setting up dental practice Archives - Page 3 of 4 - Dental practice management consultant, speaker and coach

Hello and welcome to Ascent Dental Radio. A program dedicated to the balance between the clinical aspect of health care and the business of health care. And now here is your host, Dr. Kevin Coughlin.

My name is Dr. Kevin Coughlin. Welcome to this week’s podcast which specializes in organization, development and training and education for your dental team or health care unit. The name of my website is www.ascent-dental-solutions.com. I can be reached by email at drkevin@ascent-dental-solutions.com. I hope you enjoy this podcast.

I’ll start by stating that in almost all of the information that I share for the last 33 years of practicing dentistry and continue to practice dentistry, unfortunately, almost nothing I say is original and this particular podcast is no different. I have been fortunate to take thousands and thousands of hours of continuing education and listened to many great thought leaders, not only in the dental profession but in the business profession and I have modified or addressed many of their comments to suit the needs of what I feel would be an ideal dental practice.

The following acronym will help you develop a special dental practice. Special spelled S-P-E-C-I-A-L. I would ask you to remember the word special and start with the letter S, which stands for Scheduling. If your dental practice does not have control of the schedule, your life will be miserable and your results will be just as bad. The most important concept is the time value of money. And over 33 plus years the single largest mistake I see in practice over practice in the 14 practices that I own are mistakes with the schedule, either scheduled too lightly or too heavily.

I cannot emphasize the amount of training and time that is necessary to inform your front desk managers, receptionist, team members how to schedule appropriately. There is an art to this and that art starts with the ability to profile the patient and their problem. I would strongly recommend that the individuals answering the phone should know whether the patient is a new patient or existing patient.

They should be able to determine whether they have a problem or no problem at all. If they have a problem is it top, bottom, right, left, front or back, the duration of the problem and the intensity of the problem simply by asking the following, “Mr. or Mrs. Smith, on a pain level scale of zero to ten — zero no pain, ten the most severe pain — how would you rate this?” Then you want to know the duration of the problem as you’re gathering this information which usually will take no more than three minutes on the phone.

The next issue is to be able to profile the patient with either a CareCredit check, a Wells Fargo check or some type of preliminary check for dental insurance and finance reasons to determine if it is most likely Mr. or Mrs. Smith are going to stay and want a root canal build up in crown, an implant or they’re simply going to want a prescription and deal with the problem later on or simply go for a lower type of production procedure such as an extraction because they are not interested in the time or investment in saving their teeth. This profiling and screening of the patient will dramatically improve your schedule and dramatically improve your bottom line, but perhaps most importantly make your life much more enjoyable.

The second letter in developing a special practice is P for Production. Obviously we know production is important but keep in mind what you really want to concentrate is net production. This simply means that in many types of the software what I’ll see is the office production but not net production. This means that the dental insurance has one fee and your office has another fee. For example, you may charge $1,500 for a PFM or Porcelain-fused high noble crown but your insurance company may only allow you to charge $950. Understanding net production and what you’re writing off with insurance companies, government plans, etcetera, is critical to have a profitable end of the day and end of the month bottom line.

The next letter is E for Education. If I could emphasize one thing, training, education and communication should never end. It starts with a morning meeting, it continues with a pickup in the afternoon and it should end with an ending meeting. If you feel that you can communicate without really communicating, trust me your practice has problems. This ongoing training and education should be built on proven successful processes and procedures and those processes and procedures should be written, explained and understood.

Next in the word special is C and C stands for Collection. At the end of the day if the dollars are not collected for the procedures done, your practice will be a failure. You will not have enough profit to expand and improve your staff and your business. Collection is the gasoline for the engine and you must understand that the goal is to collect 100 percent of what’s being produced. Failure to obtain that goal or have the proper processes and procedures to obtain that goal is shame on you and the results will have long term negative effects.

Next in the word special is I, and it stands for Insurance. You, your team, your managed service organization have to clearly understand the type of insurance plans and most importantly your front desk personnel because different insurance plans have different reimbursements.

As a general rule, evening hours and Saturday appointments, Sunday appointments, early morning appointments, lunch time appointments should be saved for the highest producing and production type patients possible. This means that you are dedicating your time and effort, taking away from your family and friends, you should be rewarded with the highest financial gains. This starts by fully understanding each patient, their type of insurance and what the reimbursement is going to be for that insurance and almost more importantly, your front desk understanding what is covered, what is not covered and what your patient will be expected to provide for finance in fees.

Next in the word special is the letter A, and A stands for Accounts receivable. Over and over again I find that the staff is completely disconnected on what healthy accounts receivable should be. I use the rule of 45 days. That simply means what your net production is, your accounts receivable should be 45 days of that. So if your net production is $100,000 a month, then your accounts receivable should be approximately $150,000. If the accounts receivable are in excess of that, your policies and procedures are not working or they’re not being implemented. If they’re far below that, you may want to take a hard look that your financial policies may be so strict that you’re losing opportunities to provide additional care and services.

Lastly, the L stands for Liability. In all businesses, you want to reduce your liability or risk. My personal opinion is there is no better way to reduce your liability than having written treatment plans that are signed and agreed to by your patient in writing. Failure to get these signed, scanned written treatment plans that provide the risks, benefits, options, costs is a mistake that will cost you time, money, stress and aggravation.

I hope you’ve enjoyed the podcast. There’s no reason in the world you cannot also have a very special practice providing you focus on scheduling, production, education, collection, insurance, accounts receivable and liability. If you need help with the processes and procedures in these specific areas, don’t hesitate to contact me at drkevin@ascent-dental-solutions.com or at www.ascent-dental-solutions.com and visit my website which focuses on knowledge, development, training and consultation. I hope you’ve enjoyed the following podcast and thanks so much for listening. My name is Dr. Kevin Coughlin.

Hello and welcome to Ascent Dental Radio. A program dedicated to the balance between the clinical aspect of health care and the business of health care. And now here is your host, Dr. Kevin Coughlin.

Welcome to the following podcast. My name is Dr. Kevin Coughlin, owner and creator of www.ascent-dental-solutions.com. Please visit my website and listen to additional podcasts, but today’s podcast is on designing a winning customer strategy.

So let’s get started. First, there’s a difference between believers and achievers. Data indicates that about 92 percent of CEOs believe they are providing excellent customer satisfaction. The reality, however, is only about eight percent really achieve it. The goal is to be that eight percent. How to become that eight percent and bring you from a believer to an achiever is to focus on what I refer to as the 3Ds. You must first design then develop and then deliver.

Design simply means the appropriate segmentation of your patient or customer base to complete customer experience in each of the segments involved in your valuable final product. Develop simply means you must reinvent and renew your customer experience over and over. Change is good but change must be for the better.

Lastly and perhaps most importantly, is the action step of delivering. Every department, every team member must be pulling in the same direction. Failure to achieve this last action step will put you in the 92 percenters of believers rather than achievers. The alternatives of not becoming an achiever is simply more money on advertising, more sales people, more acquisitions, more products, more gimmicks, more waste of time and money. Simply stated, you must delight your patient or customer base in all aspects.

It’s common knowledge that managers tend to feel more accountable for improving profits. Most managers do not feel they are accountable for improving patient or customer relationships or the quality of that relationship. What truly creates the difference between an average manager and an outstanding manager are those managers who focus on the accountability of improving customer relationships or the quality of that relationship.

In general we’ve talked in past podcasts about promoters versus detractors. Promoters should be the core of your business. They are the best group to invest in. They create high margins, they love to do business with us, they constantly refer additional business to us and they should drive our strategic priorities.

Detractors do not like doing business with us. They spread negative word of mouth and they defect at the first opportunity to another company or business. You constantly should try to convert your detractors to promoters and if not possible, eliminate these detractors from your business plan.

The vast majority of your customer base will be passive customers. They can be easily lured into the detractor group if you do not focus constantly on improving relationships, products and service. The goal is to take the passive group and move them into the promoter group. Constantly you should be on the lookout for finding additional promoters for your business.

As a golden rule, what is ever good for your patient or customer base and team members will generally be good for your company. You need to look at your business in totality. You need to look at your phone system, your appointment systems, your orientation and treatments, the ability to discharge, evaluation of charts if you are in the medical or dental profession, financial arrangements should be clear, concise, honest and upfront.

You must take a look at every aspect of your business, including your reception room or office, your restrooms, your operatories, your magazines, the appearance, the communication skills. In order to achieve this, most focus in on the 3Ds which is design, develop and deliver.

For additional information about this podcast and other podcasts, please visit www.ascent-dental-solutions.com. Thanks for listening and we look forward to spending more time in the future on additional business topics to help your medical and dental practice grow along with your overall business. Thanks for listening. My name is Dr. Kevin Coughlin.

In this episode Dr. Coughlin discusses the differences and similarities of patients versus customers.

kevin-headshot My name is Dr. Kevin Coughlin, owner and creator of Ascent Dental Solutions. The following podcast is a discussion of the difference and similarities of patients versus customers.

For those of us in the health care industry, my particular expertise is dentistry. For over 34 years I have been practicing dental care in Massachusetts with 14 offices and over 140 employees. I would like the health care professionals, but those particularly associated with dental health to consider patient versus consumer. Is there a difference and should there be a difference? In most cases, I believe the dental profession considers when the mouth is open you’re a patient and when your mouth is closed, you’re a consumer. If you don’t treat both of these in the correct and accurate way, your results to your organization and practice, in my opinion, will suffer.

First during this thought conversation is to consider the patient types. There are generally five types of patients. There are the event-driven, there are the reactive-driven, the proactive-driven, the discretionary-driven and the regenerative-driven.

Of these five classes, the event-driven is when something happens they seek care. If a tooth breaks or they have pain, they come in for a visit. If there is no event, they avoid health care and in particular, dental care.

The reactive-driven patient is they know they should and if something precipitates an issue, they will seek care and treatment. They are simply reactive. They are not proactive.

The proactive-driven patient is tooth-based. The decisions are prioritized one tooth at a time. This tooth is a problem, this area of my health is a problem, I will address it, but they don’t treat themselves systemically or in a whole person type of manner.

The discretionary-driven patient simply says I want to look or feel better and if I have the discretionary income, I will move forward. And the regenerative-driven type patient simply says to themselves, “Is it worth the investment? And if I find value, I will proceed with care and treatment.”

In my opinion, the event, reactive and proactive types are driven by insurance. These patients are a necessary part of a practice but you should understand that in most cases what you will hear for them is the first thing they will say is what does my insurance cover. What is my financial responsibility? If my insurance doesn’t cover it, then I am not going to proceed with care.

The last two groups of patients, which I refer to as discretionary and regenerative types, are non-insurance driven. If they have a problem, they would like to seek care and help and the insurance is just an insularly part of care and treatment.

The following statistics are of interest. The average patient in the United States over 20 years of age spends between $500 and $10,000 per year. If we looked at 1,000 patients, that would equal approximately $500,000 per year. Out of every 1,000 patients approximately 20 patients will say yes to your treatment plan and recommendations. If you could focus on your ability to increase the yes number of patients from 20 to 60, you could increase another $22,000 a year to your organization.

Basically what it boils down to is when you evaluate many organizations and offices particularly in health care, the treatment plan in most cases is acceptable. However, the problem is case acceptance by the patients or i.e. customers, is low. In most cases the poor case acceptance is extremely important for you to focus on to improve the delivery of health care and your overall bottom line to your office and organization.

In the end, it doesn’t matter how well you treatment plan. If your patient or customer is not accepting that treatment plan, your outcomes are going to be poor and your patients and organization will suffer.

In 2009 through 2011, during those two years, approximately 73 percent of the United States’ population saw a dentist. Those between the ages of age 16 and 25 were missing three teeth, and this includes wisdom teeth. Those over the age of 65 were missing nine teeth.

With the population between the ages of 16 and 90, that comes to approximately 60 million missing teeth. In 2011, it was recorded that only 2.1 million implants were placed in the United States. This means that 58 million people, customers, patients missed the opportunity to replace these missing teeth. Again, this is a glaring amount of evidence indicating that the treatments were planned but patient acceptance of doing the treatment was certainly lacking.

You should understand vision and purpose. What is actually in the best interest of your patients or customers; their oral health, systemic health, social health, lifelong health?

In my opinion, when you start as a practitioner or a health care provider and your goal is to focus on lifelong health rather than just oral, systemic, social, you will get a better outcome. Patients or customers will be moved when they understand the value and the value is the goal of lifelong health.

When you evaluate consumers in the United States, data indicates that the majority, 80 percent, will finance purchases over $1,000. If your practice or organization is not offering adequate financial arrangements, whether it’d be through CareCredit, Wells Fargo or other opportunities, this could possibly be part of the reason why case acceptance is poor.

You should also be able to understand and distinguish trust and value. As I like to say, if your patients do not believe, like and trust, or BLT with you, then it is very difficult to get case acceptance. And when you do get case acceptance and the patient does not believe, like or trust in you, I question whether you should provide care and treatment because ultimately it will lead to problems.

My suggestion is you should be focusing on aesthetics, function and structure. If you combine these three elements, you will significantly see an improvement in case acceptance. Understand that some of your patients will do nothing, some will do something and others have to do something.

In the end, to determine whether your case acceptance is adequate and you’re doing a good job communicating and your patient base actually believes, likes and trusts in you, you have to provide tracking. You must understand are your patients making an appointment, yes or no? Are they accepting your treatment, yes or no? Are they referring family and friends to your practice or organization, yes or no? Are they paying for the care and service on the way out of your office, yes or no? What is the revenue that you are generating per day? This data will tell you whether you’re heading in the right direction and whether you’re moving forward in the direction you should be.

In the end, health care providers are held in high esteem. Keep in mind that selling is not negative. If the product has value and service and you’re providing value to your patients, then it is your utmost goal to make sure that not only is your treatment plan acceptable, but your patients are accepting your treatment plan and moving forward.

I hope you’ve enjoyed the podcast. You can get more information on my website www.ascent-dental-solutions.com. My name is Dr. Coughlin and thank you for listening.

Your front line team members are the first client/customer facing representatives anyone comes into contact with when they call or enter your dental practice. Hopefully you’ve trained them to be both empathetic and professional. Let’s say you’ve gone a step further and they are also well – versed on best practices surrounding customer care. That’s it, you’re done!

Not so fast.

What happens where they’re engaged with a real life customer and the phone rings? Is your answering system as good as your staff? If not, then you have a big hole that needs a filling.

First off, the phone should be answered within four rings. If staff are too busy to do so, let it go to the answering system. Nobody wants to hear, “this is Dr. Smith’s office. I’m going to have to put you on hold.”

If it isn’t possible for any member of your team to grab that phone call within four rings, your message has to be the next best thing to speaking to a real person.

First, the answering system should allow patients a choice. They should be allowed to leave their name and phone number along with a request or question. Alternately, the caller should be able to opt to stay on the line and wait. But if they do so, it is vitally important they are reminded every 30 seconds that you haven’t forgotten about them and that someone will be with them shortly. If, after two minutes, they are still waiting, they should have an additional option to leave a message. Here is where you differentiate yourself by promising to return the call within 15 minutes. Why is this important? That 15 minutes buys your time before they call another practice to set up an appointment.

Still not convinced about the importance of this seemingly minor issue? I’ve got a simple test for you. Do you remember the last time you were put on hold for a long time? Did you call back? I would guess you might have moved onto another provider.

We are all busy. But that doesn’t mean you don’t have time for clients. How you treat someone when you are busy speaks volumes about how much you would value them as a customer.

If you want to talk about how I can transform your dental practice into a customer service dynamo, please get in touch.

So you’ve got a dental office with technicians and great patient care specialists. Who’s the most important person in your business?

The answer is surprising to some. The surprise is that it’s not you. It’s actually the front-desk person. They are a patient’s first and last point of contact. They set the tone for the patient’s experience at your practice.

Female patient coming to dental surgery check-up appointment reception

He or she must possess patience, knowledge, grace under pressure, and the ability to show empathy, along with being efficient and effective.

When recruiting for this crucial position, the following skill sets are of key importance:

∙ Sales skills

. Telephone skills

∙ Gathering and interpreting data

∙ Patient orientation

∙ Developing and providing information about a comprehensive treatment plan

∙ Reviewing financial options for the patient to receive care and treatment

∙ The ability to generate reports to assess the success and progress of your business team

∙ Review and make necessary adjustments to procedures and processes through daily, biweekly, weekly, or monthly meetings and discussions

As you can see, this is a position that goes well beyond “receptionist.” Your front desk person has to wear many hats throughout the day, and it all starts with how they answer the phone.

If you want to talk about how I can make your dental practice a dynamo in customer service, please get in touch.

To me, T.E.A.M. means “together employees achieve mastership.”

It’s a convenient acronym. But it’s more than that. In order for it to work leadership has to
make sure its team has the tools to succeed. Training, education, attitude and money are
the building blocks. Take away any of those elements and your team is just a gathering of
paid employees.

What-are-the-factors-of-successful-leadership

Medical team of three professional woman at dental surgery portrait

Experience has taught me that people, who both want and need employment, are the ideal candidates for building a great team. I’ve seen how people who hate their jobs and those who don’t need their jobs are never really fully committed to them.

Commitment, loyalty, trust and a desire to work are the ingredients for fantastic employees
who become integral parts of amazing teams. And at the risk of sounding somewhat agist -
and having been a former member of this cohort - I’ve found people in their 20s go through
so many of their own changes that the odds of them still being with your team into their 30s
is not great. That doesn’t mean you shouldn’t give young people opportunities. But do so
knowing that your job is probably seen as a stepping stone to something bigger and better.

The average dental office will have fewer than ten employees. That works in the owner’s
favour. Managing and coaching a small staff provides excellent opportunities for
mentorship and skills development while also delivering exceptional service to the patients.
But that tidy size comes at a price. Fewer staff means difficulties in times of family
commitments, illness and such. However when you have a real TEAM they pull together
and help each other out - so that your patient experience doesn’t have to suffer.

Another quality I look for when building a team, is a person’s marketing, sales and
business experience. Knowing the field of dentistry is a nice but not necessarily essential
skill for an employee to have. If forced to choose between someone who is knowledgeable
and one who has great sales and management skills, I will always pick the latter. Clinical
skills can be taught; teaching management and sales are much more difficult.

That doesn’t mean your team should be devoid of dental experience. You will always need
to have individuals with a background and knowledge of the dental business and dental
hygiene. I would be lying if I said it is easy to find such individuals; in fact, it is extremely
difficult. In some cases, it may appear impossible, but it can be done.

There is an old adage in business that for every $10,000 you pay a person, you should
spend a month to find the RIGHT person. What that means is that if you’re going to pay
someone $50,000 a year, you should be willing to spend five months on the hiring process.
I can’t emphasize that enough. It is a critical step in accomplishing your goal of developing
the ideal dental business. Not selecting the right individuals when putting together your
team will result in an enormous cost to you and your organization over the long run.

If this sounds like a lot of work - it is. But it’s the kind of work that if done right, will be pay dividends every day you open your doors.

They say you can’t take it with you. And it’s certainly true of dental practices.

Whether you plan on passing it on to family members, selling to a corporation or even another practitioner, there are three simple rules to keep in mind.

Rule 1: Value does not equal price. Value is an estimate of the financial worth of a practice determined by formulas. Price, however, is determined by the careful dance between how desperate a seller is to sell and how determined a buyer is to buy.

At present time, most of the dentists I know above the age of 60 cannot wait to sell their practice. Typically, the dental practice is one of their largest assets and is generally considered the best way to ensure a happy and secure retirement.

Rule 2: Gross production is not what you want to purchase. A much better determinant of the value of a practice is really net income. So whether you’re considering selling your dental practice or making a purchase, it’s critical that you look at net income from the seller’s tax returns related to the practice. What a buyer should look for before making the purchase is the dental practice’s ability to make a profit. So as a seller the number one goal is to make the practice as profitable as possible before putting it on the market. The more profitable it is, the more valuable it will be to a would-be purchasers.

Rule 3: Never buy a practice’s potential, only the present or historic value. Future profits can be uncertain. Many times I’ve had someone say to me, “Dr. Coughlin, I’m thinking about buying a practice. It has great potential.” You really want to make your purchase price based on today’s value, not what tomorrow’s value might or might not be.

I cannot emphasize enough that even if you feel you’re not interested in selling your practice or you’re not considering buying a practice you should be prepared to sell at any point in time.

If you are considering buying a practice or selling your own practice, I may be able to help. My coaching services leverage over 30 years of real experience growing my business from one practice to 14.

Contact me today and let’s make sure you make the best and most profitable decisions based on your current situation.

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In this episode Dr. Coughlin discusses the differences and similarities of patients versus customers.

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