Procrastinate On Purpose

Episode 075

In episode 075 we discuss a decision funnel to determine how we should spend our time performing tasks in the practice. Our discussion is based on the book “Procrastinate on Purpose” by Rory Vaden. Check it out to see if procrastination may be right for you!

Team Transitions

Episode 074

Welcome to the Business of Dentistry podcast! Check out this week’s episode as we discuss our options on reacting to team transitions and how I’ve navigated these changes recently in my practice. Listen in to hear that and more on the 74th edition of Business of Dentistry.

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Recently there have been several transitions in my practice and they’ve impacted some business decisions I’ve made. A few of our front office team members have left on their own accord because they found other opportunities.

One of the people who left had been working in an administrative role and found clinical work elsewhere, so she gave her notice and moved on. The other person was a mother with young children in school and sometimes our work schedule conflicted with caring for her kids. To solve that she found an administrative role within the school district.

We also have a team member who went on medical leave, but we don’t know how long that leave will be so we had to figure out everything they do and build a system for it. We had to transition some of these tasks to other people without overloading anyone, all the while still getting the work done.

Even though we’ve had a pretty big shake up on the administrative side lately, we are weathering the storm well.

One of the team members who left, Catherine, did so right about the time I was set to leave for my Navy reserve duty. Of course it wasn’t great timing but we made the necessary adjustments. My office manager Paul and Becca, my front office team leader, asked me what to do. I told them to start the search for finding a replacement while I was gone.

During my 2 weeks service Paul messaged me to say he and Becca thought they found someone. They both interviewed her and thought she would make a great addition to the office. He then asked if I wanted to talk with her when I returned or if they should go ahead and hire her.

Initially I was reluctant to hire this person without meeting her first. But I took a step back, took a few deep breaths and realized I have known Paul and Becca for years. I trust their judgment so this was my chance to show them. I took a big leap of faith and told them to hire this person if they really believed she was a good fit.

My initial hesitation was not because I don’t think they can hire good people on their own, it was about my ego getting in the way. When I realized that I knew I could delegate this to them and they would hire the right person.

When I returned from my two weeks in the reserves, I was walking down the hallway to our team meeting when I met Whitney. This is the first time I had a new person in the office whom I had not personally interviewed and hired. It was refreshing! I will say that it’s early in the game, but I think she has great potential.

And I’m bringing this up because this is the first time I’ve ever delegated the hiring process to my staff. You may already be doing this, but in my 16 years of practicing I’ve never done it before.

This is also timely for me because I was on social media recently and read a Facebook post from a man who had fired his entire staff, in one fell swoop. At first I thought he was kidding, but as I read more I realized he was serious!

I don’t know the entire story but it was interesting to me that someone would do something this extreme. And I’d love to have this person on the show and interview them, if you know this individual or are this person then email me. I’d love to know what prompted this person to wipe the slate clean and shut down their business while they retooled their entire staff.

On this episode, I also share how I had a similar experience in my practice, plus some office hiccups we’ve experienced with various technology. And I wrap up with a few takeaways I want to share including why a good leader often requires you to delegate, and why change is inevitable but how we react to it is so critical.

And before I go, I have to give a quick shout out to Ms. Betty Williams, who has jumped on the dental podcast listening bandwagon. Her husband is Dr. Chad Williams, and I appreciate her feedback and sharing better business practices with me. If you have any questions or anything I can help you with please email me, after you listen to episode 74 of Business of Dentistry.

Tweetable: “Transition in your team is always going to happen. ”

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A Patient’s Viewpoint With Mr. Nathan Harris

Episode 073

The Business of Dentistry is back this week with a special interview. In this episode I interview a former patient, Mr. Nathan Harris. In our discussion he gives us an unbiased opinion on what potential patients are looking for in a new dentist. Episode 73 of Business of Dentistry is definitely worth a listen.

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You may have noticed I’ve been away for awhile, I’ve had a few weeks with the military and the office has been busy because it’s summer. Now I’m back and bringing on a friend and former patient of mine to talk about dentistry from the patient’s perspective.

Nathan Harris and I met in a leadership group about 10 years ago and we’ve been friends ever since. Because he’s moving to a new area I asked him to share how he’s gone about finding a new dentist.

When looking for a new dentist, Nathan said he would go to Google and search for a phrase like “best dentist in X: (X being his new town or county). He would do a lot of research first, and including things like insurance, but also he’d research finding a place that he feels comfortable. He doesn’t like the going to the dentist but he knows it is necessary, so finding a place he feels good about it is important to him.

To get a feel for the new dentist he’d look at their online reviews, their social media and anything else he can find via Google. From there he would potentially schedule a visit or just drop by their office to see what it looks like.

He’d do so because he wants to know if it’s in a good part of town, if it is a nice-looking professional building and office space. Once he’d narrow it down to a few potential dentists he would ask around about those specific practices. He would ask for other people’s experiences and input on those potential dentists he had found.

Nathan explains word of mouth plays a bigger role than social media, so if a friend or someone else he knows, likes and trusts tells him not to go to one dentist, he’s going to listen to that over online reviews.
The opposite is true, too: a positive referral will reinforce any positive research he has found online.

As far as scheduling and the actual office visit, he wants to call to make an appointment. The first thing he’d want to hear is a smile on the other end. He believes if someone is enjoying their job and has a pleasant attitude about their work it comes across when they answer the phone. Also he wants someone who identifies the office by name, and someone who can answer basic questions or will put him in touch with someone who knows the answers.

In terms of the physical office, he is looking for a space that conveys what the office is about: cleanliness of course, but also the waiting room experience. Do they offer things like wi-fi or music or other distractions if he has to wait? He also looks for a place that doesn’t smell like a doctor’s office!

Initially, he said a tour would be nice and he would like to see the equipment and highlights of the technology available. During his first meeting with the potential new dentist he wants to spend a few minutes talking with that dentist. He also wants to hear credentials, how long they’ve been in business, and what they specialize in.

We wrap up our discussion by talking about the big three: time, money and fear, and why I try to find out what each of my patients are most concerned about from those three. Nathan shares which of those three is his biggest concern, but also why all three are critical for him.

This is a great topic from a unique perspective we don’t often get to hear from directly so let me know what you think after you listen to episode 73 of Business of Dentistry.

Tweetable: “You can hear someone smiling through the phone.”

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Struggling With My Thinking

Episode 072

Over the last few weeks I have been struggling with my thoughts. So much, they have been waking me up in the middle of the night. I’m not sure if my subconscious mind is trying to tell me something or not. Listen in to episode 72 of the Business of Dentistry to find out about my struggle and see if it may sound familiar…

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I don’t know if you have this same thought so I wanted to talk through it and get your feedback. What I’ve been working through about how we think is tactical vs. strategic. I’m comfortable thinking at the tactical level, like how to fix things.

That’s part of our training: we work in microns and millimeters and procedures on everything from dentures to crowns, etc. All of our training leads us to how to do something, how to work out the step by step of a procedure. But do we get into this profession because we think like that, or does our profession train us to think like that?

The counterpoint to this way of thinking, the tactical approach, is strategic thinking: why are we doing what we are doing? And that’s the piece I struggle with the most.

For example if you go into any of the online dental forums we’re all a part of and look at the questions being asked, most of the questions are related to the tactical thought process. There are far more questions related to the tactical side of things then to the strategy. And I’m comfortable with that thought process and that way of thinking, as most of us probably are.

However I get uncomfortable when I start to think of the why, what is our purpose. I’ve noticed that is something you don’t see much of online: the strategy. Which I understand, at least for me it’s hard to make the transition from tactical to strategic.

I don’t know if you do the same thing but I struggle with what am I going to do long-term? Like what is my real long-term game plan for my practice? I’m opening up and telling you this: I have some ideas but I’m not sure I’m comfortable with the long-term view. This is something we all have to think about, we all have to think about our exit strategy and have one in place.

I haven’t played with my exit strategy enough: do I want to work part-time eventually? Do I want to go into academics part-time? Do I want to get a job with a government agency? Do I want to get out of this entirely and do some other line of work? Do I want to sell my practice? Do I want to get an associate and sell it to them? When do I want to do this? I’m 50, but do I want to do this when I’m 55 or 60?

I struggle with those answers, but I need to know them and you need to have a game plan for yourself. It’s never too early to start looking at your exit strategies. Ask yourself why you are doing what you are doing. Where are you going with it?

I challenge you to think strategically, consider your exit plan and think about your long-term plan.

After you listen to episode 72 of the Business of Dentistry chew on that concept and those questions for awhile, no pun intended! And then let me know your thoughts.

Tweetable: “It’s hard to go from thinking in millimeters to thinking in years!”

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Introduction To Medical Coding

Episode 071

Hey folks, this episode we jump into the topic of medical coding. Now, don’t go worrying… I know medical coding is a complex topic but we are only covering the basics here. We will use a specific pathology case and go over the way I would approach the International Classification of Diseases Revision 10 (ICD-10) and Current Procedural Terminology (CPT) codes. Thanks for listening to episode 71 of Business of Dentistry!

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The reason for the topic today is because I am in a few closed Facebook groups with other dental professionals and many of them have questions and a lot of interest in how medical coding is done. Personally my office uses medical coding because we do oral surgery. In fact, we use it every day.

When I was an oral surgery resident they made us code, and I hated it (at the time)! Of course now I can see the benefit in my private practice, knowing the coding and understanding how medical coding works has helped me since going into private practice.

Let’s talk about the basics of medical coding: there are two simple components, the diagnosis code and the procedural code. The diagnosis code comes from the International Classification of Diseases, better known as ICD. The latest revision is the 10th and it’s known as ICD-10. ICD’s coding will be a combination of alpha numeric numbers.

The procedural code is based on the Comprehensive Guide for Current Procedural Terminology, better known as CPT. This code is 5 numbers.

You list your diagnosis codes to support your procedural codes; a lot of medical insurances look at ICD 10 to tell the story of what is going on with the patient, that determines whether it is a covered benefit or not for that case.

Now let’s talk about a specific case I saw online.

The case was posted with a picture of a soft tissue neoplasm. I call it that because the photo showed an anterior maxilla which had attached gingiva between the anterior teeth, pinkish red and non-ulcerated). The picture was posted asking what we thought it was and what should be done.

Personally if I were submitting this I would submit my pathology as general categories: soft tissue neoplasm vs hard tissue neoplasm.

In this instance it would be soft tissue neoplasm. In the medical diagnosis code they want to break it down even further, they want to know if it is malignant, benign. I use the code of unspecified behavior because that is really what I am looking at. I’m looking at a bump on the gums of a patient, it’s soft tissue and it’s soft tissue neoplasm but I do not have a definitive diagnosis.

I know in my mind what I think may be based on clinical and historical data, but I don’t know for sure. So when I submit this case for coverage of a biopsy I submit it as a diagnosis code of neoplasm of uncertain behavior.

Then there are several categories in the ICD-10 coding book. They break it out into lip, tongue, salivary glands, even into submandibular, sublingual, etc. They have one that is a catch-all and it’s called other specified sites in the oral cavity which means gingiva, palate, gum, mucosa, cheek, alveolar, process, etc. That particular catch-all code is more in line with this specific case.

I’m highlighting my use of medical coding here because I want you to see how I use it, and how I do it in such a way that the patient can get benefits from their medical coverage if their dental won’t pick it up (or if they don’t have dental but they have medical).

So in this particular case I would use the ICD-10 and would use the code for a soft tissue neoplasm (and I use neoplasm instead of cyst or granuloma). And I would use the code for uncertain behavior in other specified sites in the oral cavity (there’s no specific code for anterior maxilla). In our example this would be D37.09, which gives information about the actual diagnosis.

To hear what CPT code I’d use and why it’s important in terms of your reimbursement listen in to episode 71. You’ll get a clearer picture of the basics when you do along with an explanation of a common form my staff created to help with coding in our office (the same one you can get by clicking on the photo above).

Feel free to email me with any questions, comments or insights you have about medical coding. Thanks for being here, I appreciate you listening to this episode of the business of dentistry!

Tweetable: “Understanding medical coding has helped in my private practice.”

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Sitting Down With Dr. Chad Williams

Episode 070

In this episode I have the privilege and honor of speaking with my friend and colleague Dr. Chad Williams.  In our discussion he gives his story on how he went from an associate to practice owner and then we delve into some of his experiences over the past 16 years.  I think you will find what he shares informative, educational and entertaining.  Give a listen to episode 70 of Business of Dentistry!

2017 Staff Photos 031

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I asked Dr. Chad Williams to join us for a number of reasons. He’s my top referral, and one of my closest friends. Because he’s has been in practice for 16 years, he has plenty to share about what he’s done right, what he’s done wrong and what advice he has for someone in the first few years of their practice – and he’s talking about it all on today’s show.

We are both located in Lebanon, TN. He arrived in town after graduating from dental school in Louisville, Kentucky. But before settling down here, he tried to join the Army Reserves in Clarksville, TN. The Army wouldn’t take him because of multiple knee surgeries, so when he heard about a dentist in Lebanon who was leaving his practice to become a firefighter, Chad jumped at the opportunity. He’s been here ever since.

Those first few months and years had their rocky moments though. Originally he was given five months to work in the practice before deciding if he wanted to continue, walk away or buy the dental practice outright.

A few months in Chad decided he wanted to buy it. He liked the people in town, and the proximity to Nashville. So on January 1 of 2002 he bought the practice.

It didn’t take long for his new practice’s office to need an overhaul though. The original dentist hated being a dentist, and hated having a practice so he did the bare minimum in terms of services, and spent as little as possible to keep the practice running. Chad gave it a complete makeover from the carpeted floors to the outdated wallpaper.

Plus the office was in a residential area; the original dentist had remodeled a family home into a dental office so by 2005 the practice was at maximum capacity. Chad had only 1.5 rooms to work in so he and his wife Betty looked into all their possible alternatives.

They found a piece of property on the main drag of the town and thought it would be a perfect place to build a new office. It was about 1.5 acres, so he built 5,000 sq. ft. of space to lease to others, plus 4,400 sq. ft. for his dental office. They loved it and got to work on the design in 2006 and started building in 2007.

He says the entire process was as smooth as broken glass! The economy took a downturn so they struggled to fill the additional office space. They had been looking for service professionals to complement a dental practice: dental specialists, medical specialists, CPAs, lawyers, etc.

They turned down 200 liquor stores, tobacco stores, and other non-professional service businesses. Because of that they were the only tenant in the building for a few years, but recently they signed a lease with a hospice that will occupy for the front 3,000 sq. ft. and are hopeful the rest will soon be occupied as well.

We also talk about his two pieces of advice if you are in the first 3-5 years of your private practice. His first bit of advice is to lose your ego, put down your pride. He admits his practice has always done much better when he’s put aside his pride.

For example, whenever he sits down with a patient and looks at them as a peer, it changes the dynamic in a positive way. He talks to them about how he can help them, and what they need done, rather than telling them what he could do for them. Then he listens to their questions. All of this helps his patients to be less nervous and more agreeable to his treatment plan recommendations – that and his use of humor, something he is known for!

Hear the other piece when you listen in to today’s show. You’ll also hear how he works 3.5 days a week, how presents his treatment plans for greater patient buy-in, and the three hurdles that patients have. Dig in to that and more on episode 70 of the Business of Dentistry podcast!

Tweetable: “Learn from your ears, not from your mouth.”

Episode Resources

Dr. Chad Williams’ website
Dr. Chad’s practice on Facebook
Eaglesoft Dental Software
The Alan Mead Experience
Patient Activator from 1-800-Dentist
Solutionreach Total Patient Relationship Management
Platelet Rich Fibrin Basics course

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Are You Doing A Quarterly Review?

Episode 069

This is the first installment of a weekly double header. In this episode I wanted to touch base and see if you were getting quarterly business statements from your accountant. I go over a few things I look for in mine on episode 69 of Business of Dentistry podcast.

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I will start this episode off by saying I’m not an accountant – nor do I play one on TV! – but I recommend using quarterly reports. They help me understand where my practice is at so I can adjust accordingly. Let me explain how I use them and how I tailor my practice with the information in my quarterly reports.

James is my accountant and he does quarterly business statements for me, these statements are actually called “statements of revenue and expense on an income tax basis”. He runs these for me every quarter.

I suggest doing these every quarter because it gives you a snapshot of how your business is doing compared to last year at this same time. I like that fact, it breaks up the year into smaller chunks and gives time to recognize any trends in profits (good or bad). Because I do these quarterly I can adjust to those trends much quicker than if I waited til the end of the year to review everything.

Now here’s what I’m looking at when I look at these quarterly reports: first is income, then is expenses and then finally net profit.

Regarding income I look at what we collected in this year’s quarter versus last year’s, did we go up, down or stay flat? I look for trends and potential reasons why we increased or decreased, and then I either continue those trends if they helped us increase or I look for the solutions to any decrease.

For example in the first quarter of 2017 versus the first quarter of 2016 we went up 10%. I was happy with that – it’s double digit growth so of course I was happy! But I began to think back to 2016 and realized I took more time off in the first quarter of last year than I did in the first quarter of this year. So that 10% is a little misleading. If I factor in my time off from last year it could make that income be flat rather than 10%.

Next is expenses followed by net (or the bottom line). In my report expenses are covered, things like CE for my employees, payment for staff uniforms, computer improvements, marketing & advertising, service charges, dues and subscriptions, the various forms of insurance like malpractice, disability, etc. any license expenses, office supplies, etc. Those are all expenses.

Naturally we want less money spent on expenses if possible, that will give us a better net profit overall.

Finally, a the end of all of this, I look at our net income for this year’s quarter vs. last year’s quarter at this time. The first quarter of 2017 saw our practice have a 41% net increase over last year’s first quarter. We lowered our overhead, generated more income and had a better overall net income as a result – exactly where I wanted this practice to go!

I have a few qualifications, which I explain on today’s show. You’ll hear a specific example of why I stress having an emergency fund/savings for your business, and how my fund was useful for the practice earlier this year.

Listen in for that story, and then let me know if you are doing quarterly reports in your business. If not, why aren’t you? Everyone has their own way of running their business so I’d love to hear what you do differently, and how it’s working for you. Hear my thoughts on that and more on episode 69 of the Business of Dentistry.

 

Tweetable: “It’s the barometer of the health of your business and your practice.”

Episode Resources

Platelet Rich Fibrin Basics course
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Finding An $11K Mistake

Episode 068

This week I discuss a recent gap in our practice systems that revealed an $11K mistake. I also do a little self promotion about my new PRF course. Listen in to find out more on episode 68 of the Business of Dentistry.

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Usually I like to think of my office as a smooth and well-oiled machine with no problems, but recently I realized that was just me burying my head in the sand! So today’s episode is about how I came to that realization, how I found the “holes in my game” so to speak, and what we did about it in my practice.

Over the course of the last week we found a big miscommunication problem regarding some insurance claims.

One day between surgical cases, I was walking down the hall when I noticed a group of my team members were standing in the computer room. This is the room where my assistants usually go to enter the electronic patient data, patient health questionnaires, etc. It’s basically an admin room for my clinical staff.

Now I have often seen my staff in that room but they usually drop in to say hi and then move along. But not on this day. On this day I did both of my procedures – simple single tooth extractions under sedation – and they were still in that room after I had finished up.

I could tell by the way they looked at me that they were nervous about something; I got a feeling that something was going on. After I had finished with my last patient I went in to computer room to talk with them, and find out what was going on.

When I asked if someone needed to tell me something two of my admin staff said yes, if I had a few minutes to talk. I told them I did and asked them to follow me to my office. I could tell they were both very nervous, so I told them to relax because it couldn’t be all that bad!

With some trepidation they both began filling me in on what was happening and what they had found. My implant coordinator told me she had been looking for a claim that had been filed; she wanted to follow up on it. As she looked into it she saw the claim had been filed but it had not yet been paid. The work had been done but the claim hadn’t been paid yet.

Next she called Paul, our office manager, and asked if he had done anything with the claim. He said he hadn’t and that it was his understanding Meredith would handle those claims. It was then that she realized there was a miscommunication: she thought he was handling them, and he thought she was!

Next she ran a report and realized there a few implant patient cases that hadn’t been paid. And as she looked at this report she could see there were several pages of unpaid insurance claims. Meredith took it to Becca, my admin team lead, and they looked at it together. They were pretty nervous about what they were looking at because they were afraid to bring it to my attention.

While I’m not proud to admit it, they were afraid to bring it to me because I’d lost my cool in the past. I’m much, much better now because I understand that what’s done is done and getting upset won’t change anything.

We looked into it and figured it was a miscommunication and a failure of systems; everyone thought someone else was doing this job so no one was doing it.

Our next step was to find out the details about this: was this going to cost the practice money? I was under the impression that this was going to cost us money because some of the procedures were over a year old, I thought we had forfeited the claims. But we looked into it and discovered everything had been filed with the insurance companies, but not all the claims had been paid.

They looked into each case over the next few days and realized we owed some patients refunds, we were out about $200 and we had thousands in outstanding claims with several insurance companies. In fact, when they got in touch with those companies they found about $11k owed to us!

Now I tell you this to let you know these things happen on occasion, there are glitches in the system. I’m very proud of my team in how they manage the office and the business. So when this happened we worked through it. And I hope our example gives you an incentive to look at your unpaid insurance claims report  this week and track it appropriately! Let me know what you find, after you listen to episode 68 of the Business of Dentistry.

Tweetable: “Continually look at your systems and your processes.”

Episode Resources

Platelet Rich Fibrin Basics course
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A New Resource and My 1st Uber Experience

Episode 067

This week I have a new resource for you. I call it the Implant Patient Business Packet. I put it together after several listeners asked me to share the forms I talked about in the last episode, and after that I get into my first experience with Uber. Tune in to hear the details on episode 67 of the Business of Dentistry!

More About This Show

As I mentioned today’s show is about listener comments and feedback. I revisit several topics including the implant patient forms, in-house financing and credit card offers that continue to arrive in my office mail.

All of these topics I share with you and revisit because I appreciate your feedback, your questions and even when you challenge me on something. Your input – whether you agree with my thoughts – helps me with my mindset and my practice, and I hope I do the same for you because I want this show to be a win-win for all of us.

And I wrap up with my thoughts on customer service. Recently we were invited to a social outing – my wife and I – for my kids’ school and we went to downtown Nashville. So we opted for Uber because traffic down on a Friday night is awful.

Plus I thought I thought I might have a cocktail and my wife wanted a glass of wine. Instead of worrying about traffic and a designated driver we elected to take Uber, which is something we’ve never done before.

I talked my wife into it as it’s only a 10-minute ride to downtown. We opted for Uber Black, which is a little higher end. I knew if a 20-year old kid showed up in a beat old Camry my wife wouldn’t be impressed so I went for Uber Black.

Our driver arrives, and backs into our driveway because it’s raining. He hops out of the car, is wearing a suit and tie, and is well-groomed. He opens an umbrella, walks over to us and escorts my wife to the car.

He is very professional and pleasant. Because I’ve got an entrepreneurial mindset, I started to ask him questions about being an Uber driver. He tells me the requirements for being an Uber Black driver: car has to be a certain age, certain insurance, etc. It was a very high end service, and we were impressed.

A few hours later we were going home and Jimmy, our first driver, wasn’t going to be available. I knew because I had already asked him on our drive into the city. So I did the general Uber and we got a ride.

The driver arrives and it is pouring rain outside; he calls me when he gets there. He says he’s outside in a black car, but there are like 7 black cars outside! I asked which one he was and eventually found him. But there was no umbrella service this time! The guy doesn’t open any of our doors, we even had to give him directions.

As you can tell our two Uber experiences were very, very different. I’m bringing this up to highlight that customer service matters, and it doesn’t take a whole lot to have better customer service .

The next time you’re impressed with the customer service somewhere pick their brains and ask them about it. Take notes when you have great experiences and tweak them to make them fit your practice. Brainstorm with your team too and come up with ideas that will set you apart from the rest. And then let me know what you did and how it worked out. I thank you in advance for doing so and for being here on episode 67 of the Business of Dentistry!

Tweetable: “There are lots of ways to make ourselves a little better every day.”

Episode Resources

The implant patient business packet
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Patient Communication Struggles

Episode 066

Communicating with our patients is an area where we continually struggle. This week I discuss some of my shortcomings in this area and describe some of the ways we are trying to improve. Listen in for that and more on episode 66 of Business of Dentistry podcast.

More About This Show

Because we’ve focused on the big issues in our office we’ve been able to focus on smaller details, like patient communication. Recently a few things have come up in our office that I wanted to talk about with you and get your feedback.

The first one is my 8 hour rule about sedation: no food or drink 8 hours before your surgery and anesthesia. Yes that’s an old school approach so some people may instruct their patients otherwise, but it’s the rule I use with my patients.

However we routinely have people who don’t follow this. We make sure they are told this rule at their consult and it’s written on their pre-op instructions. They are also reminded of the 8 hour rule when we confirm their appointment. So we make sure they are told about it numerous times before the date of their procedure.

Yet people misinterpret it, and I don’t understand how! Typically two to three times a month we send people away because they’ve told me they’ve eaten or drank something in the previous 8 hours. And I won’t put them under sedation when that’s happened.

Now my bigger concern is these are the people who tell the truth, there must be some who just don’t tell me! I worry about how often that happens.

The other area I regularly see patient communication issues arise in is with financial agreements. This is especially true with implant patients. In our office we run into problems with patients starting the process with us; they’ll tell us they want to work with Doctor A so we reach out to that doctor. Doctor A coordinates with us and tells us they will do X as part of the procedure. So we plan accordingly and do the Y and Z parts of the procedure. We then provide the patients with an estimate based on the Y and Z parts we are doing.

But then the patient will come back to us and tell us they’ve changed insurance and changed doctors. So rather than working with Doctor A who we’ve already been in communication with and coordinated with, they now want to work with Doctor B. But Doctor B doesn’t do what Doctor A does so now I have to do doctor A’s work and charge for it, it’s an additional fee.

So of course the patient gets upset about it, even though the fee changed because the patient made a change of doctor.

Along those same lines an issue often arises when we talk to our patients about their payment options. With some patients we let them pay in increments, and we have the conversation and discuss their options. Later on they act as though the conversation never happened and they don’t know about the payment plan we discussed and agreed upon.

To help with this we’ve developed consultation sheets that explain everything. The form specifies what we talked about and then we have them sign and date it, so even if they say they didn’t agree to the payment options we now have a signed and dated form that says otherwise. It has helped a bit.

In general, I try to break communication down into simple terms. Can you think of anything else that can be done? Where do you see patterns with patients forgetting communication or complaining about something, and how do you address it? Any ideas you have I would love to hear, leave a comment below or email me.

Tweetable: “Documentation is key.”

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