Category Archives: Bulletin Articles

Your Fixer—Turnover Insurance

Doctors, when you hire a hygienist or assistant, they’re right under your nose. For the most part you can see their work and know if they’re “on the job.”

Not so much so for the front desk team. It’s hard for Doctors to have the time, much less the knowledge, to know that all the bases are covered at the front desk. Are the insurance forms and bills getting out on a timely basis? Is the Recall System organized? Is there treatment follow up on patients that didn’t previously schedule? How is the front desk person handling the phones with new patients (or anyone)? Are they doing all that can be done to keep your patients happy and your schedule full?

Let’s face it, most of you don’t have the time or inclination to really stick your nose into the practice management software and see what’s going on. Even well-meaning, experienced front desk people can be dropping the ball without knowing they’re dropping the ball. You don’t want your office systems to break down due to turnover.

That’s where Heidi Benson comes in. Heidi is our new addition but she is certainly not new to dentistry. For over 20 years, she’s been a Dentrix trainer and she’s familiar with most all dental software including: Eaglesoft and Open Dental.

So, if you have turnover, call us and Heidi will come to your office for a “Systems Check Through.” If your front desk person is doing all that should be done, you’ll have the peace of mind of knowing it. If there are areas that are slipping, Heidi will nicely offer any relevant advice. Heidi is not a threat to your new front desk people…she can be their strongest ally. We want your front desk people to be happy and you to be happy with them. You’ll have busier schedules and a better bottom line (plus peace of mind knowing it’s all under control).

So, if you’ve had turnover in the last few months and/or want your administrative staff to get a one-on-one tune up, call me. We will get it done!

THE MDA CONVENTION IS COMING – DON’T KEEP US A SECRET:

Your good words are still our single best source of new clients. Please don’t keep us a secret. When you see colleagues who tell you their practice is “stalled”, tell them to call us. We’ll make sure they’ll thank you for the suggestion.

Aspen’s Abounding!

Aspens Abounding There are now 12 Aspen Dental offices in our state, one in North Dakota, a couple in Wisconsin and one in Iowa (there are over 500 nationally). They’re actively seeking Dentists in almost all of their Minnesota locations.

An Aspen Dental opened up in Bemidji in 2015. My clients there say that it’s been closed for some months now presumably because their previous Doctor(s) departed. They are searching for another one now. For a little schadenfreude, Google “Aspen Dental Reviews.” As far as I know, they are the most maligned dental entity on the Web. Even so, they must have lots of money behind them because they keep adding clinics.

I just heard of a recent case in which a young Minnesota Doctor bought a practice and then found, probably to his chagrin, that a brand new Aspen Dental was being built across the street. He’s not a client of mine but if he was, I’d tell him, “Fear not!”

I like to use Aspen Dental as an example of what the independent private practice doesn’t want to be. Yes, they’re shiny on the outside. They cover lots of hours and carry lots of PPO’s. They can’t be ignored. They are a competitive force. However, the lawsuit cited by the ADA last year in New York, where they were sued for $450,000, says what the core of their problems is. The company was run by the “Suits” not the Doctors.

Now I’m a “Suit” myself but I like the idea that the Doctors get the final decision on what clinical treatment happens with their patients. Doctors do too and that’s one of the reasons why the larger group practice models (“Corporate Dentistry” or “DSOs”) tend to have greater turnover of both Doctors and staff than the private practitioner.

An obvious point here is if you have good staff you want to take good care of them! After the great recession, many practices did not award wage increases for a year or two – some longer. That’s changed now as the market heats up for assistants, front desk people and hygienists. Don’t take your staff for granted!

Of course, you don’t take your patients for granted either. People repeat experiences that either feel good or make them feel good. Since most dental visits don’t actually feel good, you want to make sure the patient feels good about themselves when they leave your office. That means really listening to them. Sincere compliments. Sure, you have to tell them if they need to floss more or get this or that done, but you can have them leaving feeling good about the stuff they are doing right and, most of all, that they were smart to get on in and get their checkup (or whatever). Of course, I don’t mean this in a patronizing way. For example, patients that commit to perio treatment are going through some inconvenience and expense and should be really congratulated for their efforts.

“Joe, I know getting here for these treatments can be a hassle, but you’re doing the smart thing. We see many people that wish they had done what you’re doing years ago—saving a lot of trouble. So, good for you for taking good care of your smile.”

Show Off Your Quality a Little: Ask your staff to constantly deliver the message that, “Dr. Goodguy does dentistry that looks good, feels good and lasts long.” Or phrases like, “Dr. Goodguy only uses the finest materials and your fillings (crowns or whatever) will last a long time if you take good care of them…” “Dr. Goodguy really stands behind his work. If there is anything more we can do for you, be sure to let me know. Here’s my card, just call…”

Of course, you already know that this should be getting done, but is it? If having a bright shiny Aspen Dental across the way stimulates you and your staff to take these extra steps to reinforce the value of what you do, the kind of practice you are, well then,
Aspen Dental might actually do some good!

Collections Seminar—November 4

Collections Seminar

Presented by: Shelly Ryan

Friday, November 4, 8:30 am to 12:30 pm Embassy Suites Bloomington, MN

This perennial favorite is a must for you and your team. Dealing with patients, money and insurance is something you have to do every day so why not do it well? And, it takes the whole team! Take the confusion out of dental fees and insurance so your patients follow through on treatment and your schedule stays full.

This seminar is almost always a sellout. As clients, you get first dibs and a discount! $198 first person and $178 each additional. Register by May 15th and receive $40 off per attendee. So CALL TODAY (952-921-3360) to reserve your space before we do our general mailing.

The Dental Dow—First Quarter 2016

Bill GROWTH CONTINUES—THE FIRST QUARTER 2016 DENTAL DOW: Continuing the trend of growth from last year, practice Production is up 6.1% and Collections are up 6% compared to the first quarter of 2015 for the mature area practices sampled. Patient Flow was up 3.9%. New Patients were up about 2.7% (they were up about 7% in 2015).

The highest Doctor Production per Hour in our Dental Dow sample is $1,484. The highest Hygiene Production per Hour is $213. The Average Doctor Production per Hour is $652. The Average Hygiene Production per Hour is $151. Again, keep in mind that this is a group of mature practices and a mix of Metro and Outstate locations as well.

EVERYONE ON YOUR TEAM HAS TO DEAL WITH PATIENTS, MONEY AND INSURANCE. MAKE SURE THEY KNOW HOW!

Time to Recalibrate Your Incentives

Bill Most incentives need to be adjusted each year taking into account factors like:

Additional staff
Raises given to staff
(Both of the above items change the Overhead landscape and therefore the incentive targets)
New practice goals & projects
Upcoming performance reviews

So call us and we will help you retune your bonus targets.

About a third of area practices have their staff on an incentive. If the conditions are right, we highly recommend incentives. It gives the staff a stake in the practice success. However, sometimes incentives get to the point where they are no longer stimulating performance. They go from being a “nice bonus”, to being expected, to being taken for granted and a “right.”

Sometimes it makes sense to discontinue an incentive that’s no longer helping to foster a harmonious and productive team and that extra edge of performance that we are always looking for. This is best done in conjunction with performance reviews because you can “buy-out” from an incentive by awarding increases and then change the game according to the practice’s situation – or just let it lie fallow for a while.

Productive Performance Reviews: As many of you have heard me say, I feel that a productive performance review should not be a bureaucratic “grading” process. Everybody hates that.

Instead, I feel that a performance review should be a cross between a “Wedding Anniversary” and “Let’s Make a Deal.” That is, the employee should be thanked and honored for their contributions for the past year. Recognition matters to high performing employees. So when you give a raise, it is helpful to give it with praise – in a bouquet. Then you’ll get more of what you want (happy employees). The “Let’s Make a Deal” part is where you outline 3 to 5 concrete things for the employee that you want their help with,

“So Debbie, I am very happy with how you’ve gone beyond the call to increase your skills this year, are flexible in working hours, always willing to lend a hand and always cheerful. That’s why I am giving you a 4% raise this year…

Now, for the coming year, here is where I need your help…”

Then outline to your employee what you’d like them to do.
Examples:

Get the Continuing Ed to add to their skills (for example, the front desk to learn more about QuickBooks or the Practice Management software)
Flexibility in working evening hours
More use of the intra-oral camera
Better front desk collections
Be more punctual

Be very specific and concrete. Note the requests and then the next year, if they’ve made progress in those areas, thank them. In fact, don’t wait until next year! Tell them right away if you see a change in behavior (or don’t!).

As practice owners, you have an automatic “incentive” program. You know your career, your livelihood is at stake. Employees are a step or two removed from the harsh realities and from the rewards. You don’t need anyone to motivate you to grow, to get better, etc. Create an environment so good employees can flourish. Valuable team members are always adding to their skills, always helpful, pleasant and hardworking. If you don’t recognize those qualities in an employee, they will go somewhere where they can be recognized!

Oh, and one more thing, an important part of the performance review process is to ask the employee, “What can I do to help support you in doing your job and in being happy at work?” and then really listen to what they have to say. You don’t have to grant everything that’s asked for but if you take what they say under consideration, they’ll know that. At the very least, you’re less likely to be surprised by having someone unexpectedly quit.

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 27% or 28%, then it’s time to hold off until your practice revenue catches up.

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

Dental Dow 2015 Wrap Up

Comparing 2015 to 2014 statistics for the mature area practices sampled, we found that practice production was up 6% and collections were up 4.8%.

Total patient flow was up 3% with New Patients being up 7.3%. The average production per exam was up 3.2%.

Metro Area Fees were up 1.3%. Outstate Area Fees were up 1.7%.

Producon Increase Percentages

2009	2010	2011	2012	2013	2014	2015
0.5%	1.4%	2.5%	3.3%	3.3%	4.2%	6.0%

Collecon Increase Percentages

2009	2010	2011	2012	2013	2014	2015
0.4%	0.4%	1.6%	3.5%	2.2%	3.1%	4.8%

As you can see, this is the most growth in 7 years.

Our Dow, a sampling of both Rural and Urban practices, shows an average collection percentage of 84% – down a percentage point from last year. The Collection percentage has slipped by around 1 point per year for the past five years. Doctors are raising fees but, of course, PPO Participation is affecting Collections.

Heidi is Here!

Heidi Benson “Mission Specialist”

Heidi has over 17 years in dentistry and has managed large successful practices. She has also been a Dentrix trainer for many years. Many of you are familiar with her in that role. Heidi’s deep experience makes her ideally suited for special situations. For example, dealing with a turnover of the administrative staff, making sure the new staff is in line and the systems are tuned or stay tuned. For some of you, she can be seen as a free-lance office manager. Heidi will also help you and us in technical research as the front desk area, like the clinical side, is increasingly digital and complex. Remember, my team is your team and now we have some great new talent on board.

Dental Dow—Still Cruising

The Dental Dow – Third Quarter 2015:

Comparing the first three quarters of 2015 to 2014, we find that production is up 5.7% and collections are up 4.9%. Not quite as brisk as the first two quarters but still definitely in “Up” territory.

Exams are up 2.7% with New Patients being up 12% and Open Time in Doctor and Hygiene schedules down about 5%.

PPO/Tech/Economy Survey Highlights

HIGHLIGHTS FROM OUR 2015 ECONOMY, TECHNOLOGY & INSURANCE SURVEY:

Metro Area:

More Metro practices said Production was up this year (56% vs. 40% last year). Collections were up at 53% of the practices (vs. 48%). However, only 28% of practices saw New Patients increase vs. 34% last year. 43% of Metro Area practices have or are planning to give raises to their team this year.

Outstate Practices:

62% of the practices reported that Production was up this year (vs. 46% last year) and 62% had increased Collections (vs. 48% last year). New Patients were up too (48% of the practices saw an increase in New Patients vs. 41% last year). 68% of Outstate practices have or are planning to give raises.

So all in all, the balance of the Dental Economy is on the plus side.

Trends in Technology:

Well, we are the home of Patterson and it shows with 28% of respondents saying they have a Cerec machine (3% E4D).

For the first time this year, we surveyed “Online Bill Payment” – 18% of offices now have it. Patient Registration Online – 27% and Digital Impressions Scanner -11%.

56% of offices now claim to be chartless. 36% offer Invisalign (or like). 11% of reporting practices said they had a Cone Beam Imager.

83% of practices now have Digital Radiography but that still leaves 17% to make the transition. This number had been stuck around 70% for a couple of years so the hold outs are finally upgrading.

Software:

Eaglesoft continues to be the dominant player in our area with 32% of the market (vs. 30% last year). Dentrix is still holding its own at 21%. Softdent is holding at 18% with PEB XL Dent closing in at about 17%.

We hear a lot of talk about Open Dental but it is still less than 5% of our regional market according to our survey respondents. Dentrix, Open Dental and EZ Dental (an old system surprisingly) have the highest ratings by their users.

PPO Participation:

Delta Premier (the “regular” Delta) participation is holding at 86%. Delta PPO has made a slight increase from 30% to 33% of reporting Doctors. Delta 216 has gone from 33% to 40%. (216 fees are better than they need to be). Health Partners is gaining providers from 43% last year to 46% this year. Premier PPOs (a collection of over 25 various dental insurances) has 42% participation of the providers reporting.

11% of Dentists said they dropped a PPO in the past year and 7% are planning to leave one this year. 9% have joined a PPO.

If you are considering joining or leaving a PPO, please get in touch with us. We have helped many Doctors make smart “PPO Plays” which can add $1,000s to the bottom line or save a loss of $1,000s.

There is no blanket statement on this. It really is a matter of each practice’s situation and too complex a subject to go into much detail here. I almost hate to say it but the average Collection percentage in our area now is about 85%. That low a percentage would have been unthinkable 15 years ago. However, if you are collecting less than 80%, chances are you are deeper into PPOs than you need to be. If you haven’t given this a serious look, do!

Your Response to Corporate Dentistry

LEVELING THE PLAYING FIELD:

Almost every client I talk to prides themselves on their quality of care, friendliness, individual service and so on. But, if I ask them to really list all of the things that they are doing that make them truly exceptional, they are often at a loss.

The private pharmacy practice has been all but wiped out; however, there is a big difference between who hands you your pills and who puts their hands in your mouth!

So in order to keep up with the Mega Practices, take a frank look at yours. Better yet, go visit one of those places. Is your practice décor as fresh and shiny as theirs is? Do you have updated exterior signage (where possible)? Does your staff wear the same colored scrubs; in other words, do they look like they are a professional team? Do you personally thank those that have sent you a referral? Does the staff always point out and reinforce the value of the exceptional dentistry you deliver? In other words, always, every patient that gets a crown, filling or whatever is told something to the effect of, “Dr. Murphy does excellent work. It will look good and last for years if you take good care of it. There are lots of things that go into the quality of a restoration to have it look good, last long and feel right.”

Do you have finely-tuned Recall, Treatment Presentation, Treatment Follow-Up, and Financial Arrangements systems? Is there good flow (information and patients from front to back and back to front). Is your website personalized and up to date? Are you actively earning and facilitating Google Reviews? (Simply put, Google Reviews are some of the best SEO you can get and no ethical SEO guy can get them for you – you and your team have to get patients to do these). Are you keeping up with your Continuing Ed? How about your team? Are you expanding the services in your office such as implants, ortho, perio and endo?

If one of my three sons became a dentist, for one thing, I would be very proud. If they asked me for advice, the first thing I would tell them wouldn’t be “Hire a management consultant.” It would be, “Take 3 times the Continuing Ed you are supposed to.” Substantial Continuing Education Participation is the #1 factor that I’ve seen that enhances private practitioners’ success.

HEY DOCTOR, INSIST ON BEING TREATED LIKE A “BIG GUY”

The next time you buy equipment such as Cone Beam Imaging, a CAD/CAM machine or another unit, before you write that check, say to the rep, “I am paying the same price you would charge your big corporate clients, right?” See if they give more than lip service to supporting private independent practices (still the great bulk of their business). They should give you just as good a deal as everyone else. Insist on it!*

And, when you sign up for a PPO, ask, “Are you paying others more for the same services? And, if a patient goes on your website, do you give preferential treatment to providers in the big groups when patients search for providers?”

A particularly troubling thing I’ve heard is that some insurance companies have ownership in some of the larger groups. It’s pretty convenient to give their own guys a better deal. It seems unethical and uncompetitive to me that they can collectively bargain and you can’t. Ironically, the reason that it is antitrust for dentists to collectively bargain is presumably to have fairness in the marketplace but those regulations are a lot more “fair” to the big conglomerates. Something should be done about it.

* If anyone from Patterson, Schein, etc. can tell me otherwise (that these groups don’t get price breaks) I will print a retraction.

There is a place for the big group practices. For one thing, they are an excellent training ground for associates! And the people who will eventually buy your practice. (And, hopefully continue it as a private independent practice).