The Dentist's Network #76

Thomas L. Snyder, DMD, MBA
Managing Partner
The Snyder Group, LLC
Printer Friendly Version

The Top 10 Things Your Associate Should Do to Get a Successful Start

Many recent graduates are now joining practices throughout the country as associates. Many will be on a “partner track” or, in some instances, consider purchasing the practice of their new employer in a few years. Here are 10 things that associates should consider to ensure they will have a productive and successful relationship.

1. Reactivate patients.
As we’ve mentioned in previous articles, practices that have an over abundance of patients usually have patients in need of reactivation. We recommend that your new associate be scheduled with those potential reactivated patients. This is an excellent way for an associate to meet his or her “new patient” in a normally relaxed setting.

2. Determine your clinical supply requirements.
Often associates do not meet with their employer to discuss what materials and supplies they need. It’s important for both the employer and the associate to be on the “same page” to avoid unnecessary ordering of dental supplies on the associate’s part that are not normally used in the practice.

3. Determine realistic time units.
Many associates are scheduled with identical time units as their employer. This is totally unrealistic, particularly for a recent graduate. Therefore, review your current time unit allocation and make it realistic to meet the time requirements of your “new” doctor. Since many associates are paid a salary in the early stages of their employment, allocating more time for clinical procedures can take stress off the associate and will also prevent your associate from having patients waiting unnecessarily in the reception room.

4. “Over-the-shoulder” training.
Associates need to continue their clinical learning process. We recommend that “over-the-shoulder” training be implemented in your practice, if not on a weekly basis, at least on a bi-weekly basis. By serving as the “dental assistant” for more complicated or new procedures, your associate will learn from you and gain confidence and experience to perform the procedures themselves one day.

5. Assess your strengths and weaknesses.
As a recent graduate, obviously, there are certain clinical procedures you are more adept at providing. We recommend that you analyze your employer’s production report to determine those services that are being referred to area specialists. Usually, at the top of this list is Endo. So if you’ve had limited experience in Endo, we suggest that your employer enroll you in an Endo clinical program. There are a multitude of clinical programs available encompassing all facets of dentistry. The important thing is to be realistic in your clinical self assessment and make sure that what you learn can contribute to the practice’s growth as well as yours.

6. Schedule weekly meetings.
It’s important for the employer to serve as your “mentor,” particularly during the first six to twelve months of your affiliation. This frequent communication becomes particularly worthwhile for the employer if the associate plans to become a partner. Weekly meetings should be scheduled for one hour and the topics of discussion should include case presentation issues, challenging cases, and scheduling problems.

7. Schedule monthly meetings.
Monthly meetings should be held to review the business aspects of the practice. You should review your production reports, collection reports, accounts receivable reports (if applicable) as well as other reports that may be relevant. The employer gets the opportunity here to begin to coach the young doctor in various skill sets that are needed to become a successful manager.

8. Get to know your practice’s software program.
We recommend that the associate become familiar with various software features so that they are able to run various management reports, understand scheduling, etc. Developing this skill becomes more important if your associate assumes ownership or, as a potential partner, your associate becomes more involved in the overall management process of the practice.

9. Request an experienced assistant.
Chances are many dental students have not had the opportunity to spend many hours with a chair side dental assistant. It is critical for the new associate to work with an experienced assistant, particularly during the first three to six months of employment. The associate can learn a great deal from an experienced assistant. This is done not only for clinical matters, but for recordkeeping matters as well.

10. Marketing, marketing, marketing.
It goes without saying that if you join a busy practice, you may feel that there will always be an infinite supply of patients. So, the associate fails to engage in any meaningful marketing activities. To avoid this problem, get your associate involved in activities that can generate new patient referrals. Whether it’s coaching sports teams, getting involved in service clubs or participating in church and civic activities, these engagements place the associate in a position to meet many new people and increase his/her profile in the community.

In summary, there are many practical tasks an associate can accomplish, particularly in the early stages of their employment in your practice. There is usually extra down time for your associate to follow these ten steps, so have your associate be a proactive participant and the outcome will be a successful relationship!

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.

Forward this article to a friend.

Michael Moore, Esq.
Director McKenzie
HR Solutions
Printer Friendly Version

Financial Considerations to Staff – Pitfalls

Do you allow staff to carry a balance for treatment you give them and their families? A lot of our doctors do. Do you keep track of the current balances? A lot of our doctors don’t. Do you allow one person in the office to handle the accounts? Most doctors do. Do you have a written policy that addresses how you are to be paid back if your employee resigns or is terminated? Few doctors have considered that contingency. This has meant the loss of hundreds of dollars for some doctors.

Here’s what we heard from one doctor recently. For some years, he had a trusted office manager handling the accounts. Let’s call her Sue. A couple years ago, Sue informed the doctor that she had gotten married to John. John needed dental work, and the doctor was glad to provide it. For many years, he gave staff treatment at reduced cost, and allowed them to pay off the bill over time. He had no written policy on this benefit. Sue handled the accounts. One day, Sue abruptly quit. Only after the separation did the doctor learn that Sue and John had not married, but were only living together. He immediately turned to the books, and found that Sue and John had an accrued a balance of several thousand dollars.

The first question that the doctor had for us was: Can I apply Sue’s last check to pay part of the balance owed? His second question: How do I get her to pay the rest?

The answer to the first question is No – according to the wage and hour law of your state. The answer to the second question is How serious are you? – Because you may have to file criminal charges for fraud.

In short, the doctor faced the prospect of a drawn-out and potentially nasty fight to recover the money he was owed. Ultimately, he decided to take the hard lesson. He immediately implemented a new policy that will prevent this kind of theft – because that is what it is – in the future.

Now the situation with Sue is admittedly extreme. But in the last months, with the impact of the economic downturn, we’ve seen too many of these kinds of separations – where the doctor is shocked to learn what the employee owes. And the second shock is the recognition that there is no way to recoup the value of his or her work.

Here’s how to prevent losing money on staff treatment. First, have a written policy covering the practice – which includes, at the very least – what the benefit is; who is eligible; and the repayment requirements. The last provision must provide that the doctor can, at any time, require the staff member/patient to repay the full amount owed.

Second, require a monthly report of the balances owed by each staff member. If you have your accountant provide a quarterly report on the practice’s financial condition, it is a good idea to have the accountant review this report.

Third, make sure that the person who approves the reduced-cost treatment is not the same staff member who does the accounting.

Fourth, have each staff member execute an authorization for the practice to deduct amounts owed to the practice from paychecks. Under virtually all state wage and hour laws, it is lawful to deduct such amounts from pay only with prior authorization from the employee.

With these controls in place, you should not incur any losses from your generosity. We recommend that the policy provide a maximum limit that the employee can carry on the balance owed. And, the policy should require the employee to begin paying on the balance through the payroll deduction beginning the first pay period after the charge is incurred.

By having the policy in place, if you begin to see performance problems or behavior issues with any staff member which raise concerns that you may have to terminate that person down the road, you can make sure the balance is paid down before the break comes.

Mike Moore is ranked among the best in employment law and has been named one of the top 10 lawyers in Ohio. As Director of McKenzie's HR Solutions, 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.

Forward this article to a friend.

Sally McKenzie, CEO
McKenzie Management
Printer Friendly Version

Is Yours a Culture of Acceptance?

From the front door of your practice, to the operatory, to the team that you surround yourself with, whether you realize it or not, you have created a culture. Perhaps you feel your culture is warm and inviting because you’ve decorated the waiting area in appealing colors. Or maybe you’ve equipped your treatment rooms with state-of-the-art technology that you believe conveys a culture of modern dentistry. And possibly you’ve hired some of the nicest staff you could find, creating a culture of warmth and compassion. Most importantly, you know that the quality of your dentistry is truly superior, creating a culture of excellence. So why is the culture of acceptance – treatment acceptance, that is – lacking and well below the 85% benchmark?

Many dentists have nice offices and are truly excellent clinicians. Many more use modern equipment from digital X-rays, to intraoral cameras, to laser handpieces, to computerized records etc. Still more have nice people working for them, but the fact is that patients expect those things. It takes far more than good dentistry and a gentle hygienist for patients to invest in your care.

Creating a culture of treatment acceptance starts with creating a culture of desire, which begins with education. If patients don’t know what you offer, how can they want it? Take Dr. Gregg, for example. He is a truly excellent dentist with countless hours of continuing education and multiple certifications. Yet day after day, patients come through his hygiene department for their six-month visit with Ann, his wonderful and ever gentle hygienist, only to be locked into the same 30-year-old routine.

Ann talks about her kids, and the patients’ kids, and vacations, and the weather and the latest movies, but only once does she ask the patients about their teeth. Never does she mention the unscheduled treatment that the patient hasn’t pursued, or the advantages of moving ahead with that crown the doctor has recommended rather than risking what will likely be a disaster when that cracked tooth becomes further compromised. Ann’s discussion about the dentistry starts and ends with one question. “So are you having any problems?” she asks. Most of the time, the patient says “No.”

Ann has excellent rapport with patients. She is in a perfect position to educate them. They trust her. They respect her, and while they may enjoy her soccer mom war stories, they’d appreciate learning a bit more about practice services as well.

Before the end of the visit, Dr. Gregg pops in, takes a perfunctory glance inside the oral cavity, gives the patient a hearty, “Good job,” and promptly scoots back to his chair. Simply educating patients about advancements in periodontal care, implant dentistry, veneers, orthodontics, and even basic whitening options can have a tremendous positive impact on encouraging patients to pursue treatment. Reinforcing the doctor’s previous treatment recommendations can be the deciding factor for many patients who are on the fence. While patients may not schedule all recommended treatment immediately, the hygienists’ role in moving the patient toward “yes” at some point is critical.

Other members of the staff also can play a key role in this total practice effort. At your next staff meeting, consider what you and your team can do today to create a culture of treatment acceptance, starting with patient education. For example, pull together those before and after photos you’ve been storing on your computer and put them in an album in the waiting room. Make it a point to open the album every morning, and place it on a table next to brochures about the services your practice offers.

Encourage patients to ask questions. Hang an 11 x 17 frame in every treatment room. Type a bulleted list of a few of your services in a large enough font that patients can see it when they are sitting in the chair. For example: “What would you like to know more about? Veneers, Implant Dentistry, Whitening Options, Orthodontics, Invisalign... Just Ask Me!”

Educate the team – business and clinical – on specific treatments, such as implants, so that they understand the value of care, are prepared to convey a positive attitude about the benefits of that treatment, and can explain to patients that the doctor has extensive training in delivering this type of treatment. Prepare a list of frequently asked questions and answers. Give the information to each staff member so that everyone can answer basic treatment questions.

Create desire for and understanding of your dentistry and watch your practice become a culture of treatment acceptance.

Sally McKenzie is CEO of McKenzie Management, a nationwide dental management, practice development and educational consulting firm. Working on-site with dentists since 1980, McKenzie Management provides knowledge, guidance and personalized solutions that have propelled thousands of general and specialty practices to realize their potential.

Interested in speaking to Sally about your practice concerns? Email her at sally@thedentistsnetwork.net or call 1.877.777.6151.

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

Forward this article to a friend.