With the recession in full swing, it has become increasingly more difficult for dentists to increase the number of patients which they are serving. But the need for dentists won’t be extinguished just because of the present economic woes. There will still be a need for dentists to fix broken or chipped tooth, do root canals and whiten our pearly whites. It’s just that patients aren’t as willing to opt for dental procedures unless if circumstances really warrant them. And when they do decide to have something done, they are more wary over which dentist they would entrust the job to.

Because of the way that patients have evolved, there is greater need for dentists to impress them. To do this, every dental practice should have a concept of what the ideal patient experience is. Remember that patients are not just after dentists who are the most skilled and the most qualified, although they do consider these factors. However, they’re also after an experience which they are sure to never forget. Here are a few things to be on a lookout for when creating that patient experience.

The Phone

Never ever underestimate the power of the first impression. If you are on a campaign to blow the socks off of your patients’ feet, then it’s always a good thing for you to make a first impression which they will never forget. Most patients reach out to the practice which they are considering by using the phone. So make sure that your front office worker knows exactly what to say when a prospective patient calls. You can hand over a script if necessary. It’s always a good thing to have someone from your staff call up your patient before the initial visit as well just as a form of reminder and a show of your eagerness to cater to them.

The First Visit

After you have managed to get a prospect to visit your clinic through the phone, it’s time for you to put your best foot forward. Try to place yourself in the position of your patient in order for you to come up with an idea of what they want to see or experience when first stepping into your office. Evaluate the physical state of your reception area and front desk. Do you think that you have an inviting enough space? How about your office and your clinic? You’ll be spending a good amount of time with your patient in that part of the office, explaining to them your diagnosis and proposing treatment plans, so make sure that your space doesn’t scare off patients.

The Case Presentation

You’ve met with your patient, found out what’s wrong with them, and now you’re ready to propose to them a treatment plan. Try to build strong rapport with your patient to facilitate an open, comfortable flow of conversation. Make sure to discover the things which your patients value and regard as important. And then present your treatment plan in a manner which would appeal to their sensibilities. Get your patients to make a verbal commitment and then congratulate them on their decision to value their dental health.

Your Tips

We’re of course just scratching the surface here. Do you have some tips you’d like to add? Please leave them in a comment below.

Scheduling is a Critical Task

One of the most critical responsibilities an office manager has is to manage the schedule. The dentist wants it to be productive. The hygienists want it to be full. The assistants want it to have enough time to turn over rooms and catch up on cleaning instruments. The secretaries are busy trying to fill the schedule when it has holes and confirm and take care of patients when it’s full.

A properly managed schedule keeps the staff busy and reduces chit-chat time. It also keeps the focus on our patients instead of on ‘what did you do last weekend’ conversations. The schedule dictates our profitability and is a visual reminder of our effectiveness. So, we know it’s important – but how does an office manager successfully manage the schedule?

Determine Dentist’s Ideal Schedule

First, talk with the dentist to find out what his/her idea of the perfect schedule looks like. Every dentist is different. I’ve worked with pediatric dentists who had 4 columns of patients and a team of 4 assistants and EFDAs and he not only ran on time, he was relaxed and happy and always seemed to have plenty of time for everyone in the office. I’ve also worked with general dentists who were very pleased with just one column of patients and wouldn’t trust a well-trained EFDA to touch one of their fillings. The office manager should sit down with the dentist to sketch out on a blank paper what type of schedule he/she wants. When does the dentist feel freshest and therefore want certain types of appointments? How many hygienists is he comfortable checking? Does he need blocks at any time of day? The clearer the goal of a ‘perfect schedule’ is in the dentist’s mind, the better chance you have of achieving it!

Setting Up Calendar & Schedule

Next, set up the calendar and the schedule. These are two entirely separate items. The calendar is for the month – when will the dentist be out for CE or vacation? Are any of the staff going to be out? Who will cover? How will you handle holidays or days that schools are closed? In our practice, we set up our calendar in Excel and give copies to each team to review. We do not pre-book, so we plan 2 months in advance. I expect a minimum of 6 weeks notice for any vacation time to reduce last minute changes and craziness. Once everyone has had a say in the calendar, then my secretary team leader sets our calendar up in Dentrix. We use block scheduling for each of our providers and their teams – which is not exactly what Dentrix intended, but it is a fabulous way to see at a glance which providers are open/closed.

Managing the Schedule

Now, to manage this schedule. The secretary/office manager is responsible to keep the schedule open throughout the day and watch for any changes. Any last minute no shows or cancels mean we need to hop on the phones to try to save the time from being wasted. We set goals for the team to meet hygiene open time goals as well as dentist open time goals – and we track these daily. We set collection goals for each dentist as well. On top of daily schedule management, I look at the schedule weekly. I watch to see if any staffing changes are necessary – if I have a provider that isn’t maintaining a full schedule, then we’ll add notes to ‘fill top down’ and let staff go home early. Since we maintain an entry level cleaning/sterilization person on the assistant team, if schedules are really open, I may give this person the day off – maintaining hours for my more senior staff.

Analyze, Analyze, Analyze

The dentist and office manager should each look at the results of the scheduling each month. Did you hit the production and collection goals? What was the open time vs. goal? If you’re booking too far out (remember no more than a 2 week wait for a new patient), you may need to add some staff to increase capacity. If you’re too empty, perhaps it’s time for some marketing.

Successful Scheduling Requires a Team Effort

Successfully managing a schedule takes a total team approach. The more the staff realize their part in helping the schedule stay accurate and productive, the better your schedule becomes. You’ll have several sets of eyes on the schedule that can catch errors – hopefully with enough notice to fix them! The general sense that everyone is responsible for managing the schedule can become one of the major strengths in your practice. So, how do you feel about your schedule?

Below is a brief overview of ten critical numbers every dentist should know, monitor and graph every year. The goal is to see them grow over the course of your career as you measure your overall progress and profitability as a practice.

Know These Numbers

1. Current Market Value of Your Practice.
As a general rule of thumb we recommend using 65% of last year’s collections to set the value.

2. Annual Gross Revenues.

3. Annual Reinvestment in Practice.
How much did you reinvest in your practice last year? This number should always be considered part of your overall practice value.

4. Annual Debt Reduction.
All debt reduction payments should always be considered a form of profitability. For example, if you had $1 million in debt and paid off $100,000 last year and earned a net profit of $200,000, you actually earned $300,000. Debt reduction always increases your net worth.

5. Annual Net Revenues.

6. Current Debt and Liabilities.

7. Annual Charitable Contributions.
As your practice grows through the years, it is important to track what you are giving back.

8. Annual Tax Liability.
You will want to continually measure your tax liability to see if it is increasing or decreasing.

9. Current Cash on Hand.
This number is included in your practice’s value.

10. Current Total Net Worth.
You should analyze this number annually.

What numbers do you track?

What numbers do you find important to track and improve or reduce? What, if anything, would you add to the list?

Communication may not seem that important to a dentist whose work day is filled with countless appointments, but it is a big deal for patients. The difference between having a loyal patient and losing said patient may rest on good communication.

Although the first factors that a patient may consider when choosing a dentist is their competence and cost of services, the secondary aspect that they consider is the overall experience of working with that dentist. Naturally, all dentists who have established a stable practice are considered competent enough. At the same time, competition among dentists has been quite rigid so their price ranges may not differ substantially. So what tips the scale is often the dentist’s ability to establish rapport with his or her patients which comes with good communication skills.

There are so many opportunities for a dentist to start communicating with a patient and one must take advantage of all these chances.

Before the Visit

If you think about it, the first time that a dentist will be able to talk to a patient is way before the patient even steps into the dental clinic or even meets the dentist face-to-face. Dentists communicate to potential patients with the help of their marketing efforts. For this reason, marketing efforts should be designed so that patients feel that the dentist isn’t just reaching out to them because they are seen as customers but because the dentist really intends to take good care of their teeth.

Taking Records

The next time that the dentist communicates with the patient is when he or she actually steps into the dental clinic and the front office personnel goes on to take his records. As an extension of the dentist, front office personnel should know the rationale for why they must collect specific information from their patients. Not only will patients feel a lot better about answering questions when they know why the information is relevant to their treatment but they’ll also develop confidence in the clinic.

Examination

The dentist will finally see the patient face-to-face while doing exams. Most of the time, dentists talk in code because then it’s easier for the assistant to chart the results down. But you also have the patient inside the room and it’s crucial that he or she knows the current state of his or her teeth. So make sure to use language that the patient will understand. At the same time, if you find something distressing after the patient’s exam, make sure to inject a bit of emotion in your conversation using phrases like “I’m concerned” or “I’m afraid”. This will make your patient understand the severity of the problem and feel more comfortable at the same time. Lastly, take pictures and show them to the patient so that he or she knows exactly what you’re referring to with the help of images.

Your Thoughts

Please share your patient communications tips in a comment below.

In my last post, A Well-Trained Dental Manager is Priceless I discussed the importance of providing a training program for your dental office manager. In this post, I’ll discuss my specific approach for doing just that.

My Approach to Training

Dr. Charles Smith, founder of HealthPark Dentistry, and I have used this training program over the past 15 years to take a bright, positive, new hire secretary and develop them into a knowledgeable, confident dental office manager. This training program is structured into levels of achievement: level 1 – Basics of the dental secretary position, level 2 – Working confidently as a dental secretary, level 3 – Move to Treatment Coordinator, level 4/5 – Team Leader role, level 6/7 – Marketing & Business Management. There are 2 sides to each level – the professional track and the general track. The professional track contains tasks specifically related to dental secretary work, for example, how to deal with dental insurance or handle a financial arrangement. The general track includes tasks regarding coaching on handling conflict, overall computer skills that everyone must know or books to read and apply the concepts. Each level contains about 25 tasks – some tasks must be completed in the office and others should be done on the office manager’s personal time.

Once a new secretary is hired, the dentist can offer this career development opportunity. In exchange for her investing 2-3 hours/week of her personal time (far less than attending a community college class) the dentist will invest time to meet with her as she completes the required tasks. In these meetings, the dentist and secretary will review the tasks she has completed, clarify any questions and confirm they are meeting the dentist’s standards. When a level is completed – and the secretary has now proven responsible for a significant amount of new tasks and is already accomplishing them – then she receives a raise. She then starts to work on her next level.

Benefits to this approach

- The dentist knows exactly what the office manager is doing and has been trained to do.
- The dentist spends time working with staff who are developing their career and contributing to the practice, rather than to the people who are causing trouble in the practice.
- The office manager knows exactly what is required to achieve a pay increase.
- The practice improves because the OM is focused on accomplishing the goals that benefit the office.
- The dentist feels confident that he is giving raises that have truly been earned.
- The OM gets used to learning from and meeting with the dentist in order to improve the practice – this sets a precedent for a long term professional relationship.

Let’s Look at an Example Application

To give an example of how the training works for a specific task, let’s take a look at Level 1 Task #18 – Understands & Uses the Telephone Professionally. This task starts with the concept that the telephone is a tool that can be used in a professional manner that will increase the new patient lifeblood in a practice and therefore although many people take telephone skills for granted, it is key to slow down and think about how we use a telephone as a dental secretary. It also describes phone etiquette including phrases to use and not to use. It also includes a section on the practice philosophy – how we handle emergencies, what the scheduling options are for new patients, how we want vendors handled, etc. It even includes a couple sample conversations to read how to handle a ‘dental shopper’ who asks for the price of a cap and what to say to a patient calling to cancel their appointment at the last minute. This task ends with 52 telephone questions that the secretary must write what they would say (not what they would do).

To complete this task, the secretary reads through all the task material (20 pages) on her personal time. She spends about ½ hour in the office with a more senior staff person to discuss the practice philosophy. (I recommend that the dentist review this section first to customize the material to his practice style and approach.) Then, back at home, she write down her answers to the telephone questions. If there is a senior secretary in the practice, this person can review her answers and meet to discuss which ones she got wrong and how the dentist prefers these calls handled. Otherwise, this would involve a meeting with the dentist. Again, at home, she would re-write any wrong answers and then have a final meeting with either the senior secretary or dentist to finalize that this task is completed.

Jay Gaier of The Scheduling Institute has created an entire consulting organization around the concept of using the telephone as a professional tool. His courses and coaching cost in the $10k range depending on the personalization of coaching you prefer. His brilliant marketing approach for dentists is to simply call your office pretending to be a potential new patient – and then he records your secretary handling this call. He then mails you a CD so you can hear your secretary and the pretend patient – and you can hear for yourself the telephone skills your secretary possesses. By requiring that all new hire secretaries must complete the task on Understands and Uses the Telephone Professionally, before they start answering the phone – you are raising your chances that new and existing patients will be handled correctly right from the start.

Using this one example, you can see how this training program would work. The secretary will be reading and working on her tasks and when she has 6-8 tasks she feels are ready to be ‘signed off’ by the dentist, she requests a meeting. Generally this training meeting would last ½ hour and can take place during a cancellation or hole in the schedule. By the end of this meeting, the secretary will have completed some tasks to the satisfaction of the dentist and perhaps be re-working a few tasks as well. The dentist should document this training meeting in the secretary’s employee file – keeping track of the tasks completed and still to accomplish. This becomes a record of the career development for this employee. Eventually as the secretary completes level 1 and a raise is given, this also is documented in the employee file.

Your Thoughts

What do you think about the training program Jill and Dr. Smith have developed?

What if your office manager had the ability to help you manage your practice? Imagine that she could confidently and correctly handle the variety of business decisions that occur throughout your practice – from handling upset patients to making financial arrangements, to running the practice’s marketing budget and even helping negotiate new technology purchases? On top of saving you time so you can be focusing on your clinical care, what if you had an intelligent, well-trained office manager who could implement your ideas and help you to accomplish your goals – moving forward to create the practice you want to have, but never seem to have enough time to make the necessary changes?

Invest in Training

All this and more is what you can gain for your practice when you invest in training your dental office manager. Most of the office managers I know feel that they want to do their very best for their dentist. They see the many demands on the dentist and appreciate their job – but they don’t know what to do. They don’t know how to get the training they need so they can be a real asset to their dentist. We have a perfect opportunity – a dentist that could really use some business management help and an office manager that is enthusiastic to step up.

Now, all we need is the training!

Benefits of Investing in a Training Program

There are many benefits to investing in a training plan for your office manager:

- The dentist knows exactly what the office manager is doing and has been trained to do.

-The dentist spends time working with staff who are developing their career and contributing to the practice, rather than to the people who are causing trouble in the practice.

-The office manager knows exactly what is required in her job.

- The practice improves because the OM is focused on accomplishing the goals that benefit the office.
The dentist feels confident that he is managing his staff well.

-The OM gets used to learning from and meeting with the dentist in order to improve the practice – this sets a precedent for a long term professional relationship.

Thanks to the dentist investing his time in training – the secretary is now receiving positive reinforcement to develop her skills. She is motivated and enthusiastic about the opportunity to really help the practice. She sees firsthand that the dentist is responsible for setting the philosophy and standards for the practice in enough detail so that she can carry out the tasks. The dentist appreciates the personal time invested in learning to improve the practice – and he receives positive feedback for taking his time to clarify his expectations and guidelines in the practice. Now, we have accomplished the opposite of a ‘vicious circle’ – perhaps we could call it a “happy spiral”?

Start With the Basics

The training program should start with the basics and advance to tasks on hiring other staff, managing marketing programs, tracking statistics, etc. As the secretary and dentist continue to work together – the office manager is transforming into a real business manager. She eventually will bring ideas and programs to the meetings that the dentist never considered. She will begin to read dental journals and participate in online forums and learn about dentistry outside the walls of the practice. That will lead to even more new ideas and opportunities – and if the dentist likes the new idea the office manager presents, he already has the person in place to implement! This also takes the stress off the dentist as he feels he has another intelligent, caring person who he can bounce ideas off of and together they can start to become partners that share the burden of running the practice.

As dentistry changes, we need business professionals in practices that can successfully manage the office. These office managers play a major role in reducing overhead, evaluating dental insurance plans and managing the fast-changing world of marketing. The office manager position becomes full of variety and challenge – and makes a difference in the lives of not just the dentist and staff, but also the patients and the community. A successful dental practice serves a vital role in the community – and the well-trained dental office manager is at the heart of this practice.

What’s Next?

In part II, Jill will discuss her approach to dental office manager training and provide helpful tips for implementing a dental office manager training program within your practice.

Your Thoughts

Do you have an office manager? Does your company offer office manger training? What benefits of having a dental office manger are you seeing in your practice?

The Dismissal w/Dignity Agreement

This is an agreement between an employer and employee that spells out a “healthy” arrangement to assist both parties in parting ways. It is truly a humane and respectful way to treat an outgoing employee and also resolves many issues that will often cause employer angst when it comes to having to dismiss a team member. It is truly a win/win for both parties and sends a poignant message to existing team members and patients alike.

Create Open & Honest environment for Meeting

It’s about meeting with the employee in question and sharing your feelings regarding the termination of their employment and honestly verbalizing your feelings openly and honestly and you can both be victorious is the separation process. You will find that every fear that is referenced in the article entitled Uncovering the Myths of “Fallout” from Dental Employee Dismissal can be put to rest with this approach. As with everything else, be totally prepared to sit down with the employee in question and have all of your ducks in a row including a prepared document to spell out the agreement.

Tell Employee What’s In It For Them

Let them know that you appreciate the fact that they have been trying to meet their mark and that you respect the effort they have tried to put forth, but that it is probably best for both of you to move on. Always start with “what’s in it for them” since you will find you get all of their attention when you focus on the pluses for them right from the get-go this is the best place to start. I can promise you that they will not argue the point and be most compliant. Let them know that you will NOT send them out in the cold, but rather give them time off (within reason) to pursue other job opportunities. You will also respect their position and make sure to let the existing team and patients know that this was a mutual decision to separate and move on to better both of you.

Propose a Tradeoff

What you will offer them is the opportunity to go out and take face to face interviews and possible Skill Assessment Days (working interviews) that will be designated based on tenure within your practice, this time frame is for you to determine. They will be paid for this time away from the practice to pursue other opportunities in exchange to help you to integrate their replacement. They will agree to help to coach them in, share their job descriptions and make the transition a smooth one. It will be the employer to decide if the changeover takes 2, 3 or 4 weeks to complete based on length of employment from the current employee. This process sends a wonderful message to your team since you are giving the outgoing employee every opportunity to find new employment and also gives them the comfort to say good-bye to patients they know. They will also be much more cooperative when it comes to helping with the crossover from the old employee to the new.

This has proven to be a very humane way to make the shift and it sends a wonderful message to incoming, outgoing, current employees and patients alike. Of course there are support materials to assist in the process to safeguard proper communication with the protocol.

Your Thoughts

Do you employ similar tactics when dismissing an employee in your practice? Would this approach work with your employees?

First off, I must state at the onset of this article that any employee that has participated in any illegal activities such as embezzlement or theft, or has contributed to wrong-doings that will clearly be detrimental to you or your practice must be immediately dismissed.

Fear of Fallout is Normal

The following protocol is one that would apply to situations where you (and most probably your team as well) were aware that a particular team member is just not appropriate for your practice and yet you hold onto them for fear of “fallout”. You continue to observe behavior affirming that she/he is not a fit for your practice, yet reluctantly accommodate it and stress over it, even lose sleep over it, but turn the other cheek and just plod on day after day.

After a while many of you will actually show your frustrations to the team member in question, other team members, your spouse and family, and sometimes even your patients. How healthy is this for you and even for the employee in question as well? Do you think they are not aware of this? Many employees will hang on, dealing with their own fears and concerns and interestingly have their own unhealthy reasons to stay.

Often Fear is the Result of Misconceptions

Fallout myths are common fears and misconceptions that many dentists ruminate about so often that they steer away from dismissal to avoid their perceived challenges. The fear of moving the process forward is the result of many preconceived outcomes that many employers try to avoid:

• “If I let Suzie go, the other team members will be so upset that they will “leave in sympathy”.
• “I can’t do that to Suzie knowing she will be sent out in the cold with no job”.
• Patients will leave my practice if Suzie isn’t here.
• “Maybe Suzie is the best out there and once I search for her replacement I will find no one any better”.
• “No one really knows what Suzie does except for Suzie, so how can I let her go”?

You will know it’s time when you have followed proper procedures to assist the employee with additional coaching and training as necessary and they just don’t seem to be able or willing to come around. You have spoken with them and documented these warnings and conversations along with their signature recording the fact that these areas have been properly addressed, and yet they never did meet the requirements necessary to keep them.

Dismissal With Dignity

When you know you have clearly attempted to do all you could, it is time for everyone to move on and time to engage in an Employer/Employee Dismissal Co-agreement or what I call “Dismissal with Dignity”.

Stay Tuned for Part II

Stay tuned for part II tomorrow to learn more about exactly how you can dismiss an employee with dignity.

If you already have a good practice, going to the next level is challenging. Delightful, but challenging. Why? Because you wouldn’t have a good practice if you weren’t doing a lot of things right. So, give yourself permission to pat yourself on the back for work well done. “That which is rewarded is repeated,” according to Dr. Michael LeBoeuf. And then, take a hard look at what you can do better.

Take the time to Analyze

Take a look—a hard, honest look at each and every one of your systems and ask yourself, “What are we doing well?” Do more of that! Then ask yourself the really difficult question, “How can we do this better?” That’s the most important question for dental practices today! Certainly, the time to sit back on your laurels is not now!

Take your good practices and make them great. One of the most dangerous things you can do is become complacent. As we come out from under tumultuous economic times, now, more than ever, we need to focus on constant improvement.

Take into consideration both the pros and the cons of issues that are impacting the industry today. Take a good hard look at your practice and make supreme effort to go back to the basics—the things that put you where you are now—and be diligent about making each aspect of your practice even better.

For example: No matter how well you think you customer service may be in your practice, I would suggest that it could be even better. As a team, review the internal promotion/customer service protocols you are performing that add to the health and well-being of your practice and which enhance your patient’s experience with you. Then, together, decide on three new things that you can add to your customer service protocols. Set your goals for these protocols and then design a plan of action for each of the three new protocols/services. Next, put the plans into action. Continually review the results to assure their effectiveness and success. Then, add to the services—on a regular and continual basis. Do this with each of your systems.

The 25 Management Systems

There are 25 management systems in your practice. Those systems are:

1. Attitude and Expectations / Mission Statement / Goal Setting
2. Communication Skills
3. Scheduling / Broken Appointments / Filling Voids
4. Morning Huddles / Team Meetings
5. Patient Financing
6. Insurance System
7. Full Use of Computers
8. Overhead Control / Fee Analysis
9. Payables
10. Monitors
11. Accounts Receivable Control / Statements / Collection
12. New Patient Experience
13. Treatment Planning
14. Consultations / Case Presentations
15. Patient Education
16. Clinical Efficiency
17. Charting System
18. Hygiene Retention
19. Periodontal Program
20. Marketing / Practice Building
21. Telephone Skills
22. Sterilization / Infection Control
23. Inventory Control
24. Follow Up on Treatment Diagnosed and Left Untreated
25. Intra Oral Camera System

We have never been in a practice where these systems are as good as they can be! Without question, we’ve been in some excellent practices where many things are working very well, but we’ve not seen perfection to date! If you improve each of the 25 systems by 1%, that will make a 25% difference for you – a positive difference. Taking a highly productive practice and making a positive 25% difference is very significant!

On the other hand, if you do not feel that any of your systems are as clean, or smooth flowing, as they should be, then you have a lot of work to do, but you also have a tremendous opportunity. Growth for you will be boundless!

Step back. Humble yourself. Look at your practice with wide-open eyes. Commit to making every aspect of it better. Not only will you be more productive, but you will also be more profitable, and you will obtain control of the stress that is caused by systems that are not working succinctly.

Try This Exercise

Refine each of your management systems. Find ways to make each system a bit better. This may be a good time to have your practice evaluated by a management professional. A third-party set of eyes is effective when determining where your practice can be improved. Coaches are appropriate for everyone who is interested in continuous improvement.

See the big picture

As a healthcare provider, it can be difficult at times to see beyond the clinical care you are giving and gain perspective on the big picture – the overall patient experience. And sometimes you may wonder, why does it even matter? You provide impeccable dental care, right? What more does a patient need in their dental experience? Today, the answer is, much more.

Focus on Customer Service

You cannot deny the fact that you are a small business owner and with this comes competition. If you want to be the dentist of choice in your community or for your target audience, you MUST step up and make customer service a primary focus in your practice. Excellent clinical care is absolutely necessary for you to succeed – and excellent customer service is absolutely necessary for you to thrive.

Where do you begin?

Begin at the beginning: With the telephone. How you answer the phone, gather information and, in a nutshell, how you speak to your prospective patients can and will make all the difference in their decision to schedule – or not to schedule – an appointment with you.

Develop the New Patient Experience

The new patient experience. Take the time necessary to develop this, to enhance this and ultimately, to perfect this in your practice. If you take your new patients through a phenomenal first-time visit – they will return, they will say yes to treatment, and they will refer! What more could you ask for!

Treat every visit like it’s the first visit

Treat your patient family with the same attentiveness each time they visit. And, each time they visit, ask for referrals. With every great experience comes a great story they will want to share with a friend or family member. Remember, the little extra steps you take will build a relationship that can last a lifetime – or at least a career-time!

More information about developing outstanding customer service

Visit www.jamesonmanagement.com/orange to request Orange Papers on popular practice management topics by Jameson experts.

Your Thoughts

How does your practice provide exceptional customer service?

It is a new year. The goals are set and you are ready to run the marathon and win the grand prize. The prize is an increase in practice profits, happy patients and a stellar team. Nevertheless, wait! There seems to be a bump in the road. Someone is asking for some important information. One question that needs to be answered is: How many periodontal patient appointments did your dental practice see in 2010?

How easily can you access this information? I speak to many offices that have no idea of their numbers. They do not know the number of periodontal patients they see each month. Did you know that recently the American Academy of Periodontology reported that periodontal disease in Northern America was underestimated by about 50%? Well, if no one keeps track of his or her monthly statistics then how would you know where you stand? Are you one of these statistics and are you guilty of underestimating who has periodontal disease in your dental practice?

When was the last time you looked at the numbers? Let’s just talk about your dental hygiene numbers. Here is the first question and a place to begin: “How many periodontal patients did you see in 2010?” This is only a starting point for looking over the numbers in your dental practice. Dental Professionals have a legal and ethical responsibility to assess and diagnose periodontal disease. This means that annually every patient seen in the dental office needs a periodontal screening exam completed. This is a legal document recorded in the patients’ chart.

Early Intervention Means Prevention

It still happens in the majority of dental hygiene departments. The dental hygiene department used to be thought of as a loss leader. This is not true. The dental hygiene department can produce at least 40% of the total production if your systems are in place. Look at the patient charts (You can view the patient periodontal charts easily if you have electronic charts.) and see what patients have 4mm pocket depths. Of these patients with 4mm pockets, what was the diagnosis for periodontal disease? Did these patients also have recession and mobility? Does the patient have Rheumatoid Arthritis or Diabetes? Look at the American Academy of Periodontology and review the classifications for periodontal disease. Many times dental hygiene patients have 5mm pockets and early intervention (scaling, root planing, chemotherapeutics, laser treatment, etc.) has not been diagnosed to treat these areas of disease and prevent further destruction.

Many times patients with moderate to heavy calculus and 4mm pockets are requested to come back for a prophy in 6 months. When a patient has several areas where 4mm’s are measured, bleeding on probing, systemic health conditions or illness (even the flu) and/or moderate to heavy calculus, it is time to sit the patient upright in the chair and talk “oral health/systemic health”. This is the time to discuss the cause of periodontal disease, early intervention, prevention, home-care and re-evaluation – sooner than later. We no longer “wait and watch” when there is an oral disease condition. Today – in 2011, we discuss early intervention and prevention.

All Systems Are A Go

It is a valuable service to add the periodontal screening exam to each patient. This needs to be completed annually on every patient. This includes measurement of all areas, which include but may not be limited to pocket depth, bleeding on probing, (BOP) furcation involvement, mucogingival involvement, mobility, recession and suppuration. Also noted are various disease conditions and systemic diseases. These all play a role in the classification of periodontal disease and the extent of treatment necessary.

When you begin to implement just this one service in the hygiene department, you will not only improve the value of the hygiene appointment but the practice profits will increase. This is because you now begin to diagnose patients who have early signs of periodontal disease and recommend non-surgical treatment – sooner than later. Not only will you be treatment planning for scaling, root planing, chemotherapeutic use and laser therapy, but home care products and same services will also increase. Now you are talking about adding value to patient services and increasing the practice profits! You can add to your practice profits without adding more appointments to the current schedule. It is all about planning your day before the patient walks in the door of your dental office.
When all practice management systems are in place, your net-profits will be maximized!

Profit Centers Raise Production

When you diagnose periodontal disease, you also recommend home care products to create a healthy mouth. The products you recommend such as power toothbrushes, toothpastes and oral rinses, need to be available for patients to buy and begin using that same day when they leave your office. You need to have these products available for patients to buy in your office. When the patient is seated in your chair, you can show patients exactly how to use these products effectively. You are the expert, you know exactly what the patient needs and now you can show them how to use that new product, while they are in the office.

Many periodontal patients have areas of sensitive roots and/or areas of root (cervical) decay, which requires a fluoride varnish treatment approximately every 90 days. These same day services are provided at the time of the hygiene appointment. This is just one example of adding valuable and time saving services (“same day services”) to patients. It is another way to increase profits in the dental practice. By the way – patients who have root (cervical) decay need to be using fluoride or Xylitol products at home – daily. These are just a few more products you need to have in the office and available for patients to purchase and use at home immediately.

When you have a well organized dental practice the dental hygiene department can be a huge profit center within a dental practice. Inside the dental hygiene department are other areas of profitability. Some examples of these are: home care and esthetic products along with same-day services.

Implementing special systems in the dental hygiene department is when it will produce 40% of the total office production.

Time-Saving Tips

The past 2-3 years have been unstable economically and more often than not dental offices are cutting back dental hygiene appointment times. This is not something considered a strategic business plan to increase profits. There are various other strategies to increase profits in difficult economic times.

Always take time for team meetings. The morning huddle is a great time to organize your dream day. The hygiene team members come with what their needs are. This includes a list of what patients will need an exam, x-rays and even a periodontal screening exam. If you don’t have a hygiene assistant this is the time to organize who can be there in the hygiene room to document the periodontal exam, assist with x-rays and the doctors assistants will write down when to have doctor move to the hygiene room for an exam. Meetings are a time to streamline systems and organizational skills in the dental practice.
Each month office policies should be discussed. Examples of the types of policies are to write down what types of patients need a 20, 40, 50, or 60-minute hygiene appointment. In addition, you will want to sit down as a team and discuss what services you should add to your mix of services. There are many types of services, which can be added to same day services and in the hygiene room. This saves many patients an extra appointment to your office and increases daily production from the hygiene room.

Action Items

• How many prophy patients were seen?
• How many root planing patients were seen?
• How many periodontal maintenance appointments?
• How many chemotherapeutic sites were administered?
• How much production came from the hygiene room?
• Etc., etc.

List all new products you believe are valuable to patients and the practice:
• Write a number next to each product and list the highest priority at #1
• Examples of new products are ViziLite® Plus, WAND STA, Caries Risk Assessment, Saliva pH assessment, etc.
• Oral Hygiene Products: Oral Rinses, Cosmetic Toothpastes, Sodium Lauryl Sulfate (SLS) free Products, Xylitol, Power toothbrushes, Oral Irrigator, etc.

Final Thoughts

There is no need to feel overwhelmed. Be patient with yourself when you are learning and implementing something new. Write down your “to do list”. Schedule a time to discuss your options and action steps with the entire team. This is only one reason why you want to have a 2-hour team meeting on your schedule every month. It is how you plan that creates your dream day and success in your dental business. If you fail to plan your day and especially if you fail to plan for 2011, you have planned to fail. Creating a plan is the first step to success.

There are dental experts who are here to guide you to find increased dental practice production, increased net-profits, streamline the systems in your practice and add value to your current patient services. You do not have to run the marathon alone. Call upon a partner to help you win the marathon and experience the rewards you deserve.

New Patients

New patients are also a crucial part of every successful and profitable dental practice. What does it cost for you to schedule a new patient in your dental practice? What is a new patient worth to your dental practice? There is a normal attrition of new patients annually. This can mean that 10-15% or your patients move or decide to go somewhere else due to finances, loss of insurance plans or other unknown reasons. What are you currently doing to keep the patients continually entering through the front door of your dental office?

Patient Retention

It costs the office less money to add value at the time patients are in the office. This is the easiest and most cost effective way to market your dental practice. You will find you can easily increase referrals by word-of-mouth. Why do patients choose your office over another? Think of your heart, how it beats and the fact that your blood has a constant, steady flow. This is the same constant beat and flow of patients you want to have coming into the front door of your dental practice. The patient flow should never stop. Patients need your dental office just as they need their heart to beat and the blood to constantly flow through their body. You will find when patients value the services that you provide for them they are most likely to accept your recommendations. They are more likely to pay for treatment before and when services are rendered. When patients understand the value that your dental practice brings to them, they contribute to the success of your dental practice. When you communicate the importance of good oral health and its relationship to their overall health they will take action. These are your patients who will be the main source of referrals and they are most likely to be on time for their dental appointments.

The dental hygienist (Including the dental hygiene team – hygiene assistants, if you have them) is the one auxiliary on your team who sees patients at least twice a year. Sometimes, it is recommended that a patient return to see the hygienist three to four times a year. The continuing preventive care appointments are where patients have a chance to establish an intimate relationship with the entire dental office. This is how the hygienist (And the hygiene team) play a key role in building and maintaining the active patient base. This is where patients build life-long relationships.

Keeping the Pulse

The dental hygienist is the dental practice preventive specialist. Dental hygienists are the primary oral health educators in the office. It is very important that not only the dental hygienist but also the entire team consistently educate patients about the importance of good oral health, and how it contributes to the overall health of the body. This is communicated in everything to do with the office: everything written; brochures, the website, plaques on walls, and verbally communicated on a consistent basis.

The practices who communicate this important scientific knowledge are the offices that keep patients coming in their front door. In other words, they retain their active patient base and new patients constantly call to schedule appointments throughout the lifetime of the dental practice. These are the people who understand and feel how much you really care about them.

It is important that patients understand the oral health/systemic health relationship because this is where patients become highly motivated to be involved in and take ownership of their disease and overall health. How many patients have told you they don’t want to live a healthy and longer life?!

A new study recently reported by the Centers for Disease Control (CDC) and the American Academy of Periodontology (AAP) suggests the prevalence of periodontal disease in US (Northern American) adults has been underestimated by up to 50%. The underestimate was attributed to data from partial – rather than full-mouth periodontal exams used in recent National Health Nutrition Examination Surveys (NHANES).*

Scheduling Preventive Care

Ninety percent of all hygiene appointments need to be prescheduled. It is helpful for the hygienist (Or auxiliary who just treated the patient and understands the patients’ disease process, etc.) to be the one in charge of scheduling the patients next hygiene appointment. If the office has a hygiene assistant, this person will be scheduling and dismissing the hygiene patients. When the hygiene team is fully engaged in scheduling you will find that patient compliance improves and they are most likely to have a positive attitude towards preventive care appointments. There is symmetry in the communication process when scheduling and communication are a team effort. This is when the hygiene patient flow is most likely to constantly occur. It helps patients continue their schedule for preventive care and not lose track of their routine appointments.

Scheduling for the next hygiene appointment is most effective when scheduled in the hygiene room prior to the dismissal of the patient.

Accountability

Everyone on the team needs to be held accountable. At monthly team meetings, the person who is responsible for hygiene scheduling, will give a report of cancellations, openings in the hygiene schedule and how many patients have not scheduled their necessary hygiene appointments. These patients need to be followed up on with a phone call as soon as possible. The phone call is the first step to contacting a patient for a dental appointment. An email, letter or postcard is too passive to begin contact with a patient who needs an appointment or some form of follow-up.

With computers and electronic charts, audits can be a more effective process. Chart audits and patient follow up needs to be an ongoing system in the office – daily. Everyone on the team has an important role and someone from the hygiene team needs to be designated as the scheduling coordinator. This is the one team member who will not only report on these statistics (At monthly team meetings.) but will be responsible and accountable for a daily hygiene schedule that is booked solid. When discussing the scheduling effectiveness at the team meetings, everyone needs to be able to give suggestions about what can be changed if the schedule and patient retention is not successful or challenges occur. Everyone on the dental team can be a part of all problem-solving solutions when challenges occur.

Putting it all together

Each month on the same day and same week of each month, schedule a two-hour team meeting. This should always begin with the entire team together and can include breakout sessions for each of the various departments of the dental team. Examples of these breakout sessions can include Dental Assistant training to provide improved and effective digital x-rays. Front Office: Phone communication skills and the Dental Hygiene team can learn new local anesthesia techniques for example the “Gow-Gates” injection or use of the CCLAD local anesthesia device.

Always allow an open pathway to communication for the entire team. This is just one way, which creates mutual respect and admiration. A positive and open pathway to communication will be reflected by an increase in productivity and net-profits. A happy team will lead to healthy patients and long-term success of the dental business.

Final Thoughts

Create a new and clear path moving in a direction to future successes. There are numerous high-performance systems and strategies to implement and only a few of these are listed above. These are only a few strategies that will generate positive results to improve quality of life and patient care, create higher productivity, increase net-profits and reduce stress. Every successful leader has a mentor who can lead them down a clear path and hold them accountable for their goals. This is how your vision becomes success in your life professionally as well as personally.

* Reference: Eke Pl, Thornton-Evans Go, Wei L, et al. Accuracy of the NHANES periodontal examination protocols. J Dent Res 2010 Nov; 89(11): 1208-1213.

Your Thoughts

Are you effectively utilizing your Hygiene Department? What challenges have you faced while trying to drive your practice’s profitability with your Hygiene Department?

One area of the dental practice that can drive referrals and is the second highest profit center of your dental practice is the hygiene department. The hygiene department should produce over 30% of the total office production. All systems must be in place for this productivity and profitability to occur.

The hygiene team has a key role in supporting the practice by adding value to the patient appointment. This occurs through communication and education of the dental hygiene patient. The hygiene team; hygienists and hygiene assistants, are the people who will make recommendations to the doctor, educate patients about home care and the advancements in dentistry. These are the team members who educate patients about procedures and products available to improve their overall general health.

Hygiene Team Rapport

Patients see the hygienist and interact with the hygiene team on a regular- routine basis. This is a perfect opportunity for patients to spend quality time during their dental hygiene appointment and we can easily add value to their services. During the hygiene appointment, when the hygiene team effectively communicates the value of the hygiene appointment, a positive rapport will be developed between members of the dental hygiene team and the patients. The end-result is that patients will want to continue a long-term relationship with the dental practice. When the hygiene team is providing optimal care, there will be improved case-acceptance, increased productivity and profitability for the dental practice.

Providing Optimal Care

1. Value-ad dental hygiene appointments
2. Customized patient schedule
3. Communicate oral health and systemic relationship (Educate)
4. Provide home-care products
5. Implement same day services (Whitening impressions, fluoride varnish, night guard impressions, etc.)

Words can paint a thousand pictures. Too many dental offices still use words such as “cleaning” and “recall” when communicating with patients about the dental hygiene appointment. What words do you currently use when speaking to patients about their dental hygiene appointment? The words you use to describe or speak about dental treatment will either add value or devalue their appointment and treatment. Prophylaxis isn’t the only service that dental hygienists provide in today’s’ world of dentistry. The hygiene appointment is more than a “cleaning”. The hygiene appointment includes many types of services which may include a blood pressure screening, smile analysis, periodontal screening exam, oral cancer screening, salivary pH, biofilm assessment, xerostomia, caries risk assessment (CAMBRA), scaling and root planing, nitrous oxide sedation, limited restorative dentistry, polishing, antimicrobial treatments, impressions, radiographs, etc. The dental hygiene appointment should always include patient education and post operative instructions when necessary.

Change Your Vocabulary

At your next team meeting, agree to change the vocabulary you will use with patients. Write down a list of the words that you plan to use when communicating with your patients. Add a list of these words for your team-training manual. This helps everyone can refer to this information as necessary and new employees are trained with current vocabulary words your dental practice uses. Notice how your patients will now begin speaking the same language.

Years ago, the dental hygiene appointment was an “all-for-one-and-one-for-all” type of appointment. Today’s successful dental hygiene appointment provides customized, specific appointment times for the specific treatment needs of each patient. When the dental practice utilizes a customized schedule for patient, treatment, the practice profits will increase and the patients receive optimal care.

Customize Your Appointment Schedule

Customize your appointment schedule by using 10-minute units. The practice can now comfortably accommodate: 10-minute post-op care, periodic oral hygiene assessments with fluoride treatments, delivery of whitening trays, 20- minute appointments for impressions or CAMBRA protocols, 30-minute preventive care appointments (adults, with missing teeth and little to no stain, children under 10 yrs of age with no calculus, etc.); 40-minute appointments (patients with excellent oral health, little calculus, no stain and no x-rays or exam); 50-minute appointments (preventive care patients with more calculus or a lot of stain. Patients that need x-rays and exams); and 60-minute appointments (scaling and root planning and more difficult periodontal maintenance appointments which also include x-rays and exam. (Those patients who need antimicrobial therapy.) The same type of schedule is customized for the dentist with regard to restorative, cosmetic, implant, oral surgery and endodontic procedures. It only a suggested prototype to set up for your dental hygiene department. Each professional will most likely need to be consulted to make certain they feel comfortable with these appointment time limitations.

Adding value to the dental hygiene appointment will not only inspire patients to continue returning for dental appointments in your dental practice but will allow you to provide optimal care. This systematic process is critical for the dental practice’ future productivity and profitability. It also means you keep the patients coming through the front door of your dental practice. This is how dental practice growth occurs. Using the appropriate vocabulary with patients as well as putting these words into scripts will build value for each appointment throughout the entire patient experience. Case acceptance improves with this one system in place.

Educate Your Patients

We know for many decades now, that periodontal disease is at epidemic levels. According to the National Institute of Dental and Craniofacial Research, approximately 80% of the population has gingival or periodontal disease.1 Most patients are unaware of periodontal disease due to it’s’ often painless nature. This is one of various diseases that will be detected and patients still decline your diagnosis. Why does this happen? The answer is because patients don’t feel pain. They may experience bleeding gums but this has been occurring for numerous years and they now consider this “normal“ for their mouth.

The solution to this challenge is to educate patients about the science, which corresponds to good oral health improving their overall health. Explain and give patients the scientific literature (explain the research) so they understand the importance of good oral health. The hygiene team is responsible for educating patients about their oral health and its relationship to overall health. When patients understand that untreated periodontal disease can have a negative affect on their overall health, they will now be interested in the information and more likely to schedule their necessary treatment. Periodontal assessment, combined with education, will provide patients the necessary information to improve their overall health. CAMBRA (Caries Management by Risk Assessment) is the same type of strategy. We know how to prevent decay. Current CAMBRA research identifies how to assess for a patients risk for decay. The focus is now on preventing decay not about treating the disease.

Provide Home Care Products

Continued and improved oral health starts with the patient at home. There are various products patients can use to improve their oral health. Some of these include oral irrigators, power toothbrushes, Xylitol mints and gum, fluoride gels, non-alcohol-natural oral rinses and toothpastes, etc., etc. Providing these home care products will provide patients added value by your dental practice because you will educate them how to use the product while they are in the office. When you dispense the appropriate products in the dental office, you provide patients with a resource for information and a specific place to go for immediate use of the product replacement of these when necessary. We want our patients to come to us and understand that we are the dental experts. Patients should not be going to the local drug store and ask a sales person what toothpaste, mouth rinse or oral irrigator, etc., is best to buy. We are their health care provider and we are the expert who understands what is best for their specific oral health condition. When our patients leave the dental office with their home care products, they are most likely to immediately begin follow through with their home care regimen.

When you have home care products easily available for your patients, you will notice patients not only appreciate your knowledge about how to improve their oral health, but they are happy that you made it convenient for them to purchase. When patients leave the office with the appropriate home care products, they will be more likely to use the recommended product. This is just one of the ways we can assist patients to improve their overall health.

Provide Same-Day Services

Once you have a customized patient appointment schedule, you can strategize (also discuss in the daily team huddle) to offer same-day services. One example of this is found through patients completeing the smile analysis. Because you have a questionnaire to discover what areas of the oral cavity are important to your patient, you can make some easy recommendations, which may take only a few extra minutes to

create a positive appearance and/or experience for your patient. If you understand that your patient wants whiter teeth at the beginning of the appointment, after doctor examines the patient, someone from the office (either a dental assistant or a hygiene assistant) can take the impressions and schedule the patient to return to pick up whitening trays, the gel and the homecare instructions. This saves time for the patient returning foranother appointment to take impressions and another appointment for delivery of the whitening appliance and solution.

Same day services are also helpful for patients who are categorized as moderate to extremely high risk for caries. These patients will quite possibly receive a salivary pH or biofilm assessment, review of home care and a fluoride varnish treatment. These services can very easily be administered the same day the patient is in the chair for their hygiene appointment. These are just two examples of same-day services.

These services save time for patients returning for an additional appointment and add to the daily production of the dental hygiene department. These same-day services can very simply add another $50,000.00 + US dollars to the dental practice annually.

Final Thoughts

The hygiene team is a vital part of all successful dental practices. The dental hygiene department is one of the critical components for every successful dental practice. When you implement these suggestions, the hygiene team will develop strong relationships with patients. The patients will believe in and value your team and the dental practice. When you communicate the awareness of prevention, add products to improve health and offer time saving, same-day services, you will improve the level of patient care. Once the patients understand this, you will reap the benefits by receiving new-patient referrals, increase productivity and profitability.

Your thoughts

How is your Hygiene Department adding value for your practice?

Reference: 1. http://www.adha.org/media/facts/total_health.htm Accessed on Jan. 15, 2011.

Preventive Care Appointments = Lifeline

One system in the dental office, which is often overlooked, is the dental hygiene departments’ recare system. It works best when the office doesn’t need to call patients to come in for a missed or delayed dental hygiene appointment. The dental hygiene preventive care appointments are the lifeline of your dental practice. At least 80% of the diagnosed dentistry in your practice should be coming from the dental hygiene preventive care appointments. When patients leave the dental hygiene appointment without a future appointment scheduled this will dramatically decrease your practice profitability by at least 50%.

Pre-Block/Tier Your Schedule

The most effective way to keep the hygiene schedule full is to number one, pre-block your schedule. Once you have set up a pre-blocked and tiered schedule you need to understand the meaning of all patients leaving their dental appointment with an appointment for their next dental visit; always scheduling their hygiene appointment in advance.

This strategy is designed to keep the hygiene schedule full and productive. When the hygiene schedule is not full, a domino affect will occur. Not only is it possible to have patients fall through the cracks with timely hygiene preventive care appointments but the dentist will see openings in the treatment schedule in the future. Many years ago, it was the standard of care to have a patient complete a postcard and then call in for their next hygiene appointment. Long time ago it was discovered this did not set up a good system of productivity for the dental practice as a whole.

Most offices that adhere to a strategy of having patients call to reschedule appointments will have many openings on the hygiene schedule. People are very busy in the 21st century: numerous email addresses to check, various voicemails, family activities, exercise class, church, work and professional agendas to attend to, etc. If it isn’t on their calendar months in advance they tend to put it off – near the bottom of that “to do” list. With technology today, we are able to lock in our appointments and then even have a pop-up reminder occur months, days and even minutes before an appointment is to occur.

When patients do fall through the cracks, the best method to have them return is to call them on the phone. When the correct recare system is in place, the hygiene schedule will be full. This keeps the practice “in touch” with its patients and increases patient retention dramatically. Sending a postcard to patients is too passive and impersonal. The best plan for the success of scheduling appointments is to have communication skills in place and effectively use them while the patient is in the dental office. This will avoid numerous patients falling through the cracks each year.

Dealing With Procrastinators

There will be a few patients who will not commit to scheduling a future dental hygiene appointment. You will find it very productive for all (patient and the practice) to have patients in the habit of always leaving their dental hygiene appointment with a future appointment scheduled to return to the hygienist for their preventive care. There are just some patients that will not do this. Until that patient has a feeling of urgency to schedule or else – they may not change this behavior. Once the patient understands the importance of preventing disease and when they understand that calling in a week before they are due for their preventive care appointment means they will have to wait for an appointment until they are a month or so overdue, there may never be a change in behavior.

There are some patients who may live in another country or state and they don’t know when they will be back in the area. It is very valuable to recommend that these patients have another dental hygienist see them in that other state or country while they are not available to return to your office.

The Power of Communication & Visualization

Words can create a thousand pictures.

Which question would you choose to ask your patients?

“Mr. Jones, would you like to schedule your next cleaning with me?”
“Mr. Jones, when you would like to schedule your next cleaning appointment?”
“Mr. Jones, I can see you on Wednesday July 6th or Thursday July 7th for your next continuing care appointment. Which day will work best for you?

1. Mr. Jones, would you like to schedule your next cleaning with me?

The first sentence is a closed-ended question and allows the patient to say “No” very easily. Saying “No” can cause many negative situations. Worst of all is that the patient may forget to call back in 3 or 6 months of their next hygiene appointment. When they come back to their next appointment, they have dental disease of some type, when all along we intended to prevent disease. All the hard work of the patient and hygienist was for nothing more than treating disease. (Again and again!) This is like putting a band-aid on an infected area in your body.

2. Mr. Jones, when you would like to schedule your next cleaning appointment?

The second question again, allows the patient to say “No” to an appointment. It also allows the patient to be in charge of the appointment book. You are the professional and you are the one in charge of the schedule so give patients a couple options of dates and times available for their next appointment.

3. Mr. Jones, I can see you on Wednesday July 6th or Thursday July 7th for your next continuing care appointment. Which day will work best for you?

The third question gives the tone that the patient will be coming back and they already understand the importance of why and when they will be returning for continuing care, preventive care or a periodontal maintenance appointment. In the third scenario, there are no questions to be asked. The patient already has “bought” into their treatment plan and they understand the importance of regular preventive care. It also saves time trying to figure out what time works best for the patient and your schedule.

Words to Avoid

When implementing a system for scheduling the hygiene appointment avoid using words such as “cleaning” and “recall”. The perception among patients is that a “recall” appointment is not significant. After all, you are not “recalling” the patient? Have you heard of a recall on a car with a problem? This is nothing similar to what you are doing in your dental office. You are informing patients they need to return for preventive care. Asking a patient to return for a “cleaning” is similar to having a person come clean your house. Hygienists are now thought of as a preventive care professional or non-surgical periodontal therapist. The dentist is not “recalling” the patient back into the practice to check whether they need a cleaning or tune-up, etc. We need to add value to the dental hygiene appointment by using words such as preventive care appointment, continuing care, periodontal maintenance, etc. Take out the word cleaning.

Once the patient responds to your appropriate question about their appointment and they respond with a day that works, now try to ask them to come back at a time similar to the one they are currently scheduled for on this day. Many people work best if they have specific and consistent times for special types of appointments. For example: dental, psychologist, chiropractic appointments, etc. You will begin to find that some patients want afternoon dental appointments and some prefer first thing in the morning appointments. It is a great way to help people remember their appointments when there is continuity and consistency. For younger patients always try to schedule them before the noon hour.

The significance of excellent verbal skills will help to implement a successful continuing care (“Preventive Care”) system.

When you have a strategic schedule arrange you will include pre-scheduling dental hygiene patients, blocking time for specific types of treatment and have a tiered schedule. This is the most effective system for keeping your schedule(s) full and productive.

When dental practices commit to a system of pre-scheduling the preventive care patients, the dental practice will experience the positive benefits of superior care, productivity and effective use of time, which increases the net profit.

Consider Scheduling in Hygiene Room

While a pre-scheduling patients is superior, various problems can detract from a successfully booked schedule(s).One solution is to have the dental hygienist schedule or hygiene assistant schedule, all future hygiene appointments in the hygiene room. The hygienist and/or hygiene assistant understands what and why regarding the purpose(s) of the specific interval for the next patient visit. The hygienist knows how much time needs to be allotted and what procedure(s) need to be scheduled. Without good organization and excellent verbal skills, patients will not respond well to many of the systems in your dental practice. Most of the time when a patient declines to schedule a future dental appointment; it is usually because a closed-ended question was asked when asking to make the next appointment.

Keep Communicating Throughout Dismissal

When the hygiene assistant or hygienist hands off the patient at the front office there needs to be more dialogue between the front and back office team members. When communicating, always create a perception of value and importance in the mind of the patient by saying something similar to this: “Mrs. Smith., I look forward to seeing you in July and I want to hear more about your daughters’ wedding. See you at your preventive care appointment July 6th and I will recheck that one area I was concerned about on the lower left side.” Every patient should be dismissed with a verbal reminder that there is another appointment, even if it is six months away.

Run Preventive Care Reports

Each month a member of the dental team has the daunting task of running the dental hygiene report and calling patients who don’t have an appointment but need to have an appointment. These can be patients who are over-due or who are due at this time, when the report is run.

Before any calls can be made, research has to be completed. This team member needs to research when the last hygiene appointment occurred, what are areas of concern regarding the patients periodontal health, are there other areas of concern, is there outstanding treatment, what does the insurance allow, (Not intended to dictate treatment but answer any questions about finances.) what X-rays are needed, what is the length of the appointment needed, and is there an outstanding balance? All phone numbers must be called and messages left at each number. The results of these phone calls need to be documented in the patients chart. (Paper and/or eChart.)

This is where it becomes a daunting task at best because it turns into a numbers game. Maybe one in twenty patients will answer the phone and then actually schedule an appointment. Statistics prove that it is easier to reach patients by phone between the hours of 5 p.m. and 8 pm. Now, you understand the systematic approach of pre-appointing preventive care patients, which becomes much more efficient and productive. Some offices have late evening schedules. Some offices even have Saturday appointments. This is another great time to make these calls. In addition, these are perfect times to begin calling patients who need an appointment.

Final Thoughts

One of the important systems for every successful and profitable dental hygiene department needs to include a systematic and strategic method of scheduling regular continuing care, preventive care or periodontal maintenance appointments. These appointments must be communicated in a manner that allows patients to understand the importance of preventing disease. When patients understand that without good oral health they will not have good overall health, they will listen and take action.

Continuing care, preventive care or periodontal maintenance scheduling is one of the most important systems that you will organize for the success of your dental practice. Scheduling future dental hygiene appointments is a routine system that you must follow daily. This is key to any successful dental practice. This is just as important as running your end of the year report, running daily reports, making bank deposits, etc.

This is just one of many systems, which will make your dental hygiene department rock solid.

Great leadership fuels great dental practices.

In well over two decades of helping surviving practices become thriving practices, one common theme has emerged. There is a proven and direct relationship between leadership and success. Better leaders produce better dental practices.

The leadership traits represented below reveal the “best practices” of what I consider to be great dental leaders. Although each doctor possesses his or her own unique personality, operational approach, and leadership style; these key leadership traits are common threads among all types of dental leaders. With that in mind, I would highly encourage you to evaluate your life and practice leadership regularly based on these seven key leadership traits.

As you consistently measure your leadership barometer, score yourself one point for every trait you possess. You may not be where you want to be right now, but the key questions and growth accelerators will help you build as a road map to improve your leadership skills.

1. Leaders Have a Dream

Leaders see a clear picture of the practice they area seeking to create. This portrait can be articulated with simplicity, in one or two sentences, and includes specific goals and outcomes.

2. Leaders Possess a Passion

Leaders integrate their passion for their dream into every area of their life. They think about, talk about and promote the dream and vision all the time. Your family, friends, neighbors, staff, patients, and colleagues should feel your passion for the dream.

3. Leaders Design Strategy

A dream fueled by passion will never reach its destination without a clear strategy to get there. Leaders do not simply post a banner proclaiming their dream. Every announced dream is connected to a road map to get from point A to point B.

4. Leaders Measure Results

As Dwight Eisenhower often said, “Never expect what you’re not willing to inspect and respect.” Measuring results provides accountability to the dream, evaluation of the strategy and responsibility among staff members. Real numbers and real results make the dream real.

5. Leaders Continually Learn

Leaders commit to continually growth and learning in their personal and professional lives. Their practices are marked by the concept of the Japanese word “Kaizen” which points to long-term continual improvement. Leaders work hard to be better this year than they were last year.

6. Leaders Walk in Integrity

Leaders preach what they practice and practice what they preach. Special care is taken personally and professionally to say the right thing and do the right thing as a model and example for your staff and a good representation of your practice.

7. Leaders Make Hard Decisions

The movie Gettysburg recounts the amazing courage of Colonel Joshua Chamberlain. Vastly outnumbered and void of ammunition, Chamberlain is faced with the great challenge of defending the strategic position on Little Round Top. In a moment of great courage, he makes a hard decision. “Bayonets!” he commands, as his weary soldiers charge down the hill toward a massive number of Confederate soldiers. Outnumbered and outgunned, Chamberlain’s troops capture their enemies and win the day. General Lee would later say that this decision by Chamberlain turned the battle and the war.

Leaders carry the burden of making the tough calls. Your response to hard decisions will be reflected in your practice success.

Evaluate Yourself

If you gave yourself one point for each leadership trait you currently possess, how what was your score? While even great leaders struggle in certain areas, they are always seeking grow and become better leaders. Which of these seven key leadership traits do you need to focus on today, this week, this month, this year? What is your specific plan to raise your leadership in those areas?

Developing your dream practice requires a certain level of leadership. It is possible to get there. Leaders are not born, but shaped through hard work and consistent pursuit. It has been my great privilege over the years to see leaders raise their leadership to the levels needed to create their dream practice. As you develop these seven key leadership traits, you are moving closer to the leader you need to be. Do not shrink from the challenge of becoming a better leader every day. Start now….your dream practice is waiting.

Go for it!

Final Thoughts

Think about your score above. Which key leadership traits will you work to strengthen in 2011?

If this is your staff, you know that you spend countless hours creating new rules and standards to try to get them to be more effective. You spend sleepless nights with stress racking your body wondering how you are ever going to fire your hygienist or assistant or just “get it through her head” that her approach is not working.
Is it possible to build a staff that you never have to yell at about their work habits? Is it possible to build a staff that meets and exceeds your expectations for them without your constant nagging? Yes. We have helped practices all over the United States build and rebuild their teams by moving from a rules-based leadership approach to a principle-based approach.

What does principle-based mean? Everyone on your team shares four main principles with you that allow you to trust them to be efficient and effective on their own without you constantly creating new rules and checking on them to make sure the rules are being followed.

The goal of building a team is to find and coach staff members to fully represent these four principles in your practice and in their person. This may mean you have to transition some current team members out of your practice and bring in new team members. Regardless of where your practice currently is in regard to becoming principle-based, the transition can happen if you are committed to it.

Before I share the four principles that you and your team must share, it is crucial that you as the dentist and leader are fully committed to being principle-based in your own personal and professional life. You are the model. You cannot expect your team members to perform at a higher level than you are willing to. Here are the four principles to look for in potential new team members or to cultivate in existing team members.

Here are the four principles to look for in potential new team members or to cultivate in existing team members:

Smart

Highly-profitable dental teams have smart team members. That does not necessarily mean highly-educated or able to dominate on the television show Jeopardy. It does mean that they are teachable and do not repeat mistakes. Smart dental team members learn quickly and assimilate their learning into their daily performance. They tend not to make many mistakes, but when they do, they usually do not make that same mistake again.

Smart team members require much less training and correction and intuitively know what they should be doing without being told. It is the difference between parenting a five-year old and leading a professional dental team member. If some current team members do not possess this principle, you may want to begin looking to upgrade your team. It is very difficult to coach this principle for those who do not have it

Hardworking

Some people work hard at finding what work needs to be done and others work hard at trying to be done with work. The difference for your practice is measurable in production and profit every month. You can easily name the producers the freeloaders, if you have any, in your practice.

Work ethic usually begins to show up in the teenage years. If your team member or potential team member had a hardworking job early in their life, chances are they know what hard work is all about. If they did chores as a child, that is a good sign. If they worked their way through their schooling, that is a good sign.

People can learn to work harder, so coaching from you and modeling from you and your team can help in this area. Hard work can cover a multitude of other failings.

Emotionally Mature

Do you ever feel like you’re walking on egg shells around some of your team members, afraid to say certain things or take certain actions for fear they will have a meltdown? Emotionally immature team members suck the life out of a dentist and his or her team. They can’t handle criticism, conflict, or anything that challenges their sense of self-esteem. As soon as an issue is raised, defensive walls rise up and a flood of harsh words and tears pelt their nearest enemy.

If you have a team member that every other team member always has to cater to and keep happy, it may be time to let them find a private pity party somewhere else. They are hurting your production and morale while raising your stress levels. When looking for a team member that is emotionally mature, attitude is a good measure. The ability to have a positive attitude about past failures or difficult life experiences can provide a good barometer of future performance. Be wary of hiring team members that seem emotionally fragile.

Emotional maturity generally improves with age and life experience, but can be difficult to teach. Unless your emotionally immature team member is incredibly strong in the other principles, it’s more than likely time to say goodbye.

High Integrity

Integrity is doing the right thing when no one else is looking. There is a simple word we use to describe integrity in our relationships, we call it TRUST. Great relationships in the office and outside of the office are founded upon trust.

Can you trust your team members to do what’s right when you are not around? Rules-based leadership does not trust. Rules are created to force behavior to fit within guidelines. Trust is not the issue in a rule-based context, obedience is. But, rules without relationship lead to rebellion – ask any parent of a teenager. The primary ingredient of any successful relationship is trust.

If your trust of certain team members has been damaged, it is nearly impossible to rebuild that trust. It is probably better for both of you if you send them on their way. If you have to really think about whether or not you trust someone, you don’t. Lack of trust causes suspicion and stress. Trust brings relaxation and rest.

Team members without high integrity are not worth the stress or the risk. Long-term relationships in the personal and professional life of a potential team member are good signs of a person of high integrity.

Final Thoughts

To become a principle-based practice, you must have a principle-based team. Imagine never again worrying about whether tasks are being done, patients are being cared for, and the team is on board. Stress plummets and profits skyrocket.Take the time to build or rebuild a principle-based team. It is well worth the investment in your practice and in your life.

Your Thoughts

Is your team principle-based? Share your tips for making the conversion a success.

To receive your free sample end of the year insurance letter, simply visit the Cambridge Practice Consultant website and request your copy.

After all, answering these questions, and what you do after you answer these questions could very well save your life! If you think I’m kidding, just ask Dr. Ron Arndt (The Dental Coach), DDS, MBA, MAGD.

Dr. Ron, a successful dentist, almost didn’t survive long enough to ask himself these questions. He nearly died 20 years ago after suffering a massive heart attack attributed to work-related stress. Dr. Ron’s recently released book, “Killing the Practice Before it Kills You,” details his frightening ordeal and the pivotal steps he took to turn around both his personal and professional lives.

What sets this book apart from other business books?

I appreciate that “Killing the Practice Before it Kills You” is so focused. It’s not chock-full of fluff like many business books these days. Instead, it provides you with pointed, actionable steps that you can begin implementing today to begin the process of re-centering your life and building a high-performance dental practice.

Highlights

• Discover “red flags” that may indicate that your business is killing you
• Understand how you got to where you are both personally and professionally
• Understand how to step (or jump) off the “gerbil wheel”
• Learn how to establish your personal and professional “core values”
• Learn how to then “kill your practice” and conduct a practice makeover

Final Thoughts

If your life is stress-free and hunky-dory, then you probably have no need for this book. But, for the rest of you, do yourself a favor and purchase a copy of this book. If you’re ready to get off the gerbil wheel, shift your mindest, makeover your practice and de-stress your life, then you’ll find this book an invaluable tool moving forward.

How do I purchase “Killing the Practice Before it Kills You”

You can pick up a copy of “Killing the Practice Before it Kills You” at Dr. Ron’s website, killingthepractice.com.

Special Gift

Dr. Ron is gracious enough to offer Dental Heroes’ readers a special gift with the purchase of his book. If you purchase through the link above, you’ll receive a free copy of his special report, “9 Hiring Mistakes Dentists Make.”

Editors note: This is part II of this post. To read part I, see 9 Priceless Staff Strategies that Work – Part I.

5. Audit All Your Systems

Every month you should be auditing two or three systems in your practice. The most effective approach I’ve seen to auditing systems is to conduct regular audits during your morning staff meeting. Give a staff member a heads-up that a particular system will be audited on a given date. For example, “Mary, we are going to be auditing our recare confirmation system next Tuesday.” During the morning staff meeting on Tuesday, Mary explains how the recare confirmation system works. It is important for Mary to explain how she believes the system works, not to read it from the operations manual. You can check her presentation against the operations manual, but you need to understand exactly how the system is currently operating, not how the manual says it is supposed to operate.

In most practices, systems are modified and changed often, especially as new employees arrive with experience in other practices. Small changes are made monthly and over time many small changes add up to a big change. Regular audits will keep all systems in line with the established expectations of the doctor.

6. Require Margin

Do you have an employee that leaves home just in time to get to work on time if there are no red lights, no traffic and the weather is absolutely perfect? On most days, unless everything is aligned perfectly, he or she will walk in the practice five or ten minutes late. They have failed to build margin into their commute to work.

Margin could be defined as extra space in your life, providing you with some breathing room or allowance for unexpected opportunities. Like words on a page, when there is no margin everything looks crammed in without any white space to offset the words. If you have employees whose lives are so busy and chaotic that they never have time to rest and recuperate each day, you are probably not getting their very best.

As their employer, you can expect and require that your employees arrive each day rested and ready to go. Life without margin is not healthy and will impact your team long-term if you do not address it. You may even choose to model margin in your practice by providing regular time for fun and relaxation.

7. Establish Team Leaders

Most successful practices begin establishing team leaders as they near one million dollars in revenue. It’s your job to lead your staff, but you may want or need to train and appoint department leaders for each area of your practice including hygiene, clinical, and administrative. Or, you may choose you organize your team leaders around different aspects that are unique to your practice.

Regardless, we have seen major benefits arise out of team leaders. First, they take greater ownership of the practice from vision to results. When team leaders buy in, the entire staff buys in because team leaders carry the water for you. Second, they carry and model your standards and expectations to the staff in their area of leadership. Third, they become your eyes and ears among the staff, seeing and reporting on details and trends that you may miss. You will catch issues and problems much more quickly. Fourth, solutions become a joint effort led by you but informed by your team leaders’ input.

8. Employ Team Players

It is critical to your short-term and long-term success to hire and retain only those who are fully on board with the vision of the practice. Everyone must be a team player. A team player can be defined as a staff member who understands and fully embraces the vision, seeks to always meet the high standards and expectations of the practice, and views their role as more of a mission than a job.

The good news is that the lack of jobs in the current economy presents practices with many employee options to choose from. If you currently have some staff members who are not team players, it may be time to make a change. Do not wait. There is no off-season in dentistry. You have to take the field with team players every day.

9. Resolve Conflicts Immediately

Within our culture today, it seems commonplace for people to be easily offended. When offended, people tend to make irrational choices that impact your staff chemistry and your patient’s experience. Both men and women can become “predictably irrational” when offended, according to Dan Ariely in his book Predictably Irrational, making choices and decisions that defy reason and certainly do not serve the practice well. This can be devastating to a dental practice if allowed to fester.

If you have conflict, big or small, within your staff you must act quickly to resolve it immediately. Every moment you wait, bitterness grows and shows. If staff members cannot resolve their conflicts and move beyond them, you may need to find new employees. Conflict within staff is often palpable to patients, creating an environment of hostility and tension. It also has the potential to involve other staff members as they choose sides and align themselves against one another.

Your message to employees must be direct and unequivocal, “Resolve it now or find a new place to work.” When this message is clear, conflicts will be few and far between.

People can fuel your practice or destroy it. The choice is yours. Implement the staff strategies above and watch productivity and perfomance shift dramatically in the direction of growth.

Go for it!

Your Thoughts

Do any of Ken’s strategies really resonate with you? Have you struggled with any of these in particular? Please share in a comment below.

Editors note: Due to the size of this post, I’ve broken it into two pieces. Part II will be published later this week…stay tuned…

Maximize Productivity and Minimize Problems

Are you tired of employee problems negatively impacting your practice? Your employees help power your practice. They have the potential to bring you great success or suck the life out of you and your practice. If you do not understand how to deal with people long-term, you will not be successful in the business of dentistry.

With proven strategies in place to maximize your staff’s productivity and minimize their problems, you create opportunities for peak practice performance and success. Without comprehensive and pre-emptive strategies for managing, leading and coaching your employees, you open the door to serious problems that may threaten the very existence of your practice.

Over the last twenty-five years of working with all sizes and types of dental practices, I’ve learned nine staff strategies found in the most successful practices we serve throughout the United States. When these strategies are in place, employees tend to thrive. When these strategies are absent, chaos and confusion sneak in.

1. Establish Written Standards

A professionally written Human Resource Manual is no longer optional. Without a manual covering all essentials related to employee issues, your practice is at risk.

It is critical that your practice have both a comprehensive and legally precise Human Resource Manual. We highly recommend utilizing a professional firm specializing in developing Human Resource Manuals for dental practices in your state. Each state has its own unique set of employee rules and regulations and it’s important to be in full compliance in order to minimize potential risk. Our management consulting firm recommends and helps purchase the highly-regarded Bent Ericksen manual for all of the practices we serve because of their diligence in ensuring the manual is thorough and in compliance with every law.

Regardless of the firm you choose, we do not recommend that you attempt to compile your own manual. Leave it to the legal experts. A good manual will protect you from liabilities ranging from unemployment to frivolous lawsuits. Your staff will thank you and your lawyer will rest easy.

2. Communicate Clear Expectations

It is not enough to let your staff know that you want “excellence” or “professionalism” or “good customer service.” You must communicate in detail exactly what it looks like to meet your expectations. And, you must repeat your clear expectations over and over again on a consistent basis even after they are fully implemented.

Over the last few years, we have noticed a substantial increase in the number of practices scripting out phone greetings and responses to keep the front desk in line with the clear expectations of the doctor. We’ve also noticed more and more successful practices taking their staff through role-playing exercises to ensure patient interactions represent the vision of the practice.

On the clinical end, we are seeing choreography established for every aspect of the dental process. Ranging from how a doctor prefers to receive instruments to a complete step-by-step walk-through of each and every procedure, doctors are not only sharing expectations, but also showing expectations.

As the leader of the practice, it is your responsibility to communicate clear and detailed expectations for every aspect of your practice. You do not have the right to be frustrated by staff members who do not meet your expectations if they were not clearly communicated.

3. Provide a Taste of the Experience You Want to Create

Effective communication is often best accomplished in the context of experience. As many times as you may have been told as a child to finish your dinner because there were starving kids in Africa, it probably never really settled in unless and until you tasted and smelled starvation in person.

In the same way, if you want to provide a five-star experience for your patients, your staff must experience what that looks like and feels like. Once during an in-office consultation, I conducted a quick survey of staff members. When asked to name a restaurant that provides a five-star experience, many of the staff members named Bob Evans. The doctor was stunned. No offense to Bob Evans, but I’m not sure they are in five-star territory.

You can waste hours talking about creating a special patient experience, but one trip to a five-star hotel, restaurant or resort will move them quickly from head knowledge to complete understanding.

4. Insist Life Issues Do Not Impact Performance

Every person on your staff brings life issues into their practice role. Whether it’s a family issue, financial issue, or other personal problem, they exist in your practice.

It is your responsibility, as the leader of the staff, to clearly communicate with your staff that although they may be dealing with difficult personal issues, their situation cannot affect their attitude, patient focus, performance or productivity. They must learn to park their problems at the door and not let them crowd over into the practice.

It is also important that you are aware of any issues that have the potential to impact work productivity and performance. If you have an employee who has a mother with stage-four cancer, you may have to make adjustments to help her cope during this difficult season in her life. Keep your ears and eyes open. Establishing an open door policy allows your staff the freedom to share difficult circumstances with you, providing you opportunity to stay on top of personal issues affecting your staff.

Your Thoughts

Do any of Ken’s strategies really resonate with you? Have you struggled with any of these in particular? Please share in a comment below.

Stay Tuned

Stay tuned to discover 5 more staff strategies that work in Part II of this post later this week…

Making resolutions for the New Year is common practice. Let’s begin the mantra now. Repeat after me:
“I will be better organized.”
“I will figure out how to be more productive.”
“I will get a handle on my debt.”
“I will get the most from my technology.”
“I will get training for my team.”
Is it common for you to follow through with these resolutions?
Do you have a plan in place to follow through and be more successful in 2011?

Many Businesses Plan to Fail

Why do businesses fail to plan? And do they plan to fail by not sitting down annually to analyze and plan their future potential? The real reason for failure is that usually there isn’t a strategic plan. What are the benefits of having a well thought out plan? “Stuff’ will happen in our dental business, whether we have a well-thought-out annual plan or fly by the seat of our pants. Acknowledged, well-led organizations tend to experience fewer crises, but situations will arise that demand an immediate, clear response and a series of activities to prevent the issue from getting out of hand. Here is an example where delayed acknowledgement and resolution of the issue led to less negative press, less loss of consumer faith and fewer lawsuits. It could have been worse if a plan were not in place.

Learn from Sully

On January 15, 2009, US Airways Flight 1549 took off from New York’s LaGuardia airport for Charlotte, North Carolina. Shortly after takeoff, the plane went through a flock of geese at 3,000 feet and both engines were knocked out. Captain Chesley “Sully” Sullenberger later said that he felt an “adrenaline rush” right to his core. As his heart rate increased, he forced himself to ignore the physical symptoms and face the situation.

Most of us know what happened next. Captain Sullenberger and the crew were able to guide the crippled Airbus A320 to an emergency landing on the Hudson River. Despite the fact that “no modern airliner has ever ditched in water without fatalities”, all 155 passengers survived. Sullenberger certainly hadn’t landed on water before, yet his training and planning ahead (Emergency plans in place) allowed him to make rational decisions and take appropriate actions in an extreme situation.

Though many of us have been or eventually will be involved in a crisis, surprisingly few organizations will be ready with a plan to manage any crisis let alone what the world may hold for our future; economically, professionally and personally.

How will you put an annual plan in place so that you can take charge of your practice in 2011? How do you make this a stellar plan with superior impact and get the highest profit on your bottom line? The answer: When you work with an expert practice management coach to P L A N. This is what will allow you to enjoy the benefits of a well thought out plan-even when life just happens. This is the answer to reap the benefits of success all throughout the year!

What should do today?

1. Schedule an appointment with a dental expert who is knowledgeable and can make your strategic plan a reality in 2011. Allow the expert to guide your success.

2. Schedule a date to meet with this expert in 2010 before 2011 arrives.

3. Schedule a date to meet with your team: discuss and plan now for 2011. This needs to be on the calendar before December 31, 2010. This is your “Team Annual Planning Session”.

4. Get together your P & L (Profit and Loss Statement) for the past 12 months.

5. Determine with your dental practice expert (Coach) if your overhead stacks up against the true dental industry standards.

6. Project expenses and goals with the guidance of your practice expert. This is based on the 3 logical indications: history, expenses and potential.

7. After working with your dental business expert discuss with your team at the annual planning session, how many working days will be needed to meet your budget needs. What services will you provide? (“Same Day Services”, New and Standard of Care Services). What products can you offer to add value and benefit your patients’ oral and total health?

8. With the guidance of your dental practice expert determine your practice potential and identify your obstacles.

9. Understand how to move beyond the obstacles.

10. Develop an Action Plan. This is the step that pulls your plan together and makes your resolutions stick

Download a Sample Action Plan

To download a copy of an action plan.

Few dental practices plan their future success in an effective and proactive manner. Whether through chance or poor execution, many of these dental practices who do have plans will not have a well thought-out strategic plan. Due to poor planning and/or or poor execution, many of these annual plans derail, and the crises that arise lead to lost patient appointment time, loss of practice profitability, wasted money, contentious patient issues, and can cause potential, legal quagmires.

Having an expert dental consultant guide your annual planning is only the tip of the iceberg to creating a profitable year in 2011! Don’t delay. Planning needs to be put on your calendar today! A ten-step plan will find untapped potential and successfully manage your profitability.

New Year’s Resolutions don’t occur in a minute. It’s not as if you will suddenly lose 20 pounds or instantly have more money in your 401k. Rather, it will take a series of successive moments as you work towards the change that you seek. This is the reason you need to begin planning today. Mark your calendar, get set…Go!

Your Thoughts

Does your practice have a strategic plan for next year? Do you have some tips for creating a strategic plan?

You are driving on a nice vacation and need gas. You stop at a gas station and go inside to buy some snacks while you gas is being pumped. How much do you spend while in the convenience store? The national average is $5.00US (US = American Dollar).

This month Nordstrom (A major and very popular US department store) is having their Anniversary Sale. I know all the stores were mobbed. How much do you think the average shopper spent this year at the sale? The sale just ended so I am not certain about the exact number but I just read that sales this year for Nordstrom Department Stores are up 35%!

Monitor Average Patient Revenue

Have you ever taken time to monitor what the average patient spends at a dental appointment in your office? If not, then please take time to run this report in your office. Studies say that patients will spend $300-$500.00US at each dental visit the same day they are offered the treatment or product! This means that if we communicate with powerful words, patients will complete and pay for treatment and products we recommend – the same day.

What type of services do you have available for patients to buy right now?

Do you have a complete menu of services? – – And – – Do your patients know exactly what these services are? Do you have categories of various services available? Where can patients read about the services you provide? Are they written down somewhere in the office and on your website? Plan to offer these services on your social media sites. There are so many ways you can get the word out about the services your dental practice offers.

Meet With Your Team

Take time this summer to meet with your team and discuss what services you offer in these three categories: Preventive Treatments, Restorative Treatments and Cosmetic or “Elective” Treatments. Discuss, as a team, how patients currently find out about what you offer and share as a team, ways that patients may be able to read and learn about your services more easily. How can you create in patients, the desire to buy what they want not just want you tell them they need?

Here are some suggestions to discuss at the team meeting:

• How can you make your “same day” – – cosmetic (elective) services seem and feel more appealing?
• How can you create urgency for patients to begin getting impressions taken “same day” for teeth whitening, fluoride treatments, etc., instead of making an appointment?
• Do you have desensitizing agents available for patients?
• Do you recommend fluoride varnish?
• Do you recommend Xylitol products?
• Do you recommend Power toothbrushes, toothpaste(s), mouth rinses, etc.?
• Do you utilize the intraoral camera while patients are in the chair?
• Is there something more you can add to educate patients while they are in the office?(In the reception area, consult room and operatories)
• How do you educate patients about your services when they are on your website?
• What type of photographs do you use on the website to show off your valuable services?
• Do you show off before and after photos for patients to view while they are in the office? (In the reception area, the back office and consult room?)

There are so many “same day” preventive services that you can offer patients. Even “same day” cosmetic services and products can be recommended and provided to patients that day, while they are already there for an appointment. People will buy on the spot (“Impulse buying”) when you communicate with powerful words that add value to the recommended and/or diagnosed service(s) and products. People are thinking: What’s in it for me. “WIIFM”

When you meet as a team to discuss various services you provide patients, make time to discuss ways to educate and communicate these valuable services to your patients. You can now add over $100,000.00US in production to the dental practice in 2011, when you add “same day” services. Additionally, have patients leave the office with their recommended dental products and the knowledge about how to use these properly.

One easy way to guide your patients to live a longer, healthier life and build practice revenue is to ask questions during the 1st five minutes a patient is seated in the chair.

A few of these questions are:

• Do you ever notice your mouth feels dry?
• Do you feel the need to frequently sip water?
• Do you have sensitive teeth?
• Do you like the appearance of your teeth?
• Do you like the color of your teeth?

Pay Attention to Cambra

CAMBRA (Caries Management by Risk Assessment) recommends that patients be categorized into risk levels for managing decay. When patients are at moderate to extremely high risk for caries it is recommended they have a fluoride varnish treatment every 90-120 days. Patients may say: “Insurance doesn’t pay for it.” “I don’t want it if my insurance doesn’t pay for it.” Many insurance companies will pay for fluoride varnish under the CDT code D1206. (This code is used in the United States for billing purposes.) There are insurance companies paying for this service every three months. If patients don’t have insurance or if their insurance will not cover this benefit then we have a responsibility to communicate the risks, benefits and the value of this preventive treatment to the patient. (The WIIFM part) Many patients come into a dental office and spend over $1,000.00US on restorative and even cosmetic (“Elective”) treatment. Many of these patients qualify (Meaning this is a necessary preventive treatment.) under CAMBRA for a fluoride varnish every 90-120 days and they will benefit by spending just as little as $100.00US annually to prevent decay. This service is a huge savings when a patient spends maybe $100.00US annually for prevention vs. $250.00US for possibly one mandatory restoration, a few times each year.

Offer Over-The-Counter Products

What about over the counter products for preventive care? This is another area, which will benefit the patient and the practice. Research tells us that 70% of patients who leave the dental office to fill a prescription for 5% Sodium Fluoride or Peridex, etc., return to the dental office and say they did not get the prescription filled. When we have these products available to our patients, not only are we able to have them take the products home and utilize immediately, but we can have a team member in the office teach the patient how to use the new product so self-efficacy is at the highest level possible. (Yes, even someone at the front desk can be available and educated to show the patient how to use the new power toothbrush, whitening product, or fluoride, etc.)

Offer Xylitol Products

For those patients who are in the dark and refuse to see the light (The truth!) and say, “Fluoride is a poison!” they may benefit by using Xylitol products. Xylitol products need to be available for patients to purchase in your office and utilize daily. Many dental companies sell 100% high quality Xylitol. (Read labels and find out how much Xylitol is really in the product.) The patients who are at risk for caries need 5g of Xylitol daily and the dental companies that sell Xylitol have tablets, gum, mints, etc., in a form, which allows patients to monitor their daily intake and effectively prevent decay.

Did you know that over 1,000 medications cause dry mouth? Xerostomia (Dry mouth) sets up patients for cervical decay. Fluoride treatments in the office and at home can prevent patients from spending money on mandatory restorative treatment. This also adds value to the patient appointment and revenue to the practice.

Add Fluoride Varnish to the Mix

Many years ago, patients spent 4 minutes with a bulky tray in their mouth to receive a fluoride treatment. Patients were only offered a few flavors to choose from and it was an unpleasant experience. Now, we have fluoride varnish that can be applied in less than 90 seconds. You can offer patients various flavors and no tray is used. No one needs to worry about the patient swallowing fluoride varnish. No time is spent suctioning the mouth or drying teeth. This can be applied in a wet environment with the swipe of a tiny brush over the teeth. Fluoride varnish will creep into the interproximal surfaces so there is no need to attempt applying into the interproximal surfaces.

Fluoride varnish usually costs less than $2.00US per application and the patient cost is anywhere from $25.00 – $50.00.00US per treatment; 3-4 times a year. The cost benefit ratio to the patient and the practice is huge! Think about how happy 100 patients will be, this year, if you offer just this one service. Patients may now save $1,000.00US next year on restorative treatment if they prevent decay. Choose just 4 patients in your practice each day, beginning this week, who you know can benefit from a fluoride varnish treatment. If you charge $25.00US, (A very conservative fee for this treatment.) for each treatment this increases your revenue $100.00/dayUS. This is just the tip of the iceberg when adding profits to your practice and improving patients’ health.

Start Tomorrow

During your morning team meeting (“huddle”) tomorrow I challenge you to pick 4 patients who you believe can benefit from a fluoride varnish treatment. Discuss ahead of time, what the cost will be to the patient. What will you say to the patient so they can understand why this is necessary? In addition – – What will you say to communicate the benefit to them financially? How will this affect the health of their mouth and their overall health? This is the WIIFM. Think about this with regard to each patient you offer this one service to, beginning this week.

2 Tips to take away today:

1. Create a list of questions to ask patients and discover their desires, wants and needs, etc., regarding dentistry.

2. Offer “same day” treatments and products for patients to take home with them.

You’re The Expert

We are the healthcare professionals – “The Experts”. When we share, the scientific evidence and understand how to communicate effectively, patients will sit up, listen and take action. These are just a few suggestions so you to tap into same day Preventive and Cosmetic, (“Elective”) treatment, add value to the patient appointment and profits to the practice.

If you have not read the information about CAMBRA and the benefits to patients and your practice, visit dentalpracticesolutions.com and click on the Membership Center link. It is free to all of you. Once in the Membership Center click to Register. We have a lot of information about CAMBRA right there for you!

Your Thoughts

Which same-day services are you offering your patients? Which have proven to be successful in your practice?

It’s important that your dental practice has clear and fair vacation and time clock policies. A good vacation policy will improve employee morale and help with recruiting efforts. A time clock policy will clearly establish for your employees which activities are compensable and keep you on the right side of the law.

Your practice may have already established vacation and time clock policies. However, I’d urge you to take a look at the free vacation and time clock policy the Cambridge Dental Practice Consultants are offering on their website. You may find that your existing policies could benefit from a little tweaking.

Where does your practice production stand this time of the year? How are you utilizing the team to assess and connect with the practices’ patients? Many dental practices are still feeling the economic crunch but there is still time to capture six figures of production. Just making simple changes can create more than $100,000K in additional production this year. (Less than six months left in 2010 today!)

The Secret to Capturing This

If you could increase hygiene production by $500 each day or just $62.50/hour you will have an additional $62,000K in added profits for 2010. At the time I am writing this there are approximately 100 working days left this year. This is treatment sitting in patient charts (or your computer) which has been undiagnosed and/or unscheduled production. Each time I go into an office I find that there are at least 200 patients who have untreated periodontal disease. Why did this happen? There are many reasons this happens and the best thing we can do for these patients to create a longer and very healthy life is to get them into preventive treatment. It is our responsibility to share our knowledge: the science behind periodontal disease – the oral/systemic link and how this can change the way they live life!

Now imagine that if this hygienist can co-diagnose at least $2,000/week in restorative, cosmetic dentistry and even appliances, (Occlusal guards, snore guards and/or whitening) this can boost your production potential even higher. There are approximately 26 weeks left in 2010 at this point in the year so this means another by $52,000. Together, these two services provide for over $100,000 in scheduled production on the books during the next 6 months. I will honestly and very simply tell you how to get to this profitability on your appointment schedule and in 2010. There are few steps to get this done!

Step 1 – Prevent Periodontal Disease

This is my mantra and it should be yours as a dental professional. We have a lot of scientific information available to us so we can appropriately educate our patients about the importance of good oral health. Science tells us that if we treat the disease process sooner than later we can prevent future disease (Heart disease, Diabetes, Alzheimer’s, Arteriosclerosis, etc., etc.) If we share this information with our patients most people will sit up, listen and take action. How many patients have you met and they said “No” to living a longer and healthier life? Not many!

The fact is that if one hygienist (Working 4 days a week) enrolls just 100 of your current patients into active, non-surgical periodontal therapy and then periodontal maintenance every 3-4 months; hygiene production will increase by at least $150,000.00 in the next twelve months of these scheduled treatment plans. As a dental professional you probably understand that 80% of our adult population has some form of periodontal disease. The sooner we treat the disease the more likely it is we can halt the disease process. When patients understand this they will make this an important matter in their life. They will say “Yes” to scheduling and completing treatment.

Step 2 – Remember Restorative Dentistry Needs to come from the Hygiene Department

Please remember that the entire team needs to be educated on the doctors’ philosophy. Everyone on the team needs to understand what they are expected to do and what procedures are available to the patients in your practice. Write these things down in your office manual for all future employees. Enrolling $2,000/wk out of each hygiene operatory is a very conservative number. One secret is these patients need to schedule their treatment for these production dollars to actually show up. I recommend that you take time to always schedule the next appointment before the patient walks out the door. I recommend all hygiene appointments be scheduled in the hygiene operatory not at the front desk.

Step 3 – Financial Arrangements and Follow-up

Always have patients leave your office with a written and signed financial arrangement. If patients decline treatment they also need to sign a disclosure that they understand the risks, benefits, alternative treatment and disadvantages of not completing the treatment. This is a legal liability and if you don’t explain this it can come back to bite you in legal bills, etc., if patients lose teeth or have other problems. If you don’t have a financial arrangement form, make sure you create one this week. Most dental software programs can make this a very simple thing to do.

When patients trust you and understand it is about their total health they feel an importance to have treatment completed immediately. Patients that say “No” to treatment are many times uneducated about the oral and systemic link. Make financial arrangements clear and easy for them. Help patients understand what portion of the fee they are responsible for and when it’s due. Always follow up. If a patient declines treatment always follow up with a conversation each recare appointment. The economy is difficult for many people, and at this time in our world in can be very hard for a patient to even pay $100.00/month. It sometimes takes time to change patients’ thought pattern about oral health and disease. If a patient isn’t ready to schedule that day, then put them on your follow-up list and ask for their permission to call in 2- 3 weeks.

We are more than half way through another year. These past 3 years have been tough financially but if you know how to communicate with your patients you can see the benefits of a win-win! Your patients can save money by completing preventive care now rather than later. Your patients will be happy to know they can stop future health problems and not spend more money on their teeth. Most patients would prefer to not spend their money on endodontic treatment, implants, tooth extractions, dentures, etc. Always discuss alternative treatment if the current treatment is not accepted. Most people want to live a long and health life. Having a beautiful smile makes most people feel good about themselves. When patients understand the facts they are happy about your team and know you really care. Your dental practice and the benefits you provide for them will really pay off. When patients return for the appropriate treatment you win by increased profits.

How can you expand your practice growth next year? Sometimes offices can’t get to the next step alone. Most successful leaders also have a guide or mentor. We are here to be your guide and offer special tools to make your future profitability a reality. Many times an experienced dental consultant can get you there very – very- – quickly! Pick up the phone and ask us what we can do to make this a seamless process for you and your team. Just call and ask us how today.

Much Success to all!

Your Thoughts

Are you already employing some of these tactics in your practice? What kind of results are you seeing?

To find out, I recently interviewed a man that knows all too well the realities of losing control of his practice (and himself) – only to recover and eventually operate among the top 5% of practices nationwide. This man is renowned Master Certified Dental Coach, Dr. Ron Arndt.

Dr. Arndt practiced clinical dentistry for 20 years and spent another 5 years in various executive positions within a financial planning and investment firm. This Summer, Dr. Arndt is releasing a book entitled, “Killing the Practice Before it Kills You: How Throwing Out My Business Model Saved My Life.” In the book, Dr. Arndt will go into great detail about the strategies he used to turn around his dental practice.

So, without further ado, here’s the interview:

1. How do you know if your dental practice is killing you?

Take a moment right now and consider this checklist. Have you ever experienced any of these warning signs? Check off those that reverberate with you.

• You find it difficult to get a good night’s sleep because you are thinking or worrying about the business.
• Your attention is on home when you are at work and on work when you are at home.
• You tell your spouse they are number one in your life when silently you are more focused on the success of your business. After all, it’s who you are!
• You act happy and content on the outside. In reality, your insides are churning and you never feel in control.
• Your energy level begins to fade, and you make excuses when you know you have not been taking care of yourself. You pass it off as something else.
• You are too busy to play those “goofy” games with your kids, who are so hungry for your attention.
• You read the newspaper or business journals when your spouse is talking to you because you have so much to catch up on. Then you fall asleep after twenty minutes, because you needed “just a little nap.”
• On a weeklong vacation, it takes three to four days to unwind. You feel like a new person for one or two days, then the tension builds again, welling up uncontrollably, tightening every muscle. Sunday nights are the worst.
• If you want something done right, you have to do it yourself. Only you can do it, because it takes too much time to explain and delegate a task to another person.
• You hear this voice in your head: “I don’t need anyone else. I’m smart and can do it all on my own.”

If you checked off a single one consider this a “red flag”. Don’t pass it off as inconsequential. The accumulation of these signs slowly and insidiously over time can be deadly.

2. Why are developing personal core values so important to the success of a dental practice? How do they translate into working with patients and your office team? In other words, why would they care?

I found myself defining my sense of worth and value based on the success of my business. It fueled my ego and fed my belief that I was paying off bills and creating an economic future of choice for my family. That of course included a beautiful home, nice vacations, paying for parochial school tuition, saving heavily for college education, and planning for retirement. Does that sound familiar?

I found myself developing a practice where I was working for everyone else except me. I employed two administrative people, two Chairside assistants, two expanded-functions dental auxiliaries, and two hygienists. Big numbers, big production was the name of the game . . . or so I thought. After all, I was working to be the biggest, baddest, fastest, coolest, wealthiest, and most respected dentist in town. I was unaware at the time that I was learning the lesson that a manager cannot both lead the band and play all the instruments.

After my heart attack, I consciously began to shift in many ways: my outlook, my attitude. I chose to focus not on eliminating my type A behavior, but rather on replacing it with something different. I affirmed my new life direction by codifying my values in writing. I knew I had to identify my core values, the guiding principles around which I would make all of my business decisions. They would serve as the litmus test against which I identified what was “right” and “honest” for me. I knew that these core values would be the genesis of everything that I wanted to do in the transformation of my practice. I set aside several thirty- to forty-five-minute quiet-time periods, so I could work on identifying my core values.

As a basis for this process, I used the following elements: My core values are ideas that I want to publicly affirm;

- My core values are ideas that I greatly prize and have a positive influence on my life;
- My core values are ideas that I am willing to act on;
- My core values are ideas that I would repeat if given the circumstances again and again; and,
- My core values are ideas that I choose freely and with a clear understanding and recognition of the consequences of my choice.

Why would patients care or even know?

Simple, they would see and experience my commitment in the ways I behaved not only towards them but also my team members. Patients, guests want to know that you operate from a set of values that honors and respects them in all actions. In all our interactions with patients, if we have core values in writing and committed to by all team members, we get to go back to them any time we get stuck, have a tough situation, or are confused on what actions we need to take. Core values are HUGE in how we operate our business and treat those around us. Patients know a genuine and authentically caring dental home.

3. What was the significance of firing – and then re-hiring – employees? How did that help you define leadership?

It was much more than simply “firing” the team. It was a dramatic message that the old way of doing business was over. I was not leading my team successfully and the dental team was lulled into a mindset of entitlement…a deadly combination. By Killing the Practice I was burying the old and then offering up a new solution…a solution I wanted for the way I wanted my practice to operate. This was an all or none approach that was necessary to get everyones attention. The choice was entirely up to each individual employee if they wanted to re-apply for the available openings in my new practice.

After Killing the Practice I spent the next several hours detailing exactly how I was going to run the practice. I introduced them to my core values, explained what they meant, dissecting every word and sentence. I gave them the opportunity to ask questions. I did the same for my vision, clearly laying out for them where I wanted to take the practice, again reminding them that they didn’t have to own these, they didn’t have to buy into any of what I was explaining. But if they didn’t, they no longer had the opportunity to work with me or in this office.

For the first time ever, I became the real leader in my practice, a role that I should have assumed long ago. It had taken me years to realize that the ultimate responsibility of a leader was to facilitate their development as well as my own.

4. How can a dental practice raise their fees and not upset the patients?

I finally made the decision that I was going to be paid what I was worth and I expected to connect my compensation with the value, the love, care, and extra attention I brought to my patients’ dental health and life. No more of this conversation about if the insurance will or will not cover it. Or, that’s over “Usual, Customary, and Reasonable.” That old thinking had to go. My practice was not usual and customary; we were extraordinary. I declared: “We will train on our financial arrangements and how to discuss them with our patients . . . no more laissez-faire.” My expectation was to offer up financial options for our patients that were written, fair, explained in advance, and easy to understand. And of course, any patient who’d been previously quoted a case fee was grandfathered in.

The best way to overcome the “perceived” objections was to communicate and deliver “value” for the fee. Certainly there would be a small percentage of price shoppers that would be upset, yet they were not our ideal patients. I directed my administrative team to keep a yellow pad at the front desk and list those patients who were so upset that they were going to leave the practice. We never filled one full page…barely a half page. It is my belief that no matter what our fees patients will view them as “a little pricey” and I validated that with a study I did with my crown fees.

What I have learned is that if we deliver perceived (and real) excellence combined with true patient care and outrageous service, our patients will perceive the value and not only continue to visit us, they will refer. Don’t misunderstand, this is not about gouging people, it is about being compensated for delivering remarkable human service.

5. How does cutting some benefits completely, but increasing others dramatically work?

I took a new-world view…new in that I was breaking with the typical dental management thinking of give everything and anything to retain employees. Dentistry as a profession lives in a HR bubble. In the real employment world, employees are paid for performance. Greater performance dictates greater and higher compensation and of course the opposite applies, low performance, low pay or even dismissal. In dentistry, this statement is more enigmatic: “Dr., I have been here for another year and I am entitled to a raise.” My new world view was, no more entitlements. I explained clearly that the new wage offerings would be no less than what each was currently making, however, any future increases in wages would be as a result of increased output-performance-revenues.

No more benefits of paid time off that found my team taking advantage of my generosity that cost the practice revenues and raised my stress because I was often found on Monday’s (often the busiest day of the week) short handed by 25% of my workforce because they wanted an extended weekend (67% of called in days off were on Mondays). I eliminated the eye-care benefit. I made major adjustments to my benefits package, because it was being abused. It had become expected as an entitlement and was grossly unappreciated. And my staff costs had continued to escalate because of the generosity that I had built into my staff compensation package without any real consideration to what it was costing me to provide staff services.

I was now going to track my business expenses like a real businessman and compare them to industry averages to better enable me to make better decisions. I also declared that I would no longer pay for their exotic trips to St. Thomas, the Bahamas, and Dallas. No more excursions. I expanded the continuing education credit because it encouraged their personal growth, enhanced their value, better served our patients, and was simply good business. I made people clearly aware that they would be well paid, but I was firm in my expectation: you have to show up, and produce results. Compensation would now be performance based. Then I introduced my new incentive program: a Win-Win, Pay-4-Performance arrangement. It was team-centered and fair. Did it work? You bet it did. My final 5 years in practice were my most enjoyable and profitable and my remaining team members were making more money than they had ever done in the past.

6. What does practicing meat and potato dentistry mean? Why does it work?

Meat and potato dentistry is my name for the routine, common procedure mix of services the typical patient wants. My practice was not a high end cosmetic or full-mouth rehab business. That was not what the majority of my wonderful blue-collar patients requested. While I did selective challenging cases, I brought in an oral surgeon to help me with the implant process and an orthodontist as well to help me grow my young people part of my business. We were a “family practice” and as such served moms and dads and their kids along with their grandparents and neighbors.

Nothing fancy, yet extremely personalized relationship-based care. Our patients were give full, comprehensive evaluations and treatment plans and then given full authority to determine if they wanted some, none, or all of what we recommended. We phased our care as well so that they did not feel pressured to “have to” do something. I have learned that the scar of the unchosen surgery heals slowly. We did basic, solid, caring dentistry. For those dentists who can do the big restorative and cosmetic cases, we referred our tough cases.

7. What is one tip that you would give to someone starting out their own private practice?

Start with the end in mind….a Steven Covey mindset. I’m coaching right now a young starting pediatric dentist. My first bit of coaching was to get him to dream and envision what he wants! What will make the biggest difference, and yet one of the toughest things to implant into the head and heart of a new dentist, is to identify who you are via your own Core Values. When they write out, on paper and list what they stand for they then can take the next step to write their personal AND practice Vision Statement. Armed with their Core Values and their Vision Statement, the strategic plan magically begins to unfold as any time they get stuck…the refer to their values and vision.

Above all things, this is what I want for new dentists. My fear however, after talking to Junior and Senior dental students, they won’t take the time or devote the seriousness to this process. I have seen the results with many doctors…frustration, lack of direction, financial chaos, marital issues, misplaced arrogance, and an unhappiness with their life.

Get in touch with Dr. Arndt

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Your thoughts

Have you ever felt that your practice was controlling you? How did you handle the situation? What will you takeaway from Dr. Arndt and try in your practice?

Prioritize Your Schedule

A full schedule translates into revenues and production only if the patients come in. If a practice loses 1 to 2 appointments/day, either on the hygienist’s schedule or on the dentist’s schedule, the lost production from this could be anywhere from $100 (minimally) to $900 per day, depending upon the procedure. These are dollar figures for clients and dental offices during the year 2009. Let’s assume you have 200 working days during the year, the annual lost production works out to $20,000 at the low end to $180,000 at the high end. Take into account that you lose even $20,000.00 over the next 5 years. This is $100,000.00 which can be used in many areas for a successful and profitable dental practice. Think about your salary being reduced by this much. This can really hurt a dental practice!

These figures are for a solo practitioner, with one full-time hygienist. The figures multiply for a multi-doctor office, or for a solo practitioner with more than one hygienist. Improving practice performance in this one area alone could significantly improve the financial status of many dental practices.

Practice success depends on the strength of a strategically planned schedule. It is important to have a systematic method for scheduling patients. On a daily basis, the entire dental team probably spends much of their day discussing and dealing with the topic of appointments: cancellations, broken appointments, and no-shows. This is a big source of endless frustration. No-shows and cancellations are the biggest single source of lost revenue.

It is helpful to be proactive, have a strategic approach and design a systematic schedule. Having a system in place will decrease the level of stress and increase revenue in your dental practice.

Stephen Covey, author of many professional management and family management planning books has said, “The key is not to prioritize what’s on your schedule but to schedule your priorities.”

Your first thought may be that is seems impossible to create the ideal dental practice schedule. Every dentist and most auxiliaries practice on different days, each professional may have different hours, they will provide treatment at different speeds and they will offer different services. All successful dental practices will take account for all these scheduling variables. Having a scheduling system is what creates success in all areas of the dental practice.

Effective Schedule Systems

When you have an effective scheduling system the doctor and team are now in charge of managing the patient flow. The patient flow should not manage the team.

Think of the schedule as the center of all dental practice systems. This is one system that will significantly decrease stress. When the team manages the schedule it will become efficient and predictable. This is where productivity will create increased revenues quickly.

Six tips to help you manage your practice’s scheduling

1. Use 10-minute units
Using 15 minute increments on the schedule costs the practice approximately seven days of treatment time every year. This means the doctors are working that much harder and not smarter. When you change the practice schedule to 10-minute units you are able to schedule procedures with a higher degree of accuracy. When you utilize 10-minute units of time the practice can schedule a 20-minute procedure with ease. With 15-minute units, the procedure must be scheduled either with not enough time (15 minutes) or too much (30 minutes). Ten-minute units will now offer greater flexibility and result in increased productivity.

2. Create a template for each operatory
Every 10 minute unit needs to be put into the schedule in advance. A schedule built on a 10-minute template outlines exactly how every 10-minute increment will be used for each operatory. Doctor and the auxiliaries need to take a look at the 10 minute units first. This is how they will know how each day is going to flow. This needs to be reviewed even before the team huddle begins.

3. Schedule by production
Again this allows you to take control of the schedule and the schedule will not control you. When setting up your annual schedule template decide how much production you need to stay in the black. Decide what procedure blocks will be added and at what times on the schedule. Many practices make the mistake of scheduling by reactively filling empty time slots.

3. Be proactive. First things, First
Most people during the day have more energy and as the day progresses they tend to run out of steam. For many people the time after a lunch break seems to create a decrease in energy. Try having longer, more intensive treatment options in the morning. This is the time to fill the schedule with longer procedures and high-production cases.

When you have a strong scheduling system in place you have increased productivity and profitability. When you create a schedule with production as a priority you create harmony, less stress and help the practice meet all the daily goals; production and otherwise.

4. What is a “Perfect Day”?
It doesn’t need to be a calculus equation or statistics but there needs to be a strategic mathematical formula to make certain the practice meets their goals. It is best to schedule an average daily level of production which will be equal to your annual production goal. For example, if you want to produce 1.5 million in 200 days, you need to schedule $7,500 per day. This will include the hygiene schedule and doctor’s schedule. It is not realistic to produce this same number each day. The important part is the daily average.
Having “Perfect Day” schedules and daily production goals also tend to reduce practice stress because they allow doctors and their teams to achieve a consistent day-in day-out workload.

5. Your “Perfect Day” Schedule
It will increase efficiency when you schedule the doctors, hygienists and all auxiliaries separately. If you are utilizing an assisted hygiene model the hygiene assistant should also be scheduled into the 10 minute increments.

The doctor and assistant do not always need to be in the room together. This follows true especially when using an assisted hygiene model.

It may take a few weeks and a process of time but it will significantly increase the total office productivity, decrease stress, improve patient flow and increase the annual revenue.

6. Communication is the Key to Reduced Cancellations
It is the nature of business and life in general that there will be cancellations and no-shows. When scheduling tell patients that you are “reserving” this time specifically for them. Educate all patients about the importance and leave them feeling the urgency for reserving appointments prior to leaving the office.

When the front office is speaking with patients they need to request patients give 72 hours notice if they need to change an appointment. If patients need to change their appointment on Monday it doesn’t do the office any good to cancel an appointment on Saturday. This is why you need to ask for at least 72 hours cancellation.

Take time to retrain your patients about this policy if you don’t have this in place currently. Let patients know there will be a fee for a missed appointment. The fee needs to be dependent upon the type of procedure and should be written in all policies you publish to your patients. These policies are included in the new patient package. Appointment cards need to mention there is an appropriate fee charge for cancellations outside of the 72 hours.

Quick Overview

• Schedule in 10-minute units, with a template for each operatory
• Schedule the most productive procedures first by creating ideal day schedules with ideal production goals
• Schedule longer and high end production early in the day
• Schedule doctors and assistants separately
• Build patient value for appointments to reduce no-shows and cancellations

You will create a more efficient and effective system for scheduling patients when you create your “Perfect Day” schedule. The bottom line is harmony in the office, value to the patients, improved productivity, increased revenues and reduced stress. It is a “win-win” that creates success!

Do you need guidance setting this up? Do you know how many days and hours you actually need on the schedule? Please contact us for a free assessment. Find the answers to these questions, lower your overhead and increase your revenue.

Years ago the dental hygiene department was thought of as a loss leader. When looking at the business of dentistry in the 21st century we realize there are numerous profit centers inside the dental business. When looking at the dental hygiene department there are numerous areas in this department that bring profits to the dental business.

Four-handed dentistry has been popular for dentists and by utilizing this assisted model it is only one avenue to bring increased productivity and added revenue to the hygiene department as well. This is not to be misunderstood as accelerated hygiene but as a way to provide added value to the dental hygiene department, optimal care to the patients and in addition bring increased revenue to the dental practice.

There are many factors which play a big role in the success of this dental hygiene model for business success. This is part I of 3 articles to discuss what you need to explore to understand if this business model is correct for your dental practice.

Defining these Two Words

What do the two words assist and hygiene mean? Assist means to give support or aid. What does the word hygiene mean? According to Merriam Webster this word means the science or establishment of health.

It is important to look at the meaning of these two words. This is where we begin developing a true foundation for a successful assisted hygiene model. Specifically these two words when put together mean giving support to establish health.

The challenge to a successful assisted hygiene business model is to develop a course of action where the hygiene team can continually strive as a team to provide optimal health and preventive patient-centered care with consistency and effectiveness.

Sharing the Vision

Definition of Vision: “The Fundamental Source of Power.”

As owner of a dental practice you are considered the main leader in the success of the business. Your vision implies an understanding of the past and present. More important, it offers a road map to the future and suggests guidelines to those in a given enterprise— (The business of providing health. The business of dentistry.) how people are to act and interact to attain what they regard as desirable. As a leader your vision may be intuitive or highly structured. It is the bedrock for success in meeting the twin tests of competition and selection of what your business model(s) will look like.

Before deciding to implement an assisted hygiene model in your dental business it is important to ask yourself a few questions “Is this where I want to be?” “Do I want to expand my practice?” “Do I wish to have more employees?” “Are we ready to grow?” “Do we have the correct players on our team to move forward with this business model?”

These are some of the initial questions you need to answer. If you are not set up physically, mentally or financially this may not work. Once the primary leader or business owner feels comfortable with this business model they need to share this with the team and then the patients. If everyone on the team is not on board this new business model will not work. Once the team is on board you can share your new business model for assisted hygiene with the patients and all who enter through the door of your office.

Code of Ethics

These are the driving principles, of your business. An example of this can be seen with the code of ethics the Ritz Carlton shares with all who enter through the doors of a Ritz Carlton Hotel. (Did you know the employees keep a card of these on them at all times while on the job?) The leaders at the Ritz Carlton are responsible for stewarding an icon in the luxury market, through a constant quest for excellence, to continue its success in a changing global economy and with changing customer needs.

You can also think of your code of ethics similar to the Ten Commandments for your dental business. You may ask why have a code of ethics? Below is a list of important reasons why you need to have this, share it with everyone on the team and everyone who walks through the door of your dental office.

Why you need a code of ethics

• Sets up expected behaviors (for the team and what the patients can expect)
• Promotes high standards of practice for the dental office
• Provides a benchmark
• Establishes a framework for professional behavior and responsibilities
• Gives a specific Identity to the practice – what they can be known for
• Shows development of a systematic approach and maturity of the business

When people know why you are in the business of dentistry they are more likely to remain a life-long patient and most likely be a disciple of what you represent referring all their friends and family members.
When changes occur in the practice, for example changing to an assisted hygiene model, patients are more likely to weather the change because these are the people who understand you are all about their best well-being. They know you care by everything you do and say: written and verbal.

Critical Components

A systematic approach is the key to making this and any transition a seamless process.

Define what assessments are to be completed during the hygiene appointment and which auxiliary(ies) can perform these assessments. The hygiene team in particular needs to meet and write down what screenings will be completed and at what intervals. An example may be: “At each preventive appointment patients will receive the medical history review and an oral cancer screening. The patient will also receive a caries risk assessment form and this will be reviewed by an auxiliary. The auxiliary will ask about xerostomia (dry mouth) and give oral hygiene instructions (or a review of) before the patient leaves the operatory.”

“Annually each patient seen for preventive treatments will receive a full mouth periodontal screening exam, a blood pressure screening and smile analysis.” This is just an example so you may want to meet and decide what is in the best interest of the patients and your practice model.

Once you meet with the team and create this model you will nurture and create an atmosphere of optimal preventive patient-centered care.

It is very important that you develop a customized and written protocol so each member of the assisted hygiene team and even future members of the assisted hygiene team can acknowledge, accept their role and responsibility within this new business model. The written protocol will include the daily goal(s) for production and may even include how many referrals you ask for from current patients. The written protocol will include challenges and how they will be handled, when to implement new technologies, budgets for new equipment and treatment adjuncts to continue improving the quality of patient care.

Cross-training the hygiene department and having the operatories set up the same in a systematic manner will promote a system of effectiveness. The hygienist and assistant must acknowledge the benefit of sharing duties which overlap their scopes of practice and contribute to the success of the assisted hygiene program.

Scheduling is very important and the various patient treatments (procedures) need to be categorized into low, medium or high production. Having specific blocks of time pre-scheduled in the appointment book will also help keep the assisted hygiene program on track for not only a preventive patient centered practice of optimal care but will help the team meet production goals.

Determine your expectations and each person’s perceptions. Be open to listening to your patients’ perceptions about this change. This awareness will help you and the team to proceed with clarity for success and to progress towards peak performance with a patient centered preventive program.

Journey through Peaks & Valleys

These are just a few guidelines to begin your journey for patient centered hygiene care. Possibly you already use the assisted hygiene business model. There will always be peaks and valleys in anything we do in life.

Even if you have already implemented this program of assisted hygiene you may consider the expertise of a hygiene coach or consultant as they are the experts who will provide the team with powerful solutions to bring the valleys up to peak performance.
When you become clear about your values and understand everyone’s perception not only will you exceed your expectations but those of your patients.

Happy Patient = Continued Success!

Stay Tuned

Stay tuned for part II of Debra Bittke’s series on The Assisted Hygiene Business Model…

What an exciting time we live in! We are living in a time where we are discovering new technologies. We have social media marketing strategies, everyone has a website and we are just a Google search away from one another. If you want to be on the leading edge you are looking for ways to set your practice apart from the rest.

We must pay close attention to increasing profitability, efficiency and our overhead while providing a high level of quality, attention and detail to our patient care. These are exciting times in dentistry as we explore and implement new strategies to enhance and improve our current dental practice business strategies.

Over the years, dentistry has evolved into realizing that we must carry out a patient-centered, prevention-oriented health care practice that is prosperous. It is imperative to employ sound business principles and expect our practice to be an environment in which our team has an opportunity to build a rewarding career and our patients receive extraordinary care and service. One thing that may change for our patients is a re-adjustment of their priorities as it relates to their treatment plan.

The goal of helping our patients has now progressed from treating infection and disease to good overall health. One thing that hasn’t changed is the cost of doing the business of dentistry. It is important that the team understand the cost of running a business in dentistry and a hygiene department. It is when the team understands these financial aspects of the business that members of the dental team are committed to excellence.

Working as a Team

When we work as a team we can make a difference. Everyone on the team needs to understand what systems are in place. Cross-training the team can create a harmonious playing field. When your entire team is enrolled in communicating patient education, delivering home care instructions and increasing the patient’s dental IQ we now provide a rich environment for enthusiastic teamwork, enhanced level of communication and a committed effort to improving the overall health and wellness of your patients. With a team fully engaged, your patients begin to connect and establish trust with your entire team and view the team as an invaluable resource for their total health. Working as a cohesive team provides an immediate and lasting impression for your patients. This is a cost effective marketing plan which we all know as internal marketing.

When reading about productivity in the hygiene department you may think of coming in early, working through lunch and staying late. Maybe you think the office has a prophy mill. Does this make you feel like you are running on a treadmill or riding a roller coaster? When you take time to add assessments such as a periodontal screening exam, CAMBRA, smile analysis and xerostomia, etc., you will begin to treat the total patient, work more efficiently and higher end treatment will begin to take place. Patients now have a reason to say “Yes” to treatment needs when they understand the science and importance of oral health related to their total systemic health. The assessments initiate communication for the necessary treatment and when patients understand the importance a “Yes” to treatment most likely means you are more likely to complete higher end treatment plans. This means your revenue will increase.

Another avenue to increase patient oral and systemic health is by recommending home care products. Home care products can also increase revenue and become another profit center. Can you imagine patients coming by the office even when they don’t have an appointment? They do when they purchase home care products from you. These products can be a great gift for patients to share with other friends and family members when there is a special occasion or holiday. This gives patients a reason to stop by the office frequently.

Offering home care products is just one more opportunity to add a personal touch, top of the line preventive services and exposure to your patients without marketing. When you offer products to support patients who request natural products, support your cosmetic dentistry, offer products for caries prevention and treatment of xerostomia, just to name a few. Adding home care products to what you currently offer your patients will not take time out of your schedule and will not add more patients to your schedule. It adds simple revenue with little effort on the part of the dental team.

Every time you prepare a crown or place an implant you are paying a lab bill. When you sell home care products you will not have a high overhead but many of the products you will have your patient purchase have a 70% return on investment. (ROI) This is called passive income. It is an easy way to add value to what your patients receive and it also increases your bottom line in the dental practice.

Providing a patient centered prevention – oriented atmosphere in your practice will bring out the vision, values and quality of your practice. It will set your practice up to harness to ride the big waves depending upon whatever the economic climate may be.

Creating a cohesive team and a dental practice based on excellence and the extraordinary, realizing the potential of the dental hygiene department and the entire team is essential to building the dental practice you have always dreamed of. This assures long-term relationships along side your success.

Your team members are all very important assets to the health, profitability and success of the dental practice. Your patients and the team are priceless!

There are many different factors that come into play when determining the success level of a dental practice, but one of the most important qualities that any practice should possess is excellent client service.

Clients expect more than mere technical knowledge from their healthcare professionals; they also want a dentist who is friendly, attentive and will put their minds at ease. Keeping clients as satisfied as possible will guarantee return visits – and referrals for new business.

Here are five ways to improve client service at your dental practice:

1. Provide various financial options to clients.

In these difficult financial times, many clients are finding it challenging to fit a trip to the dentist into their budgets. Your job should be to make the process as easy on them as possible. Consider granting discounts when patients pay cash upfront, creating a referral program that offers patients discounts for referring friends or relatives to your practice, and working out payment plans for patients with extenuating financial circumstances. Accepting credit card payments is another way to increase the number of payment options available to clients.

2. Expand the range of services you offer.

For example, cosmetic dentistry is a rapidly growing segment of the industry, and clients will appreciate only having to visit one practice for all of their dental needs. Popular cosmetic procedures include teeth whitening, dental implants and veneers. Another way to stimulate business is to offer spa amenities like massages or facials, which will give your practice a more relaxed, indulgent atmosphere.

3. Focus on giving each client personal attention.

Always send thank you cards after a client’s first visit to your practice, as well as to those clients who have completed extensive or costly procedures. Periodic postcard mailings are another way to stay in touch; try reminding patients that they’re due for a checkup, or offer a discount on special services like teeth whitening. Holiday cards are another way to show clients that you care. Finally, providing patients with surveys at the end of each appointment is a great way to solicit feedback and demonstrate the importance of their opinions.

4. Maintain a clean, comfortable facility.

People want to visit a dentist with a spotless office and up-to-date tools and equipment. In addition, relaxing music and television programs are mainstays of every well-equipped practice, as they put clients at ease and provide them with pleasant distractions.

5. Streamline and improve your scheduling system in order to reduce client wait times.

Nothing makes a client feel less valuable to a medical professional than having to sit in the waiting area for an hour or more. Try to schedule appointments so that clients never have to wait longer than fifteen minutes to see the dentist.

Optimize your client service with these tips and your practice is bound to see an increase in business.

When you see the words “the business of dental hygiene” what do you imagine? Perhaps you see a treadmill where high volume and financial reward are the main focus of the dental hygiene department? Or do you see a hygiene department where quality patient care and profitability are congruent, operating with systems and protocols that would not allow one to compromise the other?

A Paradigm Shift

During the past ten+ years the goal of helping our patients has now progressed from treating infection and disease into good overall health. One thing that hasn’t changed is the cost of doing the business of dental hygiene. It is important that the team understand the cost of running a business and a hygiene department. It is when the team understands these financial aspects of the business that the members of the dental team will be committed to excellence. It is important to have team meetings that educate every team member of the cost associated with the daily operations of running the business of dentistry and dental hygiene.

The Facts

The fact is, the hygiene department is the second largest profit center in the dental practice and provides support for the practice as a whole. Within the hygiene department are several other areas of profitability for the dental practice.

Most of your patients spend one hour–two to four times a year with the dental hygienist(s) and because of this ongoing relationship patients are more likely to remain in your practice, accept treatment recommendations and refer patients to the dental office. This makes your hygiene department a business within a business and it makes the executive in this department held accountable for his/her success. When the dental hygienist is held accountable for the department success and when he/she understands the vision and principles of the dental practice, success will follow. You will find the team working in harmony when they understand the vision for the practice share the same code of patient ethics and take ownership for the way patients are treated.

When every team member takes ownership of their role the patients are sure to experience a caring attitude, an ultimate dental experience, the highest level of care and the profits are sure to follow. This provides a win-win situation.

One of the most important aspects of the dental hygiene treatment that is often overlooked is the list of assessments. Dental hygienists feel as if they are on a treadmill but when the team plans the day effectively these assessments can really make the day run smoothly, allow patients to feel they received the highest level of care and now allows for a more comprehensive treatment plan to occur. The treatment plan now moves to a higher level of care.

New Treatment Heights

There is a list of 10 assessments and patient procedures that stimulate profitability in the dental hygiene department. These ten are all important aspects of the patients’ oral and total health. Not all offices participate in this list of 10 and
If you take a look at the list below and notice a missing piece choose to just implement 1 or 2 within the next month. Make an appointment this month to discuss with your team how to implement these ten successfully into the hygiene patient appointment time. Be patient with these changes and take time to discuss how to effectively implement these with full participation from the entire team.

The most overlooked assessments are the annual full-mouth periodontal screening exam. Still in the 21st century many hygienists who see a patient every six months, neglect to pick up a periodontal probe prior to picking up a curette. Most dental offices have approximately 15% of their adult patients with untreated periodontal disease. If each of these patients continues down this path we know that the research states this disease process will continue and the patient will at some point experience tooth mobility and possible tooth loss.

What will this cost the dental business? Take into account that most non-surgical periodontal treatment plans are approximately $1,000.00 for four quadrants of just scaling and root planing not taking into account the use of antimicrobials or laser therapy. Now take into account the frequency of the periodontal
maintenance appointments that follow about every 90 days. Once a periodontal patient, always a periodontal patient. It is the same as a patient with diabetes or high blood pressure. These patients are seen frequently and always at risk for future disease after the disease have been halted. We are not talking about money lost but improved health!

Another new area of treatment that is overlooked at this time is the pediatric patient – first visit. CAMBRA is a new evidence-based protocol for assessing caries. It is now the standard of care for the pediatric patient to have their first visit when the first primary tooth erupts. This appointment can be done in a consult room with the child seated on the mothers lap. This is an appointment to assess the tooth structure, biofilm and any suspicious areas of the child’s oral cavity. If you are concerned about receiving payment the CDT codes have you covered.

How many patients qualify for this preventive measure? How will this benefit your patients and your bottom line?

When the hygienist and team all understand the need to prevent and intervene at an early stage vs. wait and watch; not only does the patient gain an improved level of health but the dental hygiene production will increase. Establish periodontal and the various preventive protocols today. Now is the time to cease treating the periodontal patient with a prophy appointment and begin to utilize the
preventive measures according to the new CAMBRA guidelines.

Another area in dentistry that has changed in the past decade or more is selling home care products. Many decades ago we wrote a prescription or sent our patients to a pharmacy with names of products written on a piece of paper. Our knowledge and research over the past few decades states that 70% of these patients returned to our dental office and never took time to get the prescription filled. Patients seldom took that piece of paper with them to purchase the specific product recommended. When patients have the toothbrush they are to use and shown in the dental office how to use that new power toothbrush they are more likely to use the brush effectively.

This is the one area of your dental practice that has a net profit of about a 70%. You can spend hours preparing a crown or bridge and you have lab fees to pay at the end. The ROI (return on investment) for home care products sold in the dental office is about 70%. We want patients to buy their home care products from the experts, the people who know which toothpaste, toothbrush, mouth rinse, etc. is appropriate for the individual patient to use at home. The sales person at the local drug store and even the pharmacist is not the person to educate a patient about xylitol and its benefits let alone what type of silica is appropriate to use on the expensive restorations the dental patient just paid for.

By engaging and empowering the entire team your dental business is certain to excel. You will create a cohesive team and a dental practice based on excellence and the extraordinary. Realizing the potential of the dental hygiene team and creating a thriving profit center inside this valuable department of your business is essential to building the dental practice you have always dreamed of. This assures you long-term relationships along side your success.

Your team and the dental hygiene department are all very important assets to the health, profitability and success of the dental practice.

10 Profitability Centers in the Dental Hygiene Department

1. Perform oral health care assessments that include the review of patients’ health history, dental charting, oral cancer screening, periodontal assessments, biofilm assessment, saliva pH test, smile analysis, xerostomia, etc.

2. Expose and interpret dental radiographs (x-rays); co-diagnose

3. Non-surgical periodontal procedures, antimicrobial agents, laser therapy, etc

4. CAMBRA

5. Apply cavity-preventive agents such as fluorides varnish and sealants to the teeth

6. Administer local anesthetic and / or nitrous oxide analgesia

7. Educate patients on proper oral hygiene techniques to maintain healthy teeth and gums and recommend home care products

8. Discuss whitening treatment and take impressions when applicable

9. Administer smoking cessation programs

10. Counsel patients on the importance of good nutrition for maintaining good oral hygiene

Your Take

Which of these profitability centers currently exist in your practice. Do you plan to introduce any of the others listed here? Would you add any to the list?

Each day is a fast, frenetic ride on the practice racetrack. As hygienists we say “Treadmill”. Daily stresses morph into emergencies. You and the team dash from one procedure, patient, or task to the next and each are more critical than the last. At the end of the day you promise yourself you’re going to make changes and try to get things under control. But the fact is, it’s a rush. You’re living on chewing gum and caffeine and gulping at the fountain of adrenaline addiction, and with every near crisis averted, a sudden emergency addressed, and an urgent situation managed you do take a moment to give the team a quick high-five and congratulate yourself.

But that momentary thrill is creating long-term problems. Living in a constant state of crisis management typically means there is little happening in the way of real system management. The team is constantly reacting and scurrying in one direction one day and another the next day depending on what seemingly random course your so-called urgent priorities happen to take. Your crisis addiction, urgency addiction, adrenaline addiction – whatever you want to call it – is being satisfied at a price.

We work hard, not smart

The days are long and exhausting. What was once an exciting thrill is starting to feel a lot like burnout. The worst part, for all of your running, panting, and dashing to handle the latest and most urgent issue, practice productivity is teetering precariously between the “sorely lacking” and “barely good enough.” The problem is everyone is working hard but no one’s working smart. The focus is on dealing with whatever problem has to be managed right now and not on addressing what caused that problem and what can be done to prevent it in the future.

Turning your practice around

Had enough of life and work on the run? A mere 24 hours over the next year could transform a practice locked in a seemingly perpetual state of crisis management or lackluster success into one of superior efficiency and productivity. It also could go along way in weaning both doctor and team from an inefficiency addiction that is costing you thousands in productivity and an untold amount in long-term professional satisfaction.
It begins with a simple two hour meeting each month and a genuine commitment to making a change. This is dedicated, uninterrupted time in which doctor and all team members commit to continuously improve the practice.

Follow this 12-step plan to practice efficiency and increase profitability.

1. Create an agenda with input from the entire team. (Go to: http://dentalpracticesolutions.com/members-center/ for a copy of agenda to use.)

2. The agenda will be specific for the type of meeting you are holding. In our Tuesday Tooth Pick January 18, 2010, we listed various meetings you need to schedule during each year. For example one meeting you need to report on frequently are all areas of your dental office that impact the profitability and the success of the practice, such as: numbers of new patients, recare patients, non-surgical periodontal procedures, home-care products sold, unscheduled time units for doctor and hygiene, unscheduled patients for treatment and hygiene appointments which are not scheduled, treatment acceptance, collections, production, accounts receivables, uncollected insurance revenues over 60 days, overhead, etc.

3. Post a list of comments in one area of the office (Preferably a room where the team meets each am for the team huddle) for each team member to contribute their important thoughts and ideas on the topic for the monthly meeting.

4. Distribute the agenda at least two days in advance of the meeting.

5. Assign a different ring master (Leader of the meeting) each month who will lead the meeting and keep team members on task.

6. Assign each member of the team to report on the area for which she/he is responsible. For example, the Scheduling Coordinator reports on the monthly production as compared to the goal, the number of unscheduled time units for the Doctor, and the Doctor’s daily average production. . (Go to: http://dentalpracticesolutions.com/members-center/ for a copy of each person’s role.)

7. Designate the amount of time you will spend discussing each issue and avoid getting bogged down on unrelated topics. Discuss only what’s on the agenda.

8. Eliminate outside interruptions, and when possible hold team meetings off-site in a conference room. Many local libraries, community colleges, hospitals and other public facilities have public meeting rooms available for use. This is especially important when you are holding your annual strategic planning session. It is recommended the strategic planning meeting be held during an 8 hour period of time somewhere relaxing and fun for the team.

9. Encourage team members to come prepared to participate in the discussion. For example, if there are more unscheduled time units than desired the team can discuss strategies for addressing the openings. Seek input from everyone.

10. Delegate responsibilities and establish deadlines for completing tasks identified during the staff meetings. (See the agenda sample at http://dentalpracticesolutions.com/members-center/)

11. Share ideas during team meetings for improving the work environment, the patient experience, and the efficiency of the practice. Seek consensus from the team as to the best time to hold team meetings; meetings scheduled outside normal work hours should be considered paid time.

12. Hold meetings at least once per month, more frequently if you are implementing several changes. Before long you’ll be amazed at your cravings for stability and predictable outcomes. You’ll also be very likely to find you and your team all but addicted to the very real and measurable strides you are making in practice productivity and efficiency.

Have fun with your new addiction to efficiency! It may just increase your bottom line.

Your thoughts

Have you utilized any similar ideas within your practice? What were your results? Do you have additional tips for increasing practice efficiency?

Do you care too much?

If you have a voracious appetite for new patients, you don’t enjoy the repeat visits, and patient referrals you think you deserve, it may be because you care too much.

As a professional caregiver, being a dentist requires that you care—but not care too much.

This often comes as a surprise by many in dentistry who boast about how much they care on their website and other marketing overtures. Turns out, few patients are specifically looking for a dentist who cares! They simply assume that dentists and doctors of all types, care.

Find the “Sweet Spot”

As a healing arts professional, setting appropriate boundaries around being emotionally engaged in what patients do and don’t do is a key responsibility. Care too little and your emotional distance and mechanical detachment prevents appropriate patient bonding. Care too much and patients feel an obligation or a “duty” that can actually work against you. When you find the sweet spot between these two extremes, notice improved patient retention and an uptick in new patient referrals.

As a dentist, you probably don’t realize that searching out a new dentist is an unpleasant task. They contemplate the dreadful paperwork, the new practice environment, new procedures, new personalities and not to mention the general fear of the unknown of finding someone new. In fact, changing dentists is so distasteful, their old dentist (you) would have to inflict a lot of psychological pain to prompt them to start over with a new one.

By caring too much, you impose a type of obligation to follow through with certain home care procedures designed to improve their dental hygiene. Which is the point, right? However, to patients it often comes off as “this is what good patients do.” Even if you see it as merely a reminder about regular flossing, some patients interpret their subsequent failure to live up to your recommendations as, well, failure. Rather than face you and your disappointment, they seek care in another dentist’s office.

Of course, each patient, not you, determines if your recommendations are an obligation, or merely a friendly reminder. It may have nothing to do with what you actually say, but the tone of your voice and countless other subtle cues.

That’s why it’s critical that you care, but not to care too much.

One way to make sure your spoken recommendations are not perceived as a burdensome duty is to move from the first person, as in, “It’s my opinion that you…” or “I think you should…” or “If it were me, I’d…” to the third person: “Many of our patients find…” or “Over the years patients have reported…” Patients are likely to see this as less threatening and obligatory than first person recommendations.

Do you care too much? One way to know if patients perceive that you’ve crossed this invisible line is to take an inventory of how many patients in typical month are first timers as a ratio to total patient visits. The higher the number, the more likely you are of making this common mistake.

Your Thoughts

Do you agree with Mr. Esteb? Can you care too much?

As a dental consultant/coach, I have the opportunity to talk with dental practice owners every day. I also review and analyze dental practices on a weekly basis using my extensive dental knowledge to educate practitioners on how they can improve their practice bottom line.

What I hear consistently are dental practices which on average, see 30 new patients each month. Most dental practices have an average of 2,500 active patients. Most of our clients have been in practice for a minimum of 12 years and examine about 30 new patients every month. You may wonder why most of these practices have a mere active patient base of only 2,500 patients.

If all of these patients continued to return to the office the dental practice should have an active patient base of at approximately 3,500 patients. I am accounting for some attrition and being very forgiving with the accounting of these patient numbers.

In the United States, 78% of general dentists are solo practitioners. Why is there only enough work to keep one dentist busy? The answer is simple, dentists are losing more patients out the back door than are coming in the front door. Most practices I review have only 6 days of hygiene patients each week. With this point arises the question: why are these practices only seeing 6 days of hygiene patients each week?

First of all, I want to address the reason behind why patients may not be coming back to your office. The lack of a “personal relationship” with your patients could be to blame. By building a personal relationship with each patient, you will establish trust and give them a reason to choose your office over another one down the street.

One of the most common questions that I hear on a daily basis is, “why do we need to change? We have always done things this way.” This statement signals a major breakdown and is a silent killer for any dental practice. Dental practitioners should also keep in mind that the field of dentistry changes constantly and dental management skills that worked five to ten years ago probably do not work in today’s world.
There are many reasons why a practice might lose patients.

The “New Patient”

Your first impression is a lasting impression. I always ask doctors to periodically call their own office so they will understand how the phone is being answered. The dental practice owner and all team members need to be aware of how a client may feel when calling in to make an appointment. Do you get the feeling that the phone is answered with someone who has a smile on their face?

Offer good “Customer Service”

How long does your new patient need to wait until they are able to get an appointment in your office? If you have blocked times for new patients you are more likely to successfully accommodate them in a timely manner. If you heard something good about someone and are anxious to meet them, do you want to wait a month to meet them? Neither do your patients!

I have called many offices and an answer machine let me know the office staff was busy with another patient and was not able to answer my call. If I were a new patient calling to schedule my first appointment and I was greeted by a recorded message. I would be discouraged by this not so warm welcome.

What types of information do you send your patients home with? Do they have written oral hygiene instructions or post op instructions? Do you send out a new patient package prior to the first appointment? This can easily be done if you have a website that patients can download information from. If it is not possible to distribute the information through your website, think about emailing a package of information to save the cost of postage.

Do you make post – op calls? Do you call even after the scaling and root planning appointments? If you have a difficult or a fearful patient, think about the impact you would make if you called after hours to make certain they were feeling okay about their dental appointment that day. My niece just had her 3rd molars extracted and it was so comforting when the oral surgeon called to check on her much later that night.

How long does it take you to return patient calls? Do your patients leave with a written treatment plan for any future treatment? Are they able to send emails to confirm their appointments? What type of payment plans do you offer? These are only a few questions you should take into consideration when trying to improve upon your dental practice.

Team Hiring and Training

How do you know what type of personality fits into your practice? There are various models for testing temperaments. You need to know what type of personality fits each job description in your dental practice. You need to know if hiring another person with a strong personality will interfere with any other strong personalities that currently work in the office now.

Your Thoughts

Are you already implementing some of Debbie’s suggestions in your practice? What have been your results?

Have you ever heard the saying “If you fail to plan, you plan to fail”? Well this holds true for your dental business as well. You can not start a business and proceed blindly and just expect that everything will work out and you will achieve great success. It rarely will happen that way. At the very beginning of each year you need to sit down outside the regular dental office atmosphere and make a plan. This plan needs to include the entire team. It starts your practice off on the “right tooth”. Well, it is one way to keep you in the black.

Don’t set yourself up for failure

Without a plan you won’t know which way to progress, you won’t know what you need to do or where you should be when the day begins; let alone another year ends. The entire team will be confused about what you are working towards. What happens next? What happens in most cases is a loss of focus on the interest of the business of dentistry and loss of motivation to get where you need to go.

Would you take a journey somewhere you’ve never traveled without a road map? Of course you wouldn’t. Not if you want to successfully reach your destination. In the year 2010 you most likely have a sophisticated device such as a GPS to guide you directly to your destination.

Considering this, do you think you could successfully reach the goal in your dental business without a strategic plan?

If you are going to put your time and money into something, you don’t want to set yourself up for failure; rather you want to ensure your success.

Have an annual plan to ensure your success

When you have a plan, you will create direction for yourself and the entire team who follows your lead. You will now understand what you need to accomplish your tasks and move to the next step.

You don’t have to do this on your own. As the year ends many consulting/business firms are offering discounts to guide you to plan effectively, to travel in the right direction and end at the pot of gold.

Once you have a plan in place, you won’t have to guess what you should do next, as you will already know. You won’t spend your time wondering and waiting for success to come, only to be disappointed and clueless as to where you went wrong. I’m not saying that just any business strategic plan is going to ensure you success, but having a plan in place will significantly improve your chances!

Be prepared

This is your business…your lively hood. Having a well thought out business plan will also reduce your stress as you move along.

If you’ve ever been a parent or a babysitter of a young infant or toddler, you will know that if you go on an outing with a carefully packed diaper bag, you will feel a lot less stressed than if you just threw some things together right before you left. What if you forgot something? What if you forgot something important like diapers, bottles for formula, or the baby food?

While you are away trying to enjoy yourself your mind may constantly be stressed, trying to think if you have forgotten anything. Not a good way to run an outing at the park… or your business. Find yourself some business plan opportunities and get started!

Have all your cards in place and you will give yourself the best chance possible to be successful.

January is almost here and if you don’t have your annual strategic planning meeting on the calendar, now is the time to schedule that for you and the entire team. I want to suggest that it be held outside of your office. Make it a fun event for the entire team. There needs to be an organized agenda but make it fun, be concise and yet directive about what needs to be accomplished. Be sure to address what has been accomplished in the past year and decade as well. (Remember we begin a new decade on January 1, 2010!!) At this important meeting make it known to the team when you plan to have the office closed in 2010, holidays for the office, vacation requests and annual review dates for each team member need to be set or suggested at the least. This is just a short list to get you started on the “right tooth” when 2010 begins.

“If you don’t know where you are going; any road can take you there. Be sure to have your map in hand as you begin 2010!”

Happy Holidays and Happy New Year!

May you have a happy, healthy and prosperous 2010!

Author Bio

Debbie Seidel-Bittke, RDH, BS, is founder of Dental Practice Solutions, is a national coaching, full-service consulting, speaking and writing business focused on increased profitability in the dental office without increasing days of work in the office or more stress.

Debbie began Dental Practice Solutions in 2000. Her career has focused on all aspects of dentistry since 1975. Most recently she is known for increasing profitability in the dental office be driving the production in the dental hygiene department. Debbie has 4 specific ways to drive profits in your dental hygiene department.

You can reach Dental Practice Solutions by calling: 503-970-1122. Please visit the website for more free valuable resources: weekly newsletter, webinars and the membership center.

Your Thoughts

Does your practice have a strategic plan in place – annual or otherwise? Please share in a comment below.