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  Sally McKenzie's
 Weekly Management e-Motivator

  5.23.03 Issue #65

Don’t Ask, They Won’t Tell - Patient Survey's

Sally Mckenzie, CMC
McKenzie Management

“Top Obstacles to Achieving the Ideal Practice.”

This week… one of the barriers likely to be interfering in your ability to reach your goals. Next week I’ll discuss proven solutions.

      Most of the time the patients are pleasant, they say “thank you.” And the majority of them at least act as if they appreciate the care you and your staff provide, but you still have more patient attrition than

you can reasonably explain. Why do they leave? Why do they stay? What do they like? What do they find frustrating or annoying? How well are team members interacting with patients? What are the strengths and weaknesses of the practice? And the most important question of all, do you really want to know the answers to those questions?

It’s a lot easier, and a lot safer for that matter, to ponder these practice mysteries within the confines of your monthly staff meetings or even late at night by yourself when you can’t sleep. Unfortunately, those avenues give you essentially no real information that you can use to address unspoken patient concerns. While you and your team do receive some measure of feedback everyday from patients, you don’t know what’s really on their minds unless you ask and give them a safe avenue to respond.

Patient surveys are extremely valuable tools that can provide enormous amounts of information. The knowledge gained from asking a few straight forward questions can yield major returns for the entire team. If you have concerns about how team members are interacting with patients, pose a few simple questions and you’ll know if those worries are valid. If you are considering a major change to your practice, such as relocating or opening a second office, you can assess how your patients would react. You’ll discover how patients really feel about your new financial policy, billing procedures, or even how well they believe dental procedures are explained to them.

Surveys not only provide excellent, highly valuable information to the dental team, they send a clear message to patients that they are appreciated. Furthermore, patients respect and welcome your efforts to improve the products and services that they are purchasing.

For good reason, patient feedback is the most valuable tool in practice management and development.

Next week ... developing the survey.

Interested in having Sally speak to your dental society or study club?
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Building On The Theory

How An Ailing Business Foundation Can Cause
“Digital Chaos” Part 8

Mark Dilatush
VP Professional Relations
McKenzie Management

Technology Tool Box

Treatment Planning

Last week I discussed your collection business system as an integral part of your overall business foundation. Different ways to leverage your technology investment [see article] were explained. This week I will focus on your treatment planning system and ways to leverage your technology platform.

Below is the foundation of your treatment planning system.

Job description – The written, discussed, and agreed reason for employment
Expectations – The performance you expect from this one “system”
Goals – Clearly attainable performance objectives in support of your vision
Responsibility – Who is ultimately responsible for this particular business system
Reporting mechanisms – Which reports they run to measure their performance
Accountability – Presenting the reporting results to the owner and the team
Statistical performance reviews – Compilation of reports for the business system(s) under the responsibility of a particular team member

Your treatment coordinator or one of your business administrators assigned to your treatment planning system should report the following at each of your team meetings.

  1. Total dollars of outstanding treatment in your database
  2. Total dollars of scheduled treatment plans
  3. The percentage of scheduled treatment plan production to total outstanding treatment plans. (Divide scheduled treatment plans by the total outstanding treatment plans.)

All reports should be compared from last month to this month.

If the above business foundation exists in your office, here are some ways to use your computer system to leverage growth, efficiency, and customer service.

  1. Outstanding (unscheduled) treatment plans, make perfect outbound call lists. Your treatment coordinator is required to make a minimum of 5 outbound patient service calls per day. As the owner of the practice, you will need to provide an appropriate script template and work hours consistent with the best results for your area.
  2. Place your unscheduled treatment plans on your computer system’s electronic list. Do not print it to paper. Why? Think about it for a second. You print a list, write notes on the list, share the list with nobody, and then eventually, you throw the list away anyway! Your computer system “should” have a central communication area where you can see the list on the screen, call from the list, enter pertinent notes from the conversation, and set up the next phone call (if one is necessary).
  3. Make sure the whole team looks at the patient notes EVERY time there is telephone or visual patient contact. If your whole team is going to use the centralized note area, make sure they are in the habit of quickly reviewing the team notes area of the patient record every time there is contact with the patient.
  4. Always, always, always, always, schedule treatment FROM the treatment plan. Think of it like spooning water from one coffee cup to another. If you do not do this, you will duplicate your work and destroy the validity of your treatment plan reports. You may also communicate the need for work to a patient who has completed their work. Wow, talk about poor customer service! The key to making this a habit within your workflow is to always review the patient’s treatment plan when there is any telephone or direct contact with a patient. Just like the team patient notes, reviewing the patient’s treatment plan will really pay off !
  5. If you pre-authorize claims for your patients, make sure you enter the specifics in the treatment plan area of your computer system. Enter the EOB information directly, then follow up with the patient using the patient note area to store any pertinent notes from the conversation.
  6. Use your unscheduled treatment report. If a patient does NOT schedule after being presented treatment, what do you do with them? They SHOULD go right into your system’s “unscheduled treatment” or “tickler file”. Different systems have different names for the features. Your computer system has these “places” for a reason. They want you to put your unscheduled treatment in there so it is available to you from the scheduler. If you have a 12 unit opening next Monday, doesn’t it make sense to display all of the treatment your patient’s need that is NOT scheduled yet? It makes a LOT of sense!
  7. Keep it clean! Just like every other database in your system, your treatment coordinator needs to be responsible for maintaining the data. It is simple. Most offices purge their treatment plans older than 180 days. Your computer system probably has a utility that will do it automatically for you. Keeping your treatment plan data clean will make your performance reporting perfectly accurate.

Next week I will discuss automated scheduling systems.

Interested in having Mark speak to your dental society or study club?
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Missed Past Issues of Our e-Motivator Newsletter?

Getting The Cold Shoulder


Giving Dentists And Their Staff Different Perspectives On Day To Day Issues

Dear Coach,
I am a young dentist who has recently opened a new practice. After a bad experience with hiring a front desk person who had difficulty getting used to the job, I was forced to let her go and hire someone who, based on her resume, would work out perfectly.

For the most part she has done well, and she started out exceeding my expectations, but despite my repeated requests that she calculate and write down the patient's estimated portion for their next visit on their walkout sheet, she doesn't do it and when kindly asked to start doing so she will argue at first as to why she thinks it is a waste of time and then only concede by rolling her eyes and agreeing to do it and still never do it.

I know that I could loose my temper with her, but I don't really want to direct my staff by confrontation or by threats of loosing their jobs unless it is absolutely necessary. She also tends to take a little bit of a disrespectful tone in passing which I am sure the other dentists she has worked for would never have allowed.

Is there a tactful next step to handling this or should I simply state that if she cannot do the job as it is laid out then I will need to find someone who will?

Dr. Steven Youngblood

The Coach Replies:
As a young dentist, your “tactful” business experience will develop over time. Right now, you are experiencing a personnel relations learning curve.

When interacting with people, there are always good experiences and bad experiences and people who look good on paper. Only time and experience will give you the tools to make good team staffing decisions. However, what can we learn from your experience so far?

Let us begin by explaining to all your new hires that there is a probation period in effect. They do not have the job yet, you want to witness their performance over x amount of days. When evaluating a person, judging them by their list of activities, achievements, and past positions does not communicate who they really are and how well they will integrate into your team.

You must be aware of this for the remainder of your career. You use the piece of paper to make the first cut, and you use the interview to make the second cut, and use probation to make the third cut.

One experience that is universal is that because you will work hard in order to achieve your goals of making money, you assume that others will do the same. While reasonable, this is unjustified. There are honest people and less than honest people trying to make a living by imposing themselves on trusting employers. Therefore, you cannot assume that a new hire shares your values and beliefs.

To most people, her refusal to do what she is told demands an explanation, a threat, and the act of dismissal. While I agree with this sequence, I want to draw your attention to your personal model for expression.

"I know that I could lose my temper... I don't want to direct my staff by confrontation... Or threats of losing their jobs". You do not have to lose your temper, direct them through confrontation, or threaten them with their jobs, because all of this is automatically understood by every employee.

Perhaps it is your youth and inexperience with business and employees that leads you to believe that you are more of a family man than a business man. In families, we refrain from confrontation, threats of painful action and abandonment. In business, these consequences are assumed.

With this knowledge, you can smile at your new hire and say, "I'm sorry, I really am sorry, but you are not doing the job the way I want it done, I have to give you your notice of dismissal.” She will understand your decision. Of course, she won’t agree, but this is not your problem, it is hers, now.

One final note: will she understand your displeasure with her disrespectful attitude? The answer is "Yes" she will understand because she has encountered other people who have pushed her away because of her poor attitude.

In conclusion, I want to remind you that it is not your job to help your employees with their personal, psychological or family problems. You have a business to run and in order to enjoy your business, it must run smoothly.

Building a smooth efficient business is a huge challenge for the best of business professionals, therefore, when confronted with personnel that detracts from that vision, there is only one solution.

I encourage you to believe that your reaction to her behavior will be understood, and therefore you should not feel even the slightest reservations at expressing what you want. This is your business.

The Coach

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Helpful Tips for Becoming a Better Listener

Most people spend roughly 70% of their waking hours in some form of verbal communication. Yet, how many of us have ever had any formal training in the art of listening? Here are two things you can do to improve your listening skills.

Don't get hung up on the speaker's delivery
Sometimes there are factors that simply reveal an awkwardness in delivery rather than any attempt to mislead. The key is being able to distinguish between the two. It's easy to get turned off when someone speaks haltingly, has an irritating voice, or just doesn't come across well. The key to good listening, however, is to get beyond the manner of delivery to the underlying message. In order for this to happen, you have to resolve not to judge the message by the delivery style. It's amazing how much more clearly you can "hear" once you've made the decision to really listen rather than to criticize.

Tune out distractions
Poor listeners are distracted by interruptions; good listeners tune them out and focus on the speaker and the message. It's a discipline that lends itself to specific techniques for maintaining one's focus. Here are some things that will help: Maintain eye contact with the speaker; lean forward in your chair; let the speaker's words "ring" in your ears; and turn in your chair, if necessary, to block out unwanted distractions.



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· Office Managers
· Financial Coordinators
· Patient Coordinators
· Scheduling Coordinators
· Treatment Coordinators
· Hygiene Coordinators

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The 5 Dysfunctions of A Team- Part III
Absence of Trust
Lacking trust, teams waste inordinate amounts of time and energy managing their behaviors, they dread meetings, and they are reluctant to take risks.
Fear of Conflict
All relationships require productive conflict in order to grown.
Lack of Commitment
Reasonable human beings do not need to get their way in order to support a decision, but only need to know that their opinions have been heard and considered.
Avoidance of Accountability
The willingness of team members to call their peers on performance or behaviors that might hurt the team.
Inattention to Results
For some, being a member of a group is a type of reward, results might be desireable but not necessarily worth a great sacrifice.
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