7.8.16 Issue #748 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Patients Not Showing Up? Don’t Kill Time, Take Action
By Sally McKenzie, CEO

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Mrs. Wilson has done it again. She was scheduled for a 3pm appointment, but it’s 3:10 and there’s still no sign of her. The afternoon lull has already left the practice quiet, so instead of hitting the phones to try and fill the newly open slot, your team members decide to use the time to take a break and hope the 4pm appointment actually shows up.

This might seem harmless, but it’s hurting practice profits. If your hygienist Lucy spends an hour relaxing in the breakroom as she enjoys her favorite magazine, she’s not doing much to contribute to the 33% of production she’s responsible for. And if your Scheduling Coordinator is using the time to check personal email or make plans for the evening, the chances of you meeting your daily production goals are pretty slim.

Broken appointments shouldn’t translate into down time. Instead, team members should take action and look for ways to get patients in the chair. Here are a few ways team members can help alleviate the pain that broken appointments bring.

1. Call the Patient
When patients doesn’t show up, don’t just shrug your shoulders and wait for them to call and reschedule. Have your Scheduling Coordinator call and let them know you’re worried. Here’s an example of what the coordinator should say:

“Hello Mrs. Wilson. This is Susan from Dr. Clark’s office. We were expecting you for your appointment at 3pm. I was concerned because you haven’t arrived yet. Is everything OK?”

Listen carefully to the patient’s response. Maybe she’s stuck in traffic or is dealing with a family emergency. Remember that unexpected things happen, and your team members should be sensitive to that when calling patients. However, if you’re dealing with a patient who has a history of skipping appointments, it’s important to note that, too. Flag these patients, and instead of scheduling them in advance, let them know you’ll call them when there’s an opening:

“Mrs. Wilson, it looks like we’re having trouble scheduling a time that’s convenient for you. I don’t have any open appointments at this time, but I will call you when something becomes available.”

2. Put a List Together
The thought of rushing around to fill a last-minute opening can be stressful, which is why team members might be tempted to take a break instead. To make it easier to fill open slots, keep an updated list of patients who would prefer earlier appointment times or who you know are flexible and willing to move their appointments if necessary. Call these patients first and you just might be able to salvage the schedule.

3. Follow Up
If you can’t get the patient on the phone the day of the broken appointment, follow up later. Use this phone call to educate patients about the importance of keeping their appointments and maintaining their oral health. Politely let them know how last minute cancellations and no-shows affect the practice. Many patients have no idea that you have set aside time specifically for them, and don’t think about the fact that another patient who needs to see the doctor could have taken their appointment if they had been given the opportunity.

4. Make Hygiene a Priority
When patients cancel a hygiene appointment, it should be your Scheduling Coordinator’s priority to fill it. If the cancelling patient gives you less than half a day notice, try to move a scheduled patient from another day into that time slot. When you have more notice, turn to the recall list and contact overdue patients.

Getting recall patients in the chair is an essential part of practice success. Remember, it costs more to attract new patients to your practice than it does to keep existing patients, and recall patients represent thousands of dollars in unscheduled treatment – treatment they’re unlikely to schedule unless your practice makes an effort to reach out and educate them about the importance of maintaining their oral health.

When patients don’t show up, it can bring your team down and leave them wanting to spend this sudden free time relaxing as they wait for the next patient. This does nothing to help production and revenues, which is why it’s so important to take action when you find yourself dealing with a broken appointment. These tips will not only help you fill sudden openings, they’ll also reduce the number of cancellations and no-shows your practice deals with each day, and that of course will help you reach your production goals and grow your bottom line.

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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What is Your Conflict Style?
By Elizabeth Brackin, PsyD

Conflict is a natural part of life, and it is no different in the workplace. No matter how hard you try, sooner or later your office will have some level of conflict. The key is identifying it early on and figuring out how to best confront it when it occurs.

Conflict is not an easy subject to discuss, even when team members are getting along well. Nonetheless, unaddressed conflict can cause many problems that adversely affect your dental practice and patient satisfaction. Have you ever walked into a store or office where you can just sense there is tension around you? It may not be an altercation that you are witnessing, but you can feel the conflict in the air. Does it make you want to come back to that store or office? As the dental leader, you need to be aware of and be ready to deal with disputes when they arise among your team members and patients.

There is not a “best” way to deal with conflict. It depends on the current situation. But you can improve your leadership effectiveness by becoming more aware of your own conflict style. In turn you are able to recognize the conflict styles of others and manage problems before your office becomes undesirable to be in. There are generally five key ways to deal with conflict:

1. Avoiding
We tend to use this mode when it simply is not worth the effort to argue. Behaviors such as withdrawing and sidestepping are signals of avoidance. In the short run, avoiding does reduce tension and it can buy you time. Unfortunately, this approach tends to worsen the conflict over time. Decisions are made by default and issues fester.

2. Accommodating
When we give in to others, we show reasonableness and create goodwill. Accommodation also helps keep the “peace.” However, this style needs to be used sparingly and infrequently. For example, in situations when you know you will have a better approach in the very near future, it might be wise to accommodate. Over time, however, accommodating tends to worsen the conflict, and causes conflicts within you. People who repeatedly give in to others have limited influence.

3. Competing
Arguing or debating, using rank or position, and standing your ground are all competing behaviors. So is asserting your opinions and feelings. As with all the conflict styles, there is a benefit to competing. For example, when you have a very strong conviction about something, competing may be appropriate. Unfortunately this style prevents clarification or discussion because the goal is to get your own way no matter what. If you are overly competitive there will be a lack of feedback, reduced learning, low empowerment, and you’ll be surrounded by “yes people.”

4. Compromising
This is a mutual give-and-take process. The intention is to get past the issue and move on. Negotiating, finding a middle ground, and making concessions are reflective of compromise. When you compromise you give something up. In this respect, too much reliance on compromise is only a shade away from accommodation.

5. Collaborating
The main goal of collaboration is to work together. Use it when it’s important to meet as many current needs as possible with mutual resources. This approach cultivates commitment and esprit de corps. Examples of effective collaborating skills are listening, understanding and empathizing. Underlying causes of conflict can be identified through mutual input. However, over-use of collaboration can result in spending too much time on trivial matters and diffused responsibility.

The reasons we use different styles varies. We often avoid when we don't want to get involved or we decide it's not worth the effort to pursue. It's important to pick your battles, since they can't all be fought and won. We accommodate when we want others to like us, we like things to run smoothly, or we don't feel like we have the right to remind others of their responsibilities. We compete when we strongly believe in our ideas. We often compromise when we are in a hurry. We use collaboration when we want everyone involved to feel ownership for the outcome.

Each conflict situation offers a wide range of choices - choices in how you choose to frame or interpret others’ actions and behavior, and choices in how you will respond. With awareness and foresight, you can choose to act from a rational approach based on an objective evaluation of what is happening and what is most appropriate, rather than on reflex or just the pure emotion of the moment.

What are your conflict mode reflexes? That is, which of the five types do you automatically go to first and/or most frequently? Which mode(s) do you seldom use? Which style(s) do your employees appear to use to deal with conflict? When you recognize how you and your employees deal with conflict, your effectiveness as a leader will increase. Encourage your employees to acknowledge, deal with, and appreciate their disagreements. Don’t let your office become a battleground. Dealing with conflict up front leads to open communication, conscious cooperation among your employees, and increased productivity!

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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Is Your Hygiene Department Broken?
By Jean Gallienne, RDH BS

What type of hygiene department do you have in your practice? To help you answer this question, you can run a report that will tell you what procedures have been done in the past year based on the ADA code. If the majority of your hygiene department’s production has been produced because of prophylaxis, you may need to look at revamping your procedures.

It is the industry standard that 33% or more of total hygiene production should come from ancillary services and interceptive periodontal therapy. If your practice has a prophylaxis oriented hygiene department, the production will be a lot of routine prophylaxis, x-rays and periodic exams. A periodontal oriented department will be doing prophylaxis, periodontal maintenance appointments, root planing, x-rays, and periodic exams.

A diagnosis-based hygiene department will always evaluate the patient’s medical and dental history, then ask what changes or problems there have been since the last visit. The patient will be asked: “What changes would you like to see in your smile?” 

The next step is to perform the necessary diagnostic tests, which may include blood pressure measurements, radiographs, intra-oral photographs, periodontal probing, gingival bleeding index, plaque index, caries detection, restoration evaluation, cosmetic evaluation, joint sounds, and cancer screening. The patient should co-discover any problems during the diagnostic evaluation process. Once the patient’s comprehensive exam is complete, a determination of the necessary treatment is performed.

If the periodontal condition is stable and it is determined the patient does not need any periodontal treatment, then the hygienist can proceed with the prophylaxis. However, there still may be other treatment to be addressed. This can be scheduled at a subsequent visit.

Granted, a prophylaxis-based hygiene department and a periodontal-based hygiene department may do all of the diagnostic tests, but will continue on with the prophylaxis or assigned periodontal treatment without considering the specific needs of the patient that day or in the future.

Why would prophylaxis-based hygiene departments be so prevalent? Usually it’s because the practice has always done it that way and it’s easier to continue doing things the same. Change requires extra effort on the entire office’s part. There are many items that need to be established, such as protocol for co-discovering periodontal disease, written protocol on how to communicate and treat patients after co-discovering a problem, developed office communication skills, tactics for educating patients, staff and yourself, and financial protocol and arrangements.

There are also pre-existing team perceptions. “Well insurance won’t cover that.” If the team does not value the work they are doing for the patient, they will feel they should give it all away. They will just do the work of a periodontal maintenance appointment and not get paid for it.  

In establishing a treatment protocol for your periodontal patient, you should consider several characteristics.

• What determines the need for periodontal treatment?
• How much time is needed to perform the work?
• What will be done at each appointment?

These are just a few of the questions that need to be answered in order to start establishing your periodontal program.

There are even more systems and protocols to be determined when establishing a diagnosis-based hygiene department. An x-ray protocol needs to be in place so the hygienists and assistants no longer question when x-rays are needed for a particular patient. There must be a successful recall system in place – not one that the hygienist or other team members work when there is time, but one that has a person responsible for meeting goals and monitoring their effectiveness on a regular basis.

Have an intraoral camera protocol. How many pictures should be taken? Do you want specific pictures for every exam, in addition to suspicious areas? Determine what the doctor wants to have on the screen when he/she walks into the room. Protocol should also be established regarding how to approach a patient who has treatment pending, as well as how to help promote the treatment plan the doctor has diagnosed.

Once your practice is a diagnosis-based hygiene department, you may not only see the production go up in the hygiene department, but in the entire practice. 

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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