Ep. 44: How Well Do You Understand the Inner Workings of Your Business?
How much do you need to know about the various functions and jobs within your dental practice? If you’re the doctor, does it really matter if you know exactly how to schedule patients, how to answer the phones, how make financial arrangements with patients, how to estimate insurance, etc? In this episode, Jeff discusses why it is crucially important for you to understand all of your business processes, whether you’ve hired others to do them for you or not.
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Questions From This Episode
Why does Jeff say business owners need to understand their practice's day-to-day processes, even if they've hired staff to handle them?
Knowing how a job works and actually doing it are two different things. Understanding the daily functions of each position, like the front desk, insurance verification, and recall, lets an owner evaluate performance, set realistic expectations, and step in with confidence when something isn't working, even though the owner isn't expected to perform those tasks personally.
What five problems can happen to an owner who doesn't understand how positions in the office actually work?
Jeff outlines five: not knowing whether a task is actually needed or helpful, not knowing if it's taking too long or too little time, undermining your credibility as a leader by setting unrealistic goals, being easily fooled by staff or vendors, and having no way to judge whether the practice is over or understaffed.
How can an owner tell if a role, like a PR director or schedule coordinator, is being handled well?
Compare what's happening day to day against the reason the position was created. Jeff describes a PR director hired to generate new patients who instead spent her time working on mailing lists. Because the owners didn't understand what a PR director should be doing, they couldn't tell the role wasn't working until they checked their new patient numbers.
What's a practical way for an owner to find out whether a task is really as hard as it's been made out to be?
Jeff recommends trying the task yourself, outside of office hours: personally call a few reactivation patients, attempt to fill a hygiene opening, or time how long benefit verification actually takes. He shares an example of a doctor who personally called patients reported to be "leaving in droves" and found scheduling them was far easier than she'd been told.
What does Jeff say owners should expect from outside vendors, like marketing companies or accountants?
A vendor should be able to explain what they're going to do, how long it will take, what it will cost, and what outcome to expect, and they should be able to answer follow-up questions. If a vendor can't provide that, Jeff says it's time to find a new one
Episode Transcript
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How well do you understand the inner workings of your business? Do you know what your front desk does, not the big picture, but the specific things they actually do on a day-to-day basis? Are you familiar with how your software works, and can you use it? Do you know how to fill your schedule, handle recall, file insurance, the basic business processes in your practice?
If you're like many of your colleagues, you have some idea about it, but you don't know it all that well. And look, I understand, that's why we hire people to do these things. But knowing how these things work and actually doing them are not one and the same. And of course, I wouldn't expect you to do things you've hired employees to do. If you're verifying insurance benefits while also employing a financial coordinator, something is very wrong.
But whether you have someone who does this or not, I would still absolutely expect you to know how to do it, and everything else in your business, for that matter, for a number of reasons. By not knowing how everything in your business works, you put yourself at a severe disadvantage, and worst case, this way of operating can leave you petrified about firing a team member who really needs to go, because you have no clue how their job works.
That's what I want to talk about on this week's episode of Dental Business Rx: the importance of understanding your basic business processes. My name is Jeff Blumberg, and I'm your host. You may have listened to that intro and thought, well, I'm a doctor, why would I need to know this stuff? That's why I hired good people, smart people who know how to do it. Hire smart people and let them get on with it, and I get to focus on clinical. And sure, I get it. But again, knowing how something works and actually doing it are not the same thing. When it comes to your office, it's truly a case of what you don't know can absolutely hurt you.
To be clear, I'm not talking about management skill: hiring, organizational strategies, increasing efficiency, growth strategies, and so on. That's a separate skill set you should absolutely have as a business owner. What I'm referring to in this episode is more the day-to-day functions that make your office work. And there is some truth to this: if you lack an understanding of these day-to-day functions, you're going to run into trouble with management specifically.
If you don't understand what's happening in your office, what's involved and how things are done, five basic things can happen to you.
The first thing that can happen: you won't know if what a person is doing is actually what's needed, helpful, or should even be happening in the first place. Let me tell you a story. You may or may not be familiar with the position of PR director. You may have had one in your practice, maybe you haven't. Obviously your PR director is responsible for getting new patients. Years back, I remember talking to a couple of clients who'd hired a PR director. I asked, "How is this PR director doing?" They hadn't been to MGE for training yet. They said, "Well, we think she's doing okay." I said, "You think she's doing okay? Well, what does she do every day?" "Well, I don't know. She sits in an office, and she's working on mailing lists," which, I don't know why she'd be working on mailing lists, but that's what they told me.
She wasn't getting more new patients. When we looked at their new patient statistics, they hadn't increased. So they had this PR director, and the whole purpose of hiring a PR director is to get more new patients, and they weren't getting more new patients. They couldn't even determine whether she was doing a good or bad job, because she was working on mailing lists, and they didn't understand themselves what a PR director should be doing or what her objective was.
That's something that, in a lot of cases, if you're having a hard time determining whether a person is doing a good or bad job, take a look at what you hired them for. If you have a schedule coordinator, why would you hire one? You want a more productive, more efficiently run, more properly scheduled schedule. You want patients showing up when they should. If you have primary time blocked out in the morning for larger procedures, you should have patients in those primary time slots. It shouldn't be empty.
If that's why you hired the person, and assuming you've given them the basics on how to do their job, you'd expect to see those things actually occurring in the real world. If you hire a schedule coordinator and your schedule is more empty and you're less productive, then what was the point of having one? You were better off before you didn't have one. So a lack of understanding of what should be going on with a position puts you in the position of not knowing whether what they're doing is needed, helpful, or what should be happening.
The next thing that can happen: you won't understand whether the person is taking too long to get something done, or by extension, not really doing as much as they could, or maybe they're doing more than they should. If you don't understand their job, you could ask someone to estimate, and if you don't understand, for example, verifying benefits, that doesn't have to take long, but it takes longer than thirty seconds. Even though, depending on the benefit plan, you might still have to use fax machines, which is amazing, you have to love insurance companies. But let's say you don't understand benefit verification. You ask somebody to verify benefits, and thirty seconds later it's not done. Well, it takes longer than that. If you don't understand that, you're going to have problems.
Or let's say you have openings in your hygiene schedule, so you ask to have those filled, and whoever's handling your hygiene schedule tells you it took them all day to fill two openings. Well, that's too long. But if you don't understand how the job works, how do you know if it's too short or too long, or if they're efficient or inefficient? This also opens the door to the proverbial excuses: it's summertime, so things are slow because people are on vacation; patients have a hard time paying in December or January because of the holidays, or in April because of tax season. These are the things we hear all the time.
Well, who's telling you these things? It might be a staff member. That doesn't make the staff member a bad person, mind you. But it does mean that maybe they have a problem, they can't figure out how to collect the money they're supposed to collect, and one or two patients mention that to them, and they latch right onto it as the excuse. But then you're buying into it too. You may have tried to organize your schedule so you're doing highly productive procedures in the morning (we call that primary time), and you can't seem to fill the mornings. So you find out what's going on. "Why can't I fill these mornings?" "Well, doctor, a lot of patients don't want to come in in the morning because they're working." Okay, well, you hear that enough, and you start to think that's a fact rather than what one person is telling you.
I've seen it so many times where one person says it's hard to schedule people in the morning, and the next person just schedules them. I've also seen full hygiene schedules during the summertime when everybody's supposedly on vacation, and the highest-ever collections in December, January, and April. So if something isn't working for someone, they're going to come up with a reason why. It's very uncomfortable to have something not working out. If I'm supposed to be collecting money and I'm not collecting money, I'm looking for a reason why. If someone gives me an excuse that works out really well, maybe that explains it for me. Unfortunately, that excuse doesn't help me collect more money or fill the schedule, you see? So it's very easy to buy those excuses if you don't really understand how the job works.
I saw this happen with a client, this was years and years ago. They had hired somebody to do reactivation. This person was calling various patients to get them back in the practice, and the doctor kept hearing how all these patients were leaving the practice, in droves. So the doctor started freaking out a little: what are they doing wrong, why is this happening? So I told the doctor, "Why don't you get on the phone and call a few of these reactivation patients yourself?" She said, "Really? Me, personally?" "Yeah, why don't you personally call a few and get your own understanding of what's really going on."
So she got on the phone, and she scheduled a bunch of people. The problem was that the person doing the calling was not a great team member, but you could just as easily have somebody who doesn't know how to schedule and thinks that's just the way it is. In this case, the doctor found out it wasn't nearly as difficult as it had been made out to be.
That's something I'd recommend: if you're hitting a situation where you have some unsolvable problem, or something you think should be able to be done but you're not quite sure, try it yourself. You may go, "Well, that's going to hurt my production per hour." I mean, don't do it during office hours, but carve out a little bit of time and try it yourself. Having trouble filling a hygiene opening? Try to fill one yourself. Find out for yourself how long it takes to verify benefits. Get some understanding of these things, and you'll start to have a better understanding of your office.
The third thing that can happen if you don't understand how these jobs work, or what actually goes on, is that it can hurt you as a leader. One of the basic tenets of leadership is that you don't ask people to do things you yourself would not do. You could extend that a little further: you wouldn't ask somebody to do something you thought was truly impossible. If I thought something was completely unattainable and I couldn't attain it, I wouldn't ask someone else to try to attain it. To me, that's just bad form.
So if you don't understand how specific things work at the front desk or at the various positions in your office, you're going to set goals or targets for the office that are a bit unrealistic. You might think it's easy to go from doing eighty thousand a month to two hundred thousand the next month. You probably wouldn't think that, since you're the one producing a lot of it, but let's say you did. You tell the team, "We did eighty last month, good, let's do two hundred next month." That's a bit disconnected; it's too much, too fast. Or let's say you have to cancel a day on the schedule because you're unexpectedly going to be out of town, so you tell the front desk to cancel the day, and then you come back half an hour later and ask why everybody isn't rescheduled yet. Well, maybe it takes longer than that. You have to understand what it really takes.
The last two things: if you don't understand what's going on in your office, you'll be easily fooled, and you'll have difficulty seeing when something is wrong. This happened to me once, in kind of a silly way, and you can probably figure out how this would apply in your practice. Years back, this was almost twenty years ago, I was having custom software made for the company. The horrible thing about custom software is it's a lot like building a house: they gut the entire structure, and then all of a sudden you end up with the siding on the house, and it starts to look like a house. Before that, it doesn't look like anything. It just looks like a big concrete block.
So they're making the software, and they could have told me anything. "How's it going?" "Well, we have to add something to the flux capacitor." And I would have believed them. I understand the basics of computers, but I have no idea about writing code. So they could have told me all kinds of stuff, and I wouldn't have known what they were talking about. I had to work out a different method of managing the process, because I was so in the dark about what they were doing. I had to understand at least some of the basics and then have certain benchmarks I could push for. Otherwise, they could have fooled me continually.
And the last thing: if you don't really understand how things in your office work, the basic business processes, you'll have no clue whether you're over or understaffed. That's a question we hear quite often from newer clients: "Do you think I have too few or too many staff?" Why are we able to answer that question without actually being physically on-site in your practice, just by grabbing some metrics and having you answer some questions? Because we understand the workload of the various positions. If a practice is collecting, say, $130,000 a month with two full-time hygienists and one doctor, and we know the patient flow it has, we understand the amount of work generated in every aspect of the business, and we can give you an idea of whether you have too few or too many staff.
Again, this is something that, if you understand the processes in your practice, you'd be able to think through on your own. And this way of thinking, really understanding what's going on, applies to everything in your business, but it also applies to vendors. If you hire a vendor to do new patient marketing, you should understand how what they're going to do works. You could say the same about an accountant, or any vendor you're dealing with. For me, if I'm going to work with a vendor and I don't understand their business completely, and I find it's easier to just hire them and outsource the work, there are still a few things I'm going to want to know. They have to be able to explain to me what it is they're going to do, how long it's going to take, how much it's going to cost, and what outcome I can expect. And if I have occasional questions, they have to be able to answer them for me. If they can't do those things, I find a new vendor. Otherwise, I could be run around forever.
So look, maybe this wasn't what you wanted to hear. I'm telling you to dive more and more into your business and learn the ins and outs, so you know where every rivet is in the ship of your business, so to speak. This is why companies like MGE exist. This is what we do: education and training on the subject of management, sales, communication, and so on, versus just giving consulting and advice, because if someone actually understands something, they can think with it, and they can perform in that area.
So while this isn't necessarily an easy thing to do, it's also not all that difficult. And most importantly, the more you understand, the more control you have over your business and your destiny.
This was a short episode, but I wanted to throw this out here because I wanted you to start thinking with this. I hope this helps. Again, we appreciate you listening, and we love your feedback. If you want any help with your practice, or want to find out more about MGE, you can find us online at www.mgeonline.com, or give us a call at (800) 640-1140.
That's all I have for you this week, folks. I'll see you next week.