10.10.14 Issue #657 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

11 Reasons Your Practice Production Has Plateaued
By Sally McKenzie, CEO

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You’ve heard about those high-producing dental practices, the ones bringing in $1 or $2 million a year, but your practice certainly isn’t among them. You’d love to know their magic formula for success, because right now your practice is stuck and going nowhere fast. You’ve hit a plateau and you have no idea how to navigate around it.

The truth is, there is no secret formula. The most successful practices develop a business plan of action that keeps them moving ahead at full speed. They review production numbers every month, not just at the end of the year. If they see they’re headed toward a plateau, they put in a recovery plan that gets them over it, even if it means asking for help.

Over the 34 years that I’ve coached dental practices, I’ve found there are 11 indicators that mean a production plateau is imminent. Take a look at these indicators and ask yourself how many of them are happening in your practice right now.

1. Business staff turnover. Hiring team members might not be your favorite task, but hiring the right team members is vital to your practice’s success. When it’s time to add someone to your business staff, you have to hire someone with the necessary skill set. Is the person you want to hire good at math? Does he or she have the right temperament? If the answer is no, it won’t be long until this bad hire quits in frustration, and you’ll have to start the dreaded hiring process all over again.

2. Your staff isn’t trained properly. If you want team members to excel, you have to take the time to train them. Set new team members up with all necessary training and tools from the beginning, and you’ll see a huge increase in practice production.

3. You have no expectation level for systems. You can’t just tell your patient coordinator you want to keep busy, or tell your office manager to send out statements. You need to have specific goals for your systems, and you must communicate those goals with the team members responsible for them.

4. There’s a lack of practice performance systems. A system’s success cannot be dependent on one individual in your practice. Everyone needs to know how the systems should be performing to both industry standards and the practice’s vision, whether that’s achieving 85% case acceptance or a 98% collection to production ratio.

5. Team members have unclear job descriptions. Your team members aren’t mind readers. They need clear directions, and job descriptions that include performance measurements as well as outline exactly what their duties are and what systems they’re accountable for. 

6. Patient retention is declining. This is a big one. You can’t lose out the back door more than 50% of the new patients coming in the front door. If you are, I guarantee you’re headed for a plateau. But before you throw money at marketing to attract new patients, find out why current patients aren’t coming back. Is there a customer service issue? Are your fees too high? And, of course, you also have to look at and fix your recall system. This is the most neglected practice system, yet it’s the principal vehicle for patient retention.

7. You have a lot of unscheduled treatment. Your patient coordinator should be tracking unscheduled treatment, contacting patients on the unscheduled treatment report and getting them scheduled – not just calling when there’s a hole to fill in the schedule. Your coordinator, armed with a well-written script and winning personality, should reach out to at least five unscheduled patients a day.

8. You haven’t added new services in years. Patients want to go to the most up-to-date practice that offers the services they need. If your practice sticks with the same old, same old, not only are you not as efficient as you could be, you’re not as attractive as the high-tech practice down the street.

9. You’re not clinically efficient. Clinical inefficiency leads to slow treatment room turnaround, and that’s costing you money. Make sure you have everything you need in the room before you start treatment. Delegate more to the dental assistant, as your state allows. Never compromise on the quality of the dentistry you provide, but challenge yourself to cut production times by just 10 minutes. You’ll be amazed by how much your production per hour increases.

10. You don’t review fees for increase. Every year your costs go up, and that means your fees should as well. Many dentists don’t like to raise fees because they’re afraid it will mean losing patients, but that simply isn’t true. If you base your fees on solid data, you can create a fee schedule that is affordable for your patients and fiscally sound for your practice.

11. There’s no practice vision. You are the CEO of your practice, and are responsible for setting goals and establishing a vision. You have to develop clear and specific objectives, and communicate them to your team. If you can’t see where the practice is headed, how do you expect your team to?

You have control over your potential income. If you monitor these practice indicators, you’ll avoid plateaus and grow your income to levels you never thought possible. Soon you’ll be among those high-producing dentists everyone else in the industry envies.

Next week, how to improve your patient retention system and increase production.

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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Nancy Caudill
Senior Consultant
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How to Prepare Your Bank Deposit
By Nancy Caudill, Senior Consultant

Do you, the doctor, balance your own bank statement each month, or do you have a bookkeeper or accountant who completes this task? It is always a challenge to balance your practice management’s total collections for the month to your bank statement and/or P&L. Typically, your accountant extrapolates the income line on the P&L from your bank statement, and 9 times out of 10 this will not match your software’s deposits. Have you ever wondered why not? Let’s review how deposits should be handled to assist in the process of balancing the P&L or bank statements to your practice’s software.

Electronic Transfer of Funds
Many practices accept payments that are automatically transferred into your bank account from insurance companies. I would suggest that you NOT accept Electronic Transfer of Funds (EFTs), as it will make it impossible to balance your bank statement to your PM software. It also means that your Financial Coordinator must post those payments daily (as the notice comes in from the insurance carrier) and not let them build up. I have worked in offices where the business team felt entering the payments into their PM software was not important because all the doctor cared about was money being in the bank. This may be true, but statements and refunds can’t be managed until these payments are posted to each account.

With many of the ETFs, in order to create an Explanation of Benefits (EOB) your business team must manually print the EOB from the emailed report sent from the insurance company. This takes time and supplies. Should you feel that the timeliness of the deposit to your bank account outweighs the importance of reconciling your bank statement and preparing an accurate daily deposit, then at least make sure that payments are posted daily to patient accounts.

When to Prepare Deposits
Deposits should be created DAILY! This means that a deposit report from your PM software should be generated after all payments are posted for the day, and this report should be compared to the reconciled credit card receipts, cash and checks. Some PM softwares will suggest that you have two types of deposit reports and I agree – one that shows actual monies taken to the bank (cash and checks) and a different report for credit cards and electronic transfers (if you have any from the insurance companies). 

When does your business team actually take the deposit to your bank? This depends on the hour that your bank closes. If your business team can balance and prepare the deposit and take it to the bank at the end of the day, that is just fine. If you take it daily, that is fine too. Some offices take it to the bank the next morning. Whichever option you choose, be consistent. If the deposit is made the next morning, it will have that date on the bank statement, even though the deposit is actually from the previous day in your computer. Same if the deposit is made the same day.

The Daily Deposit
The first deposit report from your PM software should be printed and kept in a binder or saved as a pdf file. This deposit report should match the total cash and checks that are taken to the bank. The old-fashioned duplicate deposits are still the best way to manage and balance. The deposit slip is prepared with the following information: the TOTAL of the checks, the TOTAL of the cash and then the TOTAL of the deposit. There is no reason to itemize each check – that is why you have a report from your PM software. The bank does not need this information.

When the deposit is presented to the bank teller, a receipt is given back. This receipt should be attached to the “yellow” carbonless copy of the prepared deposit in your deposit book in the office. Do not remove both copies when the deposit slip is prepared, only the original that is added with the cash and checks.

The second deposit report illustrates the total credit card payments and should also balance with all the signed receipts from the patients in the office, any telephone receipts generated and made by mail AND the close-out of the credit card machines. If you have more than one credit card machine, each machine must be closed out and the totals of the machines reconciled to the second report. This is very important. All of the receipts and credit card machine close-outs should be attached to the report showing that it all balances. If it does not, something is wrong. Fix it ASAP!

The Bad News
You still won’t balance unless you don’t accept credit cards. Credit cards don’t settle for 2-5 days (depending on the credit card company), so your totals for credit card payments made during the last 2-5 days of the month will be off. This means when you are comparing your bank statement or P&L to your PM deposit for the month (or the collections or payment report), your balance will be off by those credit card payments that were posted in your office the last couple of days. You will need to manually pick up the credit card payments for those last few days on next month’s statement or P&L.

Happy Balancing!

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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Belle DuCharme, CDPMA
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Power Words for Effective Communication
By Belle DuCharme, CDPMA

Dear Belle,
I have a problem. I am the Office Manager of a small practice and my duties include making hiring decisions and speaking with other employees about being late, taking time off, etc. I feel like no one takes me seriously and they go over my head to the doctor. How do I get the respect that I need?

Respect is earned, but it isn’t something you need in this situation. It is the position of authority that the other employees are questioning. You were put in a leadership position and you haven’t taken the role yet. It would be wise to take leadership and dental management courses, but first let’s look at what you say and how you say it. 

Weak language is apparent in your question above. By using “I feel” you are drawing the attention away from the real issue and making it about you. Your goals are to gain cooperation, to lead, to nurture and to persuade. Your language shows lack of confidence, hedging and dread in face-to-face encounters. People will not see you as an authority, or in this case an Office Manager, unless you improve your communication skills. As an Office Manager, it is important to remove the emotion of “I have a problem” from your communication and learn how to distance yourself to have improved stature and credibility.

Take, for example, communicating with an employee who is late: 
About you: “I noticed you were late again Becky.”
About the team: “The team has too much work to do and we need you to be on time.”
About the doctor: “Doctor is concerned that you are late again, Becky.”
About the issue: “The practice cannot operate without all team members here on time.”

As Office Manager, you will also be put in the situation of intervening when one employee is bossing or criticizing another. Here is an example of that communication:
About you: “I want you to stop criticizing the dental assistant.”
About the employee: “You are criticizing the dental assistant and it has to stop.”
About the team: “Everyone has noticed and has said you are criticizing the dental assistant”
About the issue: “Criticizing disturbs the entire team and must end.”

By distancing the emotion from the issue (removing the “I” and “you” from the statement), you are gaining credibility and objectivity. This distancing of emotion creates authority for the position.

Current written job descriptions for all employees and an updated office policy manual will help when communicating with non-compliant employees, as these establish rules and decorum that all must abide by. When conducting performance reviews of employees, it is important to stick to the facts and have date, time, parties involved and incident details in writing. Keep emotions in check by identifying the issue or problem and resolving it with tact.

When giving instructions to employees, examine the strength of your words and whether you are getting the results that you want. For instance, do you say to the Scheduling Coordinator, “I need the unscheduled treatment report on my desk by noon” or do you say, “Do you think you will get a chance to complete that unscheduled treatment report by noon?” The first statement is a direct request and the second is indirect and gives an out. The first statement is about “I need” instead of about the report. The best statement would be, “Please have the unscheduled treatment report on my desk by noon today, thank you.”

Not knowing what to say when the situation arises can quickly strip your confidence and diminish your authority. Writing scripts for anticipated scenarios takes the fluster and the “I forgot to mention that” out of the communication. Scripts give you confidence because they are planned and structured to get the response that you want.

McKenzie Management has the power tools to give you the confidence and authority of a great Office Manager. Our customized approach will enable you to achieve better communication through the power of words and systems that you and your practice need for success. Call today and get started with our Office Manager Business Training Program.

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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