7.25.14 Issue #646 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Why Can’t You Pull the Trigger on that Practice Purchase?
By Sally McKenzie, CEO

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It was the practice she wanted in the location she desired. The equipment was in good shape; the production seemed healthy. But “Dr. Paula” couldn’t bring herself to pull the trigger. She was uneasy. She didn’t know why. The selling doctor was very good. He had an excellent reputation in the community. The practice broker was widely respected. Still Dr. Paula was anxious. She was worried that she was missing something.

Dr. Paula’s situation is not uncommon. Many doctors will throw caution to the wind and purchase the first practice that “just feels right.” However, there are many, many more in this post-recession world who drag their feet. They find themselves in a perpetual paralysis of analysis.

While the sellers have brokers advocating for them, buyers often perceive that they are at a disadvantage when purchasing practices. They worry that they don’t have enough data and become skeptical of the seller’s claims. They haven’t had someone they can turn to, someone to really comb through the numbers and the many details that go well beyond the value of the equipment and the overall production - those key systems that will make or break the incoming doctor’s success.

While both an eager buyer and an eager seller often sit on either side of a pending sale, many buyers can be hesitant and need reassurance that this investment is a wise one. Purchasing a practice is likely the most important and most expensive investment that a dentist will make. It’s not surprising that most would want to make that decision based on clear and comprehensive data and information that can be found in a practice evaluation – not to be confused with a practice valuation.

For less than the fee most dentists would charge for a couple of crowns, a practice evaluation provides purchasing doctors a wealth of objective information about the health of the practice they are considering purchasing. Think of a practice evaluation like you would a home inspection. If you are purchasing a home, you make a small investment in a home inspection. The inspector comes in and examines key functions in the home. Upon reviewing their report you have a better sense if there are minor issues that could become major concerns or seemingly major issues that are truly insignificant.

Similarly, practice buyers who can access objective information about key systems in the practice they want to purchase are empowered to more accurately assess the total health of the practice and the potential return on investment. For example, they may learn of weaknesses in the current business operations, which if addressed will open the door for additional revenues in the future. They can gather critical information about the experience and professional capacity of the team that they are inheriting.

How robust is treatment acceptance? Does the selling doctor have several openings in the schedule or does s/he have very few openings - and what does either scenario mean to the purchasing doctor? What is the active patient base? Many brokers consider the active patient base to be those patients who have been in the practice within the past two years. However, we find that a 12-month window is far more accurate. If a patient hasn’t been into the practice for two consecutive recalls, they can’t be counted as an active patient. Buyers need to know how many patients are past-due in the previous 12 months and how many are scheduled in the upcoming 12 months.

Moreover, purchasing doctors need to understand the demographics of the surrounding community. The neighborhood may have been teaming with young families 10 years ago, but now is host to an older population. That older population may be better educated and have more disposable income, but they might not be the demographic the purchasing doctor had hoped to cultivate.

Oftentimes doctors purchasing a practice have little ability to assess the seller’s marketing. The practice may have a website, but is that website effective? Additionally, buyers need information about insurance plans the practice accepts and what percentage of the practice income is from those plans.

In most cases, the practice evaluation bridges the gap between a possible sale that for whatever reason can’t seem to get traction and the successful sale that both buyer and seller feel confident about. Typically once the prospective buyers have the complete picture and their questions are answered fully, they are eager to proceed.

Before you commit to the biggest investment of your life, consider a Dental Practice Acquisition Evaluation by McKenzie Management.

For more information on this topic and more, 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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Front Desk Employees: Make the Right Hire
By Nancy Haller, Ph.D.

When patients walk into your office, the front desk employee is their first point of contact. S/he sets the tone for how you will be judged, and ultimately the success of your business. The front desk position tends to be one of the most complex roles in a dental practice. This person is often required to keep several plates spinning at the same time with an enormous list of varied tasks. Multiple telephone lines ringing, patients waiting to check in, patients lined up to check out, making appointments, keeping the schedule full, clinical co-workers asking questions, insurance, billing, etc. etc. And the front desk area is frequently the busiest and noisiest place in the practice.

Unfortunately, there’s often a revolving door of turnover with front office personnel. My experience is that many front desk hires are misfit due to poor hiring practices. It’s naïve to believe that every candidate is equally suited for the role because they have “administrative experience” on their resume. It’s even more simplistic to assume that previous work in one dental office is transferrable to your practice. The greatest predictor of success in a front desk employee is personality - not aptitude, not attitude, and not education - and assessments that provide information on likely behavior. So just how do you know if the candidate for front desk staff has what the job calls for?

McKenzie Management has the solution - The Employee Assessment Test. It assesses 12 essential personality traits so you know how closely your candidate matches the profiles of top performers in the front desk position (we also have norms for clinical assistant, hygienist, and dentist). No more guessing. You have objective and scientific data to help you in your hiring decision, and it adheres to legal guidelines for employment testing.

Dr. Jones recently identified a promising candidate for his front office. Mary works in a nearby office but is being “downsized”. She has 10 years of experience. During the interview she seemed sharp and organized. Although she claimed to be a team player, she appeared rather independent. Dr. Jones liked the fact that Mary might be the answer to his prayers - she could manage the office! However, the staff felt Mary was “too serious in a slightly uncomfortable way”.

Mary completed the Employee Assessment Test. The results indicated that her behavioral strengths are a “good fit” for front desk on several of the 12 personality factor scales. Although she seems like a good match, it is important to determine where she is not fitting.

The report shows that Mary scored above average on the scales of Dominance, Self-Assuredness and Organization. These suggest that she is assertive, confident, and driven to achieve her goals with precision. She also scored high on the scales of Rule-Consciousness and Self-Reliance. Her tendency is to follow established rules and regulations. She is resourceful in solving problems. Overall the results indicate that Mary has some natural leadership traits - she likes to call the shots. It’s likely that she is successful in scheduling to production! 

On the other hand, Mary’s scores were low on the scales of Trust, Open-Mindedness, and Liveliness. This triad of characteristics reflects a serious individual who values her autonomy. This is a great combination when the work requires quick action and/or individual initiative. However, when it comes to interpersonal style, Mary is not collaborative. Furthermore she can appear controlling because she is rather black-and-white in her perspectives. These last three scales suggest that Mary will struggle in her role in Dr. Jones’ office, a pediatric practice. The atmosphere is accommodating, jovial and easy-going.

Hiring should never be done on the basis of testing alone. Rather, the test results become one of many procedures in the selection process. When you know a candidate’s personality characteristics up front, you’ll know if this is the right person for your practice. If Mary is hired, she will need to develop a more accommodating style in her interactions with patients and co-workers. She will require coaching to learn how to find solutions that balance her preferences for data, details and practical matters with the importance of creating harmony and goodwill with the team. Dr. Jones is considering his decision.

When it comes to predicting human behavior, there is no silver bullet. But testing offers insights that interviews, references or work samples cannot. Pre-employment tests save you time, headaches and money. With the increasing importance on interpersonal effectiveness for job success, dentists who add pre-employment testing to their hiring process will have a strategic advantage. The pay-off is higher caliber employees who work harder and stay longer. It’s a small investment in the most important position in your practice, the front desk.

If you’d like a sample report of McKenzie’s Employee Assessment Test, email Dr. Haller at nhaller@mckenziemgmt.com. You can also view details for the test online HERE.

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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Dental Hygiene - One Part Clinical, Two Parts Psychological
By Carol Tekavec RDH

Some days it seems as if every patient scheduled has an emotional issue with dental treatment that must be addressed. While many people are calm and fine with having dental care, some are nervous, anxious, worried, jumpy, or just plain resistant. Having someone poking around in your mouth is an invasion of a very personal space. Our mouths are essential in our ability to communicate, eat, speak and be understood, and are vital to our appearance. Healthy teeth and an attractive smile are central to beauty. It is no wonder that a person  can be nervous about having their teeth worked on. While it would be nice to simply get down to work and perform our prophys and SRP services, many times the psychological concerns of a patient must be addressed first.

The Resistant Older Patient
Many older patients are very happy to accept scaling and root planing and then subsequent appointments for periodontal maintenance; but a few will balk at the idea. Their thought is “I don’t have long to live, I don’t want to spend money on my teeth.” This can come from a patient in their early sixties! Comparing dental services to regular maintenance on a car can sometimes be effective. For example: A year 2000 car may be fourteen years old, but still run in excellent condition. If that car needs to have new tires, would you keep driving on the bald ones because the car is “old”? With new tires, the car may be going strong for many more years. Scaling and root planing, plus regular maintenance, can give your teeth and mouth years of health. Investing in your oral health is at least as important as investing in your car.

The Health Conscious Adult
Being concerned about one’s health is a good personal quality, but sometimes a patient can present with a long list of concerns about their dental treatment that can make caring for them a challenge. They may express worries about fluoride, radiographs, sealants, resins, anesthetics, and lately even gluten. Taking the time to provide detailed information about what items and products are going to be used during their treatment can often satisfy this patient. The worst thing to do is minimize or belittle their concerns in any way. Be prepared with an information sheet about the resins, anesthetics, etc. that the office uses and don’t rush your explanations. Armed with the facts, these patients are often more than ready to proceed with their dental treatment.

The Jumpy Little Child
Some children are so anxious about their dental appointments that they flinch when you gently touch them on the arm! They are a challenge. The “Show-Tell-Do” approach can often help. Before proceeding with any treatment at all, have them hold a mouth mirror and peek into it, turn on the prophy angle and show them how the prophy cup works on a fingernail, turn on the suction and let them hold it and feel it on the outside of their cheek. Show them the air/water syringe and describe it as a “squirt gun”. Let them squirt it! Let them pick out what flavor of prophy paste they want, as well as what flavor of fluoride they prefer. Turn cartoons on the treatment room TV. If the chair light bothers them, offer sunglasses. If they have specific requests, try to honor them. One little patient of mine was ok with receiving bitewing x-rays if he could cover his eyes with his hands. Again, taking the time to try and find out what is worrying them, and then letting them know what is going on, can be all that is needed to allay their fears.

The Super Jumpy Adult
Adults can be just as anxious as children, particularly when it comes to the injection. Topical anesthetic used prior to the “shot” is a must. Also, using the technique of slow dispensing of the anesthetic and calm conversation on our part during the injection works to calm many. However, sometimes these efforts are just not enough. The Jumpy Adult, like the Jumpy Child, will often react to just about any touch with a “pain” response. These patients often benefit from listening with headphones to their choice of music, or again, looking at a program on TV. While distraction works for most, it doesn’t work for all. One of my patients benefitted from me telling him that I would describe every step I was taking during the injection process so that he would know when the actual “shot” was going to take place. He also did not want any euphemisms for “shot” so I told him: “I am now going to pull your cheek to the side. I am now holding the shot. I am placing the needle. Now I am injecting.” While this format would not be useful for many people, it was just what he needed and we got along well.

Taking care of patients is more than just taking care of their teeth. Acknowledging personal needs and concerns and addressing these as best we can is important to providing the best care possible.

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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