My staff seems to just 'go through the motions' throughout the day. I want them to see the big picture of making the office work, to be more accountable for their actions, in order to make the office run more smoothly and be more productive. What is the best way to institute a change?

Accountability, or reporting back on the results of specific activities, is a key method of ensuring the practice is moving closer to its goals. The doctor’s time is better spent when people report back on their performance instead of requiring the doctor to pour over management reports and track down a team member during the course of a busy day to try to find out why a particular objective has not been achieved.

The doctor must foster the opportunity to celebrate good performance and address poor performance. This is best done in the form of a short, regular meeting with staff responsible for business systems.

Vital Signs: Reporting back on Monthly Performance
At the end of each month, staff must prepare the necessary reports that review practice performance, preferably condensed to a single summary page. Practice Vital Signs is one example, a one page synopsis of key performance criteria.

Included in this report will be production, adjustments, payments, ending accounts receivable, same day payments (collections “over-the-counter”), pending insurance, days worked, new patients and current number of active patients. The names of the criteria may be slightly different depending on the practice management software used in the office. For instance, “Production” and “Adjustments” in Kodak/SoftDent will be termed “Charges” and “Reductions” in Dentrix.

Keep in mind, this is not a drill to transpose numbers from computer generated management reports onto a worksheet and hand to the doctor for him/her to study. It is an important function of accountability. I will include a copy of the Practice Vital Signs sheet I use for my clients at the end of this article. Feel free to modify the worksheet for your particular needs.

Staff must make sure the results of their activity during the course of the month or period, contained in Vital Signs, represent a positive direction towards the practices’ goals. If it doesn’t, then they must prepare information and/or documentation that will propose a plan to correct poor performance.

During a brief five to ten-minute meeting, the doctor must ask the staff member to report on the previous month’s performance. Questions may be broad based, or detailed to pinpoint specific areas. For example,:

“How did we do last month?”
“Based on our goal, how did we do last month in terms of production?”

“We were trying to hit an average of $5500 in production per day, how did we do?”

“I noticed our payments were below charges; what happened?”

“The adjustments seem a bit high; could you give me the details?”

{Were they professional discounts, bad debt, reductions for insurance plan participation, family courtesy, staff dentistry?}

“How does our accounts receivable compare to last month?”

“I noticed the aged accounts over 60 days have gone up, what happened?”

“The insurance over 60 days looks a bit high, what’s hindering your ability to get the claims paid? What’s your plan to reduce the balance?”

“New patients looked healthy, where did they come from?”

Remember to ask for details. Don’t accept a hunch or a guess when it relates to answering a question about a specific issue. For instance, when asking a staff member about an increase in accounts past due over 60 days without a payment, don’t accept an answer such as, “Oh, that’s mostly insurance.” Often times this type of response is not based on fact, it is merely an assumption that we are doing a good job of collecting and the insurance is holding up the process.

Rather, ask for a printed report of all accounts past due over 60 days that haven’t made a payment in 60 days and identify exactly which accounts are pending insurance payment, and which accounts are slow at paying. Then, review the practice’s payment system making sure the practice is following prudent payment protocols. Finally, review the practices’ collection sequence and verify that proper steps are being taken to address past due accounts.

With this approach, one will be able to help the staff member examine data instead of guessing. Once the real reason is revealed, formulate a plan with the team member to address the issue and ask them to provide details in the future for better justification, rather than assuming.

The old adage, “Pale ink is better than a short memory” comes to mind when documentation is discussed. Make certain notes are taken at the meetings and log them for future reference. In this way, we can trace our activity and follow up on assignments and track progress towards positive results.

Establish a proactive approach to build the practice and ward off problems by having the staff track performance, document results, and be accountable for the outcome thru reporting back to the doctor each month. Institute this approach and performance will not only be measured but the staff will be more knowledgeable regarding their efforts that will promote excitement in the workplace, creating a positive result. The staff will get into the moment rather than going through the motions.