How are your duplicatable systems in your dental office?
In dental practice, time is money!!!
I am astounded as I travel around visiting dental offices at the number of dentists that happily sit there in a treatment room with a patient watching a dental assistant get products out of drawers and cupboards.
To me this makes no sense whatsoever!!
Let’s look at it logically.
We know patient Mrs Smith is having two fillings done today. We know which teeth, and which materials will be used.
We know which materials Dr Jones uses, and we know what other pieces of equipment Dr Jones uses in preparing teeth, and in placing and polishing the filling.
So knock me down with a feather!! Why shouldn’t Mrs Smith expect that Dr Jones’s dental assistant should have all the ingredients out and ready in advance for her appointment?
Time and time again this is where I see the meter running while Dr Jones and Mrs Smith wait [patiently, I presume] while the dental assistant assembles and gathers things from drawers right there in front of them.
Aside from the cost of wasted time to the dental practice billings, it makes no sense at all for Mrs Smith to be sitting in that dental chair with her mouth open or not, for one second or minute any longer than she has to. It’s sending a message of inefficiency right there to Mrs Smith!!
Recently I’ve been visiting with one office where systems are poor, at best!
Here’s one glaringly bad example: When the doctor needs a bur to prepare a cavity, he has on his bracket a stand of say 6-8 burs, that may or may not match up with a stand that he used on the previous patient. Here lies frustration Number 1.
When the doctor needs a bur not on the stand, he has to ask the DA for that bur. She then opens a drawer. In that drawer are a multitude of burs, hundreds in fact, in stands and in packets, blunt as well as new. Some are even in sealed steri bags of assortment…. definitely no system!
The process of obtaining one bur can take anywhere from 30 to 60 seconds per bur, at best! Imagine how much time adds up every time a bur needs to be changed? Add that time up for one filling. Now multiply that number by fillings per appointment, and then again, by appointments per day? The number of minutes wasted is staggering!!
This is an absolute true time waster!!
It would be simpler if the practice set up a series of say eight identical pairs of bur stands, one high speed one slow speed with every bur necessary for a filling appointment. The doc would have these two stands on his bracket beside his drills. Then, as he is drilling, he can be thinking in advance, that he needs to change his drill bit. He doesn’t have to then stop, articulate, wait for, correct if needed, and receive with grace, the next drill needed.
This simple change in protocol would mean consistency, from patient to patient.
Also, having the stands on the bracket saves time as the doc can pick up a bur much, much quicker than he can ask for one, in most cases…
I’ve found one of the best ways to build efficiency is to have the simple procedures and appointments documented with what you want to do, and to happen, and what things you need, exactly, to help you achieve this outcome. This document, for each procedure, becomes as it evolves, the practice operation and procedure manual.
Without systems, written down systems, guidelines and procedures, each appointment becomes its own individual event. This wastes time.
And time, sadly, is money….
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Sometimes there are simple things that you can use in your dental office that come from thinking as I say, from “outside the box”. Using ideas and things not related to dentistry, in and during the practice of dentistry, to create more MAGICAL MOMENTS for your cleints, customers and patients….
Here’s one we started using in my office which has been very successful, and has been taken up like WILDFIRE by my consulting clients and shown immediate results in their offices.
The Humble Post It Note…
As dentists, sometimes we can become very, dare I say it, anal. We get so tied up in procedural detail, engrossed in the minuti of the PROCESS of the procedure that we are doing that we can sometimes forget the WHO that we are doing it to…. Has this ever happened to you? Yes? No? Believe you me this can be very, very, common…
You know, Dale Carnegie wrote: “Remember that a man’s name is to him the sweetest and most important sound in the English language.”
But sometimes you sit there, over a patient…and wonder if their name is Dianne or Dianna? Or Joanne or Joanna? I don’t know whether this has ever happened to you, but sometimes a dentist can forget the patient’s name completely……right there while they’re working on them!!
You see, the treatment rooms are often set up very poorly, when it comes to visual name prompts. In other industries, like phone calling and tele-marketing, and even at conferences, the names of the people that are being dealt with are worn, as a badge, or written, on a screen, to be easily seen and repeated, as needed.
But in the treatment room, often the patients name can’t be seen, it’s in small writing…on a computer screen, on a small chart, sometimes way away, sometimes behind your back!!
So here’s what we did in my office. …
Before bringing the patient down to the treatment room, we have our dental chairside assistant write the patients name in big letters on a post it note…..and stick the note onto the edge of a bench in the operatory.
Once the patient is seated in the chair, and the chair starts reclining, the dentist takes the post it note from the bench and adheres it to the corner of the patients bib [must be a double sized bib….more on the reason for using these in a future blog]……
So now the patient’s name is right there in front of you, beside their mouth and face, every time you need it…
And best of all, the patient doesn’t even know that it’s there!!
Now, we also have the dental assistant write on that note the patient’s next appointment date, and purpose.
What this does is save a heck of a lot of time at the end of each appointment… as the chair comes up, the doctor slips off the post it note, and farewells the patient with a very courteous and unprompted “Mrs Smith, I’ll see you on the 23rd of August for your next hygiene visit…etc”
You can’t believe how impressed the patients are with your attention to detail, and they DO notice that you haven’t had to start clicking away at the computer screen for this information…. the way every OTHER dentist does it.
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Over the past three Fridays I have been discussing my later in life realisation on how easily and simply you can divide up and appropriate the dental office’s income or billings.
This simple division helps your office to run and grow in a sustainable manner without getting too top heavy in one section of expenses or drawings.
I discussed firstly that the principal dentist, like the assistant dentist, should draw a personal 40% dental draw for his efforts.
I also discussed how there is a 20% amount for the practice owners to reinvest in the business or draw down in part or full, as a dividend, as they see fit.
This leaves a round figure of 40% of the practice income for the payment of the day-to-day dental office expenses.
This 40% in practices can be simply divided in half. The first half, or 20% of the total dental office income, should be invested in staff salaries, benefits, and bonuses. One in every five dollars coming into the dental office needs to be remunerated to the team, and they need to know this. That’s twenty cents in every dollar of practice income!
As the turnover of the office increases, then the office can either pay bonuses or increased wages to the team as reward for effort contributed in building the dental practice. Or, as the workload increases with the increased patients and billings received, then additional staff members can be employed, and funded from this ratio.
I like to think that hygienist salaries or their base salaries can be appropriated out of this 20%.
The other half, or the last 20% left of the dental office billings goes toward paying all of the other office incidentals, which incidentally aren’t that many in number.
Rent, utilities, insurances, and stock and materials. Marketing and advertising too. Laboratory expenses are already allocated in the dental draw of the dentists, traditionally. So too would be dental education of the doctors. However, team education would come out of the staff 20%…
If you look at these ratios, they make simple sense in running and maintaining a very well balanced business with happy employees and owners. If you find that there is unhappiness, in any level, then take a look at the balances and proportions…you’ll find that one of the percentages is usually, or unusually skewwhiff. Get the ratios back on track, and watch your business and your enjoyment of dentistry soar.
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Today I’m looking forward to sharing with you another MAGICAL MOMENT that you can incorporate into your dental office immediately that will set your dental office aside as being dramatically different from all other dental offices in your area.
It’s a MAGICAL MOMENT that you and your team can implement straight away to have your dental patients saying, “Wow, this dental office is different!!” Your patients and clients will immediately perceive your office as being *THE* go-to Dental Practice in your area.
These ideas and concepts that I call MAGICAL MOMENTS are some of the best pearls that I have implemented during my dental career to impacted significantly and separate my office from “other” dentists.
CHANGE NUMBER THREE.
The large majority of dental offices that I know operate their client lounges, or waiting rooms, under what I call “The Paddle Boat Principle”….. when it’s your turn to be treated you’re called out for from the front!!
When you think about it, this is really a pretty ordinary way to greet your valued paying customers, don’t you agree? Rather like a cattle muster…very, very, very impersonal, when you look at it objectively? But, you say, well everyone else is doing it, so why not be just like them? Why not indeed!!
Imagine your patients’ and clients’ reactions when they are greeted differently…here’s how we do it…and it is so simple to implement…
Start by drawing out a rudimentary map or diagram of your client lounge or waiting room [please don’t call it a “waiting” room any more!!]. Agree with your team members on a numbering or identifying system for each and every seat in your client lounge. Now if your lounge is filled with benches then you’re in big trouble…you really need to replace them with comfortable chairs…it’s a lounge not a bus stop!!
So when your valued clients or patients arrive for their appointments, here is what should happen. Firstly, they’re greeted by your team by name, as we spoke about last week…. http://bit.ly/11Iw1iv , and asked to make themselves comfortable, while being graciously motioned toward the comfortable seating. As they find a seat, your practice concierge makes a mental note of the distinguishing attire being worn by the patient, as well which specific seat they have chosen, and possibly, the reading material they have chosen from your coffee table.
This information is then conveyed to the dental assistants and back of office team members who will be looking after this specific patient. So, when its time for the dental chair-side assistant to escort the patient to the treatment room, the assistant can confidently walk directly straight up to the patient in the lounge, greet the patient by their name, exchange pleasantries, and then personalise their transfer…..
Imagine your patient’s disbelief and amazement when they are greeted personally with:
“Good afternoon Mrs. Smith. How are you? I’m Kaire and I’ll be assisting Dr Moffet today. How has your day been?”
And then, she listens, really listens…
And then, and only then, she lets Mrs. Smith know, “would you like to come with me now?” and she asks Mrs. Smith, if she can be of assistance with any of Mrs. Smith’s bags or belongings…
This method is certainly much nicer and much more personable than the traditional holler from the far side of the room. And your valued patients and clients *WILL* notice the difference…
Do this, and see the results, instantly!! You’ll be the only dentist in town treating your patients so professionally and courteously.
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Nobody likes to be ignored. Tell us your worst stories about being ignored as a customer. Leave your comments below.
Over the past two Fridays I have discussed at length the late in life discoveries that I made regarding dividing up the Dental Office income, in an appropriate manner.
This division was and is diametrically the antithesis of the way I had been practicing private practice dentistry.
Last week, I spoke specifically about paying yourself in the manner that you would pay an employee dentist, on the same commission rate that employee dentists get paid…Pay yourself 40% of your own personal production firstly!! Again, this principle is not the way that I had learned to practice dentistry.
Today I’d like to deal with the division of the remaining 60% of income generated by the practice.
In 2007, when Dental Corporation acquired my dental practice, they did so under the following principle, or agreement. As a Principal Dentist, I was obligated to stay on as a dentist in my own practice for a further five-year term. During those five years, for each and every one of those five years, I was to repay Dental Corporation 20% of my gross annual fees, as profit, or EBIT. This was a specific dollar amount. Not a percentage as such, but still designed from a percentage.
Now, the naysayers will point out that Dental Corporation paid their Principal Dentists a multiple of EBIT to purchase that practice. That multiple was between 4x and 4.5x EBIT.
The naysayers then point out that if Dental Corporation had not bought my practice, I would have earned the sale price anyway as profit. Over that 5 years anyway…. [this is a whole OTHER thread to discuss at a later date!!!]
What this target pointed out to me was that in the daily, weekly monthly, annual figures for a thriving Dental Office, after paying the labour of the dentist, and then paying the overheads of the practice, there should still be 20% left over as PROFIT for the Office Owners, the Business owners!!!
Light bulb moment!! No more paying the bills and keeping what is left, if any, after looking at bottom lines only!!
This simple division of numbers now provided clear delineation in where the practice income should go!!
Specifically today, that twenty percent for the Practice Owners can be divided up as needed…some for capital expenses, like new equipment, renovations, etc..money to reinvest INTO the business. As well as leaving money over as a dividend for business ownership. Now this is important!!
It is imperative as an investor, an investor in YOUR BUSINESS, that you draw a dividend appropriate to the market for the capital you have tied up in your business.
Just simply, if you have $800,000.00 invested in your dental office [be that start up costs, purchase price, etc. of the business] then make sure you are drawing a dividend for that capital, otherwise you may as well sell the dental office and invest the $800K in bonds or fixed interest…am I making myself clear?
[Similarly too, if you own your own premises, your Dental Office should be physically paying you an acceptable market rent. More on that next week].
It is absolutely imperative that this profit from the business capital, as business owners, be physically drawn…
If you are not segmenting this twenty percent, and allocating, then you are surely on your way to financial desolation, as opposed to heading toward your own Independence Day…
Omer Reed told me in May 2012, that in the USA, 95% of dentists at age 65 have insufficient resources to retire well…that is only 5% have attained true independence at age 65..95% have to keep working because they have to, not because they want to.
Follow my principles, and you will be well on the way to making it into the 5%!!
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