5.15.15 Issue #688 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

How to Establish a Solid Fee Schedule
By Sally McKenzie, CEO

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Establishing fees can be tricky, and if you’re like most dentists, the thought of adjusting them makes you a little nervous. You know a raise in your fees is probably long overdue, but you worry that an increase might upset your patients enough that they will take to social media to complain about your high rates or even opt to find a new dental home.

Not only is this resistance to increase your rates costing you money, it’s also keeping you from growing your practice and achieving true success. If you haven’t raised your rates in years, I can almost guarantee your practice is suffering. Maybe you haven’t been able to invest in new technology, or provide your team with the training they need to excel in their roles. Perhaps you’ve skipped opportunities to expand your skills because you didn’t want to take on the extra cost, or you’ve decided to forego much needed practice updates because you just can’t afford them.

You might think you’re giving patients what they want by offering low fees, but in reality you’re compromising on the quality of care they receive and the experience they have while visiting your practice. A small adjustment of just $4 or $5 per procedure each year wouldn’t pinch your patients, but it would do wonders for your bottom line, enabling you to make necessary enhancements to your practice and improve the quality of the care you provide.

If you’re going to run a successful, thriving dental practice that patients are proud to call their dental home, you have to make adjustments to your fees from time to time. Here, I’ve put together a few tips to help you create a solid fee schedule that will boost your bottom line.

Know how your practice compares. If you don’t already know, find out what other dentists in your area charge. Make sure your fees don’t fall too far below or go too much above the local marketplace. You also need to make sure your fees reflect your business.

Establish a standard fee for each service. Before setting or adjusting your fees, you need to determine how much it costs you to perform the dentistry. You should base your fees on your patient base, overhead, expenses, debt and your level of professional expertise.

Keep track of your overhead expenses. It’s important to make sure your overhead expenses line up with the industry benchmarks, which are: Laboratory: 10%, Dental and office supplies: 7%, Rent: 5%, Employee salaries: 19-22%, Payroll taxes and benefits: 3-5% of collections.

Recognize your skill level. If you’re a new dentist, chances are you’re not going to perform procedures as quickly as a dentist who’s been practicing for 20 years. While you’re building up your speed, focus on building relationships with your patients. In fact, if you’re establishing a new practice, I recommend not hiring a hygienist right away. Why? This will give you a chance to really build patient relationships and start making connections. Not only that, it will help keep your overhead down until your production numbers increase and you can afford to bring on a hygienist.

Connect with your patients. When patients feel connected to your practice, they won’t think twice when they notice a slight raise in your fees. Take the time to talk with patients about their families and their jobs, and about their oral health goals. Provide education and let patients know you care and want to help them maintain their oral health. This is a great way to create loyal patients who will stick with you even when your prices go up.

Avoid the fee ceiling trap. Don’t trap yourself by attempting to establish your office fee schedule based on what some third-party payer reimburses at 65% of the 85th percentile.

Create goals. Determine what kind of lifestyle you want to live, and then determine how much you need to make each year to achieve that lifestyle. Think about how many weeks you want to work each year, how many hours per week and how many patients you want to see each day. Use these numbers to come up with daily production goals that will help guide you as you establish or adjust your fees.

Make fee increases part of the plan. Establish a solid fee for each service you provide, and then plan to adjust those fees twice a year: Example, 2% the first time, then 3% for a 5% total increase each year. Trust me, this slight increase will do wonders for your bottom line.

Making fee adjustments is an important part of owning a dental practice. Patients who have a connection with the practice and who value the care you provide won’t leave just because you raised your fees a few dollars, and the increase in money coming in will help ensure you’re able to make necessary enhancements to your practice.

For additional 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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Jonathan Gale, Ph.D.
Leadership Coach
McKenzie Management
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Obtaining Patient Satisfaction
By Jonathan Gale, Ph.D.

Generally speaking, dentists take pride in preventative care, treating symptoms and emergency interventions to ultimately improve a patient’s quality of life. But there is something else dentists need to focus on these days, and that is the patient’s experience, or sense of satisfaction, from the time of scheduling to receiving the care to paying the bill. As we know from our personal experience with needing a dental procedure, or even a regular check-up, we are usually not happy about needing it! How can dentists be in the business of treating people’s problems and simultaneously be expected to receive high patient satisfaction scores?

Think of it as long-term preventative care: The more you can educate your patients to take better care of themselves and do minimal emergency interventions, the healthier your patients will be, and therefore the happier. Studies show that patients who are satisfied with their care are more likely to be compliant and have better outcomes. Patient satisfaction begins with building a strong relationship, but goes much further. Here are some ideas to consider when working to improve patient satisfaction.

1. Listen. The first step in making your patients happy is simply to listen. Often, patients complain that their dentists seem rushed and too busy to really pay attention to them. Take time to listen to your patient's concerns, and make sure to answer each one! This may be time consuming, but it will save time in follow-up calls or cancellations down the road. Make eye contact. Wait to speak until your patient has finished, then ask questions to be sure you understood everything s/he has said. This conveys to your patient that you care and want to understand their needs.

2. Treat your patient like a customer. It is important to remember that patients drive the demand for dentists. Fewer patients would not be good for business! It might seem a little too “business-y”, but part of your focus should always be on patient retention. Treat your patient like a customer whose business you don't want to lose. Smile, be courteous, and go above and beyond. This can be difficult at times, and you may need to train your staff on these skills, but the payoff is huge.

3. Keep a professional appearance. Appearances matter. Anyone with whom a patient comes in contact should be neat, tidy and professionally dressed, with no long fingernails, offensive odors (e.g., excessive perfume), unusual piercings or noticeable tattoos. Exam rooms should be spotless. Waiting rooms should be clean and stocked with current and relevant reading material. Also think about the kind of conversation your hygienists are having with your patients. Are they divulging too much personal information? Are they taking advantage of a “captive audience?” Do they ask intrusive questions, and then continually stop their procedure to allow the patient to answer? Is this what the patient wants? What could the patient say, or to whom could they say something if they did not? When a patient walks into your office and sees cleanliness and professionalism, they know they can expect to receive quality care.

4. Walk a mile in your patient's shoes. As providers, it is easy to forget what it’s like to be a patient, yet thinking about your own experience as a patient is the simplest way to approximate what might satisfy you. Patients are often scared, anxious and uncomfortable. The chair places them in an exposed, vulnerable position. They cannot see what is happening – only the tools you or your assistants are using – and they often cannot talk or voice their concerns. In addition, pain and/or fear is often a factor. Keep this step in mind when you feel a patient is being difficult or unreasonable.

5. Take complaints seriously. When your patient has a complaint, listen and take accountability. Never place blame or become defensive. Just accept the complaint, apologize, and assure the patient you will do your best to make things right. Follow up with your patient later to let them know the situation has been handled. If possible, compensate the patient in some way. This might be a gas card if the patient has driven to an appointment that had to be canceled, or a certificate for lunch if the wait was excessive.

This is not just one more list of things to remember, but instead it should be intuitive. We are all fairly discriminating consumers, a trend which is increasing as we have access to more information and options via technology. Simply think about your experience as a dental patient. What would be “satisfying” to you, even if you did not want to be there? What are some key take-aways you can implement today that align with the kind of practice you naturally run? Perhaps it is just a smile and good eye contact, or delegating to some of your staff to keep the physical office clean, contemporary, and visually appealing. Any efforts are better than none, especially when your financial success depends on it.

Dr. Gale provides coaching and training to enhance leadership skills, interpersonal communications and team building. If you would like to learn more, contact him at jgalephd@mckenziemgmt.com

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Jean Gallienne RDH BS
McKenzie Management
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By Jean Gallienne, RDH BS

I work in an office where I am responsible for monitoring hygiene numbers every month. There is one thing I have noticed continually when I do them – we do not have “no-shows” in our hygiene schedule very often. It will often be three or four months before we have one. We have four full time hygienists in our practice based on a four day work week, and two of us work a half day on Friday. What does this say about our hygiene department? It says that we have created value in the hygiene appointment.

In our practice we do not do “just a cleaning” or even “cleanings”. We do much more than that. We provide our patients with a hygiene appointment that not only matters to the health of their mouth, but also to their overall health. In addition to caring about their teeth, we help patients understand that the mouth is connected to the body by the neck and is the very beginning process of our digestive system. We rarely use the term “cleaning” in our vocabulary. Team members refer to patient appointments as hygiene appointment, periodontal maintenance appointment, or root planing. If we use any other verbiage such as cleaning or deep cleaning, it is only to teach patients the proper terminology used in our office.

Without proper education, patients may think, “I clean my teeth twice a day at home. Why do I need to pay a dental office to do something I already do?” When it comes to deep cleaning, I clean to the base of the pocket every time I am in a patient’s mouth. It has been supported by many research studies that supra gingival removal of calculus alone by a clinician is not beneficial to the patient. So, I have to explain the difference between a periodontal maintenance appointment, cleaning, and root planing. I know the difference, but the patient may become confused by this. They need to be educated by us as dental professionals.

Explaining to the patient what you are doing also helps to create value in the hygiene appointment. It is best to do this while you are doing it – not at the beginning of the appointment, end of the appointment, or even worse by the front office person as the patient is leaving. When you are probing, tell them you are probing. They may know what the numbers mean, but if you are not calling the numbers out to an assistant, the patient may not realize what you are doing. Depending on the patient and how long they have been with the practice, you may want to tell them before you begin to probe. “I am going to probe your teeth now to help us determine how healthy your gums are. You want to have less than four millimeter pocketing.”

Even though you probe each tooth at every hygiene appointment, you may not have the ability to do it out loud every single time the patient is in your chair. If this is the case and there is no assistant available, modify what is said but still tell the patient what you are doing and what the findings are, even if the findings are healthy.

The same rules apply when performing an oral cancer exam. Tell the patient you are doing the exam when you are doing it. Tell the patient of any findings you may see, even if you point out Fordyce granules that the patient may never have noticed. This helps them realize there are many things going on in and outside their mouth. Even though it is considered normal, they may not have noticed it. Now the patient is educated by the hygienist that we even look for cancer when they are in our chairs.

These examples are only a couple of the procedures we perform during a hygiene appointment. Remember, we are not “just cleaning” their teeth!

Interested in improving your hygiene department? Email hygiene@mckenziemgmt.com and ask us about our 1-Day Hygiene Training Program or call 877-777-6151

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