News

Bridging the Gap - Dental Practice Taps Consultants to help improve office operations

December 31, 2004 | Category: Office News
Darryl Ewing, The Austin Business Journal

Dr. Michael Bell has spent 25 years establishing a solid dental practice in Austin, and now he's working with consultants to help him better sink his teeth into running an optimal dental business.

It's not that Bell was struggling in his business. In fact, based on the latest American Dental Association annual average revenue data, Bell says his office is in the top 10 percent of practices nationally, with 2,400 patients. Bell warns against only worrying about service delivery, stressing that dentists must not neglect the business side of the practice.

"Even the best athletes have coaches to help them see things they don't; to help them make improvements and get to the next level," says Bell, 51, who hired Fortune Management consultants in September, making him Fortune's first Austin client.

Fortune Management, which has clients in more than 20 states and Canada, specializes in helping health care providers run their practices.

Local office founders and husband and wife Stanley Dill and Julie Demaree came to Austin in January and cover all of Texas outside of the Dallas and Houston markets. Their other dental practice client is in Hempstead, 50 miles west of Houston.

"They've helped us with everything that has to do with the business part of the practice, like time management and scheduling or how to interview patients and find out what outcomes they want to achieve (and also) the financial part of the practice," Bell says.

Larger dental practices in metropolitan areas are more likely to take advantage of business consultants, freeing the dentist and staff to focus on care delivery, says Lyda Creus Molanphy, spokesperson for the Texas Dental Association.

"It is an increasingly complex health care market with increasing demands from insurance … and that's a lot of what the business management consultants take on, while the dentist's focus is clinical," Molanphy says. Bell says Fortune has helped in three key areas:  Enhancing practice performance by monitoring key business data each day;  Improving communication among the staff and with patients; Improving the "re-care" system, which focuses on getting patients back into the office to get procedures completed. Dill says Fortune Management will work with Bell for about two and a half years, with site visits and teleconferences, meeting facilitation, ongoing coaching and monitoring and interpretation of data. Dill says the first step is getting clear on the doctor's vision for the practice and what the doctor wants to accomplish through the practice over a lifetime. Fortune worked with Bell for about a month in crafting a vision statement. "People get caught in patterns of thoughts and beliefs," Dill says. "We can step in and ask the question that interrupts the pattern," allowing the practice to do things differently or discover new plans of attack for old problems. In the Fortune model, ongoing monitoring of standard operating procedures is key to process improvement, Dill says. For example, the office monitors the number of emergency patients daily to determine their impact on regularly scheduled appointments through the day. The practice uses the data to determine whether some types of "emergency" procedures could be scheduled the following day or whether the practice can build "flex" into the schedule to allow emergency procedures to be handled during certain blocks of time.

"If the doctor's schedule is being run by emergency patients, that's not going to work long-term," Dill says. The company also tracks the number of doctor visits versus hygienist visits, the number of cancellations and missed appointments, whether patients are coming back to get diagnosed problems treated, and even the amount of time it takes to handle certain procedures, such as x-rays. The data is then used to make decisions about standard procedures to make the office run more efficiently, Dill says. The data also helps the staff understand what it realistically can accomplish in a day, without making patients feel rushed or inconvenienced.

"It's a scoreboard for the practice," Dill says. "The information is accessible to the whole team so they can see how they're doing."

Another part of Fortune's work has been providing the staff with strategies to help better communicate with patients who chronically miss or cancel appointments. The staff also has received communications training, based on the principles of motivational speaker Anthony Robbins, on how to better improve the office culture, Dill says. The staff will focus on eight elements of its office culture during a yearly planning meeting in January. Bell says he and his staff of seven women felt they could do more to support each other and to eliminate "subgroups," where office assistants might gossip about the hygienists, or vice versa.

"We have entered into some agreements on how we will choose to talk to each other and we won't subgroup," he says.

The staff completed a three-day training session last month and will undergo another one in April, where staff are given specific tasks to complete, such as getting clear on the group's vision for the office. The team also completed a Robbins "discovery exercise," which allows staffers to gain a better understanding of their teammates.

"We had some people saying, ‘You know, I've worked with you for 20 years and I didn't know that about you,'" Dill says. "They went back to the office and they saw each other differently. [The staff's attitude] begins to impact the patients differently, too."

Fortune also provided some verbal skills training in managing the re-care system —the process of making sure that patients come back to have diagnosed issues addressed and that patients never leave the office without having their next appointment scheduled.

"We try not to be a break-it-and-fix-it practice," where patients simply come in to get things done on an emergency basis, Bell says.

Instead, the practice tries to diagnose issues early and focus more on preventative care. Before the practice began to focus on the re-care process, it was scheduling follow-up appointments only at about 40 percent.

The new goal: 90 percent.

"We're tracking it. We're paying attention to it," he says. "I think there's an old saying: What gets measured gets done."

Bell's goal is to continue to refine operating processes and formalize systems to bring an associate dentist on board in the next two to three years, giving him time to handle more complex dental cases, research and community involvement. Fortune also helps identify potential dentists that match Bell's values.

Bell has a potential ten-year plan for the new dentist. After five years, Bell plans to allow the dentist to buy in to about half of the business.

Then, about five years later, Bell says he hopes to be able to transition out of the practice, making it a seamless change for patients. He believes the new focus on monitoring and data will help him attract the right associate.

"Any associate coming in wants to look at the numbers," Bell says. "People want the hard data. They want to know what they're buying in to."

File download: Bridging the Gap