Larry Silver

From The Editor:

Posted by Larry Silver

In our latest issue of The Practice Solution, you will find a variety of articles covering employee issues.

We constantly survey private practice owners throughout the United States and Canada, looking for their various practice management concerns.  This helps us focus on what types of articles to concentrate on for our various issues of The Practice Solution.

Our latest surveys showed a great deal of attention and interest in dealing with employees.  During these tough economic times, having good employees is a key to a well run, efficient office.  Efficiency always translates into higher production a better net, both vital factors during a down economy.

In this issue we’ve presented articles having to do with finding, hiring, training and dealing with employees. You will also find an article concerning how to deal with potential employee dishonesty resulting from economic stress. This article was written by an attorney familiar with such issues.

You will also find several articles taken from the world wide web that we thought would be interesting to our readers.

Again, thank-you to any and all doctors who have participated in our surveys with our research staff. Your participation helps us stay freshly abreast of what key issues are on the minds of practice owners.

Charles Mann

Managing Editor, The Practice Solution


Larry Silver

Recruiting New Employees

Posted by Larry Silver

Recruit Competent Employees

Recruit Competent Employees


NEWSPAPER

The most obvious source to be used in recruiting new personnel is the newspaper. But before we address the ad itself, let’s look at some basics.

When promoting for a new staff member, don’t ever lower your stand­ards. Keep them high and remember that you don’t just want a top quality person, but you deserve that person! Your practice growth depends upon staff who are bright, energetic, sensitive, intelligent and outgoing. Be willing to compete for that type of person.

An interesting thing to consider is that not everyone is “actively” looking for new jobs. Some of the most qualified individuals already have jobs but may be looking for a change. These individuals may seem like “cold prospects” but they actu­ally do “skim” through the want-ads just to see what is out there. So it is very important to develop an advertisement that will attract the person you are looking for.

When running your ad, it is wise to consider using a large, two-column ad rather than a standard one-column ad. A larger ad may be more costly, but it could very well pay off by helping you to gain a higher number of qualified prospective employees responding more quickly to your ad.

The Sunday paper is definitely the best time to run your ad. Sunday/Monday is a very successful combination of days for running your ad.  People who are job hunting will look through Sunday’s paper and continue looking at least through Monday.  Suburban weekly newspapers are also considered good places to advertise since they often remain in the home all week.

Do not waste your valuable ad dollars by advertising right before a major holiday.  People are less likely to read the classifieds during such times. Many applicants are involved with other matters and will usually look again after the holidays.

DEVELOPING YOUR AD

Use an attention-grabbing headline to pique curiosity (e.g., “Are You Motivated?” or “Do You Have What It Takes To Be My Assistant?” or “Are You A People Person?”).

Offer a competitive salary and benefits. Check around your area and learn what colleagues pay their employees. You can do this by asking directly or by simply looking in the newspaper under the classifieds. List the salary range offered for the position in your ad. Fewer people will respond if they have no idea of the pay involved.

List specific job duties and skills (e.g.,  “Must have good people skills and be able to handle a busy patient load while maintaining a good sense of humor.” or “Must be able to take initiative and think on your feet.”).

List the name of the practice and/or the Doctor.  This is optional but “blind box” ads have a lower response rate than those that reveal the employer. To avoid being deluged with phone calls and walk-ins, include a statement in your ad conveying that you will not accept applications in that manner (e.g., “Resumes only. No phone calls or walk-ins please.”).

Close your ad with an invitation to action. Be sure to tell interested applicants how to apply and who will receive responses in your office, for example, “Send resume and cover letter to (NAME) at (ADDRESS).”

Keep a file of all the classified ads you run along with a list of the responses to each ad.

Ask applicants which features of your ad drew them to the interview. This information could become in very useful at a later date.

AGENCIES

Employment agencies are another source of recruiting employees but can be quite expensive in certain cases.  When dealing with an agency, ensure you clearly understand the policies and arrangements. Have the agency provide you with a written outline of the procedures involved.

If you decide to use the services of an agency, be prepared to state the exact requirements for the position or unqualified applicants will call and waste your time. For example:

ASSISTANT

  1. ONE YEAR EXPERIENCE
  2. GOOD COMMUNICATION SKILLS
  3. X-RAY CERTIFIED
  4. COMPUTER LITERATE
  5. EXCELLENT PR SKILLS
  6. GOOD COMMUNICATION SKILLS
  7. ONE YEAR PREVIOUS FULL-TIME EXPERIENCE

RECEPTIONIST

WORD OF MOUTH

By letting friends, colleagues and even patients know that you have a position to fill in the practice, you may find that just the right person comes your way. Never rule out the possibility that it might be easier than you think to find that new employee simply through communicating with your own connections.

NOTICE POSTED IN THE PRACTICE

One of your patients may prove to be just the person you are looking for to fill an open position. By posting an employment opportunity notice on your bulletin board, you may find an interested patient you already know.  Many patients already know and respect the Doctor and the practice and would love to work for you. If you use this method, construct an attractive, professional and intriguing notice to be displayed. If you receive an inquiry, schedule a formal interview. Any person who applies will need to go through the same hiring process as everyone else, regardless of who they know or who referred them.


Larry Silver

APPLICANT SCREENING: THE GROUP INTERVIEW

Posted by Larry Silver

Finding a new employee can be a very time consuming process. To consolidate efforts and streamline the initial stage of the interview and selection process, have all the applicants who meet the basic criteria come into the office for a “group interview” session. The purpose is to consolidate the Office Manager’s efforts and to provide you with an opportunity to see the applicants and screen out those you do not care to invest more time in. The finalists from this segment will then be invited back for an in-depth individual interview.

Once you have collected all of the resumes from your advertising, go through them and screen out those who do not have the basic qualifications you are seeking. Consider whether or not the resume included a cover letter and if the letter really communicates something about the applicant. Look at the experience, background and talents being conveyed in the resume and letter.

Phone the applicants who appear to be the very best and schedule them to come into your office to complete an application and brief interview. During the phone call, “rate” phone voice, composure, professionalism and willingness by making notations on the resume. Schedule all of the applicants for the same time, such as an evening after work or a Saturday morning.

Make preparations ahead of time. Have packets of paperwork ready for each of your applicants. Packets should contain an application, questionnaire and a form for applicants to state employment goals and their understanding of what a dental practice is. Applicants will also be asked to write a brief collection letter and to sign an authorization for release of information form. These forms are in the back of the Office Manager section in this manual.

When the applicants arrive, welcome them all and deliver a brief statement about the practice and the position. It is best to limit this statement to fewer than ten minutes. Then and direct them to the packets handed out. Each person should complete the following.

  1. an application
  2. the job application essay
  3. the hiring questionnaire
  4. Write a brief letter to a client who has an overdue account. This gives you a good indication of how the person deals with others regarding sensitive matters.
  5. Sign and date the Authorization for Release of Information Form.

As the applicants complete their forms, rate them on their appearance, interaction with the other applicants, demeanor and reaction to this “group” interview session. As each person finishes the paperwork, take him/her individually into a private office to conduct a brief interview. Take just a few minutes to look over the forms and thank the applicant for coming in. You should also answer any basic questions at this time. Inform the person that you will review the paperwork for each applicant and determine who will be called back for a longer interview.

Before your applicants leave, give them each a card for a complimentary exam at your office. This is optional but could garner new patients even if they are not hired. Thank them all for coming in and let them know that they will be hearing from you within the next few days.

After your applicants leave, you can go over what you know about them so far by rating them each in the following categories.

THE APPLICATION

  1. IS IT NEAT AND LEGIBLE?
  2. IS IT THOROUGH?
  3. DOES THIS PERSON “JOB HOP”?
  4. ARE THERE UNEXPLAINED LAPSES IN EMPLOYMENT HISTORY?

THE EMPLOYMENT GOALS

  1. CHECK THE SPELLING, PUNCTUATION, GRAMMAR AND COMPOSITION.
  2. WHAT DOES THIS PERSON’S GOALS TELL YOU ABOUT HIM/HER?
  3. DO HIS/HER GOALS INDICATE THAT HE/SHE IS LOOKING FOR A LONG TERM POSITION?

THE COLLECTION LETTER

  1. CHECK THE SPELLING, PUNCTUATION, CONTENT AND PROFESSIONALISM.
  2. IS THIS LETTER FRIENDLY, YET FIRM?
  3. DOES THIS LETTER ACTUALLY “COMMUNICATE”?

WRITTEN VERSION OF THE PURPOSE OF A DENTAL PRACTICE

  1. LOOK FOR THE PERSON’S BASIC UNDERSTANDING OF THE PURPOSE.
  2. CHECK THE PERSON’S ABILITY TO ARTICULATE AND COMMUNICATE EFFECTIVELY.
  3. DOES THE STATEMENT CONVEY THE ATTITUDE YOU ARE LOOKING FOR IN THE POSITION YOU ARE FILLING?

Based on what you know at this point, you will be able to determine whom you wish to have back for a second interview. Phone those applicants and schedule them for their second interview. These will be scheduled separately as they take longer than the first interview.

Send reference letter request forms to former employers of your final applicants. Send rejection letters to those applicants who did not qualify for the second interview.


Larry Silver

ACTIVE LEADERSHIP

Posted by Larry Silver

It is very important for the Owner of a practice to maintain excellent communication with his/her staff and to provide active and visible leadership. The following are some key points for the executive.

Communication of Goals

Determine what the purpose (Mission Statement) of your practice is and communicate it to your staff. Let them know what the goals for the office are and keep them informed of the programs you intend to implement to achieve those goals. A well-informed staff will have greater understanding and will be likely to join you in mutual motion.

Communication Tools

The implementation and use of basic communication devices is key. These tools can be kept in place by your Office Manager but must also be reinforced by you as the senior executive. These tools include written requests or proposals, written office dispatches, written policies and the use of an effective communication relay system.

It is important that written communications are responded to swiftly. When people do not hear back regarding their communications within a reasonable period of time, they become less willing to communicate. As a result, the business can have more problems on its hands.

Staff Meetings

It is vital that you ensure that the practice holds staff meetings once per week. This is one of the most valuable opportunities available to you for educating staff, setting goals and targets and handling problem areas. The staff as a whole can address such matters. The communication lines within the business will strengthen considerably as well.

The Owner and the Office Manager should continually strive to establish strong coordination and leadership for the staff. Any problems or disagreements between the Owner and Office Manager should always be sorted out OUTSIDE of the staff meeting and should never be addressed in the presence of any staff.

Staff meetings run most effectively if the Owner and Office Manager meet prior to the staff meeting to plan and coordinate the issues to be addressed with the staff.

Setting Goals and Targets

When targeting your weekly and monthly quotas, it is advisable to plan in advance of your staff meeting. You should really confront how much production you did the week/month prior and how much can realistically be produced within the upcoming week/month with expansion in mind. Realistically look at what CAN be done. Then go over it with the rest of your staff at the staff meeting.

Each week you should bring your graphs to the meeting and keep the staff informed as to how the group is doing in approaching the goals.

Group Member Responsibility

The more each staff member takes responsibility for the office as a whole, the better your office will perform. It is very helpful to have each staff person come to the staff meeting prepared to contribute. The Owner should support the efforts of the Office Manager to show the staff the importance of this format and to gain staff compliance. The goal of the executive should be to show the staff how to take on more responsibility and how to contribute to the creativity, growth and expansion of the practice.

Policy

To create stability for the practice and to keep the lines straight, it is very important that you continue to implement written policies. There should be written policy to govern all activities in the practice.

When you write a policy, place the original in a Master Policy Manual. The Office Manager would then distribute a copy to each applicable staff person indicating that the policy is to be read and verification is to be sent to the Office Manager confirming that this has been done. A copy of the policy would be placed in the staff Job Description Manual under the General Staff Section.

The Office Manager can be very helpful in policy development but needs to know exactly what your policies are. Policies can be written and submitted to the Owner for final approval. The Office Manager can and should suggest areas where policy is needed. Staff should also be encouraged to propose policy via the Office Manager.


Larry Silver

INTERVIEWING AND SELECTING EMPLOYMENT APPLICANTS

Posted by Larry Silver

The personal interview represents the basic process to use for selecting the best available person for a job. Relying on the interview process for finding the right person demands that the interviewer possesses the necessary expertise for planning and conducting an effective interview.

Great attention must be paid to the selection and interviewing process. By doing so, you will minimize staff problems such as troublesome employees or dissatisfied employees who seek employment elsewhere. While other factors in the working environment have a great influence on the employee’s performance and satisfaction, fewer problems will arise when the selection interview is regarded as the first critical step in hiring and keeping a qualified worker.

Interviewing and selecting employees can become a time-consuming responsibility for the Office Manager. However, if this process is regarded with high importance, the likelihood of hiring the right person who will enhance the practice increases greatly.

THE INTERVIEWER’S PURPOSE

The Office Manager must be careful not to enter the interview with any preconceived ideas about the applicant, which can compromise an intelligent hiring decision. If, before or during the interview, the interviewer thinks in evaluative terms or reacts to statements from the candidate with a judgmental attitude, several results could negatively affect the hiring decision.

  • - An evaluative attitude runs the risk of premature evaluation. If the interviewer reacts negatively to any particular applicant response and thereby decides that the applicant is not suitable, an otherwise valuable employee might be lost.
  • - An evaluative attitude increases the likelihood that important questions might not be asked because the interviewer’s mind is already made up.

It is understood that the Office Manager must maintain judgment concerning the applicant’s “fit” into the organization. But the basic purpose guiding the interview must be to get in communication with the applicant and to collect information (i.e., facts, explanations, character traits, etc.) that will provide a basis for predicting an applicant’s potential success on the job. The Office Manager is a data gatherer in this situation.

The Office Manager must use his/her time wisely. Many interviewers tend to waste time and create negative impressions by asking questions about information already explained in a resume or application form. Oftentimes, the interviewer tends to talk too much. The interview should invite the applicant to do the majority of the talking. That is going to be far more revealing to the

Office Manager as to who the applicant really is. The Office Manager is looking for things that otherwise could not be found on an application or resume such as:

  • - how the applicant feels about past positions
  • - is the applicant interested in further training and professional growth
  • - how does the applicant appear to handle pressure
  • - how the applicant feels about types of management
  • -how the applicant works as part of a team

The interviewer is not only looking for the qualifications of the applicant, but also:

  • - communication abilities
  • - depth regarding goals and motivation
  • - ability to think on one’s feet
  • - willingness of the applicant
  • - trainability of the applicant

Look for answers and attitudes that demonstrate a sincere interest in contributing, rather than simply what the applicant hopes to get from the business.

Be alert to comments and questions that indicate the applicant’s willingness to learn, contribute, be flexible, take on new duties and help out when needed.

COMMON APPLICANT SELECTION CRITERIA

  1. Communication Skills: Messages are clear and easily understood. Candidate listens well and is articulate and concise.
  2. Self-confidence: Applicant seems poised and relaxed. Attitude is not defensive or hostile. This person demonstrates ability to accept responsibility and seems to understand personal feelings and ideas.
  3. Sociability: Applicant demonstrates ability to work with others. Has pleasant and supportive interpersonal style and is able to relate to others with empathy, openness and a non-defensive demeanor.
  4. Ambition and Motivation: Applicant shows an understanding of personal goals and priorities, understands attraction of the profession or job and seems capable of acting/working with minimal supervision or guidance.
  5. Perseverance and Responsibility: Applicant shows evidence of ability to start and follow through. Can be counted on to produce and get results even under adverse conditions or stress.
  6. Leadership: This person demonstrates an ability to influence others toward desired goals and provide appropriate direction and support along the way.
  7. Adaptability: Applicant demonstrates an ability to interact or communicate with a variety of different personality styles.
  8. Appearance: Personal grooming and dress habits are adequate to the demands of the position.
  9. Cooperative: Does not appear excessively competitive and possesses give and take attitude.

PLANNING AND PREPARATION

The essence of the hiring decision is to match an applicant’s qualifications with the requirements of the practice as a whole and the requirements of the job. The interviewer must have a thorough knowledge of the job. To evaluate the fit between the job, the practice and the applicant, the job must be represented in all of its dimensions.

I. Have a thorough knowledge of the job, including the following.

a. Duties and responsibilities
b. Competency requirements: What knowledge is needed to perform satisfactorily? What skills are required?
c. Enhancement skills: What job-related skills might increase the likelihood of above-average performance?
d. Performance standards: How is competency to be measured?
e. Selection criteria: What qualities would an acceptable applicant possess?

II. Prepare for the Interview.

a. Thoroughly read the resume, cover letter, application and references.
b. Prepare the questions you plan to ask, avoiding repetitious questions already answered on the paperwork. Ask open-ended questions to get the applicant talking.
c. Confirm that none of your questions are illegal or discriminatory.
d. Plan the interview to avoid wasting valuable time. Failure to plan results in an unstructured interview, which is less productive and could appear unprofessional.

FUNCTIONAL OPENING OF THE INTERVIEW

Opening an interview is functional when it achieves several important purposes.

  1. Explaining what is going to happen
  2. Establishing rapport with the applicant in order to facilitate the flow of information during the next stage
  3. Actually beginning the information-gathering process

Although it is important to set your applicant at ease when welcoming him/her to the interview, it is not really necessary to engage in a lot of trivial rapport-building techniques or icebreakers such as chatting about sports, hobbies, the weather, etc. This can tend to waste valuable time and may even actually create more tension for the applicant who is eager to delve into how they are qualified for the opening.

Remember that this is a professional business meeting and the beginning of this meeting is more than just to start talking. What is discussed demonstrates how well the interview will proceed later on.

  1. Greet the applicant cordially and introduce yourself, along with your title, indicating (if appropriate) how you would like to be addressed (if appropriate).
  2. Explain the purpose of the interview and how it will proceed.
  3. Indicate why notes will be taken and ensure that the applicant understands that note taking is not indicative of negative impressions.
  4. If appropriate, ask the applicant how he/she would prefer to be addressed.
  5. Begin the rapport-building and the data-gathering by asking questions that are positive and that provide the applicant with an opportunity to begin informing you about personal characteristics, interests and skills.

Example: “What are some of your most significant accomplishments to date? “What personal qualities are represented in those accomplishments?”

QUESTIONING SKILLS

The questions you ask and the manner in which you ask them determine the extent to which otherwise unavailable information about the candidate will be obtained.

There are some underlying categories that will guide the interviewer in planning specific questions to ask during the interview.

  1. Competency: Is the candidate technically competent to perform the required duties and fulfill the required responsibilities?
  2. Motivation and Willingness: Given that the candidate is competent, does the person demonstrate the motivation to contribute and the willingness your practice is looking for?
  3. Adaptability or “Fit”: How well will the candidate interact in the practice’s interpersonal network? Depending on the specific requirements of a job, the fact that a person possesses a high degree of competency does not ensure that he/she will be able to work with others.
  4. Personal Fulfillment: How well will the company satisfy the needs, goals and ambitions of the candidate? The apparent desirability of the applicant for the company does not ensure a constructive fit. Both must be right for each other.

KEY QUESTIONS: DEVELOPING A QUESTIONING STRATEGY

It is helpful to prepare for an interview using the format listed below. For each of the key question areas, develop two or three more specific questions you would ask for each area. While the leading questions listed are not asked themselves, they constitute the background from which the interviewer’s game plan or systematic questioning strategy is constructed.

  1. Competency: What would you ask to determine the extent to which the applicant is technically qualified to perform the job?
  2. Motivation: What questions would you ask to determine if the applicant is highly motivated, willing to utilize those skills that are technical in nature?
  3. Adaptability/Chemistry: How will you determine the extent to which the applicant’s work style, ability to work and cooperation with team members might justify hiring?
  4. Satisfaction Potential: Regardless of qualifications, the job must be satisfying to the applicant or you will have a potential problem employee. What will you ask to determine if you are the right organization for the applicant?

Do not ask questions to simply fill time and avoid the discomfort of prolonged silence. To ask the right questions, one must know why the question is being asked and how it relates to hiring criteria. Prior to the interview, make two columns on a piece of paper.

On the left, list the qualities or criteria needed in a qualified applicant. In the column on the right, list those questions which you believe will elicit responses from the applicant or which will provide insight about the candidate’s fit with the respective criteria.

OPEN-ENDED QUESTIONS

When developing your questions, use those that elicit information. Open-ended questions accomplish this better than a closed or “yes” and “no” form of questioning. Open-ended questions minimize the possibility of an interviewer talking too much and dominating the interview. They also provide a basis for observing the applicant’s communication skills and ability to organize thought. And they give the applicant a chance to provide a more complete picture of his/her thoughts and feelings.

CLOSED QUESTIONS

Closed questions restrict the range of an applicant’s response by calling for a factual or “yes” or “no” answer. Closed questions are used to gain a clear position or opinion or to establish a point of fact. By their nature, closed questions do not encourage conversation.

The following examples demonstrate how to get the same basic information with the two different types of questions. The difference will demonstrate why the open-ended question will keep the applicant talking and call for a statement of position when required.

Closed: Do you mind working overtime?

Open: Since some positions may involve working overtime, could you describe the circumstances when you would or would not agree to work overtime?
Or
How do you feel about working overtime?

Closed: Would this position help you achieve any of your goals and ambitions?

Open: Could you describe the ways in which this position might be related to any of your goals and ambitions?

LEADING QUESTIONS

For the most part, these questions should not be asked. They encourage the applicant to misrepresent true feelings or intentions. The essence of a leading question is its implied pressure for a particular answer. The question implies what an appropriate answer should be.

Example: “Working overtime wouldn’t bother you, would it?”

“You wouldn’t mind transferring to _________, would you?”

SECONDARY QUESTIONS

As discussed earlier, your interview will be as successful as you are engaging the applicant in real communication. Be willing to follow up on a previous response. In this way you are asking for clarification or enlargement of a response.

Examples: “Could you please explain what you meant by…”
“Could you tell me more about…”
“How did you feel about that?”

Secondary questions should be used to probe abstract or generalized responses.

Example: If the question, “What is one of your greatest strengths?” is asked and an applicant responds with, “My ability to get along with people”, the interviewer needs to explore that response to achieve any meaningful understanding of what the applicant has said.

Example: In response to the question, “What are the qualities of an effective supervisor?” the applicant answers “leadership”. You have no real understanding of the applicant’s concept of leadership. You might ask, “What are some of the qualities you believe leadership involves?”

You want to understand what the applicant is saying and get clear understanding of who this person really is. Abstract or generalized answers must be broken down to more specific dimensions for clarity.

COMMON AND IMPORTANT QUESTIONS

Listed below are some important and commonly used questions that can provide valuable insight into an applicant’s job qualifications. They aim at technical and motivational data as well as providing a picture of the applicant’s self-knowledge and communication skills. Some questions may be more or less relevant, depending on the job’s scope of responsibility, complexity and difficulty.

  1. What did you like best about your previous positions? What did you like the least?
  2. What skills are required for getting along with and working cooperatively with others?
  3. How do you expect to be treated by a supervisor or a manager?
  4. Describe the qualities of a good boss.
  5. Describe the qualities of a good employee.
  6. What do you find most appealing about this position?
  7. What are the strengths or assets you would bring to this practice?
  8. What are your limitations that need further attention and development?
  9. What is your definition of a successful practice?
  10. What is required to succeed as an effective employee?
  11. What should happen during an effective performance review?
  12. We are looking for an employee who is ________________ (list the criterion). Convince me that you are that person.
  13. What goals do you feel this position will help you attain?
  14. What does “being motivated” mean to you?
  15. The interviewer describes a hypothetical, pressured scenario and asks, “How would you handle that?”
  16. How would you feel about attending seminars to enhance job training?
  17. What would you do if you saw another employee violating company policy?
  18. We are all defensive about some things. What do you get defensive about?
  19. What is the biggest mistake you have made on the job and what have you done about it?
  20. We all have difficulty getting along with certain types of people. Who are the people with whom you find you have some difficulty?
  21. What are some things you have done to demonstrate initiative and creativity?
  22. What do you know about our practice and what we do?
  23. What have you learned about yourself from your previous job?
  24. If we didn’t hire you, what would we be missing?
  25. What are the greatest reservations you have about taking this position if it is offered to you?
  26. How do you react to criticism?
  27. What does an effective communicator do?
  28. Employment is a mutual relationship. What makes you feel we are right for you?
  29. In what ways would you be both easy and difficult to work with?
  30. When you have difficulty with someone, how do you handle the situation? How do you handle defensive people?
  31. What do you hope to accomplish through this position that you were unable to achieve in your last one?

CLOSING

Unfortunately, some applicants who are later rejected are misled into believing that their chances for an offer are high. The way in which an interviewer closes an interview generates positive feelings about the practice. But it can also prevent the filing of a lawsuit. An inappropriate closing can mistakenly lead an applicant into believing that the position will be offered. When it is not, the natural feeling of betrayal and hostility could lead to a charge of discrimination. To close on a positive note yet minimize the possibility of a lawsuit, the following steps might be taken.

  1. Indicate that you have pursued all of the issues on your agenda.
  2. Ask the applicant if he/she has any questions or if there are any remaining issues which should be explored.
  3. Avoid any general comments indicating approval or disapproval of the applicant’s responses. Don’t build false hopes or unwarranted discouragement.
  4. Thank the applicant for providing useful information.
  5. Indicate what will happen with the information including:
    who will evaluate it
    when the decision will be made
    how the applicant will be notified

  6. Stand first, indicating the finality of the interview and escort the applicant to the appropriate exit.


Larry Silver

Dealing with a problem employee

Posted by Larry Silver

By Ken DeRouchie
I received an email recently from a doctor having a staff problem. I replied to her and thought this might benefit some other people out there so I’m going to have this be my new article.

Question:

As an employer, how can you tell to your employee to stop her

  • being hyper
  • not to laugh at the end of each sentence
  • to stop blowing her nose as everybody can hear it
  • to stop asserting herself on someone else’s conversation

I had such a hard time saying something to my assistant about these issues. Everybody in
the office is being affected and I am not happy at all with her. I tried my best to tell her what I would prefer from her as an employee but it hasn’t worked.

Please help me.

Dr. S

Answer:

Dr. S,

There are several things that can help you in this current situation and help prevent this from happening in the future. This is a bit of a lengthy reply due to the nature of your problem. Please take the time to read through this as I believe it will give you some insight into the problem and how to handle it.

The first, and probably the most important thing is to make sure that you have very detailed job descriptions and office policies in place. In your office policy manual, there needs to be written policies about acceptable and unacceptable employee behavior. When new employees are hired, they are given a copy of this policy manual and they are to read and sign off on them. This lets them know what is and isn’t permitted in your office. They agree to this and you now have legal recourse for disciplinary action and/or termination for non-compliance.

As new policies are written, a copy is handed out to all employees for them to read and sign off on. These signed agreements are then added to their personnel files. These can then be referenced in regular employee evaluations, disciplinary actions and if needed, termination situations.

If, however, you only deliver your requests verbally, you leave these requests open to interpretation. It is imperative to have everything in writing so that there is no room for interpretation.

The other underlying issue I see here is hiring the right people to begin with. There are three steps here.

  1. How to attract the right kind of employees
  2. How to determine who to hire
  3. How to train them to do their job properly after you’ve hired them

When you are looking to fill a new position, the wording of your ad/listing is key. Where to advertise is also key. Utilizing employment agencies that pre-screen applicants to YOUR qualifications can greatly increase the quality of candidates you see, weeding out the lower quality people ahead of time.

Determining who to hire is a shot in the dark for most doctors. They read a resume, conduct an interview and take a shot. No one writes on there resume that they are chronically late, don’t take direction and can’t get along well with others. What you see on a resume is only what the applicant wants you to see. Similarly, all you hear in an interview is what they want you to hear. They say the right things or at the very least what they think YOU want to hear in order to get the job.

After they are hired they stay on their best behavior until they get comfortable and then they become themselves. Only then do you know who you’ve hired.

We believe you need a more objective way to screen and hire people so that you have a better idea of who they are, what kind of personality they have, their responsibility level, their aptitude and their work ethic. Corporations have been hiring people this way for years. Small businesses suffer through much higher turnover rates due to their lack of successful hiring techniques.

We teach doctors to test applicants. Personality tests, IQ tests, Aptitude tests are all implemented to get a feel for who a person is and how they will fit in to your practice and interact with the staff and more importantly your patients.

Once you have hired the right person, you then need to make sure you train them properly. This is where detailed and up to date job descriptions and office policies come into play. It is vital that you equip your new employee with the proper tools to do their job rather than throw them to the wolves and hope they pick up the proper way to do things as they go.

Here is a policy regarding employee performance evaluations. Take a look at this as I think it will give you an idea of the kinds of policies you should have in place in your office policy manual.

PERFORMANCE EVALUATIONS
We have established a procedure for evaluating job performance on a regular basis. These Performance Evaluations are vital for future planning and provide fair, timely and objective measurement of performance of job requirements.

We conduct at least two evaluations of a new employee during the first year. The first after approximately 90 days of employment and a second evaluation is completed after 9 to 12 months of employment.

Thereafter, each staff member receives a performance evaluation at least twice per year.

We will advise you of the time for your scheduled review at least seven days in advance. This gives both of us an opportunity to prepare so that areas of mutual concern can be addressed.

The performance appraisal is designed to:

  • maintain and improve job satisfaction by letting staff members know we are interested in their job progress and personal development
  • serve as a systematic guide to recognize needs for further training and progress planning
  • ensure a factual, objective analysis of an employee’s performance as compared with job requirements
  • help place employees in positions within the practice that best utilize their talents and capabilities
  • provide an opportunity to discuss job problems or other job-related interests
  • serve as an aid in salary administration
  • provide a basis for coordinating goals and objectives (those of the employee and of the practice)
    give recognition for superior performance

The performance evaluations will address job factors and behaviors that are observable, measurable and specifically related to job performance. The factors we consider are:

  • quality of work
  • employee relations
  • quantity of work
  • patient relations
  • job knowledge

Salary adjustments are not necessarily made at the time of the performance evaluation.

Your current situation is a volatile one. This person is causing you stress, is making the other staff uncomfortable and is bringing the overall morale of the practice down. Patients can and will pick up on this and it will negatively effect their experience at your practice. Doctors that are uncomfortable with leadership and necessary confrontation and communication will often let these situations go until they fester and erupt into a hostile situation. Good employees can leave a practice when a bad employee is not confronted and handled. If you don’t implement better hiring techniques followed by detailed job descriptions and office policies, you open your self up to the possibility of lower quality employees who don’t get trained well. Ultimately this will cause stress for you and conflicts with your staff. However, if you hire higher quality employees and equip them with ALL of the tools needed to perform their job, you will find that they are more inclined to deliver what is needed and wanted by you and they will strive to achieve it.


Larry Silver

ECONOMIC WOES LEAD TO EMPLOYMENT DISHONESTY

Posted by Larry Silver

Employee dishonesty can take many forms. No one seems to be exempt, and tough economic times only make matters worse. Although embezzlement can happen at all levels, we have encountered a number of situations in small to medium sized companies where employees were trusted and often thought of as family. When embezzlement is discovered, there is not only the reality of economic loss, but a real feeling of betrayal. After discovery, your options may be limited. The key is to establish and diligently adhere to a system of checks and balances, to minimize opportunities.

Establish Procedures

The first step is to meet with your certified public accountant, or attorney, to establish the correct procedure for your business. This alone can be difficult, because in many instances your loved and trusted bookkeeper will feel like he or she isn’t trusted. Although the feeling is understandable, you can explain that it is something that must be done because (a) it is the correct business practice; and (b) it will confirm the great job your bookkeeper is currently doing. Furthermore, should your bookkeeper become ill or otherwise unable to perform his or her duties, the procedures will already be in place for the replacement. Don’t get talked out of this step, or you could be talking to us, or someone like us, under more strenuous circumstances.

Follow Your Procedures

Establishing procedures won’t help you unless you are willing to follow the established guidelines. It takes a little effort, but nothing equivalent to the forensic work associated with discovering and determining the amount of embezzlement. Where there is embezzlement, seldom is it limited to one method of stealing. Don’t stop looking after you’ve discovered one source of theft. It is like peeling an onion. In one of our cases, the CPA said he was aware of fifty ways to embezzle money, and forty-eight had been employed.

Remedies

How you react when you discover your loss may have a significant impact on the extent of your recovery. Your emotions will run from anger, to embarrassment, how will you recover your loss. Although our advice is sought with regards to each of the above, our primary focus is usually on how to recover your money.
Acting fast is a proven key. As the victim you have a great deal of leverage. The fear of prosecution is a great motivator. Your initial reaction is to call the police and “throw away the key.” While this knee jerk reaction is understandable, it is seldom a motivation for repayment. Although criminal prosecutions can result in “civil compromises,” these are frequently less rewarding than can otherwise be accomplished.
Strike fast and tie up assets. Locate property and collect what you can. If there is a spouse or significant other, don’t overlook their involvement. If significant amounts were stolen, there is a good likelihood they were  suspicious of what was going on.

Call your insurance carrier. If you don’t have employee dishonesty coverage, get it. Make sure your limits are reasonable. You would be amazed at how much can go missing. We have been involved in cases for small to medium companies where the amounts exceeded $1,000,000.

The banks and credit card companies may be a source of recovery. Under the right circumstances, there can be liability for forgery, negligence and credit card fraud. Third party sources of recovery should not be overlooked, as the embezzlers may not have been a good steward of your money. Insurance claims and claims against banks and credit card companies normally require you to prosecute, but by the time you get to this stage, you normally have little to lose.

If you do not have a procedure of checks and balances, contact your professional today.

Written by:
Bitts & Hahs, Attorneys at Law
4949 SW Meadows Rd., Suite 260
Lake Oswego, OR 97035
503-228-5626
www.bittner-hahs.com


Larry Silver

Identifying Patients at Risk for Fatal Cardiovascular Event

Posted by Larry Silver

A new study indicates dentists can play a potentially life-saving role in health care by identifying patients at risk of fatal heart attacks and referring them to physicians for further evaluation.

Published in the November issue of the Journal of the American Dental Association, the study followed 200 patients (101 women and 99 men) in private dental practices in Sweden whose dentists used a computerized system, “HeartScore,” to calculate the risk of a patient dying from a cardiovascular event within a 10-year period.

Designed by the European Society of Cardiology, HeartScore measures cardiovascular disease risk in persons aged 40-65 by factoring the person’s age, sex, total cholesterol level, systolic blood pressure and smoking status.

Patients with HeartScores of 10 percent or higher, meaning they had a 10 percent or higher risk of having a fatal heart attack or stroke within a 10-year period, were told by dentists to seek medical advice regarding their condition.

Twelve patients in the study, all of them men, had HeartScores of 10 percent or higher. All women participating in the study had HeartScores of 5 percent or less.

Of the 12 male patients with HeartScores of 10 percent or higher, nine sought further evaluation by a medical care provider who decided that intervention was indicated for six of the patients. Two patients did not follow the dentist’s recommendation to seek further medical evaluation and one patient was only encouraged by his dentist to discontinue smoking. Physicians for three patients were not able to confirm their risk for cardiovascular disease.

All 200 patients enrolled in the study were 45 years of age or older with no history of cardiovascular disease, medications for high blood pressure, high cholesterol or diabetes and had not visited a physician during the previous year to assess their glucose, cholesterol or blood pressure levels.

The study’s authors conclude that oral health care professionals can identify patients who are unaware of their risk of developing serious complications as a result of cardiovascular disease and who are in need of medical interventions.

According to the authors,

“With emerging data suggesting an association between oral and non-oral diseases, and with the possibility of performing chairside screening tests for diseases such as cardiovascular disease and diabetes, oral health care professionals may find themselves in an opportune position to enhance the overall health and well-being of their patients.”

About the American Dental Association

The not-for-profit ADA is the nation’s largest dental association, representing more than 157,000 dentist members. The premier source of oral health information, the ADA has advocated for the public’s health and promoted the art and science of dentistry since 1859. The ADA’s state-of-the-art research facilities develop and test dental products and materials that have advanced the practice of dentistry and made the patient experience more positive. The ADA Seal of Acceptance long has been a valuable and respected guide to consumer dental care products. The monthly Journal of the American Dental Association (JADA) is the ADA’s flagship publication and the best-read scientific journal in dentistry. For more information about the ADA, visit the Association’s Web site at www.ada.org


Larry Silver

Bioluminescence Imaging Used for Eye Cancer Detection

Posted by Larry Silver

Newswise —At the moment, doctors rely on biopsy analysis to determine the progression of eye cancer. However, researchers now believe that a new technology, bioluminescence imaging (BLI), will allow doctors to detect tumors earlier and quickly choose a method of treatment that doesn’t necessarily involve eye surgery.

BLI is a new technology that uses the making and giving off of light by an organism to map diseases in a non-invasive way. Scientists have harnessed this technology to delicately detect and monitor various diseases, including eye cancer. BLI has several advantages over biopsy analysis, including in vivo monitoring, higher sensitivity, easier use and an overall more accurate correlation between cell numbers detected and tumor growth.

A study detailed in the Association for Research in Vision and Ophthalmology’s peer-reviewed Investigative Ophthalmology & Visual Science (“Non-invasive visualization of retinoblastoma growth and metastasis via bioluminescence imaging”) shows how the researchers, led by Qian Huang, MD, PhD, of the First People’s Hospital in Shanghai, China, were able to effectively create human eye tumors in mice using particular genes to label eye cancer.

BLI was then performed on the mice using the NightOwl LB 981 Molecular Imaging System to monitor the growth and succession of these created tumors.

“BLI allowed sensitive and quantitative localization and monitoring of intraocular and metastatic tumor growth in vivo and thus might be a useful tool to study cancer biology as well as anti-cancer therapies,” said Huang.

Eye cancer is the most common and aggressive form of cancer found in children under the age of 5. As with most cancers, locating the tumors during the early stages of the disease is key. “Eye removal is usually performed for larger tumors. Small tumors are treated using therapeutic approaches such as chemotherapy. Because of the fast progression, early detection is important for preservation of vision, eye retention and even survival,” says Huang.

Investigative Ophthalmology & Visual Science (IOVS) – a peer-reviewed journal published monthly online and in print (through December 2009), IOVS publishes results from original hypothesis-based clinical and laboratory research studies. IOVS ranks No. 4 in Impact Factor among ophthalmology journals.

The Association for Research in Vision and Ophthalmology (ARVO) is the largest eye and vision research organization in the world. Members include more than 12,500 eye and vision researchers from over 80 countries. The Association encourages and assists research, training, publication and knowledge-sharing in vision and ophthalmology. For more information, visit www.arvo.org.


Larry Silver

Hot Tip! The Staff Infection

Posted by Larry Silver

The Staff Infection

The “Staff Infection” is a term I came up with long ago to discuss the effects that a negative employee can have on a team. This term was always very popular with our clients, as it was very real to them that a staff infection could be just as dangerous as a “Staphylococcus Infection” and could spread just as quickly.

In short, the staff infection starts in various ways, such as with a staff member that often rolls his or her eyes at staff meetings. This staff member engages in rumor mongering and can be counted on to “stir the pot” in the office. This can be the idle staff member or the person who always seems to be busy but gets nothing done. You get the idea. This is the employee that you are “just not sure about”.

What would you think of a doctor that did not practice good sepsis control and permitted staphylococcus germs to fester in or on his or her equipment? It simply does not make sense does it – nobody would do that. Preventing any sort of infection in a patient is more than second nature to any doctor. What would your opinion be of a doctor that was aware that his or her patient had an obvious staph infection but did nothing about it? Enough said.

Let’s look at the practice, similarly, as an individual body. The office has an organic nature, it seems to grow and contract. It reacts to the changes in its environment. It is made up of individual units working together, similar to cells in a body. And just like any organic body, the practice is susceptible to infection. Failing to handle this infection when it first presents itself can be fatal.

I wish I could tell you that handling a “staff infection” was a simple routine such as “just do this one thing, and your disease will clear up.” Well, I can’t, I can give you some tips though that might help.

  1. Do not let the first sign of a staff infection fester. As soon as you notice that critical glance in your staff meeting, take it up at once. Maybe not during the meeting but as soon as possible. Sometimes a simple discussion will clear up the infection.
  2. If by chance you have allowed this problem to go on too long with out addressing it, a more formal conversation might be needed. Notes should be taken during the meeting with the staff member. Any agreements about job performance and expectations should be put in writing for future evaluation if needed.
  3. Have explicit job descriptions and office policies as well as metrics for each job. These key management tools should clearly lay out the benchmarks for job performance for every position in the office.
  4. Have a means for staff to report violations of office policies and/or failure to adequately perform job duties. Keep proper personnel files on all staff in which all hiring and performance records are kept.
  5. Conduct regular job reviews. Review any information in the personnel file as well as reviewing the staff member’s application of their job description and office policies. Lack of adequate productivity should be easily seen through good job reviews.
  6. As needed, there are many other steps that can and should be taken to address problematic staff such as: disciplinary warnings, suspension, and in the extreme case, termination.


It is important to know that very rarely does a staff infection go unnoticed by the rest of the staff. To some degree, the problematic staff member is slowly infecting the other staff members. Use of point #4 above is therefore important.

The infection will spread in direct proportion to owner’s unwillingness to handle the staff member creating the problem. Remember that a staff infection very rarely goes away all by itself.

If you want any further help or information about hiring, training and working with staff, feel free to contact us at: info@silkinmanagementgroup.com or visit our website at www.silkinmanagementgroup.com

I invite you to share any thoughts through our Discussion Forum at the Silkin Facebook Page BY CLICKING HERE and/or visiting our blog site www.blog.silkinmanagementgroup.com.

Charles Mann
Managing Editor
The Practice Solution Magazine

Silkin Group Home Page
Visit our Facebook Page
Silkin Group Blog
Silkin Group Press Room
The Practice Solution Magazine

For more information about how to better manage your practice and how to attain the goals you first set when starting out in practice, contact Silkin Group at 1-800-695-0257 or e-mail us at contact@silkinmanagementgroup.com. You can also ask us about obtaining a free practice analysis.

Click on this link to see a video presentation about Silkin Group’s services.


Larry Silver

The Problem with Policy

Posted by Larry Silver

My employee was late 3 times in the last 2 weeks. Per our office policy, I am supposed to suspend her for one day with out pay. We are really busy this week and I really need her to work. What should I do?

The problem that you have here is not uncommon. Unless you enforce the office policy, you will render the policy null and void by setting a precedent. Written policy not consistently enforced is not office policy. Office policy adherence is determined by continued enforcement by management.

Why you should have policy: Policy is the guiding principle behind the operation of any organization. Policy sets the ground rules and develops group agreement of how things “should be”. In order for any office to function most effectively as a team, agreements must be known and adhered to for smooth, efficient coordination and cooperation. As long as people know what the rules of the activity are, and those guidelines are clearly presented as being in the best interest of the activity, the policies will normally be followed. Any conflict can usually be resolved by reference to existing policy within the organization that covers such situations.

By not enforcing the policy, you send a signal to the group that policy is only enforced some of the time. It can open you up to discrimination claims by disgruntled employees who feel you follow policy for some people, but not others. You may also find your self in a situation of not being able to enforce this same policy at a later date.

You need to have office policy. But, if you have policy and don’t enforce it, or only sporadically enforce it, it can be more troublesome than not having any policy at all as it can open you up to legal claims.

The lesson is to have good, understandable, workable office policies and see that they are followed consistently.

Charles Mann
Managing Editor

The Practice Solution Magazine

Note: This article is not intended as legal advice nor should any statement made in this article be construed as legal advice. If you have any questions about the labor laws and rules of your state, contact your state labor board or labor attorney.

For an example office policy, or for more information about how to better manage your practice and how to attain the goals you first set when starting out in practice, contact Silkin at 1-800-726-1810 or e-mail us at contact@silkinmanagementgroup.com. You can also ask us about obtaining a free practice analysis.

Click on this link to see a video presentation about Silkin’s services.


Larry Silver

The Times they are a Changing.

Posted by Larry Silver

As an employer and a manager, I long ago learned the value of keeping up to date on the ever -changing rules of doing business in my home state.

Recently, I was presented with a concern of an employee that wanted to take maternity leave from work as afforded to her by the Federal Medical Leave Act. Having some familiarity with the act, I was about to point out to her that the FMLA only applied to those companies with 50 employees or more. As our company employs only 40 employees in a private firm, I told her that I would of course look into her request and get back to her the next day. I am very glad I did.

The Federal Medical Leave Act does indeed apply to employers with 50 or more employees. (For further information on the FMLA CLICK HERE.) Had I just left the matter at that, I would have made a grave error and would have created an unfortunate problem for my company and our employee. What I discovered was that my state also has a medical leave act called the Oregon Medical Leave Act. If I had not taken the time to really look into the issue and not just work from one source I would have made a costly mistake.

In a past issue of “Hot Tips!” I mentioned the importance of visiting your state website and encouraged our readers to really take the time to stay up to date on the issues relevant to managing employees. Since we are a management resource for the health care filed, I felt it important to take this a step further for anyone reading this. I therefore did some further research and can now give you the exact website that you can go to find your states labor department. From reading through the site you can find the relevant laws and rules that will apply to a variety of employee situations and decisions you often make, similar to the example I gave above.

Below you will find, listed by state all of the sites in one easy to use location.


I hope you find your state’s web site just as valuable and informative as I have in Oregon. As always, if you have a specific concern with a legal problem, or if you have a specific legal question, always consult a licensed and board certified attorney in your state.

Charles Mann
Managing Editor
The Practice Solution Magazine
Published by Silkin

For more information about how to better manage your practice and how to attain the goals you first set when starting out in practice, contact Silkin Management Group at 1-800-695-0257 or e-mail us at contact@silkinmanagementgroup.com. You can also ask us about obtaining a free practice analysis.

Click on this link to see a video presentation about Silkin Management Group’s services.


Larry Silver

ECONOMIC WOES LEAD TO EMPLOYMENT DISHONESTY

Posted by Larry Silver

Earlier this week I received the following article from one of our attorneys, via my publisher. I felt that it would be very useful for our Hot Tips readers.  Some time ago I published in Hot Tips some suggestions to help prevent employee embezzlement. The information below will add useful information to that subject. I hope you find this helpful.

Charles Mann
Managing Editor,
www.solutionsmags.com

ECONOMIC WOES LEAD TO EMPLOYMENT DISHONESTY

False Sense of Security
Employee dishonesty can take many forms. No one seems to be exempt, and tough economic times only make matters worse. Although embezzlement can happen at all levels, we have encountered a number of situations in small to medium sized companies where employees were trusted and often thought of as family. When embezzlement is discovered, there is not only the reality of economic loss, but a real feeling of betrayal. After discovery, your oppositions may be limited. The key is to establish and diligently adhere to a system of checks and balances, to minimize opportunities.

Establish Procedures
The first step is to meet with your certified public accountant, or attorney, to establish the correct procedure for your business. This alone can be difficult, because in many instances your loved and trusted bookkeeper will feel like he or she isn’t trusted. Although the feeling is understandable, you can explain that it is something that must be done because (a) it is the correct business practice; and (b) it will confirm the great job your bookkeeper is currently doing. Furthermore, should your bookkeeper become ill or otherwise unable to perform his or her duties, the procedures will already be in place for the replacement. Don’t get talked out of this step, or you could be talking to us, or someone like us, under more strenuous circumstances.

Follow Your Procedures
Establishing procedures won’t help you unless you are willing to follow the established guidelines. It takes a little effort, but nothing equivalent to the forensic work associated with discovering and determining the amount of embezzlement. Where there is embezzlement, seldom is it limited to one method of stealing. Don’t stop looking after you’ve discovered one source of theft. It is like peeling an onion. In one of our cases, the CPA said he was aware of fifty ways to embezzle money, and forty-eight had been employed.

Remedies
How you react when you discover your loss may have a significant impact on the extent of your recovery. Your emotions will run from anger, to embarrassment, how will you recover your loss. Although our advice is sought with regards to each of the above, our primary focus is usually on how to recover your money.
Acting fast is a proven key. As the victim you have a great deal of leverage. The fear of prosecution is a great motivator. Your initial reaction is to call the police and “throw away the key.” While this knee jerk reaction is understandable, it is seldom a motivation for repayment. Although criminal prosecutions can result in “civil compromises,” these are frequently less rewarding than can otherwise be accomplished.
Strike fast and tie up assets. Locate property and collect what you can. If there is a spouse or significant other, don’t overlook their involvement. If significant amounts were stolen, there is a good likelihood they were at suspicious of what was going on.
Call your insurance carrier. If you don’t have employee dishonesty coverage, get it. Make sure your limits are reasonable. You would be amazed at how much can go missing. We have been involved in cases for small to medium companies where the amounts exceeded $1,000,000.
The banks and credit card companies may be a source of recovery. Under the right circumstances, there can be liability for forgery, negligence and credit card fraud. Third party sources of recovery should not be overlooked, as the embezzlers may not have been a good steward of your money. Insurance claims and claims against banks and credit card companies normally require you to prosecute, but by the time you get to this stage, you normally have little to lose.
If you do not have a procedure of checks and balances, contact your professional today.

Written by:
Bitts & Hahs, Attorneys at Law
4949 SW Meadows Rd., Suite 260
Lake Oswego, OR 97035
503-228-5626
www.bittner-hahs.com


Larry Silver

Tracking Results

Posted by Larry Silver

In today’s economic climate a great deal can be said for the benefits of marketing effectively. There are many mediums for marketing a practice – referrals from existing patients/clients is normally the best and most cost effective means of getting new patients/clients. External marketing such as the Internet, business directories, new resident mailings, bus benches, Valpacks and even the local newspaper, radio and TV have worked for some. Some form of one or more of these has proven to be successful in various markets, but not all of them are effective in all markets. Given all this, it is vitally important to know how your new patients/clients are finding out about you and, based upon this, focusing your marketing dollars in the most effective areas.

This brings up the topic of this month’s “Hot Tip!”

Somewhere on your new patient/client form there should be a little line that says, “How did you find out about our practice?” (If you don’t have this line on your new patient/client form, you should institute it right away.) Some offices have little check boxes that mention their various marketing activities and others just offer a blank line to be filled in. However you do it, the purpose of this line is for your new patients/clients to tell you which of your marketing tools have been most effective. This is vital information for your promotional and marketing activities, as long as you do something with it. Unfortunately many doctors don’t use this information properly.

In fact, the last poll taken in our on-line journal “The Practice Solutions Magazine”, showed that 54% of those responding said that they “did nothing” with the information that they got from this question on their forms. At the same time, our current poll shows 43% stating that they are increasing the amount of marketing they are doing to counteract the down turn in the economy. The poll data seems to support that “marketing for new patients/clients” is important to practice owners but the importance of tracking effectiveness of marketing seems to be missing.

So let’s take up “effectiveness of marketing” as a running theme and discover how it might be used. A simple starting point would be to actually use the data you have already gathered by doing a quick break down of where your new patients/clients came from for the past 6 to 12 months. Assign your front desk person the task of reviewing the files of all your new patients/clients and tabulate their responses to the question concerning what brought them to your office. Once the tabulation is done, have this staff member provide you with a summary of this information – i.e. “45% came from referrals, 20% came from new resident mailings, 10% from Yellow Pages ad, etc.” Using the results from this summary, locate the area/s that seems to be providing you with the most new patients/clients. Do not be surprised if “referred by a friend or relative” shows up as the number one item – in fact you should be surprised if it doesn’t.

At this point, inspect your marketing budget. By this is meant, what do you spend to make sure people know how to find your practice? How much are you spending on your half-page ad in the phone book and how many new patients/clients came from that? What kind of materials do you have to stimulate referrals? Examine each area that you are spending your marketing dollars on and what your return is on those dollars. You’ll then want to invest more heavily in the area/s that are giving you the most return, taking into account the cost effectiveness of each activity. For example, if “referrals” is your number one draw, and the Yellow Page ad is not producing much, how can you shift your Yellow Page dollars into more support activities for referrals? As an example, creating a “Refer a friend or family member” card might be one way to start.

To summarize:

  1. have a means to know where your new patients/clients are coming from;
  2. don’t ignore this data – tabulate and evaluate the information;
  3. invest your marketing budget in the most effective areas based upon the data you gather;
  4. regularly re-assess this information and adjust your marketing plans and investments accordingly.

If you do the above regularly and religiously, you’ll find a steady increase of new patients/clients coming in your door.

Participate in our Discussion Forum! Check out the Silkin Facebook Page BY CLICKING HERE

Charles Mann
Managing Editor
The Practice Solution Magazine

For more information about how to better manage your practice and how to attain the goals you first set when starting out in practice, contact Silkin Management Group at 1-800-695-0257 or e-mail us at contact@silkinmanagementgroup.com. You can also ask us about obtaining a free practice analysis.

Click on this link to see a video presentation about Silkin Management Group’s services


Larry Silver

Public Relations and Social Responsibility

Posted by Larry Silver

This month’s “HOT TIP!” concerns the benefits to you and your practice when you get out of the office and get actively involved in your community. Whether it’s sponsoring your local little league team, or encouraging your area children’s museum to do an eye screening or “Celebration of Smiles” dental health day, you can make a positive contribution that solidifies your place in the community.

Many people volunteer with no expectation of anything in return, other than the personal sense of value, worth and integrity that comes from helping out their neighbors. You can feel great AND grow your practice through the word of mouth referrals that can come from this activity, making it easily worth the investment of your time and money.

One definition of public relations is “Good works made well known.” Many practices try to do this through a variety of marketing methods, sometimes spending a substantial amount of money doing so. While we recommend lower cost and higher return internal marketing activities, we also help our clients look for community activities that not only help those involved, but also create goodwill for the practice. This is an excellent and inexpensive way to market a practice.

Larger companies understand how important it is to be active in their communities. Socially responsible companies build brand loyalty by sponsoring events and non-profit projects: people like to know that their money is going to a company that “walks the talk” and works to make the world a better place.

I’m sure you’ve seen many examples of this such as your local bank sponsoring charities or other non-profit activities in your area. This concept is no different for a doctor’s practice. Giving of your time, money and personnel to actively work with local causes is a terrific way to build loyalty among current and future patients. Many employees also report a greater sense of pride working for an office that is making a difference in their communities.

Some examples include: providing free emergency services or services in general for the underprivileged, donating finances and/or labor for local cleanup efforts, manning bins at local food drives. The list goes on and on! Read your local newspaper to stay in touch with the types of activities that are going on in your area that you can contribute to, or think of your own, like offering free health screenings at libraries, schools, etc.

Larger companies do not miss the public relations benefit of being socially responsible, so why should your practice?

Ask your staff what sort of programs they would like to support. Your practice could donate time at a local summer fair doing a food drive. This type of project can be a bit more involved in terms of time and commitment, but has a huge impact in the community. The staff can wear t-shirts with the practice’s name on it for extra marketing value.

Although a community depends on the private practice for daily health care, the private practice also depends on the community for its livelihood. So whether it is by financial contribution, or by personal effort, get out there and get involved! The returns will be felt by everyone in the practice.

As “HOT TIPS!” is read by over 10,000 subscribers every month, this month’s HOT TIP is dedicated to those people that are active in their communities every day doing what they can to help.

I invite you to share any thoughts through our Discussion Forum at the Silkin Facebook Page BY CLICKING HERE.

Charles Mann
Managing Editor
The Practice Solution Magazine

Silkin Management Group Home Page
Visit our Facebook Page
Silkin Management Group Blog
Silkin Management Group Press Room

For more information about how to better manage your practice and how to attain the goals you first set when starting out in practice, contact Silkin Management Group at 1-800-695-0257 or e-mail us at contact@silkinmanagementgroup.com. You can also ask us about obtaining a free practice analysis.

Click on this link to see a video presentation about Silkin Management Group’s services


Larry Silver

From the Editor

Posted by Larry Silver

For starters, we wish to thank everyone reading our on-line magazine for the massive amount of help you provided in our continual surveying of practice owners. Our survey team was very busy last quarter calling all over the U.S. and Canada. The survey results were very interesting and helped us design the format for this issue of The Practice Solution Magazine.

Given the nature of today’s financial climate, it is not surprising that our survey team found that there is a great deal of attention on the ability of the practice to attract new patients and clients. Our surveys showed that 60% of the professionals we talked to do little or nothing to effectively market for new patients/clients. Therefore we have included in this issue several articles on marketing, with emphasis on internal marketing (rather than fancy and/or expensive advertising) and more specifically, doing effective marketing surveys to find out what your public needs and wants. Knowing the basics of marketing will help attract more new patients – something vital in these economic times.

We have also included a number of articles presenting viewpoints that we think are important for professionals to have during the economic slump we are all experiencing.

As always, we scoured the Internet newswires for profession specific articles that we thought might be of interest and use to our readers.

In the spirit of offering solutions to the everyday business of running a practice, I offer you the next issue of The Practice Solution Magazine.

Charles Mann
Managing Editor
The Practice Solution Magazine


Larry Silver

Letter to the Editor

Posted by Larry Silver

Letter to the Editor
By David E Lawler, DDS, D. ABDSM
Bloomington, IN


Hello,

This week, I had the pleasure of being interviewed for an article in The Practice Solution Magazine by one of your research staff. As a result of this interview, I want to encourage you to step back and look at a different topic with a broader perspective.

You are a practice management magazine whose perspective should clearly be focused on that topic. However, there are opportunities in dentistry that are rarely looked at that, especially in these troubling economic times, should be more widely discussed.

The addition of sleep medicine to my practice of dentistry has been, not only the most rewarding professional thing that I have ever done, it has been a wonderful cushion in a time of economic down-turn. If the absence of pain, bleeding or swelling, a great deal of dental services are highly discretionary and can be delayed. However, people always need air and those people with sleep-breathing disorders have their air supply greatly reduced during the night as well as their quality of life during the day and their overall health. All they need is the proper information and a therapy that they can tolerate to accept treatment.

Last week I was asked to speak to the annual meeting of the Indiana Self-Insurers Association on the management of these sleep-breathing disorders with oral appliance therapy. This was a room full of people who are intimately aware of the cost of medical care. They were wide-eyed as I showed statistics showing the dramatic drop in medical costs associated with the proper management of these disorders. In addition, there were quite a few present that now know that the annoying sound coming from their bed partners as they sleep is the sound of these people fighting for their next breath.

Similarly, yesterday I spoke to a state-wide respiratory therapy conference at our local hospital on sleep-related breathing disorders like snoring, upper airway resistance syndrome and sleep apnea and their management with oral appliances. At the break following my discussion, I was surrounded by attendees at this conference who wanted to tell me that they now recognized in themselves or their spouses, the conditions that I had just talked about. These are people who are intimately and professionally familiar with the process of breathing but who were unaware of the many forms these disorders take that allow them to remain unrecognized. Similarly, there was a sizable number who knew they or a family member had a problem but were unaware that there was an alternative, patient friendly, therapy as a substitute to the traditional CPAP therapy that they could not tolerate.

These sleep-related breathing disorders are epidemic in our society, with as many as one in five adults having a sleep breathing problem significant enough to affect their health. Since these occur only during sleep, the vast percentage of people suffering from these disorders have no clue that they are affected. Occasionally a bed-partner will say something, but usually that is only to complain about the noise disturbing their own sleep. Even those people seeking regular medical care usually are undiagnosed, since only a very small number of physicians question their patients about sleep quality. Those people who are fortunate to get a diagnosis are routinely prescribed a therapy that as many as 50% refuse or fail within the first six months of use. Those who remain undiagnosed, or who are diagnosed and yet unmanaged because they cannot tolerate their prescribed therapy, go on to live shortened lives of diminished quality with medical expenses easily doubling those who are diagnosed and able to tolerate therapy.

Oral appliance therapy can offer life saving treatment to untold thousands of people if they only knew about it. Dentists would gladly add this therapy to their existing practice model if they knew how easy it was for them to recognize these problems in their existing patient base.

Sleep medicine is a very young field of medicine. Because of that, physicians are only now starting to connect the dots between these disorders and many of the problems that they commonly treat. What is necessary is more public recognition of these disorders and this is where I believe strongly you can play a role.

I was very impressed by the amount of time and the intensity in which researcher focused on his interview this week. I am fully convinced that he is more than qualified to develop this topic in order to give it the attention your readers deserve.

Thanks, in advance, for your consideration.

David E. Lawler DDS, D. ABDSM
Diplomate American Board of Dental Sleep Medicine
The Center for Sound Sleep
www.thecenterforsoundsleep.com
2909 Buick Cadillac Blvd.
Bloomington, IN 47401
812-339-4499
812-339-6013 fax
Better health through restful sleep


Larry Silver

How to Survive Today’s Economic Time’s

Posted by Larry Silver

by Shaw Millerman

Recently the President addressed the nation regarding the economic situation we are all experiencing in this country and around the world. It is very clear that we are now seeing the very obvious signs of a national recession, despite whatever spin may be put on it by the politicians from both sides of the aisle. We know now, because it is becoming very clear to diverse business owners everywhere, that the crisis is not just going to be limited to the finance sectors or the housing sectors. And we know that it is likely to get a lot worse before it gets any better and that it won’t be over for some time. The economic problems go deep and it could possibly be a decade before we’re able to fully recover. That’s a moderate time frame, not overly optimistic or the doomsday scenario that some would have us believe.

That’s what’s happening today.

We have worked with health care professionals for over 25 years and have gone through several periods of down economic times – some called them recessions, some called them “stagflation”, as well as a variety of other names. Whatever cute label one wants to attach to tough economic times, there is no fooling people with the fact that the economy in general, and their specific economic situation is far from ideal. And today, it is stated as being the worst economic situation since the Great Depression of the 1930′s.

What we have seen happen with stand alone health care professionals during a recessionary period such as this is that the doctor/owner “tightens up”. By this we mean that they usually get very worried, get “conservative” and reduce their promotion. They may start letting go of staff people and make do with fewer personnel. They often cut corners and consequently the quality of their service may begin to suffer. When the quality of service goes down patients become unhappy and start looking for another practice. They look for a practice that provides better service. Doctors who act in this manner will begin to lose some portion of their patient base. Thus it can make it a perfect time for doctors who don’t succumb to such thinking to capture more market share and increase their productivity.

Our clients generally thrive during recessions because they know what to do. They have learned how to manage their practice through objective means. They know how to effectively market without it costing an arm and a leg. We’ve been through three of these economic downturns/recessions and we’ve seen how our clients are able to take advantage of the situation rather than be the effect of it. In fact, as part of our surveying, we recently found out that, on average, our clients who are trained and skilled in practice management, have been increasing their productivity by 10% to 15% percent during those years the nation has been in recession. And this includes all socio-economic areas of the country. This type of growth is generally not true for the average practice owner.

Our clients thrive because they are able to prepare for down economic periods. They know how to closely monitor all of key areas of the practice and thus are in control of the practice. They know if they are understaffed or overstaffed, or if they have underutilized staff. Our clients have efficient systems that keep “busy work” off their desks. They don’t have a desk full of backlogged activities. They don’t give new projects to overloaded staff people. They make realistic plans based on objective data and don’t squabble with their spouses over finances. They hire, train, and monitor staff objectively and systematically and they have composed a business plan, marketing plan and financial plan they can refer back to and review and re-evaluate as necessary.

This is called running good control over your practice. And that doesn’t mean, as some people think, that it means not having fun at work or not having relaxed staff people or having people obsess constantly over profit instead of paying attention to people and service. It simply means that you know what is going on in your practice, that your staff know their jobs and work well as a team together and, because of that, you and your staff enjoy the work environment much more.

Objective systems are the component that allow staff people to remain calm and competent. When they know their jobs inside and out, it allows them to respond creatively to unique and unanticipated situations. It allows them to be calm and composed even when work backs up or the amount of office traffic could easily overwhelm them. Staff become accountable and self motivated because their work is measured by objective statistics. They are productive rather than just busy.

Prior to the current economic situation, we have seen a large percentage of practices and businesses supported and inflated by the bull markets. But this often was an artificial inflation, built on credit and people living outside their means. Now that credit is less available, it becomes obvious which offices have the infrastructure capable to handle the change. It isn’t enough to do the same old thing. Every income source must be maximized and must be maximized with the best interest of the patient in mind. Staff must be able to communicate the importance of delivering the highest quality of care without seeming to be solely motivated by profit.

Everyday we work with practice owners to put together plans and implement those plans. We do this so practice owners are able to grow and thrive in a sane manner, in economic uncertain times, and in a time frame that allows the creation of a stable infrastructure. Not only is this possible in these times but it is essential to your financial future.

To survive any activity, you must be trained and knowledgeable in that activity. You wouldn’t be an effective doctor if you weren’t adequately trained in your profession. The business environment is very tough right now. The fact is that your practice is a business and the better you are trained in the running of your business – i.e. practice management – the better you will be able to not only survive this economic crisis, but to actually be able to expand during these tough times.


Larry Silver

Search Engine Marketing -

Posted by Larry Silver

Why Does SEO Matter More In a “Down Economy?’

By Lisa Thayer, GoldfishNetwork.com

The question on many business owners’ minds today is “How should I market my company given the current state of the economy?” The short answer is by placing your marketing dollars in client specific, targeted advertising campaigns that have a built in accountability for measuring results.

In uncertain times, a business owner’s first reaction may be to reduce their overall marketing and advertising budget as part of a “batten down the hatches” mentality. That reaction is prevalent among companies that have experienced some reduction in business lately whether due to “the economy” or for a multitude of other reasons. While that response may give your CFO temporary anxiety reduction, before you know it she’ll be pestering you about declining sales figures.

Now is the time to step back, take a deep breath and make decisive, informed business decisions and steadfastly refuse to respond emotionally to the nightly news. Review both online and offline marketing endeavors looking for those that produce the best return on investment.

Search engine marketing can often produce a better ROI than many offline marketing endeavors due to the fact that spending can be controlled, results can be measured and you can easily make incremental changes to adapt to conditions as they continue to fluctuate. Online marketing also works for you 24/7 without accruing additional payroll expense.

If you stay the course, you may even be able to spot new opportunities and actually capture a larger segment of your market as others react instead of methodically planning a marketing strategy.

The best way to achieve optimal results online is to first have a qualified search engine professional review your website. It doesn’t do you any good to spend money to drive thousands of people to your website if once they arrive on your site the visitors don’t have a compelling reason to do business with you.

When it comes to search engine optimization and marketing “one size does not fit all”.
A good SEO review should advise you in creating “calls to action”, help to solidify your unique selling proposition, present solutions to rectify any design or usability issues, and even identify areas of weakness in your competition.

Once the SEO review is complete, you will be able target your specific customers and therefore be able to maximize your efforts and reduce your ad spend.

Lisa Thayer is owner of GoldfishNetwork.com, a website design and marketing company located just south of Portland, Oregon. GoldfishNetwork.com serves clients in 12 states across the United States. Lisa can be reached at (503) 783-0440 or by e-mail: Lisa@GoldfishNetwork.com


Larry Silver

You can’t control the economy…

Posted by Larry Silver

You can’t control the economy, but you can control your practice.

By: Ken DeRouchie

I have recently been interviewing doctors around the country regarding how the economy has been affecting their practice and what they have been doing to keep their practice financially viable. I have found that many of the doctors I’ve spoken to have simply shrugged their shoulders and accepted the down-turn in the economy. Many say there’s nothing they can do about the economy and, because of that, are producing less and making much less money. At the same time, most of them who feel this way have done little to nothing in terms of making any changes in the management of their practice to combat the exterior forces that are impeding the growth and solvency of their business.

This brings to mind an old saying: “If you always do what you’ve always done, you’ll always get what you’ve always gotten”. Simply put, if everything is changing around you and you don’t change and adapt with it, you will be unable to combat the external forces – very real forces – that are slowing or stopping your practice growth. It is imperative that if you want to continue growing in the economic environment that we are all experiencing, you must be able to adapt the management of your practice to the current state of your area, your local economy, the changing demographics of your area, etc. Most practice owners can grow in a booming economy. We’ve seen that during good economic times. But only those who have sound management skills, either inherently or through training, can adapt successfully to difficult times.

In August of 2007 I conducted a user poll on The Practice Solution Magazine’s web site in which 169 practice owners participated. The survey question was “The economy of the past 6 years has negatively affected my practice?”. 51% of the doctors answered :yes”.

I decided to follow this up with another user poll in November of 2007. 171 practice owners participated.

The topic of this was “When there are slow periods of the year, I …”.

46% of the doctors replied that [they] “live with it until it picks up again”

24% of the doctors replied that [they] “do extra marketing/promotion to make sure we don’t lose money”

16% of the doctors replied that [they] “schedule vacations at that time”

4% of the doctors replied that [they] “have a hard time making payroll”

11% of the doctors replied that [they] “wish there was something I could do to counter this”

You can see that only 24% of the doctors surveyed were actually doing something proactive to handle the slow periods! Obviously, you aren’t in a position to change the country’s economy, but you can , if you know how, make effective changes in your practice to combat slow periods.

Realize that the above surveys’ were conducted prior to the recent economic collapse. I therefore conducted a third survey in the last few months in which 71 practice owners took part. Since effective marketing of a practice is essential during poor economic periods, I decided to ask the question “On your new patient/client forms, when you ask the question “How did you find out about our practice”, what do you do with the answers?”

65% said [they] “Do Nothing”
1% said [they] “Enter it into a data base then nothing”
20% said [they] “Send a thank you card”
2% said [they] “Too busy to do anything with it.”
11% said [they] “Use this info for future marketing campaigns”

As you can see, only 11% were doing something useful with this vital data!

From these 3 surveys I conclude that:

  1. Many practices across the country are hurting from the effects of the economy.
  2. Most of them aren’t doing anything about it.
  3. When they are getting new patients in they don’t even bother to strengthen or further the actions that got those new patients in.
  4. The ultimate result of all of this is most practice owners that are completely the effect of the economic environment and not in control of their practice.

If this in any way sounds somewhat or a lot like what you are going through, read on. .

Things that you CAN control:

The following list includes links to articles written about specific areas in your practice that YOU DO have control over. If you are feeling a negative impact from the economy, I highly recommend that you hunker down and dig in. There’s a lot of ground to cover here but you will find this time well spent.. You do NOT just have to shrug your shoulders and “live with it”, you CAN take back control of your practice! These articles and others in this issue of Solutions can help you.

- Your appointment schedule – Cancellations/No-shows-rescheduled appointments

- Giving Great Service

- Marketing (internal and external)

- Staff efficiency

- Collections and Receivables

- Staff salaries and production bonuses

If you get in control over each of these areas in your practice you can very effectively “out create” the external forces that are negatively impacting your practice. If, however, you simply keep doing what you have always done and don’t change your operating basis, you will find yourself on a slippery slide with a crash at the end of the ride.