Case study: Practice management and coaching programme.
Client: Dr. Inderjit Singh
Practice: Cathedral Dental
Website: www.cathedraldental.co.uk
First meeting: February 2009
Started Coaching programme: March 2009
Situation February 2009
When I met Dr Singh he had moved his young family from Hertfordshire to the quiet countryside of Suffolk. It was a life changing decision for himself and his wife.
Socially their lives had changed dramatically; they were making new friends and were missing their family as they were now a two hour drive away.
This move took place at the end of June 2009. Dr Singh bought his first practice as an investment for his families’ future – a pathway to a long term gain and greater quality of life.
At our first meeting Dr Singh confessed that running a dental practice wasn't the experience he thought it would be. Dr Singh had been on all the courses, read all the books but his plans and goals weren’t falling into place.
The practice he bought didn't have a website so Dr Singh invested £500 in developing one. This began to work as it transpired he was the only dental practice in the area to have one! He had become a member of a marketing company and was placing a few adverts locally which were working.
He was an experienced dentist and was offering treatments that were "new" to the area – no one else was offering clear braces let alone tooth whitening!
His concerns were now that although the phone was ringing, and he was working two late nights a week and Saturdays, new patient enquiries weren't being converted.
Prior to our meeting I had a mystery call made to his practice to assess the current standing of his untrained reception team.
The meeting
When I first met Dr Singh I thought he was a very intelligent caring man. He knew where he wanted to be but getting from A to B was proving more than a challenge.
I began by asking my client what his current concerns, challenges, and goals were. This led the way to a detailed and frank discussion. Dr Singh was tired and overworked; working as a dentist, entrepreneurial business owner and a practice manager. His team had no set hours, roles, or responsibilities and he was slowly losing control.
We listened to the phone call that was made to the practice and the results were as expected. The caller didn’t know:
- If they were calling the right practice
- Who they were talking to
- If the practice could definitely help with their enquiry
- What the fee would be for the treatment they desired as the team didn’t know
- The options available re initial visit
- Why they should choose his practice
The first impression of the practice was poor. It turned out everybody answered the phone differently, the phone would be left to
ring untold times as this was not seen as a priority by the team – this was not their fault. They had not received any patient focused training while employed there and they were a long standing team.
He was also overstaffed in the wrong areas and the practice needed to make a profit and come out of the red. Dr Singh needed to learn the art of delegation, instead of spending time with his family at weekends he was in the practice typing up cross infection policies and sterilization procedures – all the important documents the practice did not have. He was so overloaded with notes and items on scraps of paper there was no way he could become organised at that present time. Dr Singh did the back up, he booked his appointments - he did everything. It was nice to meet a man that could multitask but he was heading for a burn out.
The practice had no systems for the basics, no super systems for patient care. The team needed guidance and leadership. This was a big project and there was a lot to be done.
Starting off
To begin I created a list of 45 systems. I spent time with two of the most able team members and we took a whole day going through all the systems adding more for the practice and deleting some that were not appropriate.
These two team members then had to be responsible for documenting each system. We then explained to the remainder of the team the plan of action and asked them to write some out as well.
A grid was created with the system and the name of the person who was responsible for this.
Everything was in order and the next day I had a phone call from day Dr Singh. It turned out that only one of the five members of staff could use a computer. This created a back log. Under my instruction the one team member who was able to use Microsoft had to spend time training the team and creating detailed training guides that included how to turn the computer on and off.
After a delayed start this huge task began! It was now important to me that the team were pulling their weight. I was told by a couple of team members that they felt a number of the team were lazy and not pulling their weight. I then set out to produce team duties checklists.
Each team member had a list of daily, weekly, and monthly duties which they were to complete and comment on each day, week or month. At the end of every day these duties sheets had to be placed into a folder. Dr Singh could then randomly check everyone was completing their duties to the full.
In between visits I was helping Dr Singh to find a PM. I knew he was in danger of taking the first person that came along and made sure he only booked interviews with good prospective applicants. We role-played interviews and I took the lead and interviewed the first applicants for him.
Visit two
On this day I provided training that covered:
1. Vision statement creation – this helped the team to own the practice and create the mission statement and the values the practice had.
2. Courtesy system placement – to stop any whining and unfair comments
3. Communication – activating listening skills and body language
4. Review of systems – where were we in this big project?
5. Morning meetings – the importance of this communication
6. New patient enquires – how do we answer the phone, in how many rings and what do we ask our NPs?
7. Team duties checklist – Explaining the system to the team to help Dr Singh monitor the team in absence of a PM
This was followed up by a video conference call two weeks later to see how the team were coping with the change to the way that they were now dealing with the telephone calls.
At the end of this day I took some interviews and showed Dr Singh how to end an interview quickly with a candidate that was not suitable by any means! I then followed this up with a call to the agency to explain that they had sent us the wrong person – Dr Singh now knew how to deal with these situations and had seen interviews in progress.
After more role play and providing him with an interview sheet Dr Singh interviewed a strong candidate and I met her to provide a second interview.
Visit three
1. System folder review – getting up to date and delegating more systems to be documented
2. Review team duties and completion of checklists – making sure the system was being followed.
3. Practice tour – the practice was cluttered beyond belief. I went around with all team members and showed them exactly what was expected from now on
4. Np patient telephone calls – role playing and expanding their new skills
5. The new patient experience – beginning to document this super system and how each patient should be greeted and treated throughout their visits
6. Review of vision statement and USPs – making sure everyone knew the USPs they had created
7. Individual team role reviews- in preparation for the role descriptions I needed to know what each team member enjoyed doing and needed to learn.
After this visit I created all of the team’s role and responsibilities. The system folder was almost complete and the practice was moving on.
On this date we met the PM and introduced her to the team and then offered her the job.
The practice had the basics falling into place.
We began to create a new website and I wrote the content for Dr Singh.
Visit four
1. Role- play of new patient telephone enquiries
2. Treatment Coordinator Training – implementing this new role
3. Facial Rejuvenation training – none of the team knew the set ups or how to nurse for these procedures. The reception team also lacked understanding so this training was conducted to gain some insight to these procedures.
After this training I sat down with new PM and went over her list of duties, tasks and projects for the next month.
Visit five
1. DiSc Personality Assessing
2. Role play -of new patient telephone enquiries
3. Treatment Coordinator Training
The practice was now out of the red and into the black. However, the invisalign lab feeswere severely affecting the profit margins. We created a new payment system for this treatment to ensure its’ future profitability.
We appointed a new finance company which saved the practice money and the staff had training on this new system for processing the finance.
I adjusted Dr Singh’s working hours and set time aside for him during the week to hold meetings with the team, PM and associate dentist. He no longer saw patients on Fridays.
I had a networking meeting with a local photographer to create a referral system for patients, as well as arranging and negotiating a deal for team photographs for the new website.
Visit six
On this visit we created a plan of how the practice was to be marketed over the next 12 months. This included networking, adverts they had planned, the website, and SEO.
We then sat down and asked the team for their ideas given their strong local area knowledge. They had some great ideas and became very excited about the opportunity to share their input and ideas
For the remainder of the day we studied:
1. Sales for non sales people – understanding why people buy
2. Role- play of new patient telephone enquiries
After this training I finally met the associate dentist. We had a good meeting and discussed his hours and income. He was concerned that he wasn’t getting any NPs. However, this was because the NPs were attracted by Dr Singh’s treatments or his late evening
appointments.
He was also concerned as his private invoiced treatment was low due to the amount of patients on Denplan. We adjusted his working hours so he would do one late evening and a Saturday and then block booked his diary for private patients at premier times of the days he worked.
Visit seven
Due to a few staff issues the spare room we planned to use as the consultation room for the TCO wasn’t able to be used. A team member had injured her knee and needed that room to work in. This was now resolved but the TCOs did not see NPs for a while so I revisited
their training to recap areas they has lost confidence in.
The training we conducted was as follows:
1. NP journey confirmation – with document. We renamed this experience and took the experience to a whole new level with lots of role play to get it perfect!
2. Role -play of new patient phone calls – we can always improve
3. TCO training – to recap their system for NPs
The PM and team needed appraisals and Dr Singh had no experience of this so I
performed appraisals for the PM and staff that afternoon.
Results so far
Dr Singh is now:
- happy
- making money
- has a supportive team
- has a proactive team
- becoming a leader
- has a better work / life balance
Plans for next visits
1. Continued development of the verbal skills on the telephone
2. Continued development of the TCO role
3. Continued development of the patient experience
4. Digital photography training
5. Treatment presentation skills
6. Re-evaluating practice goals now the first six months has been reached
7. Optimising the business performance
8. Reviewing the accountancy and margins
