4.4.14 Issue #630 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Never Be ‘Busy’ Again
By Sally McKenzie, CEO

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Strike the following words from your vocabulary: “I just want to be busy.” No, you don’t. What you want is to be productive, because in being productive your practice is profitable. And it’s essential that both you and your team not only understand the distinction but create systems to accomplish it.

How do you achieve “productive and profitable”? It begins with a goal. Identify a realistic financial goal for your practice. For example, let’s say your goal is $700,000 in clinical production. This calculates to $14,583 per week (minus four weeks’ vacation). Working 40 hours per week requires you to produce about $364 per hour. If you want to work fewer hours, per hour production will need to increase.

Use the formula below to determine the rate of hourly production:
1. The assistant logs the amount of time it takes to perform specific procedures. If a procedure takes the doctor three appointments, record the time needed for all appointments.

2. Record the total fee for the procedure.

3. Determine the procedure value per hourly goal. Take the cost of the procedure, for example $1,200 for a crown, and divide it by the total time to perform the procedure (120 minutes). That will give you your production per minute value: $10. Multiply that by 60 minutes - $600. The excess can be applied to any shortfall caused by smaller ticket procedures.

4. Compare that amount to the doctor’s hourly production goal. It must equal or exceed the identified goal.

5. Start scheduling to meet that goal every hour of every day.

It’s likely you will need to make some other changes in production to reach your goal, such as correcting inefficiencies in the delivery of dentistry and/or decreasing the amount of time to perform certain procedures, which leads me to my next point: Maximize efficiency to manage the schedule. Doctors and assistants in every practice can improve efficiency. Take these steps to inventory and improve your time and motion:

1. The assistant should list the materials and equipment used for each procedure as well as each step necessary to complete each procedure.

2. Indicate next to each task whether it requires the doctor’s time or the assistant’s. Note that administering anesthetic is always considered assistant time. Although the doctor performs this procedure it does not require a single unit of time, 10-15 minutes, to give an injection.

3. Log the amount of time it takes for the doctor and the assistant to perform each task associated with each procedure.

The objective of this time and motion inventory is to identify tasks that can be delegated and opportunities for training that will maximize the assistant’s functions. It also enables both the doctor and the assistant to see more clearly how set-up and tasks can be made more efficient. Reducing the time it takes to perform procedures by as little as 10 minutes can significantly increase profit to the practice.

This approach neither compromises care to the patient nor suggests that the doctor rush, but it can significantly improve clinical efficiency, schedule management, and practice profit. Tip: All treatment rooms should be set up alike. This will ensure that doctor and assistant aren’t waiting for “their” room to free up.

Next, make sure that everyone is on the same page when it comes to the amount of time procedures take. Scheduling time MUST be communicated by the doctor/assistant to the scheduling coordinator – not from the scheduling coordinator to the doctor/assistant. It also should be clear and consistent. Clearly communicating the specific time needed for treatment ensures that the scheduling coordinator isn’t guessing or allocating a specific time for every patient regardless of the procedure.
For example, the doctor examines a hygiene patient and determines s/he needs three fillings. The doctor tells the hygienist specifically how much time is necessary. S/he, in turn, can specifically tell the scheduling coordinator exactly how much doctor time and assistant time to schedule. The doctor’s time should be scheduled in one color on the computer and the assistant’s in another. This simple strategy ensures that the doctor is not double-booked.

Tip: Schedule in 10-minute increments and overlap patients during the first and last 10 minutes of each appointment if scheduling doctor time and assistant time is not done routinely.

Focusing on being productive requires a willingness to recognize that “busy” doesn’t necessarily translate to profitable. Being profitable requires a commitment to implement measurable systems.

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
Interested in having McKenzie Management Seminars 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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Does Coaching Really Work?
By Nancy Haller, Ph.D.

“Oprah Winfrey has a coach. Tiger Woods has a coach. Warren Buffet has a coach.They’re the best of the best, so why shouldn’t you?”

This internet pop-up question caught my attention, and for good reason. I am a coach and I know that successful people have coaches. People who are high achievers want to continue to learn and grow. By working with a coach, they push past their boundaries and breakthroughs happen. Their life goes to another level.

Most major companies now make coaching a core part of their executive development programs. The belief is that one-on-one personal interaction with an objective third party provides a focus that other forms of organizational support cannot. A 2004 study by Right Management Consultants found that 86% of companies used coaches in their leadership development program.

In a recent issue of The Journal of Positive Psychology, rigorous scientific research shows that coaching consistently helps to improve work performance and skills, a client's well-being and coping skills, their work attitudes, and their ability to effectively regulate their behavior and accomplish meaningful goals. The conclusion is a resounding vote of confidence in the effectiveness of coaching.

Unfortunately many doctors will spend enormous amounts of their budget on equipment and office space, yet they believe being the boss is something they can or should “do on their own.The reality is that managing a practice is complex, more so now than in years past. As business and healthcare move faster and get more competitive, it’s difficult to keep up with all the changes. Add to that equation the challenging dynamics of "front office" vs. "back office” and balancing the boundaries of being friendly without being a friend. It really is lonely at the top!

I’ve been coaching dentists for many years and I’ve seen a common pattern. Frequently dentists find themselves in a leadership role by default. While learning how to extract teeth and administer nitrous oxide you probably didn't give much thought to hiring, firing, handling office disputes or delegating job responsibilities. It’s unlikely that your dental school curriculum included coursework on human behavior or management. You focused on learning clinical skills. That's what a good dentist does. But a successful dentist does more. You have to influence people every day. You need to show and tell your employees what you want them to do, and how. You need to guide your patients so they'll comply with treatment recommendations. The bottom line is that you were trained to do dentistry, yet today you’re called upon to be CEO of your business.

There really are two sides to every job in a dental practice – the technical side and the people side. You need to be competent on both in order to have a successful business. Leadership requires different skills and abilities that most dentists never had the opportunity to learn. Understandably this is tough. It requires you to let go, delegate, give up power, and teach others to do. I facilitate several different programs to help doctors develop the knowledge that is necessary for effective practice leadership. The outcomes are enhanced confidence and work satisfaction for you, improved morale and productivity for your employees, and greater care and service to your patients. By making small adjustments in your actions, you can achieve major business results.

Coaching is not like school, and it's not like therapy. Coaching is a conversation between partners who work together to achieve challenging goals. You might be wondering if you would benefit from having a coach. Step back and ask yourself what’s not working. Another approach is to determine what you can do to improve your practice, your employees’ morale, and your relationships with the patients you treat. Then honestly assess whether you feel that you can make those changes on your own, or if you need some outside help. If you aren’t able to look at the situation objectively, or if you think that an unbiased point of view might give you a broader perspective, give me a call. The amount of time, money, frustration, and damaged relationships that are saved makes coaching a necessity not a luxury.

Dr. Haller provides training for leadership effectiveness, interpersonal communication, conflict management, and team building. If you would like to learn more contact her at nhaller@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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Our New Patient Came from Your Office!
By Carol Tekavec RDH

Every office welcomes new patients! We are happy when a new individual or family finds their way to our practice, and typically try to discover how they found us. Most patients had a regular dentist before they decided to make a change. Why did they decide to leave their previous dentist? How did they pick us?  What were the problems they encountered at their former practice? What can we do to make sure they stay happy with us?

“Janette” is a married mom of two little girls. She found her way to our practice by way of a friend who told her she would get good care with our dentist. She has been coming to the office for over a year, but until today, had her two little girls at another practice. After her professional cleaning appointment this afternoon, she told me that she wanted to set up appointments for the girls right away. “I’m not happy with the girls’ dentist. He is very preoccupied and I don’t think he really listens to me when I tell him about my concerns for the kids. I like his hygienist, but I am tired of his attitude.” 

Do you ever act as if you are “too busy” for your patients? All of us know how stressful a jam-packed schedule can be, but we owe it to our patients to take a breath and focus on them during the time we are with them. Rushing into the treatment room, hurriedly completing the exam and then rushing out is not the way to keep patients satisfied. Sometimes dentists can act as if they are annoyed to be interrupted for recalls. This is a mistake for all involved. A sense of tension is conveyed by the hygienist, who dreads having to alert the dentist of the need for an exam, and patients pick up on this. If the dentist then acts in an abrupt fashion because he or she wants to return to the other room, patients can feel slighted. Moms in particular don’t like to feel rushed when it comes to their children. Giving them our complete attention is vital to retaining the family as patients.

Another common patient complaint involves not the dentist, but the staff. Patients will tell us that they like their former dentist, but don’t like having to deal with an unpleasant front-office person. “She always acts as if she’s doing me a favor by answering the phone,” one patient told us. “I got tired of trying to be friendly and receiving frowns in return,” said another. “Whenever I had a question about my insurance she seemed to be very exasperated that I didn’t simply know the answer myself,” one gentleman expressed. An unpleasant front desk staffer can really hurt a practice. This is the first person patients talk to and/or see when they come to the office. Friendly and polite should be the watchwords!

Another patient told us about a less than courteous assistant. “She puts the chair practically upside down, and even when the dentist is finished she leaves me in that position. She knows that it is hard for me to breathe with my head so low. I realize that the dentist has to see, but why does she leave me like that, and then leave the room when he is done?!” Assistants should know that they are responsible for much of a patient’s comfort. It needs to be a priority. Leaving a patient alone in an uncomfortable position is just not acceptable.

Hygienists also get their share of complaints. The two most common issues appear to be not taking enough time with the “cleaning” and being too rough. “My hygienist hurts me! She doesn’t seem to care that the ultrasonic is painful and insists on using it even though I have asked her not to.”  “My cleanings used to take about 45 minutes. Now she spends barely 20 minutes. I don’t think that I am getting a thorough job.” Cultivating a gentle touch is vital in dental hygiene. Turning down the ultrasonic, watching instrument position and pressure, and lessoning sensitivity by spraying water in the mouth and letting the patient “swish” before using the suction are a few ways to make a prophy more comfortable. Topical anesthetics can also help. Some patients cannot tolerate an ultrasonic at all. Using hand instruments exclusively for these patients can go a long way in gaining patient good will. 

Abbreviated hygiene appointments can be problematic. Appointments need to be long enough to accomplish a general assessment, perio assessment, radiographs, identification of possible restorative needs, intra-oral photographs, and the actual prophy. Although patients may be forced into a “short-time appointment” schedule, making the day’s production look better, patients can tell if there is little or no time for simple courtesies. If they feel shortchanged during their cleanings, they will leave the practice. It is also not beneficial to the office as a whole. If restorative treatment is not identified and later reinforced by the dentist during a prophy appointment, today’s hygiene production may look good, but the office total monthly production will not be what is desired.

Taking care of patients involves much more than simply being a good technician. Human needs and emotions are front and center when it comes to dental treatment. To keep our patients happy we need to remember this - we don’t want them to become new patients at someone else’s office!

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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