Thoughts on having a Non Disclosure Agreement with Employees

Post from DSN User:

“Does anyone have experience using a non disclosure agreement with employees?

I’m wanting to protect intellectual property. I know it is standard business practice in many fields and wondered if anyone here has any insights.

Thanks!”

 

Commentators:

  • “This seems like something that would be difficult to do. There’s not much that’s truly innovative or new in dental ideas, so to plant your flag as protected IP seems tough to enforce. Can you give some broad examples of what you consider IP? I personally feel that ideas are a dime a dozen but execution is the key to success.”

→ Original Poster Reply: “specific marketing strategies, systems that we develop, etc”

→ Original Commenter Reply: “I guess I don’t personally feel the need to protect those things. We execute them in a way that would be hard to properly duplicate. But I do understand wanting to protect it.”

→ Original Poster Reply: “I can understand that. We’ve had some employees leave and do destructive things. I’m trying to minimize more of that in the future”

  • “I have it in my employee manual as well. Key team members sign a more robust one. My attorney wrote them for me. I had to provide a bonus for signing them as well. For me it wasn’t about enforcing as much as it was about making sure my team understood my expectations of them. It made them feel more important too.”

 

This DSN user feels that it is necessary to have a non disclosure agreement with his employees. He has experienced retaliation from previous employees and would like to implement something that will prevent it from happening again. This makes sense, right?

 

According to one of the commentators, he feels that it doesn’t seem necessary to have a non disclosure agreement because within the dental field there aren’t any true “new” ideas.

 

Another commentator agrees with the original poster and has stated that she has her agreement incorporated within her employee manual. She said, “I don’t want someone walking out with my manuals to go next door to implement it.”

 

As dentists we work hard to get our practice in order. We implement systems and protocols. With our team we share specific marketing strategies. Even though the ideas may not be original, we still spent many hours perfecting these ideas so that we can run a smooth practice. So why shouldn’t we implement something to protect us from being taken advantage of?

 

As a DSN member you are free to ask all questions that come to mind when trying to improve your practice. Not every member is going to agree or like your idea but that is totally okay. DSN is a place where dentists can come together to discuss ideas openly without fear of being shunned or ignored.  If you’re looking for more actionable information like this, join DSN!

Advice on Outsourcing Insurance Verification

Post from DSN User:

“I have been looking at outsourcing Insurance Verification and A/R for a long time. After mistakes and poor employee performance, I have decided it is time to make the transition.

Anyone with experience with eAssist or Practice Mechanic?”

 

Commentators:

“I’ve had a phenomenal experience with eassist … but it has a lot to do with the person that manages my case, I think. We had a lengthy conversation about them last week. If you search “eassist” you find that thread and see what others think.”

———–  Original Poster Reply: “I will have to set up a demo with them…I don’t like the minimum fee though….I am a small office I get more CC and cash then insurance payments”

————  Reply: “We’re heavy PPO. I did notice that it’s still less expensive than a full time employee when you factor in taxes and benefits. In addition, you get 2 people assigned to the accounts – so it just made sense for us. Our collections are over 100% actually because we’re collecting on old debt now.”

 

As a Dentist and Practice Owner there are an endless supply of decisions to be made. No one wants to jump into something without knowing what they’re getting into. When you purchase something online more times than not you look at the reviews to see if the product is worth the money. When making business decisions the concept of seeking reviews first still applies.

 

The community that Dental Success Network has created is phenomenal in the sense that you can offer your opinion on a product or service or you can seek other’s opinions. Everyone within DSN is actively working to help one another succeed. If you need advice on a service- DSN. If you need help with a case- DSN. If you just need to vent because after an hour  with a patient you still couldn’t help them- DSN!

 

If you’re looking for more actionable information like this, join DSN!

Informing your Patients of any change within your Practice

Post from DSN User:

“Getting out in front our a major storm coming . . .

As I scale back clinically in an attempt to work on the business and serve my doctors to make them the best  possible, we are discovering patients upset/frustrated that I am no longer available to provide them care.

My team understands the vision. I have preached to them for almost 2 years that this was coming and that I can help exponentially more people away from the chair than I can at the chair. They get it.

My team is struggling to communicate this to the patients in a way that appeases them.

The team has asked if I make a short 5 minute video explaining to our patient base what our vision is and why I need to reduce my clinical time in order to make our why happen. I routinely make videos to communicate ideas to my team and patients so they thought this would be an ideal solution.

Do you think this is a good idea?”

 

Commentators:

“I think it’s a great idea. Having gone through this myself, you’re patients just want to know the why. Most will be good with hearing it from you & understanding. Especially if you endorse the authority of the docs you are entrusting their care to in that video. Another thing I did as I scaled back my clinical time was raise my fee schedule above the other Docs. If you’re in network then go out of network. So your patients who still want you can have access to you but they are going to have to pay more for that access or they can choose one of your trusted associates instead.”

 

“I like the idea of either raising your fees or going out of network. I also like the idea of a letter better than video. Even when printed and sent to many, a letter has more of a personal feel than a video, which seems to be designed for mass production. Maybe it’s just me.” 

 

Conclusion:

Original Poster

“Such great feedback. I’ll do both! A letter and a video. I’ll share it here for anyone that’s interested.

Just to be clear, the purpose of this isn’t to prevent patients from leaving the practice. 99% of them are not going anywhere. The purpose is for our patients to hear directly from me what’s going on and why things are changing. My team has tried to communicate it but still there is a gap.”

 

Thanks to DSN and its members this DSN user was able to gather feedback and make a decision. He decided that creating a video and a letter will be beneficial due to having both young and mature patients. He wants to make sure that all of his patients will be aware of the change about to take place in his practice. If you’re looking for more actionable information like this, join DSN!

Torn between Patient Confidentiality and the “Right” Thing

Post from DSN User:

“Any thoughts…

I have a patient that I have been treating the past few years and she’s now 19 years old freshman in college. Yesterday she presented for treatment with fractured crowns number 8, 9 ,24 25. When I asked her what happened, she said this was confidential between myself and her that she was involved in an altercation with a boyfriend who punched her and broke those four front Teeth. Now her parents do not know about this / she told them some story about what happened. I really wanted to let mom know who brought her but that would be a HIPPA violation! I’m wondering if I should report this case as abuse? I gave her a number to call for battered women. I was just curious to see what folks think about this situation. How would you handle it? Thank you.”

 

What is one to do when reporting abuse can be a HIPPA violation but you fear for this patient’s safety and would want nothing more than to protect them? Do you stick to your morals and report the abuse and just apologize for breaking the law later? Or do you keep quiet because this patient trusted you enough to confide in you and you wouldn’t want to break that trust? This is one of those lose-lose situations. The kind of situation that leaves you with a pit in your stomach even after you’ve made your decision.

Luckily for this DSN User he is able to reach out and seek advice. He doesn’t have to dwell on the choice on his own. He’s apart of a Safe Place where everything is kept confidential. Here is what other DSN Users had to say in regards to this lamentable situation:

 

Commentators:

 

  • “I’d report it. She could have told you any story to move along the apt but she chose to mention the abuse. It means she trusts you a lot which is great. it’s definitely a hard decision either way.”
  • “What if this was your daughter? What if next time instead of breaking a few crowns he kills her? I would make a decision based on these questions. Could you live with your decision to report, or not to report?”
  • “She’s an adult and you don’t report domestic violence. If she was 17 that’s a different story. Telling her parents would be breaking her trust. If this is a serious domestic abuse case he could kill her if word got out in the wrong way. All you can do is ask her if she would like to report it and if she wants your help to do so. This is coming from my wife, a counselor, and sadly deals with this stuff all the time up in AK. Not to mention you would be breaking HIPPA laws.”
  • “I’d have a heart-to-heart with her and encourage her to report it to the police.”
  • Heartbreaking.. As a father of 2 precious daughters, my heart goes with Dr. George Sanchez. I would NEVER forgive someone for withholding such information. Unfortunately, I think Dr. Derek Green is correct regarding the law. Ask a cop friend, attorney friend for state specific law regarding this. Ask her to sign a HIPPA release “so her parents can pay for it”. IDK, worth a shot at staying legal. My least favorite good idea is an anonymous point blank letter to the parents (postmarked far away from your office, best if from her college town). I answer to the Good Lord and assume He will forgive me for breaking this law.”

 

 

As many of the DSN User’s have stated, ‘It’s a hard decision, regardless’, but it’s a decision that has to be made. Some users suggested reporting the abuse himself while other suggested encouraging the young girl to report it herself so that no laws are being broken. There are many elements to take into account when making such an impactful decision. Are there laws that will be violated if reported? Can you live with yourself if you don’t report it? Is it worth breaking the trust of your patient? Could it cause more harm in the long haul? What would you do?

 

But being apart of a community where you can weigh your options with others is valuable. If you’re looking for more actionable information like this, join DSN!

To Pay or Not to Pay

Post from DSN User:

“Ok. True safe place moment:

I place a #30 Implant and patient has it restored. Screw comes loose and he doesn’t tell anyone. GP finds it’s loose during a Hygiene visit and re-tightens screw. It comes loose again. GP remakes crown. Comes loose again. GP refers to pros who adjusts occlusion and replaces screw. Comes loose…because it’s fractured! GP asks me to “fix” it all for free. I do. Remove implant, graft and replace implant. Now GP is asking me to cover the lab bill for the crown now.

This was caused by the patient not telling anyone the screw was loose and had likely nothing to do with my work.

Do I pay the bill just to save face?”

 

Sometimes we’re placed in unfortunate situations where you have to either swallow your pride or stand your ground. Does this User pay the bill and have it seem like she is at fault or does she not pay it and potentially ruin her relationship with the GP?

Commentators:

  • “I always see the big picture. If this is an isolated issue with the GP office, then I would cover it and move on. You will lose here. IMO it’s the price to pay to play this game of dentistry”

———–> Reply from Original Poster:  “I think I have to pay it so the relationship is not damaged with any of the parties. Referrals and Google reviews run everything.”

———–> Reply from Original Commentator: “Unfortunately, I agree with you. I had a guy two weeks ago get hurt by my assistants suction. He praised me and expressed his affection for me, but does not want to come back to my office. Figure that out..? He said he wants all his money credited to his black AMEX or he will take it further…whatever that means. I am returning $6k after all that work and aggravation. It really sucks, but I just don’t need the stress if attorneys and such.”

  • In my opinion a refund is an omission of guilt. I would have an open and honest conversation with the GP and pros. Then send them both gift cards thanking them for working with you. The implant process is just as much the surgeon who places responsibility as it is the restorative docs. I don’t see why you owe the money. But an act of goodwill with a gift card would be nice.”
  • “My instinct is hell no don’t pay the bill…..butttt, how important is this referral source? If it is a big source of patients, I would pay it, but try to make your case about it somehow. Unless you think it will burn a bridge with the referring doctor. I just don’t see how you can be responsible to pay for it though…That’s a crappy position to be in. You already replaced the implant and all? Maybe express that you did your part as a gesture of good will/faith etc. Sorry if the above was already said, I’m sure it was kinda TLDR tbh”

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _

 

It seems as though this DSN User is going to choose to bite the bullet and pay the bill in order to maintain the relationship with her GP. It’s a tough pill to swallow when you know the scenario shouldn’t have played out this way but because there are other factors that can affect the future you do what you have to do. This DSN User received a considerable amount of feedback. Some say ‘HECK NO!’ while others say ‘do it for good measure’. In the long run it’s a learning experience that will help to implement new policies to later avoid other cases like this.  Maybe the biggest take-away as a specialist is that referrals drive your business…and you have to do extraordinary things sometimes to keep referral sources happy. 

Thankfully this DSN User had a place to vent. A place she could go to express her frustrations and hear what others had to say about the deplorable position she’s in. If you’re looking for more actionable information like this, join DSN!

Getting a Deal

Post from DSN User:

“How many docs do we have interested in a Pikos video set deal?”

 

Many of our DSN members were excited and interested in getting a discount for Piko’s video set. Everyone agreed that the videos would be beneficial but the price point was too high. The original DSN member who posted the question delegated the task of negotiating a deal and ended up with an awesome outcome.

 

DSN COO: “I’m happy to try to negotiate a group buy if you or the DSN Director of Vendor’s want?”

Reply from Original Poster: “I’m happy to delegate that to you! Go for it!”

 

1 week later……

 

DSN COO: “Yes, we’re negotiating rates for the DVDs And also discounts for their conference. So… Discount for all pikos stuff. It’s looking promising, they’re eager to work together. I should hear back by this week. I told them we want the option to purchase a la carte or the full package of DVDs. They said also pricing will likely be more aggressive if it’s just streaming as opposed to the physical DVDs. I told them we have doctor’s international that would like streaming so they understood that.”

 

Offer received from company….

 

DSN COO: “Okay, we received the offer, I’ll send to the Director of Vendors and the details to you guys shortly. They’re also offering discount for course registrations.”

 

These dentists came together and Got Shit Done! If you want something, chances are someone else wants to accomplish that same thing. The first step is to throw the idea out into, in this case, DSN’s Workplace community. That’s exactly what this DSN poster did. She asked a question to get a feel of who else would like Piko’s videos and another dentist was able to score the deal through negotiation. It’s thrilling seeing Dentist’s come together to execute greater actions. If you’re looking for more actionable information like this, join DSN!

How do we Track Hygiene overhead and products?

Post from a user:

How do you deal with hygiene products and overhead? My hygienists have requested tongue scrapers, end tuft brushes, proxabrushes, biotene, etc to have as available handouts in addition to our oral b brushes (.93 cents/pt). Those products range from .67 cents to $1.37. On certain prophies, the fee is $65 and the hygienist is getting $46/hour at 1 pt/hour.”

Here’s some input from our experts across the country:

  • Have them in the office as a display for the hygienist. Let them (the hygienist) show them online where they can be purchased or make recommendations. If needed carry them in the office for purchase if needed as a convenience. Only problem is that you will have to account for the sales tax in your state”
  • “Sounds like the way their compensation is set up they aren’t really playing for your team. At that hourly rate, low price prophies in addition to auxiliary handouts, unless they are killing SRP, they aren’t likely earning their 3.3x production salary.”

→ Original Poster response: “definitely not earning 3.3x production salary, which I learned at the summit but is that strictly hygiene procedures or does that include x rays? It’s tough in southern california. A lot of hygienists are requesting $50/hour, even new grads. Thanks!”

  • “Can you give each hygienist a certain allotment every month? For example give each hygienist 5 proxabrushes. They can show patients what they look like and selectively choose who they give them to? Explain to them the concern about the low reimbursement and why you have to limit the freebies. You could also incentivize them with more products with higher production.”

→ Original Poster response: “This is kind of the route I’ve been going and really ordering the bare minimum and I’ve told my lead assistant not to keep their rooms stocked. The hygienists been complaining to my assistant that they need product but I do the ordering for the office”

  • “We show them links on Amazon rather than stock products for our hygienists to give away…same products you mentioned. Many times we’ll copy the link and send them a text message via Yapi. We find that the recommendation and extra time it took for our team to send them the links or even show them that these products exist was a WOW factor that exceeded the actual physical gift of the free toothbrush – which has become an expectation without a value proposition.
  • “Want to blow away a patient? Try bringing up something on Amazon that you recommend for them…I did this with a gum stimulator rubber tip for an ortho patient. Then straight up order it for them right in front of their eyes. Was probably the most expensive gum stimulator I’ve ever purchased at $10 but the ROI in referrals and a 5-Star review was worth it. Obviously don’t want to do this for all patients but I’m working on an internal marketing campaign that has a set monthly budget for our team. They can spend whatever they want as long as 1. It adds to the health of the patient 2. It innovates the patient experience 3. They need to share in a video on our secret Team Facebook site what, why they did it with the rest of the team. The goals are to improve patient health and experience as well as engage team members. “

→ Original Poster response: “Do you give the regular toothbrush at all or just recommendations and links?”

→ Commentator Response: “We do still currently offer the toothbrush. The hygienists noted that they see an increase in those that have electric toothbrushes (haven’t tracked this so just going by their word of mouth) so for those patients we offer the toothbrush for them to gift to someone else.”

  • “Have your recommended products bundled according to their risk assessment and diagnosis. Patients will pay for this convenience. Our product list also shows amazon pricing for transparency purposes.”
  • “ I’m getting tongue scrapers for free from my Sonicare rep. I’m using TePe proxy brush and have them on auto ship which really brings the cost down. Start with a practice box and then see what they use the most. Henry Schein brand end tuft brushes ftw on those. GSK owns Biotene and that is not sampled any longer. Write your own handouts and print in house to keep costs down.”
  • “What if you unleash your hygienists as goodwill and case acceptance rock stars? What if you give them autonomy, give them the tools to take awesome care of patients and train them to be fellow leaders in the practice? They can drive reviews, referrals and doctor treatment. If they help you eliminate external marketing expenses, drop PPOs that only pay $65 on a prophy, and keep your schedule packed with treatment . . . doesn’t that make the cost of the potions and gum gadgets irrelevant? I’m just saying you can turn most any “expense” into an “investment” if you play in a slightly different manner. What if you see them as not just producers, but as a marketing and sales department?”

 

As dentists and business owners there’s a great deal to consider and balance. In this situation the DSN member is attempting to balance their hygienist’s happiness without spending heaps of money. The feedback this DSN member received was extremely valuable. There wasn’t just one solution to the issue. Some members suggested carrying displays in their practice in order for patients to physically see the product but would then provide them with the location to purchase the product. Others said that they set up auto shipping in order to cut costs.

With this feedback the DSN member will now be able to make an educated decision on how they would like to proceed within their own practice. If you’re looking for more actionable information like this, join DSN!

Paying associates using adjusted production: How to calculate in real time

Question from DSN User

 

For those of you paying associates using adjusted production, how are you calculating it in real time? Our write offs don’t occur until after insurance payments come in so how do you calculate this number per pay period? Don’t really want to get into having a different fee schedule for each insurance plan so looking for other ideas.”

 

Commentator’s Suggestions:

From one user:

  1. I’d look at 2018 % write off, and just apply that number.
  2. Pay a daily rate, pay their “bonus” on adj prod every 3 months
  3. Pay them off of collection, or update your fee schedules. Or, pay them a guarantee for 6 weeks, after that pay them on a rolling 5 week lag, so for April, they would get paid first week of May after Adj have been accounted for. Nothing will be perfect in this case, but my ultimate vote is commission off of collection. Granted you don’t have a collection issue.
  4. Help me bro.

I’ve never understood paying off of collections due to the admin burden and risk of inaccuracy.

How do you track collections for each doctor?

Wouldn’t that be admin intensive as a staff member with likely no college degree is applying money coming back into the practice from insurance companies (sometimes 3-6mo later) to the appropriate doctor?

If their tracking is off, doctors get paid wrong, and getting paid for what you do is a hot button for anyone. So accuracy needs to be 99%.

Other doctor with Associates:

“So this is why we allow 90 days of AR to build up before we switch them over. You can track collection in the software against each provider code, so collection is just business as usual. Once it’s set up in the software, it will handle that. My vote is net production, but in this case, using a % based off of last year’s write off can be less than 99% in either direction. 9 ways to skin a cat, this is just what I’ve seen done in some of the practices I’ve analyzed. Thanks guys!”

Another expert:

“It’s just as he described. The biggest issue is auditing it and which is easier to get right. It’s easy to verify daily that you did something and it is assigned to the right provider. It’s hard to verify if the correct sequence of buttons is pushed to put different payments correctly to several different providers months after something is done. We have 3 docs and 5 hygienists. Say I saw a patient for an exam and my hyg saw a patient for a cleaning then a week later my associate for a filling. Say the total adjusted production for this was $500. Now assume we collect 99-100% of this. If we pay on an accurate adjusted production whether the collections that come in later are divided amongst those three different providers and two different dates accurately doesn’t matter–not that we don’t try to but it’s not imperative. We have spent a ton of time and a lot of grey hairs figuring out discrepancies with historical collections–this wouldn’t have been necessary if we were paying on adjusted production.

  1. What is your reservation about setting up a different fee schedule for each plan?

It’s easy to set up and, since insurances rarely raise their fees, it’s not something you’d be changing frequently. Once your staff enters payments into ledgers, payment schedules get updated and Dentrix “learns” how to estimate patient co-payments better.”

 

The benefits of having a different fee schedule for each plan are as follows:

  1. You can pay your providers accurately
  2. You can estimate patients’ out of pocket expense accurately
  3. You know how much money you are making
  4. If you take PPOs, patient ledgers can reflect PPO fees, while claims go out with your regular fees
  5. You can show patients how much money they are saving using their PPO in your office
  6. It’s easy to track your utilization and write offs for every PPO so that you could make good business decisions.

There is no downside, and, did I mention it’s easy to setup and maintain? It’s a lot less work than constantly posting adjustments. If your front office person convinced you that it’s too much work to set it up, get her some Dentrix training.

Any discrepancies are entered as PPO adjustments – either positive or negative and deducted or added to the current month.

 

  1.  We pay an hourly rate to our associate, then at the end of the month we calculate 30% of net production from the month PRIOR, once all adjustments have been made. We then subtract the last two pay periods from the 30% and pay it out as a bonus. In the end, it still nets out to 30%.
  2. We do hourly then quarterly adjustments based on collections. There’s very few errors in payment entry to the correct provider. The errors are if the treating provider incorrectly posts the completed procedure with a different provider.
  3. I think an associate should be paid on net production. The associate has no control of collection procedures, what training is performed, or who is hired for those positions. The owner of the practice should have enough confidence in his/her systems and employees to pay on net production. The owner should take the risk on collections not the associate.
  4. If you use Eaglesoft and aren’t aware of the existence of “unassigned credits” and what that really means or how running a collection report/day sheet for “end of days” vs “end of dates” gives you different numbers….paying collections may be an issue for you.

_________________________________________________

There may be many ways to accomplish a task but it’s nice to have a designated place where you can go to discuss those many ways. When asked about how dentists calculate paying associates using adjusted production in real time DSN members came together for a discussion about why they don’t think it’s a good idea and, for those who use this method, how they manage their associates pay.  

Being able to discuss a topic and receive feedback is an awesome way to gain reassurance on your thought process or get insight on how to do a task better.

If you’re looking for more actionable information like this, join DSN!

Keep Up the Fight!

Post from DSN User:

“Here’s a story….

Placed an implant as an associate in one office. Left that office. The implant did not integrate. The dentist punted her care back to me while I was an associate in a different office (just a little awkward). Opened my office where I placed a second implant. It integrated. So now this patient is crossing state line through Manhattan of all places (suffice to say it’s quite a journey from where she lives to see me). When we go to restore the abutment is a football field off the implant “fully engaged”. NBD, new impression and patient is in good spirit. I see her this evening for round 2 implant restoration. PA show incomplete seat but just a little off. NBD, I pull out the torque wrench. Tighten to 35Ncm. PA show another football field between my crown and the implant (WTF). NBD, let’s back it out and take a new impression (round 3 anyone?). I stripped the screw. Can’t move it in or out. stuck! Patient in room 1 with a hemorrhaging MB canal on 15 just a little tired of being cranked open for an hour. Good news, new patient waiting for an exam 30 minutes past appointment in room 2 and a Periodic ortho aligner seat needing IPR.

Needless to say I was thinking to myself this morning I want out!

I can’t believe sometimes how I manage. I keep it together, thrive and prosper despite working in an environment dependent on structure, order and predictability. I work with human beings! There isn’t anything less structured, ordered or predictable.

I want to extend my deep respect for all of you out there in the trenches. Keep up the fight! We are blessed and privileged to have the opportunities we have.

It’s great to be here with you all!”

 

Commentators:

  • “Some days you’re the pigeon. Some days you’re the statue. Tomorrow will be better.”
  • “Implants are easy to humble you. One wrong step early makes more wrong steps later.”
  • “Man, I’ve been in those situations too. Get some rest and live to fight another day. Some days are up and extractions come out like butter, implant abutments seat smoothly, molar rct are slam dunk, and all your crowns fit perfect. Other days, well.. are like today. Don’t be discouraged and get back on the saddle. anyone reading this knows your pain all too well, great post!”
  • “All those people bitching about dentists don’t realize how hard it can be. Some days are amazing and other days suck. I wish I could share something more profound and reassuring but I don’t have anything else to say except what you already echoed: ‘I am glad we have each other.’ “
  • “You forgot to mention all the other fires you’re trying to put out in the office!!! It’s a constant juggle, but you have to love the good and the bad and realize that you probably care more than many other dentists out there. I’m sure your patients are getting next level care, and have no problem forgiving relatively small inconsistencies!”
  • “I will be talking about how to stop being the Firefighter in Chief in your practice at the upcoming Practice on Fire Live!”
  • “I had a similar issue. I had difficulty placing an implant with the driver I had. Then same issue seating the impression post…and tried two crowns…long story short. I very carefully used a 7901 bur to try and clear the area, very gently. This was my very last option before I was going cap it and place a bridge. I think I had some debris from the screw threads from placing the implant. It worked, and I was able to seat the crown and torque to place. That was about 2 years ago. I reached out to see if anyone had this issue with no luck prior to using the bur.”
  • “I got mine handed to me last week, was in the same boat. Misery loves company, stay strong brother”
  • “Well said and right back atcha buddy. No one can fathom the stresses that we’re under everyday unless you’ve lived it. Chin up, and carry on. You’re appreciated!”
  • “Thanks for sharing man. Had a day like this yesterday. Went home and hugged the kids and kissed the wife…sanity again. Find your Peace in this wild profession”

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Here’s an example of gratitude arising from a day full of unfortunate events. These are the days when you want to say “I give up” or how this DSN user felt, “I want out!”. However, if you have a supportive group to lean on, those days will never overpower what you’re trying to accomplish. Giving up will never be an option.

Many dentists responded to this DSN user’s post with encouragement and even some of their own horror stories. Everyone gets to a point where they feel like they’re drowning so it’s crucial to share your positivity in a time of need. We are bound for great things so let’s come together and help each other succeed!

If you’re looking for more actionable information like this, join DSN!

Communicating Effectively for your Practice

Post from DSN User:

“Had a humbling moment with my team recently.

Basically, we have cancellation policies and prepayment policies for appointments that are consistently ignored.

It has been on my backburner to address, as I see it as a leadership and accountability issue….

What I discovered, is that my policy was just really not very clear. While I could elevator pitch it to you, there are a lot of grey areas that made it difficult for my team to commit to it. So it really demonstrated a breakdown in communication between myself and my team.

So, this is my new cancellation policy that we brainstormed.

Would like some feedback if anyone wants to give it a read. One thing this document contains, which I think is paramount to team buy in, are the reasons behind the policy.

I also have a shorter more bullet list quick version.”

 

The issue at hand is communicating effectively. Often times people assume they conveyed their ideas or message in a crystal clear way but it’s necessary to take into account how other people interpret things. One person could think a concept was explained clearly but the person next to them might not agree and have questions for more clarification.

The DSN poster has asked for feedback in regards to his new cancellation policy. Below you will see commentators giving feedback on the poster’s cancellation policy but you will also see comments about communicating effectively and why that matters.

 

From an expert member on the East Coast:

“I think it’s better to make them understand the value of the appointment and make it hard as hell for them to reschedule.

Do I have cancellations and no shows? Hell yes. I hate them. But for those who are the PITA ones, we handle them in a specific way.

1) We do phase one on your policy: try to save the appointment.

2) If that doesn’t work, we listen to the excuse. If it’s valid and they never miss, we let it go and let them schedule ASAP. If it’s not a good excuse, but they are a great patient, we let it go the first time.

3) Second time is different. We try to save appt, but if not, we tell them we are sorry they have to cancel and let them know “let’s find you another appointment that works for you…. Currently our first appointment available for XXX is in 6 weeks. Since this was a difficult appointment for you (if that applies because of traffic, work etc), perhaps we can find a better day or time for you?

4) If they have an appointment with me for anything major, they ride them very hard and let them know that this was a 2?3? hour appointment with Dr. XXX and these are “premium” appointments that are very hard to get. Is there anything you can do to make it? Perhaps coming a little late and staying through lunch?

5) If a great patient and they never cancel, we’ll find another time for them. If not a great patient, we push them out (typically I’m 3 months out for non-emergency tx anyway, so they just find my first available.

Finally, let me say this. It doesn’t happen often, but I have had to 1) change people’s appointments because a lab case didn’t come in, 2) change appts because I was sick or had a sick family member or another matter I had to deal with on short notice, 3) ran into an unexpected longer appt than normal and asked them if they’d like to stay or come back another time. Again, this doesn’t happen often, but I certainly don’t want them looking at a cancellation policy that’s one sided…”

 

And this from another user on Communication- “What gets said, and what gets heard”

“This concept of clarity in communication could arguably be our most important job as visionaries of our company. Here is a great example non related to dentistry.

We host a workout group every morning at 5am at our house. Usually 8-12 people show up everyday and I have become the de facto leader of the group and in charge of coming up with the workouts. This group is some of my closest friends and very accomplished, intelligent people. A doctor, a vet, 2 high level bankers, a chemist, a college professors . . .Smart people

Today I organized the workout and jotted down a summary of it on our white board. In my head it was clear as day. Simple. Straight forward. I started the timer and the workout began. For the first 5 minutes of the workout people were confused, didn’t know where to go, how many reps to do, how much weight to use, who do they partner with . . .

They were coming to me with questions DURING THE WORKOUT and I was getting frustrated . . .thinking to myself, “are you kidding me” I was thinking to myself

In retrospect I was so UNCLEAR about the workout instructions and these extremely intelligent people didn’t get it but they had the insight and courage to approach me for more clarity.

SAME THING HAS HAPPENED TO ME AT WORK, except Im probably even less clear and Im not dealing with accomplished professionals, Im dealing with girls making 20 bucks an hour who are very intimidated by me. It’s amazing that we get anything accomplished.”

 

So In Summary:

 Be crystal clear, over communicate, ask questions to verify that clarity has been achieved . . .

Otherwise we are swimming in mediocrity.

 

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