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She Dentistry Speaks: I Can't Get It All Done on Time!

July 1, 2004
Question: Help! I just can't seem to get it all done on time.


Help! I just can't seem to get it all done on time. Our schedule often runs late and now our staff is beginning to complain. What can I do?

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Kathy Larson, Organizational Expert: Use your influence! A leader's power and influence increase when she shares power with others. Be honest about the problem. Are you hanging on to all the power in your practice? If so, you will be left taking sole responsibility for this problem. Ask yourself, "Why?"

People will support what they help to create. It makes sense to share the structure of each day and determine who will be accountable for any adjustments in your day. Use your morning meeting to review the potential "land mines," and let everyone know you are counting on them. More importantly, let your team know you appreciate them and the way they manage their time. Lastly, promise to manage yours.

"Walking the talk" creates influence. You cannot be there to administer every change in the day. Leadership is ultimately an act of faith in other people. Share the burden and build your people. They are counting on it!

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Valerie Williams, Clinical Expert: Re-evaluate your hygiene schedule. If you aren't planning your ideal hygiene day and preblocking it, you may be scheduled to do eight exams a day — or 16, if you have two hygienists. This can leave everyone running behind, which creates a highly stressful office environment.

Try preblocking appointments six to nine months ahead. For example, each day consider having two to three root debridements, three supportive periodontal treatment appointments, two to three prophys, and three exams per hygienist.

By having this mix of preblocked services, the entire office will benefit. You'll run on time, deliver quality service, and hit your hygiene production goals, while keeping you and your team stress-free!

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Mary O'Neill, Relationship Expert: What you focus on becomes your reality. So before you make an honest appraisal of your work style, office schedule, and treatment plans — all of which are extremely important — take a good look at how you begin your day. Do you wake up feeling relaxed and unhurried? Or do you start your day in a rush? Do you set aside time in the morning just for you? Or are you focusing on what everyone else needs?

If you begin the morning by reflecting on the kind of day you want, the kind of experience you'd like to create, and the results you want to produce, you're much more likely to make that happen. You cannot manage time (that's a myth), but you can manage your activities. Before you get caught up in a whirlwind of motion, set aside 15 minutes of "alone time" and ask yourself: What's most important about today, and what simply must get done? Then think about the focus you want for the future.

Encourage your team to make this a daily practice too. This can set the stage for a much more relaxed and productive day, especially if you keep this intention at the forefront of your mind. Answering these questions will start your day off on the right foot and help make your life — and your team's — a lot easier.

Lastly, remember to leave a little white space in your calendar for the inevitable interruptions that occur in everyone's workday. That's the best activity management tip I ever got!

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Linda O'Grady, Front-Office Expert: Determine where the culprit lies. Are emergencies causing the problem? If so, are they patients-of-record with toothaches or new patients? Patients-of-record could indicate that you are not diagnosing potential problems. Most importantly, you'll need to determine the type of emergency. If it's a true emergency, these patients should be seen during your blocked or saved emergency time, not simply at their convenience.

Block your schedule according to "rock, sand, and water," and honor those blocks. During the morning huddle, review the schedule for possible glitches, and decide where to schedule emergencies.

Make sure your treatment plans and estimated treatment times are accurate. If you run over an average of 10 minutes per patient, you could easily end up 60 minutes behind by lunch and even later by the end of the day. Careful scrutiny of this area can have a huge, positive impact and help you and your team regain a greater sense of control over the schedule.

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Meet our guest, Risé Lyman, DDS:Dr. Risé Lyman graduated from the University of Texas Health Science Center Dental School in 1985 and entered solo private practice. In 1992, she began teaching part-time at the dental school while maintaining her practice. She acquired her MBA and has been sharing her knowledge ever since. Dr. Lyman enjoys traveling, water sports, and spending time with her husband, twin daughters, and four grandchildren.

Dr. Lyman: Many times, a patient will ask you to complete one more procedure because he or she has decided to have it done prior to a vacation or another important event. You're likely to feel compassionate, want to make the patient happy, and think it will add to production. But will it?

Here's what really happens: Mrs. Jones is in for a crown preparation on Tooth No. 3. She has decided that the bridge to replace Tooth No. 4 would truly be best. She wants you to adjust the treatment scheduled.

At first it sounds great — more production. But let's think this through. Are you prepared to begin a bridge preparation? Do you have study models? Is a temporary made? Does the patient know the difference in the cost, and does she have the money today? If each question can be answered "yes," then quickly get busy and prepare that bridge — and try doing it in the same time allotted for a crown!

But the true answer is probably "NO!" and adjusting the scheduled treatment is going to make you late. What happens when you run overtime on a patient? Murphy's Law! A simple extraction can turn into a complex procedure because a root tip broke off or the patient fainted or had a seizure ... then you're behind all day. Multiple patients are affected, your staff is stressed, and you're anxious.

To keep your staff from feeling like you're taking advantage of them — and to stop scheduling and rescheduling your day — follow this simple advice: Allow more time for each scheduled appointment and stick to the treatment plan. Pride yourself on quality care, and don't cut corners.

"SheDentistry Speaks" is a monthly feature in Woman Dentist Journal to address your practice questions. If you have a question or concern you would like to address, please visit the What Does She Think? page of on the World Wide Web.