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  Sally McKenzie's
 Weekly Management e-Motivator
  6.27.03 Issue #70

Breaking Down The Patient Retention Barrier

Sally Mckenzie, CMC
McKenzie Management

     If patients are walking out on your practice and never looking back, don’t stand there and hold the door. Take action! Most patients want to remain loyal to their dentists. Give them plenty of good reasons to do so and fill the holes through which they may be slipping.

Generate a report from your computer of all patients past due for recall appointments in the past twelve months. This is your “target audience.”
Reconnect with those inactive patients. Assign a patient coordinator to:
    - Make a specific number of calls to past due patients each day.
    - Schedule a specific number of appointments.
    - Ensure a specific number of patients complete treatment.
    - Schedule so the hygienist achieves a specific daily or monthly financial goal.
    - Manage a specific number of unscheduled time units in the hygiene schedule per day.
    - Monitor and report on recall monthly.
Reacquaint yourself and your practice with patients. Send a direct mail letter to every adult in your active and inactive files who is or was a patient in good standing. Be sure to include something about the importance of ongoing professional dental care and giving patients beautiful smiles. The letter could, for example, start with a headline in 14 point, bold type, for example: "What if You Could Finally Have that Gorgeous, Electrifying Smile You’ve Always Dreamed of?”
Provide reasonable financing options for patients. Establishing a relationship with a patient financing company such as Care Credit makes treatment more affordable and more likely patients will proceed with both necessary and elective dental treatment.
Deep six the six month recall “system.” Don’t panic. It’s not like I’m recommending you never speak to a loved one again. As fond as practices are of this low maintenance (low payoff) system, it has a tendency not to work in today’s marketplace. Practices using this technique average only 76% patient retention and have a nearly 50% higher loss of patients than similar-sized practices that do not pre-appoint. Pre-scheduling makes your hygiene schedule appear to be full when, in reality, it often is not. Evaluate your system and don't assume it is working for your practice, for your patients, at this time.
Take an approach that works. The hygienist explains the need for follow-up prophies and exams to the patient. The patient addresses the envelope in which their recall notice will be sent. The hygienist instructs the patient to schedule the next appointment when their notice arrives in the mail. (Appointments scheduled two-to-three weeks ahead are less likely to be cancelled or result in no shows.) Use a professionally written and printed recall notice [see example here] – no postcards. The hygienist writes a personal message to the patient reminding them of the need for ongoing professional dental care. An educational brochure relating to the patient’s condition or a specific practice service, such as teeth whitening, is included. Voila! You have a much more effective and professional system.
Remind today's patients of past due family members. Your computer system provides you with a routing/encounter form on each day's patients. On this form it will provide you with past due family members. Spend time at your beginning of the day meeting discussing a plan of action to fill tomorrow's schedule with today's patients.

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Building On The Theory

How An Ailing Business Foundation Can Cause
“Digital Chaos” Part 13

Mark Dilatush
VP Professional Relations
McKenzie Management

Technology Tool Box

#13 Insurance Systems Continued

Last week I discussed your insurance system as an integral part of your overall business foundation and different ways to leverage your technology investment [see article]. This week I will continue with your insurance system and additional ways to leverage your technology platform.

  1. Tracking deductibles met and unmet is really determined by which system you use. Some systems automatically pull the deductible from the patient’s portion of a balance at the first occurrence when the insurance company benefit year turns over. Notice I said benefit year and not calendar year. Some insurance companies do not renew benefits by the calendar year. Make sure you are aware of the ones that do not and update the month they use within your insurance plan screen. Some systems wait for the first insurance payment to arrive before “meeting” the deductible. Be careful with this one at the beginning of the year. Learn how your system works and work with it. The more accurate you are with patient expectations, the better service you provide.
  2. Do you have any children in your practice who need dental work done with remaining benefits on their insurance? The summer time is an excellent opportunity to see the younger range of your patient base. It is also a wonderful time to leverage the younger range of your patient base to generate new patient referrals from their parents. Run a report from your database. For example, Patient less than 18 years of age, treatment plan total greater than $0. That would be one report. Run one other report but add – remaining benefits greater than $100. You might be surprised what you will find!
  3. The end of the calendar year and the beginning of the next calendar year are wonderful opportunities to communicate with your existing patients. You will have patients who have remaining benefits (that they will lose) and most likely no deductible that require additional dental work. You will ALSO have patients after the beginning of the year who have work they needed to have done but are waiting for the insurance benefits to renew at the beginning of the insurance companies benefit year. Most dental practices pay attention to the end of the calendar year but do not exploit the opportunity after the “ball drops” on Dec 31st!
  4. Most practice management software has a note area where you can type information when posting an insurance payment. This area is underutilized but extremely effective when used properly. You want to use it for reference to the treatment rendered (if your system doesn’t automatically do so), or, use it for the reason an insurance claim was denied or paid a reduced coverage (alternate benefit). Using these simple note areas will allow you to instantly handle an incoming patient inquiry professionally, accurately, and (most important) to the satisfaction of the patient.
  5. Here’s one that many of you don’t use, or you tried to use it and it didn’t work. Bulk Payments. The bulk payment area of your software should be used any time you receive an EOB with multiple payments on it. If your computer system knows the insurance company, and can bring up a list of patients based on claim date – you can make all the payments on one screen! How efficient is that! Take the time to study how your software handles this process. If it takes you half of an hour to learn how to use it, I guarantee you will save half of an hour per week once you implement the process.

Next week we will move on to referral management.

If you have any questions or comments, please email Mark Dilatush at

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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 hired a new office manager, "Betty", approximately 1.5 years ago to take over for my

original office manager that abruptly quit on me. When she quit, I began to find out how many mistakes there had been in regards to the day-to-day management of the office. We have since had a series of office retreats so as to create written down systems manuals (with specific responsibilities and monitors for verification) and job descriptions which has gone quite well.

I would like to see my office manager assume the new role of "Practice Administrator" to oversee these systems and allow me, for the first time in my career (10 years, 5 years in solo practice) to totally concentrate on my leadership role in the office (I tend to micro-manage).

The problem is some of my staff who have been with me the longest (pre-"Betty") have doubts that she can do the job all by herself (that is appt. coordinator, financial coordinator and management) and worry about patients being greeted properly etc. because of her many "hats".

Our practice grosses quite well and all bonuses are tied to collections and are shared equally depending on how long the employee has been with us (i.e. a vesting schedule). Some of the other employees are hesitant (as am I) to add another "mouth" to feed as it will affect everyone.

How do I gracefully transfer power to my very capable employee so that I can concentrate on doing what I do best which will benefit everyone?

Sincerely, Dr. Awesome Powers

The Coach Replies:

Reading between the lines of your question, several points stand out.

  1. The fact that your office manager “abruptly quits” implies that regardless of what you believe, you didn’t track your business very carefully or she disrespected you enough not to care if she disappeared. This places your management skills in question.
  2. The fact that you are just now discovering her mistakes supports my point that you are not managing the business nor the team interactions adequately.
  3. You state that you have a tendency to micromanage, but that is obviously not the case. If you micro managed, then you would know everything that was going on, which you didn’t.
  4. As for the retreats, writing down systems is only 25% of the solution. Team cohesiveness makes systems work and daily solutions self-evident, not writing them down and creating more structure and rules. Anyone can write rules and everyone will agree when publicly confronted; this does not mean they agree nor will they follow them after the retreat.
  5. You want your “new hire” to run the business so that you can be a leader. The person who runs the business is the leader. Perhaps you want to be a better leader, i.e. coach. This is fine, but as a leader you do not give up control and responsibility.
  6. If the team members have doubts that she can do the job...why is this? Are you missing something that they live with everyday?
  7. You say that the team worries about patients being greeted/handled properly because of her many hats. According to McKenzie Management she can greet and dismiss up to 22 patients in an 8 hour day. Don’t you think there is more to this objection, and why do you believe such a justification?
  8. I think it is reasonable to have all bonuses tied to collections and shared equally with a vesting program; however, have you factored in the greed component that raises its head when you use revenues for a bonus plan instead of performance indexing. It is because you use revenues and encourage individual greed that the employees naturally voice a hesitancy to add another mouth to feed. However, the fact that you do as well demonstrates that you are part of the problem. If the new hire is an asset to the business, then you want to be generous with her and support her efforts to wear all the hats...instead, from your description, you are one of her detractors because you do not want to share. If she is your pick to take over, then why are you reluctant to reward her great performance?
  9. Finally, a word of caution. You never transfer power; this is your business and you are responsible for everything. However, you can delegate responsibility for specific outcomes. There is a difference.

In conclusion, No one can benefit if there are secrets and hidden agendas. Your assessment of your team, your new hire, your old manger, your ability to lead are all topics for further discussion. The truth is in there somewhere, but are you willing to admit to it?

The Coach

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The 5 Dysfunctions of A Team- Part VI
Absence of Trust
Most successful people in corporations learn to be competitive with their peers and protective of their reputations. It is a challenge for them to turn those instincts off for the good of a team.
Fear of Conflict
Teams know that the only purpose is to produce the best solution in the shortest amount of time.
Lack of Commitment
For most teams, all the information they need resides in the hearts and minds of the team itself and must be extracted by unfiltered debate; this is not always understood by subordinates.
Avoidance of Accountability
Peer Pressure reduces the need for excessive bureaucracy.
Inattention to Results
There must be an unrelenting focus on specific objectives and clearly defined outcomes.

"Hopefully we can come back to the center and visit soon! I also wanted to brag on our office! Yesterday, my hygiene department produced $2,025 in one day! We were so excited! Just thought I would let you know and thank you for all your advice! Our hygiene department rocks!!*

Alexis, Patient Coordinator
Graduate of The Center for Dental Career Development

*Note: Results are four months after receiving training from The Center

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

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