My Practice Is Killing Me: Fat, Sick and Nearly Dead

Maybe a tad dramatic I know…but not far from the path I was headed down. On the outside my life looked great. Smart, beautiful wife, healthy kids, cars, nice house, great vacations, and multiple profitable practices….but all of it was taking a toll on me. I gained weight, was not fulfilled, and constantly stressed inside (although you couldn’t tell from the outside).

WHY?

Because I was the bottle neck for everything. I was doing it all because I didn’t trust that anyone could do it better. I thought “if you want it done right, do it yourself”. This could not be further from the truth. There are so many people out there that could do a much better job. So what did I do?

1. I found talented team members
2. I trained them to do the things I needed them to do

A question I always ask myself now is “How can I do this for the last time?” Now of course that’s not always possible but it is for a lot of things. The way to do something for the last time is to do the following:

1. Document the step by step process of how to do it
2. Train someone else to do it
3. Hold them accountable

This is a SYSTEM

You can do this for most task in your life and business!

In the context of building a high-performance practice, you will need to know what results you want and figure out what your team needs to do day-in and day-out to achieve those results.

To keep this super simple, I’ll outline the steps you need to follow to start documenting your system:

1.Discovery Meeting
Schedule a meeting with a key team member–your manager, or maybe it’s your spouse–to discuss exactly what you’re wanting to do (including WHY). Explain that you want to document all systems and processes in the office. You would like the information in a detailed and simple form so that it includes the step-by-step of each position, along with a flow chart if applicable and accountability tools (how you are going to measure the result of this process). Explain that you would like this done for each position and system. What you should have at the end is the start of a standard operations manual.

2.Task List
Now the key team member’s job is going to be reaching out to the individual team members. They will meet with the receptionist, clinical assistant(s), hygienist(s) and dentist(s) and ask them to please list everything they do all day long. The result will be a relatively accurate roles and responsibilities list. Each of these roles, like checking patients in or out, converting patients into treatment plans or delivering treatments are tasks involved in new patient experience.
You are looking for enough detail that you get a good understanding of what your team actually does (not necessarily what it should be doing), but not so much detail that they document their mouse clicks on an intake form. I don’t need to know everything about how a new patient is entered into the software, as long as we have all five pieces of necessary information.
Name, contact information (email, phone number), insurance breakdown/policy number and how they heard about the office. The order in which this information is collected is not important, nor is the EXACT verbiage. As long has they are polite and effective, leave them alone. Nit picking will only result in conflict and your team feeling you don’t trust them to use their best judgment.

Have the key team member review and add any items that were missed or overlooked and then get it reviewed for approval.

3.Identify Gaps
Decide what you are looking to accomplish. Write down all of the goals you have for your new high-performance practice. What do you want to see in terms of revenue, profit, new patients, treatment acceptance and many others? This is the purpose of your budget. Review all of the responsibilities lists your team has submitted with your key team member(s) or A-players.
Are these processes sufficient to get you where you plan to go?
What things do you have to add?
Are you missing systems?
Are you missing components of systems?
What are the right measurements to use to verify these processes are working?
Brainstorm these with your key members. Then add those in. Now you have a workable model.

4.Draft Procedure
By this time you probably have a lot of different versions and the documentation process is nearly complete. Use a clean sheet of paper and neatly rewrite (type!) the procedures. Include any supplementals like diagrams, measurements and references.

5.Review and Revise
Have your key team member(s) read and review each procedure to ensure continuity and suitability. If you do not have A-players as key members, find a mentor, a coach or another successful dentist. They may provide you with their system which you can then adapt to your needs. By the end of this step, you will have documented what you are doing now, made changes or added steps and are now ready to roll out your system.

6.Implement
Time to bring it to the people. Have a launch party! Celebrate this major milestone in your practice. Everyone should feel like this is a big win for them. Train each of your team members on the procedures for which they are responsible, along with how to provide feedback about what works and what doesn’t throughout the coming weeks or months.

7.Measure
Measure your team’s performance in each of those areas. Let’s use accounts receivable (A/R) as an example. If your A/R system is good, you should be at 97% or more. Suppose you are continuously operating at 90%. There’s no fraud and people are doing what you’ve asked them to do. The numbers indicate that there is a problem with the system and it needs to be revisited. You can’t manage what you can’t measure.

8.Follow up
Measure the procedure and then go back to change the system or tweak it based on two things:

• Metrics
• Staff and patient feedback

Measure, take feedback into consideration, optimize, and move on quickly towards success in this area.