Friday, August 15, 2008

Confirming appointments

Olympics are killing me. Come on Michael you can do it!!! But could you just do it before 11:30pm?
Funny thing.
I was talking about the Olympics and my assistant asked who is Michael Phelps?
I said are you kidding?
No who is Michael Phelps?
Just forget it.

Anyway, the guy is a complete stud. I did do some research on him. I found out a couple of things.
First I was wrong... and he did go to college. As much as I like Michael (yes we are on a first name basis) I hate the fact that he went to the University of Michigan. I will forgive him.
Oh this is why I hate Michigan (for now). Also, they play in a weak conference. Yeah, I said it. I think the Big 10 is a weak conference and so does the national media so don't just blame me. SEC baby. Can't you just smell college football season. 2 weeks. Smells like victory.

I just can't get into gymnastics either. I don't like watching 12 year old girls that are 4'6 and 78 pounds.
But I did see that Japanese guy fall off the rings...SPLAT... that must have hurt.

I watched the Bucket List on Wednesday. I liked this movie. They picked the perfect two actors for this. I thought it had a good message. And I loved the assistant character. I will always call him Jack, from Will and Grace.

I wanted to talk to you about confirming appointments.
This may be a 12 part series because there is so much that goes into it.
Let me remind you that we are a two and half dentist practice and we have 3 full time hygienists.
Each hygienists will have 9 patients a day in our Apopka dentist office.
And the doctors will have anywhere from 4 to 12 patients in a day. I mean if someone is having a suture removal it is still considered a doctors appointment. It may be on the assistant column but for this with me.
So we have about 50-60 patients a day.
Now we are a fee for service practice. So having the people here is affects the bottom line directly.
So I am going to talk about how to schedule and how to remind.
Now I am going to tell you how we do it and you can tell me how you do it.
I, by no means, know how to do this. We basically reinvented the wheel with this one. We spoke to a number of people and asked them how they do it.

It all starts with the New Patient Exam. After this appointment the person is suppose to get another appointment.
The rule is that no one leaves the office without getting an appointment.
So the New Patient leaves the office with at least one appointment. If the patient says something like, "I don't have my schedule book, can I call you?"
"Sure" we say, "But if by chance I don't hear from you, I will make it a point to call you tomorrow."
This does two things; one they know how important it is to us and two, that if we do have to call because they "forgot", we are not bugging them, they knew it was coming.

Okay, lets say they get their cleaning and get put on a 6 month recare schedule. Well, what then. They leave with an appointment for 6 months from now.
I think this is crazy because I will forget a haircut appointment in the afternoon and I just made the appointment in the morning.
But luckily not everyone is like me.
Okay so, in our office, we like to help people remember their appointment. So a month before their appointment we will send a postcard. It has a funny picture of a penguin or a bear with teeth on it, and it says your appointment is Sept 14 at 9:30 and we are looking forward to seeing you.
Then 2 days before their appointment they get a reminder call from us.
We use a system called TELEVOX (I am going to tell you about TELEVOX on Monday), this is an automated confirmation system.

Now this all sounds great and it works about 90% of the time.
The problem is that 90% means 10% of your patients didn't show up.
So out of every 10 hygiene patients 1 is not going to show up.
Lets add this up...Every day you will have 3 no shows (three hygienists, remember).
4 days a week is 12.
50 weeks a year times 12 no shows a week is 600 a year.
If every hygiene patient averages $100 a visit, that is $60,000 a year.
For the doctor, not only do I sit around because I only schedule one patient at a time. I sit and steam because of it.
And while I am steaming I am looking for someone to blame.
99% of the time it is the patients fault. We did everything we could do to make sure they come to their appointment. We give them a reminder call. We tell them how long they are going to be at the office and tell them how much it is going to be.
Now don't forget how many man hours it takes to do all this.

But if I go one hour a day without a patient, it really hits the bottom line.
I am not saying I am busy all the time or anything like that, but that is the goal.
So lets say we try to produce $350 an hour off the doctors column and I am open one hour a day.
$350 time 4 is $1400.
Times 48 weeks is $67,000.
Times that by two doctors and that is $134,000 a year.
So the potential is there but is 100% to much to ask.
So lets say you have a practice like mine and if you can reduce the doctors and hygienists and doctors no shows in half you would make $100,000 additional dollars. Would you hire a new employee to do it.

I am not a micro manager but I might see a hygienist at the front desk. Text book sign they do not have a patient. So I will say, "What is up?"
This is how I can tell if our systems are working or not. It did seem to be working but at what cost.
At our office, come to find out that one of the three front desk people was devoting the WHOLE DAY on confirming appointments.
This is what we did for about 12 years of my practice, 6 months ago we integrated Televox into our office. I will tell you the challenges we are having with this system.

I will continue this on Monday.
All you non dental people will be bored out of your mind but it could be interesting to see the ins and outs of what your dentist does.

Have a great weekend,
Remember to rest on Sunday,

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