Patients, staff exit through revolving door

Nov. 1, 1998
Case Profile: Shiny days, starlit nights, memorable sunsets ... this Key West general practice has a front-row seat to a tropical paradise. But, after a decade of quiet growth, the tide has turned and let loose a "silent hurricane" that`s driving patients and staff through an ever-revolving door.

Sally McKenzie, CMC

Case Profile: Shiny days, starlit nights, memorable sunsets ... this Key West general practice has a front-row seat to a tropical paradise. But, after a decade of quiet growth, the tide has turned and let loose a "silent hurricane" that`s driving patients and staff through an ever-revolving door.

Symptoms: The scheduling-coordinator position has turned over three times in the last 18 months ... patient retention is at an all-time low ... and Dr. Myopic can`t see the connection.

Observations: Preblocking the schedule to the doctor`s "ideal day" went like this: The first three hours every morning were set aside for crown and bridge only; a 30-minute interval before lunch was reserved for emergencies; and all other procedures were scheduled for the afternoon. Too bad the blueprint for this ideal day was not even a close fit for a real day. And, the results proved it: poor customer service, irate patients, and a longer time for checkout because the scheduling coordinator had to explain why Patient B had to wait three months to get an appointment for two fillings discovered during her recall exam. And why Patient A, who just checked out a minute ago, got an appointment (for a crown) in two days!

Discussion: Yes, doctors, when feasible, it`s a dream-come-true to gear your practice to an "ideal day," seeing your ideal patient in every time slot. But, get real! In this case, the doctor`s ideal day became the scheduling coordinator`s recurring nightmare ... as she tried time and again to fit a square peg into a round hole. No wonder the last three scheduling coordinators left! Since no exit interviews were conducted, we can only surmise the reasons for their leaving. Imagine a 30-something-year-old woman with strong values; very feeling in her temperament ... so much so that she dislikes telling people unpleasant things like, "You can`t get an appointment for 12 weeks." She has a strong aversion to discrimination, and that`s how she views this situation ... "high-ticket patients, step right up; everyone else, see you next season." Gritting her teeth, she goes along with it as long as she can. Finally, she quits. But she`s not alone when she walks through that door for the last time ... there are patients who won`t come back either, as evidenced by a patient-retention rate of 54 percent! So much for Dr. Myopic`s "vision"of the ideal day.

Treatment Plan: First, we computer-generated a report to determine the number of crown and bridge units the doctor had performed in the last 12 months. This number then was divided by the number of days worked in that time span to find the average number of crown and bridge units he worked on per day. We determined that this work was performed in two, not three, hours each day. Therefore, we recommended that two hours per day be blocked for crown and bridge, but to make it more patient-friendly by varying the times, i.e. - 9 - 11 a.m., 4 - 6 p.m., and 5 - 7 p.m.

A review of the old schedules also revealed that only 50 percent of the time slotted for emergencies actually was used for that purpose. The remainder of the time was being used to extend the lunch hour ... a needless waste of valuable time for doctor and staff! This historical data must be used in calculating appropriate amounts of time slotted for emergencies. Our final recommendation was for these analytical procedures to be repeated every three months to ensure that times allotted for crown and bridge and emergencies are, in fact, on target.

Sally Says: When it comes to an ideal day or ideal patient profile, may your vision not blind you ... but light your way.

Sally McKenzie is president and chief operating officer of Dental Partners, Inc., a full-service, in-office dental management and practice-acquisition company. She continues to serve as president of McKenzie Management, a division of Dental Partners, Inc. She can be reached at (800) 288-1877; e-mail [email protected]; or visit her Web site at www.dpi-mckenzie.com.