The top 7 mistakes of high-performing practices: Part 3

Nov. 16, 2013
Sasha Burau, MBA, looks at high-performing practices and gives you insight into mistakes she sees every day that you can avoid. In this last of a three-part series, she discusses two more places to focus on where things could go wrong if you are not careful.

I travel to offices all over the country, and — without fail — at each office, the dentist will tell me that he or she hasn’t visited more than three other practices! That’s a problem, because you don’t have anything to compare your practice or systems to. How do you know if you are doing something right if you don’t know what other dentists are doing?

In this last of a three-part series, we are looking at the top seven mistakes high-performing practices make. Thus far, we have talked about these five mistakes …

1. Most dentists are unaware of their numbers.

2. If you do not have a person who is dedicated to recall in your office, you are missing out on a huge opportunity.

3. You all love your equipment. Everything is NEW! It’s beautiful, but NEW is expensive.

4. Intraoral cameras are the most underutilized instruments in the entire office.

5. High overhead — most of the offices I see have overhead over 65%.

You can catch up here: Read Part 1.Read Part 2.

Now we will look at the last two mistakes …

6. Lack of a financial arrangements policy.

When I go into an office leading up to the visit, I’m in constant contact with the doctor, but when I arrive, I spend the day observing and talking to the staff. The doctor frequently says the office has a financial arrangements policy, but the staff says otherwise. In many cases, the doctor makes financial arrangements with the patients or the staff doesn’t collect the money and sends statements. They usually send these at the end of the month, and this immediately increases the number of days that the accounts are past due. Here are three keys to a strong financial arrangements policy:

  • Make sure you have an easily understandable form that shows patients their payment options.
  • Financial arrangements are established with the patient prior to scheduling treatment FOR EVERY PATIENT.
  • If there are any statements, they should be sent weekly or as checks are being posted.

There is a time and a place for charity dentistry, and it is not for billed patients who do not pay.

A lot of times, we see that doctors do a fantastic job explaining treatment, but when they get to the financial aspect of treatment, they continue to talk instead of handing the patient off to the financial arrangements coordinator. You should review the needed treatment and answer all of the patients’ questions until they start to ask about the financial arrangements. At that point, turn the patient over to the financial coordinator to discuss financial options.

One of the doctors I worked with had a fantastic rapport with his patients, and many of his patients were relatives or friends (he had a huge family). He was an incredible dentist, but he would frequently work out “deals” with each patient and give them discounts. We had to disallow him from discussing financial arrangements with anyone to get him out of this habit. The selling point for him was that none of these family members or friends ever gave him a discount at their places of business. The bottom line is that if you value your work, you deserve to charge a fair and adequate price.

7. You don’t always distinguish between the two types of new patients you have: ones who already know you and ones who don’t.

The ones who know you have already bought into you and your practice. The ones who don’t know you won’t immediately trust you with a $10,000 full-mouth rehab, which is something that a lot of doctors love to present. I’m not saying that you shouldn’t tell patients about all the treatment they need — it would be unethical not to; I’m just saying that you need to present it in a palatable manner in which they are comfortable.

I was watching a case presentation in an office in Ohio where the patient was a 12-year-old girl who needed a lot of treatment to save her teeth. Both of her parents were edentulous and so was her 17-year-old brother. Her aunt was taking care of her treatment and was listening to this very extensive case presentation where the financial arrangements coordinator showed her a picture of each tooth that needed treatment and detailed what needed to be done. This lasted more than 45 minutes. Now, did the aunt know that a lot of work needed to be done? Yes, of course she did. But what was her motivator to do the work here? She didn’t necessarily have one. She had heard about this office from a local newspaper ad and brought her granddaughter for the free consultation. After the office had invested more than an hour on this exam and consultation, she left without an appointment. Was the doctor competent? Yes. Were they thorough? Yes. What did they do wrong? They overwhelmed her.

The best part of this story was the follow up. They proceeded to call this woman four times in the week following the appointment to schedule treatment.

Would you trust $10,000 with someone you didn’t know? Then why do you ask your patients to do that?

The best way to combat many of these issues is to think like a patient. Sometimes we are so focused on our part in the practice that we lose sight of how our patients feel or what we would want if we were patients in our own practice.

The most dangerous aspect of running your office is that you don’t know what you don’t know. You need to be aware of your operating costs for each day. You need to have someone videotape your case presentation so that you can see what your patients see, and you need to have the financial arrangements taken care of by someone who is not the doctor, but who has a system that the doctor is comfortable with. You can start small, implementing one change a month, but little changes will make a big difference over a long career.

Sasha Burau, MBA, is a practice consultant who has worked with Excellence in Dentistry’s Dr. Woody Oakes. She currently coaches offices on systems and implementation. She can be reached at (810) 569-9587 or via email at [email protected]. Email her to receive all of the forms and handouts for systems discussed in this article.