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Troubleshooter: Why won’t anyone cooperate in this practice?

Aug. 25, 2021
Late to work. Financial notes in the wrong places. Patients yelling at the front office team. This person is tired of her thoughtless coworkers and stressful workplace.

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QUESTION: The hygienist in our office arrives at work 20 minutes late and is late returning from lunch every day. This puts her behind by an entire patient every day and then patients take it out on us in the front. If we schedule this hygienist for longer appointments, she changes the schedule to shorten them. She’s supposed to schedule follow-up appointments for hygiene, but she usually does not.

I constantly receive calls from our oral surgery office because the assistants don't add notes, treatment plans, scan referrals, or send preauthorizations. Some patients have never received or signed a treatment plan agreement and then they’re surprised by the cost. Many patients don't receive instructions about aftercare from the clinicians. We at the front at least now print off aftercare to give patients.

I've explained all of this to the office manager. She says, "I’ll talk to X," but months go by, then she simply schedules a lunch for all of us to go over everyone's roles. The assistants nod and agree, the hygienist argues with her, the meeting ends, and that’s it! Nothing changes.

The head assistant called me about a message I left for her. I asked her to put notes about patient financial agreements into their accounts so that we at the front know what they owe, whether they get a refund, or if they have a payment plan. She told me she put notes in the medical part, and I simply asked her to move them. She yelled at me, and sadly I ended up yelling back. I can't believe I let myself get pulled in.

I don't know what to do. I want to stay at this job. I like the hours, we’re paid well, and we have insurance and vacation time. But there's so much tension and animosity. I’m tired of working 10 times harder and getting cussed out regularly by patients. What do you suggest?

ANSWER FROM KYLE SUMMERFORD, editor of Dental Office Manager Digest: The issues you have are all too common in many dental practices. There are ways to mitigate these issues, but it all starts with accountability. It sounds like the office manager doesn't put their foot down and does so for a reason; either they’re too busy with their own work, or they don't find the situation to be disruptive enough to bring it to the attention of the dentist/owner. 

In my experience, it may be that the dental practice owner has turned a blind eye to what is happening, or he or she may not be informed about the issues. If the practice owner is aware of the issues, it could be that he or she doesn't feel this is worth taking the time to address. If the issues aren't disruptive to the flow of the dental practice, then most dentists will not take the time to address them. However, I feel things should be addressed by the dentist because these issues can become burdensome on the staff and cause unnecessary animosity among staff members, which is what you described here.

My suggestion to you is to inform the practice owner yourself. These types of issues should always be addressed by the owner if the office manager has not helped to extinguish the fires. Creating a daily log of the errors that you see occurring and bringing them to the attention of the dentist would be my course of action. By doing so you will be showing the dentist that you care about the overall wellbeing and future of the practice. Good luck!

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