Every dental hygiene department has potential to be the second-highest profit center of the dental practice. Is yours in this category? Why do some hygiene departments have more success than others? Do these hygiene departments see more patients? Do they perform more dental hygiene services? Do the auxiliaries work longer hours?
The secret is in maintaining a constant flow of patients, both new and old.
New patients are the lifeline to every successful dental practice. Without new patients, production will decline and the practice will not exist. Every dental practice has a normal attrition of patients. This is a fact of business. People move, pass away, or leave because you are not on their insurance plan, and this can mean a potential annual loss of 10%. Just as your heart beats at least 60 beats per minute, you must have a continual flow of new patients walking in the door to make up for those patients who are walking out.
If new patients are the lifeline, then patient retention (continuing care) is the heartbeat of the dental practice. Your active patient base consists of patients who value your care, accept your recommendations, and pay for treatment. These are the people who trust you and your team. They refer their families, friends, and colleagues to you. These are the key players in the ongoing success of your business.
That said, to keep your lifeline and heartbeat going, you must have a scheduling system that maximizes the number of filled – and fulfilled – appointments. Think you have no control over patients refusing to schedule and patient cancellations? Think again. These next few suggestions show how you can tip the outcome to your favor, and quite successfully, at that.
Get the Hygienists Involved in Scheduling
Most patients see the hygienist more than any other auxiliary of the dental team. Thus, the hygienist carries a critical role in building and maintaining the current active patient base.
You will usually see a positive patient attitude and an increase in patient compliance occur when the hygienist is involved in scheduling the patient’s next hygiene appointment. Ideally this should occur when the patient is still present in the hygiene treatment room.
The dental hygienist is a valuable oral health educator for every dental practice. The role of the dental hygienist is to educate patients about the relationship between oral health and systemic health. Patient involvement and active participation create ownership and accountability and will ultimately reduce the cancellation and failure rates of the continuing care patients. Patients are more likely to understand the importance of why they need to schedule their next hygiene appointment when they are still in active conversation with the hygienist. There is a continuation in the patient-practitioner communication process.
Watch Your Words
Everyone on the team should understand effective words for a positive patient response. Courtesy confirmation calls, emails, text messages, and written communications define the hygiene appointment. Shoot for wording such as this:
Hello Mr. Goodman, it’s Megan calling from (insert dental practice name). We are looking forward to seeing you tomorrow at three o’clock for your preventive care appointment. I see on the schedule that Maria will be doing your annual periodontal screening exam, and Dr. Goodtooth mentioned to me that she is watching a few areas that may have possible decay in the near future. We look forward to seeing you then.
Note how the wording suggests far more than “just-a-cleaning-or-a-check-up,” adding value to your services. Also note the positive expectation of seeing the patient. Megan does not discuss the cancellation policy because it would only be a subconscious reminder that the patient can cancel if something else comes up. She also does not ask for a call back to the office to verify an appointment. She keeps it simple. Above all, set the expectation that patients understand the importance of their dental service and desire to come to see the doctor, hygienist and team members. The dialogue between the auxiliary and patient in the office is also extremely important. Here is an example of how a conversation about scheduling a next appointment may go:
“Today I found a few areas of bleeding that are considered abnormal, and the doctor is observing an area where you have the beginning of decay. Our schedule is booked tightly because patients usually schedule future appointments before they leave their hygiene appointment. I know that you like to come in first thing in the morning on Thursdays, so I recommend that we reserve your next appointment now since that’s a popular time. I can see you on Thursday, October 18th at 8am. Will this work for your schedule?”
Note the opening educational dialogue. The patient suddenly is tuned in to the importance of coming back for another appointment. Also, the wording suggests consideration for the patient’s preferred schedule, while at the same time, gently insisting on a commitment now.Tip: When patients see the doctor but are overdue for a dental hygiene appointment, if you have an opening, ask them to stay for a dental hygiene appointment when doctor is finished with treatment that day. The hygienist does the same if the doctor has an opening and the patient has incomplete treatment.
Use wording such as, “we can save you time from missing work another day,” or “we can save you time returning to the office,” etc. In summary, create statements that are certain to benefit the patient.
Build a Well-Oiled Scheduling Machine
Ideally, a brief morning meeting (a “team huddle”) enables the entire team to communicate, delegate, and maximize the day – especially the current days’ schedule. One of the most important topics reviewed at huddles with my consulting clients is having the clinical assistants audit patient records and identify who seeing the doctor that day and also overdue for hygiene care.
To achieve and assure a full and productive schedule (for all providers), the hygienist should review patient records for incomplete dental treatment, update x-rays, exams, perio exam, medical history, etc. With this current information, the hygienist can prepare to discuss issues with the patient, demonstrate/educate (with an intraoral camera), answer questions, and provide the facts, risks and benefits, when the doctor enters the treatment room. The hygienist can also discuss scheduling future appointments much better, knowing where the patient is in his/her treatment cycle.
With these facts under the team’s belt, scheduling will be much more efficient. For a hygiene department to achieve success, it should attempt to schedule 95 percent of its future dental hygiene appointments at the time of the patient’s current dental hygiene appointment.
The dental practice needs to create monitors and track the scheduling ratio. For example, count the total number of patients seen in the hygiene department each month and divide this number by the number of appointments available for the month. The hygiene or scheduling coordinator should then report the current scheduling rate to the team at monthly team meetings. The scheduling coordinator should always report in the morning huddle any open times on the hygiene schedule each day for the next week. When you have more open holes in the schedule over the next 2 weeks a strategic plan must be in place to halt the decline of the practice profitability. What is your plan when times get tough?!Chart audits and patient activation must be ongoing systems whether done via daily reviews or computer reports. While everyone on the team plays an important role, one auxiliary (the hygiene or scheduling coordinator) should be responsible and accountable for keeping the daily schedule full with paying patients to be productive. At team meetings, the scheduling coordinator should report and discuss the scheduling effectiveness rate.
Everyone needs to be aware of what is working and what is not working so that the team can create a plan of action when there is a crack in the system. Ask your team mates for suggestions to overcome challenges when you are feeling a hemorrhage in your dental hygiene schedule. You may want to consider the advice of a dental expert (consultant)who is knowledgeable in overcoming these challenges, especially during these stressful economic times.
Manage Cancellations Wisely
Preventive care and supportive periodontal maintenance appointments have the highest cancellations and failed appointment rates of any service in the dental practice. If you have one hygienist working four days a week and each day you have one cancellation, this can lead to an annual loss of at least $80,000 in hygiene department profits. (this calculation is based one hygienist with an average dental hygiene appointment cost at $150.00 USD. The hygienist sees patients 200 days a year and each patient will spend an additional $250.00 USD average annually for products and/or treatment.) The numbers used for this calculation are low but can give you an idea of the loss potential when just one patient each day no shows or cancels last minute- and- this is only taking into account one hygiene schedule!
Many dental practices charge a fee for failed appointments, and the effect of doing this has been positive in raising patient awareness of the importance of the time set aside for their appointments. Be sure, however, to put your cancellation fee in writing.
By working together, the doctor, hygienist, and entire team, communicate and share a practice philosophy for the patients, the hygiene department, and the practice. Working with the dentist as a partner in oral and systemic health care, everyone on the team is committed to the vision of the practice, proudly recommends optimal dental treatment, and refers family and friends to the dental practice.
Facilitate change by regularly scheduling meetings with your hygiene team and as a whole team to support and reinforce initiatives and explore new ideas and opportunities for growth and development, especially in scheduling. Open communication pathways will lead to mutual respect and will be reflected in increased profits, a harmonious dental team, and most importantly, healthier patients. It’s a win for all!