Exceptional Dental Practice Management

Do You Take My Insurance?

How do you talk about dental insurance in your practice?  Does everyone in your office understand how you handle insurance?  Do your patients?  A good description of the way your practice handles dental insurance should be covered in your practice's financial policy brochure.  When new patients enter the practice someone should go over that policy with them and let them know what they can expect from the practice.  All staff should be confident in discussing dental insurance plans with patients.  The person who handles insurance in the practice must be well-versed in your state's insurance rules and regulations.

In these challenging economic times, patients want to know that they will be able to get as much help paying for their dental care as possible.  Even fee for service practices would be wise to use their computer software capabilities to quickly generate forms for their patients and to go a step further and be willing to assist to some degree with complications that sometimes arise.  Some practices extend 3 months grace period with no interest which allows patients to receive their payment and ask for an amount at the time of service with the remainder divided over the three months.  Often the patient receives their payment and pays the balances well before the three months is up.  Patients appreciate the consideration and seem to accept treatment more readily. 

One of the most confusing things for patients is the PPO plan.  Patients are starting to worry when they receive a notice from their insurer saying that their dentist is not in-network and that they will receive better coverage if they choose an in-network provider.  The wording often implies that they must choose an in-network provider and that's often not the case.  Be careful to assure them that they can still use their benefit with you and explain that while they may see less of a percentage per procedure, they will still have a reasonable coverage amount available to them.

Finally, patients often don't understand the difference between medical and dental insurance.  Dental insurance is great for preventive care and general restorative care.  For patients who are in good dental health and don't have the need for extensive restorative care, it should cover a good deal of their treatment.  Medical insurance gives the most bang for the buck when things get big.  Most medical insurance has a deductible that must be met before the patient receives any real help, but if they are facing surgery or an extensive illness, medical insurance should be a big help.

Like most things success depends on knowledge and preparation.  If everyone knows how to interpret the patients plan, how to explain it so they can understand, and how your practice handles insurance, it can be a great benefit to the patient and the practice.  The next time a patient asks, "Do you take my insurance?", how will you answer?

Tell Her, Not Me

When you think about your job as a manager, do you think that you have to have all the answers and fix all the problems?  If you do, you may be more trouble to yourself than you need to be.  If you want to be a really good manager, you have to learn to lead others to learn how to think and act for themselves.

How do you teach adults to do that?  Aren't they already set in their ways?  Nope.  You have to teach them to believe that they can be right, and you also have to show them that they can survive being wrong.  That's the tough one.  People hate being caught in the wrong.  So, don't catch them, let them catch themselves.  To do that you have to trust them as people who want to do things right and believe in their character.  That means you have to know that you are hiring the right people.  Someone commented on my last post and said that to avoid the curse of the employee who is dead in the water after 6 months, you have to be very careful in your hiring. 

I agree, but I also think that it's very hard for an employee to dazzle at the interview and fizzle on the job. Recently, we hired another person in our office who would be a roving assistant, working at both the front desk, as well as helping out in the back. The idea was that the current front desk and the new staff member would function in these roles together so that one would always be at the front and the other would be available if we needed her in the back. The front desk assistant already knew all the tasks for both areas and she was to teach the new employee. In my mind, I felt she'd be happy to have the help since she seemed to be getting run a little ragged. After a few days I asked the new staff memeber how it was going and she said, "She doesn't want to train me, she's worried for her job." Since I had made it clear that I wanted them both to work in tandem and that we would work this way from now on, I was somewhat disappointed, but not shocked. The new employee said that the other employee showed her things too fast and didn't wait for her to catch on. I told her I'd talk to her the next morning. In the morning I sat them both down and told them that each of their personal success would be measured by the success of the other. If one sabotaged the other, they would both fall. I also told the new person that if she felt the other wasn't trying to teach her she needed to stop and ask her if that was true. If you haven't told her, why would you tell me? At least give her the chance to know how you feel." And it would be the same if the other employee had an issue. Talk to each other, it doesn't have to be a fight, it can just be a way to understand each other. If they needed me to intervene, it would be a conversation that included all three of us. I let them know that together, they could cause wonderful things to happen for the patients, the practice, the staff, and last, but not least, themselves. "Imagine the satisfaction of knowing you made the practice run smoothly and the patients feel wonderful because you tried and managed to put your own insecurities and self interest aside and just trust each other. Just try it today and let me know how it feels. If you don't like it, we'll talk about a different approach." At the end of the day they were stamping cards and I said, "So ladies, how did it go today." The new employee said, "I was just going to come and tell you...it was great! I learned so much from her today and I just love it!" I smiled and said, "Ok, tell her, not me."

The Six Month Curse

What is it about being in a position for 6 months that makes some people think they've got it for life?  I think it's unfortunate for everyone when an employee gets too comfortable in their progress once they hit 6 months.  I guess that they feel like they know enough to get through the day pretty well, but they don't add anything new.  Imagine if everyone in the practice, including the dentist was satisfied to stay as is after 6 months.  Now that's a scary thought.

Comfortable can be a dangerous place to be and it's a disastrous place to stay.  It's ok to hang out there for a little while, but only to get ready to move on the the next challenge and to learn more.  It is crippling to a practice to allow lethargy or complacency to take hold.  In other words, laziness and lack of interest will bring your practice down. 

Sometimes really nice people can be lazy and lack the desire to grow.  Try to push them a little and they'll spend more effort trying to push you away and throw up blocks than they will trying to go along with you.  The problem is staff gets attached and so do patients.  They don't realize that there is more to it than just being nice.  You need the total package and have a right to expect it.  If you keep up with feedback and setting goals, you have a right to expect the person to work toward those goals.  If not, you may just be faced with the six month curse.  What are you going to do about it?

Unity

"What we must decide is perhaps how we are valuable rather than how valuable we are."   ~Edgar Z. Friedenberg~

The days of an employee in a dental practice being more valuable than another, just because they have certain credentials are coming to an end.  In this new, challenging economy, it becomes ever more clear that how and what we contribute is just as important, maybe even more important, than the credentials we insert after our name.  Every person in every position has worth and the way they perform, the way they interact and treat others determines their value to the practice.

The fact that I can use CDA/CDPMA after my name doesn't mean that I'm better than someone who doesn't have the letters.  It doesn't make me work harder, behave better, or think smarter than someone who doesn't have it.  It only means that I went through a course and then  took and passed a test.  The real test is in what I do with what I know.  If I use it to help my co-workers, serve my patients and boost our practice, I'm doing something good.  It's the same with the DDS and the RDH.  They are letters that stand for the education required to earn the right to use them.  They represent long hours, dedication and some amount of personal sacrifice.  The value they represent is in the potential to serve that they allow the bearer.  To be of value, the bearer must serve and create unity between those they work with.

When a person stands on their credentials and believe that it somehow makes them more valuable than others, they are at cross-purposes with the thing they desire; to feel important.  When they take their accomplishment as see it as a means to increase the level of the work they do with others, there is true value and importance in that.  Sharing knowledge and teaching skills never diminishes what we already have, no one can take that from you.  Rather, it increases your own value and that of the person you share with.  Knowledge shared is knowledge squared.  When you share and increase the value of another to the practice and the patients, you create unity.  It is the best use of your knowledge and skill and by using those in that way, you have found the way to be of value.

Let It Be

"I made it a rule to forbear all direct contradiction to the sentiments of others, and all positive assertion of my own. ...I  soon found the advantage of this change in my manner; the conversations I engaged in went on more pleasantly.  The modest way in which I proposed my opinions procured them a readier reception and less contradiction."   ~Benjamin Franklin~

I don't know about you, but I'm one of those people whose brain has a direct path to my mouth, and unfortunately, the restraint of wisdom always seems to be a few beats late.  I'm telling you, in a world where anything goes, I would probably be clasping my hand over everyone else's mouth so I could release all the fabulous ideas that are bursting forth at any given moment.  Thank goodness I do have some self-control, or I'm sure everyone would hate me.  At some point in life, we all have to grow up and let other people talk.  I can remember sitting with my friend Diane when we were younger.  We would be sitting and talking and I'd find myself really frustrated with having to listen to her.  Why couldn't she just quiet down (nice way of saying shut up) and let me talk.  What I had to say was infinitely more interesting than what she was putting forth.  At some point, we both admitted that we were just waiting for the other to stop talking so we could get our 2 cents in.  That admission was undoubtedly fueled by wine and tolerated only because we love each other.  We laughed about, but as I go through life, I realize that the same feeling often reappears with others who are stone cold sober and would tolerate less and who don't love me enough to put up with it.  Therefore, the need for self-control.

Why are we so enamored with the sound of our own voice sending forth wise thoughts and advice?  Why do we think others want to hear our contradictions of their own wisdom and thoughts?  How come we can enjoy repeating the same story as if we've never told it before?  I think part of it is a certain amount of insecurity.  We have to show others that we have worthwhile ideas.  Part of it is a need for attention.  Some of it may just be inattention and thoughtlessness.  We don't realize that we are driving other people crazy and making ourselves look self-involved and insensitive.  Well, now we do, right?  I don't want to ruin anyone's fun, but sometimes you can have more fun when you engage and interact, rather than just conducting a one woman show.

If you've ever been around a blabber-mouth (and I sincerely hope it wasn't me), you know that it's a bore.  "When will she stop, I can't listen to one more word?", is a thought you're probably familiar with.  Now, think about friends that are quieter, and more laid-back.  When you talk to them you can tell they are interested.  When they talk, you want to hear what they have to say.  Now, think about that when you consider discussions with patients and staff.  I remember working with a hygienist that kept a running monologue going with all her patients.  She would spend an hour spouting off about her own life.  Even when she did ask the patient a question, she'd end up interrupting and answering it herself because she couldn't stand the lag time between her words entering their brain and them formulating an answer.  The patients seemed to love her though and no one bothered to mess up what seemed to be a good thing.  When she left our practice, we got the real story from the formally silent, or should I say silenced, patients.  Many missed her pleasant demeanor, but no one seemed to miss being a captive audience.  Quite a few commented that she never asked them about their oral health and never let them finish a sentence.  So, was she beloved, or tolerated?  Which would you rather be?

Let's think about staff.  Do you realize how easy it is for an out-spoken, confident, knowledgeable person to intimidate and less confident staff member into silence?  When that happens it can be a double-edged sword because the staff member may be perceived as disengaged or disinterested.  It is no accomplishment for a manager to have all the ideas, even if they're great ideas.  Why?  Because people get tired of carrying out the ideas of others.  You can conceive the idea, but sometimes you have to let your staff be the ones to come out with them.  How?  You have to guide them to the thought.  You can do this by giving examples and asking questions that will lead them to the thought.  Let's say you want your hygienists to be more proactive in developing protocols for their patients. 

Here's how the dialogue might go.  I'd sit down with them and ask them if they were seeing a lot of the same type of problem in different types of patients.  They may remark that older patients have a lot of root caries.  "Oh really, why?"  "Well, they have a lot of dry mouth issues, they have poor dexterity, they eat a lot of carbs."  "Oh, what do you think would help?"  "They could use an electric toothbrush, use Xylitol products, extra fluoride, etc."  "Ok, so what do you think we can do to get them to do that?"  We could show them a Sonicare, talk about Theramints, offer to do a fluoride treatment at their recall, and even put them on shorter recalls."  "Ok, great ideas, will you please write out that protocol and put it in your hygiene manual so it's official.  You can start implementing it right away.  Great idea!  Will you keep track of how many patients you suggest this to, how many accept, and what the results are?  We'll have a special meeting with Dr. Smith to go over your findings in three months.  I'm excited by the ideas you came up with!"  Enthusiasm, encouragement and expectation of success all help to ensure that there will be follow through.

Now, that's exactly what you had in mind.  Do you think they'll be more likely to incorporate the above into their routine interactions with patients that fit the example if you just tell them to do it, or will they be more likely to implement ideas that they thought through and verbalized themselves?  It's always much more comfortable to brainstorm than to be told what to do.

Finally, you don't always have to contradict or put forth opposing ideas.  Sometimes we can feel someone is dead wrong and still survive if we keep it to ourselves.  As long as no harm will come of it, respect the right of others to hold true to their own thoughts.  Sometimes even a gently put forth opposing thought can demoralize and deflate, and that's not what you would ever intend, is it?  So every now and then, resist and let it be.  You can't dim a shining star; if you sparkle, believe me, everyone is aware of your glow.  But too bright can be blinding and hard to stand for very long.  You can polish a glare to a luster by letting others have their own light.  

"Let your light shine within you, so that it can shine on someone else."

                                    ~Oprah Winfrey~

Ok, so a lot of people make fun of me (my husband, my daughter, my boss) because I like Oprah, but you have to admit she comes up with some pretty quotable sayings.

Basically, what I'm saying is give someone else a chance to shine.  Let others be the star.  You be the soft glow that warms the room and draws the whole world in.  Then everything will be just fine.

Total Medical Compliance Rocks

 You know me, when I like something I let you know.  Our staff and I just spent the day in training and it flew by.  Never thought I'd say that about OSHA and HIPPA training.  Casey Morris from Total Medical Compliance (TMC)did a fantastic job making what can be a boring subject, interesting.  She worked with our staff to make sure everyone understood, in everyday terms, everything we need to know to keep our staff, patients and practice safe. 

People tend to groan when they think about OSHA, but to be realistic, it's good to be safe.  We owe it to our staff to keep them healthy and injury-free.  Staff owes it to the practice to practice good work safety habits.  That is much more likely to happen with education and enforcement.  Our patients need to know that we are doing everything we can to safeguard their personal and medical information.  Again, education and enforcement makes it much more likely that it will happen.

What was so great about Casey in particular?  She's down to earth and doesn't come off as if she's here to shove your shortcomings in your face.  She's not a know it all, but she truly seems to know everything.  We've had in office training before and felt like we'd been told off by the time the person left.  Not with Casey, she was professional, yet personable and she welcomed questions and scenarios.  That helped our staff feel that they could understand how to apply what they learned in a normal working day. 

If you need training, I'd check them out.  We are now the happy owners of both a very concise and easily usable HIPPA and OSHA handbook.  There were things that came up that I never thought we needed, but that will make responding in emergencies and unusual situations easier and less stressful. Who ever thought anyone could make these subjects something to write a blog about? 

The Nobility of Labor

"It is impossible to enjoy idling thoroughly unless one has plenty of work to do."            ~Jerome K. Jerome~

Happy Labor Day, I hope you're getting a chance to relax.  I want to ask you something;  When you think about what you do for a living do you think of it as a job, or a profession?  Do you enjoy what you do?  In the past few years I've heard more and more about things that make me feel sad for people.  Assistants who read text messages while they are assisting chairside, hygienists reading magazines during downtime, front desk assistants checking out their Facebook page,  and dentists calculating the amount of years they have to endure until they can retire.  What's up with all that?  Why are people so disengaged from their work, or even just plain loathe to do it? 

I think it all begins with finding work you love.  Let's start there.  If you keep going back to a job you hate, day after day, you have three choices; quit and find something you love to do, stay and find a way to love it, or stay and be miserable.  I don't suggest the third option because not only will you be miserable, you'll make everyone around you miserable, too.    Let's see if we can fix that.

Dentists,  I'll start with you.

1. Don't keep bad staff.  These are the people you fixate on, wonder what you should do about, and dread seeing.  They keep you from being happy in your work.  They drag good employees down and cause chaos and resentment.  They are more interested in drama then their work.  Set them free, they'll have a better chance of finding something they love to do, too.  You ruin people when you tell them they need to change and then tolerate it when they don't.  Discipline has to be learned at some point, let it start with you.  They may eventually come back and thank you.
2. Find a manager that is obsessed with the business of your practice.  As Warren Buffet says, "Obsession is the price for perfection."  People who are obsessed with their profession would do it even if they weren't paid as handsomely.  They do what they do because they love it.  An obsessed manager will not only keep your team going, they'll keep pointing out the best way to go to you, too. They'll watch your money and keep an eye on the next thing that needs to be done.
3. Develop a great team.  Once you've gotten any bad employees out, work with your obsessed manager to develop a fantastic team.  It is work, but it's worth it.  It never ends, you don't get to rest on your laurels, but after a while you look at your great team, hear them serving your patients and realize, you love the process of creating this team, so why would you ever want to stop.
4. Decide what you want your practice to be, because it will evolve with or without your direction.  Do you want to stay small, or bring in associates and partners and open satellite offices?  Do you want to get out on the lecture circuit and become nationally known or are you happy in the comfortable niche you've created?  Whatever your practice becomes, be sure that your vision drove it there.  Make it a practice that you love returning to day after day, one that really makes you feel great about what you've built.
5. Look at what you do and how you do it.  Do you slow down and enjoy your patients and get to know them?  Do you understand the role that your work plays in their lives?   Do you see that your employees come to work every day to help you with your vision for your practice?  Can you make that all true for yourself?

Staff, it's your turn

1. Do you like what you do and see the value in it?  Really think about what you do.  Of course some of it seems routine or maybe even too simple.  It depends on how you think about it.  I get a lot of satisfaction from keeping the lab clean.  You might wonder how I see that as helping our patients, or even why I'd enjoy it.  If things are clean and orderly there will be less retakes of impressions and more time to spend on more satisfying patient care. It's background work and maybe no one else notices it, but it satisfies me to see it look so good.  Find the satisfaction in doing something just a little better than would be merely acceptable.
2. Value each other.  Really look at your co-workers, including your boss, and see how wonderful they are.  We all have something wonderful about us, it's just that many times the bad stuff is what we notice in the moment.  Think about it, someone else may do something annoying or ridiculous once or twice in the course of the 8 hours we spend with them.  The rest of the time they are perfectly fine and we take it for granted.  It's the 2 minutes of obnoxiousness, or aggravation that we tend to focus on for the remainder of the day.  Find a way to turn it around and brush off the annoying quirks and embrace the perfectly fine behavior that fills the rest of the day.
3. Value your patients.  They are trusting you and depending on you to care.  Do your best for them, get to know them and understand them.  Don't judge them, try to make them feel cared for.  Find pleasure in making something easier for them or helping them care for themself better.

Get it together people.  One of these days you're going to run out of time and then it's too late.  You'll have spent your life in an unhappy state.  Work hard with your head and your heart and then enjoy your rest.  Appreciate the opportunity to work, it's not a guaranteed right, just ask someone who can't find a job.  Hold up your end, find the right profession, educate yourself continuously and strive for excellence every day.  Then you will understand the nobility of labor.