As you have read during the past 3 months my summer has been extremely busy. This summer my “to do” list was too long to put on one page and what I have actually crossed off the list things — – well, let’s just say the list is still very long!
This list can be the same for your dental office. Here is a common scenario:
You have a great team meeting each month. The team feels motivated and ready to get things done. The problem is that a week passes and nothing has changed. You cannot point the finger at anyone in particular. The problem is accountability.
What can be done to get the job done and without causing a lot of pain?
Here are a few tips to check off on the “to do” list, accomplish team accountability and a winning team!

1. Action Plan
Always come to a meeting with an action plan.

2. Pass this list around to everyone and/or post it in the team break room.
(Or locker room)
Example to use in your practice:  http://bit.ly/9mfB7h

 
What you will need on the list along with some examples:
What:
What is the task: example: Develop a new patient phone questionnaire
Who:
Mandy (Front office administrator)
When:
September 15, 2010 (One month from now)

3. Timeline for completion
Give reminders at your morning team huddle a week before these are due.
Agree that it is ok to give the team gentle reminders about these tasks and deadlines.

4. Verbal and Written Agreements
In many instances you may need to have a written agreement.
I suggest you have NCR Paper so you will have a carbon copy: 1 for the team member and 1 for the office administrator or the person in charge of following up on deadlines.

5.Follow Through
Ask “How can I support you with this?”
Be certain to hold everyone accountable.

6.Creating the Winning Team!
When the action steps are complete make it a winning situation for the entire team!

Reap the Rewards!
Reward yourself and the team when success is accomplished.
This is a time to make everyone feel good!  Celebrate the success!

Successful dental offices hear the word “YES” quite frequently.

There are six steps to get your patient to say this important word.  When you choose your words and phrases carefully, “Yes”, is an easy word to get your patients to say. Case acceptance is the fulcrum of every successful dental practice, just as the dental hygiene department is the foundation.

Dentists go to school and learn the art, science and technology of dentistry. Learning business skills and how to manage business systems successfully can be daunting and one that needs special attention. Dentists are trained to work in the dental practice. To increase the number of patients who will say “YES” to case acceptance, may mean working a bit more “on” your practice. Once you get it perfect, you will create a winning situation for all!

Most dental practices have untapped potential. The potential sits right there in the patient chart(s) and your important role is to find it. When you tap into this potential, you will have a cost effective method for increasing your revenue.

The Goal is “Yes”:

In John Maxwell’s new book “Everyone Communicates Few Connect”, he talks about getting to know exactly what people want. It is important that you know exactly who your patient is. As soon as you make your entrance into that operatory, you have seven seconds to make an impression with your patient. (Especially a new patient!) These seven seconds will determine whether the patient will say “Yes” or “No” to the treatment recommendations made. 

Other aspects of connecting with your patients are not only what you say, but the tone in which you say it. Choose your words carefully. Use powerful words and not a lot of words. The words we speak to the patient will either stage their response for “Yes” or “No”, once the treatment plan has been communicated. We need to have our patients seated up in the chair and speak in a caring tone so we are not misunderstood as someone who is “lecturing”.

“The difference between the almost right word and the right word is really a large matter – it’s the difference between the lightening bug and the lightening.” Mark Twain

Step 1: Build Rapport

The oral cavity is considered by many as an intimate space and we must first establish rapport before a patient will agree to “Open wide“. We need to have a connection — A relationship with the patient — before we can tell them what to do with their mouth, health or money.

It used to be that the telephone was the most important part of connecting with a potential patient. In the world we live in now, the dental practice website is the first face seen by many potential patients. This is how a potential patient may judge you and the dental practice. This can be your first line of contact with a potential patient.

The New Patient Call

Once you answer the phone and identify that it is a potential new patient, you will need to have a new patient communication slip or form, available to take notes and write down information about this new patient.

This information will become valuable for the team to know as much as possible about this person before they enter the office door.

To view video with more information about the New Patient call go to http://bit.ly/5tipstowownewpatient

New Patient Welcome Information

You will want your new patient to come prepared for their first appointment. To make the appointment experience seamless, you will want to send a welcome envelope of information. In this 21st Century, and with all the amazing technology available, we can have this information available, for patients to download from the office website. Patients can now securely send their personal information directly through the internet to the dental office and into the patient chart. Maybe you do not have a patient chart ready until they arrive in the office, but this can be sent to a patient chart with many types of software now available.

When patients return this information prior to their first appointment, it will allow the dental team to be prepared for the patients’ first date with the dental office. Communicate the benefits of completing this information prior to their first appointment.

If you have a practice brochure send this in the welcome envelope or have one available for patients to download from your website. The brochure should have these components: an outline of the positive aspects about your office, a menu of services, explanation office policies, etc. This also leaves a feeling of commitment and gives patients a sense that you are thinking of them as a long- term patient.

New Patient Coordinator
Establishing and building rapport now continues as the patient walks through the front door of your office for the first time! A front office team member needs to be assigned as a new patient coordinator. This can be one person who is assigned to this role or you can decide that morning during the team huddle, who will be awaiting the new patient(s).

There needs to be a sense of expectation on the part of the team, when a new patient is expected for their first appointment. This new patient coordinator will make a conscientious effort to be expecting the patient to walk through the front door, stand up, shake hands, greet the patient by name, and let them know how happy you are they have chosen to be a patient at Dr. _______’s office!

Clinical Dental Assistants Role
The next person to make contact with the patient will most likely be the clinical dental assistant. Under perfect circumstances, the new patient coordinator will introduce the new patient to the clinical assistant.

When the office has a private consult room, it is valuable for the new patient coordinator to take the new patient into the consultation room. Now the clinical dental assistant can enter the consultation room and meet the new patient. This is a perfect time for the clinical dental assistant to get acquainted with the new patient. The clinical dental assistant will spend a few minutes connecting and establishing a rapport with the new patient in the consultation room and put them at ease. While in the private consultation room the clinical dental assistant can review the health history, take blood pressure and ask important questions, etc.

During this time, the new patient is able to ask questions or inquire about anything that might affect their treatment. This is also a great time to explain the practice philosophy and inform the patient what treatment will be provided that day. It is also the time and place to have doctor introduced to the patient. The same etiquette that you use in your own home will also be used in the dental office.

Introduction to Doctor
The clinical assistant will introduce the new patient to the doctor. This will now be a brief time for doctor to inquire about the new patient referral or find something in common with the patient. This is an important connection. It is nice to have this completed while in the consultation room so anything confidential or of a personal nature can easily be mentioned or discussed.

After doctor has completed his or her brief introduction and connection, the clinical assistant can give a tour of the office and then seat the patient to begin the initial treatment.

This is the difference between the lightening bug and the lightening.

Step 2: Initial Office Interview
This is a great time to have a new patient survey and review this so you know how the patient feels about certain aspects of dentistry: their fears and values, etc. Many offices will classify their patients according to the DISC profile. You can find more information about this at Google.com. Just search DISC Profile and you can find some general information. While in the private consultation room, it is a good time to review these answers or ask these quetions with the patient there to answer in privacy. This gives a personal touch and helps build trust.

Ask questions and take time to know the new patient. Some examples of questions you may want to ask are:

• What is your reason for today’s appointment?
• What makes you happiest about your smile?
• Is there anything you would like to change about your smile?
• Do you have any teeth that are causing you pain?
• Do you have sensitivity to hot and/or cold?
• Do you experience a dry mouth?
• Do you ever notice you have bad breath?
• Are you satisfied with the color of your teeth?
• Are you satisfied with the size and shape of your teeth?
• Do you have jaw pain?
• Do you have anxiety about dental appointments?
• Why did you leave your last dentist?

Once you are clear about the patients’ desires, goals, values and needs, you can begin the comprehensive (Or initial) exam, which will include the necessary x-rays.

Once the team has completed the new patient appointment, it is valuable to have the patient return for a personal consultation with doctor to discuss any treatment recommendations. If the patient is not the primary decision maker, it is best to invite this additional person to participate in the consultation. It works well to schedule a time for this consultation about one week after the comprehensive exam. Depending upon the type of diagnosis made during the comprehensive exam, this appointment only needs to be scheduled for thirty minutes and no longer than sixty minutes.

Step 3: Power of Persuasion
As healthcare professionals, we are the experts and patients will sit up and listen when we share our professional knowledge and the science behind the recommeded treatment.

Most people are visual learners. This means that your patients need to see your body language and facial expressions, to fully understand the information you are communicating to them. With this information, it makes sense to have visual aids available. There are numerous types of visual aids available for our patients. These may include CASEY, intra-oral camera photos, educational videos, photo books of before and after photos, brochures, charts and models of teeth, etc.

Patients want to know the risks and benefits of proceeding or not proceeding with their recommended treatment. They will also want to know about their financial obligation or arrangements that can be made for payment.

Know what your patients’ hot buttons are. Discover what is important to them. Some patients have a hot button that includes time. For some patients their hot button is money and for others it may be fear of the dental office. This is the WIIFM. (What’s in it for me?)

Step 4: Closure
This is the time after we have given all the possible information, questions have been asked and answers have been given. We will now ask:

• “Is there anything else you need to know?”
• How can we be of help in scheduling your next appointment?”

Doctor will now excuse him or herself and allow the patient to spend time with the financial coordinator.

Step 5: Financial Arrangements
Many times, when doctor is in the operatory with the patient, it can be (Non-verbally. with a communication monitor when used in the office.) communicated to the financial coordinator, to come in and meet the patient. This is when the financial coordinator will guide the patient into the private consultation room. (If there is one available.) It is best to discuss financial matters in a confidential area of the office. When this is not possible, plan to discuss this subject behind closed doors, or at least in a private area. Be sensitive to this subject, as it can be a touchy subject with many people. These are very difficult economic times and we need to be compassionate and empathetic about peoples’ situations.

Have many options for payment available for patients to choose from and utilize, to complete their treatment. Some of these options may be Care Credit or CHASE, etc. If patients cannot qualify, or they not able to pay for the first option, be prepared to discuss alternative care available, for the benefit of their healthcare. Many offices are utilizing private plans such as Quality Dental Plan. (This is one example that can benefit patients and the dental practice: ( http://www.qualitydentalplan.com )
Always be prepared to eliminate the barriers patients may have regarding case acceptance. Be compassionate and empathetic to patients’ feelings and personal situation(s).

Step 6: The Date
The financial coordinator will now hand the patient off to the appointment coordinator. In many offices, there may not be an appointment coordinator, so this is when the team member will suggest the best date and time to schedule treatment.
For suggestions about building an effective schedule, go to: http://bit.ly/tieredschedule

Conclusion:
Getting to the “YES” for case acceptance is a two way street. As the professional, you need to be able to ask the strategic questions to give patients the correct answers to provide the highest level of care, utilizing powerful words. When you use powerful words, you will most likely overcome patients’ barriers for accepting treatment.
Here is the win-win:

• You add value to your patients
• You add value to your dental practice
• Your patients will receive your highest level of care.
• You and the team will feel proud of what you offer
•  Your practice profits will soar to new heights!

It is not what we say but how we say it that makes a difference!

May you soar to new heights in 2011!

Debbie Seidel-Bittke, RDH, BS

This Thursday Dental Practice Solutions will host a webinar and President Debra Seidel-Bittke, will show dental offices exactly what they can do to find 100k in production during the last quarter (Plus a few weeks) of 2010. There are approximately 77 working days left this year if you live and work in the USA. This number takes into account that your office will be closed for Labor Day, Thanksgiving, Christmas and even the week between Christmas and New Years. If you don’t close for these holidays you have even more potential to consider!

I consistently find, when analyzing hygiene departments, one huge area of opportunity. This opportunity is undiagnosed and untreated periodontal disease in your existing patients who have early and even moderate signs of periodontal disease. Many practices have contacted Dental Practice Solutions this year, asking how they can get more new patients to walk in their door. The easiest way you can increase profits and add value, is to work with you current patient base. New Patients should always be coming through your front door because your current patient base can’t help but tell everyone about your dental practice! There is usually untapped potential sitting right in front of you. It is valuable to get your active and even overdue patients scheduled into non-surgical periodontal treatment; sooner than later. When you take time to frequently assess and communicate effectively, you will receive instant gratification because your current patients will understand how much you truly care and want the best for them! These are the people who will refer all their family, friends, neighbors and colleagues to your office. This is the easiest and most cost-effective way to capture new patients.

I will make very conservative projections for your growth because it needs to be attainable and something you can reach out and grab immediately. Here are a few questions you will need to answer to begin the process for the increased income stream to occur this year:

1. How many active patients do you have?

(To download a formula and accurately determine the amount of Active Patients in your practice go to:  http://www.dentalpracticesolutions.com/members-center/team-meetings/)

2. How many of your patients in your “active patient base” had a prophy this year?

(In the USA the CDT code to run a report for this procedure is: D1110)

Steps to take:

From this day forward, closely assess and analyze patients who have 4mm pockets and greater. Of  those patients who have pockets that are 4mm or higher, do they also have bleeding on probing? What is your diagnosis for these patients? It is no longer the standard of care to “wait” and “watch”. My question to you is “What are you waiting for?” When we provide early intervention to any disease process we can provide prevention and in many cases halt the progression of disease.

Most practices, (These are the ones that I have worked with and also worked in as a hygienist) have 50% of their adult patients in some sort of non-surgical periodontal and preventive treatment(s). Statistics say that in the USA there are approximately 6 million adults who have periodontitis. (To read more about this and how the statistics are calculated go to: http://bit.ly/9vSkUo)

Here is a practice example for you to look at:

• Dental Practice has 1500 active patients:
• 2 Hygienists work 4 days a week.
• Currently this dental practice has 1200 Adult Patients and 300 Pediatric Patients. (Pediatric: <14 yrs of age.)
• Currently there are 300 Active Periodontal Patients. (These are patients who have had Scaling and Root Planing and return every 3-4 months for Periodontal Maintenance Appointments.)
• Over the next 77 days the dental team will enroll 70 adult patients into active non-surgical periodontal treatment.
• Each patient will receive at least 4 appointments to Scale and Root Plane a quadrant or at least 1- 3 teeth in each quadrant. (In the USA CDT Code: D4341 = 1 quadrant and CDT Code: D4342 =  1-3 teeth in a quadrant.)
• These patients will also receive antimicrobial therapy. (CDT Code: 4381)

*Here are the average costs to complete phase I of non-surgical periodontal treatment. (This will also include the 4-6 week re-evaluation, which will be billed as a Periodontal Maintenance appointment. CDT Code: D4910) For patients who have 5mm pockets or higher they will also receive antimicrobial therapy. (Code D4981)

*Please note that I am not setting a trend or commenting on what you should charge to treat a patient in your office. This is an example and if you need advice about how much you should charge your patients, please contact our office and we can give you resources to find out what may be considered average for your area. (info@dentalpracticesolutions.com)

• 70 patients will complete Non-surgical Periodontal Treatment: Average charge per patient: $1,500.00
• Please note that 100 patients had a treatment plan communicated for non-surgical periodontal and preventive treatment but not all will accept before years end.

Total: $11,250.00                 This is the amount paid for Phase I by December 31, 2010.

• 35 Patients will return for 3-4 months Periodontal Maintenance Appointments last quarter of 2010: $125.00 each

Total: $ 4,375.00

• 100 patients in the practice purchased preventive products before December 31, 2010: Average amount Spent: $150.00 per patient.
• Examples of products sold: Power Toothbrush, Fluoride, Whitening products, toothpaste, mouth rinse, Xylitol mints, or gum, etc.

Total: $ 15,000.00                 Typical net profts for products sold in the office = Average 50%.

• 50 patients completed “same day” services. (Examples of “same day” services include: Fluoride treatments, whitening procedures, sealants, impressions for occulsal guards, impressions for snore guards, etc.) Some patients completed mandatory restorative treatment and some are still in active treatment for the next year or two (continuing treatment in several phases.) * See BLOG post dated August 2, 2010, about “same day” services to define this service.

Total: $ 30,000.00                          Total they will spend last quarter of 2010.

• 5 Patients will complete full mouth mandatory restorative and/or cosmetic dental services

Total: $ 40,000.00                          Total they will spend last quarter of 2010.

Grand Total: $100,625.00           Spent by patients last 77 working days of 2010.

These numbers are conservative. You can plod along just as you have been but if you desire to be the best you can be and offer the very best to your patients this is just one example of how you can add valuable services to your patients and profits to the practice before it’s too late.  Many of your patients coming to the office this week have new benefit packages that begin January 1, 2011. What can you do now to capture profits in 2010 and add additional value to your patients today?

We are “Healthcare Professionals”. We have a responsibility to share our knowledge with our patients. When we take time to completely assess our patients and communicate with powerful words, we can provide the very best.  Allow patients to sit up-right in the chair and give them an opportunity to listen to your findings. (You are responsible for giving patients the benefits and risks for providing treatment, etc. Sitting them up-right will stop the feeling that you are lecturing to them.) Allow time for patients to ask questions. When patients truly understand they will not only take note but will take immediate action.

How many patients this year, have you explained the scientific knowledge about the oral-systemic link to? Have you ever had a patient tell you they didn’t want to live a healthier life?

It is our responsibility as healthcare professionals, to share the important scientific knowledge. We are not in a position to ignore mandatory treatment or even withhold offering cosmetic or additional preventive services. We can not recommend treatment only because we “think” their insurance will pay for it or because we know they can afford to pay for the service(s). We have a legal liability to offer appropriate treatment and provide the very best for our patients. The rewards are astounding for all! This is just one more  example of a “Win-Win” situation!

Give us a call today so we can show you how to uncover your hygiene department’s full potential. Email info@dentalpracticesolutions or give us a call today: 503-970-1122.

You are driving on a nice vacation and need gas. You stop at a gas station and go inside to buy some snacks while the gas is pumped into your car. How much do you spend while in the convenience store? The national average is $5.00

This month Nordstrom is having their anniversary sale. I bet many of you have stopped by to see what valuable things you can find for yourself. How much did you spend? If you did not go by Nordstrom how much did you spend on the last sale you went to?

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

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

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

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

Here are some suggestions to discuss at the team meeting:

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

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

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

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

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

When you meet as a team, to discuss various services you provide patients, make time to discuss ways to educate and communicate these valuable services to your patients. You can now add over $100,000.00 in production to the dental practice in 2011. To capture this revenue complete a few preventive treatments at the time the patient is in the office. Additionally, have patients leave the office with their recommended dental products and with the knowledge about how to use them properly.

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

A few of these questions are:

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

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

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

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

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

2 Tips to take away today:

1. Ask the right questions and give valuable answers when communicating with patients

2. Offer “same day” treatments and products for patients

We are the healthcare professionals – “The Experts”.  When we share, the scientific evidence patients will sit up, listen and take action. This is just one way you can tap into that same day treatment: add value to the patient visit and profits to the practice.

If you have not read all the information about CAMBRA and the benefits to patients and your practice, we have these resources available on our website:

www.dentalpracticesolutions.com

Click on the Membership Center. It is free to all of you.

Once in the Membership Center click to Register. We have a lot of information about CAMBRA right there for you! There is much more information to utilize in your daily practice once you register. Check it out today.

Please give us a call to find out how we can get you to that next level immediately!

OFFICE: 503-970-1122

Next week I will write about same day services you should consider in your daily practice.

As Dental Professionals we have a hectic schedule and it is always a challenge to “stay on time”. Did you have any idea when you thought about entering the profession of dentistry that time would be such a virtue? Do you ever feel like you just had a day in the office on roller skates?

When it comes to the doctor and hygienist providing an effective patient exam time is of the essence! Hygienists usually have less than 5 minutes to communicate their findings to the doctor and then doctor may have 3 to 4 minutes left with the patient to explain the findings, recommendations, discuss alternative treatment, educate the patient about the risks of not completing treatment and the benefits of scheduling the treatment diagnosed. A long day in the dental office can pass quickly and when systems are in place the day can be harmonious for all. Having a plan for communicating treatment plans and staying on time are a win for everyone!

Here are a few suggestions to transition the hygiene exam into case acceptance:

1. The hygiene exam should be completed before the end of the appointment

• After the initial greet, review of medical history, blood pressure, x-rays, oral cancer exam and periodontal screening, etc., etc., are complete the doctor can now effectively make a diagnosis. This will be one simple way to prevent the hygienist and patient from waiting for doctor to arrive and complete the exam
• After these initial exams are completed by the hygienist sit the patient up in the chair to discuss the findings
• Now is the time to let doctor or the doctors assistant know the patient can be seen for the exam
  • Doctor can now complete the hygiene exam when there is a break in his or her schedule and no one should be left just waiting for doctor
• Always seat the patient in an upright position to communicate findings
  • This takes away the feeling that the patient is being lectured to
  • It allows patients to feel that you really care
  • This will allow for patients to understand you want to take time to listen to their concerns and answer their questions

This is the first ingredient of a successful hygiene patient exam.

2. Give a brief personal update

1. • When doctor enters the hygiene room for the patient exam, have the hygienist or hygiene assistant give a brief update about something personal and positive in the patients life.

An example of this positive conversation is: “Dr. Goodtooth, Mrs. Smith is going to be a grandmother! Her daughter Susan is having a baby girl in November.”

• If this is a new patient possibly let doctor know how the patient found the dental office. (Yes, you should have discussed this during the morning team huddle –and everyone in the office knows this information – but this can also be an ice breaker for new patients. It can be a way to find common ground, “break the ice” and create something pleasant to talk about.)

3. Effectively communicate and be concise

1. • During the initial hygiene examination have a paper nearby to write down the hygienists’ observations and/or findings. (Some offices have a form to complete so possible patient treatment is prepared and written down by the hygiene team member(s) for communication during the doctor exam.)
   • When doctor enters the hygiene room for the exam (after the initial personal update with doctor) be prepared to relay all the treatment information previously discussed with the hygienist and patient: any dental treatment opportunities, desires or concerns regarding the patients dental care need to be shared at this time
   • Discuss the various categories of treatment at this time: discuss the necessary treatment, elective treatment, cosmetic dentistry and various phases of the treatment plan as necessary, etc.

An example of this would be: Scenario – Mrs. Smith came in and the hygienist noticed a fracture on the lingual cusp of tooth # 19. (For those readers outside the United States or if you don’t use the universal tooth numbering system tooth # 19 is located: lower left first molar the tongue surface.) The hygienist or hygiene assistant will take a photo using the intra-oral camera and most likely an x-ray, and always before the doctor exam begins. These diagnostic tools need to be readily available for the doctor to immediately and easily view upon examination of the patient.

Once the hygienist has prepared the initial patient information a discussion about the potential treatment needs to take place with the patient – before doctor enters the room for the exam. It is very important to allow the patient a look at the area needing possible treatment before the doctor enters the room for the exam. This is where it is valuable to utilize the intraoral camera. This allows the patient to see and begin to understand what is happening in their mouth. (Especially if they are not already aware of a problem.) It is the responsibility of the hygienist to explain what is initially found and communicate this to the patient: It will sound something like this: “Mrs. Smith, I want to show you what this looks like as I found that a part of your tooth has broken off.  I believe this tooth will most likely need a crown.” (If the patient is already aware of the problem with the tooth give them the opportunity to see visually and very clearly what this looks like with the intraoral camera and the photo you have taken.) This photo and the x-rays will remain readily available for doctor to see when the diagnosis is to be made.

This type of approach adds value to the necessary treatment, provides for effective optimal patient care, efficient use of time and a reason for the patient to now accept the treatment plan. Providing a patient exam in this manner may take a total of 3 – 5 minutes with the hygienist before doctor enters the room for the periodic or comprehensive exam. The patient can now begin to ask questions and become educated about their potential treatment plan before doctor has entered the room to complete the exam. This also gives the dental team (auxiliaries) time to listen to the patient. We never want a patient to feel no one had time to listen to their concerns and we want to answer their important questions.

4. Comprehensive and Large Treatment Plans

There will always be times when more time is necessary to discuss a treatment plan. If the doctor has diagnosed many areas which need restorations or possibly the patient is interested in completing elective or cosmetic dentistry which needs a lot of time to discuss; you will want to re-appoint the patient for a time to speak with doctor privately and have their questions asked. This can also allow for extra time when necessary, with the financial coordinator, to discuss payment options or arrangements.

5. Offer various treatment plans

Not every patient is able to complete a treatment plan that is the highest level of care the dental practice can offer. Sometimes we need to be flexible and offer just a bridge instead of an implant. We need to be flexible and understand our patients’ needs. This is where we can be empathetic to the patients’ needs and offer other options for treatment.

It is also important not to overwhelm our patients with so many options. Be prepared to give patients alternative options when they need these. We have a legal obligation to give our patients the risks and benefits for optimal treatment and we need to offer what works best for our patients. If we can’t provide these options then the patient needs to be referred to a professional who can meet their needs, expectations and desires. Offer Plan A and Plan B when patients are open to hearing alternate treatment options. It is when we begin offering too much information that patients can be confused.

6. The magic word “YES”

• Be focused on what is happening in your patients personal and emotional life
  • Did they just have a death in the family?
  • Did they lose their job?
  • Do they have a fear of dental procedures?
  • What are the important values of the patient in your chair?

These are just a few suggestions to create a harmonious day and a “Yes” for case acceptance. It is about a “Win-Win” and patients living a longer and healthy life.

You may not want to do this alone and we are here to be your guide to success. Sometimes it takes the knowledge of an expert to get these systems in place.

Call us today to ask how we can help.

OFFICE: 503-970-1122

www.dentalpracticesolutions.com

In part II we discussed how every successful dental practice has a strategically planned schedule. The schedule is the core of your practice and when it is set up correctly it will direct you to many levels of success.

This week I share with you four more tips to schedule success.

4. Know your ideal daily production numbers

It is important to apply a mathematically correct number for daily production. The easiest way to achieve a desired annual production is to schedule an average daily level of production that will achieve that annual goal. For example, if you want to produce $1000, 000,000.00 in 200 days, you need to schedule $5,000 per day. While you may not produce exactly this number each day, it is the daily average that is important.

Ideal schedules and daily production goals also tend to reduce practice stress because they allow doctors and the team to achieve a consistent day-in day-out workload.

5. Virtual Assistants need to understand as well

Many offices are today (The year 2010) utilizing the services of a virtual assistant (VA). This is an outside – independently contracted person(s) who can answer the phones for your office 24/7. These people are now via remote technology and able to view your appointment book and schedule your patient appointments from their remote location.

It becomes more important than ever for your office to have a pre-blocked schedule with templates so someone who is not familiar with the day to day and hour by hour activities of your dental office, understand where the particular types of patient appointments belong on your schedule.

This is just one more suggestion to reduce stress for all involved. Have scripts written out for the VA’s to be “on the same page” with your in-office team.

6. Schedule doctors and assistants separately

Many offices schedule all of the patient time with doctors and assistants working together in the operatory the entire patient appointment time. When the doctor and assistants are scheduled and coded or tiered (I suggest color coding the doctor and auxiliaries on the schedule. See the example form for a morning schedule: http://www.dentalpracticesolutions.com/members-center/team-meetings/) within the scheduled appointment, your practice will immediately increase efficiency. (See an example of a morning schedule tiered and color coded. This lists the types of procedures scheduled and how your can add value to your services and patients along with a high production amount even in just 4 hours of the day on this example. Click to view: http://www.dentalpracticesolutions.com/members-center/) It may take a few weeks to master this new process. Most practices have been able to significantly increase productivity when implementing this scheduling method; resulting in reduced stress as the patient flow improves.

7. Reduce Failed Appointments

Failed appointments and cancellations occur in all practices. Practices can use a variety of communication techniques that build value for appointments and help decrease schedule failures, including:

• At the time you schedule the patient appointment, let patients know “This appointment has been reserved just for you.” Use effective verbal skills and scripting to emphasize the need for the treatment scheduled, as well as to educate patients on the significance of reserving appointments before they leave the office.
  • o Approximately 60% of patients who leave the office without an appointment for future treatment do not follow up to complete their treatment in an appropriate time to prevent future dental disease.
• Have the front office team inform patients that 48-hours notice is required should they need to cancel an appointment. Have the team members circle this information in red or highlight with a felt pen on the appointment card.
  • o This also needs to be written as a protocol on your medical history and acknowledged with a signature so patients understand up front. Let patients know when they first complete a health history form – there is a fee for appointment failures. (no-shows) Have them sign “acknowledgement” that they read and understand this policy. This is now a legally binding contract. You can legally collect payment when you have it written and patients sign.
• As you re-train your patients, you will go through a six-month cycle where no-shows may continue. In each case, you must tell the patient that there is normally a fee for a missed appointment, but the doctor has insisted on waiving the fee this time. That is often enough for patients to hear in order to change their behavior.
  • o Often times there are patients who are known to no-show or fail appointments. These patients can be placed on what is called an “ASAP” list to call last minute.
  • o You may also want to collect 50% of larger cases up front with a non-refundable discloser for these types of patients. Be sure to have patients sign that they understand this is a non-refundable retainer for their appointment.
  • o Most no-show fees should be in-line with the amount of time blocked for the appointment.
  • For example: A hygiene appointment –for a Prophy only may be a $50.00 charge but if the patient failed to show for a crown prep you may charge more money as this procedure is a larger case and creates a lot more down time and loss to the dental office as well as the patient when they no-show.

Conclusion

The core of all successful practices is the schedule. Improving practice efficiency and adding to your revenue begins with effective scheduling. This is one system that will impact almost every aspect of practice activity. This is a “to-do” list that is very important to your success:

• Schedule in 10-minute units, with a template for each operatory
• o Color code each provider as this makes it easy to view who is where and when
• Schedule the most productive procedures first by creating ideal day schedules with ideal production goals
  • When creating the blocked schedule add the important and larger procedures at the time you prefer to provide these procedures
  • New Patients should be appointed first thing in the morning and then right after lunch to eliminate any wait time for these very important patients
  • Schedule doctor and assistant separately when it is efficient to do
  • Color code for each provider as this makes it easy to view who is where and when
  • Build value for appointments to reduce failures and cancellations
    • o Create written and shared scripts for the team and VA’s to use and communicate the importance of their patient appointment
    • Keep these in a notebook for all of the team to review and for future team members to understand the expectations

By implementing the recommendations above, you can create a more efficient and effective scheduling system that leads to improved productivity, greater profitability, and reduced stress.

Scheduling is the most important part of any and all successful dental practices. Please understand that this is something that takes time. It is a process of building value and understanding what is happening: when, where, why and by whom. This is something you want to talk about at a team meeting to see where you can possibly make improvements and not only how and where you are pre-blocking your appointments but discuss communications skills for pre-appointing patients and helping them understand the importance of each dental appointment.

With good oral health patients will live a healthier and longer life. Most people will sit up, listen and take action when you share this important information about their life!

Remember you don’t have to take on this daunting task alone so be open to calling on a dental expert in the field of dentistry. There are many coaches and consultant who understand how to strategically set this up a successful schedule, guide you to create what will work well for your individual office and lead your team through this process – in the right direction.

We at Dental Practice Solutions are here to be your guide and resource to success!

Please give us a call today if we can guide you through this process.

OFFICE: 503-970-1122 or send an email to discuss how we can guide you where you can and should be!

Email: debrabittke@comcast.net

One important fact about a successful practice that you will always notice is a strong system of scheduling. Every practice has a schedule, but not all have a systematic approach for scheduling their day, week, month or year. If you have a proactive and strategic approach when designing your scheduling system you will decrease your level of stress and increase the income to your practice. Stephen Covey, author of many management and family management planning books has said, “The key is not to prioritize what’s on your schedule but to schedule your priorities.”

Your first thought may be – This seems impossible to create the ideal dental practice schedule. In some practices the dentist and many of the auxiliaries practice on different days.  Each dental professional in the office may work different hours, they all provide treatment at different speeds and they possibly provide different services. All successful dental practices will take into account all these scheduling variables. Having a strategic scheduling system is what creates success in all areas of the dental practice. Successful practices account for all or any of these scheduling variables.

Effective Schedule Systems

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

Think of the schedule as the core or the center of all your dental practice systems. When the team manages the schedule it will become efficient and predictable. This is where productivity will create increased revenues quickly.

Six tips to help you manage your practice’s scheduling:

Michael Gerber Author of The E-Myth says you need to work on your business not just in it.  Taking time to create an effective scheduling system for your individual dental practice will the doctor and team to manage patient flow rather than be managed by it.  When the schedule is well designed, it will significantly decrease stress because it is efficient and predictable. Here are six steps necessary to create an effective scheduling system:

1. Use 10-minute units

Many practices are still using 15-minute units for their schedules. This costs the practice approximately seven days of treatment time every year, which means that doctors are working that much harder. Shift your practice schedule to 10-minute units immediately. Ten-minute units allow the practice to schedule procedures with a higher degree of accuracy. For example, using 10-minute units, a practice can schedule a 20-minute procedure with ease. With 15-minute units, the procedure must be scheduled either with not enough time (15 minutes) or too much (30 minutes). Ten-minute units offer greater flexibility and result in increased productivity. Every 10 minute unit needs to be put into the schedule in advance. A schedule built on a 10-minute template outlines exactly how every 10-minute increment will be used for each operatory. Doctor and the auxiliaries need to take a look at the 10 minute units first. Meet at one of your monthly team meetings to discuss how this will be set up. Make certain that all the providers are present at this important meeting.

CAMBRA protocols recommend that patients come into the office for frequent oral hygiene, biofilm and saliva assessments. It is recommended that at this visit the patient has a fluoride varnish treatment. Having a ten minute increment means you can schedule this new protocol with ease. It will take no more than 2 units of time (20 minutes) and the income to the practice may be over $50,000.00 in additional revenue; not taking into account the products sold to the patient for home-care.

2. Create a template for each operatory

Every unit of the schedule needs to be put into a template in advance. A schedule built on a 10-minute template outlines exactly how every 10-minute increment will be used for each operatory. Before the first patient arrives, a doctor can look at the schedule and know very well how each day is going to flow. When putting this together give each provider a color and then highlight the increments of time in that operatory when the patient will be with this provider. When the schedule is written out and you see the highlighted colors it stops any stress because you know exactly where each team member needs to be and by the color coding you will see where they are at a specific time. During the morning team huddle review and have every member of the team understand where they are to be and at what time. This is especially useful if you don’t use a highlighted (tiered schedule) schedule for where auxiliaries are to be during procedures or specific office duties. (For example: cleaning the “Central” area, sterilizing, cleaning, confirming calls or making patient calls, etc.)

3. Schedule by production

Many practices make the mistake of scheduling by reactively filling empty time slots. Plan for emergencies during your team huddle and have an understanding of what time usually work best for the practice. What are the best times for longer procedures? Many providers prefer to see the more difficult types of treatment early in the day. Many offices request that the times before lunch or the end of the day are not big procedures so there will not be bottle necks at the front office during check in or check out. It can also help to create a harmonious atmosphere.

One of the key principles of scheduling is to always be proactive and do the most productive things first.

Many practice management consultants suggest “power scheduling” where you pick specific 1- to 3-hour time blocks, usually in the morning, and fill only these blocks with high-production cases. Without a strong scheduling system in place, the schedule will become clogged with all types of dentistry at the cost of productivity and profitability. Scheduling with production as a priority eliminates unnecessary stress and helps the practice meet its daily goals.

Quick Overview:

• Schedule in 10-minute units, with a template for each operatory
  • Highlight each doctor or auxiliary to show where they will be
• Schedule the most productive procedures first by creating ideal day schedules with ideal production goals
• Schedule longer and high end production early in the day

By implementing the recommendations above, you can create a more efficient, effective and productive scheduling system. This will lead to improved productivity, greater profitability, and reduced stress and harmony within the team and your patients as well!

Next week we will share the last 3 steps.

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

The secret to capture this:

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

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

Step 1- Prevent Periodontal Disease

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

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

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

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

Step 3-Financial Arrangements and Follow-up

Always have patients leave your office with a written and signed financial arrangement. If patients decline treatment they also need to sign a disclosure that they understand the risks, benefits, alternative treatment and disadvantages of not completing the treatment. This is a legal liability and if you don’t explain this it can come back to bite you in legal bills, etc., if patients lose teeth or have other problems. If you don’t have a financial arrangement form, make sure you create one this week. Most dental software programs can make this a very simple thing to do. When patients trust you and understand it is about their total health they feel an importance to have treatment completed immediately. Patients that say “No” to treatment are many times uneducated about the oral and systemic link. Make financial arrangements clear and easy for them. Help patients understand what portion of the fee they are responsible for and when it’s due. Always follow up. If a patient declines treatment always follow up with a conversation each recare appointment. The economy is difficult for many people, and at this time in our world in can be very hard for a patient to even pay $100.00/month. It sometimes takes time to change patients’ thought pattern about oral health and disease. If a patient isn’t ready to schedule that day, then put them on your follow-up list and ask for their permission to call in 2- 3 weeks.

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

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

Much Success to all!

Debbie Seidel-Bittke, RDH, BS

President: Dental Practice Solutions

debrabittke@comcast.net

When I first began my business in 2000, I read The E-Myth: Revisited by Michael Gerber. I have since read almost every book by Michael Gerber and believe he has solid and proven knowledge to share about systems solutions that work.

Mr. Gerber spends a lot of time talking in this book The E-Myth: Revisited how business owners take a lot of time to organize, market, sell, network, and be a proper bookkeeper to get by in their business. Business owners are told that owning their own business is something they will do and love. They are told that once they embrace and realize this, everything will fall into place for the business owner.

Unfortunately, this is far from the truth.

When a business has systems in place and these are applied purposefully, the business process has the power to transform that business into an effective organization. Incorporating these processes into every activity controls the destiny of the business. The business stays youthful and survives because of these systems. This is the reason that in the month of January 2010, I come to you writing about meetings; what type of meetings and how to plan and hold these individual meetings.

Perhaps you are thinking that some of the meetings we will discuss are a waste of time, that meetings give a chance to express negative feelings or are just a social event. Perhaps you thinking this will take time away from productivity. When the team takes time to offer meetings it offers a time to communicate, problem-solve and achieve results beyond your wildest dreams. The meetings that we at Dental Practice Solutions believe really matter will provide results which may surprise you. We make these meetings easy to implement by providing you with a step by step process. Go to our website and under Leadership Tools click on forms to download a free copy of what can create an organized morning team huddle. (www.dentalpracticesolutions.com)

We want you to be more profitable. If you continue to do the same ‘ole thing day after day and year after year you won’t achieve the results that we are talking about.

We suggest that you improve your practice profitability by first implementing team meetings.

The first meeting I want to talk about is called “the morning team huddle”. This is a way to make certain you have a seamless team working in harmony rather than chaos and frustration.

Start your day off right with a strategy-oriented team huddle and remember each team member has something to offer. This meeting will give your team a chance to work and provide patient treatment efficiently each day. You will be able to spend time strategizing how to accomplish your goals; whether they are patient flow, improving patient treatment, patient satisfaction and/or increased profits. By spending just a few minutes planning each morning you will be investing in something very important—your assets.

Planning your morning huddle

The best time to hold a huddle is in the morning, thus “the morning team huddle.”

Each team member needs to participate in this meeting. Everyone will need to take about 20 minutes to prepare for this meeting; usually the day before the huddle is held.

It is best to review the charts and patients information a day or two ahead. How will you find time to review the charts? If a patient on the day you are in the office and on the clock, cancels or no-show’s, you will review the charts during this new found time. If you don’t work in the office a day prior to the team huddle, then you will need to come in about 20 minutes early to review the charts to prepare for the huddle. To save time on the day of the huddle you may decide to review the charts a few days prior. This will allow you to spend less time. If your office has a lot of last minute cancellations reviewing charts a few days in advance may not work well. Now is a time to address other issues going on that cause these last minute cancellations. (This is another topic to discuss)The doctor needs to consider the huddle preparation time as paid time. All team members who come in or stay late to work on preparation of meetings need to be paid for this time.

Have a special place where the entire team can be accommodated by standing up during this morning meeting. Make this morning meeting location a place where patients can’t hear what you are talking about. If it is not far from the reception area then choose a room where you can close the door and have privacy. It is important to stand up rather than sit down and drink coffee. Many people are not morning people so standing up helps bring the energy level up. Leave food to a minimum as this is not a social event but a serious and timely planning session. This meeting and what occurs needs to be short and concise.

In this special area where you hold the meeting, have a calendar and have each team member sign up to be the ring master. (The leader who begins and directs this very short team meeting.) You can also have the huddle check list on the wall in this room as a guide. (Please download this from our membership center at http://dentalpracticesolutions.com/members-center/.)

Before you begin the morning huddle, leave a little note stating that you are having a team meeting to let the patients know you are preparing for their treatment and to please make themselves comfortable as you will be with them shortly. Make sure the note looks professional; be sure it is typed and add a photo and even laminate it. This is your representation while you are temporarily unavailable.

The phones will still need to be answered during the huddle so I suggest that you use a live service. Currently, there are virtual services where someone can actually pick up the phone and speak directly to your patients. Please check into one of these services as they can make patients feel more comfortable when they call and speak to a live person, rather than an answer machine telling then you are busy with patients.

At Dental Practice Solutions we recommend a specific virtual assisting service that can accommodate your phones while away from your office temporarily or even while out of the office for the day or week, etc. This is a live person who will answer your phone when it begins to ring and no one is in the office available to personally answer. (Contact us directly to learn more about this virtual assisting service.)

If you are not currently holding team huddles then I suggest that you set aside time to plan for this important morning event.

The Step-by-Step plan will look like this:

1. You will need your practice mission statement. Have this written down for every team member as I suggest that you read this together as this is one way to get everyone on the same page.
2. I recommend that you have written practice principles (a code of ethics) and have these available for everyone on the team because you will end the huddle by reading one of your ten ethics. A code of ethics is similar to your 10 commandments; it is something that reminds you how your patients will be treated. Have you ever gone to The Ritz Carlton? If you are there as a guest ask one of the team members to show you their code of ethics. Most team members have a card to show you that explains how their guests are to be treated.
3. Bring to the huddle what did and didn’t go well the previous day. The office administrator needs to be in charge of letting everyone know about the previous day’s performance, as well as, where the practice stands for production and collection goals.
4. If you have an appointment administrator this is the person to let the team know what holes or cancellations are currently in the schedule that day and the rest of the week. This is the same person who will let the team know when time is available to see an emergency patient. This is the person who lets everyone know when there is a block of time available for a new patient and non-surgical periodontal treatment. If a new patient is scheduled for the day, this is the person to let the team know all about the new patient. Think of this as a pre-introduction.
5. If the office has a financial coordinator this is the team member who will report on the previous days financial arrangements and if the patients have accepted treatment and what percentage of treatment is outstanding; this is a good time to periodically review. If a patient scheduled today has an outstanding balance this is the time to discuss payment options and make certain everything is handled appropriately.
6. Each hygienist who is seeing patients today will report on their patient information as necessary. Some examples of the information to report on are: periodic and comprehensive exams, patients who may be due for Full-mouth x-rays and are not yet scheduled, the need to administer full-mouth probing, developing and mounting of x-rays (should you still be developing these. If a patient has not completed a recent medical history (within the past 3 years.) The front office will need to have the patient come in early to complete or begin updating the medical history on the day of the treatment appointment, when necessary.
7. The dental assistants should report on the patients they will be seeing in their personal treatment room. (I believe that each assistant should have a primary room where they are the leader.) The assistant will let the front office know if a lab case has not arrived and how this situation should be handled. If the front office or hygiene department needs coverage, the assistants should to be aware so they can help out where necessary. If post operative calls were made the previous evening they need to report on the results.
8. The huddle can be ended with the doctor reading one of your practice principles. You can assign anyone to read these, but they should be passed around so everyone can learn.

You can never be too busy to have these team meetings. I know that all of you are very busy. We are here at Dental Practice Solutions to give you hope, be your guide and a resource to be the most successful!

When you begin to see the long term results you will realize it was time to make these changes. This positive change will create effective communication, greater patient satisfaction, less stress and more fun at the office.

If you are not currently holding morning huddles it may be uncomfortable in the beginning. I have never worked with an office that made this transition without some kicking and screaming because most people don’t like to change. Be patient when you begin implementing this process and within a month of regular meetings this will be as natural to you as your patients flossing their teeth each night.

We are here to guide you. We are experts in this process so please don’t hesitate to call us so we may guide you towards success. Please be sure to download our tools to help implement this important meeting.

Debbie Seidel-Bittke, RDH, BS and the team at Dental Practice Solutions

FROM THE FOUNDER

Last week I wrote about areas to conserve dollars in your dental practice. I know and understand very well how expenses in running a dental office can cause you stress and these numbers are very important to be measured as they contribute to your bottom line.

I also understand that you are each individuals with your own set of opportunities and challenges. Some of you have overhead that is sky high and others have overhead that is very low. No matter where you stand this is something very important and should be monitored monthly.
I want to give you a few more areas to watch and recommend numbers to guide you towards future success. The reason for closely watching and monitoring these numbers is to determine the success potential for your dental practice.
Case acceptance is what will help these numbers improve and take your annual net profits to their highest potential. This week I will write about fixed categories such the office lease. (Rent or mortgage) These are important areas of your financials which can—and must—be kept in line. Most of you can’t change the monthly dollar amount that you pay for your lease, (Rent or mortgage) but you may be able to decrease your total expenses thereby lowering the expense percentage for running your dental practice.
Last week I wrote about a list of specific categories of expenses as percentages for your fees charged. The most important categories to review are the following:

• Hygiene department salaries; and
• Auxiliary team members’ salaries;

This week we will review the following:

• Lab expenses;
• Rent, leases and/or mortgage;
• Supplies; and
• Additional expenses

LAB EXPENSES

The optimal expense for the lab category should be 15 percent of your monthly expenses. When lab charges are above the optimum you may need to take a serious and very hard look at the laboratory you are working with. Set aside time or assign someone in the office to research various labs for the best quality and pricing available. Lab charges also need to be reflected in your fees for services to your patients. To have the best results in your bottom line (Your net profits), dental fees should be about 4.5 to six times your lab costs.
RENT, LEASE OR MORTGAGE EXPENSES

The optimum expense for rent, a lease or your mortgage should be approximately 4 to 7 percent of monthly expenses. Rent, lease, or mortgage, is a fixed cost and if this is not at a figure between 4-7 percent, aside you may not be generating enough from your collections to account for the amount of space that you have for your office. If this is a concern it can be addressed in many ways. One way to generate more income in this situation is to utilize your office more efficiently. A few examples of how to do this is to review how you schedule your patient appointments. If you are only in the office four days a week, understand that you are paying rent, etc., for seven days a week. Is there a healthcare practitioner who would like to rent your office for one, two or three days per week? Some offices I have worked with also had other types of healthcare specialists who utilized the office space. Some examples of this are Acupuncturists, Chiropractors and Massage Therapists. I found symmetry between these types of healthcare specialists for example; the services you recommend for malocclusion, TMD, etc. I have also worked with practitioners who rented out the office to new grad dentists beginning their own orthodontic or pediatric practice. These are possibly professionals who only needed an office 1 or 2 days a week at this point in time. Also ask yourself this question: “Is my office large enough for my practice and another dentist to be treating patients at the same time?” Possibly you are able to have another dentist rent out a few chairs while you are also in the office treating patients.
DENTAL SUPPLIES

Another category that you need to analyze and constantly monitor is dental supplies. The optimal amount spent for these is 5 percent of your monthly expenses. Another way to analyze overhead in this category is to calculate the ratio of lab costs to dental supply costs. Your lab costs should be about three times those of your dental supplies. If supply costs are higher than this amount, take a closer look at how your supplies are being purchased. Consider using a supplier instead of ordering through catalogues. A local supplier will often give you a high level of service and keep you informed about sales. Never allow your supplier to go through your cabinets and place random orders. A team member needs to be in charge of ordering supplies and they need to only order what is necessary and when it is appropriate. I recommend that you have a budget set aside for your supplies. This is something you will put together about the time you have your annual strategic planning meeting. Make sure that this team member knows the office is controlling costs and operates on a set budget. Last but not least, keep all supplies in one place and implement a sound inventory control system.
OTHER EXPENSES

The above mentioned are the largest categories of a working budget. Other expenses you want to consider include office supplies (which should not exceed 3 percent of total charges); telephone (no more than 1 percent); legal and accounting fees (no more then 2 percent); additional business expenses, such as membership dues, subscriptions and licenses (a total of 3 percent); payroll taxes (2 percent); and marketing/advertising (to 1 percent).
It is important to be proactive with regard to the overhead expenses. This article represents ideal percentages for some of the biggest expense areas. You and the team need to take control now and closely monitor these areas. When these expenses are out of line you need to have a plan of action to respond. It is not always possible to maintain the same percentage of overall overhead expenses every month; however, the range should be from 50 percent (the ideal) to 65 percent of total charges.

Sometimes you may need to hire the help and guidance of a consultant who is an expert in handling overhead and expenses. You may want to also check with you accountant and verify what is best for your dental practice. The end result needs to be a winning one and one which creates a pleasant atmosphere for all!