5.13.16 Issue #740 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

4 Things Every Associate Should Ask Before Joining a Practice
By Sally McKenzie, CEO

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There’s no doubt that senior dentists and the associates they hire often come into the new arrangement with very different expectations. Associates are looking for a mentor who will help them improve their practice management and clinical skills. They want to know the practice they’ve joined shares their philosophy of care and always puts the patient first. These young dentists want stability without the pressure to bring in a lot of money right away, and are excited about the benefits that working with a senior dentist offers.

Hiring dentists, on the other hand, want to find someone who will solve all their problems. They’re so busy they can barely keep up and are ready to reduce their workload. They have visions of the new associate stepping into the role seamlessly, taking on management responsibilities, attracting new patients and helping the practice grow its bottom line.

You can see where these different sets of expectations might cause trouble. That’s why it’s so important for hiring doctors and potential associates to make sure they’re on the same page before entering into an agreement. Both sides need to be honest and ask themselves some tough questions to ensure they understand each other’s priorities and objectives.

I know this can be difficult, especially for a new dentist fresh out of dental school. To help make it easier, I’ve put together a list of four key questions every potential associate should ask the hiring dentist before joining a practice.

1. What is your approach to treatment planning? Make sure you’re comfortable with treatment planning procedures and the practice’s overall philosophy of care. Is there a Treatment Coordinator or does the dentist handle case presentations? What is the case acceptance rate? What type of patient education is offered? The answers to these questions will help you determine if the practice is right for you.

2. Is the practice saturated or struggling? Of course associates want to join a practice that is saturated, which means the patient base is made up of between 1,500 and 1,800 active patients who visit the hygienist at least once a year. Why is this so important? There’s a good chance many of these patients have unscheduled treatment, giving you the opportunity to take on a variety of cases while also boosting production.

Another benefit? You’ll likely find a fair number of patients who are overdue for their professional hygiene appointment, giving you an opportunity to meet new patients and start building relationships.

3. What kind of feedback can I expect from you? Your time as an associate should help you enhance your skills and become a better clinician. That won’t happen if the senior dentist expects you to hit the ground running with little direction or feedback. Instead, look for a dentist who is open to serving as a teacher and mentor.

I recommend meeting with the senior dentist weekly for the first six months or so. These meetings are great learning opportunities and will give you the chance to discuss difficult cases, patient concerns and management issues. This will help keep communication open between you and the senior dentist. Any concerns that come up can be addressed promptly and you won’t be left guessing about how you’re progressing. Both you and the hiring doctor will be on the same page, which is key to a successful arrangement.

You and the hiring doctor should also meet once a month to review key practice indicators. This includes accounts receivables and production reports.

4. What happens if the arrangement simply doesn’t work out? No matter how much research you do before signing on or how hard you try to keep communication open, sometimes these arrangements just don’t work. This is disappointing, but it’s something both you and the hiring dentist should prepare for from the start. Make sure the agreement you sign includes a timeframe for leaving the practice, which is usually 30 to 60 days after you inform the hiring dentist of your intention to leave. This gives you enough time to complete most of the cases you’ve started.

Remember it’s important to leave on good terms, no matter the situation. Don’t burn any bridges. Finish your time and then move on.

Becoming an associate affords you a great opportunity to learn from an experienced dentist while you enhance your skills, but don’t just jump at the first offer you get. Take the time to ask the right questions and make sure it’s a good fit. This will save both you and the hiring doctor a lot of time and frustration down the road, and will help get your career started on the right track.

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
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Elizabeth Brackin, PsyD
Leadership Coach
McKenzie Management
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Leadership and Staff Wellbeing
By Elizabeth Brackin, PsyD

Organizations and small businesses are increasingly becoming aware of the value employees bring to the overall success of the company. The ‘happy-productive worker’ paradigm predicts that employees high in wellbeing also perform better. Research strongly supports this correlation, and further suggests that effective leadership is key for ensuring and promoting employees’ wellbeing. This article lists some things you can do as a leader to get the most out of your staff and in turn, increase the success of your dental practice.

Why do successful leaders promote the wellbeing of their staff? Research supports the idea that the more engaged and fulfilled your staff are in your business, the more profitable and efficient you become. Patient experience increases and repeat business occurs.

How do you promote increased engagement of staff members?

Inspire your employees. Leaders do this by formulating a clear vision for their group and together they create goals for how the vision can be achieved. Do you have a vision? Is it clearly stated? Do you share this with your staff? Do you invite and incorporate their feedback? Is there a clearly defined set of sub-goals leading to the vision?

Stimulate, or motivate, your employees. Do you know what motivates each of your staff? Have you asked them? Or do you apply a blanket approach of annual performance reviews? Tailoring your motivational practice to each individual will pay off tenfold. It will also greatly increase their engagement in your practice.

Encourage employees to think outside the box. When leaders engender a sense of empowerment, or a feeling of connection among the employees to the company’s product or service, the employees will bring their creative energy into their work. This might seem frightening to you at first, but companies that have developed a culture around leveraging people’s creativity, such as Google, have seen unsurpassed success. How do you challenge existing mindsets, and support employees in independent decision-making?

Function as role models. How aware are you that your behavior is a model to the rest of your staff on how to behave? Do you consciously move through your day, showing your staff how to treat patients and each other? Do you exemplify a healthy work-life balance? Do you hold yourself to a high standard and celebrate successes along the way?

Show individualized consideration, or mentorship. Transformational leaders recognize that employees might be at different developmental levels. Increased productivity requires the leader to take these differences into account and tailor each interaction and conversation accordingly. This practice might seem excessive, and perhaps even coddling, but when each of your employees feels validated, whatever their capability at that time, they are already one step closer to improving their performance. Just think about whether you like to be spoken down to, or even up to. How comfortable do those approaches make you feel?

How do successful leaders promote employee wellbeing?

1. First, by showing care and consideration for your employees, these employees come to trust that their leader has their best interest at heart.

2. Second, effective leaders create a positive working environment with a clear vision and concrete steps to get there. Your staff will come to understand what their specific role is within the practice and what is expected of them. They will also understand how to help the team move forward. These type of leaders provide employees with autonomy and opportunities for development in the job. You can inspire your people to critically review existing working procedures and seek out new challenges at work. You can also encourage your staff to perform at, and above, the call of duty, and celebrate the achievement of new developmental milestones.

3. Third, effective leaders increase employees’ belief in themselves and that they can cope with the challenges with which they are faced at work. When leaders hold and express high expectations that their employees can successfully tackle the challenges they meet at work, and leaders function as role models demonstrating how new and unforeseen events can be successfully managed, employees’ self-efficacy increases and they come to believe in a successful outcome when they take on new challenges.

If this style of leadership seems appealing to you, you might want to seek out training or coaching in leadership development. There is strong evidence to support the concept that engaging in leadership coaching has a big return on investment, not only for your own development, but also the yield it returns on your dental practice.   

Dr. Brackin is available to coach you and your team to higher levels of performance. She can be reached at ebrackin@mckenziemgmt.com.

Dr. Brackin provides training for leadership effectiveness, interpersonal communications and team building. If you would like to learn more, contact her at ebrackin@mckenziemgmt.com.

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Jean Gallienne RDH BS
McKenzie Management
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Hygiene Question and Answer
By Jean Gallienne, RDH BS

I was recently asked the following question:

When a new patient comes in and we diagnose them with periodontal disease and treatment plan them for scaling and root planing, we offer them a prophylaxis at that visit to get the supra gingival calculus off the teeth and get them feeling better. We then have them come back for scaling and root planing, and they are aware prior to the prophylaxis that they will still need to return for the scaling and root planing. This has helped alleviate those patients who complain about not getting their teeth cleaned the day they come in. We have had no issues with insurance regarding coding a prophylaxis prior to scaling and root planing.

I recently had a fellow hygienist recommend that we do a full mouth debridement that day (instead of prophylaxis) with a patient needing scaling and root planing, and then have the patient return for the scaling and root planing. I have a few concerns regarding this. One, full mouth debridement is to be done to facilitate diagnosis, and some scaling and root planing patients do not need that in order to properly make a diagnosis. Also, I don’t believe an exam can be coded the same day as a full mouth debridement. So, when is the exam done? 

Full mouth debridement reimbursement is about double a prophylaxis, so it would be beneficial financially. It would require us to change how we do a few things as well. What are your thoughts on this and what do you see in practices?

When it comes to only removing the supra gingival calculus, this does not fit the code for a D1110. The code for a prophylaxis includes subgingival scaling. With that said, it is recommended that you provide the patient with the cleaning appointment they came in for to help alleviate the possibility of them complaining or possibly not returning to your practice. However, this appointment should include subgingival cleaning also.

It is great that the patient is aware of the need for scaling and root planing before the prophylaxis appointment, and I hope financials are also reviewed with the patient at that time. If the patient is motivated and wants to move forward with the root planing immediately, perhaps they will proceed with the root planing that day. During this time, the hygienist will continue to educate the patient about their periodontal disease and the treatment that has been recommended.

When it comes to having a prophylaxis before scaling and root planing, at this time most insurances are alright with this – but as we all know, this could change at any time. Some offices will do a prophylaxis after the scaling and root planing to clean the areas that are healthy. Many insurance companies do have a problem with this, but the patient is told during the financial consult that they are responsible for this “fine scale” appointment cost, and the patient is seen as a periodontal maintenance three months later.

You are correct when it comes to the description and use of the code for a full mouth debridement. The code is to be used to facilitate diagnosis. It has been my experience that this code is one of the most misused codes there is. I have not heard that you cannot do an exam on the same day.

The problem with the full mouth debridement code is that many insurances do not even cover it, or they cover it only once in a lifetime. So, if you inform a patient that it should be covered and then it is not covered, you may end up losing the patient.

More than anything, it is not using the code correctly – and that is fraud. Yes, full mouth debridement is about double the dollar amount financially and would be more beneficial to the practice. However, misusing a code is still fraud, and it is not recommended. The way your practice is currently doing their periodontal therapy is the most ethical and will help patient retention.

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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