Scheduling For Productivity 1

Seven Principles that will Lower Your Stress and Increase Your Production (Part 1 of 2)

by Tyson Steele

Almost every dentist we talk with in the Pacific Northwest faces a busy schedule. Really busy. Between restorative treatment, emergencies, exams and all the procedures that turn out to be more complex than expected, stress levels are up, productivity is down and free-time is priceless.

Many of our clients come to us with a desire to be more "efficient." They figure their problems will be solved if they just speed up their endos and crown preps or begin using "expanded hygiene."

Unfortunately, speed and efficiency may increase with these techniques, but that doesn't always translate to lower stress and increased production. In fact, most of the "highly efficient" dentists we've studied are just cramming more procedures into shorter and shorter appointments.

We call this the "roller skate" approach. It hinges on the erroneous assumption that to be "busy" or "efficient" leads to productivity. Instead, it leads to more stress and, often, decreased productivity.

Productivity

So, what is productivity?

Productivity is the measure of dollar volume of treatment completed in a certain period of time. In order to accurately measure productivity, we look at the dollar volume completed per eight hour day. In other words, Dr. South's practice may produce $68,000 per month while Dr. North produces only $58,000 per month. But if Dr. South worked 19 days ($3579/day) while Dr. North worked just 13 days ($4462/day), Dr. North's practice is actually the most productive.

In this article we'll analyze the seven Scheduling for Productivity principles that enable our archetypal dentist, Dr. North, to be so productive.

1. Daily Goals

It helps everyone on the team, especially the scheduler, to have daily production goals for the dentist and each hygienist. Scheduling for daily dollar production helps the scheduler differentiate between "busy" and productive. The goal no longer consists solely of "filling the schedule" but of filling the schedule with the "right" treatment.

Dr. North's team tracks the daily goals in the morning huddle, helping providers and schedulers to take gradual steps toward developing a more productive schedule. Also, Dr. North sets daily goals that are achievable with effort and appropriate for his practice style and fee schedule, knowing that overly high goals will disillusion team members.

2. Appropriate Fees

Fees must be appropriate for your community and your type of practice. Many dentists have fee schedules that are so low for certain procedures that they actually lose money every time they perform that procedure. The length of time it takes to perform the procedure, lab fees, staffing, rent and all the other overhead items can cost more than the fee collected. In other words, you could be paying to work!

Of course, some procedures are very difficult to perform profitably. But, you should at least have an idea that you are breaking even. Otherwise, you may find yourself very busy but not very productive.

If raising fees is an emotional issue for you and your staff members, keep in mind that dental practice overhead has increased from 56% to 69% during the last 12 years while, on average, fees have barely kept pace with inflation. During the same 12 years, however, advances in the quality of dental care have been phenomenal. By establishing appropriate fees, you are only asking what every other business is unafraid to ask . . . to receive adequate payment for the service rendered.

Dr. North reviews his fees annually, increases them at least enough to cover increased overhead and inflation, and focuses on providing great value for the patient's investment. He discounts his fees or performs complimentary procedures on a patient by patient basis, helping those who need help while charging the rest of his patients appropriately.

3. Block Scheduling

Block scheduling can take many forms. Essentially, it is the process of attempting to develop a "perfect day" schedule, placing tougher procedures during your most effective times of day, blocking out time for new patient exams, having a system in place to deal with emergency patients, and everything else. Please note that I said, "attempting to develop a perfect day schedule." In dentistry, there will never be an actual "perfect" day. But, with proper planning, some days can be more perfect than others.

A vastly important aspect to lowering your stress level is to finally "decide" that dentistry is a free-flowing profession and half the enjoyment comes from dealing with all the changes, shifts and obstacles that come up each day. This is an important paradigm shift -- enjoying the rollercoaster rather than fighting it.

Of course, enjoying the rollercoaster doesn't mean you can't do anything to smooth the ride. Schedule a staff meeting, pull some old schedules and discuss ways the day could be improved. Ask yourself, "In a perfect world, how would this day flow?" Then ask yourself, "In the real world, how would this day flow almost perfectly?" Be certain to consider all the inevitable unforeseen problems.

Dr. North has had each staff member develop a "perfect day" schedule. His team discussed scheduling strategies in team meetings and established "ideal" blocks of time and specific days for certain procedures. His scheduler strives to stay within the ideal blocks as much as possible, and the whole team maintains an open dialogue regarding the schedule.

(to be continued)

Watch for Part 2 of Scheduling for Productivity including the final four Scheduling for Productivity principles in our next issue. In the meantime, begin applying principles 1-3 now!