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As part of our effort to improve our service offerings to you, we have partnered with Diversified Practice Solutions to add new solutions and improved pricing for your dental and orthodontic practice.

Please visit us at www.DiversifiedPractice.com for updated content and solutions for your practice.

UPDATE: We haven't moved.  We're going to hang out right here for the time being.

Team training tips

In our earlier piece on giving the proper resources to the staff, we discussed training, technology and repetitions as tools to improve employee performance.  Here, we dig deeper into training.  

Obviously, training takes a number of forms and can be conveyed in a bunch of ways, but we will point out some useful techniques that we’ve seen used.  Hopefully, you can use them to apply within your own practice.  Here are some of our favorites:

Marketing: It's everyone's job

We recently had a situation with one of our new clients that just begged for a more in-depth discussion.  Results in the practice had been particularly weak and a number of metrics had deteriorated noticeably.  Fewer new patients were making appointments, fewer showing up and a smaller percentage of those that did show up were signing contracts. 

While discussing the issues with the doctor, he said something along the lines of “the problem is clearly Person x (Note, this person’s real name is not person x.  The name has been changed to protect his/her identity).  He is in charge of marketing.”

And it is this quote that gives me pause because everyone in a dental or orthodontic practice needs to be involved in marketing in one way or the other.  Yes, you may have one person or an agency assigned to help you develop ideas and make sure those ideas move forward and become reality.  But that doesn’t mean that everyone can sit back and wait for new patients to roll in the door.  Rather, that marketing person is merely one part of the process.  Everyone can and has to participate meaningfully in the process.  

Specifically, keep the following in mind:

Are my patient receivables a problem?

A question from one of our intrepid readers: 

“How do you tell if your practice receivables are out of control?”

Outstanding question.  Of course, the answer is in the data and there are quite a number of ways to determine whether or not your receivables are under control or require some additional work. 

Queuing systems: the vitals

In the last post, I mentioned that I would go deeper into queuing systems in the next writing.  As mentioned earlier, a queuing system basically tracks each patient as they move from point to point during a visit to the office.  In addition to noting which patients are where in the office, you can also see how long the patient has been in that area.

At My Practice Engine, the primary experience we have had with queuing systems is building one from the ground up.  Our patient flow protocols were already in place and our IT team built queuing into our practice management system around those protocols.  

In sum, a queuing system, when used properly, can provide extremely valuable information.  The key phrase there is “when used properly” because if used improperly, it is a waste of hardware and software.  We had one manager simply go in at various times of the day and mark every patient in the office as checked out.  So, at a specific time of day, 15 people all left at once.  I hope they had someone to hold the door for the rush of folks.  

When used properly however, there are a number of ways to use one.  One extremely simple way is to note the time a patient arrived at the office and the time that person left.  Now, that isn’t the hardcore “queuing” or tracking that the term traditionally implies, but can give you useful information.  Here’s how: 

Here's what your patients are thinking

In previous posts, we’ve discussed polling your patient base via an e-mailed or in-office survey to gauge how they feel about important aspects of your practice.  That feedback can then help guide your future decision-making to provide the best possible patient experience.  

In our practices in Spain and Mexico, we recently surveyed a fair number of patients in anticipation of managers’ meetings in each country.  So that you can combine with your own surveys or get a feel for what patients are saying, here are some key findings that may apply in your own case.

At this point, just before the jump, I’d love to throw a little linkbait at you by telling you that the results are absolutely SHOCKING, but they aren’t.  

4 quotes that should give you pause

In the vein of our previous post on declining practices, here are some quotes we’ve heard over the last few months that should cause a practice to pause and re-evaluate things.  Unlike the previous post on the topic, these aren’t necessarily indicators that the practice is in trouble, but if you hear them or find yourself saying them, any owner or business manager should take pause and reevaluate the situation.

Annual meeting fails: lessons learned

We’ve gotten several comments looking for more mistakes made during annual meetings and lessons learned from those missteps (aside from the alcohol fueled missteps and mistakes).  We here at the Engine aren’t afraid to admit our mistakes and we’ve made our share so here are more meeting fails:

Doctor’s meeting, New Orleans.  This was around the year 2000 when WiFi access wasn’t ubiquitous like it is today.  But at the time, internet access was prominent enough that we simply assumed that we could plug a network cable into a wall jack and get online.  Big mistake.  I had scheduled a breakout presentation to demo our new online reporting product.  And since this was a Saturday presentation, the one guy in the whole hotel who knew what to do was off and unavailable.  Quite clearly, doing a demo of an online product doesn’t go well when there is no online component.  We muddled through, but I got some poor reviews.

Lesson learned: Test extensively beforehand.  See if the resort will let you into the exact room early to do a quick test of everything.  And have a backup plan.  If something crashes, have something available that doesn’t require you to be online or have power or whatever.

Our summer special offer

Over the last year, we've talked about our offer of services in generic terms.  This was done intentionally simply because different practices have different needs and one size does not fit all.  A large group practice in need of reporting has a completely different set of needs than a single office practice that only has enough cash to last one more month.  But this flies in the face of the advice that we've given which says to provide a concrete offer that a patient can evaluate on his or her own terms.

So, in keeping with our own advice, here's a specific, concrete offer for you (if interested, just e-mail us at bpalmisano2@gmail.com).

Where we think we can be of most value is in improving results in struggling practices.  For these practices, we will come in, visit with you and your team, analyze numbers, find the weak areas, apply our expertise and work with you to implement solutions.  Our history is not to come in firing people (unless necessary) or asking you to spend a bunch of money that you might not have.

If the office has less than $60,000 of annual profit (per office) before owner pay, debt service and personal expenses, our services are free.  If the practice grows past the $60,000 threshold, we will take 25% of the growth only.  So, if the practice grows to $100,000 in annual profit, the $40,000 of excess profit ($100,000 - $60,000) is subject to a fee.  We would take a fee of $10,000, while you enjoy the 75% of growth.  This fee is computed and paid quarterly.

Your new office: less cost, better results

In our last post, we left off with the question of how, in this day and age, with the level of competition that exists for new patients, how can I possibly keep the cost of construction and equipment under $500,000 - $600,000?  

Here, we discuss some methodologies for you to accomplish just that task. Now, by no means do we intend to suggest that you somehow cut corners or have an office that is less than acceptable.  Nor are we suggesting that you have some bleak, stark office that resembles the inside of an asylum.  

Keep in mind that if you start 20 patients per month in a more expensive location, your return on investment and ability to repay is substantially lower than if you spent 40% less on the facility and started 18 patients per month.

Here are some things we’ve seen over the years that help to keep cost under control while allowing to create a professional, inviting environment for patients.

Read more…

New office construction: When does "nice" become too nice?

One obvious observation: you want your office to look nice.  Patients want to spend their appointment time in a comfortable, inviting environment.  Not only does this enhance the patient experience, but it also encourages patients to want to come back and refer their friends for appointments.  On top of that, you and your staff spend a lot of your waking hours in that office and for purposes of morale and energy level, you don’t want to walk into a dump every day.  

The overriding question is what constitutes “nice.”  For some that means Herman Miller chairs, fountains and chandeliers in the waiting room and Italian marble wherever you can put it.  For others, that means clean carpets and a minimum of fingerprints on the walls.  The best solution usually lies somewhere in between those two.

A number of practices operate under the notion that “if you build it, they will come.”  That only works in the movies and only if you build a baseball diamond that people can visit for free.  An uber-fancy office does not necessarily mean that patients will flow in.  This is because patients need a reason to come to the office BEFORE they see the fine interior.  It’s not like a retail store where some great signage and buzz is going to generate walk-in traffic.  For most practices outside of malls, walk-in traffic does not exist.

For some evidence of what I am discussing, a story:

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3 qualities to look for in your office manager

Throughout the life of this blog, we have discussed the size and significance of the staffing and employee cost in your practice.  Over the coming posts, we are going to dig deeper into the human resources component of that cost.  We’ll talk about components of costs, characteristics to look for in a new employee, hiring, firing, discipline and much more on incentives.  

Today, we look more closely at one of the key people in your practice: the office manager.  Over time, this person can develop into your right hand for carrying out the business operations of the practice and a trusted advisor on matters of future practice development.  They’ll usually oversee the front desk area, monitor marketing, receivables, cash management, payroll and a host of other tasks.  This person may also be responsible for other hires so his or her personality and preferences will touch every piece of the practice.  

In this segment, we look at some of the characteristics we feel are most important when considering what type of person to put in this key position (aside from the obvious things like not being a psychopath).  This characteristics are ranked in order of importance:

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Marketing strategy: Preparing for the first quarter

As we wind down 2013, many folks are looking back on the year that was, but I know that you as a forward-thinking owner of a dental or orthodontic practice are looking forward to the new year.  Specifically, you are zoned in on what should be a very lucrative quarter: the first calendar quarter of the year.

Historically, the first quarter is a strong demand quarter for potential new patients.  On top of that, you usually don’t see any other major expenditures besides, potentially, end of year income tax payments.  As such, the demand from new patients plus low stress on the expense side equal a possible increase in the bank account.  

How do you take advantage of the opportunity presented here?  In other words, how should your marketing be structured to attract as many new patients as possible during the first quarter?  As you consider this, note that two major factors come into play during the first quarter:

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5 acquisition warning flags

We’ve recently come across several acquisition deals that had real potential when reading the basic description of the practice (who writes those?  Most of them are fantastic).  But at some point in the process, red flags got thrown up that caused us to pack up our bags and head in the other direction.  

Here are some of the things that we’ve seen recently and over the years that should immediately sound warning alarms all throughout your head.  Please note that not all of these are necessarily deal-killers, but they should cause you to give extra thought and do extra homework before making a deal.

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Employee incentives: lesson learned

In the brief existence of this blog, I think you have noticed that we have regularly preached the importance of numbers and good reporting.  More important than just having the information is understanding what that information is telling you.  Does the data appear to indicate one thing, but the practice is moving in a completely different direction?

When it comes to employee incentives, the importance of quality information and goals is doubly important because if your team is unfocused or has goals different from yours, you will end up with a mess on your hands.  And by mess, I mean you are paying a bunch of money for reaching an incentive that has nothing to do with the overall success of your practice.  

I’d like to give you a story of one case in which we thought we had all the incentives lined up properly, but ended up learning a costly, yet valuable lesson instead (kind of like the plot of most sitcoms).  

Read more…

Marketing case study: Daily deals site

In our last post, we ruminated on some of the issues involved with using daily deals sites to promote dental and orthodontic procedures.  At the top of that post, we promised to discuss some results that we’ve had with using them so this post is dedicated to that subject.

Before diving in, note that as believers in quality advertising, we are willing to try a number of new avenues to keep marketing diversified and in front of as many people as possible.  You may have found the formula that works for your practice and do not want to change things.  That makes perfect sense.  But if you ever want to experiment with something without having to affect your delicate balance, we might be willing to try it (if the cost and setup are reasonable) in one or more of our offices for you and then provide full feedback on how things went.  This gives you a “live fire” test without deleteriously impacting your results if things don’t go according to plan.

With that, on to the case study:

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Marketing strategy: Daily deals sites

One media channel that some practices, including some of ours, have experimented with over the past few years are the daily deals services that have sprung up throughout the world.  You know some of the bigger names: Groupon, Living Social, Sweet Jack.  We know that they can be effective for restaurants, kids’ play areas and the like, but what about the dental and orthodontic practice?  

Generally, the process is the following: you contract with one or more of the services to advertise a price or other promotion to their “fan” base.  The ads are usually limited to a period of time and/or a certain number of people.  Once someone utilizes your services with one of the coupons from the site, you split the proceeds with the daily deals company.  Typically, you’ll split the proceeds 50/50, although Groupon has been cutting its take down to 35% in some cases to beat on the competition.  So, let’s say that you offer a deal for a $20 cleaning through Groupon.  When you get the $20 from that patient, $10 of it goes to Groupon and you keep the other $10.

In this post, we give you some of our thoughts and results that we’ve seen.  As you might expect, when the conversation with a doctor ventures into the realm of something like Groupon, we get a response along the lines of “No way.  That may work for other businesses, but not mine.”  Here are the main objections we get:

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Process simplified: generating important numbers

Over the last couple of months, we’ve thrown several computations and numbers at you.  Taking the time to compute things like the batting average, conversion rate, show up rate, etc. can benefit your practice and help you make effective, efficient decisions.  But a savvy practitioner may ask, “Those numbers are all well and good, but do you expect me to spend all of my time summarizing results and making computations?  Not only is that boring, but it also takes away time from analysis and focusing on my practice.”

And this, savvy practitioner, is an excellent point.  There are quite a number of ways to get to these numbers without burdening you with a green visor and a bunch of 7 column paper.  Here are some of your options:

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3 ways to improve your new patient show up rate

In our last post, we discussed the useful number known as the conversion rate.  One component of that conversion rate relates to patients who have made an appointment, but do not show up for that appointment.  In our scheme, the percentage of the patients that show up for their new patient consultation is known as the show up rate.  Like the conversion rate, the computation is very simple: take the number of patients that showed up for a new patient appointment divided by the number that made a new patient appointment for that period.

Like the conversion rate, this number will result in a percentage between 0 and 100 (if the number is greater than 100%, you probably have an issue with the process that computes this number).  Also like the conversion rate, we’re concerned with the trend and performance over time.  If your show up rate is 80% for 6 months straight, drops to 40% in one month and then goes right back to 80%, we’ll look at that one aberrant month, but not spend too much time stressing about it.

In a lot of ways, getting a patient to show up for that first appointment represents the last major hurdle in getting a patient into your system.  

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Key metric: conversion rate

On a regular basis, we here at My Practice Engine like to equip your dental or orthodontic practice with simple, meaningful statistics to track.  When you look at the number, that number is telling you something very powerful about your practice.  In the past, we’ve discussed things like benchmark expenses as a percentage of revenue and batting averages.  

Here’s a key marketing barometer to add to your quiver.  We refer to it as the conversion rate and it is very easy to compute.  For any given month, take your number of new contracts or total of new patients who have agreed to start treatment and divide that total by the number of consultation appointments made.  That bit of mathematics will yield a percentage somewhere between 0 and 100%. 

More important than the number itself is what does this number tell us?

As you can probably tell from the numerator and denominator, we are answering the following vital question: At what rate did potential new patients get converted into actual new patients?  If I want to sign x patients, how many consultations should be on the books for a given month.  For example, say that your conversion rate is normally 30%.  If you want to sign 10 new contracts in a month, you need to have 34 consultations booked (actually 33.333 if we take 10 divided by 30%).  

When we have a consultation on the books, there are 4 things that can cause this potential patient not to become an ongoing, paying patient.

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