AUTOMATED ANSWERING SERVICES ARE LOOSING YOU GOOD PATIENTS

It’s time to get rid of automated answering services during working hours.

The truth is that if you are using an automated answering service during working hours, you are loosing potential new and returning patients.

By survey, most patients feel that it is very impersonal to be received by an automated answering service and they get the idea that you are too busy to see them, so they rapidly hang up and move on! It reminds them too much of a big corporate operation – very impersonal and uncaring. They feel that once they get the automated answering service they are a number being handled by a machine and no longer a patient being cared for.

I can understand using an automated service when the practice is closed at the end of the day, but outside of that, there is no reason you should. Patient communication is one of the most important aspects of patient care. It will make or break a practice.

It can occur that your front desk gets flooded with incoming calls or has to work with a particularly talkative person, preventing them from answering incoming calls or patients coming into the office as quickly as they’d like. I find that the automated answering service is still not the way to go. I’ve had success in addressing this by working out alternative staff that are assigned to answer incoming calls when the front desk coordinator is unable to or by training the front desk coordinator to politely place a call on hold, so they can handle incoming calls or patients. This prevents the need to have patients talk with a robot to schedule their next appointment.

Good communication skills are valued as much or more by patients as clinical skills. Personal contact with you and your team, whether positive or negative, is the most memorable aspect of the medical care they are looking for. Patients assess the quality of their care not only on clinical excellence, but also on the quality of communication with the practice staff.

Getting rid of the automated answering service, establishing the personal touch with your patients and implemented the following guidelines will improve patient contact and thus build patient satisfaction. 

 

Telephone Communication

• Answer before the third ring.
• Smile as you speak to the caller.
• Begin with an appropriate greeting (per the policy of your office).
• Find out the reason for the call without being abrupt. 
• Offer to help the caller.
• Speak pleasantly despite pressures.
• Speak professionally.  Avoid jargon or slang.
•  Refer to the caller by name. 
•  Gather the necessary information (name, phone number, reason for the call) when taking calls for other staff members.
• Record phone messages accurately to avoid confusions. 
• Ask permission before placing callers on hold.
• Thank the patient for calling.  End without sounding abrupt.
• Check the off hours answering machine for messages at the beginning, middle and end of each day.
• Get back to people as soon as possible.
• Revise the off hours answering machine message once per month.
•  Revise the outgoing message to reflect closure for meetings, training, vacation, etc.

Reception Communication

• Smile and greet patients by name as soon as they enter the practice.
• Use the patients’ surnames until invited to use first names.
• Know the reason for the patient’s appointment.
• Sit or stand erectly and make good eye contact.
• Listen to the patient’s point of view and show that you understand.
• Answer questions in a concise yet complete manner.
• Explain the reason for appointment delays and offer the patient the choice of refreshment or a rescheduled appointment.
• Speak pleasantly despite pressure.
• Avoid jargon and slang.
• Explain clearly the financial policies of the practice.
• Use short sentences and simple language when giving instructions.
• Let patients know they are welcome in the practice.

In summary, if you get rid of the automated answering service and establish the best possible personal relationship with your patients, you will see your patient satisfaction improve and you practice will benefit in improved patient numbers and better practice viability.

It’s all about service!

HOW IMPORTANT IS YOUR OFFICE MANAGER?

In most practices I've worked with, the Office Manager, is the most underrated and undervalued position in a medical practice.

The Office Manager (or Practice Manager) is regarded, in many cases by the Owner, associates and other medical staff, as a glorified receptionist or office assistant. Often, as a result, people who have minimal to no management experience or training are hired and assigned this position, which furthers the idea that the Office Manager isn't really the manager.

This is also evident in the low pay grade of most Office Managers, where they are paid slightly higher then the front desk staff and much lower than Technical staff.

But in truth the Office Manager is a profession related to office supervisory positions, responsible for coordinating work flow and hiring, training, and supervising office staff and should be looked at as a partner in the smooth operation and stable growth of a practice.

The Office Manager is the executive who should be responsible for the smooth running of the front office operations and back office operations.

He or she should work closely with the Owner in managing day-to-day operations to obtain the longer term goals set by the Owner. Ideally, with a competent Office Manager, the Owner of the practice is allowed to practice medicine (which is why the owner usually went to so many years of school anyway!) and the Office Manager manages the practice.

The owner would set short and long-term goals for the practice and the Office Manager would be responsible for seeing that these goals were met.

Here is a summary of some of the functions an ideal Office Manager:

- Supervise the production of the personnel.

- Ensuring the smooth operation of each area and stepping in when necessary.

- Statistically tracking the growth of the practice.

- Handling staff performance issues.

- Handling human resource functions.

- Working with the Owner to set and enforce office policies.

- Run the daily and weekly production meetings.

- Hiring and firing of personnel (with approval from the Owner).

- The financial well being of the practice and planning of how monies will be used to grow the practice (in coordination with the Owner).

- Overseeing the promotion and marketing of the practice and its services.

- Ensuring the bookkeeping for the practice is in order.

- Ensuring that actions are being taken to create a steady flow of new and returning patients to the practice.

- Seeing that proper treatment plan presentation is being done by the medical staff.

- Proper scheduling of patients.

These are just a handful of the actions the Office Manager should be responsible for, which makes it clear that the Office Manager has to be regarded as more than a glorified office administrator.

To make this work the person hired as the Office Manager has to be qualified as a manager and has to be someone that can competently execute the above actions.

The position must be given its due importance.

On top of this, there needs to be a delineation of duties between the Office Manager and Owner (which I will cover in my next blog) and a regular meeting period between the Office Manager and the Owner to coordinate on practice production and goals.

Give your Office Manager position the proper value and assign that position the duties above. Then fill that position will a qualified person and you will have a steadily growing practice.

Starting a Profit Sharing System for Your Practice

The purpose of a profit sharing plan (bonus system) is to reward production and enhance staff morale and commitment to the team.

First off, a profit sharing plan should only be given when it is affordable to the practice.  Therefore, the first step in establishing a profit sharing system plan is to determine the point at which “extra” monies exist with which a share of the profits (bonus) can be paid.  To do this, you must confront your overhead (what it costs to keep your business there), what you intend to net out of the business, and additional sums to cover a reserves fund, money for owner of the practice and staff training, and money for equipment replacement or expansion.  Part of this process is to confront where your staff payroll is as a percent of your collections; for a dentist you want this ideally to be below 25%, for an optometrist close to or just below 20% and for a veterinarian close to or below 18%.

When this viability figure has been determined, you can reasonably afford to pay 20% of any collections over this amount into a staff profit sharing pool.  If, for example you determine that $60,000 is a viable level of collections (overhead met, owner of the practice's net where it should be, money for reserves, training and equipment handled), and the office collects $70,000, then 20% of $10,000 can go into the profit sharing pool, i.e., $2,000 in this example.

I recommend that this profit sharing system amount be based not on the collections figure for one month, but from a three-month running average.  For example, the collections for the past three months has been $60,000, $65,000 and $70,000.  The average of the three is $65,000, which would be  $5,000 over the $60,000 viability point, which puts $1,000 in the profit sharing pool (20% of $5,000 is $1,000).  This “running average” is designed to factor low months into the equation; otherwise, staff are not penalized for low months, only the owner of the practice is.

Now that we have a profit sharing pool of $2,000 (in our earlier example), we need to distribute it.  There are a variety of ways to do this:

1)      The simplest way to do this is just divide it evenly amongst the staff.  Part-time people either don’t participate or are given a share of the profit proportionately to their time (1/2 time people get half as much profit share (profit sharing) as full-time people, which is probably the simplest way to work this out and would also probably cause less internal noise amongst staff.

2)      Another way to divide it is proportionately to staff members’ pay – on the principle that staff value to the office is reflected is what they command as pay and that they deserve a share of the profits (or bonus compensation) on the same basis.  (For a dental practice I would not bonus Hygienists proportionately to their pay, as this would throw the bonus way off for the rest of the staff.  If Hygienists are part of this system and does not receive a bonus separately on their own production, I would bonus them at the same rate as a highly paid Expanded Functions Assistant.)

3)      You may want to work up a division of the profit sharing pie based on other factors than pay, e.g., length of time in service, responsibility level in the office, etc.  Here would simply have to work with relative percentages of the profit sharing pie meted out to staff until you felt the relative amounts were just.

An additional factor can be used to further reward an individual staff member’s personal productivity: their own production statistic!  To factor this in, you can take a staff member’s portion of the pie and divide it in half.  Let’s say in a 6-person office, an Office Manager is eligible for 25% of the profit sharing pool.  Each half is 12 ½ % of the profit sharing pool.  If there is a profit sharing that month, the OM automatically gets 12 ½ % by virtue of being on the team.  The other 12-½ % she gets provided her personal statistics are improved from the week or month prior.

These ideas are offered as a starting point for developing a bonus system and profit sharing plan for a practice.

The basics are:

1) it is affordable to the office, and

2) it does in fact effectively reward productive staff and enhance their morale, motivation and loyalty to the practice.

I hope the above was helpful and I'm sure variations on this and other ideas have been proven workable.

A Quick Way to Increase Your Practice's Production

In any practice, and on any given day, there are hundreds of parts all running simultaneously.

In practices I've worked with I've observed this to be confusing and most often, not planned for properly, which can result in lost production, poor service and internal upset. All of which can have the potential of lost patients and lost income.

I've also worked with practices that weren't regularly going over the practice growth goals and did not go over the necessary daily production goals with the staff. As a result, in each practice, potential production was lost.   

For any Practice Manager (or owner of a practice) this is a major concern and can take up a great deal of time and personal energy from the manager and owner trying to either prevent or resolve the resulting losses.

There is a solution implemented in a number of practices - the daily huddle or production meeting. It is a simple tool that can have immediate results and improve production and service to your patients.

Implementation is simple:

a) Schedule the daily huddle at the start of the day.

b) Ideally all staff attend, including the Owner, Practice Manager, associate doctors and staff. (If all of your staff can't attend, work to have have as many as possible attend as it will still be very productive.)

c) The Practice Manager runs the huddle.

d) All patients for the day are discussed, with any specific details gone over to ensure great service, like scheduling, coordination on additional coverage, etc.

e) Production targets are set for the day (e.g. how much of a specific service to be delivered, how much in treatment plans to be sold, how many reactivated patients, etc). I will discuss in a later blog how to set production targets and the value this will have in increasing your practice's overall viability.

All of this can be done in about 10 to 15 minutes and will definitely increase staff productivity and service to your clients.

It also results in improved morale and your practice staff working as a team.

Now it may take a bit to get this fully organized, but if you do, you will immediately increase the quality and amount of service to your patients, resulting in a growing practice! 

THE VALUE OF KNOWING HOW TO SELL YOUR TREATMENT PLANS

Training your staff on presentation and teaching basic sales techniques is important in getting patients to accept their treatment plans. I'm not talking about being a used car salesman, but using honest sales techniques that really help a patient see the importance of the treatment.

This also does not replace the quality of the services you've provided and the actual value of the treatment plans you offer.

When training staff on sales, a good technique, is to help the patient understand what might happen if they don't move forward with the treatment plan. Don't do this as a scare technique, but be honest so that the patient understands why you feel they need the treatment.

For those that don't close and don't decide to move forward with the treatment plan and need "some time to think about it" try to schedule them for another appointment so you can see them again and get another chance to tell the patient about their treatment plan and its value to the patient.

Also doing regular calls to past clients that have not been back to the office after a year is a very productive way to finish treatment plans. More then likely they've gotten caught up and forgot about their treatment plan and a reminder might get them back in to actually do the treatment. I call this reactivation calling.

When you do call your patients that haven't been in for a while you should have a dialog that makes it important for the patient to respond and get back in touch with your office or makes them want to come back in to see the doctor. I've worked out a fairly good "reactivation" dialog for this and if you are interested please feel free to contact me.

I would also be interested in any successful "reactivation" call dialogs that you might have. Please share them with me!