Inner-Office Communication

March 1, 1996
One of the biggest reductions of productivity and a major factor in low office morale stems from weak inner-office communication. Unless you deal with this frustration on a daily basis, you have no idea of its negative effects on the work environment.

Linda L. Miles, CSP, CMC

One of the biggest reductions of productivity and a major factor in low office morale stems from weak inner-office communication. Unless you deal with this frustration on a daily basis, you have no idea of its negative effects on the work environment.

Many dentists and staff feel they are just too busy to communicate effectively, or they don`t realize that the minute or two they spend documenting, listening or reviewing notations or computerized messages can save many hours of lost time. The best reward of taking this time is improved office morale.

Breakdowns in communication include:

1. Staff-to-patient communication. Complete health histories, insurance data, treatment plans and personal data for each patient consistently reduces the possibility of redundancy in patient education, lack of clarity and confusion regarding treatment fees and decreased case acceptance. Knowing which member of the team is accountable for each part of the communication cycle will diminish errors, increase morale and give your practice an air of efficiency, competency and success.

2. Business-to-clinical-staff communication. In most practices there are two or three clinical-staff members to every front-desk (business) staff. The busy scheduling coordinator sometimes forgets to alert the clinical team of changes in the schedule or patient notes that are pertinent to treating those patients. It is the total responsibility of the business staff to reduce stress by communicating these changes within minutes of their occurrence.

Setting up for a procedure that has changed isn`t exactly efficient, and it surely doesn`t create goodwill between business and clinical staff. Thirty seconds of communication to the clinical team can save 10 minutes of their time and is certainly worth the business staff`s time and effort. A business-staff member who goes out of the way to communicate effectively with each clinical person will be amazed at how much more willing the clinical staff will be to helping them. Reciprocal communication is a must for team-building.

3. Clinical-to-business-staff communication. A major frustration of the business staff is having a patient arrive at the desk with little or no information about what has been done, much less instruction on what needs to be scheduled or collected. Interruptions are the major source of maligned time management. The computer care slip must be carefully checked off with treatment performed, pertinent notes, fees (if they differ for any reason), treatment to be performed on the next visit and the units of chair time for that next visit. Computer terminals chairside allow all clinical staff to key-in treatment performed, appointments and the entire treatment plan. This will relieve the "bottleneck" of patients at check-out as they pay and depart. In the not-too-distant future, patient fees will go directly from the patient`s account to the doctor`s office account via wire transfer. This will completely change the present inner-office communication between clinical and business staff.

4. Doctor-to-staff communication. Monthly health-of-the-practice and statistical-data staff meetings are a must to properly maintain a practice. Morale and teamwork are enhanced when staff members present a personal, monthly progress report on their particular part of the practice. Feeling "in on what`s happening" creates accountability and heightens self-esteem. Morning huddles and daily chart audits boost inner-office communication. For part-time staff, record the monthly meeting or distribute minutes to each team member for filing in their continuing-education notebooks under the title "Staff Meetings."

Office mailboxes above the copier assure team members that memos are distributed to all at the same time. If one team member needs to communicate with another who is out of the office, a note can be left in the appropriate mail box. Computer E-mail is the best way to communicate effectively if the nature of the message isn`t confidential.

Wipe-off boards are an excellent way to keep staff up to date and should be used for tracking lab cases and other miscellaneous memos such as birthday lunches, bridal or baby showers, or scheduled vacation/leave days for the staff.

Doctor-to-staff communication is greatly enriched with one-on-one staff evaluations. These are done at 90 days for new employees and at least once a year for long-term staff. The doctor also should schedule separate luncheons every month with each section of the staff. A luncheon with dental assistants one day, hygienists another and business staff another, each month, will go a long way toward improving communication. Conversations should focus on ways to improve the care given to patients and concerns with their current positions. This is not a gripe session, but a productive, practice-enhancing session.

5. Doctor-to-doctor communication. In practices with more than one doctor, it amazes me how little the doctors communicate with each other. Lack of communication filters from the doctors to the team. Monthly meetings, weekly breakfasts or lunch sessions, and an evenly-distributed amount of practice management greatly improves communication between doctors.

On a scale of one to 10, with 10 being the highest, rate your practice on the following:

1. Staff-to-Patient Communication

1 2 3 4 5 6 7 8 9 10

2. Business-to-Clinical-Staff Communication

1 2 3 4 5 6 7 8 9 10

3. Clinical-to-Business-Staff Communication

1 2 3 4 5 6 7 8 9 10

4. Doctor-to-Staff Communication

1 2 3 4 5 6 7 8 9 10

In areas where you scored below an 8, note a few ways to enhance inner-office communication.

Communication weaknesses can`t be ignored. Openly discuss these factors and the solutions suggested by the team. Let Dental Economics and Linda L. Miles hear how these changes have improved your inner-office communication within 90 days.

The author is an internationally-recognized consultant and author on practice-management and team-building. She is founder and chief executive officer of Miles and Associates in Virginia Beach, VA.

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