Ep 140: Small Changes to the Schedule That Impact Financial Performance

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Dr. John Meis (00:01.73)
Hey everybody, welcome to this episode of The Double Your Production Podcast. I'm Doctor John Meis here and I am here with a very, very special guest, Heather Driscoll. Hey Heather.

Heather Driscoll (00:11.917)
Good morning, Dr. John, how you doing?

I am doing fantastic. So Heather and I have been working together for 23 years-ish. Yeah. And so we've done a lot of things together.

We have, yes. Yeah.

So she came working in my practice as a dental assistant initially, and then moved to the admin side, very quickly became office manager. And when we merged that practice into the larger one, Mortenson Dental Partners. We both left the practice and went to work for the larger company. She started out as a Regional Director of Operations and then National Director of Operations and then VP of Operations. At the last of her time there, she was overseeing 130 some practices.

Around there. Yep, absolutely.

Yeah. So we have been good friends and work together and we're business partners and we own a small DSO together. And we it's just an absolute pleasure to have you on the podcast. And you inform me that this is the first one that you've been on this podcast anyway, which really surprised me because we share so so much of our time and our energies together. So welcome.

Yeah, no, I was excited to get the invitation. And I'm sure way back in the day before podcasts were actually a thing, we certainly did our own version of collaboration and learning from other people. But I'm excited to be on the official Double Your Production Podcast. Well, I know the viewing audience and so fun to be able to reach people in multiple countries and be able to contribute to the great community of dentistry. So thanks for having me.

Thank you. Yeah, it's an absolute pleasure, let me tell you. So one of the foundations of having a successful practice is really how we manage scheduling. And Heather, I think this is one of the things that in our practice that you really mastered and helped the rest of us to master as well. And productivity doesn't happen without a great schedule. And without a great schedule, a lot of stress happens. And then a lot of conflict between the teams. So having this part of the practice well organized, well systematized is really important, isn't it?

It is, and I have found over the years, my strategy has come certainly just from experience. And I think you're the one who always says experience comes from bad judgment. Good judgment comes from experience and experience comes from bad judgment, I think is actually what you shared. And so certainly it's been a little bit of, you know, trial by fire. But one of the things I think I've come to appreciate over the years is that a productive and manageable schedule doesn't just happen. And I think it really starts with helping your entire team understand what you're trying to accomplish.

So why in the world does it make sense to spend time creating an environment where patients can get an exceptional, consistent experience and you can be flexible and nimble and convenient, but you can also do it in a really motivating, manageable, fulfilling kind of way. And think sometimes people hear really productive practices, statistics and numbers, and they think, gosh, they're probably running around with their hair on fire all day, every day. And what we found is that's not really the case if you have things coordinated in a way that makes sense.

Yes. And almost if you are running around with your hair on fire, you're not likely to have a very productive day.

Yeah, you might squeak out one every once in a while, but it's not very consistent or sustainable. That's for sure.

... will be consistent. Yeah, for sure. And it's a funny thing, the people who are scheduling the clinicians are usually not clinicians, right? And so that creates a little divide sometimes, because they don't know exactly how to do it, they don't know exactly how much time gets. And so that's really why it's so important to have it systematized, isn't it?

It is, and I think each person in the practice is just simply trying to perform in their role to the best of their abilities. so having had the great privilege of being on both the admin team and the clinical team, there's this little bit of natural tug of war that takes place because you're answering the phone and you're listening to people in pain and with urgencies and emergencies, and you're trying to quickly evaluate and scan the opportunities for appointment availability.

Yes.

And you see something that may not be ideal, but you don't understand maybe why it's not ideal. And then you have the clinical team who's questioning what in the world were you thinking? They're just trying to protect the patient experience too. And so if there's not a really good system for ongoing, I think education and communication about what's working about the schedule, what's not working about the schedule. I think to your point earlier, that's where conflict can arise. And I think it's hard to make the most out of opportunities when there's that stress and tension.

Yep, if there's too much on the schedule, the assistants are going to be, you know, hounding the front desk. If there's not enough, the doctor is going to start poking around, you know, because they get restless. So the schedulers are often in a difficult spot, aren't So what do you think are some, you know, we like to talk about mindset, skill set, tool set. And so what are some of the scheduling mindsets that you've seen help people improve their performance?

Absolutely. Yeah, the first one is, my absolute go-to favorite. And I always share with our teams, you know, the schedule is just a suggestion. And so what it looks like at the beginning of the day is almost never what it looks like at the end of the day. so planning for problems or, you know, potential pitfalls that may or may not happen is, is really a waste of energy, mental energy, emotional energy, all of those kinds of things. And so.

The first mindset really is just being open to the fact that there are going to be changes throughout the day. We're going to make the most of all of the opportunities we have. But to be at 7:45 in the morning worrying about a three o'clock in the afternoon appointment that may or may not still be there, it isn't always the best use of time.

What I see happening is people that are, we call them schedule watchers, people that are schedule watching, worrying about what's happening later in the day rather than what's right in front of them often have, first of all, they're burning a lot of mental energy and they're typically not looking and saying, we need to get some more stuff in here. They're typically saying, that's not going to work. This isn't going to work. And so, you know, they're burning a lot of mental energy, being anxious about it. And as you said, it may not even turn out that way by the end of the afternoon. So we have a few suggestions that you always share when you speak on this topic about schedule watchers and how to avoid that and how destructive that can be to productivity.

And usually what happens is we've all had the experience where we've had a couple of bad days or two, and then those stick with you, right? And you think that's always what's gonna happen when there's an emergency added in or someone does same day dentistry in maybe a less than perfect spot throughout the day. And so those things stick with us and then it starts to shape and influence our willingness to, you know, to want to be open-minded and say yes to certain things.

Thank

But one of the things I encourage people to do is if there are things that are happening on the schedule that you can feel yourself naturally getting a little bit of angst about, talk about it. Why is it that if the doctor has a root canal and crown scheduled, does that make the team uncomfortable? Is there something that's happened that they're afraid to put something else in the next column because of something historically that's happened. Oftentimes you'll find that either people don't have clarity on the amount of time certain appointments take or the things that make sense to naturally schedule alongside of each other. Oftentimes, you know, this is always some of my favorites. There's a room that doesn't work exactly like it should or equipment that doesn't work in a certain place or a team member that doesn't have the confidence or skill set to be able to fully delegate to them.

Yes.

And so we have these, you know, little pitfalls, but we just, sometimes I think we just ignore them and hope they go away or hope they improve. And, and it just continues to be like this little nagging in the back of your head as to why you can't do certain things or why something may not work out. And I find that we just don't take enough time to, talk about the things that are working really well and to also talk about the things that aren't working so well. And then create strategies to improve them.

So often there's frustrations between different roles in the office surrounding this. And often that frustration isn't talked about, like you said. And when it isn't talked about, that frustration rises and rises and rises. And then eventually something happens and boom, there's a blow up and a lot of conflict and a lot of hurt feelings. And really that affects the patient experience when you've got patients around when something like that happens. So communication is so important.

So one of the things that you put in place was great clarity in roles. Who schedules what kind of appointments? can you talk a little bit about that?

Yeah, so I think the front desk or the admin team can sometimes become a bottleneck for scheduling if we're not careful. And the other thing is when you're thinking about ways that patients schedule appointments, now it's an abundance of different channels, whether it's through a phone call or a text message, online appointment requests, through automated appointments, whatever it might be.

And so, you the admin team certainly has a significant role in helping to manage the schedule. But I also like to make sure that the clinical team who sometimes has the greatest insight into the specifics of appointments that they're managing and really watching the schedule, you know, for opportunities and potential obstacles as well.

So most simple, let's just start with hygiene. I think it makes the most sense for hygiene appointments to be, first of all, reappointed in the hygiene chair and then the admin team kind of being the safety net. I think the patient has the greatest connection with their hygienist and the recommendation to come back for their next appointment is probably most meaningful coming from the clinician themselves. But then certainly the admin team being a safety net for that.

I think a lot of times there needs to be either a good amount of communication or real clarity on phasing of restorative appointments. What should come first and how much time should that take and how much time between certain types of procedures? I'll never forget, even though I was trained as a dental assistant, I had never put that in practical application. And when I started working with you, I remember scheduling all of the components of an implant in one appointment and having your long time dental assistant come up and say, you what are you doing?

And I was like, well, they're getting an implant. And she's like, well, yeah, but the extraction and the implant and the abutment and the implant crowd, that doesn't all happen in one appointment. And I remembered thinking, like I didn't, I didn't realize, right. And so you don't know what you don't know. And again, everybody is just trying to do the best they can. So having that, you know, kind of checks and balances.

Yes.

I think is really important.

Yeah, for sure, for sure. So there are some resources that we found to be helpful for scheduling and communication, I guess mainly. So what are some of the things that you think are kind of critical components of resources for this?

Yeah, so probably the top of my list is radios. You know, having all of your team, including your admin team wearing radios so that there can be really quick communication about changes in the schedule. You know, if if someone's needed in a certain place in the practice to be able to facilitate same day dentistry, if they're, you know, if there's a patient running late, if there's a cancellation or a no show, whatever it might be just a really quick kind of seamless way to be able to communicate and take advantage of what's happening in real time. I would say that's the top of my list.

Yeah, you know, when we first got radios, there's a there's a bit of an adjustment base to get used to that. And there's some tricks and tips on how to use radios. But but it was so critical to our performance. And we actually had a break in at our office. And one of the things that the thieves stole was our radios.

And that first day, was such a chaotic mess without having the radios. Everybody, when we got the radios replaced, we got some of them back, we got the rest replaced. The team was just so excited to have them because it really made a big difference on our efficiency, didn't it?

It did. And I mean, yeah, to your point, who would have ever thought, because there was a little bit of a learning curve. Not great, I think, you know, once we all agreed to, you know, kind of our radio language and, you know, how we were going to utilize them, they became such an important part of what we did each day. I think that and, you know, a clinical coordinator, a traffic director with a whiteboard was a huge, huge influence to that next level of increasing productivity, being able to take that stress off of each of you as doctors and, you know, your responsibility was just listening, you know, to the clinical coordinator or looking at the whiteboard to know where you were supposed to go next. And you shouldn't have been worried about, you know, whether or not the next patient was here or whether or not the patient at three o'clock was still the same patient that it was at the beginning of the day, none of those things really needed to be something that was managed by the doc.

That's for sure. There are a handful of activities that really drive the results. It's the old 80-20 rule, 20 percent of the things that you do end up with 80 percent of the results. What are some of those things that you think are really the key results focused activities?

Yeah, again, I'm going to go back to my very favorite, the first one, and we always call it the yes attitude. I think first and foremost that everybody on the team has to be committed to the why we're there each day. And we're there each day to take care of as many people as it makes sense to be able to take care of in the most convenient and comprehensive way possible, which requires a high level of teamwork. And so I think the first kind of non-negotiable is that everybody on the team has to be rowing in the same direction that yes, we're gonna work hard, but that's what we're here for and we're gonna have fun doing it.

I think the second thing is simplicity of systems and processes. Especially in, and even in a single doctor practice, but certainly in a multi-doctor practice, having an agreement as to what room setups look like and a consistency of how and where things are stored and access to materials and instruments. And if you make any process too hard, it's going to be hard to get it right each time. And so when things are harder, we're less likely to want to do them. And so just getting really clear and simple with all of your room setups and your procedures, and that comes through education, I think, you know, and collaboration more than anything. And then probably my last one would be just that ongoing, we always called it the after action review. So on, you know, in good days and in bad days, having some kind of mechanism, you know, if you had a record day the day before, the next day in your morning huddle, being able to determine what in the world happened that allowed us to take advantage of all the opportunity that came through the door that day.

And I think a lot of times when things go really well, you celebrate and then you just think, we got lucky, right? Well, no, there was probably something specific that you did that you maybe don't consistently do. And if you can identify what that is, I think that's really valuable on the flip side. If you have a really bad day, I think it's natural to want to pump the brakes and avoid having another bad day. And so talking about, you know, knowing what we know now, what would we have done differently yesterday to avoid some of the, you know, stress that arose.

Yeah, so often practices just don't discuss what didn't go right, right there. And they don't they don't come up with sometimes things are just not going to go right. There's nothing you could have done about it, right? That's the real world. But most of the time there was something that you could have seen instead of judging, you know, it's his fault, her fault, whatever. Instead of doing that, just talking about what happened and just talking about how you you can avoid it in the future. At a recent Blue Diamond retreat. So that's our high level members retreats. We have them four times a year. And there was a practice that had had a record day. And if I remember right, it was a sixty five thousand dollar day. Yeah. And so, you know, so we celebrated that in front of the whatever a couple hundred people that were there. And then I asked, did anybody else have it? Has anyone else ever had a sixty five thousand dollar day?

It was, yes, $65,000 from one day.

And we have great members who have built great practices because of their sports and hard work and a little bit because of our help. And there were multiple practices who raised their hand that it had $65,000 days. in much of dentistry, the idea of that size of a day in a dental practice just seems so foreign. One of the practices that had a $65,000 day is a six-op practice. So it doesn't have to be gigantic practices. So if you get these systems down, it's amazing what can happen. So Heather, you are going to be sharing more detail on these strategies, on the roles and goals, the whiteboard strategies, same day dentistry strategies and things like that at The Champions of Dentistry Summit.

I am excited to be with everyone in Austin in April. And I love, you know, the fact that you alluded to these really incredibly productive practices. There are sometimes six ops, one doctor, sometimes, you know, 12 ops, two doctors, 20 ops, you name it. But it all comes down to those key activities that ultimately drive results. And sometimes it's hard for us to connect the dots between those, you know, fundamental activities and the results they're able to generate those are the kinds of things that we're going to be sharing at the Summit because it's really not, you know, that level of productivity isn't isolated to the elite few. It's really common once you understand the fundamental systems and commit to doing them consistently.

Absolutely. So the Summit, that is the Summit's focus this year. It's a three-day session and it's focusing on improving productivity while improving the patient experience. And so Heather's section is going to be talking about scheduling and it's going to be absolutely fantastic. She's an amazing speaker and an amazing person. And I'm so excited to hear about her speak and I hope to see you all there.

Wonderful. Well, I'm excited to be there as well and thanks for having me today.

You're sure welcome. So that's it for this episode of The Double Your Production Podcast. We'll see you next time.

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Ep 140: Small Changes to the Schedule That Impact Financial Performance

Ep 140: Small Changes to the Schedule That Impact Financial Performance

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