This simple phrase is the foundation of having the practice you want. Dentists generally prefer the clinical world over the business component of their practice, therefore, they fall short in holding their staff accountable for performance. The dentist, and often the office manager, functions under the false belief that everyone on the team is as dedicated to their career as they are. They become frustrated and stressed when they find that overall, the practice is underperforming.
What is underperforming anyway? If you study the November 2013 Dental Economics’ recent survey of dental practice, you see that the average dentist is producing an average of $3500 per day. The average hygienist produces $998. The average practice with both produces one million per year. To produce this one million, staff wages costs an average practice $250,000 per year or 25 percent, (salary only, no benefits). This overview of AVERAGE tells you if your team is effective.
If you don’t have the practice you want, why not? Begin the process to uncover the inefficiencies in your practice by inspecting what you expect. Decide what the standard performance is for each position. Next, determine how you will grade, (inspect) the performance you have standardized.
Here are a few of the standards I use when I analyze a practice:
• Doctor’s daily production averages at or above $3500 per day or $440 per hour.
• Hygiene daily production equals three times her salary, a minimum of $1000 per day or $125 per hour.
• Hygiene production is made up of 25- 30 percent periodontal procedures.
Business staff – each month the dentist or office manager meets with the person responsible for these performance standards:
• Collections over a 3 month average equal 97- 98percent.
• Insurance over 90 days outstanding equals 0.
• Accounts Receivable over 90 days is less than 15 percent (without ortho).
• Over- the-counter collections are at 40-60 percent.
• Treatment Acceptance is at 75 percent.
• Days are consistently scheduled to meet production goals for dentist and hygienist.
• Recall percentage , (percent of active patient s who have been in the practice within the past 6-7 months), is at 75 percent.
• Broken appointment or open time in hygiene is less than 8 percent.
• Broken appointment or open time for doctor is less than 5 percent
Dental assistants:
• Lab cases or any in-office lab work is back on time.
• Patients are seated and room is completely set up before Doctor arrives – no fetching!
• Dental supply spending is 5-7 percent.
• Assistant is in the room when Doctor arrives – no calling.
• Expanded function duties are quality, e.g., temporaries the assistant makes are quality and don’t come off.
There are other items that you might want on your standards of performance. The challenge is to be clear about the standard by writing your own expectations. Then, create a time to review – inspect what you expect. Human nature takes its natural course. If your hygienist knows you are going to look at her perio production percentage, she is going to reach for that expectation. If your business team member knows you are going to actually look at her Insurance Aging Report, she will tend to work to meet your expectation. It is human nature to want to please the “boss.” If, on the other hand, you DO NOT inspect and only expect, you will be disappointed, and an underachieving practice will ensue.
When, you ask, “How am I going to do this inspecting?” Dr. Pete Dawson in his wonderful Top 10 Percent Course gave this guideline – if you see a patient for 32 hours, at least 10 percent of that time should then be devoted to what he called sharpening diamonds. That 3.2 hours is a combination of staff meeting, staff training, and time for your inspecting.
Many dentists want to come in, perform clinical dentistry and WANT the practice of their dreams. Unfortunately, that is often a dream unrealized. To run your business as well as your practice takes an investment of time, not just money, into your highest cost overhead item – your team. The investment includes setting the standards that you expect and then taking the time to INSPECT what you EXPECT.
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