2017 BCDA Report to the Profession – Where are my bloodpressure meds?

Have you read the BCDA Report to the Profession for 2017, which was delivered to BC Dentists earlier this month? I anticipate this report every year. I read it right through and often use it in discussions with my clients. This year, I can barely get through each page without gagging.

You read that right. This year’s report is making me sick! And tired! And angry! My guess is that very few of you have made it through more than the first couple of pages without your eyes glazing over (or rolling into your head) and tossing the report aside.  

The reason? Written by Impact Economic Consultants (aka RK House) the report is more a tip-toe through the mind of an economist than it is a message for dentists. It is trying to be about how to be more efficient and more productive in a dental office (which is useful) however it is a jungle of statistics and benchmarks and assumptions that miss the mark completely in my opinion and illustrate only a small portion of what it means to practice efficiently and productively (which is not useful).

For example: Impact Consultants tell you that “the fewer minutes required to book and bill a patient, the more efficient the front desk. The evidence is that for up to 6,000 or 7,000 patient sittings per year, one person on the front desk should be able to do all the appointments and billing.  At 5,000 annual sittings, the efficient practice will require something in the order of 20 minutes per patient, while the inefficient ones will require…40 minutes”. The report then shows a scatter chart that plots ‘Front Desk Staff Minutes per Patient Sitting by Annual Patient Sitting’, which is difficult enough to decipher (sometimes these RK House charts feel like a Lumosity Brain Game to me!). It then goes on to tell you that perhaps, “for your scale of practice, you need to face the unpleasant fact that you may have too many bodies on the front desk”.

Really?  I can already hear my clients getting their knickers in a knot about not being efficient and wondering if they are overstaffed. The problem here is that this report only looks at one small portion of the bigger picture of how a practice runs, particularly when it comes to the front desk duties. These guys have blinders on, or they have not ever spent much time in a dental practice. Here, in my humble opinion, is what is left out of only this one example;

a)      At no time does this report consider demographics. Many older patients take longer to book, register, bill and collect from and rebook. For many, the trip to the dentist is an outing, not something to rush. Young parents with small children may take longer to book and bill as well.  Efficiency is not always possible.

b)     The glaring omission in this report is that whether a front desk team is efficient, is based entirely on booking and billing. What about all the other tasks that a front desk member does? What about the phone calls from patients with questions. What about the time spent entering bulk insurance payments? Tallying day end, speaking to labs, preparing mail. Sending referrals. And on and on. Before you start eliminating staff based on how many patient sittings you have vs. employee minutes, please stop and consider everything that has been left out of this calculation! Every front desk wonder-woman that I have ever met (and they are all wonder-women) have a dizzying array of tasks that have to be completed each day, all of which are important and vital to your practice.

c)      Last but not least, economists are not in the business of considering values. It’s not their job. But it is yours. How you choose to practice is up to you. What your core practice values are and how you manifest them is up to you. What is most important to you? Is it that Mrs. Jones is treated like a person and not a number? Is it that your relationship and connection with her means that you understand that she is fearful or lonely? Do you want your staff to ask her about her son or her grandkids or her recent trip? Do you want your staff to focus on how many minutes they spent with each patient (and the fewer the better-or more efficient) or do you want your staff to be committed to a positive patient experience?

I could rant on and on about this report. I do understand that Impact Consulting and its team of economists is mandated to provide a service for dentists. I am not certain, in this year’s report, that they met that objective. If I can stomach the rest of the report without blood pressure medication, I will report further.

The bottom line is this; if ALL you want is efficiency and productivity, then this is the report for you. If you want to practice in a way that is meaningful, provides a good living for you and your staff, considers and incorporates your practice values and a positive patient experience, take it with a grain of salt. A big grain. One of those giant chunks.

About Kristin

President, Nickellsilver Business Solutions Inc.
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