A complimentary e-newsletter from Linda Miles for the professional dental community.
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Miles & Associates P.O. Box 6249 Virginia Beach, VA 23456 757.721.3332 757.721.2892 (Fax) 800.922.0866 Toll-free www.DentalManagementU.com
DYNAMIC DATA
DECEMBER 2001
Dear Doctors and Staff,
The month of December should be a time of relaxation and remembrance of fun when we were children. As busy adults, it is a time for year-end monitors, cards, gifts, and the hustle and bustle of getting ready for holiday gatherings. To add to the stress of holidays this year is the war in Afghanistan. As you read this message, look at the stressors in your life at the moment. Take inventory of them, and decide that you will not carry them into the New Year.
Our phones and e-mail lines have been exceptionally busy the past two months with requests for consulting and practice development. These requests have always been cyclic in the past, but are especially heavy with year-end numbers down for most practices. In talking with dentists who have made these calls and requests for assistance, they report that the month of September was great (it was already scheduled when 9-11 happened), but the bottom has fallen out the last two months of the year.
We have also been frequently asked to serve as a consultant to start up practices. So often recently that Pauline Grabowski, one of our new consultants, and I have designed a new practice consultation that will be tailored to the new dentist in four phases of assistance. >From the initial decision to open a practice, through the lease agreement, to the set-up of systems, interviewing and hiring of the initial staff, to the training and monitoring of the first months activities. This program is now available to dentists in all 50 states and will be part of the New Dentist Program being introduced at the Holiday Dental Conference in Charlotte, NC in Dec 2002. (More information to follow in Dynamic Data.)
The month of November has been extremely busy with the initial work being completed on the inception of our Dental Business Conferences being taken into ten states by mid 2002. If your state association would like to sponsor this sought after practice and team development program, please contact Lee Tarvin at our toll free number from 9-noon at 800-922-0866. Our congratulations to Kathy Metaxas for the success of her first DBC in Perth, Western Australia. Kathy is excited and has additional courses in motion for 2002 in other cities in Australia. Pauline Grabowski and I welcome you and your team to join us on March 22,23 in Virginia Beach for our second DBC. Our November course was a huge success with dentists and staff traveling from as far away as Michigan. Our thanks to our staff, Annie Seela and Lee Tarvin for their tireless effort in making the arrangements with the hotel and attendees. Our sincere thanks to our guest speakers who provided a wealth of information in the break-out sessions. Dr. Dick Wilson, my former employer from Richmond, VA, held court at a lunch and learn on the topic of “Staff, Your Greatest Asset”, Dr. Jeff Blackburn, also a very successful Richmond dentist, spoke on “Time Management”, Anastasia Turchetta, RDH from Edenton, NC spoke on “Assisted Hygiene”, Sheila Dalton and Courtney Wooten, dental assistants from Dr. Dick Wilson’s office spoke on “The Exceptional Dental Assistant”. Pauline and I held an optional no fee hour session from 4-5 on day one. Pauline’s course was on “Computer Utilization”, and my course was on “Leadership At All Levels”.
Dr. Jeff blackburn is a sought after speaker for dental groups across the country and is a member of our Speaker’s Bureau (see our website dentalmanagementU.com for complete details). Anastasia, the most positive hygienist in dentistry today, is also available to come into practices as a consultant to assist them in setting up the Assisted Hygiene Program for total success. Sheila and Courtney are the proud owners of a new consulting firm called “EDA” (Exceptional Dental Assistants). Their mission is to turn average and good dental assistants into exceptional assistants by teaching them the vital communication skills along with the advanced clinical skills the dental assistants of tomorrow must have.
It was an exciting past six weeks in our consulting division. We like to co-consult at least twice per year so I was honored to go on two assignments with our newest consultants in late November and early December. In late November the four of us, Susan Kulakowski, Janelle Kent, Pauline Grabowski and I were together in a lovely practice in Alabama. With the fine staff, good dentistry and improved systems, this will become our solo practice of the year for 2002. While Susan and Janelle were off to the Northwest, Pauline and I spent three days in Montana. In spite of wanting to get back to our families, Pauline and I fell in love with Montana and the wonderful people in that area. We were taken on a lunchtime trek to the foothills of Yellowstone National Park before our afternoon session the second day. By the end of our third day in-office, we knew this would become our best group practice in the 23 year history of our firm.
I was asked to write a monthly column for the Seattle King County newsletter each month. (I have been honored to be a speaker there annually for the past 14 years.) I thought the readers of Dynamic Data might like to have a review of this column as their “pearls” for the month. Please see the attached for those questions and answers.
And don’t forget to take some time for yourselves this busy holiday season. Schedule a one hour massage, reflexology for your tired feet, a half day of pampering at the local salons for women and men. And last but not least, take time to count your blessings, be with your loved ones, and pray for our peace in the coming New Year.
Seattle King County Question/Answer Attachment
Q 1- What do I say to a patient who will not schedule appointments that will go beyond their insurance maximum?
A 1- Remind patients that the employee benefit plan which their employer has chosen for them covers basic preventive and basic restorative care. Ninety-five percent of all adults need more than basic dentistry. You can also say, “Mrs. Winters, you are one of our fortunate patients. A portion of your needed treatment is covered by your benefit plan. How we wish all our patients were this lucky, as many of them must pay their entire fee themselves. ” The “kiss of death” phrase in a dental practice which causes patients to be co-dependent on their plan, is: “Mrs. Winters, I’ll have Judy call your insurance company to see what they’ll cover”. Implying that if it isn’t covered, the patient will not want to have the treatment is the very reason some practices have more trouble with insurance co-dependency than others.
Q 2- How do I know when my practice will support another hygienist?
A 2- First, know how many true active patients you have. You need one full-time hygienist for every 800-1000 active patients. (Depending on whether the practice sees patients 4, 4.5 or 5 days per week and also the mix of adults and children). The wave of the future is to have two chairs per hygienist and a designated assistant for those two hygiene chairs. The hygienist can see 14-15 patients per day in this model.
Q 3- What are your thoughts on confirming appointments? What is your thought on the patient who cancels their appointment when they are called to remind them of this appointment?
A 3- I’ve known for years that 1/3 of the patients are annoyed and frustrated with the confirmation call, 1/3 of the patients will not be there without it, and 1/3 of the patients use the call to say, “I was just getting ready to call and cancel that appointment”.
Rather than a reminder or confirmation call, I prefer to call it a courtesy call. The appointment cards should have at the bottom, “This time has been reserved just for you. Consider this card your confirmation”. In other words, the appointment is confirmed when the card is given. The courtesy caller should say, “hello Mrs. Winters. This is Beth from Doctor Brown’s office. This is your courtesy call to let you know, we’re looking forward to seeing you tomorrow at 10″.
Q 4- How do you feel about having a senior citizen discount if you already offer a cash courtesy discount?
A 4- Twenty years ago, cash allowances for prompt payment or senior courtesies were popular. In today’s dentistry, we don’t see as many allowances due to the fact you can not discriminate with bank card patients. if you offer a 5 % cash courtesy for collecting the fees up front, you must also allow this on credit card patients which increases the write offs up to 8%. The percentage paid to use the credit cards is a business expense that is not allowed to be passed on to the patients. Senior citizens are often demanding of their senior courtesy when in fact, many seniors are financially well off. Most dentists realize when you take 10% off the top, you take 30% off the net. In fact, I no longer recommend any courtesies unless the practice wants to adopt a needy family or two and donate their services. Courtesies can get completely out of hand and are in fact an apology for one’s fees. NOTE: never refer to allowances or courtesies as “discounts”. These are blue light specials at K-Mart that tarnish one’s professional image.
Q 5- How do you convince patients to come in the middle of the day or take their children out of school for appointments. How do you deal with everyone wanting the after 3 PM appointments?
A 5- Some practices that are a true “bedroom community” (people take public transportation into town and are only in their homes to sleep), give incentives for patients who can come between 10 AM and 3 PM. For every appointment made between 10 and 3, the patients’ names go into a fish bowl for an end of the month drawing for four $50 gift certificates. These can be for a local restaurant, movie tickets, floral shops, food and toy stores.
It is amazing that the same parents who claim they can’t take their children out of school for dental appointments now find a way to get them there when they learn of the mid day incentives. They now say, “Oh, I’m sure they can all come in mid day, my mother-in-law will bring them.
Q 6- How much detail should go into an office/financial policy sheet that is given to each new patient?
A 6- Firm yet friendly financial guidelines must be fully understood by the entire dental team before they can be introduced to new patients. Making the patients feel you are more interested in their care than their money should come across, yet the practice must be run like a successful business which requires certain policies.
Using positive words for positive results is the key to successful collections. Patients should be given a list of the financial options available. IE: “Mrs. Wagner, for your convenience we also offer Visa, Master Card and Discover, in addition to our normal cash or check services”.
“We are also happy to let our patients know we have a financial partner called _________________ , for those patients who wish to have interest free, longer-term financial assistance”.
Q 7-How can an office without a hygienist (due to the shortage) maintain a strong continuing care program while also doing the restorative, meet production goals and stay on time?
A 7- The hygiene department is the “backbone” of the practice. Finding a hygienist is not impossible even in remote areas. If however, all resources have been tapped, and there is still no hygienist, there is no way the dentist can continue to do the restorative, meet production goals and stay on time. I have consulted two practices in 23 years that have in fact, a successful practice without a practicing hygienist. These dentists have become proficient in delegating everything in their state dental practice act that dental assistants can do. They delegate most of the patient education to the qualified assistants. This helps in rare occasions when a practice is between hygienists. I would not recommend this pace to all practitioners.
Q 8- How do you approach a patient (who has a crown or bridge to do so it can be spaced out , and who can’t pay their portion of treatment) about a finance program when they say they aren’t interested, (don’t use credit cards, etc. or you know they may not qualify)?
A 8- I use the friendly, “we’re here to help you Mrs. Weaver” routine. “In fact, at our practice we believe in doing the dentistry right, not over. You’ve had a lot of break and fix dentistry in the past. If we can find a way to deliver total quality care, and make it affordable to you, do you mind if we introduce you to this type of care?” Patients will then find a way to pay for good dentistry just the way they find the way to pay for anything else they want.
If there’s a fear of them not qualifying, I would be very hesitant to do a major treatment plan without strict, yet friendly fee arrangements. Most people have a source of money in time of need. It is our job as dental professionals to make the patients want what they need by outlining the benefits of the care. It is also the job of the care-givers to be upbeat and not too dogmatic about the fees which is a turn off to all levels of socio-economic patients. Linda Miles, CEO LLMiles and Associates P.O. Box 6249 Virginia Beach, VA 23456 800.922.0866
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Miles & Associates’ corporate headquarters may be reached at 800.922.0866. Fax us at 757.721.2892. On the web at www.DentalManagementU.com, or via email at lindamiles@cox.net.
Miles & Associates – DEC 2001
Miles & Associates Linda L Miles & Associates P.O. Box 6249 Virginia Beach, VA 23456-0249 Phone: 757.721.3332 FAX: 757.721.2892 800.922.0866 Toll-free