DYNAMIC DATA, Spring 2006

Dear Doctors and Staff,

It has been a whirlwind first quarter for most practices. Many of the ones that we monitor monthly have had their best quarter in the history of their practice. One such practice was an office I started consulting in 1982 when their solo practice had a goal of $32,000 per month. That same four-doctor practice just had a seven figure first quarter…Now that’s progress!! Their hygiene department did over $300,000 of that figure. What’s their secret? In addition to loving dentistry, these four dentists are great leaders with a knack for attracting patients who want the level of care that their practice provides. They also follow the 12 Necessities of a Successful Practice. That was my topic during my one-hour interview with Care Credit in December. If you have not already received your complimentary copy of this CD, please call Care Credit in CA and request it. If your practice is enrolled with Care Credit patient financing call 800-859-9975. If you would like to know more about how Care Credit can propel your practice by getting you out of the lending institution business, call 800-300-3046 Ext. 4519.

I can’t believe how many dentists still believe they can save or make money by extending credit in-office. The cost of financing in-office is not only twice as expensive as the fees by an out of office patient finance company, the practice often must hire another employee to devote time to mailing hundreds of statements and making dozens of collection calls each month. BUT….the real expense is the number of broken appointments in practices that extend in-office credit. Their number is normally two to three times higher than practices that use an outside patient finance company. Omer Reed said in 1978, in Williamsburg, VA, “people who owe you money don’t like you”. Over the years I have added a couple of other parts to that true statement, “people who owe you money do not refer to you”, and “people who owe you money break appointments”. So the hidden costs of practices financing the dentistry are HUGE! One dentist recently was proud of the fact that his office actually made over $24,000 in interest charged to patients last year. Taking into consideration the additional staff to do tons of statements in this 5 doctor mid-western practice, the cost of postage, making collection calls and the higher broken appointment ratio, the practice is losing money…not to mention the adversarial relationships that are created when a collection call has to be made for slower paying accounts. GET SMART…allow your team to spend their A/R management time doing more productive duties such as marketing, reactivation of inactive recalls, and more direct customer service versus behind the scenes busy work that ends up costing much more than patient financing such as Care Credit.
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What are some of the issues we have dealt with this past quarter? These concerns have come from non-client calls as well as practices we have worked with for years.

ACCOUNTABILITY-Some staff members dislike defined duties on a daily basis, as hiding inadequacies is much easier when “everyone does everything”. Dentists need to know just who to go to when the schedule is less than ideal, or when a case is not back from the lab yet the patient is here for a crown seating. They need to know that each patient’s visit flows from person A to person B and that all steps of communication are handled superbly, not one way with this patient and another way with the next. Without a “system” for passing each patient through the various phases of the patient visit, mistakes are made, breakdowns in communication occur, which negatively impacts productivity. It is not easy to follow a set protocol, but practicing dentistry is like acting in a play. Without a pre-determined line, a cue from another person, a timed schedule for completion, an ending in mind, the show does not go on as planned. In a successful practice, each person involved realizes it is SHOW TIME at all times and it takes team effort to have the day go without too many glitches. Leaving off procedures in charting, hoping someone else will enter it for them, depending on someone else to do the instruments because they did them a few times before, or not calling to fill an opening in the schedule within five minutes of that opening shows a lack of accountability.

MORALE PROBLEMS-When the practice is very busy there is normally less time for those working in the practice to whine, moan, groan, gossip, and point fingers at co-workers for not doing their job. After an all-time high (like the first quarter of 2006), when the month of April started, a few more complaints surfaced in emails and phone calls from not only staff but dentists as well. A feeling of not being appreciated, or the boss resenting the bonuses paid the past three months and threatening to change the rules as the bonuses paid were too much. Some had been too busy to hold regular staff meetings and planning sessions. We all know, “when the communication dies, motivation dies. When motivation dies, morale drops and so does the production”. It is VERY important to hold regular staff meetings and especially important during the busiest months.

ABSENTEEISM-With the late winter and early spring, many practices have experienced a high rate of illness in the ranks of their staff and staff families. Even some dentists who are never ill did not avoid the flu viruses of the past few months. When an employee is out, it truly creates a burden for the coworkers and the dentist. Some dental practices have sick allowance but most prefer to have a WELL BONUS that rewards staff for being well. Each employee has four personal days per year (one per quarter). They may use these days for extra vacation, a long weekend, and illness or children activities at school. If they use one in the quarter they are paid. If they use two days in one quarter they are paid for one and not paid for the second day off. At the end of the employees’ anniversary month, their unused days are bought back at their daily rate. If the employee has perfect attendance and turns in all four personal days they are awarded an additional $200 bonus. While any “system” can be manipulated and there is no perfect system, this one has worked very well for many practices over the 28 years I have recommended it to client practices. There is also a question of fairness with the monthly BONUS if a staff member is absent. Because it is a hardship on the rest of the team, I feel it is only fair to keep 25% of that person’s monthly bonus for each day the employee is absent. Those funds are then divided at the end of each month with those who had perfect attendance. Paying people to be “on the job” is much better than paying people to be ill. If the sick pay does not carry over, and it usually doesn’t, you don’t have employees taking it versus losing it during the last quarter of the year.

ATTITUDE OF GRATITUDE-When is the last time the dentist in your practice left the office feeling totally appreciated by the entire staff? I hear of late how many team members focus on what is wrong with their jobs versus what is right. Staff members complain that we got “this” but we also want “that”. When is enough really enough? Don’t look for the employer to be the only one showing appreciation. How long has it been since the team did something very special for the dentists to say “thank you”? And we are grateful for A) B) C) and D). I encourage my client practices to make a list of what is right and what is good about the job they have and what they might miss if they were forced to go elsewhere to work. Sugar attracts more flies than salt. Start a campaign to REALLY show appreciation for the facility you work in, the technology your dentist has invested in to make your job easier, the CE opportunities provided to you, the lunches out, the generous benefit package that your practice provides and your nice boss in general. Dentists have a tough job taking care of patients, running a business they were not trained to run and being personnel director to a group of employees who never seem completely happy. Change your work environment and watch how much more you enjoy going to work each day. Focus on what’s right and quit picking and whining about what may not be 100%. PS: There is no perfect job!

Dentists, do the same exercise for each member of your team. What personal and professional qualities do they bring to your practice that you would have a difficult time finding in another in their same department (hygiene, administrative and clinical assisting)? Do you as the business owner focus on what’s right at staff meetings? Do you hire, train, trust then praise your team on a daily basis? Do you allow them to grow and prosper with you as the practice grows? Do you get more excited than they do when goals are reached and you GET TO generate those bonus checks? Or are the bonus checks delayed with an excuse each month, which leads the team to believe you really don’t want to share the practice growth with the staff? An attitude of gratitude is very necessary in order to keep the office a fun, exciting and rewarding place to work. And it goes both ways!
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Recently, I had the pleasure of hearing a presentation given by Nancy Hammel and Dr. Michael Silverman of DOCS (Dental Organization for Conscious Sedation) regarding the benefits of Oral Sedation Dentistry. Nancy is the Director for Team Education and Dr. Silverman is the Founder and President of DOCS.

Both Nancy and Michael spoke eloquently about the huge demand for safe, comfortable, and effective methods of providing dental care, pointing out that a significant portion of the population do not go to the dentist on a regular basis because of their fear and anxiety. They offered a very compelling argument that oral sedation dentistry will continue to increase in demand and as is fast becoming a necessary tool for every successful practice in America.

I found their program to be not only educational, but also lively and fun. Dentists and Team Members will learn the necessary skills to return to their practices and begin implementation immediately. I am now thoroughly convinced that Oral Sedation Dentistry can be a huge benefit for fearful patients as well as a great service that will in turn enhance practice success by impacting profitability for those dentists who are willing to invest in the training and necessary equipment.

I strongly recommend that dentists as well as team members attend. Below is a listing of their upcoming seminars.

May 19-21 - Chicago
June 22-24 - Seattle
July 28-30 - Boston
Sept 28-30 - Kansas City
Nov 9-11 - Las Vegas
Nov 30-Dec 2 - Atlanta

For more information call 877-325-DOCS or visit www.sedationdocs.com

NEED MONEY?

If you are a new dentist or an established dentist in need of practice financing for expansion or start up, please review the following:

Capital4HealthCare consistently provides prudent practice advice for purchasing and expanding dentists as well as sophisticated practice finance solutions carefully crafted to enhance purchasing power and for practice growth. Our clients are recent graduates, associates and established practitioners who are acquiring first practices or expanding their practices by acquisition or organically. Our team includes five dentists, we represent clients nationwide and we offer a variety of conventional, SBA, specialty, investment banking and institutional investment resources in order to achieve the best practice financing result for our clients as to interest rate, term and loan amount. We invite dentists to visit our website at www.capital4healthcare.com; we may be contacted toll-free at 800-324-8808, by e-mail at information@capital4healthcare.com.

A word on overstaffing from:

THE EFFECTIVE EXECUTIVE IN ACTION By: Peter Drucker and Joseph Maciariello

There is a fairly reliable symptom of overstaffing. If the senior people in the group…spend more than a fraction of their time, maybe one tenth, on “problems of human relations”, on feuds and friction, on jurisdictional disputes and questions of co-operation, then the work force is almost certainly too large. People get into each other’s way. People have become an impediment to performance, rather than the means thereto. In a lean organization people have room to move without colliding with one another and can do their work without having to explain it all the time. (Page 24)
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In our local newspaper this morning…worth passing along. (Hope none of these are on your team)

AMERICA----THE SELF-INDULGENT

“The government owes me a comfortable life and retirement.”
“My employer owes me higher wages and improved benefits every year.”
“The boss at our company is ridiculously overpaid and works half as hard as I do.”
“Do unto others before they do it unto you.”
“Sports heroes are GODS”
“I’m close to my children...we play video games all the time.”
“Personal accountability is an old-fashioned idea”
“God? Get real. Total non-factor in contemporary society”
“My “say anything, do anything, come as I am, in your face” attitude is my birthright.
“There are a few problems in this country. I’m just wondering when THEY will fix them?”
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GOOD NEWS FOR ASSOCIATIONS LOOKING FOR PRACTICE MANAGEMENT

 COURSES THAT NOT ONLY GIVE “THE TASTE” BUT ALSO “THE RECIPE”

For the past 19 years, I have given my flagship two-day total practice management course, the LLM&A Dental Business Conferences four times during each year. This course gets rave reviews and tons of feedback from enthusiastic team members and dentists with proud reports of their improvements the first 90 days, 6 months and after a year. As soon as a new employee is hired, their dentist or Practice Administrator calls or emails asking, “When’s Linda’s next Dental Business Conference?” It has become a must for new employees to get up to speed with advanced co-workers in the savviest practices in North America and has been lauded as “the shot of Vitamin B-12 needed when dentists or team members feel a little less than excited about their day to day duties.

The DBC is recommended for the entire dental team for as we all know, management of today’s dental practice is a TOTALTEAM EFFORT. Everyone needs effective verbal skills when greeting patients over the telephone, and when scheduling or discouraging those broken appointments the practice does not need or deserve. Dental team chairside communication sets the stage for case acceptance, scheduling is done by more than the scheduling coordinator, and hopefully no one in the practice (including the dentist) is timid when it comes to answering simple fee questions from patients?….Passing the buck means: A) fees are not really important in this office, or B) I think the fees are too high and I’d rather someone else answer that! While only the Financial Coordinator should discuss HOW patients will pay, having positive feedback to simple fee questions eliminates patients saying NO to needed treatment. Patients will find a way to pay for ideal dentistry just as they find a way to eat out 6 times per week and buy whatever else they want. Learn how to make patients become non-co-dependant on their insurance plans. The DBC also covers hygiene department improvements to become the most profitable passive income center in the practice and Marketing is our closing segment.

If your dental study club or state association would like to sponsor LLM personally to come to your area to present the two day DBC, members can save 20% per registrant and save money on hotel and airfares for your member dentists and their teams. Call Lee Tarvin at 800-922-0866 to secure one of my late 2006 or 2007 dates (8 available openings through 2007). We provide a sample marketing brochure for you to duplicate and mail, printed and shipped workbooks, DISC profiles for all, and a checklist for ease in sponsorship. Your association provides the meeting space, AV equipment, breakfast and lunch both days and 60-100 attendees.
 

Testimonial from a recent attendee of our San Diego 2-day Dental Business Conference:

Just wanted to drop you this quick note to update you on our weekly meetings that we implemented on February 1st, as per your model.

We have been doing this for almost 3 months now and so far, we produced/collected 10% MORE in February and 11% MORE in March. We closely monitor our practice by the numbers and can clearly track the increase. I must say that SOMETHING IS CERTAINLY WORKING. Plus, our entire team is more 'refreshed' and cheerfully productive. The overall team communication is stronger than ever and thus, less stressful at the end of the day - everyday. What you preach about being "happy tired" rather than "stressed tired" is definitely the case here.

Our concern with implementing this was that we would be taking a chunk of time out of our workweek for these meetings and consequently, less production. In fact, our team was very worried about how this would affect their goals and bonuses. Well, I am happy to report that in February, they made their regular bonus and in March (which is typically a slow month for us) they made SUPER bonus. Needless to say, there's nothing but smiles, motivation, and positive attitudes around here. All this is solely due to YOU and what you teach us to do. We're working less and making more $$$. Life is good. 

Dr. Grayson & Cynthia Sellers, Port Isabel & Los Fresnos Dental Centers, TX
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Check out this site…I was amazed with how easy it is to get coverage for patients in the cross coding arena:

IPS- Integrated Practice Solutions, is a medical technology company that provides third party billing services to medical/dental practices using a proprietary computer program with a user-friendly interface. One of the company's primary products, Medallyon, is unique in merging dental treatment with medical insurance reimbursement. The company's services incorporate innovative technologies with an experienced management team and customer service focused on improving dental patients' acceptance of planned treatment along with client profitability.
www.ipsdental.com

ALL YOU NEED TO KNOW ABOUT DENTAL INSURANCE

Speaking of coding for insurances. If you do not have a copy of Dr. Charles Blair’s new coding book, CD-2005 Coding, get one at www.DrCharlesBlair.com. It will become your insurance go-to book. And to stay current with all the many changes in the insurance utilization arena, narratives etc., I hope that you and your team have access to INSURANCE SOLUTIONS NEWSLETTERS by Vicki Anderson of WA. www.insurancesolutionsnewsletter.com. Dental Insurance is changing!


Are you and your team?

Have a great spring and hopefully you have planned some time off this summer for family vacations. Children have a tendency to grow up VERY fast. My granddaughters are now 15 and almost 12. It seems like my two children, LaDona and David should be that age…Take time off this summer to enjoy and celebrate time off with your family. You work hard. You deserve it!

As we go to press, I am gearing up for a Private Practice Team Retreat (PPTR), with a private practice from Texas in Scottsdale next weekend. I have just had a wonderful team retreat in St. Johns, Virgin Islands with another client practice from TN last month. In September, I go to Hawaii with a large group from NC for their Retreat. If you and your team wish to be one of my 8 Private Practice Retreats for 2007, please call Lee at 800-922-0866. My consultants and I love doing private retreats for a re-awakening of the practice values, focusing as a team on the five-year doctor’s vision, and having an outside objective non-biased person assess the total health of the practice as it is…and discover how it can be when everyone pulls together.

Best personal wishes,
Linda Miles, CSP, CMC
lindamiles@cox.net
www.DentalManagementU.com
www.SpeakingConsultingNetwork.com
1-800-922-0866
lindamiles@cox.net