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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:  

Time Study

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: 

  1. The time the patient arrived
  2. The time the patient is seated
  3. The time the procedure begins
  4. 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. 

Scheduling Appointments

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:

 

  1. Schedule based on the average procedure times unless the doctor or hygienist specifically requests more time based on knowledge of the patient. 
  2. Only major appointments are scheduled for the first several appointments of the day. 
  3. A longermajor appointment is ideal for the first appointment of the day as doctors and assistants are fresher first thing in the morning. 
  4. 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. 
  5. Two to three hours of minor and miscellaneous appointments are scheduled after lunch. 
  6. 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).

  1. Never book minor or miscellaneous appointments in the middle of major appointments. 

Offering Appointments

  1. Never ask a patient what day or time “works for them”. 
  2. 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.
  3. 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. 

Example:

"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.”

 

  1. 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.

Accountability

  1. One person needs to be overall responsible for the schedule. 
  2. 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. 
  3. All appointments are initialed by the person who made appointment (staff field).

Stay On Schedule

  1. Doctors and hygienists should never do more work than is scheduled unless additional treatment can be done without delaying the next patient.
  2. Ideally, there is one assistant per room. Each DA is responsible for their room’s production.
  3. The doctor should delegate whatever he/she can (x-rays, temps, etc).
  4. Verify that emergency patients are actual emergencies. If a true emergency, the patient should know they will likely have some waiting to do. 
  5. Potential emergency slots for the day can be named during the daily huddle. 
  6. 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. 
  7. 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.
  8. 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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What Does A Dental Consultant Do? Charge?

Many dentists will tell you dental consulting works. If dental practice management firms had no worth or benefit they could not stand up to harsh economic realities for long. What a veteran dental consultant brings to the table are systems and protocols successfully implemented in other practices that have been improved and tweaked over many years. Top dental consultants talk and network with each other. They pay attention to what works and what doesn't work across all dental practices.

Marketing & New Patients

Practice management consultants generally have little marketing training or background. 

Note: Cambridge'a consultants are Certified SEO and Ad Words Specialists

Dental Office Systems

Key systems dental consultants implement:

  1. New Patient Phone Call
  2. Insurance Processing
  3. New Patient Experience and Patient Education
  4. Financial Arrangements
  5. Scheduling
  6. Confirmation
  7. Unscheduled Treatment Followup
  8. Reactivation
  9. Huddle
  10. Stat Monitoring
  11. Daily and Weekly Checklists
  12. General Policy Manual

Your Staff

You will not get much ROI from your dental consulting if your staff do not have your back. You do not beed a team of cheer leaders jumping up and down with enthusiasm, but you do need staff who are smart and take some pride and ownership in what they do. If there is more than the usual drama in your practice that needs to be sorted out before you will get any real results.

Staff Accountability 

What gets monitored gets done.

The "big" obvious numbers are important to monitor, but when you look at them they are typically already "in the books". You want your team to concentrate and be accountable daily on the "small" stats that bring about the "big" stats. How many practice owners know how many calls were made to unscheduled patients each day or overdue re-care or inactive patients? Many dentists vastly underestimate how much daily "outflow" is needed to keep a schedule full. How may dentists know what % of slots were open in their hygiene schedule each day? How many know how many NP calls there were yesterday, who scheduled and if they end up showing up? More importantly how many staff know considering it's their job to do?

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 re-care or need reactivation. Other staff can and should help in coordination with the accountable employee, but that employee accountable reports daily on a spreadsheet like this: 1. # of calls or personal texts sent 2. # of contact
3. # of appointments with name and date 4. # of arrivals

It is the employee who is either making themselves valuable to you or not. If they are doing so, dismissing them will never enter your mind. On the other hand, if they are not making themselves valuable, you will be doing them and yourself a favor by giving them the opportunity to find a practice or other employment that is a better fit for them.  

Leadership

What most practice owners are missing is not how to book an appointment but how to be effective leaders. 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. Agreement among all team members is key. Your written office policies should contain those agreements and should answer most questions staff come up with. Doing so will save you much time and simplify the management of your practice. Staff non compliance is a sure sign of poor leadership. The primary reason practices underperform is staff non compliance.  Key traits of leaders. All it takes is discipline: 

  1. Always keep a cool head especially when "under fire"
  2. Realize that all mistakes are an opportunity for you and your staff to learn.
  3. Set a good example.
  4. Always be learning.
  5. Take care of yourself.
  6. Fight the impulse to address multiple issue at the same time. Frantic activity creates spotty results.

Cost

$35.000.00 is the average fee for a one year program with dental practice management companies you are likely familiar with. For those companies that require you and your staff to travel to their facility or seminar you also need to add in the cost of travel, staff pay and lost production from time away from your practice. 

Questions You Should Ask

  1. Do you and/or your staff have to travel or does the consultant come to you?
  2. Is the program mostly one on one consulting versus seminars or courses with multiple clients in attendance? There are advantages to both.
  3. 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.
  4. 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.
  5. 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.

If you do a little homework it should be fairly easy to pick a reputable consultant that is a good fit for you and your practice.