Creating a Team Approach to Patient Reactivation
Keeping dental patients in an active status and on schedule for preventive care is a challenge for many practices. As a practice owner, I hear over and over that due to uncompleted treatment plans in patient records, most dentists are “file cabinet millionaires.” In the more than 20 years my husband and I have been in practice, we have made many attempts to correct this problem, but everything we tried failed after a few weeks or months.
Over the years, we have experienced ups and downs in patient flow due to various factors. What routinely happens is that patient reactivation programs are pushed heavily when business is slow, and then pushed to the back burner when patient flow improves. In good times, the business office staff is too busy serving patients and keeping up with paperwork to think about patients who don’t think of us!
Our most recent chart audit program is unusual because it is still working after more than seven months. Even more surprising, there is little need to frequently remind staff to use it! Our staff of 17 part-time and full-time staff support three general dentists and two part-time specialists. What is finally working is a team approach combined with a unique incentive program that has teams reminding each other to use downtime effectively.
Using an audit system taught to us by hygiene consultant Annette Linder, RDH, our office administrator created a team competition format that turned a burdensome task into a fun contest. Two-person teams were created with employees who share similar job descriptions and work schedules. All staff members were trained to use a specific recording sheet for patient calls, the computer to access information, and patient charts to document messages. After the initial learning phase, staff was also instructed on follow-up calls and reactivation letters to patients who did not respond to phone messages. Each team was assigned a section of patient files each month and was to follow this group until all were appointed or sent a letter (two weeks after a second call). The goal is to audit all current patient files twice in a 12-month period.
Staff rewards occur at our monthly team meetings. Our administrator, Carri, who runs the meetings, reports the results of the reactivation program. The two-person team with the most patients appointed wins a spa certificate for each partner. All participants receive an appreciation gift, usually a gift card for a coffee shop or favorite sandwich shop. In the seven months since we started the program, three teams have won twice, and one team has won once. There has been at least one winning team in each department of the practice, including hygienists.
Audit winners
The track record for scheduling success increased dramatically after our team fully learned the system. The first two months showed a success rate of about 15 percent of contacts making appointments. In the following months, appointment rates rose as high as 33 percent, showing not only greater skills by team members, but the value of following up on calls made during previous weeks. Team members have actually been caught “high-fiving” each other after a productive session that resulted in several appointments. These efforts over the last seven months have resulted in more than 170 patients scheduling dental appointments.
Many offices may wonder how teams find time for this system when most of their workday is taken up with direct patient care. Initially, some team members felt that business staff would have an unfair advantage because they already spend a significant portion of their time on the phone and are close to patient records. Over a week’s time, though, this did not prove to be true, since like all team members, they had priority work that had to be done each day before time could be allotted to secondary tasks. Success occurred when teams learned to budget their time effectively, such as projecting patient flow so that one clinical assistant worked with the doctor while the other spent 20 minutes making patient calls. Business staff took advantage of lulls in patient flow to review patient charts. Hygienists did not have the advantage of as much free time, but all teams were authorized to spend additional nonovertime minutes each week if they chose to follow up or make initial patient calls.
Our chart audit system is not a substitute for a well-run recare program, which is maintained by the scheduling coordinator for our five dental hygienists. Each hygiene patient in the system receives a computer-generated postcard to remind him or her of appointments made or due to be scheduled. All hygienists preschedule as many patients as possible for recare appointments. Nonetheless, appointments cancelled without rescheduling, or patients who claim they are too busy to schedule three to six months in advance, create the “overdue” situation we deal with on an ongoing basis.
Patient reactivation has been a frustrating process in our group practice for at least 15 years. We struggled with various ideas, such as hiring a part-time employee to spend time each week on the project, offering bonuses to existing staff for each overdue patient appointed, assigning a number of charts each week to each business staff person or doctor team, and more. What we learned is that calling patients to schedule needed treatment can be a difficult job that often sees little reward. Even the most talented team member can experience burnout when faced with the burden of this task on a perpetual basis. However, with the team approach, co-workers who share the effort bring better results and energize each other with immediate positive feedback. Most importantly, we realize that team members place value on efforts that are recognized, not only by employers, but by co-workers as well. As business owners, we are gratified to see a feeling of ownership among our team, as they enjoy their work more while making a significant and measurable contribution to the success of the practice. ■
Julie E. Kangas, DDS
Dr. Kangas practices with her husband, William R. Jungman, DDS, in Escondido, Calif. They maintain a group practice with a general dentist associate, an endodontist, and a periodontist. Dr. Kangas is currently a program chair of the Escondido Chapter of the American Business Women’s Association. You may contact her at [email protected].
