Managing Staff Vacations

Episode 053

Do you allow your staff to work when you are on vacation? How much vacation do you give your staff? Paid holidays? Check out this week’s episode of the Business of Dentistry to hear my take on these topics and more.

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This episode was recorded while I was completing my reserve drill weekend from the Naval Station Great Lakes in Great Lakes, Illinois. Because I was on leave and out of the office, it raised the topic for today’s show: staff vacation.

In the past, I’ve kept the office open when I was out. I didn’t make my staff take a vacation when I did, but now I do. I wanted to talk about this so you can understand why I’ve changed my policies, and you can take a look at your own staff vacation procedure.

As part of the expense of staffing, paying out vacation makes a pretty big impact on our bottom line.  Personally, I give 6 paid holidays a year. If someone has been on staff for under 3 years, they also get two weeks paid vacation after their first six months. For employees who have been in the practice for over three years, they get three weeks (or 15 business days).

I do that to give more to the folks who are loyal. And I don’t take more than three weeks myself so I don’t offer more than that for my staff.

Today I go down to a skeleton crew when I am out: I have one front office person and one clinical person who stay in the office. I do that so if someone has an insurance or scheduling schedule question there is someone in the office who can do help them. And if someone has a clinical question or needs a post-op there is also someone in the office to address those needs (although it’s pretty rare that this happens).

So I keep two people in the office when I’m not there. The rest of the staff can use their paid vacation days on those days when I am out, or they can take unpaid leave. It’s gone over pretty well, for the most part.

The biggest difficulty I have had is planning my vacations and my time off. I’m not great at planning out too far in advance. I’m a vacation martyr and am not always good about taking time off! However my staff is now prompting me: they want to know when I will be out of the office so they can plan their vacation days and/or unpaid leave around my dates.

Since we’re talking about vacation days, we also have to touch on the subject of holidays. As I said earlier, my practice gives six paid holidays a year. Those holidays specifically are New Year’s Day, Memorial Day, 4th of July, Labor Day, Thanksgiving and Christmas. When those holidays fall on a weekend – as they do this year – we usually take the following day off. However this created some issues. In the past, I had people who would call in sick to extend their holiday.

I was frustrated by this so I created a new policy. I told the staff that if they didn’t have approved vacation for the day before the holiday or the day after, they won’t get that holiday as a paid day of work. That cut the absences down to almost nil!

As part of that policy, I do allow people to have a paid day if they bring in a doctor’s note. We started this particular policy about three years ago, and despite a little push back, eventually everyone came around.

On today’s show I’ll also talk about what to do with accrued vacation, and why we prorate vacation days in our office now.

After you listen in, I’d love to hear from you! Email me or leave a comment here, let me know if you want a Facebook group for all the listeners of this show. And feel free to reach out with feedback and/or topics you’d like me to cover on this show! Thank you for tuning in and being a part of episode 53 of the Business of Dentistry.

Tweetable: “The biggest overhead we have is staffing.”

Episode Resources

The Dental Hacks Facebook group
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Approaching Fees For The Big Cases

Episode 052

How do you handle questions about fees on the big cases? This week I discuss this topic on a large implant case that we just completed. Have a listen to episode 52 of the Business of Dentistry podcast…

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This past week was a super busy and interesting week in my office. We had multiple surgeries, including an all-day implant surgery. I wanted to talk to you about that case in particular.

The work that needed to be done for the patient carried a hefty price tag, it was an expensive surgery and restorative case. The average around here for a case like this one is $25k per arch, so a substantial amount of money is involved.

Prior to the procedure, the patient came in with her mom. I was there, of course, along with my implant treatment coordinator Meredith and Dr. Long who would be the restorative doctor on the case.

We all sat down with the patient and the patient’s mom to go over the case, answer their questions, review the treatment plan, as well as the fees and finances, and to talk about how all of this was going to play out. This was extremely beneficial for us and for the patient, I encourage you to do the same: have everyone in the same room prior to surgeries and procedures and have everyone’s questions answered in one sitting.

I leaned on Dr. Long to help answer restorative questions, and I was there to answer their surgical questions. My point is the entire team should be present to answer all of the patients questions as completely and fully as possible, prior to scheduling the procedure.

One piece of that conversation was the financial aspect. The surgical fee for this particular case was $27k, and we talked to the patient about it ahead of time. She made it easy for us and paid it upfront.

But we came in with options for her if she couldn’t pay the costs ahead of time. That’s also something I encourage you to do: figure out ahead of time what payment plan options you will offer your patient. That’s something to think about before you talk with the patient.

Based on my past experiences, I suggest you secure at least 50% before you do the procedure, and have a financial plan going forward for yourself and your patients for the remainder. You have to have a way for them to finance these procedures if they don’t pay upfront. Some practices offer in-house financing as an alternative, I do not.

In the past my office has used CareCredit. Some people prefer third-party financing, for example we have worked with American General, and Springfield Financial to name a few. You may have different options available to your practice.

Either way it’s important for your patients to have payment options for big procedures and for them to get the treatment they need, even if they don’t have the funds to pay in full upfront.

When I haven’t secured a substantial portion of the fees ahead of time, I have eaten a lot of costs for expensive procedures. Sometimes the patients simply stopped making payments after the work had already been done; so you want the patient to have some skin in the game before you get all the necessary equipment and pieces for their procedure.

I brought this up today because it was relevant and timely, but also because it’s a bit controversial. Some people believe doctors should not talk money, and should not talk about fees; they should delegate that to someone in the office.

Others believe the doctor should be able to look the patient in the eye comfortably and have a good idea of their fees, explain them and talk about them with their patients.

Listen in to hear why I’ve changed my philosophy on this today, and how I used to handle fees in the past as well as why I don’t do a hard sell with any case. Then let’s hear from you: how do you handle the fees and financing for big procedures? Shoot me an email and let me know, or leave a comment here after you listen to episode 51 of the Business of Dentistry!

Tweetable: “Talk to the patient about the financial side of things.”

Episode Resources

Dr. Jon Alan Long on Business of Dentistry
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We All Have Systems But “How Good Are They?”

Episode 051

We get a little more philosophical this week when I make the argument that we already have systems in our practice. We may not think we have systems but we do, the question is “How good are they?” We answer that and more on episode 51 of the Business of Dentistry.

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Until very recently I had always thought I didn’t have any systems in my business during the first few years it was starting.  There was no standard protocol for how things were done in the different areas of my practice.

But the other day I was listening to someone who said we all have systems, even if we think we don’t. We all have ways we do things in our businesses and the other areas of our lives, those are our systems. So we have systems, it’s a matter of how productive and effective those systems are and whether or not they give us the results we want.

I’m sharing it with you on this episode because it is a perspective I hadn’t considered it before, and it’s new way to look at systems. We all have habits, and ways of doing things. And when it is all said and done, the results we have are a direct reflection of how good those systems are.

This made me realize I had systems in place in the early days of my practice, but they weren’t good! They were inefficient and had holes in them.

Now think about what you do throughout your day at home and at work. What systems do you have and what are the results you are getting? Are they effective systems? If you have the results you want then yes they are, and if you don’t then no they are not.

I am a big believer in accountability and responsiblity: we only have ourselves to blame for what we do and do not have. It’s not the easiest pill to swallow, it’s far easier to blame someone else and play victim.  I do it too! I find that I drift into victim mode and then I have to bring myself back to my own accountability and responsibility in the situation.

If you don’t have the results you want, tell yourself you need to change things. Then ask  what do I need to change? How do I need to change my existing systems so I am more productive and successful?

When you can answer those questions, take note of your responses. Tackle the high priorities first and get those out of the way before moving on.

On today’s show I explain why scheduling was such a big boulder for me initially, how I tackled this problem, and what jiu jitsu has to do with systems.

I’ll leave you with this final thought: it’s important to know that not doing something is also a system! If you are not working out, or you do not have a morning ritual, or a plan in place for patient referrals you will or won’t accept, those are all systems. They may be systems that don’t give you the results you want, but they are systems.

Now I’d love to hear from you: is there an area of your life where you are going to update your existing system? Send me an email or leave a comment here after you listen to episode 51 of the Business of Dentistry.


Tweetable: “We only have ourselves to blame for what we do and do not have.”

Episode Resources

Voices of Dentistry
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