Down-home or downhill?

Aug. 1, 1999
Case Profile: Southern Ohio is the location of this practice, just a stone`s throw from my own hometown of Barnesville. A general dentist - practicing for 11 years - has a folksy practice, a modest income, and a so-so staff.

Sally McKenzie, CMC

Case Profile: Southern Ohio is the location of this practice, just a stone`s throw from my own hometown of Barnesville. A general dentist - practicing for 11 years - has a folksy practice, a modest income, and a so-so staff.

Symptoms: In a last-ditch effort to turn job performance up a notch - after years of sitting back and accepting mediocrity - the doctor recently implemented an across-the-board bonus system for his staff without thinking it through. Now it`s costing him a lot more for the status quo.

Observations: Although a down-home atmosphere can be refreshing, this one`s so laid back that there`s a ho-hum mindset among staff members. Not a spark of life or creativity. Not even a clever excuse offered by the chairside assistant who has trouble getting up in the morning. Only five or 10 minutes late each day, she thinks it`s no big deal. But when you combine those five or 10 minutes with a good 30 minutes more that it takes her to get going, it becomes a very big deal. Sadly, productivity losses don`t end there. The business assistant - who gets paid to be on the phone calling past-due accounts, and confirming appointments - receives far more than her share of personal calls. Even when she`s not talking with her kids, or mother, or sister, she`s telling a co-worker or a patient about the soap opera going on at home.

Discussion: In his quest for greater productivity, the doctor resorted to dangling a carrot in front of his staff members to get them to do what is already their job. The fact is that these long-standing employees don`t have the vaguest notion of how to increase productivity. Make more copies of the daily schedule? Ultrasonic clean instruments twice? Reconfirm confirmed appointments? Would that increase productivity?

Treatment Plan: Step one of the treatment plan was to help our doctor come to terms with some basic truths.

First, if his employees - who`ve been with him for five to 10 years - actually possessed the knowledge and skills to increase productivity, but hadn`t done so because they weren`t being paid enough, would he really want them to continue working for him? Next is the recognition that no group of employees will put out the same amount of effort ... so what`s the point of an even distribution of bonus perks? Employees need to be rewarded on an individual basis for performance above and beyond what is required. Period.

Step two is to establish clearly defined practice objectives, as well as specific job expectations. This process is spelled out in my book, How To Reward Your Dental Team. If the financial coordinator is expected to have a 35 percent over-the-counter collection ratio, but she achieves 48 percent, her performance calls for a reward.

Step three - and I can`t overstate the importance of this - Determine what type of reward would best motivate each employee. Using the test I developed for How To Reward Your Dental Team, we found that of this doctor`s five employees, three would rather get time off to spend with their families than to receive bonus money. The more an employee treasures the reward she receives for outstanding performance, the more likely she is to repeat it.

Sally Says: Increased productivity does not call for a bonus. It`s a requirement for surviving in business, and the means to providing your employee with a secure job that pays a fair wage. Rewards above and beyond are given only for performance above and beyond.

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, e-mail to [email protected], or check out her Web site at www.mckenziemgmt.com.

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