I've never written to your magazine before, although I faithfully read it every month. It seems that I've also read other articles that touched me in the same way as the one by Dr. Jack D. Griffen Jr. titled, "Dumb Ideas ... or How To Go From the Frying Pan to the Fire!" (December issue). Dr. Griffen described my practice to a tee, and, in doing so, he gave me a welcomed boost of confidence.
I've been in private practice for 22 years. For the first time, I've tried to change the new-patient exam routine so that it comes before the traditional prophy/X-rays/exam visit. The change has proven impossible due to my busy schedule and what I perceive as my patients' unwillingness to come in an extra time. As Dr. Griffen stated, most patients don't need more than 10 minutes of consultation time. For them, it's most convenient after the prophy. I've often felt my inability to restructure this system represented a philosophical failure on my part.
Hiring an office manager has been exactly as difficult as Dr. Griffen predicted. I agree that it's mostly my job to oversee things, but being somewhat disorganized makes it a burden. I also agreed with Dr. Griffen's views on Web sites, plants, and scented candles; I am grateful for his writing about these subjects. I rarely use amalgam, although I keep it in my office just in case a patient requests it. I have two Accu-Cams, a CAESY system, and a laser, but no chairside computers, digital X-ray, or Panorex, because I agree that you can't have everything.
My fees are average to low for my area. I provide payment arrangements (I do get stuck occasionally). Some patients call me Jerry. I'm sympathetic and compassionate, and some people travel great distances to see me. Yet, I don't consider myself anything special. I make a great living, work pretty hard, and I have lots of the usual staff and patient headaches, but I couldn't or wouldn't talk my son out of going to dental school.
Dr. Griffen, thanks for validating the way I do things.
Jerrold B. Resnick, DMD, PA
St. Petersburg, Fla.
Short-term fix with a long-term liability
I always read Dental Economics from front to back as soon as it arrives in my office. One article caught my attention in the January issue by Charles Blair.
First, may I say that Charles has been a long-time friend, and I have the highest degree of respect for him and the outstanding work he does for our profession. His "Fifty Ways To Boost Practice Profitability" had many great tips for dentists of all ages, but I must take exception to several of the tips. I consider them a short-term fix with a long-term liability!
The first exception is that Dr. Blair recommends a 5 percent discount upfront for cash payments, but recommends reducing that discount to 3 percent if the patient wishes to use his or her bank card. This was a good idea until October 1998, when the banks put a stop to these methods and deemed them "discrimination." As you may have noticed, the gas stations for months had signs that read "one price cash or credit." If a patient reports this discrimination to a bank card center, the business owner can lose his or her privilege of accepting bank cards. The banks consider this a cost of doing business to those accepting bank cards.
Number 11 of Dr. Blair's tips says, "Recruit and hire the best possible employees, even if it means paying higher-than-average wages. Doing so ensures the highest productivity per dollar paid, and helps avoid costly turnover." While I agree with part of this statement, we all know that some of the highest-paying dentists in the profession can't keep staff long because the work environment is so negative and no appreciation is shown. Staff members work for more than money; paying someone higher-than-average wages does not mean he or she will perform at higher levels than others in dentistry who are paid less per hour. Some of the most dedicated staff members I have met in the past 22 years of consulting and speaking were not lured to their jobs with money.
I think Dr. Blair meant that if the salaries in the practice are too low to attract quality applicants, the salary and compensation packages should be reviewed and updated to bring them in line with the 21st century.
Number 12 advised dentists to keep only a skeleton crew of business staff employees when the doctor isn't seeing patients.
Number 17 advises hourly pay rather than salary! With the staff shortages we have in dentistry today, how many good staff members will accept a full-time job, then be off without pay while the dentist takes 6-10 weeks per year for CE and vacations? Not only is this advice detrimental to keeping staff, it is the biggest cause of staff turnover. I don't know about Dr. Blair, but my personal bills go on 52 weeks per year. Show me a person who can be off without pay for weeks during the year, and I will show you a person who will seek employment elsewhere!
We all know that hourly pay creates a "you owe me" mentality (unionized thinking). In my client offices that have salaried, 52-weeks-per-year staff, the amount paid to these dedicated workers is small compared to the constant turnover problem with staff members who took a full-time job because they needed it, then learned "Oh, by the way, when I'm off, you're off without pay."
Number 19 recommends that the retirement fund be age-based to increase funding for the doctor and reduce it for the staff. If money is the only reason an employer works, this is good advice. Frankly, the money that I have funded for my staff over the past two decades is the best money our firm has ever invested. If it were not for my staff, their retirement, nor mine, would not be a reality.
My theory is, "Take care of your people and your people will take care of your clients and you!"
Overall, Dr. Blair's advice has merit, but when it comes to defending staff-turnover issues, I just had to give another point of view.
CEO, LLMiles and Associates
Virginia Beach, Va.