6.5.15 Issue #691 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

What to Consider When Paying Hygiene a Guaranteed Salary
By Sally McKenzie, CEO

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You treat your hygienist, Katie, just like any other employee. You pay a guaranteed hourly rate, a structure that seems fair to you. Not only do you know exactly how much you’re paying her each month, she never has to wonder how much her paycheck will be – no matter how much, or how little, is produced during the pay period.

And that’s the problem. When you pay your hygienists a guaranteed hourly rate, they don’t have much motivation or reason to improve their production numbers. You limit the amount they can earn, so instead of working to grow their income and your practice’s productivity numbers, they become perfectly fine settling for the status quo, especially if they know they can count on a yearly raise, no matter what.

In my more than 30 years as a dental consultant, I’ve found that many practices follow this payment method and don’t even realize how much it’s hurting their practice. Most dentists are reluctant to make any changes because it’s a payment structure their hygienists like, so they continue to offer guaranteed wages while their bottom line suffers the consequences.

How can you fix this? I suggest you start treating your hygienists like the producers they are, instead of as a typical employee. Instead of paying a guaranteed salary, make sure wages are no more than 33% of what the hygienist produces. Hygienists really should be in the same category as associate dentists. That’s right, associate dentists. And associate dentists are typically paid 25-35% of what they produce.

Still not convinced? Let me give you an example. Let’s say your hygienist makes $25 an hour and works 8 hour days. That’s $200 a day. If she produces $600 a day - or three times her salary - then you’re golden. The hygienist gets one-third in compensation, you can apply one-third to hygiene department expenses, and the last third comes back to the practice as profit.

Sadly, this isn’t how it plays out in most practices. If your practice doesn’t have a Scheduling Coordinator trained to make sure your hygienists are scheduled to produce three times their salary, or if no one is accountable for the recall system that feeds the hygiene schedule, guess what? You’re going to have plenty of days when hygiene just doesn’t meet that goal. While this isn’t the hygienists’ fault, you’re still not meeting production goals. In fact you’re losing money, yet you have to pay your hygienists that guaranteed salary.

Now you might be thinking you can task your hygienists with calling recall patients during down time to help boost those production numbers. That’s sure to get more patients in the chair. There are dentists who go this route, but I don’t recommend it. Think about it. Do you really want your $50 an hour hygienist dialing for dollars? No, you want him/her producing.

Again, you should look at your hygienists much as you would an associate, and I bet you’d never ask an associate to work the phones. When producers are tasked with recall, your practice actually sacrifices more patient activity than it gains, so resist the temptation and make a designated business operations employee accountable for the recall system.

Let’s get back to your hygiene salary. When it comes to hygiene wages, I believe the best system to consider is paying hygienists a guaranteed base plus commission. This gives them the base pay they want, while still providing incentive to boost their productivity numbers. And when it’s time to hire a new hygienist, I recommend playing this up in your advertising. Why? It will attract candidates who understand the benefits of this model, and who will work hard not only to increase their income, but to boost practice production numbers and revenues as well.

If you’re considering making this change with your current hygienists, I bet you’re worried they may be resistant. After all, they’re used to making the same amount no matter what, and switching to this two-tier system may make them nervous. My advice? Explain how this model benefits the hygiene team and the practice. Before, earning potential was limited. This model leaves room for income to grow. The more that is produced, the more can be earned, which is good for both hygiene and the practice. 

Bottom line: If hygiene isn’t producing three times their salary, it’s hurting your practice. To improve hygiene production numbers and increase your revenues, consider ditching the guaranteed salary structure and switching to a system that will help you meet practice goals.

Next week: Why a two-tier hygiene salary may work best

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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Nancy Caudill
Senior Consultant
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Routing Slips... Why Do I Need Them?
By Nancy Caudill, Senior Consultant

Do you know what all the reports are used for in your practice management software?  Probably not…and that is okay! However, communication among the team members is vital to the success of a dental practice, as you well know.  When we ask employees to list their Top 10 Pet Peeves, they almost always say a “lack of communication” in the office.
In no uncertain terms, in my opinion, the routing slip is the #1 most important communication tool in your office. Not sure what it is? Ask your business manager to print one from your software (she may need to contact support in order to learn how) and review it with me:

Demographic Information
The top part of the form includes all the necessary information about the patient, such as name, address, telephone numbers, insurance information that includes unused dental benefits, and account balances. Also, you will find medical alerts, account and patient notes, recall notes and other Memo-type information that pertains to the patient.

Family Members
A list of all the additional family members that are attached to this patient is located here, including their recall information and whether they are scheduled or not.  This is very important in order to maintain a healthy patient retention.

Scheduled Treatment
There is an area that lists all the treatment that has been included with this appointment, as well as any notes that may have been added, such as “Check upper left side” or even the patient’s “portion” of payment.

Unscheduled Treatment
This is the most important area of the routing slip, because it indicates additional opportunities for increasing production without having to dig through the patient’s paper record or digital record. It is right here!

How is the Routing Slip Implemented?
Depending on the number of business staff that you have, the hygiene routing slips are printed and reviewed by the Hygiene Coordinator. The doctor’s routing slips are printed and reviewed by the Schedule Coordinator. This task allows them to become familiar with the patients being seen the next day and assists in expediting the morning meeting, as they highlight the areas of importance, such as past due family members, unscheduled treatment, birthdays, medical alerts that could affect treatment, financial concerns and unused insurance benefits, as well as the treatment that is scheduled for the patient.

The routing slips are now made available for the clinical team to review prior to the morning meeting. They are looking for discrepancies in the treatment, lab cases not delivered, etc.

During the morning meeting, the routing slips’ pertinent information is shared with the team, as well as a review of the schedule for “hiccups.” Most importantly, the production totals are presented from the previous day for celebration and production totals for today to help meet production goals.

Now what?
The routing slips are used in the treatment rooms to confirm treatment that was completed by checking, drawing a line through or adding to the existing list of treatment.  If the next visit is part of a treatment plan on the routing slip, this should be circled and the time indicated for scheduling.

As the assistant dismisses the patient to the Schedule Coordinator, the routing slip is presented to her, along with the patient. At this point, the Schedule Coordinator knows exactly what was performed today, as well as what to schedule next.

In order to balance the production at the end of the day for each provider, the routing slips can be used to confirm that the production was posted to the correct provider.  Once this task is completed, the routing slips can be permanently retired.

In the world of “chartless,” routing slips are especially important, as they become a disposable paper record that is used for only this appointment to improve the communication of the entire team and increase their knowledge of each patient.

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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How to Manage a “Lone Ranger” Employee
By Belle DuCharme, CDPMA

Dental practices thrive on a team approach to get through the work day. The hiring process revolves around putting together a team of people who will work well together towards a goal of great patient care. Matching the best personality types to job descriptions has proven to be an effective way to create a great team. Demonstrating good sportsmanship is valued when a team member needs help; another team member will gladly jump in to complete the job. In a team environment, members are willing to give credit where credit is due and take direction toward a common goal. Team players love the strong sense of being part of a team when they know they are all on the same page.

What happens when you have a star employee who doesn’t appear to be part of the team and who thrives on autonomy – a motivated self-starter who gets the job done without the help of anyone else? This person is referred to as a Lone Ranger. They do not like to be micro-managed because they have usually completed a task before being asked to do it. Some Lone Rangers are so committed to the business they can solve problems and reach goals that their employer has been trying to do for years. To the rest of the team, a Lone Ranger can appear aloof and a bit fanatic about seeing that things are done correctly.

When an employer says, “I want someone who can do it all, does not have to be motivated and will think outside the box” the response is, “You are looking for a Lone Ranger.”  Lone Rangers prefer working solo and feel they accomplish more that way, but will work with a team when they see a balance in participation and doing their best work. Lone rangers are not a bad thing to a business, but their roles within the business need to be a good fit. Giving a Lone Ranger an entire project with a deadline for completion is often a way to use this talent. In practices where growth is the result of the hard work of a Lone Ranger Office Manager, this person may be reluctant to search for a new hire to share the job duties for fear of upsetting the work accomplished.

Recently a client mentioned his ongoing frustration with a member of his dental team. “How can I turn a Lone Ranger into a team player?” First, look to the written job description that the Lone Ranger agreed to in the hiring process. If it says “must be a team player” then define what kind of team participation is required. For instance, is the team supposed to participate in the morning meetings and the monthly staff meeting and then work independently? Is this person supposed to delegate and monitor work assignments of others or help and motivate team members? The Lone Ranger may be the one seeing that tasks are completed on time by other team members.

Define the type of team participation the practice needs. Does it need cross functional teams that work smoothly and seamlessly, or separate work by individuals? Many dental practices operate as separate job descriptions without crossover, such as a dental assistant and a business coordinator. Both work separate from each other but the business coordinator must consider how the dental assistant will be needed when scheduling patient appointments, allowing time to take down and set up a room, sterilization, charting and patient education. In many practices, if the dental assistant needs help, the business coordinator will step in to assist. The Lone Ranger may see this as an organizational issue and time management problem to be solved.

Don’t assume that your Lone Ranger realizes he or she is behaving in a certain way, or realizes the impact of that behavior on the group or team. Probe during the interview to find out how much team experience this person has had within a group work setting or even playing sports. Arrange an informal private meeting to review job expectations and requirements. Take a collaborative problem-solving approach as a first step. Get the Lone Ranger’s perspective. Agree on a follow-up date to review the situation. Don’t wait until the annual performance review to bring these issues up.

Learn how to manage your team effectively to bring about positive results. Call McKenzie Management today, 877-777-6151 or email training@mckenziemgmt.com and inquire about our Dentist CEO or Office Manager training program.

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