When we last left our story, we had a problem with the front desk staff turning off patients by being dismissive and generally unpleasant. The doctor was busy in the back trying to treat patients and tended to steer clear of the front desk in his quest to provide the best patient care possible.
Very clearly, our first task was to address these individuals who probably had skills applicable to other areas, but it appeared that making folks feel at home was not one of those skills. Seemingly, the most obvious solution would be to simply terminate these 3 people and replace them with others who had more of a friendly demeanor about them.
As a general rule, I do not enjoy firing people nor do I ever look to that as a first solution to a problem. Personally, I've been fired without having the chance to make a situation right, and it sucks. In addition, these people had experience in the practice and may have had skills applicable elsewhere. We’ve dealt with a number of staff people who aren’t the super friendly type when patients walk in the door, but may be absolute superstars when it comes to financial, technological or receivables matters. That should definitely be explored.
The conversation with the front desk staff began very frankly with a discussion of what we had heard and observed within the office. That was followed by the standard denials and pushback. That’s never an issue. No one likes to hear that they are considered to be the source of a problem, but once we let the dust settle a bit, we were able to get into a discussion of the problems.
The staff expressed that they felt stuck in a rut. Pay had not changed, the daily routine had become a drag and a general malaise had fallen over the practice. In sum, they didn’t really care because they didn’t have a reason to care. Now, that’s not necessarily a good thing. Staff should be motivated because they enjoy what they do and there really aren’t many more enjoyable places to work than an active orthodontic office. But sometimes the proper positive motivation can move someone to action.
That was the course we chose. After discussing the problem, we offered an incentive program. If the office got 20 initial bandings (we said initial bandings instead of contracts to ensure that the patients actually got started) per month, each person in the office would receive a bonus of 10% of pay. For the staff, now they had a simple, tangible goal to reach with a tangible rewards for reaching that goal. We would certainly offer our suggestions for the methods to improve new patient flow, but ultimately, success and increased income was up to them. If they wanted to drive through a neighborhood, find potential patients and drive them to the office for treatment, they could do that. But in the end, no patients, no bonus.
For the practice, this was a win-win situation. If IBs doubled from 10 per month to 20 per month, the value of contracts would increase by about $40,000 per month (10 extra IBs * $4,000 per contract). Total staff pay was at about $10,000 per month so any bonus reached would total $1,000. $1,000 of extra pay for $40,000 in contracts? That’s a no brainer. If the staff failed to meet the goal, no money would come out of pocket.
And for the staff, not only was the money an incentive (potentially an extra $12,000 per year?? Yes, please), this plan put everyone on notice that we had reached a critical point. If people wouldn’t step up and try to sign patients even with additional money on the line, new people would have to be hired. If some worked harder, but some didn’t, we were pretty certain that those working harder would work just as hard to weed out the anchors on growth.
On top of that, we had a reputation problem to solve. Here, the solution was simple. Get out in the community and put on the “good” face. Bring doughnuts and pizza to local dentists and nearby businesses, sponsor several open houses, and not only provide sponsorship for little league teams, but also show up at the games and show support. After a long period of depression, it was time for smiles, handshakes and friendliness.
Finally, the doctor had to be more involved in the front of the office. We weren’t asking him to handle phone calls or file insurance claims, but he had to occasionally visit the front, take the temperature of the situation and keep morale up.
The results
After 3 months of the project, one of the front desk staff cracked under the pressure of the “Cheeriness Campaign” and moved on. The other 2 put forth a strong effort to generate referrals from existing patients and to contact those who had been turned off earlier by the practice. Within the next 6 months, the office hit the 20 IB incentive 4 times. The practice happily paid the bonuses and accepted the additional new patient flow.
After that, a more involved program with tiers was set up. If the office came up just short of the 20 IB goal, a smaller bonus could be earned. A 3 month stretch with 30 IBs per month got a larger bonus plus an all expenses paid trip to Disney World or Las Vegas (gambling, alcohol and pictures with Elsa excluded).
In the end, this one worked out well. But you have to be able to judge how people are going to respond to an incentive. It doesn’t always work. In upcoming posts, you’ll certainly hear more about our failuers in this regard.
Comments, questions. Feel free to contact us at bpalmisano2@gmail.com.
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