9.26.14 Issue #655 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Schedule for Practice Success, Not Chaos
By Sally McKenzie, CEO

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There’s no question your practice is busy. Most days, you see patient after patient and barely have time for a break. Even the cancellations and no-shows that plague every practice typically don’t slow you down. You have plenty of patients who are happy to take those appointment slots, rather than wait three weeks or more to see you. Like many other dentists, you equate practice success with a full schedule and busy days. The problem is, running a profitable dental practice isn’t about working at a break-neck speed or simply “keeping busy.” It’s about productivity.

Controlling your schedule, rather than letting it control you, is key to achieving maximum productivity and profitability. In fact, the schedule is probably the most critical system in your practice, yet it’s also one of the most abused. A hodge-podge of names and dates strung together with little or no direction, other than to keep you busy, just isn’t going to cut it. And it’s likely stressing you out, costing you patients and hurting your bottom line.

Your schedule coordinator’s job isn’t to keep you busy; it’s to make sure you meet daily production goals. If any of these seven scenarios are playing out in your practice right now, that isn’t happening:

1. You’re booked more than three weeks out and it’s pretty common for patients to have to wait weeks to get an appointment, even for routine procedures.
2. There is no consistency for procedure times. Some are booked for 30 minutes, while others are scheduled for 60 or even 90 minutes.
3. Your coordinator has one objective: To keep the schedule full.
4. The hygiene schedule is booked out for months.
5. You and your team members consider a sit-down lunch a luxury. Usually, you steal 10 minutes to catch a quick breath and gulp down your meal before moving on to your next appointment.
6. You’re losing patients.
7. Worst of all, revenues are flat.

It’s time to stop the chaos and take back your schedule. And you can start by losing the inefficient, ineffective scheduling system you’ve relied on for years, and create a system that actually works, based on real numbers and practice goals.

The First Steps
You have to start setting and meeting daily production goals. When you do, you’ll have a more streamlined practice-building schedule that reduces daily stress and chaos, while giving you and your team more time to focus on not only treating and diagnosing patients, but providing the best care possible.

Ready to start? First, gather your team members and identify attainable goals, both as a practice and as individuals. Make sure every team member understands how their daily efforts effect the practice’s ability to achieve these goals.

Next, determine how much money it takes to realize your ideal lifestyle, and how many hours a week you’re willing to work to get there. Then factor in all your practice-related overhead costs, from attending CE to paying your team members.

Once you define your personal and professional goals as well as the financial realities that come with running a dental practice, you and your team members will have a clearer picture of how much revenue you need to bring in each day, and that number should dictate the schedule. You’ll have clear goals to achieve, and your schedule will serve as your roadmap to success.

Manage the Schedule
Empower one team member to set and maintain the schedule. Give this committed team member all the necessary tools and training he or she needs to succeed, and make sure he or she understands how to schedule to meet daily production goals, not just to keep you busy.

Here’s an example of what I mean. Maybe your goal is to earn $1 million a year. After you take out 33% for hygiene you’re left with $670,000, which works out to be $13,958 per week, assuming you take four weeks of vacation. If you work 32 hours a week, you’ll need to bring in $436 an hour to meet your goal.

Let’s say you charge $1,200 for a crown, which takes two appointments for a total of two hours to place (if you can do it in less time, even better). This rate exceeds your hourly goal by $236, and could even be applied to any shortfalls. While you’re not placing crowns every hour of every day, you have to leave room in your schedule for these types of procedures. Don’t overbook hygiene, and please, please stop scheduling appointments six months out.

Use the formula below to help determine the rate of hourly production and whether your practice is meeting production objectives:

1. The clinical assistant logs exactly how long it takes to perform a procedure, including time for all necessary 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 $215, then divide that by the total time to perform the procedure, let’s say 50 minutes. That makes production per minute value $4.30, and when you multiple that by 60 minutes, you get $258 an hour.
4. This is the number you must meet or exceed.

Knowing this target focuses your team and shifts your practice’s atmosphere from pressured to productive. You’ve taken control of your time and your schedule, the very foundation of your practice’s success. This enables you and your team members to deliver the best possible care without burning out, and sets you on a clear path toward success and profitability.

Next week, I tell you how to avoid the three most common scheduling mistakes.

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
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Belle DuCharme, CDPMA
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Time Management or Out of Time?
By Belle DuCharme, CDPMA

Ever wonder where the day went? When you’re busy in the whirlwind of activity that is a typical dental practice, time is one of the most valued commodities. When harnessed correctly, we have a productive, profitable and smooth running day. But when derailed by issues that zap the time and energy from us, we are less than enthused about the work we do.

It would be simple to say “buck up and ride it out” or “it is what it is” and just deal with it, which is what I hear from dental team members who believe they have no say in what happens in their dental practice. But the first step to finding relief is to acknowledge that there is a problem, and the second is to remember that there is a solution to any problem. If chaos is the accepted mode of the day and you are happy with that, then okay. But if you want to bring change to your day and create synergy and harmony, consider some of the following observations and recommendations:

1. Start the day with a personal or group affirmation, such as thanking the team for being there on time.

2. Start every day with a morning meeting to confirm the schedule and recognize any problematic patients or time allotment issues. 

3. Have a current list of patients available for last minute appointments. Time is critical when you need to fill a last minute cancellation.

4. Identify patients who have additional treatment needed that could possibly extend their appointment should there be a cancellation.

5. Focus on the most important issue that will affect the outcome of the day. This issue could be an individual goal or a group goal. For the clinical team, it might be setting up for a surgery and having team members in place to ensure all goes well. For the front desk team, it may be securing financing for the surgery prior to the day-of, getting signatures on paperwork prior to treatment, calling in prescriptions and confirming that the patient has a ride home.

6. Maintain communication within the practice during the day by instant email messaging, intercom or phone system. Instruct the business team to keep the clinical team aware of late arrivals or last minute cancellations and direct them to possible patients that could take the open time.

7. Delegate duties to other members of the team to help support a critical issue that needs to be completed. For example, if you want to update the fee schedules in the system but cannot be interrupted, delegate an estimated amount of time to a team member to answer the phone and check patients in so the task can be completed.

8. Create short task lists for everyone based on the most critical issue of the day. Accountability would be to complete these tasks by the end of the day. This helps the team to manage their time more efficiently.

9. Schedule and prioritize. Just as the doctor and hygienist are bound by their schedules, the business team also has tasks to schedule to completion, such as outbound calls to the unscheduled patients or follow-up on collection accounts. If these tasks are not scheduled into your day and given priority, they will not happen.

10. Define job descriptions. The first step to accountability is a written job description for each team member. This is the basis for their job success. Each person needs to know what is expected of them and how they integrate into the success of the team.

11. Have a standardized protocol that the entire team understands for daily operations in the practice. For instance, what is the protocol for a patient who is 15 minutes late? What is the protocol for scheduling a surgical patient? What is the protocol for scheduling an emergency patient? What is the protocol for a new patient? If everyone understands and follows these protocols, there is less time wasted asking questions and making errors.

12. Communicate to patients how long they will wait and ask them if it is okay. If you are running behind, apologize and offer the patient an option to reschedule. Look to see what happened that day and try to anticipate the future. Making patients wait is one of the top five complaints for dental practices.

Don’t let time be your enemy. If you want to learn how to schedule your day so you are less stressed, more productive and more profitable, call McKenzie Management today at 877-777-6151 for Professional Business Training.

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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Nancy Caudill
Senior Consultant
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What is YOUR Philosophy Regarding Treatment Planning?
By Nancy Caudill, Senior Consultant

The question presented to me was: What is the industry standard for treatment acceptance and why would it vary from practice to practice? Let’s take a look at the following scenarios:

The Age of the Practice
If you have purchased an older practice with older patients, typically there is a lot of restorative work to be done. An exception to this rule would be an older practice that was owned by a doctor who was more direct with patients and may have completed most of the treatment that was needed, or at least what the patients were willing to accept. In this case you just have to wait until something breaks!

On the other hand, an older practice where the doctor has been very conservative with the treatment recommendations may tend to say, “Someday you will need a crown/filling”. This approach is beneficial, assuming that the doctor still owns the practice when these “acorns turn into oak trees”. However, the downfall of this approach is that when a doctor has been very conservative in his or her approach to dentistry and sells the practice, the dentist coming in reaps the benefits of all those “acorns” that were planted.

The Number of New Patients
The more new patients, the more obvious treatment there is to recommend and the easier it is for patients to accept. As a result, there is a higher number of treatment recommendations and higher acceptance percentage. The fewer new patients you have, the less treatment there is to easily recommend and the lower the treatment recommendations. This is not to say that the acceptance would be any lower. This would depend on the skills of the dentist and his/her support staff, right?

The Philosophy of the Dentist
Some dentists are very black and white: I see a cavity, you need a filling/crown. I see a crack, you need a filling/crown. I see leaky margins, you need a filling/crown. The old silver fillings are past their usefulness, you need new fillings. Others are more shades of grey: You might need a crown in the future if this tooth starts bothering you. You might need a crown in the future if more of the cusp breaks off. This old silver filling has passed its usefulness, but if nothing hurts, let’s just wait.

Is the Practice Insurance Driven?
For offices that have always allowed insurance to play a large part in the decision-making process of the patient, once that patient has used up their annual benefits they don ’t accept any more treatment until next year, unless something hurts. For those offices that are more “want based”, patients are much more accepting of the recommended treatment by their dentist and have a much higher acceptance rate.

How Busy is the Practice?
Too many times, I see hygienists and doctors not taking the time with patients to educate them about their needs, and more importantly, their wants. Patients buy what they want. Doctors and staff, in general, are not good at offering patients options when there are no symptoms and it is not as easy to “sell” the patient on treatment.

The Dentist’s Ability to Present Treatment
Let‘s say that you have a patient with a fracture or craze line but the tooth is still intact, asymptomatic, etc. The patient has the following options:

1. Do nothing and wait until it breaks (could be tomorrow or years from now)
2. Repair the fracture with a large filling which doesn’t have a good long-term prognosis
3. Remove the fracture and restore the tooth with a crown to protect it from more damage in the future, with much longer-lasting results

Patients will respond to these 3 scenarios differently, depending on whether they are proactive or reactive. You don’t really know what the patient is going to choose unless you know your patient very well, and you may. It is like the scenario of buying new tires for your car – do you wait until you have a flat tire or do you replace them when the tread is wearing?

I also observe dentists using words like, “I think, maybe, could be, small, little, etc. This does not exude confidence in the diagnosis and can affect the patient’s willingness to accept treatment being recommended. Would you want your medical doctor to tell you that he/she “thinks” you need your appendix removed?

I see many dentists who “under-diagnose” or delay telling the patient what they see because it is the path of least resistance. A diagnosis may require more time to educate the patient and/or listening to patients ask questions or lament that they can’t afford treatment. I tell my clients all the time, it is not your fault that stuff happens to your patients’ teeth. You should feel good that you can help them save what was damaged so they don’t lose the tooth.

There is no right or wrong. You have to do what you are most comfortable with in your approach with patients. But at the same time, it is not fair to expect your schedule coordinator to keep you busy if there is no treatment being presented. If I had a magic wand, I would encourage my clients to give all the options to the patient and let them decide what direction they want to take. Your financial coordinator will help them to afford it.

If you would like more information on how McKenzie's Consulting Coaching Programs can help you implement proven strategies, email info@mckenziemgmt.com

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