We Need More Help at the Front Desk!

Quote

We Need More Help at the Front Desk!

Why is it that team members in the non-clinical roles, often referred to as the “front desk staff”, complain about the amount of work they have to do and always seem to be stressed out? Here are a few of the comments we hear all the time:

The people in the back don’t understand all the stuff we have to do”.
“How can I do the insurance when I keep having to answer the phone?”
“We never get caught up.”
“I’m constantly having to stop what I’m doing to take care of a patient. Then when I come back to it, I forget where I am.”

We have a couple of theories about the traditional front desk configuration and why it sets most teams up for failure.
THEORY 1: The front desk isn’t the area in which the dentist works. He or she doesn’t fully understand the challenges the staff is faced with and is less likely to know how the systems work against them, not to mention the outdated equipment and software challenges. For instance, many practices have only made a partial transition to paperless charts, making the practice dependent on two systems (paper and  computer), which makes locating information more difficult, causing duplication and increasing the chance of error. The dentist rarely understands the challenges this poses for the team. (This is a subject in itself!)DISCONNECTED

THEORY 2: People who work in this arena often develop tunnel vision and have difficulty
seeing new ways to structure their work. The result is that the front desk staff keeps doing the same old things in the same old ways, and not doing any of them at optimal level.

THEORY 3: When the non-clinical staff complains long enough, the dentist usually breaks down and adds another person to the team to do the same things the other team members are doing, creating more confusion, more errors and even less efficiency and effectiveness – not to mention more overhead!

So, what’s the answer? Consider separating the tasks into two areas of specialty and assign the responsibilities to the individual who has the right skill sets. Let’s look at the responsibilities of the non-clinical staff and how those duties break down.

There are three distinct areas of focus in every practice – what we call the A-B-Cs :

A – Administrative:
Depositphotos_24330111_m

Responsibilities that support the business of the business. They are related to paper and tasks – not patients. They can occur “behind the    scenes” and in most cases, are not ones that must be addressed in the moment.
The key in this role: to be EFFICIENT with THINGS.

Just some of the responsibilities that might fall under this heading are:
– review chart entries at dayʼs end to balance against deposits
-insurance pre-authorization, submissions, review and followup
-opening and sorting mail with distribution to appropriate person
-entering payments from mail and over the counter
-printing receipts for patients
-monthly statements
-daily deposit
-monthly and annual closing and archiving
-organizing invoices and packing slips before matching to statements for payment
-payables entry in accounting system
-preparation of a/p report for dentist review and approval
-preparation of checks for dentistʼs signature
-mailing signed checks
-inventory of office supplies
-purchase of office supplies and patient amenities
-errands as assigned
-correspondence
-maintenance of office equipment and machinery
-computer system oversight and IT
-maintaining patient amenities (ie: coffee station, water, etc)
-hourly upkeep of patient washroom and reception area
-implementation of marketing, promotion
-communication and follow up with the lab
-communication and follow up with vendors
-planning continuing education
-planning meetings

These responsibilities require focus, attention, detail, someone with self-direction and organizational skills -an analytical thinker.  This same concept can also be applied in the clinical area of the practice – responsibilities associated with sterilization, operatory preparation, inventory and lab duties. They are all essential to providing patient care but occur independently of patient care.

B – Behavioral:
Depositphotos_24330021_mThis arena has to do solely with the business of our patient’s business and is often the most overlooked area. These responsibilities often occur with patients and are focused on patient care, connection and communication. While some of the duties require planning and preparation, events often occur in the moment, can not be predicted and must be responded to in real time. This job requires an individual with big picture thinking. The best people are those with sensibility, grace, maturity, empathy, curiosity, good listening skills, confidence, good command of language, and the ability to think on their feet.
The key in this role: to be effective with PEOPLE.

The responsibilities that most often fall under this heading are:

-working with new patients from initial telephone call through treatment planning
discussion
-supporting patients in the moment whether on the telephone or in person
-urgency triage and establishing clear expectations with urgency patients
-maintaining oversight of patients in process – those for whom treatment has been
recommended but not yet completed
-organizing and managing the “lost souls” project – those for whom treatment has been
recommended and have dropped out of sight
-handling fees and financial arrangement discussions that are not properly handled
elsewhere
-addressing patient complaints and issues in a timely manner
-ensuring that patient interests and concerns are clearly understood by all
-supporting patients by helping them price-test their treatment options
-ensuring that all patient-contact staff are prepared behaviorally for patients before they
arrive
-identifying patterns and trends with patients as they occur
-maintaining oversight of the schedule and making appointments as necessary
-managing patient correspondence and followup
-coordinating non-clinical aspects of care with specialists and referrals
-internal training on communications and patient relations
-connecting with referral sources, public relations, networking

C – Clinical:
Depositphotos_24330067_mEvents related to the delivery of care. Commands most of the focus of the practice and is often the most up-to-date area. Requires the attention and oversight of the dentist/business owner. Removes the dentist/owner from constant oversight of the two other areas, making it even more important that self-directed, well-matched, highly-effective people are placed in the non-clinical roles.

As you can see, the non-clinical staff is responsible for two of the three critical areas of the practice. These staff members are often asked to perform both Administrative and Behavioral roles simultaneously while the responsibilities are very different from one another and require different skill sets.  It becomes clear that when we ask them to assume both roles, they are split between two very different responsibilities, making them choose in the moment which is more important. This usually creates more problems, and sets them up for failure, making them less effective or efficient in either of these areas.

It is our opinion that when you separate the Administrative from Behavioral roles and hire/assign responsibilities based upon strength in one of these two areas, you encourage deep competency, similar to your competency in the area of dentistry. Each person performs at a higher level when they are focused on only one arena and they become more successful than if they were asked to do everything with less effectiveness.

This is not to say that a person who is assigned administrative responsibilities can’t support the one who is responsible for patient connection by answering the phone, welcoming patients or checking patients out when necessary. There are always exceptions. Some practices opt for a third person to act as a greeter or to handle phone triage and appointment scheduling. Remember, the goal is to encourage deep competency in their skill set and prevent team members from performing in areas where they are not as skilled.

This concept may require you to think differently about the individuals, skill sets and responsibilities in your practice. A good exercise for each of your non-clinical team members is to have them make a list of their duties and determine whether it is administrative or behavioral (we hope you aren’t asking them to also perform clinical roles too!). Ask them to assess how much of their work load is in each of these arenas and discuss how roles might be shifted to better serve this new model.

Take home message: You most likely don’t need more people serving in a non-clinical role – you just need the right people, with the right skill sets, in the right positions, which creates a better, more efficient and effective systems.

A caveat here – you may discover that you have team members who share similar skill sets leaving you with no one to serve an administrative or behavioral role. This may be the eureka moment that explains why certain problems keep occurring in your practice.  This process may also cause you to consider restructuring your non-clinical staff altogether. We can help you consider your options and sort through the implications of making changes to better serve the practice and your patients.

Advertisements

My Prediction for 2013

Standard

Image

Good news!  U. S. News and World Report has announced their list of the top jobs (those in greatest demand) for 2013 and topping the list at number one is dentist!  Following in the number ten position is dental hygienist! At the risk of angering some of you, I’m going to say it. No more whining! You can position your practice and seize the market. But you must decide to take a good hard look at your practice and make some improvements.  Look at these FIVE ELEMENTS and ask whether you are making the most of each opportunity:

1) Your Physical plant

Patients have very little in which to judge your expertise or competence and some will assess you by the appearance of your practice. From the exterior and signage to the decor, wall art and clutter, look at your practice with new eyes or ask a third party or professional to give you their honest opinion. And while you must like and be comfortable in your surroundings, the more important issue is who you are targeting and what will appeal to them.

2) How are patients welcomed?

The best investment you can make is to train the team members entrusted with answering the phone and welcoming new AND existing patients. NO AMOUNT OF ADVERTISING OR EXTERNAL MARKETING WILL BENEFIT YOU until your team members learn how to connect with people in the most effective way. The challenge is that you rarely know how your team members are engaging people because you are focused on doing dentistry. Enlist the help of a professional to both assess and train your team appropriately.

3) Work on building relationships

This may sound like a no-brainer but there is more to building a relationship than learning where your patients work, their children’s names or where they went on their last vacation. Everyone who works in the practice must be capable and willing to learn communication skills that will carry your relationships beyond the superficial. This requires learning why patients come to you, what they are asking and expecting of you, and how you can connect with them in ways that help them get what they want. The end result is more patients authorizing more dentistry sooner!

4) Fostering referrals

It stands to reason that if you manage expectations and give patients what they want, they will be happy and continue to come to your practice. Far too often, we don’t ask our best, most satisfied patients for referrals. Do you and your team know the art of asking for referrals in a genuine way? Do you have a referral program that encourages people to voluntarily share their experience in direct and viral ways? Enlist the help of a professional to AMP UP this highly overlooked goldmine.

5) Marketing

For you old-school guys and gals, WAKE UP!  It’s 2013 and if you aren’t getting your business out into the community, you will be left behind. For those of you who have marketing plans in place, now is the time to re-assess their effectiveness.  Keep these three essential elements in mind as you craft your campaigns:

Reach – who you are targeting

Frequency  –  how often you are sending messages out

Top of the Mind Awareness/Familiarity  –  being in the consumer’s mind when they are in the market or have a need

I encourage you to consider more non-traditional means of promoting your practice with a heavy emphasis on education and good-will marketing. Think creatively and out of the box. Don’t rely on a team member to try to implement your marketing when they “have time”. Instead, hire someone who can focus on it.

I predict that if you tackle all five of these goals this year, your practice will SOAR. I would love to help you with each of these areas to make 2013 your greatest year ever and be poised for success for years to come.

Practice Perception Part II: What messages might your staff be sending?

Standard

In the first installment of Practice Perception, I asked; Does your physical plant represent your practice mission? We looked at the elements that contribute to painting a fuller picture of what your practice is about and is often the primary way patients can assess who you are and your level of professionalism and expertise.

Of course, there are other factors that contribute to your practice image.  One of the most powerful influencers is your staff. They can be a primary reason why patients are attracted to or end up leaving your practice.

Inside the practice, you certainly would want your team to be on their best behavior and represent you in a positive light. However, you can’t assume they will behave or act appropriately without being specific about your expectations. Make sure your employee manual contains specific guidelines for things as basic as the following:

PERSONAL APPEARANCE – include specifics on what you will or will not tolerate regarding: jewelry, piercings, tattoos, hair, personal hygiene, oral health, cologne or perfume, or tobacco smoke or smell.  

CLOTHING – if you supply uniforms, this should not be an issue. If you don’t, you must be specific about what is and is not appropriate.

CHATTER – quite often, dentists complain that the staff banter gets in the way of patient care. Patients who hear staff talking amongst themselves while they sit idly waiting will feel ignored. The hard and fast rule should be that the content of staff conversations in places outside the staff break room should be focused exclusively on patient care. In addition, remind your staff there should be no bad-mouthing or negative comments to other staff members or patients at any time.

PRIVACY – and of course, any conversations relating to patient care should be private and discussed in a place where they would not risk being overheard by others.

TEXTING, CELL PHONES AND SOCIAL MEDIA – team members gripe all the time about patients who use their phones during their appointments. Imagine how patients feel when a staff member diverts their attention from patients to text or use their phone or check their Facebook. It is rude and inappropriate. Period. Patients should not see or hear a staff member’s personal phone – not even a buzz when it’s placed on silent.

You cannot stop team members from using Facebook or other social media outlets outside of the practice, but you can remind them that what they post about their job or the practice is up for scrutiny. Depending on the comment, it could present the practice in a bad light. Comments can also cross privacy boundaries.  In order to protect themselves and the practice, you should request that they refrain from commenting on anything related to the practice.

ATTITUDE – you have probably experienced your share of passive-aggressive behavior by your team. It manifests itself in ways in which you may not be aware until it is brought to your attention by another team member or a patient; being surly or short with someone, slamming doors or banging things, ignoring others, sarcasm and responding in an overly exaggerated sweetness that is “put on”. Patients pick up on these behaviors and it reflects poorly on the practice and you as their leader.

OUTSIDE THE PRACTICE:

How many times have you been in public and seen one of your patients?  Whether it’s at the grocery store, gas station, sporting event or the countless other places you might go, you are keenly aware of how you might be perceived by your patients outside the practice. Your staff?  Not so much.  

When they aren’t working, your staff are probably not thinking about patients seeing them in a less-than-flattering light. And there’s not a whole lot you can do about it. However, you can encourage them to be on their best behavior. Remind them that they can be a powerful influencer to encourage patients to stay active in their dental care by the warm greeting or response they give patients outside the practice.

Enforcing these expectations can be difficult but it is essential that your staff understand  how vitally important they are in influencing practice perception. They are a huge part of the equation.

Practice Perception: From the inside out

Standard

In my previous post, I mentioned a dying bamboo centerpiece we discovered in a restaurant to illustrate the importance of practice perception. My main point was that patients have no way to judge your clinical abilities and the indicators they will use to determine what your practice is about or gauge your expertise are the physical plant, the environment you create and the way you engage your patients in the process. Let’s take it one step further.

Does your physical plant represent your practice mission and is it in alignment with what you offer?

In this and future posts, I want to focus on the physical plant and environment and shed light on those areas you may want to evaluate in your practice.

For example, for new patients, the most important place in your practice is the reception area. This is where the look and feel of the practice is established and should be congruent with the image and messages you are sending into the marketplace. You want this space to set the stage for what the patient can come to expect from you and your team.

Let’s use a simple exercise and approach this process by using the five senses as a guide. If your practice specializes in working with anxious or fearful patients, how would you want your reception area to look, feel, sound, smell and even taste? Visualize in your mind how a person might enter into and experience the environment.You want to project the image of clean, soft, comforting, soothing, uncluttered space.

Sight

The colors would be blues, greens or violets to calm the mind, provide harmony and balance and encourage meditation. Artwork would be minimal and serene – no generic smiling people portraits. The space would be accented with side tables and you wouldn’t find ratty magazines or stand up displays promoting procedures or electric toothbrushes.  Instead, visitors might discover hardcover picture books about photography, travel, animals, or inspirational short stories. Plants would bring in the natural environment and remove the clinical feel. A couple of carefully-placed live flowers might dot the room showing your care and attention.

The lighting would not come from harsh overhead or can lights but instead would be a mixture of floor and table lamps and sconces, providing soft, warm pools of light through the space.

Touch

There would be soft, inviting comfy chairs or loveseats, perhaps with pillows. Massage chairs might be another option. The floor would be carpeted or would have throw rugs, which also softens the sound of footsteps and voices.

Sound

Patients might hear instrumental spa music just loud enough that sounds from the clinical area would be masked. A water feature like a fountain, or a live or virtual aquarium would support the calming environment and add a distraction for anxious patients. No loud phones ringing, no speaker phone, and the volume of voices would be kept low.

Smell

Candles or wall plug-ins would dispense the aroma of lavender, mint or jasmine to aid in calming fearful visitors. No clinical or “staff lunch” smells would be detected.

Taste

A coffee, tea and water station would invite visitors to make themselves at home with an assortment of flavors, including calming camomile.

Can you begin to see and experience this reception area in your mind’s eye? This sets the stage for what they will experience throughout their visit. The physical space and everything you do should be congruent with this.

You may want to gather your staff together and perform this exercise in your own practice.  Paint a picture for your team of the way you would like to treat your patients and how you want your practice to be perceived, based on your specialty and mission. Start with the physical plant. Come up with ways you can support the message.  Walk through the space and evaluate what is in the space now. What doesn’t belong? What would you want to change or how would you improve the features? Then do this same exercise for each area of the practice:

Entrance
Reception
Front desk
Clinical areas
Business office
Treatment consultation room
Other public areas: hallways, bathroom

I would love to see photos of your reception area to see how you welcome patients.

In my next blog posts, I will look at the following equally important areas of perception: Staff, external messages and marketing messages. Be sure to click on the “Follow” button so you will get notification of the next post.

The Dying Bamboo

Standard

Recently, Sandy and I had dinner with a dentist and his wife before we visited their practice for observation. The restaurant was in the airport hotel where we were staying.  We were greeted and seated immediately and as we settled in, both of us noticed the centerpiece; a trendy looking slate stone vase that held a single bamboo shoot.  Sounds like a great concept, right?  If only the bamboo wasn’t falling over and the leaves weren’t yellow and wilted.  It was downright sad.

Immediately, this symbol of good luck became a depressing sign, so we removed it from the table.  It might also have been a sign for the lack of attention the restaurant received from the management and employees. As the dinner progressed, I noticed the bread was stale, the water glasses sat empty without a refill, and the meals were plated with little care. I began to wonder whether the food prep area was sanitary. Was the walk-in refrigerator temperature to “code”? Did the employees wash their hands? I didn’t have high expectations for the meal. Luckily, our server was decent and our food was acceptable but the experience was less than what I expect from this type of restaurant. I left underwhelmed.

What we discovered were telltale signs that no one was paying attention to the details. If those details weren’t being tended to, what about the things that really mattered?  In their book,“In Search of Excellence,” Peters and Waterman make the following observation:

“When there are coffee stains on the tray tables, passengers wonder about the quality of the maintenance of the airplane’s engines.

These signs undermine confidence. The same is true in your practice. For example, on a recent consultation visit to an upscale cosmetic practice, I immediately noticed something that seemed out of place. The sign in front of the building and the landscaping was top notch. The reception area was gorgeous and it was obvious an interior designer was consulted. The environment was warm and the sounds were soothing. Then I saw it. The spot on the carpet. It did not belong. When I asked the group about it later in the day, most of the team had no idea what I was talking about. Two staff members did recall the spot and said that it had been there for as long as they could remember. No one seemed to feel it was a big deal. That spot was as significant as the dying bamboo centerpiece.

Point 1: Patients have no way to judge your clinical abilities and the indicators they will use to gauge your expertise are the physical plant, the environment you create and the way you engage your patients in the process. If the little details aren’t tended to, your patients will wonder if the things that truly matter – proper diagnosis, clinical expertise, sanitation standards – are also being overlooked.

Point 2: Your team must be vigilant all the time. Create a culture where your staff is encouraged to pay attention to the little things – the stain on the carpet, the full trash can in the patient’s bathroom, a patient’s concerned look or the negative comment he or she might make on their way out. Everything matters. Patients notice. You can’t let down your guard.

Over the course of the next several articles, we will review the physical plant and environment and shed light on those areas you may want to pay more attention to in your practice. If there is a specific area you would like for me to address, please comment below or email and let me know.