The Bio-Engineering Co.

Do too many of your patients find it difficult to cooperate during treatment?  Do you have a specific program in place to deal with this?  Do you have at least one clinical team member properly trained to make that program a success?  If not, maybe this pearl can help.

In general, there are three types of patients:

1) the many who naturally cooperate

2) the few who are naturally uncooperative

3) those who would cooperate if they knew WHY, HOW and WHEN.

You will have limited success with the uncooperative patients, typically ending up with a compromised or terminated treatment.

You can have much greater success with those who would cooperate if they knew how.  These are the patients who want help; and if you don’t give them enough, you will lose them and/or waste your resources and reputation.

The best way to help all of your patients is to have a comprehensive patient training program to assure their cooperation.

To have an effective Patient Cooperation Program you need:

1) a Patient Trainer (PT) to do the patient training

2) a Patient Training Program to help the patient

3) a Program to Train the Patient Trainer.

See the attached PDF for such a program.

Does your treatment seem to fall behind on non-cooperative patients?  Are your patients and families upset because they are in treatment too long?  Are your referring dentists upset with not knowing how treatment is progressing?  If so, maybe this pearl can help.

With the advancements in braces and archwire technology there is a trend to have appointments as many weeks apart as possible.  This is good because the patient comes in less and there is a slight decrease in the number of patients seen per day.

But this trend toward long appointment intervals (over 8 weeks) is getting out of hand and run-on cases have increased dramatically.  Lets face it, if you have an appointment interval of 10-12 weeks, and the patient isn’t cooperating, your treatment will be 2-3 months behind by their next appointment—not good!

In the past, a simple check on the progress of treatment every 6 months was realistic—it is not very realistic today.  But, a periodic review in the projected middle of treatment or at a specific stage of treatment is realistic and very helpful for reducing potential run-on cases.

Triggering the review is the difficult part and requires that you code the Tx Chart.  Some computer software systems even have a review date system built in and are very helpful for indicating when a review is needed.  If so, you can pick out a significant date in Tx (10, 14, 18, etc., months) when you should have a certain level of tooth movement completed (i.e., leveling, rotations, retraction, etc.) and use that date to trigger your review.

Other than keeping your treatment on track and informing the patient/family of their progress, an important aspect of a review is to get the patient back to their family dentist for an exam and cleaning and to tell the dentist the status of treatment (so that he/she can intelligently respond to the patient/family when asked).

Not having a review is a recipe for disaster, but at least one review/start can head that off.  See the attached PDF’s and Word® files to set up your review system.

Is your Financial Coordinator a strong analyzer who pays attention to financial detail?  Is your Financial Coordinator a weak director who finds it difficult to collect past due accounts?  Unfortunately, this is typically the situation, but this pearl can help you to reconcile this dilemma.

A typical Financial Coordinator is usually a task-oriented-person with a strong analyzer style, but a weak get-it-done director style.  The strong analyzer style allows her to work on accounts, paying attention to every detail associated with the account.  But a weak director style makes her indecisive and afraid to go after past due accounts.  This is especially true if her relater style is also strong. 

Being an ideal bookkeeper, being afraid to go after past due accounts is natural, but not necessary.  There are a few things to keep in mind when trying to resolve past due accounts:

1) A past due account does not make the guarantor a bad person, just someone who needs help to catch up.

2) The bookkeeper is not doing the guarantor a favor by avoiding them the first month they are past due, they probably just forgot to pay and will appreciate the reminder.

3) If she let’s them get two or more months past due she is doing them a disservice.  Every month makes their past due amount greater and more difficult for them to catch up.

4) When contacting them she should have a mind-set and attitude that she is there to help.  Her first approach is to get them to pay the full amount due by a specific date.  If they cannot pay the full amount she should make a new financial agreement that they and you can live with.

5) Most of all, she should look forward to contacting them so that their problem (and yours) can be resolved amicably.

If she finds it extremely distressing to go after past due accounts she should ask the doctor to allow her to work with a helper who can call the guarantor and resolve their accounts (someone with a stronger director style).  The bookkeeper will still be in charge of the past due collections, but somebody else will be responsible for getting the guarantor's payments to her.

Going after past due accounts need not be a negative experience if you have a positive attitude about working with the guarantor, which is what it's all about.

Print out and give your bookkeeper a copy of the attached PDF "Handout for Bookkeeper".

Also give her a copy of and review with her the attached PDF procedure for "Past Due Control".

And if necessary, find your bookkeeper a helper to make the past due calls for her.

Do your patients look forward to or resent visits to your office?  Are you doing all you can to make their visits as pleasant as possible?  Maybe this checklist for exceptional patient visits will help.

With longer times between treatment visits it is important that every visit be exceptional.  That means that everything is done that is needed to assure a successful treatment.  It also means that it is important that the patient shows up for their necessary treatment.

If you provide the kind of visits that makes the patient happy to be there they will show up on time.  It also means that they will sing your praises to others who will seek treatment in your practice.

Refer to the attached PDF for a checklist to determine whether you are providing the most exceptional treatment visits possible.

Are too many of your exam patients ready to start not getting started?  Do you have too many Will-Call-Back patients after their exams?  Are these Will-Call-Back patients getting lost and thus, not started?  If so this pearl may help.

It is a shame to put so much effort into marketing your exam patients, only to see them not start.  Less than 12% (12 out of every 100) of your exams should waver about starting treatment; making them Will-Call-Back patients.  Some of this is due to the doctor or TC's personality, which can be helped as will be discussed in the next management pearl.  But, no matter what the situation, there will be will-call-back patients that need to be followed up upon and started.  It helps to have an organized system to accomplish this—see the attached PFD for a system that works.

Are all of your current team members fully trained in their positions?  Are your new team members fully trained in just a few weeks?  If not, maybe this pearl can help.

Lets face it, making system changes in your practice isn’t typically met with great staff zeal.  But if your team is a part of the entire process, your success is more probable.

Sooo...Analyze the attachments below to see how the A~D~D~I~C~T straightforward approach works, Decide how you want to improve your Training systems, Design your Training systems to fit your needs, Implement your Training System designs, Critique the effectiveness of your Training systems, and Tweak what needs to be improved.

Obtain your "Team Member Training Management Kit" to install your MAJOR Team member training Systems.

Use past Hiring management pearls to create your Hiring sub-systems (see PDF for listing with attachment).

Refer to the attached PDF to learn about the nine A~D~D~I~C~T MAJOR practice systems and their 45 supporting sub-systems.

Obtain your A~D~D~I~C~T straightforward guide to "Self-Optimize Your Entire Practice"

Do new team members get their OSHA training on day-1, or are you leaving yourself liable?  Is all of your team member’s OSHA training up to date?  Do you have an “instant” OSHA training system in place?  If not, maybe this pearl can help.

If the term “OSHA” were never mentioned again, it would be too soon.  Unfortunately, like taxes, it is a fact of life and the penalties can be severe, especially when it comes to team training.  If you willfully don’t OSHA train your team member before she starts working with patients, the fine is between $5,000 and $70,000 per team member…not fun.

There is no reason not to have a system in place that lets you OSHA train your new team members on day-1 of employment.  Just make that training a part of your new team member “legal orientation”, which every new team member must go through, whether highly experienced or not.  If you only use a periodic OSHA consulting “service” that does not provide “instant” OSHA training, you can be liable.

What you need:

A team member "Legal Orientation Checklist” to make sure that all is accounted for (see page-1 of "Employee Medical & Personnel Record"  PDF)

A “Medical/Personnel Record” (paper file) on every employee indicating that all of the OSHA requirements are accounted for (see pages 2-16 of "Employee Medical & Personnel Record" PDF)

A book/manual, computer program or online "OSHA Training System"

Do you find it difficult to identify where your team needs improvement?  Do poor attitudes that are difficult to confront permeate your team?  Are there team members you would like to improve, but if not possible, replace?  If so, this pearl can help.

Evaluating where a team member needs to improve is not difficult, but it does take time, truthfulness and a systematic approach.  Even though we all dislike criticism (the truth?), we all do want to improve, be thought better of, and feel better about ourselves and others.

Even though most team members seem fully trained, most are not.  And the first step to being fully trained is to identify the areas where they need improvement.  The attached “Team Member Evaluation System” PDF and “Team Member Evaluation form” PDF are adequate to evaluate every team member so that they can be retrained and attain their maximum potential.

This evaluation sub-system of team training, determines who needs to be trained in what tasks.  It also helps to have an effective training program—that is the purpose of the “Team Member Training Kit”, which is one of the 9 major systems that you use to manage your practice.

As far as correcting inappropriate attitudes, most people don’t realize that their attitudes may be disruptive.  Most people think, “There’s nothing wrong with my attitude, but others may have bad attitudes!”

Most of our attitudes stem from our personality, which we naturally think are acceptable—many times this is not the case.  It’s hard to change who we are, which is why it is best to have certain personalities in certain positions to be naturally successful using their natural attitudes.  Even so, some attitudes (listed on the evaluation form PDF) are not acceptable, but once addressed, improvements can be made.  And, if the attitudes cannot be changed, that team member needs to be replaced in her position.

And if they need replacement, the "Organization & Hiring Kit" is the most effective way to do it, once you terminate the undesirables.

Are your team members the best available to employ in their positions?  Are they naturally inclined to do well in their positions?  Do they share a “team attitude” and do they last?  If not, maybe this pearl can help.

Lets face it, making system changes in your practice isn’t typically met with great staff zeal.  But if your team is a part of the entire process, your success is more probable.

Sooo...Analyze the attachments below to see how the A~D~D~I~C~T straightforward approach works, Decide how you want to improve your Hiring systems, Design your Hiring systems to fit your needs, Implement your Hiring System designs, Critique the effectiveness of your Hiring systems, and Tweak what needs to be improved.

Obtain your "Team Organization & Hiring Management Kit" to install your MAJOR Organization and Hiring Systems.

Use past Hiring management pearls to create your Hiring sub-systems (see PDF for listing).

Refer to the attached PDF to learn about the nine A~D~D~I~C~T MAJOR practice systems and their dozens of supporting sub-systems.

Obtain your A~D~D~I~C~T straightforward guide to "Self-Optimize Your Entire Practice"

Is your patient information secure from wondering eyes?  Does your team NOT discuss your patient’s problems with others?  Do you have sufficient documentation at the start of treatment to comply with HIPAA regulations?  If not, maybe this pearl may help.

In order to be compliant with HIPAA and avoid legal and punitive repercussions from disgruntled patients and team members you need to employ the following forms in your practice:

Notice of Practice Policies on Patient Privacy (hand-out given to patient to review at their leisure)

Acknowledgement of Receipt of Notice of Practice Policies on Patient Privacy form (to prove you gave them the notification)… (printed on your letterhead)

Patient’s Level of Privacy Consent form (This orthodontic-related part states specifically what they do and do not consent to in their treatment and is completed by the TC…print on your letterhead)

Staff HIPAA Training Signature Form (to make sure that each team member is educated to comply with HIPAA…print on your letterhead)

HIPAA Patient Complaint form (in case there is an unfortunate incident)

HIPAA Associate Privacy form (for non-partner associates…if you have any…to complete)

HIPAA - Privacy LABELS for paper Tx Chart (if used, or can be put electronically into the patient’s electronic Tx Chart)

Disclaimer: these forms are to help you comply with the complicated HIPAA regulations; they have no legal meaning except that you tried.  Your practice and teams attitude about keeping patient information private is the key to success.

Refer to the attached PDFs for these forms.