High Capacity (Quality) Dentistry P5

We don’t have a problem with doctor no shows.  It never happens. I mean very rarely, less than 5% probably, but on the hygiene side, it’s different. Those people, a lot of times, they don’t have any skin on the game.  They don’t have any deposits. They come in.  Their insurance pays 100%.  They don’t care.  So, we just have a lot of cancellations.

So, I could have just had days of hygiene booked where people were just, it would look like somebody shot it with a 12 gauge shot gun.  It’s full of holes.  People are not showing up. I could’ve done that and accepted it and said that’s just the way it is.  If you do that though and you have hygienists that are commissioned, they’re going to be unhappy because they’re not going to make enough money because they have no control over that.  They’re not on the phone scheduling, or if you pay them a salary, you’re not going to be happy because half the day they’re going to be sitting in the back drinking a Diet Coke and reading People magazine.  That’s what’s going to happen if they’re not commission, and you don’t do something about the scheduling system.

So, we just came, one day, to accept, years ago, that no matter how many times we confirm, no matter how many times they tell us “yes”, we send them a voicemail, we e-mail them, we texted them, put it on Facebook, no matter how many times they say they’re coming, a lot of them just are just coming to those hygiene appointments.  So, what I decided to do was take a page out of the airlines book, and I decided to start overbooking.  That sounds terrible doesn’t it?  Overbooking.

Everybody listening is saying, “Oh, I get it now.  The old Chris Griffin.  He overbooks.  That’s how he produces so much.  He probably stays up to 10 o’clock every night.”  No, I don’t do any of that.  Let me tell you what I mean.  This only applies to hygiene. It only applies if you have no shows like we did, but if you hygienists working, we book three columns as if three hygienists were going to be here.

I know you’re going to say, “What if all three people show up at the same time?”  That might happen occasionally, but it is very rare.  Normally, we can easily maneuver things around with an extra room we have to make sure that people don’t feel like they’re having to wait because if one hygienists is busy, one of my assistants can go start the x-rays.

Worst case scenario is once a month, once every two months, that’s it.  As an emergency, emergency backup, when all three people show up for two slots or all four people show up for three slots in my practice, I might occasionally have to go in do a hard tissue probe and scale and let my assistants chrome and polish and do the x-rays on a patient.  That only happens once a month, once every two months.  I promise.

Now, what do we get with that for me having to do a probe once every two months?  We get an almost guaranteed full book of hygiene for all the hygienists that are here, and rarely do we get complaints from patients about not being seen on time because with the way we work it out, they are seen on time.  It’s just that they may not be seen by the hygienist, but with the patient, what difference does it make?  They don’t know.  Why would they care if an assistant takes their x-rays instead of their hygienist?  They don’t care. So, that’s how we handle that situation.

Alright. Number three, with all the offensive things I just said about hygienists, let me say that the hygiene department is probably the most important department in your practice because in my practice, by the way, that’s where all the patients are.

So, let me share with you real quick. I had a client who was telling me, “Gosh, Chris let me show you my schedule.”  They show me their schedule, and I about fainted, threw up on the floor. I mean, this thing was full on hygiene, and had two patients, two one hour appointment all that.  That’s it.  I mean, I call him up and I said, “Hey.  What in the world is going on?”  He said, “Well, Chris.  People just aren’t accepting treatments.  I don’t know.  We can’t get anybody to book.”

I said, “Did your hygienist show up?”  He said, “Yeah.  We’re full on hygiene. It’s what’s keeping us afloat.”  I said, “Well, let me look here.  You got 16 patient in hygiene, and they all get 30 teeth. Now do that math.  How many teeth is that?”  He said, “Well, that’s a lot of teeth.”  I said, “If I had that many teeth, you’re telling me that you have 8 hours.  You could have done anything. You just sat there and didn’t do anything.  You’re telling me that none of those had anything wrong with them where you could have just gone and done it while they’re there?”  He said, “We believe that you’re just supposed to sell the whole enchilada.  If they don’t accept the kind of treatment that you put in your own mouth or your mom’s mouth or your wife’s mouth.  Then, let them go home and think about it.”  Well, obviously, I think that’s wrong.

If you have hours available, you need to be pulling stuff out of hygiene all day and filling up your schedule.  Hygiene is what Greg Stanley once called a bubbling cauldron.  It’s just a cauldron or a big melting pot full of patients and stuff to do, and you need to keep that healthy a humanly possible.  That’s why I think it’s important, as we go on into the future.

Number four, grasp the opportunity.  Same day dentistry.  That is so important.  We have a very unique system on how we do same day dentistry, and let puzzle through this.  We’ll get you there real quick.

Number five, you’ve got to be honest with the doctors and the team.  Are you really pulling together, or are you pulling against each other?  Now, sit back.  Like I said earlier, you’ve got to be honest with yourself.  Make sure you’re on the same page.  Now, you’re team can really help you out.  Don’t be mean to them, but at the same time, if they’re not going to pull with you and they’re going to pull against you, you need to find a team that will pull with you.

Number six.  This is my favorite, favorite part, mastering workflow.  Here’s one of those automobile practices we were talking about earlier.  Master workflow, and let me show you how we do it in our practice.  Now, this is on that website.  It’s on the website we talked about earlier.  If you want to get it, look at it, follow along as we go.  I’m just going to briefly go through some of it, but this is a workflow choreography map of taking a prospect who didn’t know about your practice all the way down to case acceptance, what you do through treatment and the whole experience.  If they don’t accept your treatment, what you do to try to get them back on schedule to try to get them back inside.

So, let’s just go through some of this.  Number one, they’re a prospect.  We’re just going to move on forward.  Let’s assume you did some whiz, bang marketing, got them in the door.  They made it to your practice, okay.  They make it to your front door.  They come in.  What do they see?  Do they see a grumpy person?  Is anyone talking to them?  Do they see somebody friendly?  In our practice, we do give them paperwork to fill out.  We also take them on a tour of the office where we show them how clean the sterilization area is.  In my case, they can say honestly, “What a really nice room.  They say, “This room is where Dr. Griffin films his case studies.  He presents all around the world in his lectures.” It sounds really cool.

If you don’t have that, you can put up some pictures of some celebrities, local celebrities, or any famous people that you’ve got in the area or patients where you can use as examples of before and after.  “This is where Dr. so and so works on their special patients on their extreme makeover patients, on their VIP patients.”  Whatever it is, and you can do that.

Then, you sit them back down in the waiting room.  You give them a gift.  Now, if you’re gifting someone, it makes them feel comfortable.  It makes them say, “Wow.  This is different than anything else I’ve done before in dental office.”  You have staff people retrieve them the right way.  There is a protocol for that.  We talked earlier about the route board and stuff like that, but let’s not get into that right this second.

Let’s get down to the oral exam because I did promise to talk about the three phase diagnosis.  Alright.  So, the patient’s seated.  The assistant’s going to ask about the chief complaint.  We were these little radios. They can radio in information to the doctor.  In my state, I have to go into the room, order the x-rays.  It’s a pain sometimes, but it’s okay.  That does, thought, give me a chance to apply phase I of my diagnosis.

So, let’s talk about phase I.  When I come into the room the first time, the first thing I’m going to do is I’m going to just go up shake their hand if it’s a man, or if it’s a woman, I don’t shake their hand.  I just go sit in front of them or I look right at them.  I’ll introduce myself, and they’ll introduce themselves.  I’ll try to make some kind of connection.

Admittedly, this is Mississippi, and this is a small town in Mississippi.  It’s probably easier for me to make a connection.  I’m somehow or another, kin to, relate to, went to school with, my mom taught them, or something with 90% of the people that walk in here.  It’s like playing that Kevin Bacon game, seven degrees or whatever.  I absolutely can do that with most of my patients, try to find some connection with them, and ask them, “What can I do for you?”  I ask them, “How can I help you?”  I learn that from Roy Smith a few year ago, and it works every time.

They’ll usually tell you what’s going on, and I’ll just take a look.  In two seconds, I’ll order x-rays.  So, I’ll be out there doing something else.  Actually this is a picture of our kanban or route board.  So, I go out in the hallway, and I find the number one priority on this thing.  I go to that room.  In this case, I’m probably going to check hygiene in room 5.  Then, the assistant does a lot of the heavy lifting.  I’m out of the room.  They get everything ready.  They do the x-rays, and they get more information.

When they get everything they need, they go back to the route board, again, and that route board does a lot of things.  This is sort of the air traffic controller of our practice.  That’s where everything is written and everything is done.  There’s no way I could have an efficient flow of a high capacity of volume through the practice without it.  It would be too much chaos.

What it does is it allows me to focus. Every time I’m out in the hall, I’m looking for priority number one, I’m going to that room, whatever it is, and I’m focusing on that patient. I’m coming back into the hall and looking for the broadcast here.  I’m looking for priority one.  I’m going to that room.  So, the assistants, they have a set of rules that they have to follow to keep it updated, but all I have to do is follow it from place to place.  That’s what makes my life easy, so much easier than it could be.

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