No ones taking charge

Feb. 1, 1999
Case Profile: Although her practice is in High Point, North Carolina - furniture capitol of the world - our young general practitioner is far from sitting pretty.

Sally McKenzie, CMC

Case Profile: Although her practice is in High Point, North Carolina - furniture capitol of the world - our young general practitioner is far from sitting pretty.

Symptoms: Having prematurely brought in an associate, this practice has one too many doctors, a declining number of patients ... and a staff that`s not up to the challenges at hand.

Observations: A Southern gentlelady, our Dr. Scarlet gives the illusion of being in control. But, in truth, she`ll do almost anything to avoid confrontation: Like bringing in an associate because the schedule is booked out three to four weeks! Like accommodating staff schedules at the expense of the practice. Strikingly similar to a baton in a relay race, each vital practice decision is passed from hand to hand, manipulated by all, and dropped when the going gets tough.

Discussion: This place is up for grabs. To accommodate the two doctors in a three-operatory office, the schedule was split 7 a.m. - 1 p.m. and 1 p.m. - 7 p.m. This business assistant had to be out by 3 p.m. ... and that one couldn`t come in until noon. What happened here is what typically happens whenever a 12-hour workday is divided evenly among staff in two six-hour shifts ... accountability for practice systems goes out the window as part-time mentalities take hold. The 37-percent patient retention here proves my point ... as does the decay in practice revenues. No one`s taking charge. Here`s the sum total of the recall system: If and when one of the hygienists has a cancellation, she`ll make calls. Some system! And collections? One of the business assistants prints next-day route slips, reviews patient accounts, and while confirming appointments, she tells patients how much money they`ll need to bring. It`s no wonder that this practice is losing patients as fast as it`s losing money. What it boils down to is no systems, no accountability, no job descriptions, no structure, and no performance measurements. High marks in High Point? No way!

Treatment Plan: When the associate doctor leaves this spring, we`ll be going back in to determine whether or not to replace him. Clinically speaking, chairside assistants have been underutilized in this practice. If more responsibility were delegated to these assistants, it might free up the schedule enough so that Dr. Scarlet could go back to being a solo practitioner ... with only a two-week wait!

In the interim, here`s what else needs to be done. First, the doctor needs to look for staff that fits her schedule ... not compromise her business to fit staff whims and whimsy. Next, instead of splitting the shifts evenly, the core office staff should work from 7 a.m. to 4 p.m., with part-timers filling in the 4 - 7 p.m. shift. Once in place, this core staff must be responsible for improving patient retention, increasing the collection ratio, reducing accounts receivable, streamlining scheduling procedures, providing outstanding customer service ... and seeing to it that part-timers don`t drop the ball in any area during their shift. Of course, none of this can be implemented without sufficient training, as well as very specific job descriptions and management that understands the importance of and implements performance measurements. Although these are not new ideas, I keep hammering away at them because they`re all too critical to be cast aside as they had been here.

Sally Says: Hiring right, training, job descriptions, accountability, and performance measurement. It`s a formula. Why mess with success?

Sally McKenzie is president of Dental Partners/McKenzie Management, a full-service, in-office dental management company. She can be reached at (800) 288-1877; e-mail [email protected]; or visit Sally`s Web site at