381: Systemization: Where to Start?

This one’s for all the system folks out there! Heck, it’s for the non-system folks, too, because Kiera’s here to share how to start getting your practice organized!

First, know that the Dental A-Team has created a 12 Systems Comprehensive Success Cycle, aka the systems we think are MOST important to get established in your office! The 12 systems are as follows ...

1. Company goals

2. KPIs

3. Billing

4. Operations manual

5. Scheduling

6. Patient flow

7. Treatment planning

8. Marketing

9. Hygiene

10. Meetings

11. Office manager/HR

12. Communication and morale

Gotta love 12-step programs, right? Well, here are five we recommend starting off with when building systems:

1. Hand-offs (see our NDTR cheat sheet)

2. Tracking (here’s a sample scorecard)

3. End-of-day checklists (a DAT-approved example)

4. Hiring

5. Billing

Establishing systems will turn your practice into a fully functioning one, so get started today!

Episode resources:

Reach out to Kiera

See our 12 Systems Comprehensive Success Cycle

Subscribe to The Dental A-Team podcast

Visit The Dental A-Team website

Review the podcast on iTunes

Podcast Transcript:

Kiera Dent:

Hey, everyone. Welcome to the Dental A Team Podcast. I'm your host Kiera Dent, and I had this crazy idea that maybe I could combine a doctor and a team member's perspective. Because let's face it, dentistry can be a challenging profession with those two perspectives. I've been a dental assistant, treatment coordinator, scheduler, biller, office manager, regional manager, practice owner, and I have a team of traveling consultants where we have traveled to over 165 different offices, coaching teams. Yep. We don't just understand you. We are you. Our mission is to positively impact the world of dental. And I believe that this podcast is the greatest way I can help elevate teams, grow VIP experiences, reduce stress, and create A teams. Welcome to the Dental A Team Podcast!

            Hello Dental A Team listeners. This is Kiera, and this podcast is going out to all you system humans. You know who you are! The people who want your practice to run on a system. But guess what? Like where do we start for a system? What is a system? So a system is basically a predictable... It's like a standard set of rules or procedures by which something is always done. So we can create systems for how we answer the phone. We can create systems for how we confirm our patients. We can create systems for how we set up for a crown, a root canal. We can create a system for how we diagnose perio. We can set up a system for how we call patients for recare, unscheduled treatment plans, billing, AR, sending out statements. Every one of those things is a system. If you don't know, the Dental A Team created the 12 systems.

            Yes, that's right. We wanted to create a way that every single year you get through all the main, most important parts of a practice. Or excuse me of... yeah, a practice, I guess is the way to say it. But it's more like the systems within the practice. So we created 12 systems that we feel are the most important. So on our Dental A Team page, you guys have to... it's like a little hidden, sorry about that. You have to go down to the bottom and click on FAQ. FAQ is where we have our 12 systems in there. It's a comprehensive success cycle. So the 12 systems that we have found in practices are: the system of company goals, setting company goals, creating company goals. Then we also have the system of KPIs, key performance indicators, the tracking and measuring of such goals.

            Then we have billing. Billing in and of itself is a massive system. There's about a billion things under billing. But in and of itself, billing is an area to focus on. Operations manual, creating those systems, scheduling, all the parts under scheduling, patient flow, creating those new patient experiences, returning patients experiences. How do we do all those handoffs? Treatment planning and all the pieces around treatment planning. Marketing. Marketing also needs to have a system. The hygiene department, all pieces under hygiene, perio, re-care, continuing care, how we talk about night guards, how we tee up treatment. What would doctor do? Co-diagnosing. All of those are systems. Meetings and their cadence along with agendas. Office manager and human resources. And then communication and morale. All of those are the systems that we believe create a fully functioning practice. There are multiple systems within each of those categories, but that way you guys have a quick visual of what is a systematized practice and then what are the systems below those?

            So all of our coaching clients, they get to go through our 12 systems and online, we have every system broken down. We have a scorecard for every single system. So that way you can just kind of chip away at the systematized practice as you're going along. Patient, or excuse me, clients love it because it gives you a focus in a direction. And then every month you have a theme that you're focused on. Yes, of course you might be struggling with hiring. No big deal. But in the month of March, we also focus on billing. So we just make sure we tidy up those billing systems. That way your billing is always being focused on at least once a year in the midst of the chaos of the practice, if you will. Okay? The whirlwind, I think that feels a little bit better. So hiring and onboarding and all these different things, but yet we don't let those other systems slip and fall.

            So what I wanted to give you guys today is a quick systemization jumpstart of what we go into for every practice. Now it's going to be a little bit different. Start-up, existing practice, all the things. However, I found that these things are the most important. So when you're building your systems, build these ones first. So number one, I'm big on handoffs. You guys know NDTR. Build out your system for handoffs. The reason why is because I feel if we're putting all this effort into our exams, into our patient experience, but we dropped the ball on our handoff, guess what? That patient actually missed the most important piece of getting their treatment scheduled. And so that's why I always go in and I build the handoffs first. So it's the handoff from doctor to team, to... excuse me, team to doctor, and then doctor back to team when it deals with treatment, co-diagnosing, all of that.

            So I would build up your hand off system. Where are all those checkpoints and how do we actually do it with one another? You guys know our pretty nice bow wrap-up at the end of every appointment comes from the NDTR. So next visit, date to return, time needed for the appointment, and recare being scheduled. That's the pretty bow, wraps up the appointment, we can then schedule back. So I would get that system in place. There's also the ICRP handoff, and that's for hygienists or assistants to the doctor, that would be the introduction of the patient for the I, complimenting the patient, giving a recap of treatment discussed or treatment we're doing, and then a personal factor about that patient. That way we have quicker bonds with doctor and patient. They're not trying to pull that information out of there. So that would be system number one. Hands down, all day long, every single day.

            But then system number two is how do we track our success of our practice and how many patients we're actually helping? So I create a scorecard or a scoreboard if you will. So we can all see how we're doing as a practice. I like to track production, collections, new patients, case acceptance, Google reviews, and anything else you want. Try to keep it below 10 things you're tracking. Otherwise, we're tracking everything and nothing's really moving forward. But I really key in on the most important pieces that are going to move our practice forward and help us know how many patients are we actually helping? So that's the scorecard I create and we fill it in every single day as a team, because guess what? You're now doing these perfect handoffs or tracking the success of our practice. Those two things will go hand in hand. If you're a start-up practice, we want to see how many new patients, Google reviews we're getting to see is our experience amazing. Are we getting patients to then call to refer their friends in? Are we growing our practice in the most successful way? So that would be system number two.

            System number three, or end of day checklist. Yep. This way, everybody knows what's expected of them, we're all working together as a team and we're making sure all the boxes are being checked off of what should be completed before we all go home at the end of the day. That way we're carefree, everything's moving on. I would ramp that up with a Friday KPI scorecard of tracking it on the things that are most important per department. So billing, watching our AR, our collections, our claims, those items, our office manager. We're looking at the overall overhead of our practice, we're looking at our production, our collections, looking at our new patient numbers. In hygiene we're looking at our perio. We're looking at our open time. How many patients do we have open versus filled scheduling?

            Hello, Dental A Team listeners. All right. One of my absolute favorite quotes is "You are always one decision away from a totally different life." So what life do you want to have? Do you want more accountability? Do you want a team that's trained? Do you want to have somebody who thinks outside the box and creates just for you? Do you want to have a coach? Do you want to have team training? Do you just need somebody to kick you in the rear and get you going? Okay, don't worry. I'm in every single one of those boxes.

            And that's why we created Dental A Team silver, gold, and platinum. It's going to be customized team training for you on the terms you want. So silver? Silver is more for accountability. Gold? Gold includes all of our online training, plus the accountability. And platinum includes all of that, and in office. You guys, I would strongly suggest you go join Dental A Team gold today because you're always one decision away from a totally different life. So what are you waiting for? Hop on over to thedentalateam.com today. You guys, we only have so many spaces. So get over there today and sign up for Dental A Team, silver, gold, or platinum.

            I would also be looking at our dollar per hour. What are our hygienists producing to make sure that we're actually being comprehensive on our care with our patients? That's truly the only reason I track your dollar per hour is because I know that if we put it on there, we're going to make sure that we look for our FMX frequencies. We're going to look for our comp exam frequencies. We're going to make sure we're offering fluoride to our patients, that we're diagnosing SRP and we're not just doing bloody prophies. That's truly the only reason I like to track your dollar per hour, because I want to make sure that you're really being comprehensive with your patients, because I know hygienists that you want to just take care of your patients. And so making sure that we're truly doing that because it will reflect in your numbers.

            Then same thing with our dental assistant crew. Having them track how many times they're getting out of the room, because guess what? If we're getting up and down out of the room all the time, that's not great patient care, and it's not an efficient practice. Same day conversions. If we can offer a patient to do same-day treatment, why wouldn't we? So I love dental assistants to track that looking for opportunities. I was in a practice the other day, and my heart stopped. The patients were coming back for one or two fillings at a time, and they had a whole quad of fillings and we hadn't even talked to them about it. And I thought, okay, is this really VIP patient care? The answer would be no, because I don't think we even offered it to them. Of course, if there's financing or whatnot, that's one story.

            But at the same time, at least offering it to our patients and scheduling quadrant dentistry versus solo tooth dentistry. That we were really maximizing our patient's time. Doctors, I'd be checking your production per hour, making sure that you yourself are also diagnosing correctly, not over-diagnosing, but diagnosing correctly. You should be producing pretty well, and if we're not, that could be a scheduling issue as well. So it helps not only keep doctors on track, but also our scheduling team on track. Schedulers, how much open time did you have on doctor schedule and on hygiene schedule, and how many days did you get your doctor and hygienist scheduled to goal? That makes sure that we're actually being very proactive on our scheduling, making sure that we are filling in our time, we're using correct verbiage, we're not having no-shows and cancellations. I also would probably be tracking the no-shows and cancellations, if that tends to be an issue in your practice.

            So whew! There we go. Those are my three top systems. There are a thousand systems. Like I listed off, I could rattle off system after system, after system, after system. However, if I'm jump-starting a practice or I'm coming in to spruce up a practice, those are my top three things that I look for. So our handoffs, our tracking with a daily scorecard and a weekly KPI scorecard, and then our end of day checklist, ensuring all the things are buttoned up. All the pieces, and everyone knows what they want to do. If you guys need examples of these click in the show notes. Alex, be sure to ask me for an end of day checklist sample. I'll be sure to share that with you. And NDTR, I'll give you guys a little sample on that. Plus I'll also give you a sample of a scoreboard that you can have.

            So Alex, just make sure I add those. You guys, click in the show notes, they'll all be there, you guys can download those. That way you can get a quick systemization jumpstart. Now if I was adding my fourth system, it would be on my hiring process. How do we write ads, how do we onboard team members, and how do we ensure that they're set up for success with monthly one-on-one check-ins? Because I know if I can keep team members happy all other systems will come into play. But that would be number four system, because I've got to be able to have a good recruitment process, a good check-in process. Now, if I wanted to go to system number five, it'd be my billing process. Making sure my AR, my statements. I have a billing scorecard that I really love to use.

            We share it with our practices to make sure the billing is being completed because billing can get really, really out of hand really quickly. So setting the benchmarks. Typically, I like to see about a 15% of collections of our 30 to 60, 10% 60 to 90, and 5% above 90. So if we have $100,000 of collections, then we'd want to only have $15,000 in our 30 to 60, $10,000 and $5,000. Those are super aggressive. But if you have those standards from the get go, or implement them now and work towards them, you're going to ensure that you don't get out of whack. Now, of course, I understand that there's ortho, that there are payment plans that definitely throw our AR a little askew. You can put them on a billing type, pull them out, but on general speaking claims and transactions and patient and insurance portions, that's what I like to strive for and aim for.

            So I definitely make sure I have a billing system in play. And doctors, I would make sure that you actually understand what all those numbers mean. So I have a lot of doctors that we coach right now, and we actually go through a P&L, we go through all the insurance information, so that way you feel very confident and competent when it comes to knowing how are you getting paid and ensuring that the money's actually coming into your practice. Because that can be very frightening as an owner to not know how the money's coming in and hope and pray that someone upfront knows what the heck they're doing. And that's completely dependent on the livelihood of your practice. So those would be my top five systems that I implement. Like I said, meeting cadences and our perio protocol. Perio protocol would definitely be another one I'd pop in there because I want all my hygienists diagnosing perio the same way.

            Those would be my... I would also have like recare and unscheduled treatment, but that comes later, guys. This is just the systemization jumpstart to get you guys at least thinking about systems. I would have them written down, I would have them recorded, and I'd have that given to every new hire. Because those are the main things that are going to set your practice apart and if you can nail those items, a lot of things can build from that. They say "Repetition is the mother of all skill." I think Tony Robbins was the one who said that, that's the they. Tony Robbins. "Repetition is the mother of all skill." So repeating these systems, this would be what I'd roll out in my weekly meetings. This would be at the morning huddle role-play. This would be in all the places to make sure I have those five things dialed in hot.

            You could also throw in our new patient experience. What does a new patient flow look like from phone call, to seating in the room, to our treatment plan, to out they go? What does that look like? There are so many things, but I would say, get systematized, have a jumpstart. You might disagree with me. You might say "Kiera, those aren't my top five systems." That's fine. You put together your five systemization jumpstart. So that way every new hire knows your top five systems, and have that in play. That way everybody's operating on the same top tier highest level at all times. All right, you guys, if you want more help with your systems, you guys reach out to us, [email protected]. This is what we do all day long. We literally work with our practices to make sure all 12 of their systems are in play.

            We check in with them. We make sure that they themselves are doing well. We have a three-pronged approach. We focus on the financials of the practice to make sure we're helping as many people as we possibly can and that we're healthy and a thriving business. We work on you as a person to make sure you are fulfilled and balanced and just really loving what you're doing. And then we work on the systems and teams. So we call it the MYS. MYS, M-Y-S. So money, you, systems, and teams. And they don't go in that order. It's just our best acronym, so I hope you guys like it. Because we want you to know this is my practice, this is my life, this is my team. This is my system. So money, you as a person, systems, and teams. That's our approach with all of our coaching clients.

            So if that resonates with you, that's what we felt was the most important to make sure people are balanced, patients are happy, practices are thriving, and at the end of the day, you're living your dream versus feeling like you're I guess beholden to a life that you're not enjoying. So guys, if you want help with getting those systems in play, we make sure our practices are systematized. We check in with them, we have a checklist for them, we have all the systems that we implement, and then we help them get them implemented into their practice. Because sometimes it's nice to know about it. You can hear about this all day long on the podcast, but then actual execution? That's a whole different story. And I believe that if you hear something it's just a wish until it's actively executed, then it's a reality. So let's execute. Let's make these things a reality. And as always, if we can help you, we'd love to.

            [email protected]. I'd love to hear from you guys. It's been a while. So get those pen pals out. Write me. I'd love to hear from you guys. As always, thanks for listening. I'll catch you next time on the Dental A Team Podcast.

            And that wraps it up for another episode of the Dental A Team Podcast. Thank you so much for listening, and we'll talk to you next time.