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Dental Team

How to determine dental staffing needs as you reopen

June 5, 2020
As dentists reopen, they’ll have to adjust to a new normal and think about what new policies and procedures to implement to keep team members, patients, and themselves safe. There’s a lot to consider, says Sally McKenzie.

As you reopen your practice, it’s not a matter of just picking up where you left off before the coronavirus closures. You’ll have to adjust to a new normal and think about what new policies and procedures to implement to keep your team members, your patients, and yourself safe. There’s a lot to consider, including staffing needs.

The truth is, as much as you’d like to ramp up production right away, it’s likely to be slow going at first. Many patients who are still nervous about being exposed to COVID-19 will wait to schedule, while those who were out of work may have financial concerns that will keep them from going forward with needed dentistry.  

To be successful, it’s critical to think about the new role your team members will play moving forward. I suggest you start by assessing the size of your team as well as updating the duties they must perform.

Determining staffing needs

The industry standard for payroll (not including employer paid payroll taxes and benefits) is 20% to 22% of revenues. After being closed for a few months, that probably isn’t where you are today. Expect payroll to be above that benchmark until you get some short-term history on whether production and revenues will rebound to where they were before closures. In the meantime, assess where you are now and identify areas that can be improved.

To make that assessment, ask yourself these questions:

  • Do I need the same number of employees as before the pandemic? 
  • Have roles shifted? If yes, how?
  • Could job descriptions be more defined?
  • Should new responsibilities/duties be added to job descriptions?
  • Are there tasks that can be automated and taken off of job descriptions? 
  • How can job descriptions be altered to include more producing tasks? 
  • What performance measurements can I put in place?

Next, determine what improvements team members, from the front office to the clinical team, can make to help your practice thrive.

The front office

The business employee’s day should be split into patient tasks (checking patients in and out, collecting payment) and non-patient tasks (billing, processing insurance). If your practice works eight-hour days, or 480 minutes, your business employee should spend 240 minutes on nonpatient tasks and the other 240 on patient tasks. If you factor in 10 minutes per patient for check-in and check-out tasks, this means one business employee can process 24 patients a day. So, if you see 19 patients a day and have two business employees, there’s a good chance you’re over that 20% to 22% of revenue industry standard.

The challenge is that many business team employees start to feel overwhelmed when daily patient numbers increase to about 22. Tasks start falling through the cracks, so the dentist often decides to bring in help, but then doesn’t give the new employee a job description that’s focused on producing. So, payroll expenses go up but production, and therefore revenue, does not.

Here’s the solution. As the patient count goes up, start sectioning out the business employee’s job description and give correlating tasks to the second employee. For example, anything associated with money (billing, delinquent account calls, insurance, and collections) should become part of the financial coordinator’s responsibilities. This takes some pressure off of the original business employee while ensuring the new team member stays productive.

The hygienist

The key here is to ensure payroll expenses are no more than 33% of your hygienist’s net production. When it goes above that benchmark, the guaranteed base you’re paying is higher than the hygienist’s production.

Openings in the schedule are a big contributor to this problem, whether caused by broken appointments or slots never being filled at all. If unfilled appointments are a common issue, it’s likely because the hygienist is not being scheduled to meet production goals, which is a telltale sign there’s a problem with your scheduling system.

Preappointing patients months in advance, weaknesses in the confirmation process, lack of patient education about the importance of return visits, high fees, and aggressive treatment options may be among other reasons your office has openings. Putting a plan in place to address these issues will help get more slots filled.

Not having a periodontal therapy program will keep you above that 33% benchmark. Implementing such a program represents a huge opportunity. Making sure you’re on the same page with your hygienist as to when x-rays should be taken is another way to raise production numbers.

Dental assistants

Do you delegate advanced duties to your assistant, or do you prefer to take on most tasks yourself? The answer to that question is important, because how you use your assistant will help determine how many you should schedule.

Typically, you need one assistant for an average of 13 doctor patients in an eight-hour day. Dentists who delegate advanced duties to an assistant as allowed by state law and who operate out of two or more treatment rooms will need more. The key, no matter how many assistants you have, is to make sure they’re working all the time, even when there are gaps in the schedule. Here’s a list of productive tasks they can take on:

  • Review lab cases
  • Find ways to save money on dental supplies
  • Contact yesterday’s patients to see how they’re doing
  • Review pending treatment plans with waiting patients
  • Create information sheets
  • Review the protocol to sell comprehensive exams to emergency patients
  • Assist the hygienist
  • Reach out to past due patients using a script

Assessing staffing needs is critical right now, but you don’t have to do it on your own. Feel free to contact me if you’d like more guidance. I can set you up with a consultant through my new virtual dental programs.

Sally McKenzie is CEO of McKenzie Management, a full-service, nationwide dental practice management company. For over 30 years, Sally has immersed herself in techniques, systems, and methods to improve the performance of dental practices. She was a dental auxiliary, dental business administrator, and dental educator for several years prior to founding McKenzie Management in 1980. Contact her at (877) 777-6151 or [email protected].