I recently spoke at an event with Michael Birbari, of Dundee Securities in Burlington. His seminar began with a very important reminder to me: success is a learned behaviour and not one invented by an individual. The techniques we employ to reach our various levels of success are indeed fundamental. The most accomplished people have reached their heights by using common sense tools available to all of us for generations.
So, if we can learn from the dentists who have achieved their goals, what exactly should we look for?
We performed an informal study of successful dentists and discovered that their practices exhibit a similar common denominator: they centre their practice management philosophy upon… their patients!
My father, Roy Brown, has studied the work of Wilson Southam, The Group of Cox and many other reputable dental leaders since the 1950s. My associates and I are very fortunate he continues to pass along information to us today. The core philosophy of these great minds was that you should focus your practice management primarily upon the “patient-centred practice” philosophy.
What exactly does that mean? How complicated is it to learn this proven philosophy? And is it still achievable in today’s ultra high-tech dental environment? The answer is, “Absolutely.”
The patient-centred practice simply means the majority of your practice modalities should be designed to serve the patient first. As a patient myself, allow me to offer the following suggestions on how to centre your practice around our needs:
1. Staff retention is important to the patient too
First and most importantly, I suggest you make all the reasonable attempts to reduce staff turnover, and that you employ only the best available personnel. Familiarity, when visiting health care facilities, is a very powerful tool for patient retention. Most patients eventually develop a rapport with the dental office team and are comforted to see the same friendly people each visit. Turnover, although unpreventable at times, reflects upon your ability to retain staff.
The team at the office I attend is mostly long-standing and are a significant factor in my loyalty. Therefore, I assume my dentist is a good “boss” or business owner and that’s why they stay. This reflects very favourably upon her technical abilities, a judgement I have made completely on my own. Your patients do the same thing when assessing your business acumen.
2. Minimize distractions
As a patient I would prefer to have a treatment plan presented to me outside of the operatory. A small and private treatment planning room can be very conducive to gaining my confidence and trust. Patients are much more likely to have a complete understanding of the treatment you are presenting when not confronted by various sounds, smells and disruptions of the dental office. Be cautious though, about using a private office with too many degrees on the wall, as it may intimidate some patients into feeling inferior.
As well, you should sit in the same type of chair and at the same height level as the patient, and use a table or desk that is identical on both sides. The objective is to create a non-threatening environment where I feel at ease while you present the information. People are much more likely to accept your suggestions when they are delivered in a warm and uncluttered space. Do not allow me to view highly technical or surgical images unless necessary. The use of modern imaging systems or high-quality display models can show me the possible results. The SciCan Image FX software and the Casey Patient Education CD-ROM are two examples of powerful tools for the delivery of before-and-after photos.
3. Be flexible around fees
Once a treatment plan is finished, we now need to talk about fees. I may not have the immediate ability to afford your treatment, and therefore wish to discuss payment options. If so, never do this while I am at the front desk, as I may well be uncomfortable discussing my personal finances in front of the staff or patients in the waiting room. Again, I suggest the treatment planning room. In many practices, I find these rooms are about the size of a small operatory. Decor is limited to one or two pleasant wall pictures, a small table and chair set (get at least two chairs for other family members) and an X-ray viewer. The models or computer screen should not be a barrier to the patient. Put them to the side and view everything as though you and the patient are both seeing them for the first time.
4. Explain and refine the administrative process
If your practice typically prepares pre-determinations for patients, please tell me exactly what will happen once it is mailed. Do I have any obligations to proceed? What do I do when something arrives in the mail? In many instances, insurance companies send a reply to the patient and not to your office. We have been in dental offices that believe if the patient really wants the work done, they will call.
I suggest that while in some cases this may be true, often the patient thinks just the opposite. They assume you are aware of the insurance approval and believe you don’t really want the work – and that’s why the office hasn’t called to make an appointment. A friend of mine proved this point recently by stating, “My dentist doesn’t care. The forms came months ago and no one has called me!”
This friend was approved for over $4,000 in work and he wanted it done. He even thought of going elsewhere because he felt “they don’t need my business.” Protocols for follow-up on submitted treatment plans are easy and may only require minimal tracking and management. I frequently discover tens of thousands of dollars of untracked treatments with which patients want to move forward.
Furthermore, in order to reduce downtime, keep a short list of patients who live or work nearby and are likely to have flexible schedules. For example, self-employed professionals are able to adjust their schedules quickly and go to the dental office on very short notice. If my dental office called today, there is a high probability I could go in for a cleaning within hours. Although I prefer every six months, a week or two here or there makes no difference in the quality of care I receive from them.
There is a tremendous cost to down time in a dental practice, as that revenue is lost forever. One hour a day of down time for the hygienist equates to about $100. If the hygiene department works 200 days per year, that’s $20,000 in lost income. The only way to make up for lost income is to work extended hours (which may cut into personal time) or increase wage expense unnecessarily.
We hear the new economy is all about information. Does a dental practice need to increase the flow of information to the patient? The answer is yes, but how can it be accomplished? Is it necessary to buy the latest and greatest computers to perform thousands of data scans, print dozens of reports and generate lists of overdue patients and many other tasks? My answer is maybe.
We find that the dental software in some practices is neither used effectively, nor understood by the dentist. Also, staff turnover often results in limited training and improper use of the many functions available. In some practices, we see manual systems that are exact duplicates of those on the computer – and the office uses both at all times. Appointment books, ledger cards and insurance forms are kept in manual and electronic form at a very high cost of time and resources.
My suggestion is to use either a manual or automated system – but pick one only. Purchase extra training and learn to use the technology yourself. Then you can be satisfied you are not entering the high-tech age just for the sake of buying high-tech, while knowing nothing about it. Watch out also for the “upgrade bug,” which can be a never-ending saga. If you catch it, you may find you never have the right mix of hardware, software or staff, but if you just buy a new “widget,” your problems will go away. Has anyone heard this claim before? “Mr. Brown, all you need is a new interface that will communicate with the slave drive so the server can connect to the stackable hard drive and then your e-mail network will be seamlessly running along side the 10/100 Ethernet network… blah, blah, blah!”
I just about gave up on computers last year when the tech people started rambling like this. However, we stuck it out, at considerable cost, and now have the very best system in the business. However, is that what you need for your dental practice? Dentistry is very different than other businesses and I have found the practice that concentrates on the patient – not the patient’s information – will be more successful.
In the words of Mr. Birbari, success is a learned behaviour, not luck. If you duplicate the behaviour of the most successful dental practices, your practice can be the optimal patient-centred practice too.
By Timothy A. Brown