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Dental Practice Consulting: Block Scheduling
Your practice will be rushed, hectic and stressed without a schedule that is well designed. The purpose of blocking scheduling is to decrease stress, keep production on an even keel from one day to the next while maintaining or increasing production. These are the steps for implementing with guidelines:
Over two to three weeks get accurate times of every procedure. All staff can help. Create an index card for each patient that comes in. Note the following on the card:
- The time the patient arrived
- The time the patient is seated
- The time the procedure begins
- The time the procedure ends
At the end of two or three weeks, average out the times for each procedure.
Provider times can vary. Schedule based on the specific provider’s times.
Daily Production Goal
Divide your Average Monthly Production for past four months by the numbers of working days for the current month. That is the minimal amount of production that needs to be scheduled per day. Increase the daily goal by 5%-10% if you like.
Major appointments (crown & bridge, partials, veneers, etc.), minor appointments (amalgams, composites, root canal therapy, etc.) and miscellaneous appointments (seats, exams, emergencies, adjustments, etc.) are scheduled as follows:
- Schedule based on the average procedure times unless the doctor or hygienist specifically requests more time based on knowledge of the patient.
- Only major appointments are scheduled for the first several appointments of the day.
- A longermajor appointment is ideal for the first appointment of the day as doctors and assistants are fresher first thing in the morning.
- The rest of that day’s major appointments are filled in, one after the other, typically until lunch. Ideally you reach 75% of your daily goal by then.
- Two to three hours of minor and miscellaneous appointments are scheduled after lunch.
- Book all appointments ten minutes before the end of a previous appointment. Examples:
a. If an appointment ends at 11:00 am, the next appointment should be scheduled at 10:50am.
b. If there is an opening from 2:00pm to 3:30pm never book a thirty-minute appointment at 2:30pm. You would always first try to book it at 1:50pm (ten minutes before the end of the previous appointment).
- Never book minor or miscellaneous appointments in the middle of major appointments.
- Never ask a patient what day or time “works for them”.
- Always offer the next two available appointment times closest to the current day that is best for the practice schedule. If those appointment times don’t work for the patient, offer the next two available times closest to the current day that are best for the practice schedule.
- Motivated patients typically schedule quickly but, if a patient wants to schedule a few weeks out because the times offered “don’t work for them” you should communicate an honest sense of urgency.
"The doctor doesn’t think it’s a good idea for you to wait on this so, if you can make your schedule work, we can get you in tomorrow at 2:00 pm or the day after at 11:00am.”
- If the patient still schedules out more than a week or so, let the patient know you will call them if there is an opening for their preferred time(s). Make notes in their chart. Put on short call list.
- One person needs to be overall responsible for the schedule.
- Other staff will schedule patients depending how you run your practice but, any that do should be familiar with and abide by these block scheduling guidelines.
- All appointments are initialed by the person who made appointment (staff field).
Stay On Schedule
- Doctors and hygienists should never do more work than is scheduled unless additional treatment can be done without delaying the next patient.
- Ideally, there is one assistant per room. Each DA is responsible for their room’s production.
- The doctor should delegate whatever he/she can (x-rays, temps, etc).
- Verify that emergency patients are actual emergencies. If a true emergency, the patient should know they will likely have some waiting to do.
- Potential emergency slots for the day can be named during the daily huddle.
- Overly late patients are only seen if the work done will not keep the next patient waiting. The front desk must get doctor or hygienist approval before bringing the overly late patient to the back but, again, only see the patient if doing so will not keep the next patient waiting.
- Some practices double book a slot using their “short call list” if a scheduled patient has not confirmed. If the unconfirmed patient shows up, the unconfirmed patient is seen after the “short list” patient but, again, only with doctor or hygienist approval and only if doing so will not keep the next patient waiting.
- If the schedule falls behind, the front desk asks the next patient if they would like to wait or reschedule.
Kevin Tighe, Cambridge Dental Consultants, Senior Consultant, got bitten hard by the business and marketing bug during long summer days working at his dad's Madison Avenue ad agency. After joining Cambridge as a speaker in the mid-1990s, Kevin went on to become Cambridge’s senior consultant and eventually CEO. Cambridge Dental Consultants is a full-service dental practice management company offering customized dental office manuals. Frustrated? High overhead? Schedule a chat with Kevin at
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There is the good, the bad and the ugly of dental practice management, but many dentists will still tell you the probability is your dental consulting will work if you and your consultant are on the same page. It stands to reason that if a dental consultant had little value, worth or benefit that consultant could not stand up to harsh economic realities for long. A veteran dental consultant is also a "personal coach" who shold bring management wisdom based on "in the trenches" experience along with systems and protocols to that have been successfully implemented in other practices. Top dental consultants talk and network with each other. They pay attention to what systems work and don't across many dental practices.
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Daily and Weekly Checklists
General Policy Manual
What gets monitored, gets managed. It is as simple as that. The only way to monitor what gets done is with daily stats especially for your weak areas. For example, one employee should be specifically responsible for calls to patients who are unscheduled, overdue for re-care or need reactivation. Other staff can and should help in coordination with the accountable employee.
What most practice owners are lack in knowledge is not how to book an appointment, but rather how to be an effective leader. The best systems in the world are useless if the staff do not comply. Good leaders know how to get staff to willingly follow through and comply.
Questions To Ask
Do you and/or your staff have to travel or does the consultant come to you?
Is the program mostly one on one consulting versus seminars or courses with multiple clients in attendance?There are advantages to both.
If the dental consulting is one on one who will actually deliver the consulting? I recommend knowing who your specific dental consultant will be prior to signing on the dotted line.
Is program based on a specific dental practice management system? You want to avoid cookie-cutter programs. Ensure the program will be tailor-made to fit your practice's specific needs.
The cost (including travel expenses and downtime) is certainly not the only factor, everything else being equal, it is still a major factor to consider. It's unwise to pay too much, but it's worse to pay too little.
Top Dental Practice Mangement Consultant
My name is Kevin Tighe. I am Cambridge's CEO and Senior Consultant. Before joining the Cambridge team I was in charge of setting up workshops for large nonprofits throughout the United States and Canada. During that time, I was fortunate to receive mentoring from several world-class business consultants, including a dental practice management guru, which led to a position at Cambridge as their seminar organizer. In time, I began crisscrossing the country delivering seminars myself for the better part of a decade. Subsequently, I moved up to senior consultant and eventually owner. Contributing writer to Dental Economics/DIQ, JADA, AGD Impact and Dental Town Magazine.
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