Stress in the practice: a case study

When I ask the attendees at my practice management seminars if any of them are experiencing stress, they don’t raise their hands, they just start laughing because the answer is obviously ‘yes’.

Unfortunately, stress in the dental practice is no laughing matter. Operating at a chaotic pace without effective management systems virtually guarantees an inefficient practice that is not as productive as it could be.

What’s the solution? Implementation of management systems. The following case study shows how systems can effectively reduce stress in the practice.

In July 1995, Dr Jones* joined a small practice and one year later purchased the office. The practice grew quickly and Dr Jones, along with one associate, now has 12 staff members. Dr Jones believed reducing stress was the number one goal that caused him to seek consulting assistance.

Much of the overall stress in the practice was being caused by the schedule and a lack of systems. This caused a chaotic, unpredictable working environment when the staff found it difficult to deal with the everyday issues any practice faces.

‘The number of patients we were trying to see and the amount of work that we were trying to do was just getting to be overwhelming,’ Dr Jones said. ‘Our practice was growing, but I felt like we were just running around like a chicken with its head cut off.’

After meeting with Dr Jones’s team, their consultant performed an on-site practice evaluation, made recommendations and helped the practice implement some specific systems to reduce stress and increase production. These systems included:

• Power cell scheduling

• Daily morning meetings

• Improving case presentation by offering financial options

As the consultant worked to help the practice implement power cell scheduling, Dr Jones quickly noticed a positive effect on the business. He now credits power cell scheduling as the main reason why his practice operates with much less stress than it did just 18 months previously.

‘That was the key,’ he said. ‘I think the most important thing was bringing the whole team to the training facility to help them understand how the power cell scheduling works. I could have gone to the course and taken all the notes and come back and shared it with them, but I don’t think that would have worked as well.’

The daily morning meetings that the consultant introduced were also a major aid to the success of the practice. Dr Jones noted that from the time he bought the practice until he entered the consulting programme, such staff meetings were rare. With these in place, the staff was prepared to

effectively handle issues as they arose and stay on top of their schedules by reviewing them every morning.

‘We have the morning meetings, which everybody likes, and we wouldn’t think of doing it any other way now,’ Dr Jones added. ‘We’ve gone to having as many meetings in a month as we used to do in seven or eight years.’

Case presentation systems encouraged the staff to discuss fees in detail and assist patients in finding payment plans that were comfortable to them and beneficial for the practice.

Concepts such as offering a 5% courtesy to patients who paid in full for a treatment plan up front played a key role in the increased case acceptance, production and collections in the practice.

The practice achieved significant growth in production in a 12-month period and also increased collections. Aside from the sheer numerical results, Dr Jones says the practice operates more efficiently and with less stress now than ever before.

‘There’s always some resistance to change,’ he said. ‘I think our consultant was really good about helping the staff realise that we needed to make some changes and it was going to be a good thing in the long run.’

Excessive stress should be viewed as one of the greatest threats to practice success. The effects can be widespread – it can wear down the doctor, cause staff turnover and lower the quality of customer service.

I challenge all dentists to strive for the goal of establishing documented business systems to create a level of expertise within their practice and lower stress.

* The doctor’s name has been changed to protect his privacy.

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