Connecting Dental Health Professionals

Critical Front to Back Communication

May 1st, 2017 | By Dr. Marynak | Blog

By Dr. Deborah Marynak

I’ve said it before, I love to develop systems and there are numerous systems that need to be in place in a successful Dental practice. Systems are simply a method of communication regarding how the office operates

As I’ve worked in various offices, there are many systems that I have been asked to improve. There’s collection systems, patient flow, recall systems (I prefer recare to recall), informed consent, documentation and inventory systems to name a few. But, the system that I’ve seen that needs the most improvement is the communication (or lack thereof) between the front and the back.

So, I will apologize in advance if I ruffle some feathers, but there are some simple truths regarding this system that need to be said.

1. Paperwork is an administrative in nature; paperwork is to be done at the front desk. Patients in need of new medical histories, informed consent, updating insurance information, etc. can arrive early and do their paperwork before their treatment time ensues.

2. Changes in the schedule need to be effectively communicated to the Clinical Team. It doesn’t matter how this is done, whether it’s on paper or in a computer. It shouldn’t be a secret that gets revealed once the patient shows up for the appointment.

3. Additions to the schedule need to be communicated. If the clinical staff is already navigating a full schedule, most patients presenting with a toothache will need to do a “sit and wait”. Please don’t come and ask us when we’re going to get that TA back; we will get to the toothache when there’s a break in the action.

4. Proper Scheduling of the planned procedure is critical; the Clinical Team will not know how to set up for treatment unless they know what treatment has been planned. For example, if the schedule says “fills”, do they set up for alloys or composites? Do they prepare for upper right and lower left or the opposite?

On the flip side…

5. Clinical verbiage is established in the back. Treatment plans can’t be appropriately presented unless the Administrative Team knows exactly what’s being planned. For example: what kind of a crown, implant, partial, cleaning, etc., is being planned.

6. No matter who is responsible for establishing the treatment that has been performed or how it’s communicated, the Administrative Team cannot collect the appropriate fees without knowing exactly what has been done.

In consulting, you’ll see Administrative staff coming back asking questions and Clinical staff running up to get paperwork that isn’t complete. This is a complete waste of time and loss of revenue. If you are amongst a Team that receives bonuses based on productivity, you’re essentially flushing your bonus down the toilet!

How’s the communication in your office? What part in the function of your day do you play.

“The single biggest problem with communication is the illusion that it has taken place.”

– George Bernard Shaw

Are You Saving Time Or Wasting It

January 31st, 2017 | By Dr. Marynak | Blog

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By Dr. Deborah Marynak

I apologize for harping on this subject again, but it’s simply a passion of mine. One of my strongest skills is organization. The antithesis of organization is chaos and I simply don’t function well in chaos. The subject I’m talking about is systems. The first thing I notice in any office is the systems, or the absence of them. Mostly it’s the absence I notice and I want to jump in and take chaos to repeatable, successful systems.

The happiest, most productive dental offices that I have experienced have repeatable, successful systems. They have identified obstacles and procedures that were not working well and they’ve set about to eliminate stress and replaced it with order. Let’s talk about some examples.

In one office a prescription was printed from the operatory computer and printed in the front. An Administrative Team Member walked into the operatory with pen in hand, reached down to an accessible drawer and pulled out one glove. The Dentist turned, took off her right glove, signed the script, replaced the glove and turned back to the task at hand.

In another office the Doctor had to remove gloves, gown and mask, walk to their office, unlock a drawer, retrieve a prescription pad and walk back to the operatory to fill out the prescription. Whew! I get exhausted just thinking about it!

I experienced an office that had all of their referrals in each operatory, readily organized and available. They are returned to the front desk and scanned into the computer while the patient checked out. In another office they have the referrals in one, two and even three areas. Sometimes they’re missing referrals and Team members would run from place to place searching for the necessary paperwork, get them filled out, copy them and lastly place them in charts. A complete waste of time.

In my private practice I had an alphabetized system of where all inventory was stored. It was easy to invite Dental Assisting Students to do their clinical requirements in our office; they could find anything simply by checking the inventory system in place. I spent a morning in another office and started to keep track of how many times I observed a Team member looking for something or trying to decide where to put an item “where everyone would know where it was being stored”.

Our ordering consisted of a tag system whereby when the second to the last item was taken from inventory, the tag would simply be place in a basket. Our rep would go to the basket, write down the necessary order and leave. It required no man hours once the system was established.

I was hired by a Dentist to help in combining his office with an office he had purchased. He didn’t want to take any of his productive time to put the two practices together, requesting my help to make it as painless as possible while he continued to work.

I soon learned of the enormous task of going through this practice, drawer by drawer and finding a new definition for chaos. There was inventory stuffed in the back of drawers and in the back of cabinets; I found paperwork literally stuffed in drawers at the front desk, so much so, that it was difficult to open and close the drawer. There was paperwork and old x-rays (30 years old) stuffed in enormous envelopes they called “charts” that was completely unnecessary. Although this type of disorganization is rare, it was easy to see why this practice had failed and was rescued by my client.

I cannot say enough about the importance of developing sound systems. Dentistry is stressful enough without adding the problem of disorganization; this, however is big part of an even bigger picture. Without open, mature communication within the entire Team, systems will fail. There must be 100% cooperation from the Doctor to the cleaning crew, although I have learned that most Doctors couldn’t tell you where anything has been stored.

Keep in mind, the systems mentioned here aren’t all there is to organization. There are systems for virtually everything we do in a Dental Office. There should be systems in place for scheduling, cancellations/failed appointments, accounts payable and receivable, HR policies, and clinical systems such as tray/bur set-ups, turning rooms, sterilization, etc., etc.

But let’s not put the cart before the horse. Without the communication part, problems will arise. Watch for our blog on communication. It all starts with communication.

“Remember, Time Is Money”

– Benjamin Franklin

Are Your Systems Spot On?

November 2nd, 2016 | By Dr. Marynak | Blog

By Dr. Deborah Marynak

I recall my years in private practice as very hard work. It wasn’t the Dentistry that exhausted me; it was the daily running of the office. Inventory, payroll, quarterly taxes, and Staffing issues were constants in my professional life. I felt there weren’t enough hours in a day to deal with the issues that were my responsibilities. I went through periods that were awesome; production was up, the Team was spot on in their work ethic and our office environment was light-hearted and fun. But the days where nothing seemed to go well, I just couldn’t put my finger on the problem and how to keep the good days happening on a consistent level.

In looking back, I recall a Temporary Hygienist asking for a moment in my office. She wanted to talk to me about the systems (or absence of them) that were lacking in my Dental Practice. I really wasn’t exactly sure what she was talking about because it was nothing I’d recalled studying in Dental School. I’m not sure when or where along the way I learned that I, Dr. Marynak, didn’t, or better yet couldn’t function well in chaos.

It’s very clear to me now: when I start to feel uncomfortable at work, I know I’m working in a chaotic environment. Chaos can come in many forms. Perhaps the necessary paperwork isn’t where it should be, the Receptionist isn’t getting the new patients to complete the necessary forms, the Dental Assistant keeps forgetting to bring the lab prescription to the operatory, there’s a lab case that wasn’t sent out and it was prepped three days ago and I can go on and on!

Now many of you are saying “isn’t it the Team that’s causing these issues?” I’d answer “yes” and let’s face it, we all forget things from time to time. I know that I’ve worked in offices where systems are all but completely absent and in offices where systems were crisp and clear, concise and repeatable. I much prefer working in the later. I go home feeling accomplished, content and peaceful. When I spend eight hours in the former, I go home exhausted, depressed and my brain in a fog.

What’s the point in my discussing all of this with you today? Part of hiring a new member to your Team is trying to get at what makes them tick. Discovering their work ethic is paramount. Do they cut corners? Are they timely people? Can they work as a Team member? Do they leave their personal problems at home? My personal feeling is that when a Team member is being payed, they should be all in for the eight to ten hours they are working in your Dental Office.

Let me tell you about MM. MM is a phenomenal chairside assistant. She worked with me for several months as my primary chairside Assistant in a Corporate Practice. Occasionally MM wasn’t at work, was late, left early, went home at lunch (40 minutes away…one way).

One day in her absence, I looked into our restorative bin and it looked as though someone had turned it upside down and shook it. Everyday items were literally thrown into the bin: wedges in four places, matrix bands in all four corners, composite shades all dumped together, etc., etc. When I picked her up for a C.E. class one day and stepped into her home, it clicked. The house looked like a bomb had gone off. You could have gotten the same information by looking into her car.

At the recent ADA Convention, I met a Dentist who told me he was having trouble with his Receptionist. He sat down one day to investigate why his deposits had been light and he was concerned that he may find embezzlement. What he discovered was that the Receptionist was writing off account balances. I reminded him that that doesn’t mean there isn’t any embezzlement taking place and an owner Dentist should be watching his accounts receivable. I also told him that I learned from personal experience that you never hire an individual to handle money who has money problems of their own. Now I know why some companies do background checks; all Dental Offices should start with a ninety-day probationary period and consider background checks.

If you add a problem employee to poor systems, you will have chaos, lose money, waste time and go home with a foggy brain, unable to make complete sentences. And this doesn’t just affect the Dentist; your “A” Team will suffer as well. So, in finding that new employee, do what the United States Army does: ask for three personal references and three professional references. And don’t just think you can tell…call all six references. Find out what their job description entailed, find out how long they were employed and ask them if there were another opening in their office, would they rehire them.

The rare situation is the office that has had the same Team for several years. I met a Hygienist at the ADA Convention and she told me they had a stack of resumes in their office from people wanting to work in their office. Fortunately, they hadn’t had an opening in years; that speaks volumes about the Dentist, the Dental Team, their successful systems, their communication skills and the treatment delivery to their patients. High Five to that Dental Practice!

“I think as a company, if you can get those two things right — having a clear direction on what you are trying to do and bringing in great people who can execute on the stuff — then you can do pretty well.”

– Mark Zuckerberg, CEO of Facebook

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