by James R. Pride, DDS; Amy Morgan; and Mary Lynn Wheaton
The second year was critical in carrying Dr. Thompson's practice forward to achieve these goals:
To firmly establish newly implemented systems
- To transform the staff into self-directed work teams that perform up to expectations out of commitment and habit, without constant supervision from the dentist
- To transform the dentist from a task manager to a leader, who provides inspiration and direction
- To introduce even more changes
Dentists who rest on their laurels after making management improvements risk regression to the mean, a common phenomenon in which practices that achieve stunning improvements lapse into their former state through lack of continued effort and leadership.
Communication and training are essential to growth. Consequently, Dr. Thompson's team participated in staff workshops that harnessed their enthusiasm for following through on what they had learned once they were back in the office.
Dr. Thompson's goal for the second year was to reinforce the training she received from her consultant. A key tool for accomplishing this is the staff meeting. When run effectively, meetings can help the team maintain its enthusiasm, overcome obstacles, sharpen its focus, and ensure successful change. Running an effective staff meeting does not happen automatically; it must be learned by both the dentist and the staff.
"At first we wanted to discontinue our staff meetings," recalls Dr. Thompson. "I did all the talking in our meetings. The staff would listen apprehensively, as if waiting to be told what they did wrong. All in all, the meetings seemed to be a waste of time."
This is a common problem. No one wants to sit through a boring meeting with finger-pointing and no positive change.
Dr. Thompson's meetings suffered from the top four meeting-killers in dental practices:
- No focus, no specific goals, no agenda
- Inconsistent participation of doctor and team
- No process of analysis or problem-solving
- No accountability, no follow-through
Through her consultant's guidance, Dr. Thompson revamped her staff meetings from a "doctor-does-all-the-talking" format to a "staff-driven" design in which the doctor makes comments and gives direction only when necessary. This new arrangement led to greater staff involvement and commitment.
Dr. Thompson employed these key methods to kill the meeting-killers:
- Use an agenda to set times for specific topics.
- Establish rotating roles for the staff as meeting facilitator and scribe (note-taker) to ensure everyone's participation.
- Use problem-solving tools for analysis and action planning.
- Develop action plans to address what will be done, when it will be done, and who will be responsible.
"At first no one wanted to be the facilitator or the recorder," recalls Dr. Thompson. "But now, my staff members like it when their turn in the rotation comes. For the most part, it's the staff who writes items on the agenda for discussion, without much input from me. A lot of questions are raised and answered at these meetings, so the staff doesn't have to come to me for answers while I'm working. That saves me a lot of time. The staff was pleasantly surprised to find that the meetings weren't going to be gripe sessions, but forums for them to share problems they were having. We now find these weekly meetings so helpful that we can't imagine operating without them."
The following are some issues that Dr. Thompson's staff raised and resolved during their meetings. The staff members themselves conducted the meetings, with Dr. Thompson providing guidance as needed.
Negotiating financial arrangements — "Our financial coordinator would immediately offer patients a payment plan, without first giving them a chance to pay the whole amount in advance, with a 5 percent courtesy adjustment. At one staff meeting, all of the team members practiced asking for full payment from patients. When the financial coordinator saw how the others had difficulty doing this, she knew she wasn't the only one who was struggling. It also gave the other team members insight into how much skill negotiating requires."
Dealing with emergencies — This meeting clarified for the staff the kinds of cases that need to be seen immediately, those that can be delayed, the questions they need to ask, and the way to place emergencies in the schedule.
Reviewing practice statistics and progress toward goals — Once a month, Dr. Thompson conducts a meeting herself, where she reviews trend indicators (practice statistics) and assesses how the practice is doing in meeting the goals set forth in the annual plan. When the practice falls short of its goals, both the doctor and the staff brainstorm on ways to get back on track.
Other improvements — Some changes that were implemented in the practice included the following: implementing a chart conversion, being better prepared for patients by taking time at the previous appointment to highlight the next procedure to be done, and preblocking the schedule for scaling and root planing to eliminate scheduling delays after diagnosis. "We spent a lot of time at the meetings fine-tuning communication among ourselves," recalls Dr. Thompson. "This helped a lot."
The staff meetings were pivotal in improving communication with patients, with 15 minutes of each meeting devoted to practicing verbal skills. Sometimes — as in the case of negotiating financial arrangements — an entire meeting would be devoted to learning a critical verbal skill.
Through effective meetings, Dr. Thompson and her staff were able to solve problems, fine-tune their systems, and introduce more changes. Their efforts paid off! Six months into the second year of the management program, the practice hit $412,862 in production, which was 75 percent of the previous year's entire production and 16 percent above their goal.
Next month, we'll discuss how this remarkable practice finished its incredible year.
To obtain the video-workbook program, "How To Have Meetings That Work," call Pride Institute at (800) 925-2600.
This series chronicles the true story of a young dentist whom we're calling Dr. Mary Thompson. In two years, she transformed her $255,000-a-year start-up practice into an $812,099-a-year, high-quality office.
Previous articles in Dental Economics described how Dr. Thompson, just three years out of school, began her program of management improvement with the dream of buying the practice next door and doubling her patient base. Pride Institute consultants helped her develop a strategy to purchase the second practice and craft an annual plan.
After consolidating the two practices, however, her goals for increasing production were not met immediately. Changes had to be made in scheduling, hygiene, and recruiting new patients to the practice. These efforts, plus the replacement of a poorly performing staff member, yielded a year-end production of $549,169, 20 percent higher than the goal and a remarkable 115 percent over the previous year.
Dr. Thompson began her second year of management improvement with the challenging goal of raising total office production by 27 percent. Having learned how to base salary increases on collections — instead of on guesswork — the doctor gave raises to her staff members both to reward their efforts and to motivate them further.
How to hold meetings that work —
- Hold a weekly, one-hour staff meeting during normal working hours.
- Prior to the meeting, ask the facilitator to post a blank agenda for the staff and doctor to list issues for discussion.
- Allow staff members to take turns being the facilitator and the recorder.
- Practice verbal skills for 15 minutes at every meeting.
- Devote one meeting per month to a dentist-conducted review of practice statistics and progress toward achieving goals.