Sally McKenzie, CMC
Case Profile: What a view ... the awesome wonder of Mount St. Helen`s as it pierces the horizon. No sign of the devastation caused by the volcano`s eruption almost two decades ago. Although this Oregon general practice was in its infancy back then, the scarred landscape still remains.
Symptoms: A wicked drop in production since last year ... collections, virtually nonexistent ... patient retention, a joke ... while the doctor is being deluded by his receptionist, duped by his "management firm," and kept in the dark by his accountant.
Observations: The doctor is charged $300 a month by his management group - and I use that term loosely! What`s more, he pays another $230 to his accountant. Five-hundred-plus per month for "professional" management, yet, until we sat down and poured over the books, the doctor had no clue that production had dropped almost $50,000 in the last year! And, sadly, that`s not the only bad news we uncovered. Of 2,400 charts, only 755 are active. Of last month`s $33,000 in production, $30,000 still is on the books. In fact, 42 percent of total accounts receivable is more than 90 days past due.
On the personnel - and personal - side, Suzanne, the receptionist, received calls from her teen-age kids every 20 minutes from 3 p.m. on every day. Each call brought "Mom" visibly closer to home and further from the obligations of her job. Once school was out, so was Suzanne.
The proverbial straw breaking the camel`s back is that, last year, the management group - in its infinite wisdom - recommended hiring an associate dentist whom the practice has neither the need for nor the money to pay an associate.
Discussion: For brevity, I`ll just hit the highlights in the real-life "As The World Turns" soap opera. About five years ago, the doctor got divorced after his wife admitted to having an affair with their clergyman. A couple of years later, Suzanne - who`d been the doctor`s chairside assistant for more than 15 years - and who had long commiserated with him about his personal problems and hers - talked the doctor into letting her become his receptionist. In effect, she took over the running of the practice. The timing of this, by the way, coincided nicely with Suzanne`s divorce from the man she described as a self-absorbed, bulimic, compulsive gambler! Are you getting the picture? Doctor, doctor, how many times do I have to remind you that getting too chummy with staff invariably leads to a serious breach in logical thinking and discipline?
Treatment Plan: Although our first inclination as a consulting company was to fire Suzanne - the individual responsible for having 2.75 x monthly production in accounts receivable - we identified the practice weaknesses as system failures, instead of personal washouts. Here`s our plan of action: 1) Put systems into place for collections/accounts receivable, patient retention, and unscheduled treatment. 2) Provide Suzanne with the professional training she`ll need to be successful with these practice systems. 3) Set up a system of performance measurements, which will determine how well Suzanne is meeting practice expectations.
The other significant recommendations are as follows: 4) Have the associate dentist look for a more promising affiliation. 5) Send the existing accountant and management firm packing. 6) Have the doctor take a Dale Carnegie course and become the master of his destiny rather than a victim of it.
Although Mount St. Helens stands ready to erupt, not everything must go up in smoke.
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.
