Saturday, March 28, 2009

Averages vs. Leverage

Why Can’t Everyone Say Yes?

The Law of Averages vs. The Law of Leverage

What is reasonable to expect for a case acceptance ratio? A recent inquiry through the Crown Council e-mail network elicited my following comments:

Before you decide what is a good case acceptance ratio, consider two natural laws: the Law of Averages and the Law of Leverage.

The Law of Averages: The more people you present to, the more people will accept. It is like baseball. The more times you get up to bat, the more chances you have to get a hit. That is marketing for your practice. The more you tweak your marketing, the more you can influence the number and the type of people who respond. If you want your "case acceptance" to be really good, just dump more and more money and time into your marketing to eliminate the people you don't want and have more of the people you do want. It costs a lot of money, but if the whole goal is just to have great case acceptance, then you are going to have to really get your marketing very refined to bring in exactly the kind of patient you want who is ready to accept today.

The Law of Leverage: With the right systems and verbal skills in place, you can increase the amount of dentistry that people accept. Archimedes once said that if you gave him a lever and allowed him to place the fulcrum, he could move the world. Your case acceptance system and verbal skills is that fulcrum. Let me emphasize the SYSTEM part. You have heard me say many times, 94% of success is in the system. You have to have a case acceptance system that works and works for you. That is one of our biggest areas of focus at the Total Patient Service Institute; a case acceptance system that meets the patient where he or she is today and helps them move forward toward life-time care. Once you have that system in place, the next job is to get the team to follow in your footsteps in that system. How do you get them to do it? Training, measurement, and accountability. It takes all three.

Here’s a summary. Averages: You’ll get more hits the more times you get up to bat. Leverage: The more skill and the better system you have, the better chance you’ll get a hit each time you do get up to bat. So what is more important? The Law of Averages or the Law of Leverage? Both laws are important and they work hand-in-hand. Just remember: it is a lot easier to persuade people who have never really considered comprehensive dentistry than it is to find the few who have!

Here’s another natural law that will bring us to the final answer: The Law of Continual Improvement. Dr. W. Edwards Deming, the grand daddy of quality was never a big fan of "bench marking." He was an advocate of continual and never-ending improvement. If you have an "acceptable percentage" then it is easy to stop improving. For example, I used to think that 100% conversion of prospective patient calls to scheduled appointments was "acceptable" until I discovered that much better that 100% is possible. But if we had never been trying to improve, we would have never discovered better than 100%. So keep pushing the envelope. You never know what is possible.

So what is a good case acceptance percentage? If you finally decide on an average that is good enough, then you are probably headed for trouble. Continually engage the Law of Averages combined with the Law of Leverage and if you stick with the Law of Continual Improvement, your results will just keep getting better and better and better.

Saturday, March 14, 2009

The Power of Focus

If you are like me, there was a time as a kid when you discovered the power of magnification. For me it happened when Dad took a magnifying glass out of his drawer and we went outside with a small piece of paper. Positioning the magnifying glass in the perfect position in relation to the rays of the sun, he lit the paper on fire. Three seeming unrelated things: a piece of paper, a magnifying glass, and the rays of the sun. But when the three are focused just the right way, they are very powerful. That is the magnifying power of focus.

The same principle applies in the office. That which we focus on with the right ingredients, has the power to ignite a powerful force. What are the ingredients?
1. Focus
2. Skill
3. Measurement

First: Focus. While talking to a long-time dentist acquaintance of mine this week, he commented on how they had doubled their average new patient flow last month. How did it happen? Focus! A new internet tool they are using on their website records the in-bound calls that are generated from their website. In listening to those calls, it was clear that things had gotten off track in this area and it was time for some focused effort for improvement. Their first step of improvement was simply to make a decision to focus on a specific area for improvement and stay after it until things got better.

Second: Skill. Once you have determined your area of focus, there needs to be skills and systems implemented or re-implemented to get better results. In our first example, the team immediately went back to their ToPS New Patient Relationship Form and started using it on every potential new patient call. Next, they reviewed their ToPS verbal skills that they learned at the ToPS “Total Immersion” Course and started using them on each and every call. The best intentions and most positive attitude will only go so far. With the right skills…and the right attitude, results will start happening.

Third: Measurement. We all need feedback. Without measurement we never know if our focused efforts are paying off. In addition to the total number of new patients, this team started measuring the ratio of potential new patient calls to new patients scheduled from those calls as we have discussed before. With daily measurement, the team could see if their efforts were focused properly and if they were getting better results. In the magnifying glass example, there is a difference between creating a bright light and creating a burning flame. Sometimes the difference is a slight twist of the wrist. But without visible feedback, you would never know if you were on fire or not! So how do you know if your practice is “on fire?” You’ll never know unless you measure the areas on which you are focusing.

So where do you need to put your magnification focus in your practice? You can’t focus on everything all the time. But you can focus on some things some of the time. With the proper focus in the right areas, you can move through the practice one area at a time and light them all on fire!”

1. Focus
2. Skill
3. Measurement

Three ingredients of continual, never-ending improvement. Decide right now where you need to put some magnified focus in your practice…and watch things catch fire!

Saturday, March 7, 2009

Redirect and Appoint

While speaking this week at the Canadian Dental Association/Pacific Dental Conference in Vancouver, B.C., a point came up worth revisiting from time-to-time in the office. It has to do with doing the right thing for the patient when the patient has not been doing the right thing for him or herself!

Here’s the scenario:

A patient who has not been in for a couple of years or more, who has unscheduled treatment, calls with a “problem.” A tooth that you had discussed in the past, but the patient refused treatment has now broken. The patient is not in pain, but wants to come in to get it treated or “smoothed off.” Before you jump right in and schedule the patient to get the tooth fixed, you might want to rethink your direction. There might be a bigger opportunity here that would be in the patient’s best interest. Is it better for the patient to just keep patching things when they break, or get on a path of lifetime care? So here is how you Redirect and Appoint.

Appointment Coordinator (AC): “Mr. Jones, I am so sorry to hear you are having problems. Could you hold for just a moment while I get your records?”


AC: “Mr. Jones, I have your records here. Let me guess. Is it the tooth on the lower left?” (Make the best guess you can without asking which tooth.)

Patient: “No, it is on the upper right.”

AC: “Interesting. I would have guessed that the tooth on the lower left would have broken before the one on the upper right. Mr. Jones, it looks like your body is starting to tell you something. I can tell by looking at your chart that this is not going to be an isolated incident. There are other teeth that are much worse off than the one that broke. Let’s go ahead and get you scheduled right away to come in and address the tooth that did break and while you are here, I am going to schedule an exam so you can have an update on your current health and you can discuss with the doctor what to do so this does not happen again or worse in these other areas. Does that make sense?”

Here’s the point:
1. The only way to get a patient on the right track is to have current records and a treatment plan. Doesn’t it make sense to do that in one visit when urgency is compelling them to come in rather than trying to convince them to come back for an exam after the urgency is gone.

2. All of us need a little push from time to time to be reminded of what is really important. When the body gives patients a reminder that it is being neglected, we need to be right there to reinforce that message and get them on the right track instead of supervising the patient’s neglect.

So, watch and listen for these opportunities to “Redirect and Appoint.” It is the right thing for the patient, the right thing for the practice, and the right thing for your professional and clinical integrity.