Linda Miles

Over the past thirty years of consulting I have researched what it takes to create the successful two or more doctor practice and I've made notes on why so many of them fail.

What are some of the ground rules for a successful relationship and whose job is it to see that it works? The ground rules are quite simple and the answer to part two of the question is: EVERYONE in the practice is responsible for making it work.

Do You Need A Second Dentist?

The first ground rule is to make sure that the practice needs another dentist before the decision is made to turn from solo to duo. There is only ONE reason a second dentist should be brought into a practice and that is: the practice is too busy and one dentist can't physically take care of the patient load.

The Entire Team Needs Need To Be Involved.

The second ground rule is that "the staff should be in on the what's happening now". The proper introduction to the staff is to sit down and explain to them that "we have built a dental practice we should all be proud to be part of." The dentist/owner then goes on to say, "in order for us to continue to serve the number of patients that wish to come here, we need a second dentist and in hiring this person, I NEED YOUR HELP!" These are the four magical words that empower the team to realize that they are important in the decision.

The smart senior dentist asks the team to create on paper the ideal candidate for the office as the second dentist. At a team meeting they offer personal and professional traits they hope the new dentist possesses. If the staff members feel involved in this important decision and the actual selection process, even though the owner/dentist is the final decision maker, staff are much more anxious to make the new dentist a great addition.

Rules For All

Rules for the Dentist/Owner:

1. Never speak unfavorably about the new dentist to the staff for any reason.
2. Never compare the new dentist's skills to your own. Remember you were new once.
3. Don't expect the associate dentist to be a moneymaker and practice builder the first twelve months.
4. Don't hoard your patients and get mad if you see their names on the new doctor's schedule.
5. Don't take all the big cases and expect the associate to be happy with "left-over" dentistry or procedures that you dislike doing.
6. Show strong and positive leadership at all times. Be a mentor and teacher for the younger dentist. Be proud of him/her and introduce them to all the patients and your colleagues at meetings.

Rules For the Business Staff:

1. When answering the phone or greeting patients, don't refer to Doctor B as "our Associate". Sounding supportive of Dr. B and putting them on an even field by title is key in patient acceptance and trust.
2. Concentrate on being as loyal to the Associate's schedule as Doctor A's. Remember when the Associate is successful it benefits the entire practice.
3. Promote the Associate over the telephone and introduce him/her every time the opportunity presents itself. When the staff show interest in the Associate, the patients follow suit.
4. Try to have the same collections savvy with the Associate's patients as Dr. A's. Remember most associates are paid a percentage of their collections so they rely heavily on the business staff for a decent paycheck.
5. Let the Associate know daily how they did for the day with numbers, goals, computer reports and such. They will only be as interested in the business of dentistry if the information and enthusiasm from their co-workers is strong.

Rules For the Clinical Staff:

1. Speak favorably about the new dentist to all patients.Showing acceptance of the Associate develops trust from patients to the new doctor.
2. When you see Dr. B looking for instruments, having challenges with a difficult patient, or getting behind schedule, offer assistance and show that you are there to help make their transition into the practice easier.
3. While assisting Dr. B, interact with him or her in a positive and respectful manner. Oftentimes with younger associates and older staff, the staff often think they know more than the associate (and sometimes this is true based on years of experience). With an estimated 60-70% of Associate failures being blamed on rude and overbearing employees, this is a biggie!
4. Offer to hold weekly hands-on training sessions for the Associate dentist on office clinical protocol. Ask the Associate to share his or her newest clinical tips with the office.
5. Always speak favorably about Dr. B in and out of the office. The staff will be the Associate's greatest referral source next to the Associate's own friends and family circle. When the enthusiasm of the Associate is high, their success doubles.

Rules for the Associate Doctor:

1. Under NO circumstance should the Associate (male or female) become the staff's best friend nor sounding board. If the two dentists make a pact that they will support each other in all types of issues, damage control is in place.
2. While it is fine to have lunch with the staff from time to time, make sure as the Associate dentist that the conversations remain non-office related in nature and the new dentist should conduct him or herself in a positive and professional manner at all times. The first thirty days set the tone for the relationship for the future.
3. The Associate dentist can not divulge confidential information regarding the associateship, or the staff given to them by Dr. A.Knowing how to be a confidant is part of the success package. It is very tempting to be "in on" certain office information and not be able to share it with others. 
4. Take as many courses available to become a better clinician, better business person and better Associate. Show initiative and discuss your goals and how you can reach them.
5. Show appreciation for the staff and Dr. A. Let them know how much you appreciate the opportunity to be part of the practice and the effort they are putting forth on your behalf.

More About Miles Global... 

Jan Keller

Wouldn't it be nice if every payment arrangement interaction between your office and your patients went smoothly, with no awkwardness, misunderstandings or embarrassment? The bottom line is, you can make that happen. "Perfect" payment arrangements are possible if you follow these 4 easy steps:

1.  Gather information prior to speaking with the patient, including a discussion with the doctor 1-2 days prior to the consultation. If the negotiation process occurs on the same day as the appointment, excellent communication skills are vital. Repeating the recommended treatment plan (verbally) from hygienist to doctor allows the patient to hear it for the second time. Ask the patient if they have any questions before the Financial Coordinator (FA) takes over.
2. Prepare where the negotiations will take place. A private, quiet area with computer access is ideal. Be prepared, have all the information you need in hand, eg x-rays and a written treatment plan. Be prepared, as well, for resistance or discussion.
3. Don't be afraid to negotiate. Let's say the FA presents the first payment option to the patient. If the patient is agreeable to this option, the FA moves on to documentation of the arrangement, gets the patient's signature, schedules the treatment, and says "thank you". Job well done! However, if the first option is not acceptable to the patient, move to the second option according to your office guidelines. The key here is to stop and wait for the patient to respond. We're often uncomfortable with silence and don't allow the patient a moment to think and respond before jumping in with the second and third options because we're afraid they will say no. It's okay if they say no! The goal is to negotiate until they agree.
4. Documentation is critical. Patients should always sign consent forms, as well as a federal truth-in-lending form which clearly defines the negotiated payment arrangements. And remember, documentation is crucial even if the patient declines treatment.

More About Jan Keller and Associates...