Practice Management: What is the recipe for success?

This post is largely adapted from the PennWell’s Dental Group CE information pamphlet: The Business of Dentistry

This informatio is also available in PDF

Download the original pamphlet (PDF)

When you elected to own your own practice, you hopefully made a conscious decision to assume all the responsibilities that come with ownership. You can’t act like an associate when you are an owner. If the aspects of ownership are unclear to you then get clear and get clear fast. As an owner, you are taking responsibility for the oral health of your patients, the livelihood of your staff and the financial health of your family. The most important asset of your business, above all, is your patient base. Maintaining the patients you have while adding additional patients is essential for practice survival.

There are three areas that require your constant focus. Take care of these areas and success is inevitable. Ignore any of them at your peril.

• High Quality State of the Art Dentistry
• Outstanding Customer Service
• Practice Profitability

High-Quality State of the Art Dentistry

• Ensure that the techniques and materials you are using are regarded by the leaders in dentistry as tried and true. State of the Art dentistry is not experimental dentistry.
• Ensure that your equipment supports your techniques and the outcome you need.
• Invest in your team and yourself to ensure optimal results through continual training and coaching.
• Verify that the hygiene department in both the general dental office and the periodontal office are uncompromisingly and appropriately managing patients’ periodontal issues, with major emphasis on the patients’ overall health.

Outstanding Customer Service

Clearly identify the collective “Belief Systems” regarding customer (patient) service. The ranking of priorities must be:

1. Patient
2. Team
3. Self

The goal is to consistently make the patient #1 by addressing their needs and wants and creating an emotional impact on them:

When the Patient, Team, Self (PTS) priority is in place, the individual then, by definition, is taken care of by the team. Everyone’s needs are met.

 A second belief must be that the patient’s time is more valuable than the doctors or practice’s time. Be clear who is paying the bill. Timing your procedures is critical.

• Work endlessly on designing your schedule. Request that the clinical team review the schedule two weeks out to ensure that it will still work for both patients and team. Be sure to block schedule for productivity. Ensure that your morning huddle focuses on ‘pinch points’ and opportunities in the schedule. Patients who are seen on time, get out on time and have their emotional needs met, will refer.
• Work endlessly on team training so that all communication is patient focused and elegant. Tell your patients what you can do for them, not what you can’t do. Your patients need to hear, ‘My pleasure’ and ‘I’d be happy to’, ‘Yes, we can do that’. Do away with all the ‘Rules and Punishments’ you have for your patients.
• Work endlessly to ensure that all your patients have at least one or more appointments. Regard your patient base as your most valuable asset. Do not let them fall out of your cycle of health due to your neglect.

Keep your Patients in the Wellness Wheel

The purpose of the Practice Wellness Wheel is to ensure that every patient has at least one appointment. The Wheel allows you to focus on those areas of your practice that need attention in order for you to achieve the objective of every patient having an appointment.

• Keep your patients within the Wheel.
• Follow the arrows and follow the path of your patients, use reactivation to put those patients who have fallen out of the Wheel back on the wellness track.

Your practice cannot help but grow and be successful when you focus on the Wheel. Your patients will benefit with health and well-being.

Many of your patients would describe what you do to them as unpleasant or worse. Even if a patient has never had an unpleasant experience, there is that constant fear that ‘this visit could be the one time that I will experience pain’.

Patients accept this aspect of dentistry. What your patients don’t accept is a poor emotional experience.

• Invest endlessly in team training on emotional behavior and elegant communication skills to the same degree that you invest in clinical training.
• Never assume that your business will improve by taking a more advanced clinical course while neglecting the customer service component. This is shortsighted and foolish.

When referrals to specialists are needed, the general dentist must have met with the specialist and agreed upon a standard of care and the communication necessary to provide the patient with the best experience.

• As the specialist, approximately 80% of the referrals come from 20% of the practices that refer to them. Build great relationships and ‘lock up’ the 20% by providing and committing to superior responsive service. This will solidify the referral base.

Practice Profitablity

The basics of practice profitability are:

• Manage your income
• Keep current on your financial obligations
• Manage both practice and student debt
• Reinvest in the business as needed, with training, equipment and facility improvements
• Pay yourself
• Pay off personal debt
• Accumulate wealth
• Provide a lifestyle for yourself and family

Managing your income is essential for long-term financial success. Practice income comes from two sources:

• Patient payments: remove the negative emotional knee jerk reaction that doctors commonly have toward insurance. Your patients certainly do not view insurance as negative. They see it as an essential benefit without which many would never come and see you in the first place.
  • Congratulate your patient for having insurance and explain to them what it means.
  • If your schedule is half empty and you do not see an opportunity to increase your ‘full paying patient load’, then clearly joining the most attractive insurance plans allows you to fill your schedule. Use incremental thinking to obtain the best result.
  • Manage your insurance efficiently and in a timely manner. Insurance is essentially ‘guaranteed income’, when properly managed.
  • Collect the patient’s portion of the treatment fees at the time of service by ensuring that the clinical team is trained to ‘hand off’ to the administrative team, that the patient is informed of their cost prior to service – ‘inform before perform’, use outside financing when necessary and do not become the patient’s banker.
• Review practice accounts receivable in detail at least monthly with particular focus on any accounts over sixty days and major focus on accounts over ninety days. The goal is to have accounts receivable to be no more than fifty percent of the monthly production, i.e., if the practice produces $100,000 month, then receivables must be no more than $50,000. Also ensure that when the receivables report is run, that it does not include credits because credits reduce the total and also reduce the 0 – 30 day amounts due.
• Ensure that you are billing using an ‘alpha’ system for outstanding patient balance, i.e., the alphabet is broken down so that statements are sent daily rather than monthly to reduce the work load in the administrative area and statements are resent after insurance payments have been received.
• Daily, weekly and monthly monitoring of the primary components of the practice, especially production, collections, receivables and new patient flow is a must.

 Leaderability = Leadership + Accountability

• You must become a great leader who manages with accountability:
• You must have a vision
• Your employees want a passionate leader
• Be a great decision maker
• Trust is the force that connects people to each other
• Leadership is not just about what you do, it’s about what you can inspire, encourage and empower each other
• A leader brings out the best within others by sharing the best within themselves
• Rules without the relationship lead to rebellion
• Lead with optimism, enthusiasm, and positive energy, guard against pessimism and weed out negativity
• Leaders inspire and teach other people to focus on solutions, not complaints

Great leaders do not compromise values or standards. Great leaders maintain high standards and hire the best people to achieve excellence in all areas. A great leader needs a high performance, self-managed team to support the vision and the practice culture. Steve Jobs said it best – ‘Going to bed at night saying we’ve done something wonderful – that’s what matters to me.’

This information was reproduced with permission from the PennWell’s Dental Group.

This information is provided as a clinical support tool and does not warrant continuing education credit.