The Dentist's Network #56 Marketing, New Associate and Disability Claims


	Dental Marketing Associate Integration Disability Claims

Joel Harris, President
ADA Intelligent Dental
Marketing, Inc.
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The Eight Principles Of Successful Dental Marketing

Sometimes in business it’s important to get back to the basics and dental marketing is no exception. Dental marketing is actually fairly simple but it’s easy to get lost in the endless advice and philosophies that circulate throughout the dental industry. I’d like to help you cut through the mess and look at dental marketing in its most basic elements.

Before you spend any time or a dime of your money on a marketing plan, it is critical that you understand a few marketing principles that are timeless and proven not only in dentistry but in every industry that provides a service or product to consumers. This article is written specifically for dentists and dental professionals, but it contains sound advice for any small business owner.

These eight points aren’t optional, or just my opinion from personal experience. If you aren’t ready to follow these principles or if you are skeptical about their importance, I don’t believe you are ready for marketing. From my experience, dentists who don’t follow these principles rarely have positive marketing results. When analyzing any failed dental marketing plan at least a few of these principles have been overlooked, ignored or even intentionally left out.

COMMITMENT: An average marketing plan executed by individuals who are truly committed to the plan will always be more effective than a brilliant marketing plan that lacks dedication and focus. When I say “commitment” I mean that you pledge to make marketing a top priority by following the remaining seven principles.
INVESTMENT: Marketing is not an expense. Marketing is an investment. It’s as important as your lab bill, new equipment, payroll and your student loan payment. Never cut your marketing budget, especially if you’re doing it to reduce expenses. The only time you should reduce your marketing budget is when your new patient flow exceeds your capacity. Even when this happens, never completely stop spending something on marketing every month.
MOMENTUM: Develop a good plan and assign someone to execute and measure it as often as every day. Skipping weeks or months at a time will you cost you more in the long run as you expend extra energy and money re-creating momentum. It’s OK to fine tune the plan as you go and experiment with different variables, but never stop. Stopping just means you’ll have to re-start, which is always more difficult. Some dentists lose important momentum because they have to be re-sold every few months on the truth of principle #2.
PATIENCE: Marketing is not a quick fix. If you need immediate results you’re setting yourself up for a negative experience. If you do not exercise patience, it will be difficult to practice many of the other marketing principles. Measure results and monitor your efforts and be willing to make a final assessment after your plan has completely run its course. Patience is a marketing virtue.
DIVERSITY: Individual marketing tactics rarely work. Using a variety of integrated marketing tactics is always more profitable and effective. The credibility of a great name and logo, combined with an attention-getting direct mail piece that promotes a content-rich website is an example of this principle at work. Make your marketing a complete experience for the consumer from the first touch to the last.
FREQUENCY: It is a proven marketing law that a group of consumers who receive a marketing piece twice respond more. That means that your cost per response goes down as frequency goes up. This law of frequency needs to be measured to determine the limits of the return on investment, but in simple terms the law is absolutely valid. Don’t make the mistake of changing the target after one attempt or your marketing will always be more expensive.
ANALYSIS: You cannot manage what you do not measure. It is an old management adage that is a very important rule of dental marketing. Unless you accurately and consistently measure your marketing results you’ll never know what to improve or change. Imagine being able to predict with complete certainty the results of your marketing investment. It’s actually very realistic and not a huge mystery if you analyze and measure every effort made.
CONVERSION: You can do everything perfectly but if your receptionist isn’t trained and effective at converting marketing calls into scheduled appointments your plan will fail. Don’t assume that you don’t have this problem. Most dentists would be shocked and frustrated if they were able to hear the way people are handled when they call the office. Your receptionist is your marketing front line. Make sure you hire, train and compensate this person accordingly.

Joel Harris is CEO and Co-Founder of Intelligent Dental Marketing, one of the nation's leading dental marketing companies focused exclusively on dental practices. Intelligent Dental Marketing provides powerful marketing tools to help dentists grow their patient base increase their profit and improve their image. Joel can be reached directly at 877.942.8855.

Interested in speaking to Joel about your marketing concerns? Email him at joel@thedentistsnetwork.net.

Interested in having Joel speak to your dental society or study club? Click here.

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Thomas L. Snyder, DMD, MBA
Managing Partner
The Snyder Group, LLC
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Integrating Your First Associate-Part I

When you hire your associate there is a lot of work that needs to be done. We’ll present solid suggestions in this two-part series to ensure that your relationship will be profitable and successful.

Determine the number of patients to be assigned to your associate. As we’ve mentioned in previous articles, saturated practices usually have an active patient base of 1,500 to 1,700 patients. To determine which patients to assign to your associate, you should designate those patients you want to retain. The remaining balances of patients are those to be assigned to the associate. Many of these patients most probably are patients who have to be reactivated first.
Reactivation Hygiene. Saturated practices usually have retention problems, meaning many patients are past due for their hygiene appointments and that means adding hygiene days to your practice. But before hiring a new hygienist to meet this backlog, have your new associate conduct the reactivation hygiene appointments. This is a smart economic decision, too, because reactivation efforts are never guaranteed to be 100% successful. Before you hire another staff member along with your new associate, we suggest that the associate be the first provider patients see when they return to the practice. This is an excellent way to meet the patient because the recare appointment is a non-threatening visit in most instances, and thus gives the new doctor a comfortable way to be introduced. Obviously, if dental treatment is needed, it can be scheduled with the associate. When the patient is scheduled for the next recare appointment, it should be with a hygienist. If you follow this approach, you’ll have a more precise way of determining the additional hygienists that you need to meet the new demand, upon a successful reactivation campaign.

Facility Utilization. If you only have four operatories and two hygienists, chances are you will need to do some creative scheduling to allow the practice to be utilized fully. If you are planning to reduce your clinical schedule, that will help. Creating two doctor schedules for the majority of the week, for example, early morning to afternoon and mid-day to early evening, may be the most appropriate way to get maximum use of your facility as well as optimize production.
Staffing Requirements. Most likely, if you are a solo practitioner, you’ll need to hire a new dental assistant, particularly if your associate is full time. We strongly recommend that after you hire your associate, you assign your most experienced dental assistant to work with the young doctor. You can then train the new assistant. This will ensure two things: first, the associate will learn your practice’s routines and second, it provides a better forum in which to have your associate introduced to patients. Chances are your experienced assistant knows many of your patients. When the associate leaves the operatory for a hygiene exam, for example, it provides a chance for the assistant to answer questions about the new doctor or to talk about his/her background.
Scheduling Templates. Believe it or not, many dentists just schedule an associate without any consideration for the actual time that may be required to perform clinical procedures. If your associate has just recently graduated from dental school, chances are he/she needs a lot more time to prepare restorations, crowns, etc. than you do! Therefore, before the associate starts working in your practice, discuss clinical time management and develop realistic time units for treating patients. There is nothing worse than having a reception room of annoyed patients because their new doctor has fallen behind schedule. Also, once you have determined your associate’s break-even point, it’s easy to set realistic production goals. Typically, our production goals for new doctors vary anywhere from $800 up to $1,200. Associates with experience would have production goals set higher than this range. These goals can be modified after the first three to six months of employment to more accurately reflect the production goals of the associate.

As you can see, integrating an associate takes a good deal of planning and attention. Taking the time to properly induct your new associate will pay big dividends!

In part two of this article, we’ll present ideas for marketing, effective communication and mentoring/clinical training for associates.

Dr. Thomas L. Snyder is Managing Partner of The Snyder Group, LLC, a nationwide practice transition and financial management consulting firm. With more than 75 years of experience in the field, The Snyder Group can provide you a full range of services relating to practice transition matters and retirement planning. They can be reached directly at 1.800.988.5674.

If you would like additional help, email Dr. Snyder at drsnyder@thedentistsnetwork.net.

Interested in having Dr. Snyder speak to your dental society or study club? Click here.

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Michael Moore, Esq.
Director McKenzie
HR Solutions
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Special Alert: Increased Exposure To Disability Claims

Last month, we wrote about the changes to the Americans with Disabilities Act (ADA) that were making their way through Congress. As we predicted, those amendments to the ADA shot through the legislative process and were last week signed into law by President Bush.

These changes, which will be adopted by every state that has similar disability rights laws, constitute nothing less than overthrowing a decade of settled law that dramatically favored employers. The ADA and state laws modeled after it provide that if an employee has a disability the employer must provide reasonable accommodation to that employee and may not discriminate against that employee on basis of the disability. If the answer to the question, “Does the employee have a disability under the law?” is no, the employer has no duty to the employee at all, and thus cannot be held liable for adverse employment actions.

It was assumed by those who enacted the ADA that the question of disability would be determined without regard to assistive devices or medication. For example, if someone has a leg amputated, that person would clearly have a disability, thus triggering employer liability for failure to accommodate or for discrimination. The same would be true for someone subject to grand mal seizures from epilepsy.

However, in a series of decisions in the late 1990s, the United States Supreme Court rejected that interpretation, holding that disability would be determined after considering assistive devices or medication. Thus, if an amputee could walk reasonably well with prosthesis, he/she would not qualify as being disabled. If the epileptic’s seizures were well controlled with medication, that person likewise would not qualify under the law.

Congress has now, in the amendments, specifically repudiated the Supreme Court interpretation. Courts must determine disability as originally conceived by the Congress. Moreover, the law requires the courts to liberally apply the ADA in favor of employees— striking down hundreds of cases that have strictly construed it against employees.

What does this mean for employers? Let’s consider a typical office scenario. A chairside assistant, Mary, employed for a number of years by Dr. Smith is diagnosed with rheumatoid arthritis. She has been having difficulty sitting and working for periods during the work day at her position. The arthritis is controlled pretty well with medication but her doctor would state that without it, she would have substantial impairments in her ability to sit, stand, walk and work.

Under the settled law, Mary would not have a disability and if Dr. Smith decided to terminate her because she was increasingly unable to do the job, he would have no exposure. However, under the new amendments, she is a qualified person with a disability, and Dr. Smith’s obligations are much more complicated.

Consider that Mary may ask Dr. Smith to bring in a consultant to modify the equipment so that she can more easily do her job. This constitutes a request for accommodations and Dr. Smith rejects that request at his peril. If he does hire a consultant, and the consultant recommends changes that may cost several thousands of dollars, Dr. Smith must carefully consider whether that accommodation is reasonable or not. Mary may ask for a change in work schedule, or to have more time to perform her duties, or any of a host of possible requests. The law requires that the doctor engage in an “interactive process” designed to reveal the most reasonable accommodation—and it is Dr. Smith’s duty to show that accommodations asked for are unduly burdensome to his practice.

Once Mary is in that protected class of individuals with disabilities, Dr. Smith faces liability if he decides for any reason to terminate Mary. Assume that Mary has always been difficult with co-workers and somewhat rigid in making changes. If Dr. Smith decides on new office procedures and Mary’s attitude and obstruction become a real problem, how does he deal with it? Will a termination be viewed by a plaintiff’s lawyer as discrimination—the asserted reason of behavior issues cited as a mere pretext to get rid of a disabled employee? The scenarios are almost endless.

Dr. Smith could simply claim that he did not know Mary had a disability, that she never mentioned it and her doctor never sent a letter to him. Unfortunately, the cases do hold that an employee need not mention disability or the law when requesting an accommodation. Moreover, knowledge of an illness or simply seeing the employee having difficulty performing the job may be constructive knowledge of a disability. Fortunately, there are practical means of reducing the risk of claims to a manageable level.

First, a complete review of your office manual or human resources policies is in order. Your application/interview forms must contain the question, “Do you require an accommodation?” This will alert you immediately to an applicant claiming a disability.

Second, your practice should have written job descriptions for each position. The law does not require the employer to eliminate “essential job functions” as part of an accommodation. For example, it would not be reasonable for Mary to demand that she be allowed to handle only two or three patients each day. A written job description is assumed by the courts to be competent evidence of what each employee must do as essential functions. However, without a job description, it is Dr. Smith’s word against Mary’s as to what the essentials are. Dr. Smith does not want to be in that position.

As to separating an employee who has a disability, your best defense is to have in place legitimate policies for performance, and following—and documenting—your efforts. In this regard, the usual practice of issuing warnings and suspensions is counterproductive. We have developed performance correction policies that are non-punitive, reasonable and designed to place the responsibility for performance improvement in the control of the employee.

When you are faced with an employee who asks for some type of change to help her do her job better because of some medical issue, it is the time to call in someone who can assist in guiding you through the complexities of determining disability and the need for accommodation. We can help you navigate those hazards, and there are a number of organizations which will work with employers and employees on issues of accommodation.

The lesson here is to not delay reviewing your policies and forms. Be ready now for what clearly is going to become a huge area of employment litigation beginning in 2009.

Mike Moore is ranked among the best in employment law and named one of the top 10 lawyers in Ohio. As Director of McKenzie's HRSolutions, Mike is the creator of the Employment Policy and Handbook, geared to providing dentists who are unsophisticated in the legal arena with a step-by-step policy manual.

Click here to hear Mike present “7 Elements of an Effective Employment Policy.” Email Mike at mike@thedentistsnetwork.net.

Interested in having Mike speak to your dental society or study club? Click here.

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