Looking for a utility infielder

May 1, 2000
Case Profile: This general practice in metropolitan Phoenix is located close to a stadium that hosts professional baseball teams during spring training. The doctor - a solo practitioner, with three hygienists, four assistants, and three business employees - would be very happy to trade in his hand instruments for a bat and glove.

Sally McKenzie, CMC

Case Profile: This general practice in metropolitan Phoenix is located close to a stadium that hosts professional baseball teams during spring training. The doctor - a solo practitioner, with three hygienists, four assistants, and three business employees - would be very happy to trade in his hand instruments for a bat and glove.

Symptoms: Retention is down - strike one. Receivables are up - strike two. There`s $270,000 in unscheduled treatment - that`s strrrrrrike three.

Observations: The most significant factor is that the doctor is out in left field. He readily declares that he`s not a leader and doesn`t want to "manage" his practice or staff. He wants to do his dentistry and be left alone to dream about practice - baseball that is, not dental. Since the doctor has abandoned management of his team, what he sorely needs is what`s known in baseball as a "utility infielder" - the one person on a team who is capable of taking any position, including that of captain.

Because job descriptions have never been developed, all three business employees are involved in scheduling, handling the phones, patient accounts, recall, etc. The right hand constantly overlaps what the left one is doing. As a result, there`s no time and no one available to complete some tasks or to start others.

Sonya has been with the practice for 10 years, but is by no means "computer savvy." Denise started six months ago and Renee began three months before that. They are nice girls, but they haven`t been given the training they need to do their jobs - if they knew what those jobs were!

Finally, in the hygiene area, perio accounts for only 3 percent of production. No runs, no hits, but errors galore.

Discussion: Somebody has to pick up the management ball and run with it. Although staff members are busy doing whatever it is they think they should be doing at the moment, they don`t have a grasp of how their jobs fit into the life-cycle or goals of the practice. That`s a laugh - what goals?

Treatment plan: In the absence of a managing doctor on the scene, the first step is to recruit a business administrator/treatment coordinator who can bring some semblance of structure to staff efforts while addressing issues like job descriptions, training, performance measurements, hiring, firing, salary negotiation, etc. With payroll presently at 20 percent, this new hire - at around $35,000 - will need to be strong enough to carry his or her own weight.

Here`s my suggestion: This new employee needs to immediately call in the $270,000 in unscheduled treatments. With the help of Sonya - who will be appointed and trained as financial coordinator - the new staff member needs to reduce accounts receivable from 1.5 to 1 x monthly production, while reducing the 26 percent over 90 days to 15 percent.

Next, Denise will be appointed and trained as scheduling coordinator. She then will be expected to schedule production goals. Renee, who will be patient coordinator, must be trained to bring back recall patients, greatly improving the 56 percent patient retention and schedule hygiene-production goals as well.

In the clinical area, hygienists should receive the necessary training to increase interceptive periodontal-therapy programs from the present 3 percent to 33 percent of production. Finally, fees should be increased in several specific areas. Then, and only then, can this doctor and his practice play ball.

Sally says: Some might look at this situation like a coach who needs to discipline an unruly player. I would rather see it as an exceptional challenge which requires more creativity than correction. After all, isn`t that what dentistry is about?

Sally McKenzie, a proponent of advanced education for dental professionals, has recently launched The Center for Dental Career Development, in La Jolla, Calif. A Certified Management Consultant, nationally known lecturer, and author with more than three decades in the dental profession, Sally is a consultant to the Council on Dental Practice of the ADA. McKenzie Management and Associates, Inc., provides in-office analysis of the business, clinical, and hygiene departments; conducts on-site staff training; and offers a full line of educational management books, audiotapes, and videos. Call Sally toll-free at (877) 777-6151, e-mail: [email protected], or visit her Web site at: www.mckenziemgmt.com. For information on The Center for Dental Career Development, call toll-free at (877) 900-5775 or visit the Web site at www.dentalcareerdevelop.com.

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