Romper Room revisited

Dec. 1, 1999
Case Profile: A picturesque vineyard lies just across the meadow from this laid-back West Coast owner/associate general practice. Staff includes four front-desk employees, four dental assistants, and four part-time hygienists.

Sally McKenzie, CMC

Case Profile: A picturesque vineyard lies just across the meadow from this laid-back West Coast owner/associate general practice. Staff includes four front-desk employees, four dental assistants, and four part-time hygienists.

Patient base is composed primarily of area professionals, vineyard owners, management, and not-too-shabby retirees. Despite having all the components of a California Dreamin? kind of practice, this is one ba-a-a-d dream, dude.

Symptoms: The numbers for collection, patient retention, and unscheduled treatment are nothing short of disastrous, and have their own tales to tell.

Observations: After observing this office in action on the first morning, I didn?t know if staff would rather see me pack my bags and leave E or pack a lunch and play with them. Of the four front-desk girls (and I do mean girls), the oldest is 22. Three are married, two have babies, the third is trying to get pregnant, and the fourth is looking for Mr. Right. With Obusy workO as their cover, they indulge in perpetual chit-chat. On that first morning, I jotted down key words I overheard as they talked. The list went from diaper rash, colic, pediatricians, and creamed corn soup, to how to get stains off woodwork, how to fix a traffic ticket, how to conceive, how to know when you?re really in love, and how to avoid pre-wedding syndrome. I fully expected Dr. Ruth, Martha Stewart, and Judge Judy to walk in at any moment.

Discussion: Youth in a dental office can be refreshing, but not when a Romper Room teeny-bopper decked out in teddy-bear-studded scrubs, says to an elderly couple at checkout, OHey, how you guys doin?? Didja guys wanna pay?O In this direct quote, Melanie sounds like she?s still selling tickets to an ice-cream social at the high school E and no one has told her otherwise! Nor has anyone given her or her Romper Roommates any job descriptions, job training, or accountability. Clinical?s got to be better than this, right? Yeah, fer sure!

With two doctors and four dental assistants, simple math would dictate two assistants assigned to Dr. Mellow Owner and two assigned to Dr. Make-No-Waves Associate. Nix E things here are so laid back that whoever is free at the moment

will assist. Adding even more chaos to the flying-by-the seat-of-the-pants

goings-on are the four part-time hygienists. You?ve heard of whirling dervishes?

Well, I think they perform here daily. Pity the poor patients trying to figure out who?s on first. Dazed and confused by the time they leave, patients never get to know their hygienist. Any question, Doctor, about why patient retention

is 46 percent E and over 90 days is 47 percent E or why there?s a whopping $1.7 million in unscheduled treatment plans? The only question is: How did this happen?

Not liking structure, the good doctor always welcomed freedom and change. He believed that his calm and cool hands-off management style worked pretty well back in the days when he had two staff members. But now, 12 employees later ? plus an associate dentist ? the old calm and cool has brought the practice pretty darn close to crash and burn. Gotta work quick if we?re going to save this one!

Treatment Plan:

1. Hire a mature office manager who can turn the Romper Room Obending, stretching, and reaching for the starsO into a professional support structure, complete with job descriptions and accountability. By outlining expectations, providing training, reviewing employee performance, and rendering feedback, a good office manager should be able to maximize the energy in this group of young women, and, at the same time, minimize their adolescent mindsets and mannerisms.

Areas of training should include collection, billing, scheduling, and recall.

2. Assign dental assistants to a doctor.

3. Say goodbye to two hygienists, and give the two remaining ones longer hours,

the exact number to be determined by demand. Then, schedule to goal.

4. Call and order McKenzie Management and Associates? audiotape series, OA Team Approach to Treatment Plan Acceptance: Getting Patients To Say OYes.?O In conjunction with listening to these tapes, either the office manager or another staff member should be trained as, and take on the responsibilities of, treatment coordinator. Whatever the salary, it pales in comparison to leaving $1.7 million on the table.

Sally Says: Staff, like children, will tend to meet what is expected of them, be that more or less.

Sally McKenzie is a Certified Management Consultant, nationally known lecturer, and author with more than 32 years in the dental profession. Her sole

proprietorship, McKenzie Management and Associates, provides in-office systems? analysis of the business, clinical, and hygiene department; staff training; and offers a full line of educational-management books, audiotapes, and videos.

McKenzie?s dental clients span 40 states over 20 years. She is a consultant to the Council on Dental Practice of the ADA. Call Sally at (877) 777-6151, or e-mail: [email protected], or check out her Web site at