Have the lab make a digital image of the final restoration for comparison to the approved temporaries so Dr. Penna can approve the result before the case is shipped.We spoke to Larry Zenk about his views on this case. Larry has 26 years of experience in the laboratory industry. Currently vice president of Keller Laboratory, he is responsible for professional development and key-account management. Larry and Keller Laboratory participate at PAC Live™ Functional Anterior Esthetic Courses, where they first met Dr. Penna and his team.
Initially, Dr. Penna communicated through traditional means - handwritten prescriptions, phone calls, and the occasional photo. Shortly after receiving a few surprises, he began using cosmetic images to describe patients' expectations more accurately and to request diagnostic wax-ups that would match those images. The next step in this evolution was when Dr. Penna requested that photos of the wax-up be sent to him for approval. Finally, he requested that the wax-ups not only match his imaged case, but also that the lab photograph the final porcelain results, side by side with his study model of the diagnostic wax-up.
Larry enthusiastically supports Dr. Penna's approach, saying that there is no doubt that cosmetic imaging, diagnostic wax-ups, and visual communication significantly increase the chances for success. This approach means there will be fewer remakes and fewer reworks, which translates to better outcomes, higher margins, higher productivity, and more opportunity for word-of-mouth referrals for both the lab and the dentist. Many labs report that they remake between 5 and 8 percent of cases due to errors in process, miscommunication, or results that don't meet expectations. The cost of such remakes on smile-design cases can be very high in terms of patient confidence and doctor satisfaction. Dr. Penna's TQM process virtually eliminates most of the causes for rework.
Larry shares, "Dr. Penna has one of the lowest remake percentages of virtually anybody I work with… To achieve our shared success on cases, we spend a little more time communicating than is usual. Because of our success, however, we don't have to review failures. We don't debate paying for remakes, because there aren't any to discuss. That allows us more time to plan other cases and to grow our businesses together."
Dr. Penna will tell you that abdicating responsibility for your case to the lab is a mistake. He does not rush his cases, nor does he rush his lab. He understands that the first link is between the patient and the doctor. Frequently, Dr. Penna points out, the patient's expectations are different from the doctor's at the beginning. It is important to work to get the right look so you can meet your patient's expectations. How you communicate those expectations to the lab is the next challenge. Digital images have facilitated this exchange and made dentist-to-lab communication easier.
Does Dr. Penna's "bulletproof plan" take more time by building all of those TQM checks and balances into the process? He says, "My time is probably not more than 30 minutes, and my assistant's time might be up to two hours ... We do a custom work-up with the patient, detailing color, shape, and length and rounding corners. The patients tell the assistants more than they tell the doctor. The change in my team's attitude is incredible. They get so excited about these cases. Becoming a part of this protocol has allowed them to develop additional skills."
Dr. Penna tells us that interactive communication with his patient and his lab is critical to a successful outcome. This sequential dialogue with the lab - the checking before a final restoration is completed, as well as the full engagement of the patient in the process - is at the heart of his "bulletproof plan." Clearly, he understands TQM's essence: getting it right the first time. Digital images and cosmetic imaging provide a quality media for planning and integrating quality assurance into the treatment protocol.
Total Quality Management - a time-proven protocol - works as a method to improve communications among all parties - the dentist, the patient, and the lab. For every case Dr. Penna does, he gets at least one solid referral. His conversion rate for patient case acceptance is nearly 100 percent. And, just as important, his hourly productivity was at $600 previously; now, it is more than $1,000 per hour. As the saying goes, "If something is worth doing, it is worth doing well." Effective communication with patients and labs matters. For Dr. Penna and his team, quality methods are "bulletproof." Good quality is indeed good business.
This article was developed with the cooperation of Dr. James Penna and his team and Larry Zenk at Keller Laboratories, Inc. Dr. Penna can be reached via email at [email protected], and Zenk can be contacted at Keller Laboratories at (888) 919-7577, Ext. 4037, or email [email protected] and visit www.kellerlab.com.