Monthly Archives: May 2012

Google Places + Google+ = The New Google+ Local

Dental Marketing Changes with Google's Announcement of Google+ LocalFor most dentists, keeping up with Google and ranking on Page One in local search are focal aspects of their marketing efforts for attracting new patients.

You know the drill. Claim your listing. Verify it with a PIN number. Follow Google’s guidelines to a T. Try to consolidate duplicates. Check back regularly to make sure things are in good standing. And, try like heck to encourage happy patients to submit reviews so you keep little gold stars next to your name.

This may seem like a lot of busy work, but the truth is that web searchers and potential patients perceive value in having gold stars next to your listing and are influenced by the reviews they read. Also, it’s the single greatest common denominator we’re seeing to help dentists “get found” on line. Let’s face it, Google reviews are your modern day “word of mouth referral from a friend.”

Well, Today The Game Changed Again. Introducing Google+ Local.

A better word might be “evolved.” If you checked out your Google Places page today, it may have looked a little different to you. This morning, Google announced that the merge of Google Places and Google + into the new Google+ Local.

Dentist Reviews on Google+ Local Page

But, don’t worry. Despite getting used to a new format, this next evolution of Google’s local program is considered to be an improvement by the early feedback of local search experts such as Linda Buquet and Mike Blumenthal. And, this is certain not to be the last trick that Google has up it’s sleeve so the game continues.

What we do know at this point is:

  • You can still manage your information via your Places dashboard, verify your listing data and respond to reviews.
  • You can still post offers the same way.
  • You cannot upload videos to your Place page anymore.
  • Instead of the scoring system of receiving 1-5 stars, Google has incorporated the more comprehensive 1-30 Zagat scoring system.
  • Reviews from both Google and Zagat users will reside on your Google+ local page and will be attributed to either “A Google User” or “A Zagat user” until that user chooses to change it to their name.
  • If you haven’t done so, consider setting up a Google+ business page.
  • More updates will follow in the coming months.

We will continue to keep our clients updated on new advancements. Stay tuned for more information. In the meantime, if you would like to learn more you can read about Google+ Local in the Google Help Forum. For questions about your particular Google Places listing or setting up a Google+ Business Page, please contact APM at (952) 921-3360 or apm@advancedpracticemanagement.com.

Cost Control and Result Control, Part Two

As you may recall, the last time I wrote about “Cost Control.” Most of you have, or will be, within the next 2-3 years making investments of $50,000 more in technology; digital x-rays, Diagnodent, lasers, clinical charting software, monitors, patient education software, Cerec, electric handpieces, endo equipment and so on.

This can easily come out to over $12,000 per treatment room. For starters, you want to make sure that you don’t pay too much. That’s where specing out what needs to be done and comparative bidding come in. Many of these items are bought together (especially digital x-rays, monitors, intra-oral cameras and clinical charting software). Get competitive bids. Moreover, and probably more importantly, get expert help in planning your technological upgrades to make sure they work well for you. When your hygienists’ time is worth over $120/hr. and your time is worth over $500/hr. you don’t need glitches. Interrupting your work flow can be very expensive!

Today I’m focusing on “Result Control.”

As an owner you want to get a return on every investment you make. In fact, the whole idea of good management is to get the biggest return on the resources you have; your time, your money and your skills. What organization would spend thousands of dollars without having a clear idea of the outcome they want in return? Upgrading just for the sake of upgrading is insanity. So, as you make these investments what outcomes are you planning on?

My favorite example of this is intra-oral cameras. Over 50% of dentists now have intra-oral cameras and half of those cameras are used fewer than five times per week. Very poor result control. If you purchase intra-oral cameras, you are presumably doing this so you can better inform the patient so the patient will make better choices which results in more case acceptance. Better case acceptance means more production. This should show up in increased crown and bridge (for example). Therefore if you buy intra-oral cameras and your crown and bridge doesn’t go up, you didn’t get result control. It’s a pretty good bet they aren’t being used. So, to get them used!

Four-step plan for your office:

1) Do Clinical Calibration with staff so they know to what end you want this educational tool used. Have a meeting in your practice to talk about when you feel it’s in the patients’ best interest to crown a tooth and when you don’t. When is a composite indicated vs. a crown or vs. an amalgam? Who are good candidates for implants and who aren’t? When are x-rays really needed? How about fluorides? If you haven’t worked through these issues with the staff, they’ll be pointing the intra-oral camera around but only vaguely knowing what they are trying to do. Check out the article on Clinical Calibration posted on our website. www. AdvancedPracticeManagement.com.

2) Be very sure your cameras and monitors are ergonomically set up. And, don’t ask the hygienists to share a camera. You’ll do far better paying for two cameras that are actually used than one shared camera sitting in the hallway or lab.

3) Track how many times your intraoral camera is used per day or per week. If you’re not measuring this, it’s probably not being used enough. When you first get the intra-oral cameras, ask the hygienists to keep a tally of when they’ve used it. Over 2/3 of the adult patients should be shown something. It doesn’t always have to be something bad. Showing patients what’s good is helpful too. You like it when you go to the doctor and hear good things too, right? Anyway, the more the patient knows (and people learn through what they see) the more they appreciate what you can do for them.

4) Put this all together in a set of goals: • As a result of this Patient Education Technology (e.g., intra-oral cameras) we will see an increase in patient acceptance by two crowns per week. Therefore, we believe that there will be $8,000 more per month in production (that’s great result control). • We will use the intra-oral camera on 70% of our adult patients. This will be tracked on the daily schedules by each hygienist. The exceptions would be patients who have other problems that are not easily visualized by the camera, a patient due for full-mouth x-rays, the patient arrives late or there is some other mitigating circumstance. DIGITAL X-RAYS: When digital x-rays are installed in your treatmentroom there will likely also be capability such that your hygienist can set up her own appointments, enter treatment plans, enter progress notes, enter today’s charges, use the intra-oral camera and use patient education software.

In most practices that have paid for these technological capabilities, only two or three of the above are performed regularly. What is the plan for your office?

Entering treatment plans, setting up the next appointment, entering today’s charges, all take your hygienists’ time. However, digital x-rays help save the hygienists’ time. No running to the processor, no mounting, etc. What are the expectations of how the team will use the extra time? Your hygienist simply must have the training so that she is completely comfortable with the software so she can perform these functions. Then it’s likely the patient will arrive at the front desk with all the information already available to your administrative staff. Then the administrative team can do what they do best-work with the patient to make their dentistry as comfortable and affordable as possible (financial options) and commit them to treatment. That should result in more treatment done, right? Measure it!

Hour-long hygiene appointments

A subtle change that’s very expensive: Many offices reserve 45 or 50 minutes for standard adult recall hygiene appointments. Often when all of this new technology is introduced, the hygienist will feel they need more time. It doesn’t seem like a big deal to increase hygiene appointment lengths to 60 minutes, but that results in one fewer patient seen per day on average. Not only does this reduce the hygienists production by over $120 per day—it reduces demand for the doctor’s services by over $300 per day (Many dental offices produce $400+ per exam so any decrease in hygiene flow can really take the wind out of your sails.) Fifteen fewer hygiene visits per month all of a sudden can mean $6,000 less treatment per month. That’s a very negative bang for the buck for your investment in technology!

Another solution is to add more technology! For example, automated or voice activated perio charting. Or, a digital pano. It takes just 8 seconds – even less than digital full-mouth x-rays (in situations where it’s clinically acceptable). These technologies can help your hygienists maintain their visit per day capacity even while increasing their productivity per visit.

However, it’s clear that hour-long hygiene appointments are becoming increasingly common. You may be fighting a losing battle if you keep these lengths so tight that the hygienists won’t buy in to or really employ the technology you paid for. So, what do you do?

In a larger office a possibility is to hire a hygiene assistant so they can keep appointment lengths to 50 minutes. However, I’ve seen offices hire this assistant and still have appointment lengths go to an hour and so the bottom line is hurt. Again, if you add a hygiene coordinator/assistant, you have to have result control.

For many of you the best course of action would be to allow the hygienist the additional time but make sure they use the technology. That’s your quid pro quo. “We now provide digital x-rays to save you time. I really need you to use the intra-oral camera, the Diagnodent, etc.”

Then, since you’ve subtly cut into your hygiene capacity, you have to add additional hygiene time to counteract that. It will all work out if your hygienists are presenting the treatment. Your case acceptance will go up and that will more than counter the reduced patient flow per day per hygienist. If you added hygiene time then you’ll keep your flow up and allow room for growth.

I’ve seen mistakes in the above that cost offices thousands of dollars directly and many thousands more indirectly.

Getting a bang out of your Cerec

CAD/CAM-Cerec: I’ve never been able to talk a client into or out of buying a Cerec machine! I feel that most of the time this decision is made at a gut level. That’s fine. That’s your business. However, it’s my business to make sure that if you buy a Cerec you get bang for your buck.

First of all, before you make this very expensive investment, ask yourself, “Is there somewhere else I can get a bigger return on my dollar?” I’ll argue that there are many smaller investments you should make first as you ramp the practice up such as; Diagnodent, automated endo, intra-oral cameras and perhaps non-technology items such as better signage, advertising, training a treatment coordinator, and getting you and your team significant continuing education.

Before you buy the Cerec, “Count Crowns.” That is, for a month or two keep tally of how many patients for which you feel the Cerec would have been the right solution. Most of my clients tell me that there are some cases that are better suited to Cerec than others. I’m not a clinician, it’s up to you to make your own judgments about that based on discussions with your colleagues or authorities you respect. Then, once you buy the Cerec, make sure that you are employing it as much as you planned on and see that your lab expenses really do decrease.

Another subtle cost of a Cerec machine is that at least initially, it takes longer to do crowns. Many doctors I’ve observed with Cerec will initially have to spend 2 – 2 ½ hours per unit. Obviously, if your time is worth $500 per hour, you don’t save enough on the lab cost to justify that extra hour (or even ½ hr) in getting a crown completed (most doctors take an hour for a conventional prep and a half hour for seating- 1 ½ hour total). So if you do 20 units per month and the Cerec machine takes you an extra half hour, that still “costs” you $5,000 per month in capacity. Now hold on Patterson folks, before you call me, hear me out. The answer here is additional training. There are excellent post purchase sources for training on Cerec to bring the procedure time down. If you buy a Cerec machine and don’t plan on training your staff to help you use it, well, you’re going to have poor result control. With the correct experience and training, I’ve seen many doctors bring their single unit Cerec times down to 1 – 1 ½ hours. I am simply astonished to see that a doctor will spend $100,000+ on a piece of equipment but flinch at the idea of an extra couple thousand dollars in training to really come into song with it.

Training and preparing your staff

Speaking of training, that’s also very true for all the technology that you’re going to put in your and the hygienists’ room. After an initial 3–4 days of training, arrange for follow up training in three months. In a larger clinic, I think it makes sense to have a trainer on board for a day or two as everyone is using the clinical charting and other matters. It really helps that there is someone right in the building who can show you how to do things. Also, just as in paper charting, you have to decide as a group how you are going to chart. There are a lot of choices and you have to pick the configuration for your office. This takes some time and focus.

So, as with so many things, it’s best to begin with the end in mind. What are the outcomes you intend to get? And, how are you going to measure them? Before you go out to purchase the technology, make it absolutely clear to the staff that you need their commitment to use it! Prioritize your expenditures and tackle them in order of where you can get the biggest bang per buck. In this way your practice builds up more and more profits and momentum. Don’t buy technology because “everyone else has it” or even if, “no one else has it”! Buy it because you know the outcome you want for your office. And, by the way, just “an up-to-date image” is not enough if you are serious about your bottom line. It has to be for go, not just show.

In summary, if you spend $$$$ on technology:

  1. Define the outcomes you expect (and increased revenues or decreased expenses have to be part of that).
  2. Get staff’s understanding and commitment (e.g., clinical calibration).
  3. Get additional training. The “built in” amount is not usually enough.
  4. Measure activity (e.g., time used per day) and results (dollars brought in or saved).
  5. Celebrate your successes. Recognize and reward your staff accordingly.

Beyond the DOW: Recent Economic Survey of Dentists

Monday, November 9, 2009

I recently completed my fee, wage and economic surveys for the Upper Midwest. Over 300 practices responded.

33% of the Metro practices surveyed said they were up this year, 46% were down and 21% even. For Outstate offices (including the edges of North and South Dakota, Iowa and Wisconsin) the outlook was a little better. 41% of the practices said they were up, 28% down and 31% even.

17% of Metro Area practices felt the economy is not a factor at all but 73% felt the economy had a “moderately negative” effect. 27% of Outstate offices said the economy hasn’t affected them at all and 70% said “moderately negative”.

29% of Metro Area offices have given or plan to give raises this year and 41% said they won’t. In Outstate offices 54% have given or plan to give raises this year with 24% saying that they do not plan to give raises (the rest variable or not sure).

There is no question that the current economy is having an impact on practices. Just three years ago “5% growth” was more or less the rule.

I believe in management. Whenever we see Doctors take actual steps to improve, they do improve! Things just don’t come as easily as they might have in previous years.

Feel like talking about your situation? Got some ideas? I have a standing offer of a free 20 minute consultation that allows you and I to get to know each other and share information that will be beneficial to both of us. Call me at 952 921 3360.

’til next time…
Posted by Bill Rossi at 8:55 AM
Labels: Advanced Practice Management, Bill Rossi, Dental Consultant, Dental seminars, Economic news for midwest dentists, Staff management

Let’s talk about Result Control.

Monday, December 7, 2009

As you may recall, last time I wrote about “Cost Control.”

Now, let’s talk about Result Control.
Most of you have, or will be, within the next 2–3 years, making investments of $50,000 more in technology, digital x-rays, Diagnodent, lasers, clinical charting software, monitors, patient education software, Cerec, electric hand pieces, endo equipment and so on.

This can easily come out to over $12,000 per treatment room.

For starters, you want to make sure that you don’t pay too much.

That’s where spec-ing out what needs to be done and competitive bidding come in. Many of these items are bought at the same time (especially digital x-rays, monitors, intra-oral cameras and clinical charting software).

We’ve helped clinics save $10,000s of dollars by getting competitive bids. Moreover, and probably more importantly, getting expert help in planning your technological upgrades can make sure that they actually work well for you.

When your hygienists’ time is worth over $120/hr. and your time is worth over $500/hr. you don’t need glitches. Interrupting your work flow can be very expensive!

Today I’m focusing on “Result Control.”

As an owner you want to get a return on every investment you make. In fact, the whole idea of good management is to get the biggest return on the resources you have: your time, your money and your skills. What organization would spend thousands of dollars without having a clear idea of the outcome they want in return? Upgrading just for the sake of upgrading is insanity. So, as you make these investments what outcomes are you planning on?

My favorite example of this is intra-oral cameras.

Over 50% of dentists now have intra-oral cameras and half of those cameras are used fewer than five times per week. Very poor result control. If you purchase intra-oral cameras, you are presumably doing this so you can better inform the patient so the patient will make better choices which results in more case acceptance. Better case acceptance means more production. This should show up in increased crown and bridge (for example). Therefore, if you buy intra-oral cameras and your crown and bridge doesn’t go up, you didn’t get result control. It’s a pretty good bet they aren’t being used. So, to get them used, do the following:

Do Clinical Calibration with staff so they know to what end you want this educational tool used. Have a meeting in your practice to talk about when you feel it’s in the patients’ best interest to crown a tooth and when you don’t. When is a composite indicated vs. a crown or vs. an amalgam? Who are good candidates for implants and who aren’t? When are x-rays really needed? How about fluorides? If you haven’t worked through these issues with the staff, they’ll be pointing the intra-oral camera around but only vaguely knowing what they are trying to do. Check out the article on Clinical Calibration posted on the Dental Economics Magazine website.

Be very sure your cameras and monitors are ergonomically set up. And, don’t ask the hygienists to share a camera. You’ll do far better paying for two cameras that are actually used than one shared camera sitting in the hallway or lab.

Track how many times your intra-oral camera is used per day or per week. If you’re not measuring this, it’s probably not being used enough. When you first get the intra-oral cameras, ask the hygienists to keep a tally of when they’ve used it. Over 2/3 of the adult patients should be shown something. It doesn’t always have to be something bad. Showing patients what’s good is helpful too. You like it when you go to the Doctor and hear good things too, right? Anyway, the more the patient knows (and people learn through what they see) the more they appreciate what you can do for them.

Put this all together in a set of goals:

As a result of this Patient Education Technology (e.g., intra-oral cameras) we will see an increase in patient acceptance by two crowns per week. Therefore, we believe that there will be $8,000 more per month in production (that’s great result control).

We will use the intra-oral camera on 70% or our adult patients. This will be tracked on the daily schedules by each hygienist. The exceptions would be patients who have other problems that are not easily visualized by the camera, a patient due for full-mouth x-rays, the patient arrives late or there is some other mitigating circumstance.

Digital X-rays: When digital x-rays are installed in your treatment room, there will likely also be capabilities such that your hygienist can set up her own appointments, enter treatment plans, enter progress notes, enter today’s charges, use the intra-oral camera and use patient education software.

In most practices that have paid for these technological capabilities, only two or three of the above are performed regularly. What is the plan for your office?

Entering treatment plans, setting up the next appointment, entering today’s charges, all take your hygienists’ time. However, digital x-rays help save the hygienists’ time. No running to the processor, no mounting, etc.

What are the expectations of how the team will use the extra time? Your hygienist simply must have the training so that she is completely comfortable with the software so she can perform these functions. Then, it’s likely the patient will arrive at the front desk with all the information already available to your administrative staff.

Then the administrative team can do what they do best—work with the patient to make their dentistry as comfortable and affordable as possible (financial options) and commit them to treatment. That should result in more treatment done, right? Measure it!

A Subtle Change That’s Very Expensive:

Many offices reserve 50 minutes for standard adult recall hygiene appointments. Often when all of this new technology is introduced, the hygienist will feel they need more time. It doesn’t seem like a big deal to increase hygiene appointment lengths to 60 minutes but that results in one fewer patient seen per day on average. Not only does this reduce the hygienist’s production by over $120 per day— it reduces demand for the Doctor’s services by over $300 per day (Many dental offices produce $400+ per exam so any decrease in hygiene flow can really take the wind out of your sails.) Fifteen fewer hygiene visits per month all of a sudden can mean $6,000 less treatment per month. That’s a very negative bang for the buck for your investment in technology!

Another solution is to add more technology! For example, automated or voice activated perio charting. Or, a digital pano. It takes just 8 seconds—even less than digital full-mouth x-rays (in situations where it’s clinically acceptable).

These technologies can help your hygienists maintain their visits per day capacity even while increasing their productivity per visit. However, it’s clear that hour long hygiene appointment lengths are becoming increasingly common. You may be fighting a losing battle if you keep these lengths so tight that the hygienists won’t buy into or really employ the technology you paid for.

So, what do you do? In a larger office a possibility is to hire a hygiene assistant so they can keep appointment lengths at 50 minutes. However, I’ve seen offices hire this assistant and still have appointment lengths go to an hour and so the bottom line is hurt. Again, if you add a hygiene coordinator/assistant, you have to have result control.

For many of you the best course of action would be to allow the hygienist the additional time but make sure they use the technology. That’s your quid pro quo. “We now provide digital x-rays to save you time. I really need you to use the intra-oral camera, the Diagnodent, etc.”

Then, since you’ve subtly cut into your hygiene capacity, you have to add additional hygiene time to counteract that.

It will all work out if your hygienists are presenting the treatment. Your case acceptance will go up and that will more than counter the reduced patient flow per day per hygienist. If you added hygiene time then you’ll keep your flow up and allow room for growth.

I’ve seen mistakes in the above cost offices thousands of dollars directly and many thousands more indirectly.

CAD/CAM, Cerec:

I’ve never been able to talk a client into or out of a Cerec machine! I feel that most of the time this decision is made at a gut level. That’s fine. That’s your business. However, it’s my business to make sure that if you buy a Cerec you get bang for your buck.

First of all, before you make this very expensive investment, ask yourself, “Is there somewhere else I can get a bigger return on my dollar?” I’ll argue that there are many smaller investments you should make first as you ramp the practice up such as: Diagnodent, automated endo, intra-oral cameras and perhaps non-technology items such as better signage, advertising, training a treatment coordinator, and getting you and your team significant continuing education.

Before you buy the Cerec, “Count Crowns.” That is, for a month or two keep tally of how many patients for which you feel the Cerec would have been the right solution.

Most of my clients tell me that there are some cases that are better suited to Cerec than others. I’m not a clinician, it’s up to you to make your own judgments about that based on discussions with your colleagues or authorities you respect. Then, once you buy the Cerec, make sure that you are employing it as much as you planned on and see that your lab expenses really do decrease.

Another subtle cost of a Cerec machine is that, at least initially, it takes longer to do crowns.

Many Doctors I’ve observed with Cerec will initially have to spend 2–2 1/2 hours per unit. Obviously, if your time is worth $500 per hour, you don’t save enough on the lab to cost justify that extra hour (or even 1/2 hr) in getting a crown completed (most Doctors take an hour for a conventional prep and a half hour for seating— 1 1/2 hour total).

So if you do 20 units per month and the Cerec machine takes you an extra half hour, that still “costs” you $5,000 per month in capacity. Now hold on Patterson folks, before you call me, hear me out. The answer here is additional training. There are excellent post purchase sources for training on Cerec to bring the procedure time down. If you buy a Cerec machine and don’t plan on training your staff to help you use it, well, you’re going to have poor result control. With the correct experience and training, I’ve seen many Doctors bring their single unit Cerec times down to 1–1 1/2 hours.

I am simply astonished to see that a Doctor will spend $100,000+ on a piece of equipment but flinch at the idea of an extra couple thousand dollars in training to really come into song with it.

Speaking of training, that’s also very true for all the technology that you’re going to put in your and the hygienists’ room. After an initial 3–4 days of training, arrange for follow up training in three months. In a larger clinic, I think it makes sense to have a trainer on board for a day or two as everyone is using the clinical charting and other matters. It really helps that there is someone right in the building who can show you how to do things. Then, given you have adequate demand, this can be a very good business investment. Also, just as in paper charting you have to decide as a group how you are going to chart. There are a lot of choices and you have to pick the configuration for your office. This takes some time and training support.

So, as with so many things, it’s best to begin with the end in mind. What are the outcomes you intend to get? And, how are you going to measure them? Before you go out to purchase the technology, make it absolutely clear to the staff that you need their commitment to use it! Prioritize your expenditures and tackle them in order of where you can get the biggest bang per buck. In this way your practice builds up more and more profits and momentum.

Don’t buy technology because “everyone else has it” or even if “no one else has it”! Buy it because you know the outcome you want for your office. And by the way, just “an up-to-date image” is not enough if you are serious about your bottom line. It has to be for go, not just show.

You’ll find lots more information like this, free for the reading, on our website’s News page, going back to 2005. As usual, I offer my free 20-minute consultation whenever you have a minute to talk. 952 921 3360. Bookmark this page or our website for later reference.

’til next time…

Posted by Bill Rossi at 9:09 AM
Labels: Advanced Practice Management, Bill Rossi, Dental Consultant, digital record keeping, intra-oral cameras

Leadership and Staff Raises

Monday, January 4, 2010

Leadership and Staff Raises

In our recent economic survey we asked area Dentists if they plan to give staff raises in 2009. 41% of Metro Area and 24% of Outstate offices said, “No.” Only 30% of Metro and 54% of Outstate dentists will give raises in 2009.

Staff wages are the major overhead item, so it certainly makes sense to go slow with raises if your practice isn’t growing. I’ve often said that the staff’s compensation should be linked to how the practice does, not just to the economy or the consumer price index (which by the way was up 1.8% in 2009).

Even if you’re not giving raises, you should at least give your staff recognition, direction and hope. That’s leadership.

“Look, we’ve had a flat year but I want to let you know that I do appreciate your efforts (giving specific recognition to each staff person). And, I do need your help in the coming year because despite the economy we intend to press on and make the practice better all the time. Once we’ve gotten a string of 4 to 6 months that shows growth then we’ll revisit the wage situation and consider raises at that time.”

Wage increases should be based on these three major factors:

The market rates for wages. (See the Advanced Practice Management Surveys).

How the practice is doing (practice growth and profitability).

Individual merit.

Smart Wage Decisions:

I believe it’s best to take a look at staff wages as a percentage of collections at least once per year for the sake of determining how much will be available for wages and raises.

If your total gross wages were running at about 25% of collections, for example, last year and they are 23.5% now (because your collections grew) then you are in a position to give raises.

If staff salaries have crept up to 26% or 27%, then it’s time to hold off until your practice revenue catches up.

Using this very simple method, you can keep the biggest chunk of your overhead (staff wages) under control.

Incentives:

About one third of dental practices have team incentives. When they work they can work beautifully. They can really pull a team together and lead to greater production. Some of you have been burned by incentives or are jaded about them. The key thing is that if you have set up an incentive with the staff for practice growth you have to have a plan for growth.

You, as the leader of the practice, have to quarterback that plan. Incentives are not indicated and will fail if the staff is at each other’s throats, there is no realistic plan to grow the practice and the Doctor doesn’t do his/her part to lead by example.

Agree? Disagree? How do you handle leadership and staff raises?

Post your comments!

Then give me a call at 952 921 3360 to discuss these or other issues in your practice. Please call with confidence. I consider this a professional-level discussion.

Check out what your colleagues are saying about us.

’til next time…

Posted by Bill Rossi at 8:29 AM
Labels: Advanced Practice Management, Bill Rossi, Dental Consultant, Staff management

Dying for Dentistry — and — Little Things result in Big Gains

Friday, March 19, 2010
Dying for Dentistry

Our man, Matt, heroically tried to make his consulting appointment on January 7th and got caught in a snowstorm in Southwestern Minnesota.

At 10:30 in the morning, he was told by the Highway Patrol they probably wouldn’t get to him until late at night or even the next day.

However, miraculously, his wife rescued him from 160 miles away. It was a Google rescue. Go to our About Us page to watch the story that aired on Fox 9 News on February 10th.

Little Things = Big Gains

When we take a close look at practices that are experiencing good growth, we sometimes find that growth is generated by or can be explained by significant big events such as: adding an associate, a new facility or extensive remodeling, a significant Continuing Education event, or change for the better in personnel.

These dramatic events can change the chemistry or capacity of a practice, the motivation of the Doctor and/or the team and result in growth.

Staff wages are the major overhead item, so it certainly makes sense to go slow with raises if your practice isn’t growing. I’ve often said that the staff’s compensation should be linked to how the practice does, not just to the economy or the consumer price index (which by the way was up 1.8% in 2009).

However, we find that most of the time growth comes from a number of small improvements that cumulatively have a large effect. This is what management is all about…catching every little bit of wind you can in your sails.

I’ve provided a number of examples in our latest newsletter, our February Bulletin.

’til next time…

Posted by Bill Rossi at 5:34 PM
Labels: Advanced Practice Management, Bill Rossi, Dental Consultant, dying for dentistry, Matt Lahn, Staff management

Your Practice Area Demographics

Saturday, May 1, 2010

Are Demographics Destiny?

If you listen to anyone on the lecture circuit and most consultants, they’ll tell you that it doesn’t matter where you practice…it matters how you practice.

True, mostly.

I have certainly seen the substantial difference good management can make wherever you’re practicing,

However, after 30 years of doing this I have come to think that even the most virtuous, capable dentist with a well-managed office can be hurt by crummy demographics.

The toughest demographic—a low population to dentist ratio.

Many dentists locate with the income of the population in mind and little attention to much else. That’s why there’s very high dentist to population ratios in affluent areas such as Wayzata, Edina and North Oaks.

It’s been my experience that these are some of the toughest, most competitive places in the state to practice. The high per capita income does not overcome the high dentist population ratio.

Dentists have an easier time of it if they’re located in a place with a lower dentist population ratio even if the population’s income is not in the top tiers.

On the other hand, there’s a point where the population’s income can be so low that no matter if you have a low dentist to population ratio (e.g. lots of patients) it isn’t worth it because you find yourself doing less and less on more and more people—a version of dental hell.

You can see more info, stats, even charts in our May news letter on the Advanced Practice Management web site.

Posted by Bill Rossi at 10:08 AM
Labels: Advanced Practice Management, Bill Rossi, Dental Consultant, Economic news for midwest dentists, Practice Management

Saturday, May 1, 2010

Your Practice Area Demographics

Are Demographics Destiny?

If you listen to anyone on the lecture circuit and most consultants, they’ll tell you that it doesn’t matter where you practice…it matters how you practice.

True, mostly.

I have certainly seen the substantial difference good management can make wherever you’re practicing,

However, after 30 years of doing this I have come to think that even the most virtuous, capable dentist with a well-managed office can be hurt by crummy demographics.

The toughest demographic—a low population to dentist ratio.

Many dentists locate with the income of the population in mind and little attention to much else. That’s why there’s very high dentist to population ratios in affluent areas such as Wayzata, Edina and North Oaks.

It’s been my experience that these are some of the toughest, most competitive places in the state to practice. The high per capita income does not overcome the high dentist population ratio.

Dentists have an easier time of it if they’re located in a place with a lower dentist population ratio even if the population’s income is not in the top tiers.

On the other hand, there’s a point where the population’s income can be so low that no matter if you have a low dentist to population ratio (e.g. lots of patients) it isn’t worth it because you find yourself doing less and less on more and more people—a version of dental hell.

 

You can see more info, stats, even charts in our May news letter on the Advanced Practice Management web site.

Online comments and reviews

Monday, June 21, 2010
Protect Your Reputation.

Keep an Eye Online!

As you probably read in the recent Northwest Dentistry, given the pervasiveness of The Web, every Dentist is vulnerable to receive a derogatory review online.

I’ve seen several occasions in the last few weeks where Dentists didn’t even know that there were negative reviews online. Do a Google search for your area…for example, “Maple Grove Dentist.”

First of all, see if you come up under Google Maps within the first page or two. If not, get after your web guys. Also, make sure there is a link to your website. We’re surprised how often there isn’t.

Then read the reviews. The only defense against a negative review is to have it diluted by a preponderance of positive reviews. Get patients who you are especially close with to write positive reviews ASAP.

When you’re looking for vacation places or searching online, you read reviews, don’t you? As you know, in many places (but not all, yet), The Web is replacing Yellow Pages as a source of new patients. And despite years of controversy, I personally have seen Yellow Page and online advertising work, so it’s worth staying on top of this. A bunch of good reviews can make a difference in your new patient flow.

Posted by Bill Rossi at 7:51 AM
Labels: Advanced Practice Management, Bill Rossi, online reputation

Profitability and Overhead Control

Sunday, August 15, 2010

Another Word about Profitability and Overhead Control
Want to make sure your net is good?
Overhead Control really consists of: Confrontation: Often, reducing overhead comes down to confrontation such as:
Bargaining with your lab guys.
Holding your staff accountable for results (given the correct direction and training— that’s our job to help).
Terminating staff members who are not performing well.
Making sure you are price shopping and bargaining when making any significant investments in technology, facility, anything.
Enforcing work place rules (time clock, reasonable vacation time and coordination).
Result Control: Making sure that for whatever technology, equipment, facility or advertising you invest in you get a good “bang for your buck.” Please see the “Result Control “articles I’ve written regarding this on my website (under Articles) AdvancedPracticeManagement.com
Keeping an eye on the numbers. You can’t manage what you don’t measure and many dental offices have Profit and Loss reports that don’t clearly show the bottom line and don’t organize the expenses into rational groups that make it easy to compare to industry standards.
Wise selection (or de-selection) of PPO participation to limit discounts.
Increasing practice productivity through seeing more patients or doing more for the patients you see.
Posted by Bill Rossi at 3:57 PM
Labels: Advanced Practice Management, dental office overhead, dental office profitability

Health Care Reform and your free consultation

Wednesday, September 1, 2010
How Health Care Reform Will Impact Your Practice in 2010

The Patient Protection and Affordable Care Act (PPACA) will impact you and your employees beginning this fall.

There are still major aspects of the bill that are open for interpretation and are subject to change. However, it is important you know how this bill will affect you and your employees in 2010.

When is a free consultation really free?

When you give me a call for a brief discussion. We can talk for 15 to 20 minutes about what’s on your mind.

Before you call, check out the testimonials on our web site from dentists who called me and are glad they did. Real dentists, real practices, real names and photographs. I’m sure you’ll recognize at least a couple of fellow dentists. 952 921 3360

Posted by Bill Rossi at 4:04 PM
Labels: Advanced Practice Management, Bill Rossi, health care reform