Managing Misconduct

Episode 038

This week we continue our conversation about managing staff misconduct by discussing a progressive approach to discipline.  You will note this was a shorter episode since I had a cold, as you will hear in my voice.  Thanks for listening and have a great weekend!

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On today’s show we’re going a bit deeper into staffing issues. Specifically conduct problems – what happens when staff members break rules, ignore regulations, and violate procedures? How do you handle situations when they won’t do what they need to do?

Personally I hate this type of thing and I’ve been inconsistent with my handling and approach to it in the past. But my office manager, Paul, has helped me to become more regimented and on point with my response to these issues. He brings a wealth of knowledge and firsthand experience to the team and to this topic, as a result we’ve worked out a better system.

When a staff member has problems, we implement our disciplinary response. The first step is to analyze what was done wrong, dig into the facts and make sure we know what is accurate. If another staff member reported misconduct, we make sure it isn’t hearsay.

It’s also important to make sure all staff know the rules, so we look into whether or not the staff member was adequately informed about the rules and chose to break them anyway. Earlier in my career I wasn’t always strict about having rules and regulations in place, nor informing my staff of the practice’s policies and expectations.

I’ve learned you have to have rules and regulations in order for people to follow them. You can’t expect people to follow the rules if you don’t have them! And you must be consistent with the rules.

Also you have to communicate what the rules are and how you want them followed, then you must reinforce them.

I’d recommend getting a policy manual to help enforce the rules, even minor infractions.  You have to enforce the small things or the bigger ones will certainly show up too.

In my practice we have in place what we call a progressive discipline model. Every infraction is responded to in increasing intensity and severity, step by step. Typically we start with
verbal counseling. We have a conversation with them (and I strongly believe in praise in public and punish in private, so these are kept private).

The next step is written counseling, a written memo is issued if the same rule is again broken after the verbal counseling step. The first memo doesn’t go on file but if the infraction happens again then the third step is a written memo that goes in their file.

If misconduct occurs again then it has an impact on their annual evaluation, and impacts pay raises and bonuses. After that, the person is suspended without pay. I’ve never gotten that far because the few people on my staff who have reached this point quit before it goes any farther.

Now that you know my response to misconduct, I’m curious to hear what you do in your office. How do you discipline in your practice? Do you have a plan in place already? If so, how do you back it up? If not get one – after you listen to today’s episode of Business of Dentistry!

Tweetable: “Make sure you’ve got the rules in place!

Episode Resources

Episode 37 of Business of Dentistry
Business of Dentistry on Facebook

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Understanding Staff Problems

Episode 037

This week we discuss a way to look at problems from your staff. To keep it simple, I have boiled the reasons staff fail to do the things they are asked to do into two categories. Listen in to hear what they are and find out my thoughts about staffing issues on episode 37 of Business of Dentistry. Thanks!

No Problems

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Staff problems are something we all encounter from time to time, sometimes we even have to deal with them on daily. But I wondered why? Why are we dealing with this type of issue so much? It’s time-consuming, finance-consuming and is often very frustrating.

So I did some digging and some research into this area. I wanted to understand where these problems are coming from and what can be done to minimize them. I also wanted to find ways to improve my approach to handling problems as they arise within my staff and in my practice.

Typically any problem with a staff member comes down to one of two things: it’s either conduct or performance-related. And on today’s episode I’ll explain what each of those mean, and give specific examples to illustrate the differences.

A conduct issue is when something isn’t done the way it is meant to be done. And a performance issue is something not being done because the person doesn’t know how or hasn’t been properly trained on that task. It is a lack of knowledge or training, rather than a person’s lack of willingness as it is with conduct.

To highlight an example of this take someone who is chronically late. Being late happens every now and again for most people, but someone who is consistently late has a conduct issue. They know they have to arrive at work at a specific time, just like everyone else, but they don’t do it. They don’t change their behavior even though they have been instructed on the proper procedure (arrive to work on time) – that makes it a conduct issue.

Scheduling your patient visits and your overall office workflow is another matter however. This is a performance issue in most cases. In my office we are light years ahead of where we were in this area and that’s because I’ve set up procedures and trainings for my staff on the proper way to schedule our day to day office activities.

Soap notes are another great example of an area of performance as is your sterilization process. Although we don’t have a sterilization problem, I speak from experience when I tell you I had to take responsibility and accountability for performance issues with my staff.

Ultimately performance problems stem from a leadership problem, and that means setting aside our egos to look at where we have gone wrong and what we can to rectify the situation. In the past I’ve allowed things to slide that led to poor performance in some areas from my staff, but once I stepped up and created proper training procedures for them the problems subsided.

While I’d like to be able to tell you that you’ll never have any staffing problems, that’s just not the case. So the next time something comes up in your office ask yourself if it is a conduct problem or a performance problem. Is the problem a result of improper or lack of training, or is the person (or persons) simply not ignoring the office guidelines?

I’d love to know what you discover the next time you have an incident with your staff, and how you handle it. Leave a comment here or drop me an email anytime! Thanks for listening to today’s edition of Business of Dentistry.

 

Tweetable: “We have to hold ourselves accountable as practice owners.”

Episode Resources

Business of Dentistry on Facebook
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Special Edition: Buyer Beware When Hiring Consultants

Episode 036

Special Edition: This episode discusses, in my opinion, disturbing information on one of the consulting groups I had mentioned in a previous episode. It kept me up last night and I did not want to wait until Friday to discuss it.  Give it a listen and let me know what you think of today’s Business of Dentistry show.

Cavet Emptor

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If you’ve listened to previous episodes of this show you know I am here to be transparent and to share with you what works and what doesn’t work in my experience, and in my practice. If you tuned in for episode 33 of Business of Dentistry then you also know I have been speaking with a consultant.

For those of you who missed that episode or don’t remember the details, here’s a refresher: Recently I was asked to do a survey by a company, and even before returning their phone calls I did my due diligence on them. The company seemed legitimate so I did survey. They offered me a free session with one of their consultants as a token of appreciation.

So I got on phone with consultant, and he seemed very knowledgeable. He told me he analyzes practices to see if he can provide solutions to their problems, and there’s no obligation.

He also suggested we have multiple phone calls, again no obligation and no charge. I agreed and we had several conversations about my practice, what wasn’t working, etc.

We got to the end of the phone calls and the analysis a few weeks later, and to wrap things up we did an overall summary of what is wrong with my practice. He agreed with my summation and also added one suggestion.

Then he asked what I wanted to do next, and I knew this was a sales pitch. I also knew it was coming, that was fine with me. I didn’t mind because their insights into my practice’s problems were spot on. They were so good that I was considering working with them even prior to the sales page, although their fees were between $25k and $35k.

Before I signed on the dotted line I did a little more due diligence. What I found almost kept me up at night! Because I am not trying to promote something I don’t believe in, I wanted to share with you what I found. I believe in being transparent with you, no matter what.

As I dug into the history of this company more, I found some disturbing history. Simply by Googling “bad experiences with dental consultants” I found a wealth of information. Special thanks to the gentleman behind The Wealthy Dentist, I believe he saved me a lot of heartache, hassle and cash!

It seems this particular company that I had been speaking with was using consultations as a strategy to promote Scientology! Check out the links in the Resources section below for more details, but many people had gone through the same survey/free consultation experience I had only to wind up being pitched to join Scientology.

Personally, I keep my practice and religion separate. My problem with the approach these consultants used was their bait and switch tactics, I don’t like the premise and the method they are using to promote their beliefs.

The information I found was so disturbing that I had to share with you. When you listen to today’s episode you’ll hear some of the information I found on a forum, some of which spells out exactly what happened to me! The reason I did today’s edition of Business of Dentistry is so you know what you are getting yourself into if you choose to work with them.

Tweetable: My purpose is to encourage you and help you protect yourself!

Episode Resources

The Wealthy Dentist
Hollander Consultants and Scientology
How Dentists Are Recruited
Business of Dentistry on Facebook
Connect with me on Twitter
Leave us a rating or review on iTunes!

Recognizing Lost Income

Episode 035

Tired of the the highs and lows of your monthly income? Do you understand the patterns in your practice that make one month great and the next month a letdown? Check out episode 35 of Business of Dentistry to learn how to recognize lost income and how to create a plan and strategy to reduce it.

loss

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Recently I was talking with a friend about the seasonal ups and downs in my practice. I was explaining how summers are very busy for us and the fall isn’t quite as productive. He suggested I chart out my productivity and income for the last 12 months, and then look at the best month and the worst month. He said the difference between the two is lost income.

I wasn’t quite sure what he meant so we dug in further. I am diligent about charting my monthly data so I was able to see July of last year was the most productive and September was the least. The rest of the year was all over the map!

Let’s look at specifics to better understand the phrase “lost income”. For example, if your best month brought in $150k and your least active month generated $75k, then the lost income in that worst month is $75k.

Do you know what your numbers are? What was your least productive month versus your most productive month? Subtracting the lowest number from the biggest number will give you your lost income (or lost productivity, I use the two phrases interchangeably on today’s show).

Once you know that number now ask yourself why was your most productive month so productive. Do you know? Was it because you ran a special marketing campaign? Was it because kids were not in school? And was it fun for you and your staff, or was it chaotic?

And was your least productive month slow because you were on vacation, because kids were back in school, etc? Is that a slow time of year traditionally or was there another reason?

The key to leveling out the gap between those two numbers is to know what the gap is, why it exists and then creating a plan and strategy to bridge it. Can you run a special marketing campaign for that slow month? Can you take your vacation at another time of year? If you need some ideas or someone to bounce thoughts off of talk to your business manager, or your office manager and create a strategy together.

Once you have a strategy in place also choose your daily target. Take the monthly total you want to hit and divide by the number of days you want to work in that month, the number you are left with is your daily goal.

With that all in place you are well on your way to recouping lost income and regaining productivity in your business. This is an essential tool to running a smoother practice, and decreasing your worries about monthly slumps. The first step to doing this is to know what your numbers are so your for action item this week is to look at your data and gather that information. Then leave a comment here or send me an email, after you listen to episode 35 of Business of Dentistry!

 

Tweetable: You have to be proactive!

Episode Resources

Business of Dentistry on Facebook
Connect with me on Twitter
Leave us a rating or review on iTunes!

Confessions Of A Distracted Dentist

Episode 034

Do you ever find yourself distracted when you know you should be doing something productive in your practice? This week I give a confession on some of the things that have turned me into a distracted dentist. Check out episode 34 of Business of Dentistry podcast to see if you may have a similar problem, and what to do about it!

Distractions

 

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Have you ever taken stock of where your time goes each day? Or maybe you’ve just mentally checked in with yourself during the day, and noted whether you were working on a productive-type task or something else.

That’s what I recently did: I spent some time mentally evaluating myself and where I was spending my time. And I discovered a number of distractions were keeping me from being as productive as possible.

In an effort to keep myself accountable and to also help you, I’m sharing those distractions and the productive tasks to substitute them with on today’s show.

For most of us our practice is our livelihood, so we want to focus on that first and foremost. However we often get sidetracked by distractions! When I evaluated where I spent my time I found social media, the Internet, email, small talk and new projects have been my sidetracks.

I encourage you to do the same thing: look at where you are spending your time at the office. Are you taking your eye off of your practice to deal with non-dentist business tasks? If so, I have numerous ways to refocus your time and attention on your office and ultimately, your business.

1. Patient care.
The first of which is patient care. You should be dealing with patient care for most of the time you’re in your office. not watching cat videos or jiu jitsu videos if you are me!

2. Patient administration.
The second is patient administration. Rather than looking at Facebook or getting into a Facebook messenger conversation, you should be finishing the administrative components of patient care. My staff does most of the paperwork but I still need to review their work and make sure the files are completed. And the goal is to do this on a daily basis and wrap up the clients’ paperwork on the day they visit.

3. Coordinate with your staff.
Coordinating with your staff can make you and your office much more productive and efficient. For example, do you work with them and have them get medical clearance when necessary? Or do you have them coordinate appointments with multi-disciplinary specialists?

That’s got to be done, it should be one of your focal points. Coordinating with your staff and other professionals will improve your patient care.

4. Overall treatment planning.
Do you spend the time needed to review x-rays, to plan your surgical guides and implant cases? Do you review clinical photos, models and look at your lab cases? Do you go over the lab images with your staff?

There are a lot of things we should be doing more efficiently, and treatment planning is one of them. I’m just as guilty – I’m good at it but I could be more efficient and effective with the time I spend on this task.

5. Working on your practice.
I’m talking about working on tasks and projects that will help grow your practice, not the day to day activities that keep it running. This is when you put your executive hat on and look at the long-term planning in your business.

For example, plan your vacations with your family and put them on the big office schedule for all of your staff. I do that as well as my Navy reserve time, I add it to our long-term calendar that projects out 6 to 12 months. I’m not great at doing this consistently but I should keep at it and get better.

Now that you’ve got a list of where to put your time and attention, do some self-evaluation on your time spent. Check out what you’re doing over the course of the next week. Personally, I  didn’t do a log or track my time. I just did some mental notes: I asked myself what am I doing right now?

That’s your for action item for the week: mentally check out what you’re doing throughout your day and let me know what you find either on the comments below or via email. Thanks for being here and listening to episode 34 of Business of Dentistry!

Tweetable: The multi-tasking mindset doesn’t work.

Episode Resources

Business of Dentistry on Facebook
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Leave us a rating or review on iTunes!

Practice Strategy Using C.A.S.E.

Episode 033

This week we discuss how to collect data, analyze it, find solutions, and execute the solutions for declining trends in our practice. Give it a listen!

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One day recently there was a note from my staff telling me someone from Practical Solutions magazine had called. The message specifically said it was not a sales call and they were in fact calling because they were wondering if I would be willing to be interviewed by them for research they are doing.

After checking them out online, I discovered the man who had called, a man named Mike, was one of their research analysts. The call seemed legitimate to me so I phoned him back and we had a brief conversation during which I answered their questions anonymously.

When we wrapped up he told me they couldn’t offer any kind of compensation, but if I had specific questions about my practice they could put me in touch with a consultant who could help me with those questions. Because I believe in learning from others in our industry, no matter how successful we are, I accepted Mike’s offer to connect with the consultant.

The consultant I spoke with was named Jeremy and we had several conversations, during which we developed a strong rapport. We’re both martial artists with young children at home so we bonded very quickly.

During our last conversation we spoke about monitoring different areas of a practice, areas like collections, scheduling, cancellations, etc. There are about a dozen areas but those are a few we focused on. Specifically we talked about those areas and my data collection process in them: how is the data being tracked for production, and cancellations? How is accounts receivable and insurance being tracked?

With his help I could see there are areas in my practice which we need to track better; Jeremy suggested doing so with a dashboard. A dashboard will help to look at trends, either up or down. It helps the practice owner like me or you to easily define areas that are impacting the overall health of our practice.

By talking with him and walking through the steps necessary to create and implement the data and the data in the dashboard I came up with my own acronym and phrase called the CASE principle. Here is what it stands for:

C – Collect Data
Bring in all the data you can and put it in a dashboard where it can be evaluated in one place. As the CEO of your practice you’re going to look at this data regularly, preferably monthly.

A – Assess The Data
Then you have to analyze that data. Look at what areas are growing and what areas are in decline. Evaluate the data regularly to identify plateaus and decreases then we come up with solutions.

S – Solutions
Now that you’ve found the areas that need help, what can be done to fix the declines and plateaus? You have to find solutions for those areas, either by yourself or with your staff. Be sure to ask for their ideas and solutions.

E – Execution
After finding the solutions your next step is execution of them. This stage is where you implement those solutions you came up with in your last step. Ask how can you execute and carry out the solutions to improve the areas that have plateaued or are in decline?

On today’s episode I outline a real-life example, including what to do if your staff is reluctant to implement and execute new solutions. There is a very simple way to get everyone on board with any changes you want to create in your practice! Tune in for all of that and more on episode 33 of Business of Dentistry!

 

Tweetable: Communication is key.

Episode Resources

Practice Solutions magazine
The Dental Guys podcast

Episode 19 of The Dental Guys podcast
Episode 8 of The Dental Guys podcast
Business of Dentistry on Facebook

Connect with me on Twitter
Leave us a rating or review on iTunes!