Monitoring your practice’s vital signs

Dr Michael Sernik, July 2005 - “I just want to do dentistry. I’m not interested in management or leadership or the business of dentistry.”

Paradoxically, the dentists that continue with this attitude often end up frustrated and stressed in their careers. Their days are often too busy or not busy enough. They have patients who need comprehensive treatment electing to have short-term solutions. They have staff problems and complain of too much annoying paperwork.

The modern, evolved Dentist understands that to run an efficient, low stress practice, deliver consistent high quality dentistry and create a successful career in dentistry, it is imperative to spend time improving communication and practice management skills:

Communications skills include:

  • Team to patient communications (Education and Motivation)
  • Team to team communications. (Team Building)
  • Leader to team communications. (Management and Leadership)

Practice management systems include:

  • Schedule Systems
  • Preventive Systems
  • Patient Financial Arrangement
  • New Patient Systems 
  • HR Systems and Policies
  • Marketing

The question is how can you tell if your systems and skills are up to scratch in your practice?
More and more, modern Dentists are using Key Performance Indicators (K.P.I’s) to get a handle on how well their practice is being run. Every modern CEO knows that every day, they need to look at a handful of K.P.I’s to get a snapshot of the health of their business. These act as forward indicators to help the CEO understand what needs attention. So what K.P.I’s should a dentist look at to see if his practice is healthy? At Prime Practice, we have found that there are ten really useful K.P.I’s that can help point to room for improvement in the skills and systems of a practice.

Prime K.P.I’s

1. Production per hour worked
2. Collection Percentage
3. Clinician hours scheduled
4. Number of new patients
5. Percentage of patients reappointed
6. New patient conversion rate
7. Amount paid per unique patient per year.
8. Average appointment time
9. Number of active patients (unique patients in the last 18 months)
10. Number of indirect treatments done per last 100 unique patients

(NB: All K.P.I’s are per clinician per quarter)

As a Dentist, my first reaction to practice K.P.I’s was ‘what for?’ What am I going to do with the numbers I get? The only way I will be able to improve at any of the numbers will be to work harder or faster in that area and I’m already working as hard and as fast as I can.”

There is some merit in this attitude, as numbers in isolation have limited usefulness. Is an average appointment time of 32 minutes high or low? And if it is high what options are there?
K.P.I’s are interrelated and need to be compared and looked at as several pieces of a bigger puzzle in order for them to be understood.

What is missing is some knowledge about how to analyse, interpret and improve, a comparison over time and a comparison between clinicians:

How to analyse, interpret and improve to illustrate how important this is, let us look at how we analyse percentage reappointed, new patients per quarter and number of active patients.

Percentage reappointed is the percentage of patients who leave with a firm appointment in place. If all patients (even those who have just finished a treatment plan) leave each appointment with another appointment booked, it tells us something positive about the communications skills of the front desk personnel.

Number of active patients should equal the previous quarter’s number plus the new patients that you have seen in the last quarter. An analysis of these numbers will tell us how many patients are being lost every quarter (the Attrition Rate). If the percentage reappointed is high and the number of patients lost is also high, it indicates that the Front Office Staff may be doing a good job booking the patient in, but there is a deficiency in the patient’s commitment to maintenance treatment. The cause of this deficiency usually lies in the treatment room. Chances are that the clinician has not deepened the patient’s concerns relating to the consequences of not attending maintenance treatment.

A comparison over time a comparison over time can be done simply by comparing this quarter’s results to previous quarters and helps you see if you are improving or getting worse in any metric.

A comparison across clinicians
a comparison across clinicians can be done within your practice by simply comparing one dentists K.P.I’s to another or by asking practice management companies like Prime or supply company reps.

When a rep from a dental supply company visits a dentist, it is common for the dentist to ask the rep how they compare with other dentists.

Prime Practice, Australasia’s leading practice management company, is working with the leading dental software companies to display these Prime K.P.I’s as a standard report with one click on the computer. Henry Schein Regional, the dominant dental supply company is training all its reps to help clinicians understand the value of K.P.I’s during their site visits. The reps will also be able to get a comparative sense of where the clinician sits in comparison to other clinicians.

This type of service will be welcomed my many practitioners because it can help to quantify the relative efficiency of a practice and give dentists an indication of what management issues could be looked at.

[Published in Australasian Dental Practice, July/August 2005]

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