David Schwab Ph.D. Archives - David Schwab, Ph.D.

Important Lesson from Leadership Expert John Maxwell

I recently had the pleasure of hearing bestselling author John Maxwell give a presentation in Orlando. Mr. Maxwell is a world-renowned leadership expert. One of his principles, as explained in his book “The 17 Laws of Teamwork,” is what he calls the “Law of Mount Everest: As the challenge escalates, the need for teamwork elevates.”

The following scenarios can cause a mountain of challenges:

Record-setting production. It might seem counterintuitive to think that high production is a problem, but working at full capacity puts a stress on your systems. You have to book patients farther out, and any unexpected staff absence can compromise your efficiency and customer service.
You hire a new employee. A new team member may be a welcome addition. There are challenges, however, when integrating a new personality into a dental office environment, which is essentially a tight-knit family. The new employee will also take up some of everyone’s time because proper training is essential.
A new doctor joins the practice. Bringing in a new doctor opens a world of possibilities—and potential pitfalls. Never underestimate the interpersonal challenges involved when a new doctor comes on board.

In each of these situations, the management mountain is harder to climb. The status quo management model may not work considering these new realities.

To deal with these issues proactively, you should:

Hold more team meetings (even brief ones).
Communicate more regularly with the team via brief memos (bullet points are fine).
Review expectations and job descriptions (and bring them up to date as needed).
Analyze your overall staffing situation (and hire additional help if warranted.)

You should be proud of scaling new heights, but at the same time you need to be mindful of the need to nurture and train the team that helped get you there.

Collecting Payment Out of Network

How do you collect payment when you are out of network, and the company prohibits patients from assigning benefits to the practice?

What are the patient’s payment options? Can the patient use HSA/FSA?

The answer is that the patient can use HSA/FSA to pay the practice in full and then reimburse their HSA/FSA when the insurance reimbursement check is received.

According to the IRS website: “If amounts were distributed during the year from an HSA because of a mistake of fact due to reasonable cause, the account beneficiary may repay the mistaken distribution no later than the due date of the tax return (not counting extensions) following the first year the account beneficiary knew or should have known the distribution was a mistake.”

This rule covers the scenario where a patient charges 100% of the dental treatment fee to their HSA/FSA because the exact insurance reimbursement amount is unknown at the time of treatment, and the insurance company subsequently sends the patient a check for partial reimbursement. The IRS has a form for this purpose.

It would be easier for the patient to put the full treatment amount on their credit card and subsequently get reimbursed to the extent allowed by the insurance company.

There is another very good option. According to CareCredit®, if the practice is out of network with the patient’s dental insurance carrier, the patient can charge the full amount of the fee to CareCredit®. When the patient receives partial reimbursement from the insurance company, the patient has the option of putting those funds toward early repayment of the CareCredit® balance.

The patient is not obligated to use those funds to accelerate CareCredit®repayment, of course. The patient only needs to pay off their CareCredit® balance within the prescribed interest free period to avoid interest charges.

By being aware of these payment options, practices can be best prepared when dealing with out-of-network insurance questions.

No More Deer in the Headlights: Speaking Confidently About Fees Chairside

Most dental team training programs have a glaring omission: clinical team members are often not trained to answer patients’ questions regarding fees. Administrative team members at the front deal with these questions every day, and many are quite adept at explaining value for the dollar with regard to proposed treatment. However, when patients turn to an assistant or a hygienist chairside and express concern about dental fees, the clinical staff are often unprepared.

It is common for back-office team members to be uncomfortable with these types of questions. They may respond by saying, “You have to speak to someone up front about that,” which is a true statement except that it is often conveyed in a halting tone that betrays a lack of confidence. The effect that financial questions have on assistants and hygienists is similar to Superman being exposed to kryptonite. Over the years, the super-human caped crusader was unstoppable—until he was exposed to material from Krypton, his home planet. Back-office team members should not lose their superpowers when a patient asks why a procedure seems so expensive.

Here are three very good answers when patients ask about fees chairside. My comments are in italics.

Our fees reflect the quality of care provided uniquely to you. Dr. Smile uses only the best materials and technology. This statement brims with confidence and reinforces value for the dollar.
It’s a great investment in your health. You deserve it. Patients need to hear again from their trusted assistant or hygienist that the proposed treatment is in their best interest.
Patients tell us all the time that they wish they had decided sooner to have the treatment. Let’s go to the front and you can speak to Julie about different financial options. This transition is seamless and can be used with any of these answers.

Clinical team members are not expected to make financial arrangements or discuss fees in depth with patients. However, their verbal responses to patients’ questions about fees and body language are very important. The deer-in-the-headlights look is an expression of anxiety. When all dental team members are properly trained to handle the money question and respond succinctly with rock-solid confidence, patients feel more comfortable moving forward with recommended treatment. Practices owe it to the team and the patients to provide such training.

No Cost Dental Team Motivation

No Cost Dental Team Motivation is the topic of Episode 2 of The Personal Report, which is now available on YouTube. To see the video, click here:

Here’s the transcript of Episode 2 on motivation.

We have a great topic for you today: No Cost Team Motivation. So, how do we keep the team motivated?

Well, let me just tell you a little story. Some years ago, I was involved in a focus group. Do you ever watch “Law and Order”? They watch through the glass and they’ve got somebody in the box and the people who are being interrogated can’t see you through the one-way mirror.

Well, a focus group works that way and we interviewed people who are in the dental profession, hygienists and assistants, and so forth, and asked them what motivated them. We actually divided them into two groups. We preselected them, through a survey, happy people and unhappy people. And it didn’t matter whether we interviewed the happy people or the unhappy people: when they made a list with the focus group facilitator about what motivated them, money was not number one. Oh, it was on the list, and it’s important, but it wasn’t number one.

You know what number one was? Praise, recognition, somebody cares, somebody noticed. So, the no cost way is to praise, but let’s be more specific about that, and when you give praise, always make it specific. Don’t just say, “Oh, you know, you’re wonderful,” or “Oh, I’m so happy you’re here.” That’s good, you need to say that, but make it more specific. “Yesterday, when the patient was starting to get upset, you handled it so well.” The other day the entire schedule was going to fall apart, but you got on the phone and we had a good schedule. The schedule is full–wow, what a great job!”

So you want to be very specific in your praise. We always say, praise in public, criticize in private. Now, you can praise in private, but if you happen to say it publicly, if you praise in public, if other people hear the praise, believe me, the person who’s hearing the praise, they’re not going to mind that other people know that somebody is getting praise and that they’re the one who’s being praised, because they did a good job for something specific.

Any criticism, though, has to be in private. No matter how mild the criticism, you want to really make that private, but that praise, specific praise, and public praise, are very, very important. And the next thing I will tell you is, don’t couch the praise; never use the word “but” when you’re praising.

Here’s what you don’t want to do: you don’t want to say, “You know yesterday, you stayed late, nobody asked you stay late, You took your initiative and you just did it without anybody asking and you got all the work done, but you know, if you were more organized, you wouldn’t have to stay late.” You’ve just taken it all away. First you were on a roll, you were saying all these good things, and then you added “but,” and here comes some criticism in underneath.

Praise is praise. “You did a great job.” Period. And let people know that. Now, if at another time, you need to talk to somebody on the side and say, “work on your organizational skills,” that’s a different story, but praise has to be specific and it has to be unqualified; we don’t want to say the word “but.”

Let me leave you with this thought: when I talk about praise, I can just hear all the staff out there saying, “yeah, I’ve got to get the doctor to watch this video. See, see, you should say nice things about us.” Okay, fair point, but I think that everybody on the team needs to praise other people on the team–when it’s deserved, of course. When somebody does something praise worthy, don’t be shy, tell them. And, by the way, sometimes even the doctor does something praise worthy and you can say something nice about him or her also.

I hope you’re enjoying the Personal Report. You know, I do have my Free Report; we’re getting a lot of good feedback. If you want a copy of the Free Report, “The Three Mistakes Every Dental Practice Must Avoid,” then just go to thepersonalreport@yahoo.com. Just send a quick email to thepersonalreport@yahoo.com and we’ll send you the Free Report.

You’re always, of course, welcome to contact me through my website, which is davidschwab.com. Thanks so much for watching The Personal Report.

You May Need a Coach If. . .

Great athletes need coaches. Great dentists need coaches, too. Take advantage of the free consultation offer below.

You may need a dental coach if:

You are facing major decisions about the future of your practice. You are wondering if you should buy, sell, expand, cut back, or bring in another dentist. Ask yourself: Do I need a trusted confident, outside of my business and family—someone who can lead me to the right choices?
You feel that your team needs more training. Ask yourself: Could targeted training for specific individuals improve their performance and help the bottom line?
You are not sure if all team members “get it.” Ask yourself: Have I clearly and consistently communicated my expectations to my team?
You feel that your practice has reached a plateau. Ask yourself: Am I feeling burned out? Or, do I have a lot of energy but just need direction?
You think that case acceptance should be higher. Ask yourself: Am I using the best verbal skills and teaching my team to follow my lead? Do I have an effective follow-up protocol in place to prevent patients from “falling through the cracks”?
You are feeling unsure about your management style. Ask yourself: As an employer, am I too harsh, too lenient, or just right?
You are worried about overhead but you need more help at busy times. Ask yourself: Am I adequately staffed to provide outstanding customer service? Am I utilizing the full talents of everyone on the payroll?

If you answered yes to one or more of these questions—or if you have other issues that you would like to discuss in confidence with a highly experienced dental coach, please contact me.

Coaching services are conducted by phone consultations, in-person visits to the office, or both.

Free consultation. Contact me to schedule a free 30-minute telephone coaching session (limited time offer) so I can start helping you immediately. I promise to listen carefully and provide cogent, confidential advice.

Click for contact info.

Subscribe to The Personal Report video program.

Ultimate Secret of Practice Management

What is the ultimate secret of practice management? This blog is the final installment of my three-part series on how dental practices can learn from the phenomenal success of amazon.com. In the first part, I discussed the need for practice efficiency. The second lesson was about focusing on value, not price.

Another lesson from Jeff Bezos, founder of amazon.com, is a relentless emphasis on customer service. As with the other great tips from Mr. Bezos, however, we need to adapt that lesson from amazon to the practice of dentistry.

Everyone knows that the patient comes first, and customer service is already stressed in most dental practices. I interpret the customer service lesson to be much more nuanced than a general desire to be polite and friendly. Customer service in a dental practice occurs not only because team members have an intuitive sense of how to treat people well, but because they are well trained.

The third—and most important—lesson we learn from amazon is the ultimate secret of practice management—a relentless emphasis on team training. Continual training gives the team the specific tools they need to provide outstanding customer service.

Here are three great ways to train your team:

1. Ask for examples. At a team meeting, ask everyone to give examples of great customer service they have experienced themselves. Don’t ask for service horror stories. Keep the conversation and the lesson positive. Ask what happened, why it was so memorable, and how great customer service has a lasting impact on one’s relationship with a company.

2. Set the standard. In my next blog, I will discuss “sticky situations” that occur in dental offices and how to resolve them. The doctor and office manager need to tell team members what to say in challenging situations.

3. Use outside resources. I have a Team Training Video Series and I also provide training by phone, Skype, and in person. Having a team coach is a great way to keep everyone trained, focused and motivated.

There is another great benefit of team training. It’s the reason team training is the ultimate secret of practice management. Team training feeds the other principles we have discussed in this series. With proper training, practice efficiency soars. Also, when team members have the right verbal skills, they are able to communicate value for the dollar and move past the cost objection.
There is a synergistic effect among the three principles because they are mutually reinforcing and underpinned by the ultimate secret of practice management: continual, relentless, purposeful team training.

Click to access the following resources:

Efficiency: Part 1.
Value, not Cost: Part 2

davidschwab.com

Price and Value Are Not the Same

Price and value are not the same! In my previous blog, I discussed lessons from amazon.com founder Jeff Bezos. He identified three business fundamentals that are not going to change in the coming years. The first one is the need for speed, which I translated for the dental profession as the pursuit of efficiency.

Bezos says that customers never say they want higher prices, but the amazon model shows that people will pay more when they perceive value. The lesson for dentistry is not to run a race to the bottom by cutting fees in the face of competition. It’s all about value, not price.

Amazon plays the value game and plays it well. Consumer advocate and radio personality Clarke Howard cited a recent study:

“We all know Walmart is cheap and Amazon is convenient, right? But is that convenience worth paying up to 100% more to you? Because that’s the premium a new study says you’ll pay on select items when you choose to get them on Amazon.com.”

Amazon.com saves time. Why drive to Walmart or even shop online with Walmart when Amazon makes the customer experience so seamless and easy? Amazon is extraordinarily convenient. Consumers will pay for great service, and patients will pay for quality dentistry (a service) because they want it done right.

Your messages to your dental patients should be:

It’s never cheaper to do it twice. Our goal is to do it once and do it right.
We do not offer the cheapest dentistry. We offer a high quality service.
The dentistry we provide is a great value for the dollar.

Make sure all members of your team know the difference between price and value–something I cover in detail in my consulting work and lectures.

Even the most cost-conscious consumers want value, which means not spending any money unwisely. People want to get the maximum return on their investment. It’s called value. That value is not the same as cost, but it does come at a price.

Next post: The third lesson from amazon.com applied to dentistry.

Click here to read my blog on efficiency.

Click here for more info on the study referenced above.

Asking the Right Questions to Improve Efficiency

Are you asking the right questions? We all want to know what is going to change in the next ten years. One of most prescient business leaders in the world, Jeff Bezos, founder of amazon.com, says that we should ask another question: “What will not change in the next ten years?”

Bezos, quoted in Peter Diamandis’ book, Bold: How to Go Big, Create Wealth, and Impact the World, says that no one has ever told him that Amazon’s delivery is too fast. He concludes that in his business, one factor that will not change is the need to improve delivery speed.

Amazon is continually trying to deliver orders faster. The company pioneered e-books. No more waiting for a book to arrive; simply click and the books downloads to your Kindle or other device in seconds. The company is now testing how to deliver tangible products in hours using drones.

There are three critical factors that will not change in dentistry. Let’s discuss speed and how we can apply the lesson to dentistry. I will address the other factors in subsequent posts as we continue to explore lessons from Amazon.

In dentistry, there is always a need to make the delivery of dental services faster by improving efficiency. It is important to note that I am not advocating spending less time with patients. On the contrary, I am focusing on finding ways to use your time and the patient’s time more efficiently.

Here are the right questions for your team to discuss.

How can our appointment process by streamlined? How can we spend less time on the phone scheduling and confirming?
How can we make better use of automated confirmation systems?
How can communication between front and back be improved so we can schedule more efficiently?
How can we ensure that we have some openings in the schedule at the ready for new patients who want to be seen very soon, even if they do not have any urgent dental needs?
How can we streamline the check out and fee collection process?

I pose these questions to teams when I consult with practices and challenge the teams to find answers. While practices do not arrive at perfect answers, they improve these processes, and that is the goal.

To have a substantive team meeting, work through these questions in depth to improve efficiency. As I always say, you may not have all the answers, but if you have the right questions, you will improve your business.

Next post: The second factor that will not change in dentistry and how you can improve.

www.davidschwab.com

Role Playing Made Fun and Effective

When it comes to the phrase “role playing,” many dental team members react the way lay people respond when they hear “root canal.” They do not want any part of it. Just as modern root canals are often comfortable for patients and the procedure removes the source of their discomfort, role playing can be made fun and effective. What’s the catch? It has to be done right.

Here are some tips for running a successful role playing session.

One person plays the role of the team member while someone else pretends to be the patient. The person playing the patient role can offer objections to the cost of treatment or throw up other road blocks, but no one should overplay the part. Forget the histrionics. The “patient” can be skeptical but must always be polite and at least somewhat malleable.
Each scenario should be no more than one minute long.
Immediately following the session, ask everyone on the team what the role player did right. There can be no criticism until there is praise.
Next, ask the role player what he or she did right.
Ask the role player a key question: “What could you do next time to improve?”
Other team members can chime in, but they have to be supportive. Example: “I agree that you could have asked more open questions, but you were doing great in the beginning.”
Give the role player a chance for redemption by repeating the same scenario. The person you are training will inevitably do better the second time around.
Ask the entire team for comment on why round two was better.
Ask the person you are training if they felt more comfortable when they had a chance to improve. They will almost always concur because they learned what to say and what not to say.
Have others role play. When the entire session is done, summarize the learning experience and thank everyone for their cooperation.

As you can see, the goal is not to catch someone doing something wrong, but to reward good behavior and encourage the person being trained to make improvements. The other team members are not really judges but a cheering section. People tend to be harder on themselves than they are on other people, so don’t worry about bad behavior going unnoticed.

By role playing in a positive fashion, you will help team members learn to deal with difficult situations in the office in a supportive environment.

Hospitality: The Secret Sauce in Business Success

Hospitality as the “secret sauce” in business success was explained recently in a segment on 60 Minutes. The interview featured Danny Meyer, an incredibly successful restaurateur. Meyer wrote a book called Setting the Table in 2009 that has since been reprinted and made available in an electronic format. You can find it on amazon.com

Meyer made it big in the restaurant business in New York. “If you can make it here, you can make it anywhere,” as the song says. It is even more impressive that Meyer achieved his phenomenal entrepreneurial success in the restaurant business, where the competition is brutal, profit margins are small, and so many things can go wrong.

His formula is simple yet compelling. Meyer says that in a restaurant, it is obvious that if the food is not good, then no one is going to come back. For that reason, he places tremendous emphasis on quality control—freshness, tried and true recipes that people like, attractive presentation, and ingredients that all work together to give customers a great taste sensation. People come for the food; the food has to consistently meet and exceed expectations.

The other, equally important factor is hospitality, the “secret sauce.” Meyer says that people have to have a great experience when they come to a restaurant. He explains that the experience is provided not only by friendly and competent servers, but by everyone in the restaurant who interacts with customers.

Meyer is always moving from table to table. He smiles, makes small talk, asks for feedback, and thanks people for coming in. The pride he takes in his work is evident and he genuinely wants everyone to have a good time. People like him and they appreciate the hospitality as much as they like the food.

I saw this philosophy in action recently. I had lunch at a modest, family-run restaurant in a small town. The food was very good, but the experience was memorable because of the hospitality. The owner came out, introduced himself, thanked me for being a first-time customer, and explained that he is building his business one satisfied customer at a time. We had an enjoyable conversation. By the time I left the restaurant, I felt that I had made a friend. The next time I drive thorough that town, I will visit my friend the restaurant owner and have another meal. I have also told others about the restaurant.

I know dentists who not only provide quality dental care, but who walk into the reception area and greet patients. They are always gracious hosts, welcoming new patients, catching up with loyal patients of record, and connecting with everyone who comes to see them.

In these practices, people come back and tell their friends because the hospitality is as impressive as the dentistry.