Scheduling Problems? by Sabri Blumberg
Reactivating Your Patient Base by Jeffrey M. Blumberg
MGE’s weekly webletter, Issue 7.
Here is the next edition of MGE’s weekly webletter. The purpose of this webletter is to provide ideas, tips and suggestions to make your practice more successful.
Feel free to send us your comments and suggestions, or requests for future webletter topics you would like to see covered.
Scheduling Problems?
By Sabri Blumberg
Deputy Chief Operating Officer, MGE
Consistently maintaining a productive (and efficient) schedule can be a challenge.
If you’re having problems with your schedule (i.e., not productive enough, too many cancellations and no-shows, etc.) the first place to start would be your scheduling policy.
Now, I know there are quite a few variables or “reasons” that combined contribute to a non-productive appointment book. Take an improperly scheduled morning, too little time for a few procedures and add a few cancellations and no-shows and you could have a real mess.
However, if you’re having trouble with the schedule – regardless of the “reasons,” I’d still start with a thorough review of the scheduling policy in your office. Why? Well, policy provides the “rules of the game,” so to speak. With no rules you have no game.
Having a common set of rules for everyone (your staff) to play by fosters AGREEMENT among the staff. With this agreement in place they can all move in the same direction – they are all on the same page. For that matter, lack of policy can create innumerable DISAGREEMENTS amongst your staff. How?
Well, let’s imagine for a minute that you have no financial policy in the office. There is no set way that patients are supposed to pay for their treatment plans. Now, let’s say you have two of your staff collecting money up front – “Jane” and “Bill.” In the absence of “rules” (policy) on how money is to be collected – Jane and Bill come up with some on their own. Bill allows patients to pay $50 a month on a $5,000 balance and Jane has patients pay half down.You get upset with Bill as $50 a month doesn’t cut it. You think Jane is “great” as she collects more. Jane and Bill “disagree” on how to collect money and argue about it. You end up with a mess.
Well, expect nothing less than things like this if you don’t lay out clear rules.
It’s another matter entirely if your office policy was “Half down on the start and half 30 days later.” If that was the case, then Jane is in compliance with policy and Bill is not. With NO policy – who knows what you’re going to get!
So, if your only rule for the schedule is “fill it” and you don’t have a clear cut system of policies and actions relating to it (i.e., how long to schedule for different procedures, when you see different types of procedures and when you fit new patients in), then expect varying degrees of problems or outright anarchy!
If you don’t have a scheduling system that allows you to work efficiently and productively, I’d recommend the MGE Scheduling for Production Seminar. (Click here more information).
If you do have a scheduling system you’re happy with and are still having trouble staying productive and efficient, I’ll point out three areas that may be behind your problems:
1. You are scheduling “by committee” as opposed to having one person responsible.
If you have a couple of front desk staff and “everybody” schedules, you are making a mistake. One of the basic management concepts we teach on the MGE program has to do with a clear division of duties for each position. You give someone a job, it has a specific product that you expect from it and you can assign a statistic to this job to determine if the area is expanding or contracting. Obviously, if a person is working out well and learning more as they go, they will become more efficient and statistics will improve.
Conversely, if you have a situation where “everyone” is responsible for the schedule – then in reality NO ONE IS. Have you ever had a room or closet in your home or office that didn’t belong to anyone? Since it was “no one’s responsibility,” it was most likely a mess.
Make one person responsible and accountable for running the schedule. In the event a patient needs to schedule and this person is not available, another staff member can do it, but they would turn over the information about what was done to the person responsible at their first opportunity.
2. Your staff have little to no training on how to handle people.
You are in the people business.
The person running your schedule may be very knowledgeable about dentistry and how the schedule is supposed to work, but if they have difficulty handling and directing people, you will be in trouble.
Just as there is a technology to doing anything from prepping a crown to making tasty soup, there is a technology of how to handle and communicate with people effectively. If you don’t know it, you will run into problems. And not to burst any bubbles, but this is not resolved by teaching your staff special “words” to use when scheduling or giving them a script.
Handling people effectively and cheerfully begins with understanding people and how to communicate with them. This comes from being trained. Without this information and skill, you will end up with patients controlling the schedule. Countless times I have had a client bring their scheduler to seminars here at MGE on how to communicate better and then watched as they went back and put control in on the schedule.
So the lesson here is: You are in the business of handling people. Ensure your staff are trained in this area along with the basics of doing their job in your office.
c. You have an inordinate amount of cancellations and/or no-shows.
I have heard all kinds of reasons why patients cancel or fail. Lack of confirmation, people don’t think dentistry is important, etc. Unfortunately, none of these answers lead to a solution to the problem.
So, what is the problem?
Generally speaking the reason for most cancellations or no-shows, especially for larger procedures is the patient is not “closed” on doing the treatment. They are not “sold.” They may appear to be when they leave the office and schedule.
How do you know the difference? Well, see the answer under “b” above – learn the technology of handling people. We begin teaching clients about this at the MGE New Patient Workshop (click here for more information) and really get into detail at the MGE Communication and Sales Seminars.
So, there you have it. While I could get into more detail about any of these issues (as well as a few others I didn’t mention), I hope this helps to get you going in the right direction.
If you want further information about MGE or would like to contact Ms. Blumberg, call (800) 640-1140 or e-mail her at sabri@mgeonline.com.
Sabri Blumberg provides this general dental practice management advice to furnish you with suggestions of actions that have been shown to have potential to help you improve your practice. Neither MGE nor Ms. Blumberg may be held liable for adverse actions resulting from your implementation of these suggestions, which are provided only as examples of topics covered by the MGE program.
MGE’s weekly webletter, Issue 18.
Here is the next edition of MGE’s weekly webletter. The purpose of this webletter is to provide ideas, tips and suggestions to make your practice more successful.
Feel free to send us your comments and suggestions, or requests for future webletter topics you would like to see covered.
Reactivating Your Patient Base
By Jeffrey M. Blumberg
Chief Operating Officer, MGE
What is an “active patient?” Depending on who you ask, it can be any patient who’s been in for some kind of service in the past year or two. From my experience, it’s normally defined as a patient who’s been in within the last two years.
OK then. How would you define an “inactive patient”?
Using the criteria above, this would default to someone who hasn’t been in the office within the past two years. You could also add patients with whom it is confirmed that they will not be returning (moved, etc.).
In the case of buying or selling a practice, I’d have absolutely no problem using these definitions when working to establish the sale price.
However, if you’re using these criteria in managing your practice – I believe that you’re making a grave mistake.
Inactive Patients
From my experience, the most common reasons patients are termed “inactive”by a dental office are:
- The patient says they don’t want to come back,
- The patient has passed away,
- They’ve moved out of the area,
- They’ve changed insurances and are now on an HMO or PPO plan for which the office is not a provider and
- The patient misses their recare (or other) appointment(s), the office tries to contact them a few or several times to reschedule and if they cannot be reached, they are deactivated when the office does chart audits.
Reasons “1” through “3” make sense. Number “4” is not an absolutely “black or white” issue and I’ll cover this later in this article. Reason number ”5,” however, makes no sense.
Based on personal experience and observation, along with numerous discussions with dentists, reason “5” above is the most common reason a chart is made “inactive.” In other words, in many cases the majority of a dentist’s “inactives” fall into this category.
Usually after a patient misses or cancels their recare visit, there’s some follow-up – a few phone calls, a postcard or two. But in the main from what I’ve found it’s not much. I’ve seen cases where the patient wasn’t followed up at all, only to be “deactivated” two years later during a chart audit.
In my discussions on the subject with doctors and office managers, I’m always assured that these records are kept handy and that if any of these patients happened to call back in, they would, of course, be scheduled for an appointment. Unfortunately, the consensus is more or less that once a patient is made inactive, there’s no real effort to contact them.
For a practice to spend however much it spends marketing for new patients, or in the case of referrals, the time and effort building enough goodwill to get them, it makes little sense to turn around and “drop” a patient after a few phone calls go unanswered or unreturned.
The “Inactive” Patient
Have you ever had a patient come back to the office after being gone for two, three or maybe more years? Chances are you have.
Now, did that patient ever think of themselves as an “inactive” patient due to their absence from your practice? Probably not. In their mind, they just hadn’t “been there in a while.” I think you’ll find this to be the case with most patients who you consider to be “inactive.”
Look – people get busy, life happens, things happen. They tend to forget about things. It happens to the best of us. Don’t take it personally when a patient hasn’t been in for a while and write them off as “someone with a low dental IQ who doesn’t care about their teeth.” Instead, take a different viewpoint – they are your patients whether they are showing up or not and your office’s job is to work with them to get them in and help them.
From a business standpoint, approaching it any other way means that, at best, you’re wasting a portion of your patient base and any goodwill or potential referrals they might bring.
And keep something else in mind: you’ve probably had a patient or (twenty) that despite your best efforts hadn’t been in for years. All of a sudden, they have a problem – toothache, etc. They show up, you take care of them and find they experience resurgence in their desire to take care of their dental health. They come in for a new initial exam, follow through with their treatment and become a regular patient. We’ve all seen it. While they were initially motivated to take action because of a problem, they followed through with the rest to avoid future problems due to a renewed sense of importance for their dental health.
With all of this in mind, let me pose two scenarios:
In Doctor “A’s” practice, they “deactivate” a patient if they haven’t been in for two years. No communication follows. They file the chart away or deactivate it in the computer.
Patient “X” has been deactivated. It’s been four years since he’s seen Dr. A. He gets a toothache. Having heard nothing from Dr. A for about two years, there’s a fair chance he’ll call another dentist.
In Doctor “B’s” practice, they stay on top of patients who aren’t scheduled with regular communication and mail (letters, newsletters, etc.) regardless of how long it’s been.
Patient “Y” hasn’t seen Dr. B in four years. He has a toothache. He’s received regular mail and occasional phone calls (as part of a reactivation program) from the office to schedule an appointment. He never appointed, but always appreciated the calls. The regular mail and newsletters from Dr. B have in effect kept Dr. B’soffice “on the brain.” Who do you think Patient Y calls for his toothache? Most likely Dr. B, as “Dr. B is his dentist.” He hasn’t been “forgotten about” even though he hasn’t shown up.
Now, of course, this is simplistic. Other issues such as customer service and whether the patient actually liked the office come into play. But I hope you see the moral here.
In Patient “X’s” mind, Doctor A is a dentist he saw four years ago.
In Patient Y’s mind, DOCTOR B IS HIS DENTIST.
When to Deactivate a Patient?
For MGE Clients, we suggest a simple philosophy as to when to “deactivate” a patient:
- The patient doesn’t want to come back.
- The patient has moved very far away (i.e., out of state) and has said they won’t be coming back.
- The patient has passed away.
- You decide to dismiss a patient.
And that’s about it.
Note: If you find yourself dismissing a patient, make sure it’s for a good reason and always ensure you do it per the letter of the law as outlined in your state’s Dental Practice Act or other applicable laws. I would also suggest consulting your attorney and/or malpractice carrier if you wish to dismiss a patient to ensure you’re doing it right.
What about Patients Who Join an HMO or PPO?
Of course, you may run into issues where a patient joins an HMO or PPO in which you don’t participate. Does this mean you should drop all communication and “deactivate” them? Not necessarily.
In the case of PPO patients, there might be no problem at all, depending on your fee schedule. HMOs may be a different story.
While you would take a patient who’s left your office to go a participating dentist off of any recall lists, you can still keep them on any lists for newsletters and any type of seasonal mailings you might do. So, while you may not follow up with phone calls, they could still receive regular communication (mail) from your office.
It’s a lot more common than you might think for a patient to leave an office to go with a participating dentist, only to come back to their original, nonparticipating dentist. The reasons vary – they liked the old office better, the HMO office made them wait too long, etc. Either way, if there’s a chance this might happen, regular mail only facilitates this process. At worst, you might get a few referrals from this ex-patient.
Summary
Very often, I’ve found that marketing to past and present patients gets a higher response than to potential new patients. Why? At least your past and present base have an idea of who you are and have actually been to your facility. Potential new patients have never met or seen you before. This doesn’t mean you don’t market to new patients. It means that you shouldn’t ignore your existing base.
If you would like some direction on this issue, ask for a copy of our “Reactivation Program.” It includes a step by step procedure for reactivating your patient base, along with sample letters and the like.
If you really want to go all out, come and do the MGE New Patient Workshop. We’ll show you how to cover all the bases – internal marketing and external marketing for new patients along with information on how to reactivate your existing patient base.
Just remember, whether a person shows up regularly or not, they are still your patient. Treat them that way.
Wishing you the best!
PLEASE NOTE: This article provided by MGE: Management Experts, Inc. consists of suggestions and ideas that could be used to help improve the solvency and viability of a dental practice. There is no guarantee that the information provided is appropriate to your practice. Each practice, their owners, officers and staff are individually responsible for ensuring that any system implemented in the practice complies with the applicable federal, state and local accounting, tax and employment laws, rules and regulations governing the place in which your practice is located. These suggestions do NOT constitute legal or accounting advice. You should seek advice from your own accounting and legal advisors as to what is appropriate to implement in your practice, prior to implementation. MGE: Management Experts, Inc., its officers, directors, shareholders, employees, agents and the writer of this article, are not responsible for any claims, real or otherwise, associated with this material and information or any part thereof.
