Archive for May, 2014

1 of 3 Steps to Establish Performance Expectations

Friday, May 30th, 2014

It stands to reason that most dental practice team members are far more likely to succeed when they know what is expected of them, when there are goals they can seek to achieve, when they are part of an overall effort to attain a common objective, and when they know what path to follow. It seems so profoundly simple and obvious, as fundamental as turning on the lights, unlocking the doors, and opening the practice for business each morning.

Yet this simple concept is often lost on dental practice owners. Commonly, the assumption is that employees “instinctively know” what is expected of them, particularly if they have worked in another practice. The doctor can’t understand why employees don’t just “do their jobs,” and employees can’t understand why the doctor “won’t tell them what s/he wants.” Consistently, the culprit is lack of or weak performance measurement systems. Successfully measuring employee performance requires a clear and well defined strategy, and it starts with three key steps:

Step #1 – Create Specific Job Descriptions
Define the job that each staff member is responsible for performing. Specify the skills the person in the position should have. Outline the specific duties and responsibilities of the job. Include the job title, a summary of the position, and a list of job duties. This can be the ideal tool to explain to employees exactly what is expected of them.

For example, your dental assistant’s job description should include points such as attending beginning of the day meetings, completing case presentations, reinforcing to patients the quality of care delivered in the practice, directing the doctor to check hygiene patients, completing post treatment care calls, converting emergency patients to new patients, turning the treatment room around promptly, etc.

Avoid the common yet dangerous pitfall of overlapping job duties. Instead, cross-train so that each area has coverage when the point person is out ill or is unavailable. If you overlap duties, employees are given tasks but not responsibility. Consequently, the team member quickly becomes frustrated. S/he wants to take ownership for a particular system, but can’t because it’s not “her/his system” to oversee. It’s simply not in the practice’s best interest to have multiple people responsible for areas such as collections or scheduling.

Interested in speaking to Sally about your practice concerns? Email her at


Perio Considerations

Wednesday, May 14th, 2014

From Guest Blog Contributor: Dr. Michael Rethman

I concur that 80% (or more) of perio therapy can and should occur in the GPs office: the trick is knowing what should occur where and when — in other words when to refer and why. Chronic periodontitis is usually site-specific and often progresses slowly which can trap GPs in situations where they fear referring later on because things went downhill early-on. Furthermore, most dentists (me included, and I’m a perio) aren’t good at blind scaling and root planing, many RDHs aren’t either. So assuming that you or your RDH are somehow good at this is foolish — unless, of course, you are using an endoscope or surgical access, the latter of which may be overkill.


As noted by Dr. Fazio, sites that show no plaque yet persist with BoP suggest strongly for getting help. One trick to a happy practice is to establish a good relationship with a nearby periodontist or two and ask them to help you refine your treatment skills and referral paradigms as well as be involved in multi-disciplinary treatment planning and execution — that may include optimal periodontal or implant placement/maintenance skills that you simply don’t have. (Not all perios are stars either, but they have nearly double the formal dental education of most GPs and if the ones you contact don’t want to help or don’t seem all that informed, find others.) Also, there exists a publication entitled Management of Patients with the Chronic Periodontal Diseases that may help you too, I think it’s available at Finally, remember that your state grants you a license to practice dentistry and patients consent to your “touching” because both the state and your patients expect that you will always hold their interests paramount — over yours especially. Part of that responsibility entails not only doing what you think is ethical and correct but also learning more and more over the years so you get better and better at doing knowing what’s “right” — and I’m not talking about your practice gross income here… I am talking more about sleeping well at night…. Aloha all and have fun!

Screenshot 2014-05-14 14.51.46

Dr. Rethman is a board-certified periodontist with over five years of general practice experience. He is also a dental research scientist and a former Director of the U.S. Army Institute of Dental Research, as well as a past-President of the American Academy of Periodontology. Dr. Rethman also recently chaired the ADA’s Council on Scientific Affairs for an unprecedented three years and has recently chaired and/or served on numerous expert panels that systematically assessed the scientific literature to provide up-to-date information regarding a variety of important clinical topics.

24 hours to Goal

Monday, May 5th, 2014

In our previous posts we have talked about setting goals for growth. Now that we have closed out the first quarter of 2014 you have a baseline to set some goals from.


Regardless of whether in business or at home, there are certain goals that can help us as individuals to improve the areas of our lives where we wish to see growth.
Let’s set those goals so we can reach toward greater personal and professional fulfillment and achievement. On average, I feel safe to say we feel better when we are more productive. Why not do more to fulfill that need which in turn improves your environment and perhaps those who get to experience being around you as well.


Take a moment to consider that your time has become your most important asset. No matter where you choose to spend that time, there are ways to keep track of how it is spent. Taking time for self improvement obvious measure for how that resource as it is most certainly finite and precious resource that we have. An important comparison for benchmarks are going to be this first quarter compared to last quarter as compares to yearly averages as well as specifically the first quarter of years past.
There is a lot of information available perhaps and not enough time to sift through it all.


For others it was just more of the same. Inadequate systems that managed to shuffle through the first quarter will limp into the second. Productivity will continue to teeter between the “sorely lacking” and the “barely good enough” levels – not because the doctor isn’t working his/her hardest or individual team members aren’t committed to the cause. Rather it’s typically because the primary focus is on dealing with whatever problem has to be managed right now and not on addressing what caused that problem and what can be done to prevent it in the future.


Ironically, a mere 24 hours over the next year could transform a practice locked in a seemingly perpetual state of crisis management or lackluster success into one of superior efficiency and productivity. Monthly business meetings that are given just two hours of dedicated, uninterrupted doctor and staff time could be most cost-effective, production efficient step you’ll take to achieve your practice’s full potential in the coming year. The key: designate every member of the team a contributor.


Here’s how:


1. Block off two hours each month over the next 12 months. These are the 24-hours that you commit to continuously improving your practice during the next year.
2. Develop an agenda with input from the entire team.
3. Include all areas that impact the profitability/success of the practice. For example: numbers of new patients, recall patients, collections, treatment acceptance, production, accounts receivables, unscheduled time units for doctor and hygiene, uncollected insurance revenues over 60 days, overhead, etc.
4. Distribute the agenda at least two days in advance of the meeting.
5. Assign each member of the team to report on the area for which they are responsible. For example, the scheduling coordinator reports on the monthly production as compared to the goal, the number of unscheduled time units for the doctor, and the doctor’s daily average production.
6. Encourage team members to come prepared to discuss topics on the agenda. For example, if the doctor has a higher number of unscheduled time units than desired, the team can discuss contacting patients with unscheduled treatment, encouraging hygiene patients with unscheduled treatment to move forward on recommended care, identifying patients with unused insurance benefits, etc.
7. Seek input from everyone by asking questions such as, “What is your reaction to that?” “As the patient, how would you react?” “What are the advantages of this approach? What are the potential disadvantages?”
8. Delegate responsibilities and establish deadlines for completing tasks identified during the staff meetings. For example, if hygiene cancellations are high and the group has developed a plan to reduce the cancellations the person responsible, probably the hygiene coordinator, needs to know she is accountable for implementing the changes and should be prepared to report on the effects of those changes at the next monthly meeting.
9. Share ideas during staff meetings for improving the work environment, the patient experience, and the efficiency of the practice.
10. Designate the amount of time you will spend discussing each issue and avoid getting bogged down on unrelated topics.
11. Discuss only what is on the agenda.
12. Hold staff meetings off-site in a conference room with a conference table. Many local libraries, community colleges, and other public facilities have public meeting rooms available for use.
13. Eliminate outside interruptions.
14. Seek consensus from the staff as to the best time to hold staff meetings; meetings scheduled outside normal work hours should be paid.
15. Hold meetings at least once per month, more frequently if you are implementing several changes.


Meetings are meant to be designated times in which you can focus all of your energy and team resources on addressing key management issues and problems that arise as a part of operating a small business. Run correctly, they are the most effective means to identify and solve problems, establish policies, share information, motivate each other, define areas of responsibility, and exchange ideas. Use them to your practice’s full advantage.


Shoot HIGH and finish strong next quarter!