Monday, February 20, 2017

SLAM DUNK FOR STAFF RELATIONS
Before telling you “the rest of the story,” a bit of background with several threads of information woven together: we live in a house built by one of Greenville, NC’s finest builders. My home is not large or palatial, but attractive, solid, comfortable, and built using quality materials. We respect the builder as a construction professional, as a family man with several grown children, and as a man of faith.
For Christmas, our granddaughter, Danielle, gave us a set of daily devotional writings, beautiful 5” x 5” cards with a Scripture on one side and a “Declaration” written by our builder’s daughter, Cleere Cherry, on the flip side. We have learned these two young women have been friends for years, retaining their friendship while they have both begun small businesses, each in her own special field of expertise.
Now let me tie that information together so it makes sense for your dental office. Often I come across articles, emails, pictures, messages, even jokes I’d like to share with you, but I hesitate doing so. Why? Because they reflect my faith, and I’ve been advised to use caution in addressing non-dental topics in my writings, particularly any that might smack of faith or impart a religious thought. I’m going to ignore that bit of advice for this posting. The devotional card I read this very morning begged to be shared and shouted to me, “Let dentists and team members hear this principle, and they can then decide if it will be helpful in their office.” So—here goes:
Let no one seek his own good, but that of his neighbor. Corinthians 10:4
On the flip side, Cleere wrote:
Lord, thank you for giving me Your eyes to see others today. As I go into situations and enter new circumstances, help me to see those in need, whether that be a smile, a conversation, or more. I am so thankful for all the blessings You have given me and promise that I will open my hands, eyes, and heart to blessing another today. Humble me and let me always see others as greater than myself. You tell me that the greatest way to be a leader is to be a servant. Thank you for leading by example.
Now consider this: what would the relationships among your dental team members and with your patients be like if this philosophy pervaded your office? If every person, starting with you, doctor, treated every other person, teammate, and patient alike, with a servant’s heart, sharing and caring openly, patiently, warmly, with a you-before-me attitude? What changes would be apparent in your office?
After more than 35 years of working in the dental profession with literally hundreds of practitioners and thousands of staff members, I can attest to the effects of such a philosophy in practice because I’ve worked with a number of practices that operate on that level. An office following the principle of putting others first, before self, is second to none, enjoyable, profitable, thriving, and enduring. Please give it some thought.
--> And if you’re interested in Cleere’s company, Cleerely Stated, which specializes in devotional writings including a new-to-market set just for men, original, customized greeting cards, specialized baby d├ęcor items, charming wall plaque quotation displays, and other personalized items, please visit her website: cleerecherry.com -->

Monday, February 13, 2017


MORNING HUDDLES—ABSOLUTELY THE BEST WAY TO BEGIN A WORK DAY
Over the years we have been “blog mates,” we have discussed five types of team meetings that will boost every aspect of a dental practice when two conditions are met: 
1.    The staff buys in, understanding why the meetings are necessary, what is to be accomplished in each, how follow-up will work, and by participating through input into the planning and occasional leadership of meetings. 
2.    The decisions made at each meeting are acted upon, or the reason for not acting upon a decision is explained. Nothing kills enthusiasm for regular team meetings like waiting for suggestions and decisions to be implemented—only to have nothing change.  
The five types of meetings are:
·         Morning huddles
·         Area meetings in which business and clinical staff meet together, separately
·         Monthly general staff meetings that include everyone, even part-time staff
·         Annual retreats, held off site, in which everyone participates to review the past year and plan for the year ahead
·         One-on-ones in which performance appraisals are given, interpersonal problems are mediated, details of compensation, pay raises, or benefits are discussed, and so on      
If your practice currently does not have regularly scheduled staff meetings, consider beginning the process with a Morning Huddle. A well-planned Huddle should take no more than 10 to 12 minutes before the first patient is seated. Following is a suggested agenda. Customized, perhaps by a senior team member, to meet the needs of your office, the Huddle is invaluable in making each day better organized with a smooth flow.
 
Agenda for Morning Huddle
Operative
·         Number of patients scheduled? Unusual previous appointment with anyone?
·         Medical alerts? Rx for pre-med or prophylactic coverage double-checked—today? Tomorrow?
·         Time for emergencies?
·         Assignment of dental assistants for the day if multi-doctor, multi-chair practice
 Hygiene
·         Number of patients scheduled? Special conditions or needs?
·         Number of new patients scheduled? Special conditions or needs?
·         Medical alerts? Rxs for today double checked? For tomorrow?
 
Business Desk and Activities Report
     ·         Yesterday’s production; % of goal
     ·         Month to Date (MTD) production vs MTD goal
     ·         Today’s projected production
     ·         Tomorrow’s projected production
     ·         MTD new patient count
     ·         Previous collection problem with scheduled patients today? Tomorrow?
     ·         Number of broken appointments yesterday? Number rescheduled?
     ·         Concerns with schedule today? Tomorrow? Through five days hence?
     ·         Review information about today’s new patients.
     ·         Share any personal information about individual patients that will allow clinical staff to relate warmly, on a personal level with each patient.
 
For an orthodontic practice or an ortho component in a practice:
·         Bandings? De-bandings? On whom? Time? Assistant assignment.
·         Appliances? Delivered from lab or completed in-office? Any problems?
·         Impressions? On whom? Purpose?
·         Records? On whom?
·         Consults scheduled within three days? With whom? Work ups complete and reviewed?
·         Appliances due tomorrow? For whom? Type? Ready? Problems?
·         Unusual or special needs today?
·         Follow-ups from yesterday?
 
If you choose, close the Huddle with an inspirational quotation or a thought-for-the-day chosen by team members on a rotating basis. Some practices in which I have worked close each day’s Huddle with a brief prayer.
 
In addition to assuring that the day flows smoothly, with potential problems handled before they occur, the Huddle assures team members’ prompt arrival, allows personal notes about individual patients to be shared so doctor and staff can make positive comments, alerts staff to how production is progressing through the month, and gives the entire team a feeling of cohesion. Try Morning Huddles—I think you’ll find them well worth the effort and time.  
 
 

 
 
 
 
WHAT’S WITH STAFF PAY INCREASES?
According to recent practice management surveys, 36.5% of private practitioners gave pay raises to staff in 2016. 51% of those giving raises gave an average 3% increase. Three percent has been the national average annual pay increase across all businesses, industries, and organizations since 2012.
More dentists are following the national business trend of rewarding above-average employees through a bonus system rather than a standard annual pay increase. The most prevalent bonus calculation is based on an increase in practice collections.
As a practice management consultant, I have consistently recommended giving pay increases, including bonuses, based on merit rather than across-the-board equal distributions. Top performers should receive a higher percentage of the staff compensation budget in order to retain them and to reward them appropriately. Under-performing staff members who carry much less of the practice load should not receive raises or bonuses equal to those of top-notch team members. Equal raises and/or bonuses only serve to demoralize top performers while failing to incentivize poor performers.

This having been said, the 3% average pay increases mentioned above may actually indicate an office in which top staff received a 4% to 5% increase in total compensation while poor performers received zero to 1% or 2%. In summary: reward excellence in work performance with above-average pay increases and/or bonuses as production and collections allow. Set specific work goals, coach, and re-train poor performers; or replace them.

Monday, February 6, 2017

BLAZING EPIDEMIC—PRESCRIPTION OPIOID ABUSE

Here are some terrifying statistics from the U.S. Surgeon General’s first official report on addiction: more than 20 million people in our country have substance abuse disorders. Only one in ten will receive appropriate treatment. The report states “all health care professionals can play a role in addressing substance misuse and use disorders through prevention strategies and health care services.”

A personal aside—since 2010 I have volunteered as a mentor, teacher, driver, worker, confidant, friend, Christian counselor, even a cook at times, for participants in a substance abuse recovery program. In this capacity, I have known scores of individuals I would never have met otherwise—an amazing enrichment and privilege in my life. These people come from all walks of life with all levels of experience—business owners, RNs and other health care providers, teachers, veterans, bosses and day laborers, n’er-do-wells and solid citizens, rich and poor, young and old, various faiths or none at all. I share this to say I have witnessed firsthand the horror of addiction, and I applaud any and all efforts to stem the tide of addiction that is threatening to drown our country. Many addicts I have known admit that they became ensnared when they first received a prescription of opioids for pain relief, including dental pain.

For at least the past five years, organized dentistry has been actively working to promote awareness of the dangers of misuse of opioids, one of the most radical and frequent forms of substance abuse. The American Dental Association, along with 88 other health organizations led by the American Osteopathic Association, has petitioned Congress for maximum funding for the Comprehensive Addiction and Recovery Act (CARA), passed with bipartisan efforts and signed into law in July 2016. Under this new law, prescribers are authorized to write partial-fill prescriptions for Schedule II controlled substances. Additionally, the law includes grants to increase health care providers’ pain management training and to enhance prescription drug monitoring programs.

The CARA opens the way for maximum funding for prevention and treatment of this epidemic of opioid misuse and related disorders. The combination of CARA and the Surgeon General’s report issued in November 2016 has raised the general public’s view of opioid and other substance addictions as a chronic disease rather than a moral weakness or failure. The dental profession can be proud of leading the way on this change in perception that will allow opioid and other substance abuse illnesses to be treated as the diseases they are.

In the fall 2016, the ADA House of Delegates issued a statement on the Use of Opioids in the Treatment of Dental Pain that includes a plea for dentists to “follow and continually review the Centers for Disease Control and State Licensing Boards’ recommendations for safe opioid prescribing.”  With increased awareness, continuous training, and determination, dentists can rightfully remain on the leading edge of fighting this major epidemic threatening our country.


For more information on opioid prescribing, training sessions, webinars, etc., go to www.ADA.org/opioids.

Monday, January 30, 2017

WELCOME CDT CODE ADDITION BEGINS JANUARY 1, 2017
In March each year, the Council on Dental Benefit Programs Code Maintenance Committee meets to add, delete, or modify CDT codes, most often following suggestions submitted by ADA members during the previous year. One of the most requested additions in March 2016 was a new scaling code: D4346—Scaling in the Generalized Presence of Moderate or Severe Gingival Inflammation—Full Mouth After Oral Evaluation can be used after January 1, 2017.

The Chairman of the Code Committee describes D4346 as “more than a prophylaxis because the clinical condition of the patient’s gingiva is compromised as evident by the level of inflammation, but less extensive and intrusive than scaling and root planning since there is no bone or attachment loss.”
Coverage for the procedure will vary according to the benefit plan and the payer. Some payers may have frequency limits, and it is predicted that benefit companies will closely monitor utilization of this code. Reimbursement is expected to be in a range between prophylaxis and scaling and root planing.

For more information on this and other changes to the CDT 2017, visit www.ADA.org/en/publications/cdt/coding-education. Search for “Guidance on the D4346 Scaling Procedure.” Dr. Charles Blair’s excellent annual publication, Coding With Confidence: The “Go To” Dental Guide, is ready for sale online at Practicon.com or by phone at 800-959-9505. Dr. Blair’s Guide includes, of course, the new D4346 code with full explanation. Regular use of his Guide assures your staff will eliminate coding errors and boost legitimate reimbursement.