Episode Transcript
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Paul Etchison (00:02):
Now I guarantee
you, at some point in your
career people working for you onyour admin team they're going
to tell you either that you needto pay them more or that you
need to hire more people upfront, and a lot of times they
will tell you both at the sametime.
So what are you, as an owner,to do?
How do you know if you are justinefficient at the front or if
(00:24):
you truly need more people?
As owners, we want to take careof our teams.
We want to pay them more, butrealistically, we have to watch
costs and payroll is the biggestcost we often have.
So today I am going to teachyou exactly how to know how many
admin people you need on yourteam and give you some tips and
tricks to make your front endmore efficient, so that you
(00:46):
don't need so many and you canhave better control over that
cost on your profit and loss.
If you've ever wondered howmany people you need up front,
well, this is the episode foryou.
Stay tuned, let's get to it.
My name is Dr Paul Edgison andyou are listening to the Dental
Practice Heroes Heroes podcast,where we teach owner dentists
how to practice less, make moreand take more time off without
(01:09):
cutting corners or running ahigh volume practice.
I've authored two books onpractice management.
I've been coaching dentists forover five years now and I own a
large multi-doc practice in thesouth suburbs of Chicago.
My goal is to teach ownerdentists how to live better
lives by running more efficientpractices that allow them to
take more time off.
Now I want to share a storywith you that helps illustrate
(01:34):
that the answer to chaos in youroffice is not always throwing
more employees at it.
It can be something different.
Now, when we came back fromCOVID I mean you've heard me
talk about COVID before I lovedwhen it happened.
I know a lot of bad stuffhappened, but I'm saying I loved
being off.
I loved being home for 11 weekswith my family and, to tell you
the truth, I really wasn't allthat excited to come back to
(01:56):
work.
I mean we had all these newrules and regulations and things
that we had to do.
We had air purifiers all overthe place.
We were doing a whole bunch ofdifferent disinfection.
We were wearing an incredibleamount of PPE.
I mean I remember feeling likea fricking Eskimo.
I did that for a week and I'mlike I can't do this.
I'm sweating my ass off.
I'm not wearing a gown, I justdidn't do it.
(02:18):
So I didn't follow theprotocols as they were
determined.
But you know, we come back fromCOVID I guess we're trying all
these new things on and my frontdesk goes from you know, bring
the patient in check if theyhave a balance and tell them to
have a seat, and now all of asudden we want them to stay in
their car and we're texting themto tell them to stay in their
car, and now they have to fillout an additional form for COVID
(02:40):
, acknowledging that COVID is apandemic and you know we can't
guarantee that they won't getCOVID from us, that we're
following all the protocols andsometimes we have to update
forms.
We had to do this other stuff.
So it's like there was thisfront end burden.
Now I want to say like therewas a burden on every part of
the practice due to COVID, butthere was an additional front
end burden and what we noticedwas it was the front was getting
(03:01):
so burnt out because it wasjust like so much to do.
They were so busy justfollowing the new protocols and
it was in a complete pain in theass.
So the solution, doc, withthese new protocols we need more
help up front.
Well, you know that sounds good, but since we have new
protocols, we can't see as manypeople.
(03:22):
Revenue is down.
Where's this money going tocome from?
Right, and I think a lot ofdoctors were in this predicament
and it was stressful.
It was a pain in the ass.
So what was the solution?
Did I really need more peopleor not?
Now I'm going to tell you whatI ended up doing, but I want to
share a more recent story that'sgoing to explain how I found
the answer to this, because Ididn't have this information
(03:44):
back then when I was worriedabout it at COVID.
I have this information now.
So very recently at my practicewe have been auditing different
departments and looking atpayroll and looking at are we
overstaffed or not?
We were growing, growing,growing, trying to get ourselves
to $6 million in collections.
We got there and then you know,we've kind of been hovering
right under 6 million for nowthere's no more capacity in my
(04:05):
practice to grow past that.
So about $6 million is where wewill be at collections.
So we're auditing differentdepartments, we're looking at
how many people we have.
I reached out to my regionalmanager and I said I'm really
struggling to see if I'moverstaffed at the front, and
you know what I mean.
It's like you go up front andyou see people not doing stuff.
You see them on their phonesand you're like man, I got too
many people up here.
(04:25):
But then it's sometimes they'reall on the phone and you can't
get anyone to help you with thepatient you have in the chair
and you're like, huh, maybe weneed more people.
So I'm talking to my regionalmanager and she mentions to me
that MB2 did this case studywith all their practices and
essentially what they did isthey looked at the best
practices, so not like the topechelon of practices, but the
(04:48):
majority of the best practices,so like the good practices, and
they said how many admin peopledo these teams have that have a
good profitability, they'reefficient and they run their
practice well?
So it's not like the unicornpractices.
These are reasonable thingsthat you can do.
They found that for every$720,000 in collections, you
(05:11):
should have one full-timeemployee.
Now here's the specialdisclaimers.
This does not include youroffice manager.
So for every $720,000 incollections, you should have one
full-time front desk person.
$120,000 in collections, youshould have one full-time front
desk person, not including youroffice manager.
So if you're collecting about$1.5 million, you should have
two front desk people and anoffice manager.
(05:33):
Now this is them doingeverything, from insurance
verification to revenue cyclemanagement, posting the EOB,
sending statements, everything,start to finish, admin
scheduling, answering the phone.
They're doing it all.
I know you're saying what aboutwhen you outsource stuff?
And we're seeing atransformation on the admin side
(05:53):
of dentistry because ofartificial intelligence.
So there are going to be a lotmore things that you outsource.
So I want to give you threedifferent areas where you can
really focus on the efficiencyof front desk to make sure that
you're finding that optimalbalance between employees and
efficiencies.
First of all, what can yououtsource?
Can you outsource the insuranceverification?
(06:16):
Is that something that ispredictably going to be correct?
Now, a lot of people say wetried it before.
It didn't work.
We had like a certainpercentage of these were entered
wrong and then we didn't trustany of them, so we never wanted
to do it again.
So what I would ask you is whenyou do this on your own, do you
get a certain percentage ofthem wrong?
(06:36):
Yeah, you probably do so.
There's always going to be somelevel of error.
But now with artificialintelligence, you can get the
insurance breakdowns.
They can enter it into thecomputer for you.
It can save you a ton of timeand, depending on how big your
practice is, I mean for me tooutsource insurance verification
.
That's probably one and a halffull-time front desk people for
(06:57):
me.
You know the $6 millionpractice.
Now the other thing is we'reseeing AI with claim follow-up
and the revenue cycle stuff.
So our goal of outsourcing isnot so much that we don't want
to hire personnel, but it's moreso that our personnel can focus
on the patients and again, it'sa very difficult hiring
environment right now, so wemight be short staffed.
(07:17):
So it might help us.
We might have to outsource.
Another thing you really haveto manage with your front desk
is managing the phones.
If we don't answer our phones,we are losing opportunities for
new patients.
So we need to be able to answerthe phone and when we answer
the phone we've got to have themental energy to be polite and
be friendly and make a goodimpression.
So if we're like chaos andrunning all over the place and
we pick up the phone and we'rejust like crazy busy, that's not
(07:40):
going to give the best patientexperience.
So here's some ways you canhelp.
Your front desk with.
The phone is one.
I love this idea.
It's called auto attendant.
Now, if you're using VoIPservices, this is really easy to
set up.
You set up auto attendant andwhat this means is when somebody
calls your practice, it picksup automatically and it plays a
message Our says you know well,thank you for calling Nelson
(08:02):
Ridge Family Dental, we'regiving you the greatest
experiences, our utmost priority, something like that.
But then it says if you'relooking to schedule a cleaning
or a new patient visit, you canschedule online at
nelsonridgecom.
So we tell them that firstthing.
The reason we do is becausemaybe that will save a phone
call.
A lot of people would prefer toschedule online.
(08:23):
So if my team doesn't have toanswer that, that's one less
phone call they had to take andnow they can schedule online.
They can enter in their owninformation and it goes straight
into our system and it saves ussome time.
Now the other benefit of doingthis auto-attendant is you can
also set it up so that you knowif you've got.
If you're a new patient, pressone.
If you're this, press two.
Or you can say I like if youhave questions about your bill
(08:45):
or your insurance, press threeand if you want, you can send
that to a voicemail so that youcan tell them to leave a message
with your name what yourquestion is.
And then that way, when it'snot a busy time, you can get all
the information you need andyou can call that person back,
because most people are going totry to call you during their
lunch break it's a very populartime, say from like maybe 1045
(09:07):
to like 2 pm.
A lot of people calling.
So you need to be there toanswer the phone.
And if somebody calls with abilling question and you don't
have the answer, I mean you'relooking through it they're
sitting there waiting on hold.
It's a phone call that doesn'tneed to happen at that point, so
you can just send them to avoicemail.
And the other benefit of doingauto-attendant is that now you
didn't miss a call, they're juston hold.
(09:27):
And you can set up with VoIPproviders we do this with ours
is that if somebody hangs upwhile they're on hold, it
automatically texts them andsays we are so sorry, we didn't
get to you.
Please tell us what we can helpyou with and we will text you
back as soon as possible andoften people say, hey, I just
was looking to make a newappointment and we'll text them
back, okay, great, and we juststart communicating with them
that way.
(09:47):
Or we follow up with thembecause we missed it, but most
of the time, because they'realready on hold and they're not
like going to a voicemail, wewill get to them before they
hang up.
So those are some ways that youcan really help the phones as
you grow, because the fact ofthe matter is is you don't want
to miss phone calls and a lot ofpeople will have those busy
lunch hours and will miss somephone calls and that immediately
(10:08):
means that we don't have enoughpeople.
I want you to think about theanalogy of a restaurant.
A restaurant is fairly maybenot that busy Monday through
Thursday, but on Friday,saturday, man, there's a wait
list.
So you might have to wait 30minutes, you might have to wait
an hour before getting to yourtable.
If you just walk in there,nobody working in that
restaurant is gonna say, dude,look at this wait list, we need
(10:28):
more tables, we need more tables, we need more staff, we need
more of this, because you wouldsay, hey, well, throughout the
week we're not really packed atall.
This is an efficient way to runthis, because on the weekends
we got a little bit of awaitlist, but we're still
seating as many people as wewant to.
So the same thing goes for yourfront desk.
You may not have enough peopleto answer a million phone calls
at some parts of the day, butfor the most part of your week
(10:51):
you do have enough people.
So just because you have a fewparts where it gets a little bit
busy, know that that's expected.
Use that restaurant analogywith your team so that they can
understand that, because oftenthey will think we need more
people.
Obviously, look at how weweren't able to answer all those
phone calls and take care ofall those patients so often.
We don't need more people, wejust need better processes.
(11:13):
Look at the efficiencies ofyour front desk.
I can tell you one big spotthat we often drop the ball is
we don't do phone training, andwhen we don't do phone training
we can often spend way too muchtime on the phone.
Now I know with a new patientcall it's going to take more
time.
You want to give a goodexperience, you want to warm
them up to coming to the office,but you don't need to be on the
phone for 15 minutes for thatphone call.
(11:34):
I need to be like a four orfive minute phone call tops.
So you want to train your teamon the proper way to answer the
phones.
If you're looking for sometraining, we have my online
training at the heroective.
You can get all my trainingvideos.
There's about three hours ofactual phone calls and critiques
.
That helps your team see whatnot to do and what they should
do.
But you can check that out atdentalpracticeheroescom.
(11:54):
That will help your front endteam immensely.
Stay off the phone so long andland and convert more new
patients for your practice.
Now let's look at the form entry.
We used to, a long time ago,have them do their new patient
forms.
We print them out, they wouldfill them in and then we would
take them back and we wouldenter in all the information
into our practice managementsystem from those sheets.
(12:15):
We don't do that anymore.
So that's one of the ones thatwe automate at our office.
We automate a number of otherthings that we used to sign and
scan.
We don't do that anymore.
So do you need to look for atechnological upgrade so that
you can take care of some ofthese tasks that you were doing
manually and do themautomatically.
So just look at your processesand see what's out there, and
(12:37):
the best part about automatingany kind of new patient forms or
stuff like that is that thepatient enters it in and it goes
straight into your system.
So there's no errors becauseyou're copying it over from a
piece of paper.
What about payments?
You know we used to sendstatements like crazy we did.
It was like twice a month wehad to print out all these
statements, stuff the envelopeand send them.
Now it's just texting a link.
(12:57):
You know we don't send thosestatements anymore.
We text them a link.
They can click on the link.
It shows an invoice.
They can pay it right there.
So before you hire more people,really look and say am I maxing
out the efficiency of my team?
Because chances are you're not.
You can automate more things.
Let's go back to the COVID time, when my front desk team was
struggling because of all thenew protocols, like checking in
(13:19):
the patient, texting them.
Stay in your car texting them.
Okay, come in, we'll let you in, like cause we couldn't have
anybody in the waiting roomtogether.
Oh my gosh, we're going tocontaminate everybody.
So what we ended up doing is wedid not hire any more people.
We did exactly what I explainedin this episode is we looked at
our systems and we looked at allthe different steps along the
way and said what can weautomate?
So we automated the check-inprocess, which saved us a ton of
(13:42):
time.
It would automatically text thepatient about 30 minutes before
their appointment Say hey, whenyou get to the office, click
this link.
They'd click the link, it wouldcheck them in, they would do
any new patient forms that theyneeded to do, and then we can
automatically text them from oursystem when we were ready for
them.
So it was all automated.
And when we automated that,that was the same time that we
switched to automating patientforms as well, which also saved
(14:04):
us a ton of time.
And then we switched toinformed consents being on an
iPad instead of being on paperwhere we had to scan it.
So there was a number ofprocesses where we were able to
cut down the time and becomemore efficient and be able to
work in this new workflow thatwas created by the new
guidelines and protocols thatwere intended to keep all of our
patients and our workers safefrom COVID.
(14:27):
So once we optimized everything,everything was great and we
didn't need any more people andeverybody's job was a lot easier
, which is better, because now Icould pay my team more.
I don't have to hire more people.
So if you're looking tooptimize more areas of your
office, and check out the HeroCollective at
dentalpracticeheroescom andhere's your final takeaways the
(14:49):
$720,000 rule one full-timeemployee at the front for every
$720,000 in collections Use itas a benchmark.
I don't want you to take afront desk team that's chaotic,
seems like they're burning outand say the solution is more
people, because I promise youmore times than not, it is not
more people.
You got to look at what can beoutsourced.
You got to look at how thephones are managed, all the
processes that you can automateand optimize all those things,
(15:12):
and if you still then need morepeople, well then you can hire
more people.
So thank you so much forlistening.
I hope you're having a greatspring and getting geared up for
summer.
By the time this episode comesout, I will be coming back from
a 10 day vacation to Vegas andTurks and Caicos, so I'm super
pumped for that.
Thank you so much everybody forlistening.
(15:32):
We will talk to you next time.