Performance based Dental Practice...

[FutureDocBerg]

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I took an entrepreneurial business course last spring and learned about performance based businesses. Ones that I remember off the top of my head are Optimax (Rochester) and Josephs Lite Cookies... If anyone has taken a course like this I'm sure you have heard about him....


The whole idea is to create a pay scale based on the performance of the company. For instance, if you hire great employees that are always looking to better the business, get more clients, build a reputation, an outstanding service effort, and they all do their part to build the practice, they get a base pay, but receive a monthly bonus based on the business's success.

The example given in the Josephs cookie business was that there are people that have been working the factory for years and years, but they all work together and put their two cents in on how to make the business more efficient, less waste etc etc. In turn of everyone coming together, the business becomes extremely successful, and the employees are making upwards of 80k/ year as an assembly line worker (not literally but close to it).

But think about it, if your a hygienist, assistant or secretary, and you go out and promote your practice, and get a great practice going, they should be rewarded right? And they all work together to "give them the pickle!" For those of you that have seen this video, its amazing. Customer satisfaction is huge. Also, word of mouth advertising is the best kind, free and most effective. I know I base high judgments on what people I know say about a business/service.

I think this sort of environment would thrive...

Does anyone know what I mean or am talking about? And better yet, does anyone know of a practice based on this philosophy? Any comments would be appreciated!

-Zach

 

[diagnodent]

Performance based pay is how many offices are run. It is not a new concept for dental offices. Monthly bonuses are given based on production/collections or new patients, etc.

 

[gryffindor]

Plug #2 for today for Dentaltown. Go on there to read about many practices that utilize this and other methods of employee loyalty & motivation. The pickle video is corny, but the message is simple: treat people right and don't sweat the small stuff.

 

[capisce?]

It's not an easy thing to discuss money and income with your staff. You have to remember that many times these are very young individuals with little grasp on what overhead is, your bills, etc. Some offices do it but i would not be comfortable sharing office production with my staff. In their mind if you are bringing in 100k/mos then surely they are underpaid and you are greedy. I'm all for bonuses tied to performance but rather than actual practice numbers I would base it on evaluations. If the practice is doing well you can give them spontaneous bonuses as you feel. You never want your staff to under perform in order to squeeze in another patient and make more money. There are lots of different opinions on the subject and no right or wrong answer. That's just my 2c.

 

[gryffindor]

capisce?, I'm not sure why you quoted me, I wasn't advocating any method in particular of how to reimburse staff. Just saying there are several huge discussions on Dentaltown about it which I'm sure you know.

 

[capisce?]

capisce?, I'm not sure why you quoted me, I wasn't advocating any method in particular of how to reimburse staff. Just saying there are several huge discussions on Dentaltown about it which I'm sure you know.

I'm not sure either 😀 Edited the quote out 👍

 

[FutureDocBerg]

Hmm, lots of talk about dental town, is this a webbased info site or an actual magazine? I guess I can google it and find out for myself. I would like to read more into it.

However, I can see how they would think your being greedy seeing as the hygienists clean the teeth and seems you might poke in to check their work and say it ok, and feel they did most the work. I realize this is an exaggeration but many people think this is all dentists do... which is way off.

Either way, I am still curious about others opinions, and if you could direct link me and other to the site it would be appreciated!

Cheers!

=Zach

 

[gryffindor]

Hmm, lots of talk about dental town, is this a webbased info site or an actual magazine? I guess I can google it and find out for myself. I would like to read more into it.

=Zach

It is both, a website and a magazine. The website has a zillion times more useful info on it than the magazine. Go here:

http://forums.studentdoctor.net/showpost.php?p=1391816&postcount=6

 

[RDAtoDDS]

I have worked as dental assistant for 10 years, and the majority of offices I've worked in give bonuses based on production and/or collection monthly. It is not a big deal sharing production goals and achievements with you staff, after all they can ball p0ark the number anyway. But if they don't have a concrete stimulus like a production goal, they will not work as hard to reach it. Giving bonuses on evaluation can be problematic, because dental assistants job can be quantified easily, therefore the evaluation becomes subjective, and thus can be argued with and disagreed. If the bonuses are doled out based on concrete numbers like prod/coll, then everyone know what needs to be done and if it was done or not.

I just thought I'd give my 2c as a past assistant and future dentist.👍

 

[makushin]

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[RDAtoDDS]

Let me start by pointing out that you are comparing a cookie business to a healthcare practice and they are held to much different ethical and legal standards. I'm sure you are aware of this, but it is an important point.

I agree w/capisce, you should keep your numbers as hush as possible, nothing good will come out of your employees or patients knowing your income. A lot of the numbers will leak out anyway, but I think it is best to keep a lid on it as much as possible. Even an unsuccessful dentist seems "rich" to most the population, and unfortunately because of the nature of the job, the greedy label sticks to a dentist or physician more than most business owners. Let them think salary.com or the BLS statistics are accurate.


There has to be some element of performance based incentives, but because of the ethical concerns, I don't think you want to create a situation where employees are being basically commissioned or are quasi-partners. Or course associates and hygiene can be handled differently, and they already are.

I could not disagree more with makusin or capisce in regards to keeping your numbers quite form your employees. It is a proven fact in business that when the employees feel that they are a part of a business and they can see that they contribute in concrete numbers, they perform better. What bad can come out of the assistants knowing how much the office makes, I think it can goive them pride and a sence of acomplishment. Being an assistant, is a very percarious job, your work is almost never changing and can get boring. When that happens you start to slack off, and the office and patients suffer. But if the office staff knows that if they reach a certain goal their paycheck will be bigger, they will work harder to promote the Dr's treatment, and the office in general. Finacial rewards that are based on actual numbers are the best motivators of good work.
Trust me guys, the patients believe the assistants much more than they do the Dr's. I know I was one for 10 years. Countless time after the Dr's l;eaves the room, the patients would ask," Do I really need that", or " What do you think". If your assistant has no insentive to promote your treatment plan, in other wirds if they don;t care how much money the office make, they will not be your advocate to the patient. And the worst thing is, you will never fiond out, because the patient is not going to come to the Dr. and say that the assistant told them not to do the treatment, or even if the assistant just did not enthusiasticaly promoted the treatment, the patients see that the same way.
So, the moral of the story is, get your staff involved and enthusiastic about the office and making money. We are going in to this business to make money, correct, no one plans on volunteering, right. It's only fair, the more money the office makes, the more money should be made by all staff.

 

[capisce?]

I could not disagree more with makusin or capisce in regards to keeping your numbers quite form your employees. It is a proven fact in business that when the employees feel that they are a part of a business and they can see that they contribute in concrete numbers, they perform better. What bad can come out of the assistants knowing how much the office makes, I think it can goive them pride and a sence of acomplishment. Being an assistant, is a very percarious job, your work is almost never changing and can get boring. When that happens you start to slack off, and the office and patients suffer. But if the office staff knows that if they reach a certain goal their paycheck will be bigger, they will work harder to promote the Dr's treatment, and the office in general. Finacial rewards that are based on actual numbers are the best motivators of good work.
Trust me guys, the patients believe the assistants much more than they do the Dr's. I know I was one for 10 years. Countless time after the Dr's l;eaves the room, the patients would ask," Do I really need that", or " What do you think". If your assistant has no insentive to promote your treatment plan, in other wirds if they don;t care how much money the office make, they will not be your advocate to the patient. And the worst thing is, you will never fiond out, because the patient is not going to come to the Dr. and say that the assistant told them not to do the treatment, or even if the assistant just did not enthusiasticaly promoted the treatment, the patients see that the same way.
So, the moral of the story is, get your staff involved and enthusiastic about the office and making money. We are going in to this business to make money, correct, no one plans on volunteering, right. It's only fair, the more money the office makes, the more money should be made by all staff.

Some good points made from the perspective of a non-dentist. I though speak from the viewpoint of the owner dentist. I'm all about rewarding employees when the practice does well. I just choose to use different parameters than the financial numbers. As has been suggested head over to dentaltown to see how many different the opinions are. No right or wrong just personal preference. You will be able to see the owner side once you get to that point. 20 year old assistants with little education have a hard time grasping the reality of what those numbers mean.

I shadowed a pediatric dentist who had a very nice system. He had a binder that was dedicated to whatever their reward trip would be. The time I was there it was their vegas binder. Whatever extra treatment they worked in, whether it was another patient or an extra quad of work that day, it was put in the binder. All of that work went towards their trip. I thought that was a nice creative way to reward staff. Really though for those of you interested head over to dentaltown and have a look. There are some seasoned vets over there discussing the pros and cons.

 

[skinetic]

Production bonuses are a tricky subject.

Personally, it's better to keep them off the books, just in case of that one lawsuit that may attempt to subpoena and make your associates and business look bad in court. You can probably use intermediaries to pay bonuses for "consulting work" as an independent contractor.

It's possible to give production bonuses without disclosing the bulk of financial information. You could tell them that you performed x number of procedures, or that within this time period, we see an x percent increase in these certain procedures, we want you to increase y amount of procedures (they do not need to know the reason).

If your assistants and other auxiliary staff are badmouthing and not confirming the dentist's recommendations, that's a real problem. They should help sell, not hinder.

 

[FutureDocBerg]

I still think that if you have an experiences staff that knows the roles of their positions and know the averages of the pay scales that they would respect the business.

Of course an assistant isn't going to make 70k/ year and a hygienist isn't going to make 100k per year, but based on their experiences if their over the top due to their influences on making the business a raging success then they should be rewarded by it.

IE, an assistant over a few months makes a difference, her pay goes from what would be 15/hr to 20/ hr... and a hygienist from a 1200/biweekly paycheck goes to 1500 due to high praise. Your pay is likely to increase substantially, no?.

People pay people just to walk around and prmote businesses just by saying it to everyone they talk to...

Why wouldnt the people that count that work in your office do more...

Specially considering that most assistants and hygienists work for multiple dentists??

If you can have a committed staff that truely promotes your business for multiple years, then why have to worry about changing staff.

Like that prestigous position that is hard to get because people NEVER leave that job??

I think it has power in itself...