answering questions when we have them.”

So how exactly are the employees to know what’s expected? How do they gauge if their contribution is valuable to the practice? The “no news is good news” approach to management may have been perfectly acceptable to the post WWII generation, but it won’t serve dentists well in today’s modern workplace.

As we dug a little deeper, we discovered that in actuality, Dr. Craig believed that if he hired an employee to do a job, s/he should know what to do, particularly if the employee came with previous experience. After all, he reasoned, no one had to tell him how to do the dentistry. And that is a common practice management myth. The doctor wants “experienced” employees, so s/he doesn’t have to spell out the details.

Regardless of how much experience new hires bring to a practice, it doesn’t guarantee their success, nor does it absolve the doctor from his/her responsibility to provide clear guidance, direction, goals, and feedback. For Dr. Craig, subscribing to the myth was costing him a fortune in staff turnover and lost patients, who were puzzled (if not concerned) by the perpetual stream of new employees. They would ask - so where’s “Mary” or “Abby” or “Michelle” or “JT” and frankly it was becoming embarrassing to have to sheepishly say they were no longer with the practice.

Naturally, there were a few factors that played into staff attrition, but chief among them was the simple fact that employees never knew where they stood. Dr. Craig mistakenly saw performance reviews as uncomfortable exchanges in which he would have to tell an employee what he didn’t like about their performance, and then, he believed, they would get mad and quit. Or, he would have to tell them that he didn’t have any problems with their performance and then, he believed, they would expect a raise. And with staff in a perpetual state of flux, why, he reasoned, should he spend time on this burdensome administrative detail. Ironically, his dodging the matter yielded essentially the same result – employees quit and it cost his practice more money.

Today’s dynamic workplace needs a steady stream of two-way communication. Feedback and performance evaluations are the breakfasts of champions for highly functioning and effective practices. As the coach of your team, performance reviews help you fine tune your star players and spot both problems and/or potential.

Performance reviews enable you to set forth exactly what your expectations are, from how staff set up the tray tables, to how they answer the phone, to how they handle emergency patients, and the list goes on. They enable you to engage employees individually to help them see clearly how their role is essential to the success of the practice. They provide a forum to discuss opportunities and challenges for the individual and the practice.

Additionally, it is in performance reviews that specific and measurable goals are established and progress toward them is evaluated. Without goals, practice teams wander aimlessly. It’s like being dropped in the wilderness without a compass; they are left to guess which direction is the right course to follow.

Feedback enables you to correct and praise in the moment. Like goals, feedback is specific - but it is offered regularly, if not daily. Rather than saying, “You did a great job today with Mrs. Smith,” say, “Great job today handling Mrs. Smith’s situation. You kept your cool and were really helpful and considerate of her needs.” Remember to praise progress, not just perfection. Positive feedback is the cheapest and most effective motivation you can give your team. Offer it generously and sincerely. Couple it with periodic performance evaluations, and watch your practice profits soar.

Interested in speaking to Gene about your practice concerns? Email gene@mckenziemgmt.com

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