Double trouble! Navigating two significant practice hurdles
The day had hardly begun when I heard, "What do you mean we have no schedule? I can't get my computer to log in" from my stressed business manager.
By Lori Trost, DMD
The day had hardly begun when I heard, "What do you mean we have no schedule? I can't get my computer to log in" from my stressed business manager. "Dr. Trost, my desktop screen is blank. I've been trying for 20 minutes to get the server to turn on. I've even checked the breaker box."
Of course I responded, "Try rebooting. That will fix it." Those words seemed hopeful. Yet the silence on the other end of the phone spoke volumes. My brain started racing. What knocked out the server? Was it a power surge? Could last night's storm have anything to do with this? How could this be happening?
The emergency plea to Nick, our computer tech, must have worked. After an unsuccessful attempt to log in, he said he could be onsite immediately. I thought, he's been "fixing, anti-virusing, and firewalling" us for several years, so he'll know what to do. I looked at the clock, and all this was happening before 8 a.m. Surely we'd have all this behind us before patients started arriving in 30 minutes.
A mere hour later, the computer disaster began to unfold. The diagnosis was grim. Our main server was struck by lightning, and that overrode both surge and power protection. Nick further discovered that while the backup was running in the evening, the lightning strike interrupted and discontinued that process. Although we back up daily onto an external hard drive, a mega-onsite server, and also to the cloud, all information for that month -- whether it be current, completed that month, or entered for future treatment or appointments -- was not to be found or accessed. The plan was to take the server offsite to the facility where each hard drive and backup could be examined.
What did this really mean? Time and reality began to collide. Every digital X-ray, digital Panorex, intraoral camera picture, appointment, treatment plan, insurance claim, text confirmation, the list went on, was affected.
Our practice has proudly been digital for 12 years. Using Dentrix as our backbone, in tandem with Gendex VixWin radiographs, an Instramentarium Panorex, and Spectra intraoral cameras, we have benefitted from the integrations of systems, in addition to providing excellent diagnostic capabilities and office efficiency for our patients. The blend of information that can be shared between six operatories, the front desk, and patients is impressive. It is digital harmony at its finest. But today there was no synchronization, just blank screens.
Somehow, we managed to limp along for the next two and a half weeks. A new customized server was installed, and thankfully all the data -- patient records, X-rays, photographs, insurance claims, and the like -- were recovered. At times, my team and I had to exercise immense patience, but we managed. Slowly but surely, each area that we rely on computerization was restored -- texts/emails from eCentral, imaging, and finally, insurance claims.
Six weeks prior to the computer disaster we experienced a serious credit card processing fiasco. The processing company for our patient credit transactions encountered a computer glitch. Payments were being recorded, but monies were not being deposited into the practice bank account. None of this was discovered until the end-of-month bank statement arrived in the mail. Almost 35% of the practice income reserve was missing. How could the bank do this? Instant panic set in, and getting the statement on a Saturday did not help!
Monday could not come quickly enough. After contacting the bank and explaining the missing funds, they were able to confirm that they had not received any monies from the credit card processors. Although this allowed us to identify the source, a chess game began.
Our initial contact with the credit card processors did not offer any answers or financial responsibility. They were clearly aware of a computer problem on their end, but none of their clients were complaining or questioning the missing funds. The problem did not seem to warrant any urgency, but my practice was missing money needed for payroll, supplies, and general business! Their nonchalant attitude toward rectifying this matter was appalling. More phone calls were made, and a week later there was still no resolution from the credit card processor, who claimed no responsibility. Only after the bank's legal team became involved did the credit processor act. Monies were located over the two to three weeks and deposited into my account. However, another hurdle presented itself. Ironically the bank deposits grew, but in large chunks of released and "non-batched" money. With each release of funds, the routing number had to be deciphered and coordinated to its corresponding credit card receipt from my terminal. This was extremely labor intensive. Ultimately, the credit card processor waived any fees related to my account for the affected two months and issued a prorated interest payment.
It goes without saying that this is a tedious economic climate. Whether your practice is small or large, urban or rural, we all encounter similar challenges from the business of dentistry. Unforeseen events such as loss of income or inability to collect monies that are due can cause serious, if not catastrophic effects on a practice. The key is to minimize the damage by having checks and balances systems in place, and to prepare for the unlikely computer failure or income loss. Although I have been practicing for over 25 years, several lessons from these experiences warrant sharing.
Here's what I learned:
Hire a reputable computer company, and then back up, back up, back up -- Make sure the technicians are knowledgeable with your software and are reliable when it comes to service, especially emergencies. They need to be able to access your system remotely because this saves cost and time.
Use dependable software such as Dentrix, and participate in their service plan -- You may get sticker shock when you first look at the cost of a service plan, but consider hourly service rates and how quickly they can add up. If you are a service plan member, you have a priority status, and in a crisis that can save you significant money and frustration – e.g., idle employees, a dentist unable to generate revenue, or lost data.
Carry a solid replacement insurance policy such as State Farm -- You do not want to find out after the fact that you are not covered for costly digital replacement equipment. The cost of a customized server, data transfer, and installation is significant. Troubleshooting a new system alone can cost several thousand dollars. While you're at it, secure an interruption of business policy.
Review bank statements monthly and reconcile with your credit card processor -- I know it's easy to wait for a few months and then bundle your monthly paperwork and send it off to the accountant, but DO NOT DO THIS! If I had not looked at that monthly statement, my practice would be in a serious financial hole!
Manage your credit card statements online -- Since the credit processing snafu, our practice now makes good use of an online system that provides immediate, real-time transaction information. I would also encourage you to share access with your accountant so that he or she can stay current.
Shop your credit card processing rate -- A silver lining in this whole fiasco was discovering that we could lower our processing rate. You will be surprised how willing they are to negotiate. We were able to cut our rate in half.
Create a reserve account for technology -- And then, replace computers and other digital items on an intentional calendar basis. This action ensures current updates while lowering the cost of a big total if done all at once.
Stick to a monthly budget -- An unprepared business/practice would have gone under. The adage of saving for a rainy day is so true.
Hopefully you or your practice will never experience these problems. By implementing solid business principles, you can avoid common pitfalls that cause financial distress. Here's to checks and balances and NOT to control, alt, delete!
Lori Trost, DMD, actively practices in Columbia, Ill., merging contemporary esthetics, implants, and MID. She is a nationally recognized lecturer, clinical evaluator, and author. She specializes in productive and efficient dental techniques and materials for the entire dental team. Her vision and approach to everyday dentistry is informational, motivational, and refreshing. You may contact her at email@example.com.
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