2.2.18 Issue #830 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Get Practice Debt Under Control
By Sally McKenzie, CEO

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You knew becoming a successful practice owner wouldn’t be easy, but you probably didn’t truly appreciate all the challenges that come with the job. It’s not just about diagnosing and treating patients, which of course is what most dentists would prefer to focus on. You also must understand the business elements of running a practice, and that includes managing debt. 

Debt is a pain point for many of the dentists I work with, and is often the biggest barrier keeping them from their goals. For many of these dentists, it seems all they do is write check after check each month, without ever making a dent in what they owe. This becomes exhausting and frustrating, and leaves some dentists wondering if they’ll ever get practice debt under control.

The answer is yes – with the right guidance. That’s what I’m here for. Here are a few tips to get you started.

Look at your cash flow. Many dentists simply don’t have a good grasp of their practice’s financial situation, which certainly doesn’t help them manage debt. Before you can take control of your finances, you must understand them – which is why I suggest conducting a cash flow assessment in your practice.

To do that, start by logging the numbers for net production and collections over the last 12 months, the percentage of accounts receivable over the last 90 days, and the total monthly payments made to leases, loans and business credit cards. From there, take a look at your average monthly payments to the lab, dental supplies, salaries, taxes and benefits, monthly facilities costs and all the miscellaneous expenses that don’t seem like much until you add them up.

When you’re finished, you’ll actually know where all your money goes each month – and that’s the first step in finally getting your debt under control.

Hire an expert. You’re probably thinking, Sally, this is great and all, but what exactly do I do with this cash flow assessment once I have it? Good question. I suggest you hire someone to help you figure that out. A financial expert from McKenzie Management, for example, can give you guidance based on your unique circumstances. He or she will come up with a plan to reduce your debt obligations so you can finally start enjoying success as a dentist.

Depending on your situation, the expert could recommend a variety of different ways to start reducing debt. For example, sometimes consolidating your loans and refinancing them at a lower rate is the best way forward. In other situations, it might make sense to buy the space you’re practicing in rather than paying a monthly fee to lease it. The point is, there isn’t one solution that will work for everyone, but a financial expert can tell you what adjustments will help ease some of the financial burden that’s been holding your practice back.

Start focusing on your systems. If your practice systems aren’t performing up to snuff, I can guarantee they’re contributing to your overhead and debt problems. Many dentists just don’t understand the important role these 20 systems play in their practice’s financial health, so they neglect them. This is often a costly mistake. I suggest really getting to know your systems. Take the time to look at them and determine where the problems are, then develop a plan to fix those problems. Is this a lot of work? Yes, but once you have strong, efficient systems in place, you’ll be rewarded with higher production numbers, a more robust bottom line, and of course, less debt.

Dealing with debt isn’t easy. Most dentists just don’t know how to handle it, so they never implement the necessary changes and their debt gets even more out of control. But if you commit to identifying problems and making adjustments, you’ll be able to reduce debt and finally start growing your practice.

Of course, this isn’t something you have to do all on your own. Contact McKenzie Management and we’ll provide the guidance you need to turn your struggling practice into a thriving 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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Carol Tekavec, RDH
Hygiene Consultant
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Patients Are on the Lookout for “Scams”
By Carol Tekavec RDH

Recently I was directed to a website that discussed “how to avoid being scammed by your dentist.” It was written and produced by an insurance carrier. Several situations were outlined along with some suggestions on how to “protect yourself”. It was a pretty depressing read that seemed to focus on the idea that dentists are essentially untrustworthy and patients should keep their guard up. Some of the red-flag issues highlighted:

Recommending unnecessary x-rays. Taking “too many” radiographs was discussed as being one way dentists scam their patients. Potential patients were warned that x-rays are often not necessary on a regular basis, and the reason for taking x-rays should be explained beforehand.

I have to agree that patients should know why we are taking x-rays. Explaining why the x-rays are needed and then showing the patient what they reveal is essential for gaining and maintaining patient trust. This is particularly important with new patients. Scheduling a new patient to meet the hygienist (but not the dentist) first and then proceeding with “routine” x-rays can make a patient mistrustful. If a patient asks why the x-rays are being taken, responding that “this is what the office always does” is not sufficient.

Ideally the dentist should meet the patient first and perform a preliminary exam, with x-rays being ordered for that particular patient. If the office wants to schedule with the hygienist first, the dentist should at least meet the patient in the hygiene room and mention what x-rays should be taken. If a patient perceives that the dentist is ordering the radiographs, it makes a much better impression than doing something because of a “routine”.

Recommending many restorations. Patients were cautioned that unless they had discomfort or could see the decay themselves, submitting to “many” restorations or crowns could be a mistake. It was pointed out that if they have dental insurance, a dentist might be overtreating in order to bill insurance.

Since patients may have decay or other issues that are not “hurting” and/or may need numerous restorations, what should you do? The best way to build trust when a patient needs quite a bit of dental treatment is to “show and tell”. Use intraoral photos, radiographs on a light box/monitor where problems can be easily shown, or a mirror so they can look directly in their own mouths. The key here is taking the time to help patients understand what is needed. The explanations don’t necessarily have to be made by the dentist; a knowledgeable assistant or hygienist can do this. The important thing is that the explanations are provided and not rushed. It is important for a fee estimate to be provided as well. If the patient is not prepared to set up an appointment right away, so be it. Pressuring patients to schedule only encourages them to cancel later. The decision to proceed needs to be their own.

“White Coat Bullying”. This was a new, derogatory term to me. It was described as when the dentist uses his or her position as a person in authority to belittle or push a patient into scheduling treatment. Needless to say, as in the example listed above, pressuring patients to receive treatment that they do not trust they need is going to backfire.

Deep Cleaning when a “standard cleaning” is sufficient.  This section of the article featured a hygienist holding what looked like an ultra-sonic scaler giving a sly look at the camera. Really bad. We all know that getting patients on board with their periodontal treatment can be a big challenge. It is sometimes hard to explain the differences between a prophy and scaling and root planing. If the patient perceives no difference when treatment is actually performed, there can be problems. 

The way to handle this issue is before treatment begins. Sufficient time must be given to explanations of what is being done and why it is being done. For example: Compare x-rays and photos of a healthy mouth condition to the patient’s x-rays and photos. Healthy mouth examples can be obtained through many dental supply companies in their “preventive treatment” sections, or actual samples of an anonymous patient of the office can be used.

Show patients a periodontal probe, how it is divided into millimeter sections, and what information we obtain from using it. If possible, show examples of what happens if periodontal disease is left unchecked. Use local anesthesia in sensitive areas to allow for effective scaling. Allow sufficient time to adequately treat all areas of the mouth. Perhaps do one side of the mouth at a time over two appointments. Use ultrasonics and oral irrigation and explain how and why this is being done. Patients will not trust a “deep scaling” that takes 45 minutes, just as their previous “cleanings” did. Plus, effective full-mouth treatment can not actually be done in that short amount of time.

We need to be sure we are helping our patients trust us by being open and transparent about what we are doing. While we know we have their best interest at heart, we have to encourage their trust by how we approach their treatment and what is done when taking care of them.

Carol Tekavec RDH is the Director of Hygiene for McKenzie Management. Interested in knowing more about how to improve your hygiene department? Email hygiene@mckenziemgmt.com.

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