Blueprints for Success

Navigating Insurance Administration

Charles Blair, DDS

Our profession is in the midst of massive changes. We are shifting from solo practices to corporate dentistry. In addition, we are entering into a PPO environment. Currently there are 11 PPO dental plans sold to each indemnity dental plan sold nationwide. What this means is that if you are a non-participating provider now, I expect you will be participating in a PPO within the next five years.

With this rapid shift to the PPO environment come new challenges for the dental practice. Many dental team members and dentists are at a loss as to how to submit primary and secondary insurance claims. In our call support center, more than one half of our support requests pertain to insurance administration. One of the areas of constant confusion is how to properly handle primary and secondary insurance when the secondary plan coordinates benefits. It is important to always submit your full fee on claims not your PPO contracted procedure fees. The four reasons to always submit your full fee are:

  •  Full calculation of coordination of benefits to ensure the patient receives her maximum available benefit
  • If your PPO increases their fee schedule and upon review of your fees submitted, you have submitted your contracted fees then you will remain within their current fee schedule and you will miss out on a fee schedule increase
  • Insurance companies set their contract UCR fees based upon data of fees submitted not contracted fees
  • Submitting your full fee will enable you to analyze your PPO participation by determining the write offs for each PPO plan and compare

As part of my seminars I give a coordination of benefits, write off calculation test and have approximately a 95-percent failure rate. This is due to a lack of understanding patient responsibility. The PPO controls the fee of what the patient pays. Coordination of benefits is different. Coordination of benefits determines the provider write off as the provider can retain up to his full fee submitted in some primary and secondary scenarios. Tips for primary and secondary insurance submission:

  • Always submit your full fee, not your PPO fee
  • Always submit secondary claims regardless
  • Always assign benefits to the provider, never the patient
  • Never perform any PPO write off adjustments until after ALL dental plans have paid

To assist you with understanding and training your dental team members, we have some tools for you. Send an email to info@practicebooster.com and type in the subject line COB calculator and test. We will then send you a COB test to educate your team and an Excel spreadsheet to calculate the provider write off when there is more than one dental plan.

Editor’s note: Dr. Blair has recently released a 250-page book on how to handle insurance administration – Administration With Confidence. Go to www.practicebooster.com and visit our store to order your copy.

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Moving Your Practice To A Relationship-Based Practice

Mike Robichaux, DDS

Not too long ago, I had the opportunity to visit with an entrepreneur who chose the dental arena as an opportunity in which to invest. During our long conversation I asked him a question… “What about the patients?” His answer stunned me and still affects me today. He said “We don’t care about the patients!”

When I think back to my youth, growing up in rural South Louisiana, there is one thing that is for sure relative to the dentists who treated me, and that is that they truly cared for me. By today’s standards, their care was archaic but there was never any doubt as to their motives. Over the past 45 years of working within this great profession, few would argue that things are changing.

Of all the various models available to the practicing dentist today, the one that best preserves and nourishes the spirit of the dentist and his other team and those who truly earn the trust of their patients is the Relationship-Based practice of dentistry. Sadly, maybe only 5 percent of the dentists practice within this model, and even more amazing is the belief amongst many of our colleagues that no one can make a living by building a practice around the best interests of our patients.

So how would one know if his or her practice is a true RB practice? One would expect that a dentist who loves people, forms relationships quickly, and is loved by patients surely must have a RB practice. Not necessarily so. Let’s look at the characteristics of a true RB practice.

  • To begin with, the practice is small, perhaps around 1100 patients, seeing 8-10 new patients per month.
  • Usually, there is one hygienist, one or two front office and two clinical team members.
  • They work less than 26 clinical hours per week and around 160 days a year. There is a pension plan for the doctor and team. The team does not “clock in”. Overhead cost is around 50 percent of gross.

The dentist is highly trained, gaining 100 or more hours of C.E. per year. His time is equally divided among personal growth, behavioral acumen, and technical mastery. The team is an integral part of all training. The patients are fully aware of these accomplishments.

The dentist is equally as concerned about the cause of problems as he or she is in how to repair them. New patients are interviewed to discern their desires, then examined thoroughly in a way that they learn of the condition of their mouths at the same time the dentist does, and then they learn their options relative to achieving their goals.

Case acceptance is very high and accounts receivables are less than one and half times of production. Collection is always 98 percent or better. Cancellations and no-shows are infrequent. Appreciation abounds amongst the patients, team, and dentist. A sense of peace permeates the office the vast majority of time…we haven’t made it to heaven yet.

This type of practice is for real and is active across the United States. It may be the best kept secret in dentistry today and may be a cure for all that ails us.

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Are You Living For Success?

Jim Reisman, DDS

Success comes in many different forms — Personal and Professional. What will be our legacy when we retire or die? What story will be written about the road we traveled?

What have I learned from 37 years in practice, 36 years as a spouse, 30 years as a parent, and 63 years a person?

  1. Your reputation is one of the most precious things you own. Guard it with integrity and honesty. Keep it safe. Make decisions that safeguard it. What can take a lifetime to build can be destroyed in a moment.
  2. Never let money be the force that guides your decisions with family and patients. Your patients’ needs and your ability to provide their needed service are what’s important. We need to make good business decisions to be profitable, but as my dad always told me, “take care of people and they will take care of you.” If our patients think we are selling them something, then we will lose their trust.
  3. Finding balance in life (like the Pankey cross) is critical to emotional health and success. Seek out your passions, whether it is running, fishing, hunting, travel, or CE. But make time for family! Time for the spouse, kids, parents, and whomever is part of your life.
  4. Find time for fueling your soul. Find a spiritual source, whether it is organized religion or communing with nature. Time to pray, reflect, or enjoy the moment is important and essential for the health of the soul.
  5. Surround yourself with a team of people who together are greater the than sum of the parts. They are the caregivers to our patients with their smiles and strengths.

My final thoughts…
How will your headstone read? What will be said at your funeral? It can never be about the number of toys in your toy box, cars in the garage, or money in the bank. Success is written by the lives we touch and the memories we create.

Robert Louis Stevenson said it best…
“The man is a success who has lived well, laughed often, and loved much; who has garnered the respect of intelligent men and the love of children; who has filled his niche and accomplished his tasks; who leaves the world better than he found it, whether by an improved poppy, a perfect poem, or a rescued soul; who never lacked appreciation of earth’s beauty or failed to express it; who looked for the best in others and gave the best he had.”

 

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The Dental Insurance Myth

Barry Polansky, DMD

If you are a dentist who never participated with dental plans and live in a geographic area that has been hit hard by the recession, and if you are like me, then the thought of participating has probably crossed your mind a few times over the last couple of years.

Last week I heard a veteran dental consultant admit they she changed her tune. In the past she advised dentists not to participate but lately found herself advising her clients to selectively participate.

I have thought long and hard on this issue…even about the future of fee for service dentistry as a continuing viable model. The gut reaction is that fee for service has seen its last days, and the more plans you affiliate with, the better prepared you will be.

Readers who follow me online know that I am a big fan of thinking…thinking critically, rather than reacting to my gut.

I live in Jersey, a highly competitive area for dentists.

Geography is important when looking at this issue. For example, if I lived in a town where 75 percent of the population was covered by insurance, that would be a major factor in my decision-making process.

But I live in Jersey…lots of people…lots of dentists. A level, competitive market.

Looking at the stats, probably only 47 percent of the population has dental insurance. Fifty three percent do not. I can live with that. What do those 53 percent of patients have in common? If you said that they have to pay for dentistry, you would be right.

And the 47 percent…well, they each have different ideas about who pays for their dentistry. No two people think alike. We can’t generalize about values. I hear a lot of talk these days about entitlement issues, but let’s not get political. In better economic times people have a less difficult time paying “out of pocket.” But let’s not kid ourselves — out of pocket expenses are the issue. They always have been, and always will be. Whether insurance is a factor or not…values trump everything.

The biggest difference is the size of the pockets.

I heard a statistic once that claimed that 95 percent of dental benefits are left on the table each year because people don’t want to pay after they reach their limit. Hmm! That bothered me on many levels. The effect of dental insurance on actual treatment seems to be less than what most people believe.

So why does the insurance question cloud our thinking — and I mean everyone’s thinking — doctors, patients, businessmen and politicians?

Why do dentists allow this illusion to interfere with their life’s work? By participating the dentist will certainly get an increase in patients. They will come from that 47 percent…and bring with them the questions about who pays what and what gets covered, and what is excluded, and when they can do it and, and, and…

Those that don’t participate, only have to deal with one patient at a time, one case at a time. By not participating the dentist maintains his autonomy (freedom to make all decisions), his ability to create meaningful dentistry on people who value the dentistry (they pay for it) and his level of competence by doing procedures that may not be covered by insurance companies…ever!

When I look at it like that, I feel better, knowing I am doing the right thing. Economies change…but people remain constant…people want to keep their teeth. When our culture finally wakes up to realize that it’s the dental profession that wears the white hats…not the insurance companies, then we may put insurance into the proper perspective.

Just my thoughts.

 

 

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Five Fresh New Ways To Show Patients You Care

Linda Miles, CSP, CMC

At a retirement party last December, we honored our practice administrator Joyce for more than 25 years of service at my side. In addition to team past and present, spouses, suppliers, and a few select patients attended. The journey to find a new Administrative Coordinator for our practice has been difficult and prolonged. Why is this selection process so challenging, and what have we learned along the way that might be useful to you?

With a weaker economy, many practices are discovering that they must go back to basics and remember what made them successful in the beginning. Many businesses that become successful also become lax in doing those little things that make a big difference. It boils down to making patients feel so special in your practice that they can’t wait to come back for excellent service and refer others to you. Following are five fresh ways to reignite your customer service fire.

  1. Work out a special deal with a local florist that you will place a card in front of each bouquet at your front desk “Compliments of ______ Florist” along with their cards for marketing their business. You never know when a patient thinks, how beautiful, I need to send ______flowers for ______. By ordering more than 40 bouquets each year (delivered every Monday morning), you can most always get these for 10% above cost. On the last work day of each week, select a special patient or team member and give them the flowers to take home.
  2. When a new patient calls to make an appointment, give your doctor the name, date and time of the appointment and their phone number. When the doctor has a three-minute break, he or she can call the appointed new patient to introduce himself and let the new patient know how much he is looking forward to meeting them on _______ at ____. Dentists who take the time to do this have a 95% chance of eliminating a new patient no-show!
  3. At the morning huddle each team member and dentist announces to the rest of the group which patient that they spent time with the day before will receive a personal thank you note from them (mailed the day after). It takes less than three minutes to write a quick thank you note, and if there are seven people on your team, that is seven lucky patients each day (112 per month). The cost to the practice is a postage stamp and the card (estimate $1.50 per or $168.00 per month). Some of you might say emails are quicker and less costly….but how do YOU feel when someone takes the time to write a personal note these days?
  4. The person answering your telephone can make or break the chances of a call turning into an appointment by how they sound and what they say. Having voice mail take the call in a patient facility is the “kiss of death” during office hours. The person who takes the calls must sound friendly, caring, enthusiastic and empathetic. Each scheduling coordinator’s daily goal should be to turn 90% of the callers into appointed patients. Some will already be patients, but many incoming calls do not result in making an appointment due to the tone of voice and attitude of the person taking those calls. Over-zealous (desperate sounding) is as bad as an uncaring, non enthusiastic tone.
  5. The day after each new patient visit the dental assistant who works in treatment room #2 as the New Patient Coordinator, calls each new patient to “see how well we did yesterday”. If your customer service was top-notch as it should be, the new patient will brag about how impressed they were. This is a perfect time to invite other new patients into the practice by saying: “Mrs. Brown, we are so happy that you enjoyed your first visit with us. We also enjoyed meeting you. If you have any friends, relatives, neighbors or co-workers who do not have a personal dentist, we hope that you will tell them about our practice. And please post your testimonial for us on Facebook, Yelp or Twitter.

Linda Miles, CSP, CMC is the Founder of Linda Miles and Associates (now Miles Global) and the Speaking Consulting Network. Linda has been a member of AADP since the mid ’90s. Please visit Linda’s two newest sites at www.AskLindaMiles.com and www.OralCancerCause.org.

 

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Practice Transition Planning: A Model For Success

Paul Sletten, BA

Dentists always go into practice transitions full of good intentions, desiring quality results that will improve their practices, reduce stress, create new practice owners, enhance prospects for the future and positively impact the patients in the practice. Yet practice transitions, in general, do not have the successful track record that these intentions might suggest.The results of unsuccessful transitions most often include frustrated dentists and team members, extraordinary costs associated with the failed venture, significant disruption to the practice and a loss of focus. They are usually the result of a lack of planning and attempts to “make it up on the run”. Here are five steps you can take to insure success in your transitions.

Effective transition planning incorporates five essential phases:
1. Personal clarification. Dentist and spouse begin by individually doing their own personal-life-plan updates and identifying their personal objectives in order to formulate a clear vision of their preferred future together. The essence of effective life planning is to make a determination as to how you would see your ideal life circumstance five years from now in 2018. Richly describe what you want your life to be like at that point, and then use those insights to create an updated vision of where you ideally want to be. The process looks like this:

  • Dentist clarifies.
  • Spouse clarifies. It is important for her/him to be formally involved in this process even if they have no active participation in the dental practice itself.
  • Then they come together as a couple to clarify in the areas of future, faith, family, friends, fitness, finances, and fun.

2. Professional clarification. Personal clarification illuminates professional direction. In this second phase of transition planning, your practice is evaluated in the light of your identified personal objectives. You use your new vision to define a professional direction with outcomes that are appropriate for you, your team and patients.

3. Transition planning. With personal and professional objectives clarified, it is possible to tailor a transition plan that fits your practice’s unique characteristics. Phase three of transition planning provides you with a custom operational plan that identifies specific action steps for achieving your preferred outcomes and prepares you and your practice to take those steps.

This then becomes a team-based planning process. You bring your updated personal plans and vision back to the practice, share it with your team and begin the process of additional planning with the team fully engaged. The team can help flesh out the vision, and importantly, must be included in the implementation of any action steps. Contrast this with the more typical model of the dentist (spouse excluded) and advisors sitting behind closed doors making big persona-l and practice-transition plans and then sharing them only at the last minute with those who must help implement those plans.

4. Implementation. Your plan now becomes reality for both you and your team. You have identified a set of strategic-action steps, set timelines for achievement, identified ideal outcomes, and delegated responsibility for implementation to individual team members and other trusted advisors. You coordinate all action steps appropriate to achieving your plan.

5. Plan follow-up. Your plans and priorities may change during this process. Continued effort and continual review are necessary for you, your team and patients to live together successfully with the adaptations you make to change. If your target changes, you will want to make course corrections involving all other stakeholders in the process.

Life planning and practice planning must be fully integrated. Life planning precedes practice planning so that each individual moves forward into practice transition plans with a clearly identified and updated personal vision and series of action steps. This insures that you will live a life by design and not by default — A life that brings you all you plan for and richly deserve.

 

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Spring 2013: A Ripe Season For Dentistry

 

By Linda Lakin RDH, MS

Spring is here! The season of blooming flowers, lush green plants, warm breezes, welcome drizzles, joining gyms, venturing outdoors for bike rides and jogs, and brilliant sunshine, all which create positive energy.

Here in the Northeast, dentistry has been experiencing “spring” for the past six months. I find that after a noticeable economic lull, there has been a resurgence in spending in the service industry, especially with my dental clients. Practices have been performing more treatments, increasing production and collections, responding to patient desires by customizing treatment paths resulting in more affirmative responses, benefiting from improved consumer confidence, and having more fun as a team. This has not happened by chance, rather by revisiting the basic systems and procedures during the downtimes and regrouping visions and goals to embrace the changing and complex marketplace. Investments in facilities, technology and training in emotional intelligence prevailed. Existing techniques for human relations and customer service were expanded while exceeding expectations became the daily mantra.

Dental management experts ponder whether this is enough. The speakers at the 2013 AADP annual meeting addressed leadership, same-day dentistry, the ‘yes’ philosophy, social media, branding, marketing, and reputation protection, digital dentistry, and the correlation between oral health, heart attacks, and strokes. Each of us brought a plethora of wisdom back to our practices to elevate the experiences and results for both our teams and our patients.

The AADP members and guests were enlightened when Dr. Imtiaz Manji told us, “Convenience is the new driver of loyalty.” Encarta dictionary defines convenience as “the quality of being or making things easy, useful or of increasing comfort.” Our challenge is to specifically relate this concept to our dental practices. The concept most prevalently used to regard convenience is to obtain the technology, facility and auxiliaries to accommodate delivery of same-day dentistry and maintain all specialties in house.

In reality, there are many more ways to address and achieve convenience in our practices. There is convenience in accessibility, creating visibility and presence through your website and social media channels. Convenience in treatment planning and case presentation, having flexibility in designing treatment options to meet the patient desires and adopting case presentation styles that match the patient communication styles creates a connection that makes it easy for the patient to say yes. There is convenience in financing, offering financial options that are comfortable for the patient to fit into their monthly budgets. And there is convenience in accommodation, variable office hours, minimal-wait times, advanced-priority scheduling, owning the ‘yes’ philosophy, and providing outstanding customer service. All this combined together creates the ultimate in convenience, better known as concierge/executive dentistry, a concept many practices continue to strive to perfect.

Spring is here, the marketplace is ripe —What plans have you and your team made to continue enjoying the benefits of the season? If this question makes you pause to contemplate, then you need to react and react to improve your practice.
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HOUSTON- WE HAVE A PROBLEM

Rick Willeford, MBS, CPA/CFP

You may recall those fateful words from the movie Apollo 13, if not the actual space mission. The spacecraft was several hundred thousand miles into space, heading for the moon, when an accident damaged their oxygen-generating equipment. At that moment, all seemed fine. No immediate danger. However, the engineers quickly calculated that they only had 24 hours of oxygen and electricity left.

But they were 30+ hours from home. As you can imagine, that news quickly got their attention—and hardened their resolve to do something about it. NOW!!

They immediately cut their non-essential power usage—including heat. Ground Control worked on minimizing the systems required for handling reentry and splashdown. The astronauts eventually got inside their own spacesuits to conserve heat and gain some extra oxygen. Even so, it was going to be close. Very close.

Why do I mention this? I was reminded of this story as I counsel with many middle aged and older dentists regarding their finances. As with the astronauts’ initial oxygen supply, the dentists’ current income was often adequate, if not more than they needed. Or at least it felt that way. At least while they continued to work…

However, when I did some financial “engineering” calculations, I discovered that they did not have sufficient funds to make it to a safe splashdown. I think they had probably suspected as much, but life was good. Why rock the boat. Surely we can put off that problem for another day. Until the days turn into months, and the months…

I am reminded of the story where Uncle

Cletus is rocking on his front porch with his dog, Old Blue. Old Blue is just moaning and groaning. Bubba comes by from next door and says, “Cletus, how come Old Blue is making such a ruckus?” Cletus says, “Well, the dumb dog is lying on a nail.” Bubba asks,

“Why doesn’t the dog move!?!” Cletus says,“Well, I guess it just doesn’t hurt enough yet!”

We all know the tales of the Tortoise and the Hare; the Ant and the Grasshopper. But “knowing” is not “doing”. It is time that many of us take on some sense of Apollo 13 urgency and start planning for an exit strategy.

This problem is exacerbated for the older dentists who are in limbo: they want to quit, but can’t afford to.

They have a nice practice, grossing $850,000 or even more. The problem is that it is not big enough to sell (or maybe even just bring in an associate) and still let the selling/host doctor work a few days a week. There isn’t enough time to suddenly build a bigger nest egg.

Part of their exit strategy has to include getting started a few years early—or now—and build their practice so that it can be large enough for more than one dentist. Or they can reduce their personal spending needs. Or improve their investment returns. There are a number of consultant members in AADP who can help you.

But if you are nearing final approach, you may need to take some drastic measures, as did the astronauts.

And, yes, they did make it!

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TIPS FROM THE ORIGINAL MASTERMIND GROUP

Dr. Bob Hamric

Since many of you were outside, enjoying the facility and nice weather in Phoenix, you missed a great Original Mastermind Session. So here are some important highlights that may impact your practice profitability and your future

1) Most practices call the patient after a difficult procedure but not many take the time to call a patient after a specialist does a procedure. ( Mrs Dove, this is Dr Hamric, I am calling to see how  Jamie did today at the oral Surgeon. ) WOW shows you care.

2) Embezzlement studies show that at some time 60 percent of dentists will have an employee steal money. In one practice the most-trusted, highly paid front-desk employee was able to steal $60,000 over 2 years, and the dentist had no clue. In other practices up to $500,000 have been taken. Don’t think it can’t happen to you. Maintain control on the money passing through. Your accountant is part of your team — seek his advice. He can help you set up a solid system to prevent embezzlement. Always check sign in sheet against your day sheet. Account for each patient. Bank deposit ticket must match day sheet total for cash, checks and credit card. Don’t be so busy in the clinic that you lose control of the front desk and insurance check control. One employee had a separate account for “her” money mostly from insurance. Cash can disappear too. Always send your normal fee to insurance and keep up with write offs monthly.

3) Those of you that are filing insurance can save thousands by using RENAISSANCE Systems to file you claims. We were using Dentrix and switched to Renaissance and saved $20,000 a year, They do not charge per claim but a flat service fee. They exhibited in Phoenix for the first time. Contact Danielle Harding  877- 499-9024 ext 2342. Ask about how they can send your statements out for .50 each. Yes fifty cents. For sure save on filing claims and statements.

4) The number one problem in dentistry today is lost time — BROKEN APPOINTMENTS, CANCELLATIONS AND NO SHOWS. What are your production goals per hour? Multiply that number by the number hours of lost time last month. What would it be worth to cut that number in half ? There is a proven, published system — a 150-page manual involving 11 tactics. The Game Changer was developed and written by John Cotton. Go to www.fillthechairs.com for info and to order your edition. John placed one in the silent auction. Two members bid on it, so he gave both members a copy to get twice the amount going to AADP Foundation.

5) The GOLD MINE IN YOUR PRACTICE is in your perio department. Do you want to double or triple your production? Type I, II, III perio can be easily treated in office and does not require the doctor’s two hands. Add $200,000 annually to your bottom line if done properly. One system to consider is the STM program taught by Zila using the Pro-Select 3 piezo unit — it is magic. How many adult prophies were done in your office last month? How many 4341 procedures? If the ADA states 80 percent of the American population have some form of perio, then you may be over looking perio. It is malpractice to do a prophy on infected gums. Contact Zila at 800 228-5595, for a seminar in your area.

6) EPLI POLICY. ( Employment Practices Liability Insurance)  Check your malpractice or liability coverage to insure you have this coverage — and how much. This covers wrongful termination, sexual harassment, hostile work environment, improper hiring tactics and age discrimination. All of these happen to a dentist somewhere every day. This may not seem like a big deal to you because you think every one in your practice loves you. Don’t kid yourself — Trust me, in today’s world it will probably happen. You may be innocent, but to defend yourself it may cost you $50,000 – $100,000 dollars in attorney fees. Collier has suggested your coverage be $500,000 per claim/$1,000,000 aggregate purchased through a stand-alone policy. I checked with my CNA policy and it was around a $400 additional premium. But, it’s worth it. Protect yourself and you assets.

Where Can You Get More Help…
Dr. Charles Blair’s Code Advisor saves time and money. The Practice Booster. 866-858-7596 or PracticeBooster.com Subscribe to The Insurance Solutions Newsletter

Recommended Newsletters:
• Collier and Associates csanews.com
• Human Resources: HRSpecialist.com
• Cleveland Clinic: 800-829-2506 Men’s Health Advisor & Heart Advisor
• Dr. Woody Oakes: theprofitabledentist.com, 800-337-8467
• Sally McKenzie’s E-Management Newsletter dentalsubscriber@mckenziemgmt.com

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Conflict Resolution

Larry Leber, DDS

Imagine — raising FOUR teenage sons! Can you feel the amount of conflict? After a couple of sessions with the family counselor, I learned to NOT get involved in their arguments. We sent them to the laundry room with two rules: no hitting and not to come out until it was totally resolved. I’ve used this lesson throughout my practice life. I know that conflict is probably not an issue in your office but if it should arise, I’d ask the parties involved to go to a private room in order to discuss the problem. I’d have them read the following suggestions before going into the room.
L=Listen: we really need to listen what the other person is saying, feeling and try to understand their perspective. Many times we are already thinking of our answer before the other person stops talking.
E=Emotions: we need to take the emotions out of our discussions. We should not just react or attack the other person. When it comes to emotions, we should all try to have a longer fuse.
B=Brainstorm: in discussing the problem, collect as many solutions as possible. Remember, when brainstorming, no idea is dumb. Write them down and look for areas of agreement.
E=Everyone: it’s very important for both parties to articulate their concerns. This is especially true for staff meetings. After brainstorming and discussing the issue, “everyone” needs to give their opinion. “People never really change without first feeling understood”.
R=Repeat: repeat exactly what the other person said, “If I heard you right, you said…………..” What this does, is to let the other person know that you are trying to understand their point of view.
S=Standards: sometimes after using all the above techniques, you still might disagree. Then it is a good idea to resort to standards. ‘What is the average salary for this position in our community, the average rent, etc.’

This anachronism spells: LEBERS. It was not my intent to have it spell my last name when I started listing the six steps in conflict resolution. But dentists get through gross anatomy on anachronisms, so I knew you could relate.

At your next staff meeting, I offer  a suggestion. Summarize the above in order to set the tone for a lively session. I feel that sometimes there is a “fear of conflict” and staff members will avoid addressing the tough issues. Encourage your staff to engage in a passionate debate. You don’t want a staff with just artificial harmony. By having everyone participate, you will be building TRUST, which is the foundation of a good team.

Remember when it comes to conflict resolution; “A good heart is the medicine that heals all conflicts”.

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Be Passionate About Your Dreams and Your Goals for Your Practice

Alice Kozlowicz

We would all like a blue print for success. — A foolproof plan or prescription we can follow, that if followed explicitly, we could look back on our lives and feel victorious. Products and services that advertise making us successful at weight loss, public speaking, financial planning or a luxury car that has us appear as though we are successful are usually a ploy to get us off track.

Being successful usually involves hard work, perseverance, dedication, and most of all, a passion to be at the top of your game. The most important ingredient of these is passion, because without passion, there is no desire to work hard, there is no perseverance to go on, and dedication goes right out the window. What does a blue print for success look like? Where do you start? How does it feel to be successful? Am I too old or too young to be successful?

The first component you need to lay out your plan is passion. When there is enthusiasm for your work and life, you are dedicated and can persevere to see it though to fruition. Passion gives us the burning desire to accomplish what we set out to do. We all get “stuck,” and when we do, our passion and desire pull us through.

It is always helpful to have someone in your corner, inspiring you to move forward, when you come up against obstacles. There will be challenges, and things will impede you along the way. This is part of life. Great leaders move through these challenges and build character along the way. We all learn best from the mistakes we make.

You are never too young or too old to be successful. If you are young and have big dreams, write down the dreams and goals you want to accomplish. Surrounding yourself with other successful people and mentors can be very beneficial to your success. Passion will help you find a way. Write down your ideas and organize the steps to get you there.

Another obstacle for some is feeling they are too old. You are never too old to learn, grow, and put your dreams and desires into motion. Most often, the only thing stopping us from our successful destiny is ourselves. We doubt our capability and paralyze ourselves with fear. Recognizing our fears and getting back on track is part of being successful.

So what is the key to success? Be passionate about your dreams and your goals. Write your goals and dreams down, because we are more likely to follow and accomplish them, when they are in writing. Celebrate your accomplishments along the way, no matter how small. Thank the people who help you get there, and be humble about your achievements. Always lead by example, because successful people are usually always leaders. Most importantly, when you achieve your goals, please realize success is always a journey, not a destination. Lastly, above and beyond anything else, thank your Creator for your gifts and talents.

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How Can I Be Sure of My Investments?

Mason Moise

Recently my wife Anne and I took our children to a nearby theme park for a day of fun. Spending the day with the kids reminded me of what is on the minds of investors these days. Most of our readers’ questions center around: “How can I know what to invest in? How can I be certain in a time filled with uncertainty?”

The theme park we went to is Carowinds. One of the unique things about it is that it straddles the North Carolina and South Carolina border. There is a giant strip of concrete down the middle of the park that lets you know in which state you are standing. Elizabeth, my daughter, had a fun time trying to walk with one foot on each side of the strip. Her gait was more than a bit awkward as she straddled the Carolinas’ border throughout the day. Besides from just looking weird, walking the strip rarely took us to our next ride anyway.

Unfortunately, there is no giant strip in the investment world to let you know where you are. It is difficult to invest with conviction when there is no concrete direction in our economy. The only state we seem to be in is one of flux. Our portfolios also feel awkward spread across the different asset classes and sectors. It always seems that this diversification does nothing to help. We are always in the wrong spot at the wrong time. How can you be sure?

Diversification can be overdone and quite often is just an excuse to be lazy in your decision making. After all, if you can’t beat the market, why would you try? Among asset classes there are: equities, bonds, real estate, commodities and currencies — the list goes on. For each category it can be broken down into high grade, low grade, no grade, big, medium and small — growth, value and GARP. Don’t forget domestic, international, global and emerging markets. And we thought politicians were tough to pin down. Elizabeth would tell you that trying to be in more than one place at one time will not work and will make your legs hurt after a while.

Where should your investments be? Unless we slip into deflation (à la Japan), longer term bonds look disastrous. Equities have much more appeal. You can earn the same, if not greater, yield than bonds and have the capital appreciation as well.

My six year old Andrew adeptly pointed out the error in this analysis while at Carowinds. He wanted nothing to do with the ups and downs of a roller coaster. He explained that he was fine watching everyone else scream and was content with his cotton candy. Of the 206 trading days this year, only 3 have had less than 1% volatility. The average daily change in value has been 1.96% throughout the year. Talk about a roller coaster!

I am not proud of this: I cajoled and then bribed Andrew to ride a roller coaster. It cost me five dollars to have him ride the Carolina Goldrusher. At his insistence, we wound up riding it four times. The reward was worth the risk.

Not to be outdone by his little brother, my oldest (Mason, Jr. — 11) got in line to ride the 2nd biggest coaster on the property while I was with Andrew. The Vortex is quite imposing. I was able to jump two fences to catch up with him, and we rode together in the front of the 50 mph, 2min thriller. At the end, I looked over at my ashen son. With his eyes still closed he asked, “Is it over?” I grabbed his hand and said that it was. He grinned and said, “I survived the Vortex!” Investing today feels a lot like being in a vortex. It will end and not only will we survive, we will prosper.

Mason Moise lives in Mt Pleasant, SC and is the editor of The Jackson Letter, a financial newsletter for dentist. He can be reached at rmm@jacksonfinancial.org

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Learning from Mistakes Makes for a Stronger Office Team

Susan Maples, DDS

“If the rate of change outside the organization exceeds the rate of change inside, the END is in sight.”

Jack Welch coined that. Do you buy it? I do! But YIKES — the world outside our little private practice business is changing freakishly fast. Have you noticed that we remain one of the last bastions of independence in all of health care? If we want to preserve some measure of autonomy, our teams must dance lighter on their feet, get better at casting off worn out rhythms and try new steps.

Does your business feel sluggish? Or are you are tired of being the only change instigator — the guy with a cattle prod who’s met at the door with an eye-roll? Consider exploring the element of safety in your office culture. Your team’s ability to safely examine mistakes is directly proportional to the measure of innovative change. Just as with our personal mishaps, examining our organizational goofs is the truest path to growth.

Learn to celebrate mistakes! Call attention to them with future focus, and ask yourselves “What else is possible?” It isn’t an easy shift. Unfortunately, in any business where excellence (and in our case precision) becomes a cultural value, honoring mistakes seems counter-intuitive. In countless subtle ways we penalize instead: cast blame and reprimand the culprit with a review of our established SOP’s Ouch!

To avoid such humiliation (or just to save time), team members learn to patch and hide their little blunders. Sound familiar? What a lost opportunity to re-think your SOPs. Remember that momentous scientific breakthrough flies more from examining extraneous data than normative data.

Dell Computer Company, in its early years, had a weekly TGIF celebration, The Hour of Horror, whereby employees were encouraged to collect customer complaints and bring them forward in this party-like brainstorming event. Instead of looking back, they were possibility-focused, seeking innovatively better solutions to everyday problems. So cool!

Two years ago I conducted a corporate low-ropes retreat for a group of hyper-driven executives. Their culture was rooted in Good-To-Great-EXCELLENCE! I was hired to help build trust. Managers were living in silos and hiding mistakes to save face. During one of the challenges the whole team was to transport each person and some 2×4’s across an imaginary mine field on cinder blocks — without touching the ground. If anyone touched, the whole team had to pick up their lumber and start again. I watched quietly while they blatantly touched, and dismissed their “oops”. The after-gloat was huge. They howled that they were surely the best and fastest to ever accomplish this arduous task!

I asked if anyone recalled an accidental “touch” and they furtively looked away. When I confronted them with the 13 (THIRTEEN!) “mistakes”, they were embarrassed and ashamed. Imagine the learning if they had allowed themselves to start again, with a new idea, after each mistake! It was a big “ah ha”! Today their corporate culture recognizes how a safe environment promotes change. And change promotes success!

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Dentistry’s “Clean” Little Secrets Do Well by Doing Good*

Daniel A. Bobrow, MBA

Americans give at an astounding rate. In 2007, U.S. citizens privately gave $295 billion to charity. That’s more than the entire gross domestic product of all but about 25 nations in the world.** And that does not account for the ‘in kind’ giving, that is, donations of clothing, services, and other non-monetary assistance.

My experience suggests that those in the dental profession are well above average when it comes to being generous.

Secret #1

Any dentist who has volunteered on an overseas dental project, worked in a soup kitchen, raised money for a worthwhile cause, or performed some similar selfless act already knows that, when we give of ourselves, we invariably get much more than we give.

And that leads us to the second secret.

Secret #2

Studies have shown that, given a choice between similar service providers, consumers will choose the one demonstrating social responsibility. A survey by The Golin Harris Group finds Americans are sending a clear message to Corporate America: Do more, be authentic, and the business rewards will follow.*

Since 1998 the Climb For A Cause©/Smile Tree© Foundation has helped dental practices across North America realize the simple, but powerful truth that, when a practice commits itself to making a positive difference, practice growth is an unavoidable consequence of that commitment.

Consider this excerpt from a Time Magazine poll (9/10/09):

We…look(ed) at how people are serving these days. The most striking results centered not on volunteering but on the cash register…(even) as people acknowledged that times were tough, 38% of Americans 18 and older, some 86 million people, reported… buying green products and goods from companies they thought had responsible values.

In other words, doing ‘good’ can also mean doing well.

Secret #3 “It’s easier than you think!”

In the nearly twenty years I’ve helped professionals stage local events, the most common sentiment I hear is “Wish I’d done this sooner!” The sense of camaraderie and the goodwill generated among practice team members and current and prospective patients alike is truly remarkable.

Making It Happen

So, just how does one conceive and implement an effective cause-marketing+ strategy?

Let’s use the example of The Smile Tree© which offers practices the opportunity to make a positive difference in the lives of children in developing nations, while making a positive impact with their patients of record and their community as well. It also offers fun and rewarding ways to show you care without ever having to leave your home town. Practices simply agree to ‘adopt’ one or more dental projects and, by so doing, becoming a ‘Branch Office ‘ of the Smile Tree. Currently, funds raised help maintain dental education and treatment projects in Guatemala, Nepal, and India.

Branch Offices receive an array of tools for sharing their good works with current patients, and the community at large. Some of these include: posters, lapel buttons, floss cards, and more to communicate with patients the practice’s status as a Smile Tree Branch Office. Participating practices also receive press releases to local media notifying them, and the community they serve, of their status as a Branch Office, as well as a fundraising page linked from the practice’s website home page, which drives traffic to the practice site. Practices also receive periodic communications (letters, photos and drawings) from those whose lives have been touched through the practice’s involvement and generosity.

There are a number of fun and simple ways to ‘grow the Smile Tree’, that is, to fund raise. Examples include: offering patients the option of helping grow the Smile Tree by “adding a dollar to today’s treatment” and offering to match it, including a note on monthly billing statements thanking patients for growing the Smile Tree and inviting them to learn more by visiting the practice website, from which a link to the fundraising page resides. As people donate, their name is automatically added to the roster of giving patients.

But, by far, the best way to both generate funds and grow the practice is by having a party. Because I also run a dental marketing firm, I offer, as a token of our appreciation to the Branch Office, complimentary assistance with organizing, promoting, and staging a successful local event.

Don’t Just Do It, Do It Right

Whatever cause you choose to support, remember that the more people you involve in your efforts, the better it is for your selected charity. In the process, you bond with team members, solidify patient relationships, and meet new friends and that is a winning combination!

*Ben Franklin

**Marriott Alumni Magazine, Brigham Young University.

+Cause-Related Marketing : The process by which an individual or organization seeks to achieve one or more business objectives as a consequence of its commitment to some form of philanthropy.

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Commit, Believe and Achieve: Find Time to Facilitate Growth and Change Your Practice

Rhonda R. Savage, DDS

Time management is one of our greatest challenges in the practice of dentistry. Do you ever procrastinate? Some of us are good about making the big decisions, but the daily follow through is a challenge. Here are some tips on time management that help make the job more ‘do-able.’

Find a quiet place and have two pieces of paper in front of you…or work off of two computer monitors so you can see your work, side by side. One list is titled, “Have to Do” and the other is “Should Do.” Then, on the “Have to Do” list, write down only those things you must do today. Tackle those few items each day.

How do you choose and prioritize those items to tackle first? Ask yourself this question: “Will my work, my patients, my co-workers or family suffer in any significant way if I fail to do this today?”

On your “Should Do” list, written down all the things you feel you ought to do or think it would be a good idea to do. File this list for future reference.

Quarterly objectives: Divide your “Should Do” list into three categories:

  1. Innovation: Select one practice parameter and evaluate it:
    • Can I delegate it? Can it be done better by someone else?
      Examples: Bookkeeping, chart notes, laboratory work
    • Can this area be improved?
      Examples: Scheduling, collections, recare/reactivation, insurance management, verbal skills.
  2. Growth: Make a schedule for skill development:
    • Decide on the number of books you’ll read, courses you’ll attend and ways you plan to develop your team.
    • Decide upon the new techniques you want to implement in your practice.
    • What are the steps necessary to train team members?
  3. Maintenance Objectives: Decide on one improvement you will make in your practice
    • What steps will it take to accomplish the improvement?
    • What your method of ‘making the change stick’ or retention of the improvement.
    • All efforts should have an accountability factor built in; remember: “What gets measured gets treasured!”

Share your plans with your team and review your progress at your team meetings.

As you complete your quarterly plan, draft the plan for the next quarter.

Three ways to track progress:

  • Keep a daily log.
  • Take out your “Have to Do” list and tackle the list, one by one.
  • Set aside 5 minutes to record into your log, using a 2-part entry:
    • What did I/we accomplish yesterday?
    • What will I/we accomplish today?

Focused energy increases your alertness; broaden your knowledge to increase your experience. Team members often say, “We have great ideas, but nothing ever happens.” It’s important to always be changing, learning and achieving in dentistry. As William Butler Yeats says, “Happiness is neither virtue or pleasure nor this thing nor that, but simply growth. We are happy when we are growing.”

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Prosperity In Hard Times

Jason B. White, MBA

Why is it that in the face of adversity some practices still prosper?

The successful offices are able to answer the following three questions with an unqualified “YES.”

  1. Can I trust this person?
  2. Do they care about me?
  3. Does this person know what they’re talking about?

How do we connect with other people? A connection requires levels of communication with people, exchanges of ideas, and understandings of an emotional level, not just a clinical diagnosis and treatment plan.

What are our core values? They are sets of standards or beliefs. They are things that we will not compromise for short-term gain, for convenience, or for profit. You will hold to your core values, even if the environment you find yourself in doesn’t reward you for doing so.

Who you are has a lot to do with how you treat other people. Your core values are yours, and they are not there for anyone else to judge, whether they’re right or wrong. I will know if I can connect with you or not connect with you by beginning to understand your core values. People buy what you believe, not what you do.

This is true for dental practices as well. Your core values are like a compass. You pull them out when you have to make tough decisions or course of corrections. When you come to a difficult fork in the road and need to determine which way to go, you pull out your compass and say, “Which way would be more like me, based on who I think I am and that for which I stand.”

Whether you know it or not, you’ve been sharing your core values with your children all along. This is so they know what to do when they make choices that represent who they are.

This is called “being real, being authentic and genuine.” This is what people look for when they decide if they’re going to connect with your practice or not. Consequently, if we’re going to have people trust us, care about us, and know what we’re talking about, we must be certain that our core values be “real, authentic and genuine.” There must be time in the schedule to allow this to happen. It’s not “just a cleaning” or a D.O. on #5.

A good home-based exercise would be to ask the kids at dinner what the family’s core values are and what evidence they have of what they say they are.

The, do the same at your office:

Make a list of all the things that drives your patients or your team members crazy and then make a separate list of all those things that delight them.

Another question for your business is, “What are we able to provide that people value the most?” If I knew the answer to that question, I would spend a lot of focused time trying to provide the answers on how to do that.

Our danger is that we lose our sensitivity to understanding other people’s dreams and what they want. We become so enamored in our own selves and the way we do things that we forget to pay attention. Don’t be the doctor or the doctor’s team who are accused of losing their sensitivity to the patients’ needs because they’ve been doing it so long that it’s routine.

In other words, it’s not about teeth — it’s about what people aspire to have and who they aspire to be. This is so much more meaningful than websites or the latest technology. People buy what they believe from you, not what you do or how you do it.

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Increase Your Bottom Line With Perio

Robert Hamric, DMD

I presently serve as the Administrator for Alabama Family Dentistry. This is a group practice with 5 partner dentists and 1 associate. We have 3 practices with a total of 26 operatories — 7 devoted to hygiene. We employ 47 people including 2 lab techs. All dentists are general dentists providing all areas of dentistry except orthodontics. We rarely refer patients out. We take most PPO dental plans, so 90% of our fees are set. We have an abundance of new patients, so we do not feel a recession. Our partners take home 50 percent of their collections. The hygiene department isn’t part of their compensation, therefore it is important to operate a strong hygiene department to pay bills and maintain overhead.

When I was with Cornerstone Dental, we surveyed more than100 practices and found the weakest link in most practices to be the hygiene department. On average hygienists produced $500-$600 a day and many dentists didn’t know the actual income from hygiene production. Hygienists were just “cleaning” teeth and looking for dentistry for the doctor to do. Periodontal disease was overlooked, unless it was really bad and those cases were referred out — often worth more than $100,000 annually. If the ADA states 75 percent of the people in the U.S. have some form of perio…. then many people are having prophies on infected gums. A prophy, by definition, is preformed on healthy gums.

Our hygiene goal at AFD is $1500 a day, per hygienist. ($1500 x 7 = $10,500) This is obtainable with a solid perio management program. How much more can pass to your bottom line with a hygiene department treating type I, II, III perio nonsurgically in your office? $200,000 a year?

If Somebody Is Already Doing It, It Must Be Possible.

  1. We follow a step-by-step process with patients. Verbal skills are very important. The patient must be aware he or she has a problem and want to correct it. This is done with a “co diagnosis”, with the hygienist saying “Today we will begin your exam by first checking your gums before we check your teeth, have you noticed any bleeding when you brush?” Always end a statement with a question. The person asking the question is in control of the conversation.
  2. Hand the patient a large hand mirror. “Hold this mirror and let’s look together as I check your gums for any pockets that might indicate gum disease. I will be using this measuring instrument (show the probe and how it is marked in mm). Any pocket more than 3 mm may indicate gum disease. I don’t anticipate any problems. Have you ever had this done before?”
  3. If after probing, no problem, then proceed with a normal prophy. If the patient DOES has a problem… do not say anything until the patient speaks. Most will say “ I have a problem, don’t I “ or “What can I do about this?” If they do not say anything in ask this question… “how long have you had this infection?” — Wow, a powerful question. The patient must understand they have a problem before they will accept proper treatment. Next, explain the treatment plan — always inform before you perform.
  4. We no longer hand scale. We use the Pro-Select 3 from Zila. This is a piezo scaler with irrigation that allows us to do 2 quadrants in 1 hour. We complete a type II or type III case in 3 appointments. Results are fantastic as there is no torn up tissue and patients love it. Our non-surgical program would not be successful without this instrument.
  5. The doctor no longer needs to administer local anesthesia. We use Cetacaine topical with luer lock syringe and irrigating tips (new product). It is not expensive. The hygienist applies this into the sulcus, which allows about 60 minutes for complete comfort. Try it!
  6. We do not schedule 6-month appointments in advance, so we always have time each week for new patients and time to schedule perio treatments. We do schedule 3-month appointments following completion. New patients are the lifeblood of the practice. Emergency patients are seen immediately and new patients are scheduled in hygiene within a week. If you can not do this, then hire more hygienists. Hygienists devote full time to production, as a hygiene coordinator handles treatment plans, case presentations and recall scheduling.
  7. Out hygienists are paid hourly plus a commission for every perio procedure they perform. I keep records on each hygienist that indicates their total production for the month and every procedure they perform. This way we know exactly what each hygienist contributes to the practice. I will have my production sheet at my Lunch & Learn in San Antonio, or contact me and I can mail one to you.

In conclusion, the hygiene department should be a major profit center for the practice. Patients need treatment and the practice can thrive with a perio program. Just think how much you could increase the bottom line. Could you use an additional $200,000 a year in production?

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Shed Or You’re Dead®: Seven Unconventional Strategies That Every Dental Professional Needs To Know To Keep Your Organization Alive!

Kathy B. Dempsey, CSP

Millions of dollars and thousands of hours are lost each year due to the inability to get employees to move forward with your organization’s changes. The bottom line: NO organization can thrive unless their people learn how to SHED. Remarkably, lizards can teach us a lot about work health and success. They grow by shedding their skin. If they don’t shed, they die! The same is true with organizations. If they don’t shed, they become unhealthy and die!

Below are seven shedding strategies that I’ve successfully used in my 20 years of organizational development work. My goal is to ignite your organization to SHED for Success™!

  1. Quit! Yes, I said quit! When was the last time your organization sat down and focused on answering one question: What do we need to stop doing? If you haven’t read Seth Godin’s new book, The Dip, do so! The most successful companies know when to SHED and when NOT to SHED. Begin by asking, “What’s outgrown or overgrown in your organization? Work roles? Clients? Products? Budgets?”
  2. Panic Now! Yes, have a panic attack now! Most people who panic do it too late. The blessing with panicking is being consumed with “what ifs.” So, stop and deliberately panic now. Get your team together and have a Panic Party! Ask yourself, “What if we lose our biggest client? What if our computer system crashes? What if we lose the most valuable member of our team?” Consciously asking yourself “what if” will allow you to more strategically plan for the future.
  3. Hallucinate! Yes, I said hallucinate! Most organization don’t spend enough time hallucinating, or visualizing, their future state. Is your organization currently stuck or facing challenges? Can your team imagine being twice as successful as you are right now? Hallucinate, or visualize, then go ahead and throw a party and celebrate your success now! Then operate as if your success has already happened. You’ll be AMAZED at the results!
  4. Shut up! Yes, stop talking! Most people don’t listen well. They are too consumed with their own agendas. Want to have an edge on your competition? Then listen to your customers. Listen to your staff. Listen to your gut. It’s no coincidence that Bill Marriott, CEO of Marriott hotels, spends 80 percent of his time visiting sites and listening to his staff.
  5. Be Codependent! Yes, the best work environments are those that mutually support each other. Can you imagine a work place where everyone shines and is recognized for it? But how can organizations be supportive in these unpredictability times? John Bollinger, MD, psychiatrist says, “People can survive just about anything if they have three things: honesty, a plan, and support.”
  6. Be a Know-It-All! Yes, have a “know-it-all” passion to learn! Many executives are now saying the number one skill they look for in hiring employees in today’s environment is the ability to “learn on the fly.” Training guru Bob Pike says, “Learning has not taken place until behavior has changed.” Are you hiring the right people? Are you training them? Is behavior really changing? Are you getting ROI? If you are conducting training and can’t clearly define what business objectives you’re addressing, it’s time to SHED the training!
  7. Be Narcissistic! Yes, be selfish! Many organizations are burning up their most valuable resource — their human capital. In this fast paced 24/7 world, do you ever hear employees saying, “Work is driving me crazy?” Or “I wish I could get out of the fast lane?” If so, encourage your employees to pull over and take time to refuel. Cars, like humans, who neglect regular maintenance, break down. Taking care of the human resources FIRST will allow the necessary energy for your organization to thrive! Let’s learn from the lizard. It‘s time for a corporate exfoliation. Shedding will help you stop wasting resources and propel your organization to move forward.

“In times of change, those who shed will grow and prosper; those who refuse to shed will find themselves well-equipped for an organization (and life) that no longer exists.”

SHED OR YOU’RE DEAD®! — What do you need to SHED today?

Kathy B. Dempsey is author of Shed or You’re Dead®: 31 Unconventional Strategies for Growth and Change (Writers Digest International Book Award). She ignites organizations to SHED and move forward with unlimited possibilities. Kathy led Memorial Health Care System’s strategic organizational development efforts to become one of top 100 hospitals in America. Get proven strategies to SHED for Success™ at www.KeepShedding.com, and be sure to sign up for one or more of Kathy’s sessions at AADP 2011 San Antonio.

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That Was Then, This Is Now!

Linda Drevenstedt, MS, Linda@drevenstedt.com

It is really too bad that we don’t always appreciate good situations until they are gone. Many dentists have enjoyed the practice of their dreams with appreciative patients who refer. The practice was able to be selective in the people who became new patients. The new patient gate was closed to those who, “God forbid,” wanted a cleaning on their first appointment. The luxury of a long, doctor-only, new-patient exam was one true marker of a quality practice. That was then, this is now.

A perfect storm of events led to this article. One event was the opportunity I had to serve on the Strategic Planning Committee and be a part of the sub committee that looked at future trends that would affect AADP. Those trends have been a core of how I have guided my clients this past year. As I looked at trends that affected the academy, I saw trends that affect my clients.

The second event was the slow down I observed in many of my existing and new client practices because of outdated new- patient systems. The two things came together. New patients were drying up for clients that were schooled in the Pankey, Dawson, etc. new patient process. Nothing other than the economy had changed in practices that are now suffering from lack of new patients.

The economic downturn has influenced dental consumer trends in important ways that many of you may not want to face. In the past, you may have been able to ignore these truths and still grow. But. What is TRUE now is this:

  1. Even the most discerning, well-heeled dental consumer wants to use his or her dental insurance benefits to the max. This means even when you have FAB customer service and perfect crown margins, most patients will follow their insurance benefits to find providers.
  2. The small businesses that provide dental insurance are moving rapidly to reduced fee plans (PPOs) to save money.
  3. Most adults who call to make a new patient appointment want to have their teeth cleaned on the first appointment. If they have jobs, they want to keep them and not need to have two appointments in your office to become a new patient. A “cleaning” is the primary request of the non-emergency new patient.

In two recent practice analyses (different parts of the USA), this is what I found: The practices have been spending money on new logos, new websites and some very tasteful, non-offer-based marketing. The practices have historically gotten all new patients from patient referrals. Many new patients are now calling due to the internet. Many of those patients request a “cleaning” appointment. The practices did NOT allow for that. The front office staff, therefore, were challenged to “reeducate” the patient on the phone to accept the two-hour, new-patient doctor appointment to learn what type of “cleaning” they might need. One front office team member told me she turns away 5 to 7 people per month who call and only want a cleaning.

That was then, this is now. If you spend one cent on a website, marketing of any type, it is time to raise the barriers and let them “come on down.” Let them get their teeth cleaned and figure a way to have the doctor see the patient for 20 to 30 minutes. You can always ask them to come back if there is a complex issue the patient is ready to address. Let them come for a “meet and greet” if they are interested in implants, Cerac®, Invisalign®, etc. Use your best relationship-building interview to win them over as a full new patient.

Practices are built on relationships. It is hard to have a good relationship with a new person calling when they are denied their request. If you don’t need new patients, then keep the barrier in place. If, on the other hand, you could use a few more new patients since you may have lost some to insurance changes, consider letting them come in their way. You can never do the beautiful dentistry you know how to do if the patient never gets into your office.

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Dentists & Teams That Get Results…Unleashing the Power of Emotional Intelligence

Bob Frazer, Jr., DDS

Today’s economic climate has made Emotional Intelligence (EI) more important than ever. Fear, anxiety and feelings of scarcity abound. We must recognize and acknowledge our patient’s feelings for them to truly feel and understood. During a recent business conference, the CEO of BB&T (the fastest growing and highest rated U.S. bank in customer satisfaction) said that the biggest reason for their success was required EI training for any employee who works with more than 25 people!

Daniel Goleman (Primal Leadership) defines “Emotional Intelligence as our capacity for recognizing our own feelings and those of others, for motivating ourselves, for managing emotions well in ourselves and our relationships.” Studies on star performers show that 75 percent of high achiever’s success comes from EI, while 25 percent comes from technical competency. Every major discretionary purchase is first an emotional decision. Effective leadership demands emotional competency.

In our Coaching work with dentists and teams, we’ve found that elevating EI is the most predictable way to raise our client’s effectiveness. EI has four key domains: self-awareness, self-management, social awareness and relationship management. It all begins with Self Awareness—an understanding of oneself and our emotions (what we’re feeling). Goleman states, “The most telling sign of self awareness is a propensity for self reflection and thoughtfulness. Intuition comes naturally to the self-aware leader.” It is indeed an inside-out process.

Every leader’s primal challenge is self manage­ment, that provides our focused drive to achieve goals, overcome challenges and the dissonant (negative) emotions they generate. EI prevents the emotional hijacking that occurs when the seat of emotions—the amygdala—becomes aroused. Brain scans show that we become “hard wired” neurologically to respond to emotions in a certain way. Reading about EI isn’t enough! We must practice new emotional responses.

Our emotions are constantly interacting with, affecting and responding to others. Think of the last time you had a day when almost every patient you saw was irritable, nervous, fearful or distrustful. Or, the staff seemed to be having a bad day. How did you begin to feel—even if you came in feeling terrific?! How did that day contrast with the way you felt on a day when you worked with cheerful, relaxed, thankful, self-confident patients and staff? Emotions are contagious—your staff’s limbic systems influence yours and your patients! Doctor leaders—research has shown that the most powerful influence on the emotional climate of any group is the leader.

When leaders drive emotions positively, they bring out the best in everyone. This effect is called resonance. When they drive emotions negatively, they spawn dissonance, undermining trust and the emotional foundations that let people shine. The emotions of the leader are particularly contagious.

Research has shown that unlike I.Q., E.Q. can be raised through emotional competency training and coaching. As an advanced EI workshop client said, “You can’t get too much of this EI stuff.”

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You’re Hired…. And Not Forever

Linda Lakin, RDH, MS, LindaLakinConsultants.com/

Diamonds are forever but a position in your dental office may not be. As I travel through my consulting world, I am continually confronted with human resource issues present in so many dental offices. There are many reasons that exist for poor morale, low job performance, personality conflicts, high absenteeism and a sense of lack of appreciation. Some don’t have job titles, others have titles with no authority, responsibility or accountability, and many work day to day without job descriptions. How often do we see the eternal office manager who has held that position for 20 years without all of the responsibility?

The dentist, as a leader of his business, seeks to build an environment for co-ownership with the team. The four steps to accomplish this are to hire correctly; train and cross-train, evaluate and motivate; reward and praise. Incorporating some basic human resource management principles into your practices will help achieve co-ownership. These include, but are not limited to job descriptions, employee policy manuals and performance appraisals. Job descriptions define the purpose of the position in relation to the overall practice, detailing specific duties and measurable outcomes. The employee policy manual is a written agreement of expectations accepted and signed by doctor and each employee and updated regularly. Performance appraisals are scheduled at least once a year concentrating on duties and responsibilities, levels of performance in defined areas and specific plans for professional and personal growth. Of course, daily signs of appreciation and praise are proven to motivate and enhance team building and job satisfaction. Remember the 3 Rules of Praising; be specific, be sincere and be timely. Catch people doing things right and tell them, tell the patients and tell other team members!

Throughout one’s career there are many opportunities to re-evaluate and redefine an employee’s relationship with a dental practice. The dentist — leader must help each team member move toward more responsibility and continual growth, which includes system analysis and cross training. Max DePree states in his book Leadership Is An Art that the signs of outstanding leadership appear among followers as they reach their potential, learn and serve, achieve and surpass required results, change with grace and manage conflict. Take some time to contemplate his perception that the majority of workers are, essentially, volunteers and see how this fits into your style of leadership. Do you have a contract or covenant with your employees? Is your relationship one of superficiality or intimacy? Do you practice hierarchical or roving leadership?

It is important to acknowledge that every job may not be forever, and it is OK to make a change. It is your responsibility to incorporate sound hiring techniques, have concrete and updated systems in place, comprehensively train, identify and cultivate unique traits and abilities, and then delegate the authority and responsibility for each employee to perform their job. Following all this, you must continually evaluate the process and results. If the practice is not flourishing by having this team member present then, please, move forward and good luck!

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Take Your Patients from Awareness to Action

Ms. Mary Osborne

The plan seems simple and clear: Diagnose. Control disease. Restore to health. Most of our clinical training led us to believe that, if we did it right our patients would follow that course. If we educated them about their problems and broke the solution into small enough pieces for them, they would readily complete treatment.

The reality is that many patients never move beyond Phase One dentistry. Many patients whirl around in what a dentist I know refers to as the “eddy” in his practice. They cycle through hygiene on a somewhat regular basis, avoiding any forward movement with an “if it ain’t broke, don’t fix it” mentality.

What if you reframed your thinking about Phase One dentistry? What if you changed the goal of Phase One dentistry from “disease control” to “awareness”? What if you challenged yourself to use the initial phase of treatment to intentionally raise your patients’ awareness and ownership of the conditions present in their mouths?

Action requires more than education because intellectual understanding alone is typically not enough to cause people to act. Awareness involves a heightened sensory connection to the information. When I have a physical awareness of clinical conditions, it is harder to distance myself from those conditions; harder to remain in denial about them. Awareness leads to ownership, and ownership leads to action.

The reason many people become more committed to diet and exercise in the spring and summer than in the winter, is that we have a heightened awareness of the consequences of our actions. Looking in a mirror and seeing oneself in a bathing suit is more motivating than numbers on a scale. Experience trumps information.

Raising awareness requires getting our patients engaged; getting them “in their mouths.” Engagement has been described as “that which occurs when the student is working at least as hard as the teacher.” Who is currently doing most of the work in your interactions with your patients? How can you use Phase One treatment time to engage them more in working to solve their own problems?

Whether the initial phase of care involves periodontal therapy, splint therapy, or operative dentistry, you—and every member of your team—have countless opportunities to engage your patients and raise their awareness:

Periodontal Therapy: Initial perio therapy usually takes a series of visits. As a hygienist, I thought my primary responsibilities in those visits were to remove deposits and teach patients about oral hygiene. I learned that more was possible. With a mirror I could help them see the difference between a healthy pocket which did not bleed and a deeper pocket which did bleed. I could help them hear the squeak of dental floss over a clean surface. I could help them experience the rough edges or overhanging margins of an old restoration while I scale their teeth.

Splint Therapy: Instead of just grinding on plastic and chatting, we could ask patients what they notice when they first take their appliance out in the morning. If they don’t know, ask them to pay attention to where their teeth hit first. We can ask them what difference they notice in their muscles when they first wake up. We can invite them to touch muscles on both sides of their face and ask what differences they notice between the two. They may not have an answer to any of these questions the first time you ask, but they probably will the second time.

Decay Removal: We talk about this phase as a process of “putting out fires” before rebuilding, but we can also engage the patient in understanding how they got where they are and what to expect in the future. We can help them hear the difference in an instrument over a smooth margin vs. a faulty margin. We can help them see the missing tooth structure when the tooth is prepped tso they better understand the fragility of the remaining structure. We show them plaque in difficult to reach places and ask them if they would like some help in becoming more effective removing it.

You don’t have to wait until the next visit to help your patients move forward with care, and you don’t have to nag them into compliance. These are just a few ideas on how to add engagement to information, and add awareness to knowledge.

At your next morning huddle talk about what you can do that day to help a patient experience one aspect of his or her existing conditions. Your practice challenge is choosing one patient each day to plant a seed that will raise his or her awareness about something they aren’t concerned about, but you are. I’d love to hear the ways in which you and your team use phase-one dentistry to take patients from awareness to action!

Consultant Mary Osborne has worked in dentistry for more than 35 years as a hygienist and patient facilitator. She has a deep belief in the potential for significant growth through authentic communication.

She can be reached at 206-937-5851 or 1564 Alki Ave, SW #303; Seattle, WA 98116. Her email address is mary@maryosborne.com

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Getting Treatment Accepted – Value Equals Success and Profits

Lynn Garber

Are your patients accepting and completing the treatment you recommend? In today’s economy people are watching their dollars and the purchases they make are thought out carefully. They weigh value against cost asking themselves, “Is the benefit I will get from this worth spending the money?”

DENTISTRY IS AN INVESTMENT! It is an investment in both looking and feeling better. The question then arises, “How do we convey this message to our patient’s?” The answer is simple, “listen to your patients.” People purchase on their needs, not yours. Patients have their own agenda:

  • Time
  • Money/Value
  • Pain
  • Prestige

Therefore it becomes the responsibility of the dental office to be a really good listener; remember listening is 90% of communication. To be a good communicator:

  • Make sure you understand clearly what you wish to communicate
  • Communication takes two, a sender and a receiver
  • Communicate the meaning behind the words
  • Don’t over verbalize
  • Be enthusiastic and tell the truth

The patient needs support in understanding the value of their purchase. The conversation created about the end result benefit of treatment is the determining factor for the patient. If it supports the patients needs value will be placed on the dollars they will be spending:

  • Ask open-ended questions which contain who, what, where, when, why and how
  • Focus on your patient’s needs, not your own
  • As you listen, give your patients plenty of positive feedback
  • Learn to “connect” emotionally with your patients, how they feel
  • Don’t begin your case presentation until yours patients have established their needs

Remember, patients measure the value of your service visualizing how it will benefit them. Their decision about whether or not to go ahead with dental treatment is usually emotional, not logical.

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Build Your Practice With “Paid-For Dentistry”

Lois Banta

Why is it that most people readily commit to spending thousands of dollars for a new car but when it comes to investing in dental treatment, well…that’s a whole different story. According to the patient, money or should I say lack of it, is the main objection. How many times have you heard, “I can’t afford it”?

This is the information age and informed patients will make good decisions about their dental health. And a well-trained dental team is an essential part of patient education. Soundly spelled out financial guidelines and well thought out verbal skills are critical when presenting treatment plans. Patients will feel in control of the process when they understand your fees and your financial guidelines.

It is important to outline acceptable payment arrangements for the patient and for the dental practice. It is also necessary to offer financial options in addition to cash or check, i.e. bankcard such as, outside financing. The advantage in offering several payment options is that it allows for flexibility. When flexible financial arrangements are offered, patients have the tools available to say yes to their needed dentistry. However, you do not want to become the bank for the patient so, never offer “in-house” financing. This can create an accounts receivable nightmare. Additionally, patients with paid-for dentistry never complain about their bill, fail their appointments or misunderstand their dental treatment. Therefore, when you include outside financing in your payment options, magic ensues!

Be a good listener. There are effective ways to engage your patient in conversation about their financial responsibility. Instead of asking them, “Do you have any questions?” ask the patient, “What questions can we answer about the financial arrangements we just discussed?” How you say it makes all the difference. Having the confidence to explain the fees and collect them is as important as presenting and having the patient accept the dental treatment.

Keep track of your statistics and examine your successes. Monitor what percentage of your patients chooses to pay by cash, check, bank card or outside financing. When offering outside financing, make sure the dental team is well trained in how and when to offer it. Don’t lose an opportunity to help both your practice and your patient. To insure success, make a plan, put it in writing, train everyone and grow your practice to unlimited potential!

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Servicing and Maintaining Your Existing Patient Base

Linda Lakin RDH, MS

A highlight of the 2009 AADP meeting in Austin was the Consultant’s Roundtable facilitated by Dr. Tom McDougal and featuring Linda Drevenstedt, Alice Kozlowicz, and Linda Lakin. A plethora of concerns and issues were discussed and many pearls for action were taken home. It was acknowledged that now is the time to take care of our existing patients, those who already know and love us, and this article highlights that dialogue.

How many of you know LIFETIME FITNESS? It’s the new, cutting edge gym, with a restaurant, a bar, basketball and squash courts, teen socializing, indoor/outdoor pools – you get the picture. And, they opened down the block from the previous “hot gym”. I need to tell all of you sitting here today at the great AADP meeting that if this has not already happened to you, it WILL happen in today’s marketplace. The new, sate of the art dental spa will open and they’re coming after you!

So the game has changed from acquiring new patients to keeping and maintaining old ones, we must shift more resources to serve our steady patients, because they pay the bills!! The current issues of Businessweek acknowledges this, “Top performers are treating their best customers better than ever, even if that means doing less to wow new ones!

To stay in the market, it is crucial that we know how to achieve the 4 C’s of maintaining and servicing your existing patient base:

  • CONNECTION
  • COMPLACENCY
  • COMMUNICATION
  • COMMITMENT

CONNECTION is simply another word for really effective customer service and an unforgettable customer experience. Jeff Bezos, founder & CEO of Amazon understands the difference and strives for the best customer experience and the minimum need for customer service.

COMPLACENCY is defined in Encarta Dictionary as “self-satisfied and unaware of possible dangers”. The past years of abundance have led to complacency on the part of many dental teams exhibited by:

  • Taking our PATIENTS for granted
  • Taking our JOBS for granted and
  • Taking our SYSTEMS for granted

Therefore we must return to basics, review all systems, procedures and policies to be sure that we are doing it all right, go back to school, train and crosstrain!

COMMUNICATION is vital for servicing and maintaining existing patients and poses these questions:

  • Have we met patient desires, and more importantly exceeded expectations EVERY contact, EVERY time?
  • Does our customer service program create an experience that the patient cannot and will not give up?
  • Have we updated marketing plans to address today and tomorrow’s marketplace?
  • Have we fostered our relationships with referral sources and identified and nourished new ones?
  • Is our patient reactivation program effective, what are the details and who is accountable?
  • Does our business plan enable us to measure these vital benchmarks and are we acting on what they reveal?

COMMITMENT with honesty and accountability is more critical than ever. All team members are present, on board with honesty and a true desire to make a difference. Each one of us is accountable for our actions, the effect on the entire team and the results. Team members explore ways to be exceptional team players and doctors seek to become more effective and dynamic leaders.

With a plan, each one of us can proactively meet the uniqueness of today’s playing field. Consider flexing your workforce by cross-training and maximizing your team, spoiling your current team with flexibility and other rewards, and babying your best customers with extra attention and flexible rules.

In this rapidly changing marketplace understand that the fundamentals remain constant while the need to re-energize and jumpstart your practices will fluctuate. Keep your fingers on the pulse and you will be rewarded with a committed, dedicated patient base who will help you grow.

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Mining For Gold….

Linda Miles, CSP, CMC

Within every practice over two years old there is a FILE of GOLD commonly called past due preventive care patients. The older the practice, the deeper the veins of GOLD. For whatever reason, patients tend to fall out of the re-care system and are not reactivated until a positive call to action takes place. There are several steps to take to assure the dentist that the reactivation calls are indeed positive.

  1. The person(s) making the calls should be eager to strike gold with each call and not see this as a dreaded duty dumped upon them. Tone of voice of the person making each call and their commitment to the patient is important to the total success.
  2. First, a purging of the charts (manually or digitally) must be done to determine how many patients are past due for preventive care. A list should be compiled but the chart must also be available to make notes/entries during the reactivation call.
  3. The mission is threefold when the call is made. A) To schedule the past due patient into hygiene. B) To ask about other family members who also may be past due or not presently seeing a dentist. C) If a patient wishes to be placed in your inactive file for whatever reason, chart the reason(s) and discuss these at every monthly team meeting. If you have no idea WHY patients are going elsewhere, you will continue losing patients for the same reason.

During the slow economic downturn, it is natural for patients to want to postpone preventive care appointments. If they say, “I know it has been over a year for our family dental visits but money is a real problem right now”, don’t forget to remind patients: “That is the reason Dr. _____ asked me to make these calls, “preventive dentistry is not expensive but emergency dentistry can be”. Or, “our doctor likes to discover small dental problems before they develop into major dental emergencies”. Giving them a benefit they relate to which often brings the gold to the surface. They not only schedule an appointment, they keep it! For a copy of the LLM&A Reactivation Sheet email me at lindamiles@cox.net.

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Communicating the Hard Stuff

Karen Cortell Reisman, M.S.

An article written about the Sichaun earthquake disaster in the Shanghai Daily discussed the outrage and grief of the families affected by this calamity. This article suggests an excellent way to communicate terrible information.

Wang Yong writes, “In times of great danger and distress, staying calm is important, and the best way to calm an emotional public is to tell it what you know and don’t know. If the media or the government doesn’t disclose these facts to the public in a timely manner, misunderstanding will grow, feeding unjustified anger and fear.”

What does this comment have to do with you?

Fortunately you don’t have earthquakes or other natural disasters in your dental practices. Yet, from time to time – you do face emotional patients and team. You do encounter difficult situations, whether it is presenting a scary diagnosis, working with a challenging patient, or handling an awkward moment at the front desk.

Using Yong’s thoughtful advice, here’s how you can communicate the hard stuff in your practice.

  1. Stay calm. The minute you lose your temper, you have lost. In times of great stress, take a deep breath. That old adage of counting to ten – there’s a reason this saying is still around! Metaphorically step back and silently count to ten. Keep your voice steady.
  2. Tell what you know. Even if this is difficult, you must state the facts up front. Your listener will respect you for this, even if not immediately.
  3. Tell what you don’t know. You don’t know everything. Be honest with your patient. You don’t know how long the veneers will really last. You have a good idea. You have data and averages. Tell them what you know and tell them what you don’t know.
  4. Be timely. This concept is as much a blessing for you as it is for the listener. If you need to delivery difficult information, say – some negative feedback for someone on your team, or ultimately- you need to transition someone off your team – letting this drag out is tension filled for you and everyone else. Pick an appropriate time, preferably sooner than later, and communicate the hard stuff by following steps 1 through 3 above.

Writing this article reminds me of a few very difficult moments during the final days of my beloved mother’s life. My sister and I spent every waking hour in the hospital waiting room of the intensive care unit as our mother valiantly tried to fight back from her inevitable fatal heart attack. This was a time fraught with potential misunderstandings (when was this or that tube being inserted, when was this or that procedure going to happen or not happen…), potential anger (why was this happening to her, to us…), and potential fear (how can I cope with this negative outcome?).

I vividly recall the phenomenal medical team. They stayed calm. They told us what they knew – the positives and the negatives. They told us what they didn’t know – that science does not have all of the answers. They were timely with the information; and we became smarter at knowing when we wanted to hear the data. I discovered that there were times, especially late in the evening, when I did NOT want all of the answers. It keeps you from sleeping.

When you have to communicate the hard stuff – in your office or at home – heed the advice gleaned from the Shanghai Daily. Stay calm. Share what you know. State what you don’t know. Be timely.

© Karen Cortell Reisman, M.S. – Speaker, Coach, and Author

Since 1992 Karen Cortell Reisman, M.S. has taught corporate and association audiences how to communicate, sell, and thrive. Across North America and Europe her audiences have listened, laughed, and learned. Find out about her Letters From Einstein keynote and read her articles at www.KarenCortellReisman.com.

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Dealing with a slow economy – Staff Issues

J.E. Simmons

In light of the fact that the economy will slowly recover, it is important to take inventory of your practice i.e. is your practice set up in a way that you are getting the most out of your practice in a slow developing economy. There are many areas to discuss but for the purpose of this article we will focus on the staff.

Often times the difference between a successful practice and a mediocre practice is the staff effectiveness with the patients. Most of the patient’s perception of your practice is based on how your staff greets them on the phone and in person, how long their wait times are, and how treatment plans are communicated and financial transactions are handled. Does the patient feel like the staff genuinely cares about them or are they just another patient? Their experience will also dictate whether the patient will refer their friends and family as well.

With a slow economic recovery how will you keep your staff motivated? Most doctors believe to keep good staff they have to constantly give wage increases even when your compensation as a doctor goes down. Studies show that employees value recognition and appreciation more than the wage increases. A lack of appreciation is the single most cited reason team members leave.

To show your appreciation, catch them doing something good, often, and praise them in front of others, and communicate the impact of what they are doing has on achieving the goals of the practice.

Communication is important in all relationships. Use the current environment as an opportunity to get everybody on the bandwagon. Things are tougher for everybody compared to a couple of years ago. The staff wants open and honest communication. We recommend sharing practice financial information such as collections each month, letting each staff person know how important they are to achieving those numbers. Comparing collections to prior periods or against a target will allow the team to coalesce around a shared goal, providing each team member with a sense of belonging to a team with a purpose. If the staff knows the goals and you have clearly communicated where collections need to reach before raises or bonuses can be given, for instance, then you will be making major strides to keeping the staff morale high.

When dealing with your staff, always remember that how you lead is how your staff will treat patients. Your attitude is contagious and the team will only be as enthusiastic towards the practice as you are. When you live each day with a purpose and a vision, and you will be amazed at how morale can improve.

J.E. Simmons & Co. is a leading national fee-only financial planning firm specializing in serving dentists and other healthcare professionals. For more than 20 years, J.E. Simmons has been providing comprehensive financial planning, including business profitability and transitions, tax, investment, estate, insurance, asset protection and retirement planning, to a select group of elite dental practices nationwide. For more information about our services, go to www.jesimmons.com.

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