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Where is Your Net Profit?

You’ve worked hard all week; the office atmosphere is rife with discipline and brisk efficiency. The staff have been getting along with one another and you are proud of the team spirit they’ve both individually and collectively demonstrated. In fact, your staff has almost read your mind and anticipated your every need. All of the patients have arrived on time for their appointments, and the majority of them have even heeded your advice and accepted your treatment plans!

Now it’s Friday afternoon; the staff has received their paychecks, which reflect production bonuses that you’ve doled out in appreciation of their contribution to the overall increase in production. But then you look at your bank balance and you’re surprised and sorely disappointed at the lack of funds left over for you. What happened?

Where is your net profit? Did you work hard all week just to earn less money? The bank balance should be going up, not down!

You wonder if it’s worth all the effort. All of that increased production might just have landed you into a “higher office-overhead/higher tax-bracket” situation. It’s that frustrating income vortex — the place where, despite producing and collecting more, you take home the same amount or less. And following a few of these “successful” weeks, you shake your head and realize that if you endure much more of that kind of success, you’ll go broke! So, what should you do?

Let’s start by taking a look at the myriad of possibilities of what might have occurred that resulted in your not having any profit for yourself:

Management Issues:

  • Could you consolidate loans for equipment and/or your practice into just one loan, in order to reduce your monthly loan payment and possibly the interest amount?
  • Can you reduce the amount of inventory the practice maintains?
  • Are you collecting your Accounts Receivables with minimal aging? Do you collect at least 97% of the amounts billed?
  • Do you have any sort of monitoring system that helps you to know at a glance, statistically, who is productive and who isn’t?
  • Do you have written office policies that are known and enforced?
  • Does each position in the office have a fully delineated job description?

To learn the 8 staff-related issues that can plague you and adversely affect your net income read the final half of this article by filling out this form (Highly Recommended).

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Leadership Attributes and Management Qualities

As a practice owner, you should be asking yourself the following questions objectively:

  • Am I a good leader?
  • Do I run from conflict?
  • Am I able to motivate my staff?
  • Is my office harmonious or is it filled with conflict?
  • Does my staff “own” their jobs, or do they just punch in and out?
  • Do I ever feel that my staff is “holding me hostage”?
  • Am I running my practice? …or is my practice running me?

Did you answer any of those questions favorably? If you’re like the average practice owner, the answer is no. That’s because, like most doctors, you were not trained in leadership and executive skills. Consequently, you will often find yourself in management situations in which you lack certainty about what to do. Insufficient leadership could easily result in poor staff performance, unhappy patients, needless stress and lost income.

Maxim: The Morale of the Staff Is Based Upon Their Individual and Office Production.

Believe it or not, most staff members want to do a good job. They want to improve and they like being acknowledged for a job well done. When one produces a good product, it’s a reflection of his competence. Demonstration of competence raises anyone’s morale. As a leader, you have the opportunity to foster an environment that can bring about ever-increasing competence and morale.

So, how does one become a good leader? Is leadership a personality trait with which only a few are blessed? No! Leadership skills are taught and, with practice, can be put successfully into daily use.

The first quality a good leader has to have is the ability to confront situations, i.e., to face up to them. If you are the type of owner who runs and hides from conflict and staff problems, then you need some improvement in this area. First, decide that you are going to face up to the problem. Simply take a moment and make the decision; this is very helpful.

Next, grab someone — a friend, your spouse or a colleague — and roleplay the problem. Have that person play the part of the troublesome individual, hitting you hard with backtalk, new problems, can’t-be-dones, etc. Be sure to do the drill until you find that you are more confident and even feel somewhat excited to try out your new skills and presentation. You will be surprised at how easily the situation will resolve once you do this. Keep in mind that your staff can’t and won’t follow if you don’t lead.

It is very important for you to maintain excellent communication with your staff and to provide demonstrable leadership.

To learn Six Key Actions That You, As An Executive, Should Take fill out this form.

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How to Write a Mission Statement

The owner of a veterinary practice recently asked us about how a mission statement should be written, what it should focus on and what the final objective should be. This example is for this particular veterinary practice, but all of the concepts we will cover apply equally to any other private healthcare practice.

Their current mission statement is below:

“To honor our patients, (our) Animal Hospital ensures that each client is confident in the care they are receiving for their animal companion, comfortable with all aspects of the hospital and staff, as well as engaged in all areas of their pet’s health and wellbeing.”

The idea of this mission statement is good. My only concern with it is that it is somewhat limited. Here’s what I mean.

The effectiveness of a mission statement is that it creates the goal towards which the practice strives. The goal, once stated, is what is called an ideal scene, meaning what the practice would look like to the practice owners if it was functioning at an ideal level. This ideal scene is then compared to the existing scene. The differences are the corrections that need to be undertaken.

Let’s use your mission statement as an example. Let’s say when you compare this mission statement, this ideal scene, with the existing scene you find what’s missing is that the clients aren’t as engaged in all areas of their pet’s health and wellbeing as you would like. Let’s say too many of them view their pets as a bit disposable. This can be a problem in more rural areas where pet owners often feel that if something is wrong with the pet, rather than fix it, they’ll have the pet put down and get a new pet….in other words, the pet is viewed as discretionary or disposable.

So, how does this missing ingredient to the mission statement affect the doctors? The doctors have to compromise their treatment of the patients to align with the clients’ wishes. While it’s a bit optimistic to think that all clients will do everything that is best for the pet and not take their pocketbook into account, when the pendulum swings too much in that direction, the doctor’s work satisfaction declines. I’ve seen this really crush the morale of the doctor. So, assuming this was indeed a true mission statement, now we have the existing scene not lining up with the ideal scene and the result is the doctors are not happy.

To see how to resolve this issue in your practice read the final half of this article by filling out this form.

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How to Properly Correct Employees

It would be wonderful if employees never make mistakes and always do a perfect job. But we’re all human; on-the-job errors are part and parcel of working in a practice. That begs this question: What do you do when a staff member messes up and how do you correct him?

Here are some suggestions on how to properly correct your staff:

As part of this overall process, you must have written job descriptions and office policies that clearly delineate which tasks a person is responsible for on his/her job and the overall working guidelines for the office, respectively. The reason that proper, written job descriptions and office policies are so important is that you should use them as part of your correction procedure. Unfortunately, very few practice owners have them in place.

For starters, if you need to correct a staff member, make sure you review any specific disciplinary policies that you have issued, so that your actions are consistent with them. For example, if your policy states that proven theft results in an automatic discharge, you would not utilize a gradient approach to termination by merely reprimanding someone guilty of stealing.

Typically, the first step in correcting a staff member is to direct his attention to the specific item he violated, as delineated in his job description or in your written policies, indicating the appropriate action that he failed to take or the inappropriate action that he did take. Direct the staff member to reread the policy and/or job description. Ensure that he understands it and clear up any confusions or misunderstandings. This corrective action is usually sufficient to handle the first offense.

If the staff member commits a second offense involving the same issue, the office manager or practice owner should review the situation with the staff member and have him sign a copy of the policy or procedure that covers what was violated, as an attestation that he understands it and agrees to abide by it. We then recommend that you put a copy of the signed document in the staff member’s personnel file and give him a copy to put in his staff binder. One may consider that this constitutes a warning.

To learn how to apply these policies in specific situations, such as;  How many warnings should be issued? What if the employee is an excellent producer? Read the final half of this article by filling out this form.

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Claims Against Dental Amalgam Lack Scientific Evidence

PANEL REPORT FINDS HEALTH CLAIMS AGAINST
DENTAL AMALGAM LACK SCIENTIFIC EVIDENCE

The American Dental Association recently announced that a review of seven years worth of scientific studies concludes there is insufficient evidence “of a link between dental mercury and health problems, except in rare instances of allergic reactions,” according to a report released today by the Life Sciences Research Office, Inc. (LSRO) in Bethesda, Maryland.

Established in 1962, LSRO is a non-profit, independent organization with a worldwide network of experts that studies issues in biomedicine, healthcare, nutrition, food safety and the environment.

LSRO conducted the independent scientific review of dental amalgam at the request of a work group made up of representatives from the National Institutes of Health, Centers for Disease Control and Prevention, Food and Drug Administration and the U.S. Public Health Service. The report, Review and Analysis of the Literature on the Potential Adverse Health Effects of Dental Amalgam, updates and reaches the same conclusion as two earlier reviews by the U.S. Dept. of Health and Human Services of the dental material, which is an alloy made of silver, copper, tin and zinc, bound by elemental mercury. The silver-colored material is widely used to fill dental cavities.

“This report further substantiates the American Dental Association’s position that dental amalgam is a safe, effective material to fill cavities, based on science and clinical experience,” said Dr. James B. Bramson, ADA executive director. “Countless people’s teeth have been saved by using amalgam, which is one of the most durable and affordable cavity filling materials available, especially for large cavities in the back teeth where chewing forces are the greatest.”

The LSRO report was based on a review of nearly a thousand papers from peer-reviewed scientific literature along with public comments submitted to the Federal Register and involved a multidisciplinary panel of experts in fields such as toxicology, allergy, pediatrics, epidemiology and pathology.

The American Dental Association is the nation’s largest dental association, representing more than 149,000 members.