Calif Dental New Plan.indd

Hygiene Department Growth Plan 2020




Hello Dr. Patel,
This overall plan is a general guide for the expansion and growth of the hygiene department at California Dental Care.
The focus of this plan is based on several factors, primarily
a) an estimated 80 new patients per month,
b) scheduling and performing a minimum number of hygiene patients per hygienist
10 per day,
c) production performance that reaches the national benchmark daily production of
$1,500/day.
The office is well set up for major increase in hygiene operative spaces as well as space planning that is exemplary in the industry, meaning, adequate number of hygiene operatories and administrative space for the Retention Coordinator (also called the Hygiene Coordinator).
As a note, the position in charge of this department is best named the “Retention Coordinator” as is describes the product and duties that are performed. It is preferred over “Hygiene Coordinator” which has no connotation of retention of the patients.
The foremost importance of the hygiene department is retention of the patients to dramatically improve overall dental health of the patient. The primary objective to achieve retention is through use of patient education which is achieved through a repeated public relations campaign and message of “Wellness.”
Let’s explain why this is so critical....
MINDSET OF DENTAL CONSUMERS
The “mindset” of patients in relation to “going to the dentist” must be known by the administrative staff, but most importantly the Retention Coordinator, hygienists and hygiene assistants. In other words, while all employees of the office should know and understand this “patient mindset,” the staff of the hygiene department must know and apply the “public relations message” of “Wellness” repeatedly...and believe in it!
Here is why!


Consumer Mindset Scale of Importance
Every business, their service or product, is “positioned” in the mind of their consumer. For example, let us use a scale of logic that is from 0 on the bottom and 10 at the very top. At the top of the scale is most important, pleasurable and desirable. The bottom of the scale represents the least importance, un-pleasurable and undesirable. This scale is illustrated on the opposite page due to its importance in REPOSITIONING dentistry.
This scale gives a representation of a universal “mindset” regarding what is “Most Important” at the top of the scale and “Least Important” at the bottom of the scale, with many activities in between.
Family, one’s job/occupation and health are at the very top of the scale for almost everyone. At the bottom of the scale, the least important and undesirable are things like divorce, breaking up with a loved one, loss of a friend or family member.
For our purposes, which is RETENTION of patients, look where dentistry “falls on the scale.”
Have you ever wondered why patients “cancel,” “no show” or “don’t take calls” or “go to voice mail when you call” and on and on? The Scale of Importance explains and gives us insight as to why patients take so long before they go to dentist? Many patients wait until their have pain or a major problem before they call to make an appointment. As well, the scale explains why patients miss appointments or don’t return routinely for their recall visits.
Dentistry, as a “mindset” of consumers is positioned on the scale at around 2! And herein lies the answer to why the majority of dental consumers are not retained (cancel, no show, or come back in 3 to 5 years with another major complaint).
Why is dentistry so low on the scale? To answer this question, one has to survey and know the “mindset” of the consumer(s) or patient.
A “mindset” is defined in the Oxford dictionary as: the established set of attitudes held by a person or group of people. A mindset is what one thinks about different things: People, cars, music, devices such as iPhone, iPad, computers, PlayStation as well as restaurants, entertainment; services they receive in different industries, like going to a hotel, getting one’s nails done, one’s hair streaked, having a massage, going to a concert, a funeral, or a hospital...and yes, for our purposes, going to the dentist.


What is the “mindset” or thought process when one thinks of “going to a dentist?” In other terms, what the is POSITIONING of dental consumers on this scale? They think the following: Pain, fear, needles, costly or expensive, not pleasurable, undesirable and second opinion.
Most Important
Most Pleasurable/Desirable
Family, Job/Employment, Health
10
8
6
4
2
0
Relaxing, doing “nothing around the house,” walking the dog,, etc.
Recreation, Vacation, Personal Hobbies, shopping, a new home/car
Night out with family/friends, dinner, movies or similar
Manicure/Pedicure, Message, Hair Makeover or similar, exercise, Staying Healthy/Wellness
Cleaning the house, Mowing the lawn, being a “taxi driver” for the kids, etc.
Going to the Dentist, going to DMV, paying taxes,
Losing one’s job, Getting ill,, surgery, Hospitalization, breaking up, divorce
Lose of a loved one
Least Important
Least Pleasurable/Undesirable
Mindset Scale of Importance


Positioning & Public Relations
The positioning of dentistry in the mind of dental consumers falls low on the Scale. This gives us an “open door” in resolving the subject of patient retention!
Positioning as a subject is closely related to Public Relations, or in other words, the use of PR. The technology of PR (Public Relations) is extremely powerful . With a survey of consumers about any subject, one can develop a “PR Campaign” to change the outlook or mindset of the audience addressed. Our audience are dental consumers, or patients of the office.
Any company, subject or idea can be REPOSITIONED with the use of PR. How is this done? Repositioning of a company, subject or idea can be accomplished in four ways:
1) Positioning ABOVE the competition, company or idea. 2) Positioning WITH the competition, company or idea.
3) Positioning BELOW the competition, company or idea. 4) Positioning AGAINST the competition, company or idea.
This is done routinely in the news, by companies, politicians, self-interest groups, industries and many others.
For example, a non-profit organization promotes the idea of “Clean air, water, rivers and oceans.” They use images and advertising that position AGAINST “polluted rivers,” “dirty oceans with plastics on the shore line,” and so on. These images are memorable and they create an increase of awareness of the problem. They use PR to gain agreement, funding, and support.
Similarly, as another example, a new rental car company is new in the marketplace. This occurred with AVIS Rent-a-Car over 2 decades ago. They were new and Hertz Rent-a-Car was #1. A bright PR executive introduced a campaign to position right BELOW Hertz. They couldn’t position ABOVE or WITH or AGAINST Hertz. Why? They can’t promote AGAINST the very industry they are in! They couldn’t promote ABOVE Hertz as they were clearly #1, so to do so, would be false PR. They couldn’t promote WITH Hertz
as they were not Hertz, they were a different company! They chose to promote just BELOW Hertz, with a brilliant campaign called “We Try Harder. We’re No. 2.”


David Ogilvy1 praised Avis ads as a feat of “diabolical positioning.” “The ‘We Try Harder’ ads were an instant hit. Within a year, Avis went from losing $3.2 million to earning $1.2 million— the first time it had been profitable in more than a decade. From 1963 to 1966, as Hertz ignored the Avis campaign, the market-share percentage gap between the two brands shrunk from 61–29 to 49–36. Terrified Hertz executives projected that by 1968 Avis might need a new ad campaign—because it would no longer be No. 2.”
Public relations is powerful! It changes everything. Another short example, is when 7-Up positioned AGAINST cola! They became the “Uncola,” which changed the entire sales and revenue of the company.
Back to Dentistry!! The dialogues for the mission statement, cancellation card, reactivation script as well as the framed mission statements, office stationery, appointment cards, business cards...each are used to embed a change in mindset AGAINST the negative idea(s) patients have about dentistry to make them positive!
Positioning AGAINST Consumer Mindset
The result is a REPOSITIONING of dental consumer’s mindset to a point HIGHER on the Scale of Importance. (See diagram on following pages)
The entire staff should embrace the overall concept of “Wellness” or “Healthy Dentistry” or some synonym or phrase to accomplish the repositioning.
As an example, the “mission statement” should be turned into a short “slogan” or “motto” that can be on all stationery, appointment cards, business cards...and even when answering the phone. Take a look at Nike. What is their “motto” or “slogan?” Everyone knows it...”Just Do it!”
Toyota on all commercials has a clear mantra, or motto that says, “Let’s Go Places,” which aligns with vacations or going on an adventure!
A shortened motto or mantra should be under the heading of “Wellness” or “Health” or similar. The staff should get together and help formulate something everyone likes, which aligns with the PR message. For example, “Wellness for Life,” or “Dental Health for Life” or something short and catchy!!
1 Ogilvy is a New York City-based British advertising, marketing, and public relations agency. It was founded in 1850 by Edmund Mather as a London-based agency. In 1964, the firm became known as Ogilvy & Mather after merging with a New York City agency that was founded in 1948 by David Ogilvy. It is now one of the largest advertising and public relations companies in the world.
Fear, pain
Costly or expensive 2nd opinions Undesirable
eliminate future pain
dramatically reduce future dental costs build trust, use trustworthy
desirable dentistry through education


The REPOSITIONING of consumer’s mindset about dentistry is illustrated below. We are simply positioning with the words “Wellness, Health, etc.,” along with exercise. Look at Trader Joe’s, Whole Foods, the LA Fitness clubs and Message Envy and on an on.
Most Important
Most Pleasurable/Desirable
Family, Job/Employment, Health
10
8
6
4
2
0
Relaxing, doing “nothing around the house,” walking the dog,, etc.
Recreation, Vacation, Personal Hobbies, shopping, a new home/car
Night out with family/friends, dinner, movies or similar
Manicure/Pedicure, Message, Hair Makeover or similar, exercise, Staying Healthy/Wellness
Cleaning the house, Mowing the lawn, being a “taxi driver” for the kids, etc.
Going to the Dentist, going to DMV, paying taxes,
Losing one’s job, Getting ill,, surgery, Hospitalization, breaking up, divorce
Lose of a loved one
Least Important
Least Pleasurable/Undesirable


Through PR and REPOSITIONING, dentistry simply raises higher to the middle of the scale. As such, you’re changing the “minds” of your consumer and thus, the ability to retain and have patients return becomes far greater. You’re fighting a ghost! That ghost is what they THINK about coming to the dentist. Let’s change their mind!
Most Important
Most Pleasurable/Desirable
Family, Job/Employment, Health
10
8
6
4
2
0
Relaxing, doing “nothing around the house,” walking the dog,, etc.
Recreation, Vacation, Personal Hobbies, shopping, a new home/car
Night out with family/friends, dinner, movies or similar
Going to the Dentist, Staying Healthy/Wellness Manicure/Pedicure, Message, Hair Makeover, exercise or similar
Cleaning the house, Mowing the lawn, being a “taxi driver” for the kids, etc.
Going to DMV, urgent care paying taxes,
Losing one’s job, Getting ill,, surgery, Hospitalization, breaking up, divorce
Lose of a loved one
Least Important
Least Pleasurable/Undesirable


Growth Plan
To formulate a growth plan I’ve used the information provided in your email. You gave both
the present situation as well as the proposal for next year. Using this information, as well as a new patient monthly inflow of around 80 patients per month, we can predict an outcome on how to achieve your overall objective. The below information is what you provided...thanks for sending this.
• Booking 8 patients a day, includes 2 patients that are New patients to the practice. • No hygiene assistant.
• Hygienists take radio-graphs on the recall patients.
• Dental assistant takes radio-graphs on the New Patients.
Our present availability is as follows:
Monday
Tuesday Wednesday Thursday
Friday
WEEKLY TOTAL: 88
88 patients a week X 49 work weeks = YEARLY TOTAL: 4312
• Book 10-12 patients a day, per Hygienist, includes 2 patients that are New patients to the practice per Hygienist per day.
• Hygiene assistant.
• Hygienist and Hygiene assistant to take radio-graphs on the recall patients. • Hygiene assistant to take radio-graphs on the New Patients.
= 24 = 16 = 24 = 16 = 8


Hygiene Growth
The estimated growth is based on about 80 patients per month. Conservatively, I have used an average of 10 patients/day/hygienist as “actual cleanings/RPCs, etc.” which means about 11 to 12 scheduled per day per hygienist. This gives the office 9 new days of hygiene each month. The objective is to maintain a 45% recall or retention of the new 9 days, or in other words, a loss of 55%. Earlier in this same formula we said 45% loss, so we’re being more than optimistic to attain the objective of increasing days of hygiene.
The average of “10 patients/day per hygienist” was suggested due to the national average daily cancellation rate, which is 12% to 16%. This means with good control, there will be an average of
1 1/2 cancellations per day per hygienist. It is important to note that the control factor is vital and that being said, the “scheduled appointments for each hygienist” should be set at a minimum of 12. As such, the accomplishment of 10 actual hygiene patients is an achievable goal.
The below gives an overview of the “math” as a benchmark to achieving the objective target. The target or objective is recommended to be real and the math below is a good proven guideline for setting the increase of your hygiene days in the department.
Jan June
8 days 55% loss of database
1 Full time hygienist added/year
Revenue Calculations
55% loss of database
Jan
3.5 days 3.5 days 8 days
15 days/mo 1,800
3.5 days
8 days
Hygiene Visits/year added Each day = 10 hygiene appts
The following calculations for projected hygiene 2010 are based on 2 hygienist per day five days a week, assuming each is working an 8 hour day:
10 days/week of hygiene x 10 actual appointments/hygienist/day = 100 appts/wk or 4,900 visits/yr. Annual Hygiene Revenue: Average $1,500/day x 10 day of hygiene/wk x 49 weeks = $735,000.


Clarity on Allocating Job Duties to Whom
The question proposed on job duties is an excellent one as without clarity of duties between the hygienist, hygiene assistant(s) and Retention Coordinator (also called the Hygiene Coordinator), the confusions and disagreement will slow the program but more importantly it normally results in staff turnover.
I have attached several documents that lay out the job functions and duties for:
• The Hygiene Retention Coordinator • The dental hygienists
• The hygiene assistants
The duties listed for each are well formulated and long term have shown to be the most workable. They’re can be modifications to the duties but limit them as much as possible.
Importance of the Department Head
The most important aspect of growth, is a strong Department Head with leadership qualities. The employees within the Hygiene Department must know “the buck stops with the Hygiene Retention Coordinator.”
The Department Head is in charge of all hygiene assistants as otherwise, the assistant ends up with 4 or 5 “bosses” telling her what to do or what “she didn’t do.”
The Department Head sets the priorities for the hygiene assistant. The duties of the hygiene assistant are LISTED and known by everyone in the department, so her duties, which are policy, are what dictate what she does.
The hygienist need to know that the assistant, once on post, has the authority to adjudicate “what is important,” under the guidance of the Department Head.
Training & Coordination
Training of the employees in the Hygiene Department is quite paramount. But what training? The most vital training is:
a) to know each others duties! With full clarity. b) to know and use the administrative forms.


Without good administration, which brings about an organized department, the growth is difficult and slow. The forms, reports, statistics are cumbersome at first, but they become secondary and almost effortless once they are in use as a pattern.
Training Method
The training method is based on checklists and videos which are image driven. Most important to the training is the number of times OVER THE MATERIALS!
The videos are not watched 1X. Not just 2X. But 3, 4 or more times.
The courses and duties and functions of each member of the department are done not 1X, not 2X but 3 or 4. I have been to over 55 offices across the country to interview staff and doctors, hygiene coordinators and assistants. There are TWO key missing elements in offices that have confusions and/or have slow progress:
a) The Hygiene Coordinator is absent or weak as a leader. It’s a department that will generate in excess of $1M a year...it needs an executive with the ability to control staff and administration.
b) Uneducated and lack of knowledge on most any part of each others duties or the actual administrative forms. When “tested” or asked questions about the system, the answers given show an immediate lack of training and education.
A simple question of “what are the 4 business laws?” and which one is most important to the hygiene department,” can’t be answered! Or, how do you hand out a care-to-share care and what dialogue to you use? Not able to answer this! Or, give me the mission statement, and it misses nearly every part of the most important words that reposition dentistry to obtain better retention. I could go on and on, but those office staff that I interviewed that went over the materials 3 times (which is on the Progress Board), made the best progress within 4 to 6 months...they had the system with an increase in daily production and more hygiene days.
Okay my friends...both Dr. Patel and Ashley:) Please review the overall plan and the attachments and then let’s set a time to meet...out next meeting is an important one!
My Kindest Regards,
Greg Hughes
CEO Viva Concepts, LLC