The Dentist's Network #94

Thomas L. Snyder, DMD, MBA
Managing Partner
The Snyder Group, LLC
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The Top 10 Things You Should Do To Get Your Associate To Be Successful

For those considering hiring your first associate, here are 10 things you should consider to make this a successful relationship.

1. Reactivate Patients
We recommend that a patient reactivation program be implemented to coincide with the associate joining your practice. Reactivation is an effective strategy as there is usually not enough capacity for one doctor to handle the entire patient base. When patients are reactivated, we recommend that the reactivation hygiene appointment be scheduled with the associate. This is the ideal way for an associate to get to know the patient and hopefully create the bond for that patient to become their new dentist. In addition, the hygiene appointment is probably the most non-threatening appointment in the dental practice. Therefore, it affords the new associate ample time to get to know the patient.

2. Determine Any Special Clinical Supply Requirements
We suggest you meet with your associate at the outset to determine what additional clinical supplies or equipment is needed. If your associate will be providing services that you have been referring out, you may need to enhance your armamentarium.

3. Determine Realistic Time Units
Many associates are scheduled using identical time units as their employer. This is totally unrealistic for many procedures, particularly if you are hiring a recent graduate. Make the time units commensurate with the skill and experience of your associate. You do not want to have your patients waiting unnecessarily in the reception area because the associate cannot meet the practice’s time allotment for clinical procedures.

4. “Over-the-Shoulder” Training
All new practitioners must continue their clinical and professional development. We recommend that “over-the-shoulder” training be implemented in your practice, especially at the outset. By serving as the “dental assistant” for more complicated procedures or for those procedures that the associate has never experienced is an ideal way for your associate to learn from you and gain the confidence to develop the skills to perform them one day.

5. Assess Your Associate’s Strengths And Weaknesses
For many recent graduates, there are certain clinical procedures with which they have little experience. If your associate has worked elsewhere, review their production reports (if available). You’ll get a good idea of what they are experienced with. Since many GP’s refer much of their Endo, this is a natural opportunity for a new associate to perform those procedures - within their skill and abilities, of course. So, even if your new associate has limited experience in Endo, we suggest that you enroll them in an Endo continuing education program.

6. Schedule Weekly “Clinical Matters” Meetings
Since you will be serving as your associate’s “mentor,” we recommend frequent communication in order to prevent problems from occurring. These weekly meetings should be scheduled for one hour with topics of discussion to include: treatment planning, case presentations, challenging cases and scheduling problems. After the first six months, you may reduce to a bi-weekly basis and reduce the time frame accordingly as they show progress.

7. Schedule Monthly “Business” Meetings
Monthly business meetings should be scheduled to review all non-clinical aspects of your practice. You should review the associate’s production reports, accounts receivable reports (if applicable), incomplete dentistry reports, as well as other reports that may be relevant. You’ll get the opportunity to begin coaching your associate in developing those analytical skills that are needed to become a successful manager as a future partner or business owner.

8. Have Your Associate Learn About Your Practice’s Software Program
We recommend that your associate become familiar with various software features so that they are able to understand certain management reports, become adept at scheduling, etc. Developing this skill becomes more important if your associate is on a “partner track.” For example, running a detailed production report by services provided will underscore how your associate is spending their time in various clinical areas. Running an incomplete dentistry report may give them an insight into their success or lack thereof with their case presentation skills.

9. Assign An Experienced Assistant
Chances are most associates have not had the opportunity to spend an adequate number of hours with a chair side dental assistant in dental school or, sometimes, in a residency program. It is critical for your associate to work with an experienced assistant, particularly during the first three to six months of their employment. They can learn a great deal from an experienced assistant, such as clinical routines, instrument transfer, proper ergonomics, as well as practice record keeping protocol.

10. Marketing, Marketing, Marketing
It goes without saying that if an associate joins a busy practice, chances are they may feel that there will always be an infinite supply of patients. Consequently, many associates fail to engage in any meaningful marketing activities. To avoid this problem, get them involved in activities that can generate new patient referrals. Whether it’s coaching sports teams, joining community service clubs or participating in church and civic activities, these opportunities place your associate in a position to meet many new people who may become future patients as well as increase their profile in the community.

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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Sally McKenzie, CEO
McKenzie Management
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Are You Productive or Merely Filling Time?

The schedule: it’s your plan for the day, your strategy for profit, proof that yours is a successful practice… at least in theory. The reality for many dentists is that their schedules are none of the above. Rather, they are merely a hodge-podge of space and time strung together with little direction. There’s an opening, fill it. I recommend you begin measuring your success based not on how many open time units can be closed, but rather how effective you and your staff are during each.

Effectively managing the schedule requires constant vigilance, commitment, and yes, training. It is the vehicle that drives the financial needs and wants of your practice. But before you can set out on the open road of opportunity, you must have a clear picture of your financial demands and goals. You want more continuing education. You want to reward the hard work of the team with a raise and/or bonuses. Rent, taxes, utilities and regulatory fees have to be paid. You want to take this business of yours to the next level. Knowing where you are and where you want to be are the first steps. The next is charting the course to get there.

Once you have a clear idea of what you want from your practice, you can focus on maximizing the schedule to achieve specific production goals. Perhaps you, the doctor, want to produce $500,000 annually. This calculates to about $11,363 per week (taking four weeks out for vacation). Working 32 hours per week means you will need to produce about $355 per hour. A crown charged out at $1000, which takes two appointments for a total of two hours, exceeds the per hour production goal by $145. This excess can be applied to any shortfall caused by smaller ticket procedures.

Next, follow the steps below to determine the rate of hourly production and find out whether your practice is poised to meet production objectives or needs to shore up clinical systems.

1. The assistant logs the amount of time it takes to perform specific procedures. If the procedure takes the doctor three appointments, she/he should record the time needed for all three appointments.

2. Record the total fee for the procedure.

3. Determine the procedure value per hourly goal. Take the cost of the procedure, for example $215, divide it by the total time to perform the procedure, 50 minutes. Production per minute value - $4.30. Multiply that by 60 minutes - $258/hour.

4. The amount must equal or exceed the identified goal.

It’s likely you will need to make some other changes in production to reach your goal, such as correcting inefficiencies in the delivery of dentistry and/or decreasing the amount of time to perform certain procedures, which leads us to Step #5.

5. Doctors practicing in states allowing expanded functions for assistants can make significant strides in managing their days as well as scheduling to meet production goals when they maximize the effectiveness of their assistants. But doctors and assistants in every practice can improve efficiency, lower stress, and increase profits just by assessing time and motion. Read on.

The assistant should list the materials and equipment used for each procedure as well as each step necessary to complete each procedure.
Indicate next to each task whether it requires the doctor’s time or the assistant’s. Note that administering anesthetic is always considered assistant time, although if the doctor performs this procedure it does not require a single unit of time, 10-15 minutes, to give an injection.
Log the amount of time it takes for the doctor and the assistant to perform each task associated with each procedure.

The objective of this time and motion inventory is to identify tasks that can be delegated and opportunities for training that will maximize the assistant’s functions. It also enables both the doctor and the assistant to see more clearly how set-up and tasks can be made more efficient. Reducing the time it takes to perform procedures by as little as 10 minutes can significantly increase profit to the practice.

Don’t let your day or your profits be driven by a reckless hodge-podge of space and time. Take control of your scheduling and production and you take control of your profits.

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.

Hear Sally’s FREE podcasts at The Dentist’s Network - HERE

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Dr. Lorne Lavine
Dental Technology Consultants
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Paying For Equipment

As many dentists are evaluating all the latest and greatest technology, the one important decision that is often left to the end is, for some, the most important one: how do you end up paying for everything? Amidst mountains of dental school debt and constant news about a tough credit market, the thought of taking on more liabilities as a new dentist can be daunting. And for veteran practices flush with some extra cash, it may seem a waste to pay money on “interest” when a single cash payment can do the trick. But before you get out that checkbook, you really should evaluate the options.

The Use Of Equipment Generates Profits
The only time that ownership of an asset earns profit is when that asset appreciates in value - like real estate, patent rights, precious metals or collectibles. Another mitigating factor against ownership is that new technology is obsolescing everything that was “new technology” before, and that is something that is going to continue to happen in the future... only faster. Leasing solves these two problems.

Tax Savings – Article 179 and Direct Tax Expensing
Through a quirk in the tax laws, it is now possible to get “paid in advance" to add equipment. As of 2010, small businesses can write off up to $134,000 of equipment the year they put it in service. By leasing that equipment, you can have the government pay its share up front, essentially getting free use for over a year. For companies not qualifying for or choosing the Article 179 alternative, lease payments are written off as made, eliminating the need for depreciation schedules and allowing faster write off. The result of this is more cash freed up for other uses than would be available in a purchase/depreciate environment.

Save Your Cash!
Business people are lulled into thinking that paying cash is a good way to acquire equipment because doing so avoids finance charges and interest expense, resulting in lower total cash outlay. In fact, paying cash can be the most expensive way to solve the problem.

Liquidity Is Critical
You must have reserves. This can become an outright survival issue when slow paying patients, slow revenues or unexpected expenses put pressure on cash reserves. On payday, your employees do not want to know how many people owe you money.

Alternative Uses Of Funds
If all you are going to do with the cash you conserve by leasing is to put it in the bank at 3% or so, there wouldn’t be much benefit. But, there are so many other ways you can deploy your cash that offer huge potential returns. A few things you can do with cash which you probably cannot do any other way would be building a cash reserve in case patients pay slowly, taking quantity buying opportunities, getting a bargain at an auction, taking cash discounts (2% each 10 days is a 72% return), or funding new marketing programs.

100% + Financing
Get 100% financing plus the additional funds to cover costs. Leases can cover everything you need to make your equipment work for you. This includes software, installation, related leasehold improvements, training and even some supply items. All of this reduces your initial costs to minimal levels, letting you earn revenue from your new equipment faster.

Flexible and Easy
Leases generally feature simplified documentation, easy one page applications, and accelerated approval times - all designed to get you the equipment you need without delay. If your practice is cyclical, that can be a crucial benefit to leasing. Programs can be matched to the logical period of time that you will be using that equipment before it is necessary to upgrade; and often allow you to upgrade without penalty.

So, when considering the buy vs. finance decision on your new equipment purchase, look beyond rate alone to the underlying considerations. You may find that sometimes it costs less to pay more.

Lorne Lavine, DMD is the Founder and President of Dental Technology Consultants. Dr. Lavine holds two prestigious certifications, the A+ Certified Technician designation and the Network+ Certified Professional. These designations demonstrate proficiency in computer repair, operating systems, network design and installation. Dental Technology Consultants provides dentists a full range of services relating to the implementation of technology.

Interested in having Dr. Lavine speak to your dental society or study club? Click here. Dr. Lavine can be reached at drlavine@thedentistsnetwork.net.

Hear Dr. Lavine’s FREE podcasts at The Dentist’s Network - HERE

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