EP 90: 4 Secrets To Better Scheduling

 

Is your practice behind schedule almost every day? Are you rushing from one patient to the next? Does it take weeks before you can fit a new patient in? If you answered yes just once, you’re not alone.

And while there’s no such thing as a perfect schedule, you can make progress. You can see more patients, with fewer headaches, without risking a loss of patient flow, production, and profitability. How? That’s the subject of today’s episode of the Double Your Production Podcast.

You’ll discover:

  • The 4 keys to efficient scheduling
  • How to really know if you have capacity problems
  • Powerful ways to maximize productivity
  • 6 ways to expand your capacity (the right way)
  • And more.

Intro: Welcome to the Double Your Production Podcast with The Team Training Institute. The one place designed for Dentists and their staff who want to grow their practices by following in the footsteps of those that have done it. Who are in the trenches who know exactly what you are going through. Now your leaders, the stars of the broadcast, Dr. John Meis and Wendy Briggs.

Wendy Briggs: Here's the thing when it comes to scheduling efficiency, sometimes I feel like we go about this the same old ways. Every once in a while, it's important that we check in and shake things up. Okay. How are you going about catching patients or filling your schedule or enrolling patients in your schedule. Okay. When it comes to scheduling. What are we doing differently? How are we utilizing our schedule more effectively? We're going to do a quick efficient schedule checkup. I'm just going to ask a series of questions and you guys can think about it in your brain or write it down, just to see how we're doing with scheduling. Okay. I'll read them out loud because the text is somewhat small, because there's a lot of questions.

Are canceled appointments and no-shows an epidemic or a serious problem in your practice? Okay. Does your office consistently run behind schedule? Think hygiene and operative. Are you rushing one appointment so you can get onto the next? Do you feel rushed? Does your team feel rushed? Do you feel like the team is rushing you to get to the next? Does it take weeks before you can fit a new patient into your schedule? Especially those high demand appointment times. Does your schedule allow you to perform the kind of dentistry you want to be doing or do you feel like your schedule is filled with garbage type appointments? Are schedule holds causing excessive stress for you and your team? Is your schedule so overbooked that you don't even have time to eat or take a bathroom break?

Is your schedule burning you out? Okay. All really important questions. Do a quick check in and see where you are on that and your answers to these questions hopefully will sharpen your attentiveness when we talk through some of these solutions. Right? I know I'm up against a pretty difficult battle because we're talking about scheduling, which is not the most engaging of topics, bur it is a really important topic. Okay. So your answers to some of these questions should really determine how closely you want to pay attention to some of the solutions that we'll be talking about as we go. Okay. So we're going to be talking about four elements to schedule efficiency. In all honesty, we could go so many different ways when we talk about schedule efficiency, but these are the four elements that I felt like related the most to your own productive capacity as providers.

If we have these dialed in or figured out, we're going to be able to be more effective from a scheduling standpoint and a provider standpoint. So capacity blockages, this is the first thing. We've talked about this quite a lot. You hear this literally at every retreat we do. Well we're capacity blocked. Some of your questions about hiring or doing an assisted model have directly to do with, what's your capacity versus demand scenario in your office. The answers to some of these questions that people ask are different depending on, if you're out of capacity or if you're trying to generate more demand. Okay. You can be out of capacity with ops hours, Doctor time. There's a lot of ways that we can be out of capacity. We're going to talk through hygiene effectiveness and we heard from the panel this morning and that was results from some of the strategies and the tactics that we're going to be talking through today.

Restorative provider productivity and Dr. John touched on this yesterday as well, but we're going to get again into the nitty gritty a little bit about different ways that that practices manage the schedule for their providers. Then of course minimizing no-show and open time. Okay. These are four elements to heightened scheduling efficiency that we're going to talk through. We're going to spend some time on several of these strategies. I can say this to be a hundred percent true. One size does not fit all. So you won't have your coaches or myself or Dr. John say, "Here's exactly how you should schedule." You'll get a tool from us that say, okay, you guys look at your provider capacity and your provider's efficiency and speed and experience and figure out what works for you as far as standard blocks of time, because we need to know that information, but we're not going to tell you this is how long this procedure should take. Does that make sense?

I will also tell you that we don't ascribe to one particular scheduling method, because every practice is different. What works in one practice is certainly not going to work in another because of variables. Okay. This I think is both freeing and frustrating, because sometimes you all just want us to tell you what to do when it comes to the schedule. We're reluctant to do that because we know one size does not fit all. You're not dealing with exactly the same things and you're going to schedule a 21 op location far differently than you would schedule a three op location. Okay. That's something to keep in mind and is we look at our practice success loop. It's important that we understand there's a lot of these choke points that have to do with our schedule and how we efficiently use the Doctors and Hygienist's time. Right?

A lot of this has to do with that. Converting to an appointment, knowing what to do, how much time to spend, when they arrive for that appointment. Are we timely? Have we scheduled it appropriately so that we are running on time? If you think about that all the way through. Treatment delivered efficiently has a lot to do with the schedule, which is why we're having this discussion. Then the patient making another appointment. All of these things are managed by how effective we are with the schedule. Okay. It's an important topic. Let's first again to the first element, which is capacity blockages. We're not going to spend a lot of time here because I feel like we do spend a lot of time discussing this. It is such an important element for us to understand and to understand what can happen to the growth of the practice when we don't have our capacity blockages resolved, or when we're not paying attention and find ourselves out of capacity in a way that can be adjusted or corrected with some creative thinking.

Okay. If demand exceeds capacity, what we're doing is we're losing opportunities. All right. If we're out of restorative capacity, we really have two choices and this is what's fascinating is not everybody in the room is going to make the same choice when faced with this decision and that's perfectly fine. I know there are some people in this room that might get a little intimidated when you hear about, oh, who's open their fourth location, Lamb Bricks has got multiple locations. Some of you are here because you want to take your one location and optimize every opportunity within those four walls. You may not really ever plan to have multiples and that's completely fine. Right? Depending on your vision and what you really want long term, that's, what's going to decide these choices. Really to simplify, we've got a choice that we can expand our capacity. Right?

We can expand our capacity in more than one way. We can expand our hours. We can expand our facility. We can hire additional providers. Okay. That all allows us to expand our capacity. Okay. We can shrink demand and the way we do that is we drop our lowest paying insurance plans. We can raise fees. We can stop doing inefficient, non-profitable procedures. Okay. We heard yesterday, somebody said, our Doctors didn't want to do dentures. So I took that on, right? Some practices will just stop doing them all together. That's an example. What we're talking about here is stop doing non-efficient, nonprofitable procedures, or things that you, you don't enjoy. You can decide that. Over the years, we've worked with some practices that say, "Hey, I'm not really interested in going multiple locations. I just want to focus on my practice." Then once you get to that sweet spot, where you're at a capacity, you're highly profitable, they choose the second option.

They're going to shrink demand. They're going to start eliminating some of the junky insurance plans, so that the time that they do have in the office is more effective and more efficient. Really you have to decide which direction you want to go. Some of you can do a little bit of both. Right? Some of you might say, okay, we really have an opportunity to expand our hours. We're going to focus on that and really using our facility more effectively, more efficiently. Once we achieve that, then we'll start dropping some of the low insurance plans. Again, the group think during COVID was drop them, all. Right? It's too much of a headache. Drop all your insurance plans. We're not dealing with that, but sadly, for many practices, they didn't have a proper strategy in place. What they found was when they dropped them all at once, what happened to their demand?

What happened to their livelihood? There's a lot of fire sales on practices right now. You can pick up practices for next to nothing. If you're paying attention, sadly, that's sad to me. Here's someone's entire life work that is now really devalued and they have no other options, right? So in a way these decisions are really important. All right. If restorative schedule is not out of capacity, we need to expand our hygiene capacity. We know that hygiene directly feeds our restorative. Yes? We know about 75% of all restorative comes from hygiene. So if our restorative schedule... If we're seeking to increase demand there, we need to address our hygiene capacity first.

Okay. We also need to evaluate what we're doing. Are we doing a team driven case, acceptance approach? Look at our diagnostic percentages per provider. Dr. Cook and I are visiting about that just on the break. Sometimes there's a provider that's super good at talking restorative and others that really aren't quite to that same level yet, but that's really critical to know. Is that something we need to work on? Okay. Expanding hygiene capacity can mean more providers. It can also mean better skill sets with the providers you have.

Okay. If there's extra ops, we can use for hygiene. If yes, we can hire another or move to an assisted model. If you have a Hygienist who really gets it and does it well, give them an opportunity to move to an expanded model. Okay. Don't make an assumption that they won't want to do that. Just like we were saying, even with a new hire, we have to sell them on the concept of a system at hygiene. Why is it what's best for them as a provider? That's where I would start. Okay. If there's no extra ops, we need to expand our hygiene. We can expand our hygiene hours or we can expand our facility and we can also get creative with how we're scheduling hygiene. Okay. Here's a quick capacity check in for us. This is how you know, right. If you haven't done this recently. If a patient wants to schedule an appointment in hygiene, how long are they going to wait for that appointment? If a patient wants to schedule an appointment in hygiene in prime hours, how long are they waiting?

What hours should we be open to best serve our patients? Are we maximizing all the times available? Okay. What do patients want? This is the topic of the last retreat. Remember expanded hours are an expectation of more than half of our patients today. It didn't use to be that way, but it's evolving to that, right? Remember Banker's hours. Now what do we see 24/7? Accessibility is really critical for our patients and consumers of today. We've seen this shift to a higher focus on consumerism rather than, we're going to do it this way because that's what we want to do.

Okay. Appointment availability check-in. Are you offering early and late appointments, lunch hour options, any treatment done any time of day? That's one thing that's kind of interesting. Sometimes we see a practice that's historically reserved X amount of time in the morning for surgical procedures or whatever it may be. Someone will want to schedule an appointment at that time and they're told, "yeah, we can't do that," right? Again, that's an example of not having appointment availability and expanded capacity. Are you able to do same day emergency care? That's a quick capacity check-in for you. All right. Chairs. Let's do check-in on ops and chairs that we have. Okay. When are they full? Are they full all the time? Filling the empty chairs hours [inaudible 00:13:49] again, Dr. John's told this story many times where he felt like he had plenty of capacity because there were times throughout the day that he had empty chairs in his 21 op facility.

This is before they were 21 ops. I think they were 15. His way of thinking was, I have open chairs at sometimes a day. Therefore I have plenty of capacity, but that's in a way a myth or outdated thinking, because if you think about it, when do patients want to come in, if we had more chair time or more availability during those high demand appointment times, what do you think is going to happen? You're going to see more patients during those times. So being creative about how we utilize our space is also part of this, right? If we have semi operational ops to get rid of those. Have we looked at expanding hours, especially in that primetime appointment expansion. These are really important measures that you can be taking to identify where your biggest opportunities lie when it comes to capacity.

Okay. So maximizing that facility, what can we do? We mentioned this morning, we talked about split shifts, right? That's a powerful way to optimize opportunity. Frankly when I was practicing hygiene, I took the early morning shift and I loved it. I worked 07:00 to 15:00, no lunch straight through. It was amazing. Okay. There are other providers that would absolutely not want that. They might like the later shift, they might want to get up and head to the gym and take kids to school and do all those things before they actually head to the office. So you never know until you actually ask what's your preferred timeframe. If you could choose a 07:00 to 15:00 or a 12:00 to 19:00, which would you prefer? What you'll find is often the team gets behind that when they're given the choice. They might want two days early, two days late.

Right? So once you actually chart it out, schedule it out and then put that in front of the patient and say, these are the shifts we need to fill team. What would be your ideal? What's funny is how often these things work themselves out. Okay. We can do split shifts. My favorite example... Sometimes we learn a lot of what not to do, right? I actually had a neighbor and a good friend that said, "Hey, I need some help in my practice. We're really not doing very well. There's two Doctors, two Hygienists." I'm like, oh, awesome. How many chairs do you have? You know what the answer was? Four... Two Doctors and two Hygienists were trying to work out of a four op practice. Guess what their hours were? 09:00 to 17:00 every day, all were there at the exact same time.

Again we think differently. Right? One of the very first things we did was we said, "It's ridiculous that both Doctors sit there at the exact same time, you got to split that up." Right? You got all these hours that these chairs are sitting empty, because of course nobody wanted to work the Friday or the Saturday. You're going to be so much more productive if you are able to split that up. Right? Again thinking differently is important. Every day, days of the week, when you working, when you have opportunity, are you using creative scheduling or hygiene blitz to help us catch up if we're out of capacity on the hygiene side. If we've tried this, how effective was it? Did we have team support? I've had a couple conversations with somebody this weekend that said not really, we did not have team support.

They didn't get the vision. Okay. How do we change that? Does that mean we tried it once. It didn't work, so we're not going to do it again. No, it means we learn from what didn't work. We refine that, we improve upon it and we present planned B. Hygiene blitz day number two, the next generation new and version. Right? We have to help them see the vision of why this makes sense. Okay. Again, in the middle of difficulty lies opportunity, we know there's plenty of opportunity to serve patients better, but we are the ones as leaders in our organizations and our practices that drive those opportunities.

Resources:

1. All listeners of the Double Your Production Podcast are invited to schedule a customized Practice Analysis Amplifier where we will review your current production and create your personalized roadmap for doubling your production. Click here to schedule.

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