SUCCESSFUL WAY TO HANDLE CANCELLED APPOINTMENTS

I suggest the following steps as a successful method to handle patients or clients that have cancelled a scheduled treatment appointment:

1.      When someone calls to cancel they need to be reminded of the importance of the treatment plan, their specific medical health need and immediately rescheduled.

2.      If they do not reschedule, this indicates that they have some questions or concerns that have not been addressed and which need to be handled.

3.      At this point you, if they don't reschedule, the doctor needs to call them and follow up on why they are not continuing with the treatment plan. The doctor needs to ask them what happened and/or why they are not scheduling. Listen to their answer as there is something that must be handled, such as past experiences that were not good, alarming information they’ve heard about the treatment, financial concerns, etc.

4.      Get the information and handle it by providing the additional information the patient needs so what ever their concern was it has been addressed.

5.      Once they are handled, reiterate the importance of the treatment plan and get them scheduled for the next visit.

These steps have improved patients rescheduling after previously cancelling treatment appointments. 

Holding a Productive Practice Management Meeting

Some weeks back I posted an article on the value of the Office Manager. As part of that article I brought up the subject of scheduling a regular meeting time between the practice Owner and the Office Manager to plan the production and management of the practice. Following is an outline for this meeting:

1.      Review your practice's statistics - compare this week's (or month's) key production numbers (such as Gross Production, Net Production, New Patients, Total Exams, Amount of Treatment Plans Presented Compared to the Total Amount Accepted, etc) to the previous week's or month's numbers to determine if the practice is growing or detracting.

2.      Determine the necessary steps to improve the production of the practice. Write a plan of action (also known as a "battle plan") for implementing the steps you determine necessary to revert any decline and/or create stable growth.

3.      Review any items from the previous meeting that needs to be followed up on, including the previous week’s (or month's) plan of action to determine which targets were completed and any targets that need to be carried over to the new plan of action.

4.      Take up any promotional matters; i.e., review the Promotional Calendar; review the previous month’s New Patient log to see where new patients are coming from; ensure that promotional actions are being planned; and discuss the effectiveness of promo being done. Ensure that you add any promotion action targets to your plan of action for the week.

5.      Take up any financial matters, i.e., any needed or proposed expenditures.  Also review the previous weeks's (month’s) expenses by category and compare to your budget. Determine any necessary actions to curb spending, plan on long term purchases, etc.

6.      Review the Accounts Receivable Aging Report to ensure all aging A/R is being confronted and worked.

7.      Take up any additional personnel matters to ensure these are being handled or are scheduled for handling: 

               a) personnel problems, 

               b) personnel successes, 

               c) needs for training, 

               d) job reviews, 

               e) correction or staff disciplinary actions

8.      Take up any proposed changes in policy or procedure for the practice.

9.      Discuss and decide on your theme or subjects for the next staff meeting and write up an agenda.

Getting the above steps done weekly, will improve the coordination between the Office Manager and Owner and will result in improved management and overall stable growth of the practice.

CREATING A PRODUCTIVE REFERRAL SYSTEM FOR YOUR PRACTICE

Happy clients and word of mouth marketing is one of the most effective methods to fill your practice with new patients. An internal referral campaign to get your existing patients excited about telling their friends and families about your  the way to actively create new patients and is very important and very inexpensive.

This is one of the first things I start when working with a practice:


1. Encouraging referrals – when a new patient calls in, find out who referred them.  This of course is done by the receptionist over the phone.  Make a point to acknowledge the person whom referred the new patient.  For example, if Sally Smith referred the patient, the receptionist would say something such as “My, Sally Smith’s such a nice lady, isn’t she?  It was so kind of her to recommend our services to you!”  This if the first time the new patient hears about referrals.

 

The new patient then comes into the office and fills out a New Patient form on which it has a question, “Who may we thank for referring you?”  This is the second time the new patient’s attention has been directed to the idea of “referrals”.

 

Finally, the Doctor introduces himself to the new patient, looks at the forms, and notes who the patient has been referred by and says, “I see Sally Smith referred you.  We all really enjoy her.”  This is the third time the patient has thought about referrals.  This impresses upon the new patient the fact that referring new people to the practice is very much encouraged and is appreciated.

2. Put a tastefully bold sign you waiting area - "We would like to help as many people as possible with their health needs. Please feel free to tell your family and friends that we are accepting new patients!" or a similar wording.

3. Survey your employees and patients for an award or discount you can give them for getting new patients into the practice (obviously can't violate any local laws on referring patients). This can be a Starbucks card, gas card, or something similar for each new patient gotten from referrals and can increase with the number of referrals a patient or staff member gets.

4. Create simple referral cards with the practice's contact information and stating that your practice is accepting new patients. Offer a special for new patients. Something significant, but not at a loss for the practice.

5. Hand out two (2) referral cards to all patients as they leave. Tell them how many people don't take care of their dental needs and that you want to help provide needed dental care and that you would like them to tell as many of their friends and family as possible about your practice. Let them know what special the new patient will get and what award they get when someone comes in with a referral card.

6. The staff should initial the cards they hand out so they can be awarded too.

7. Also recommend drilling your staff on this so they are comfortable doing it.

I have had real success implementing the above steps in many practices, though I have found that for each practice they have different response times before they start seeing an improvement in new patient numbers, but it does work.

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!