Last updated on November 18th, 2017 at 10:19 am
Over the years, I tried a number of scheduling systems. I eventually amalgamated what I’d learned along with what I found to be effective in my practice into a system that worked quite well.
For the most part I did major production before noon, went to lunch on time, did minor production procedures in the afternoon and went home within fifteen minutes of the last patient’s scheduled departure time. We had a nice mix of procedures throughout the day and each day was, for all intents and purposes, the same – and very well controlled.
The emphasis in our system was on accountability and control.
In many offices, scheduling breaks down into nothing more than “filling time.” The next available appointment is given to the next available patient with little attention paid to the types of procedures scheduled that day or how many patients will be seen along with potential productivity on the schedule.
This leads to stress, non-productive days, running behind or working into lunch and/or staying late. All of which are just poor appointment book control. The game is to maintain a balance between productivity and staying on time so no one waits (which is ultimately a component of customer service).
What I’ve decided to do in this article is share the Scheduling Policies I used, which gave me and my staff guidance as to how to control the schedule. It included points that made us all happy, which was key: all of us (my staff and I) agreed to each of these points and followed them. And while these are merely suggestions as to what may work for you, I strongly advise that you create a similar policy that applies to your office and covers each of these points. Don’t be afraid to change my recommendation if it is not applicable in your circumstances. At the very least I hope to spark creative conversation in this article between you and your staff as to how to productively handle the appointment book in your practice.
Here it goes:
SCHEDULING POLICY #1: There must be a daily production goal.
Not having a daily goal is like playing a game with no scoreboard. It would get boring very quickly if no one knew who was winning. Fans would leave the stands and players would leave the field. So, there must be a daily goal.
There’s a very simple formula:
- Decide what you want the monthly goal to be.
- Divide into that the number of days you’ll be working that month.
- If you’re a GP, I suggest you count on at least 25% of the goal to come from Hygiene production.
Monthly goal is $64,000 and you will be working 16 days. This makes the daily goal $4,000. That would be $3,000 from the doctor and $1,000 from the Hygienist.
If you have no Hygienist then you should plan on the same percentage of production coming from the doctor doing dental services and hygiene services. Obviously, you won’t be hitting your production goals if you do nothing but cleanings all day long.
SCHEDULING POLICY #2: There must be one person ultimately responsible for the daily production. Another can help but one must be responsible. No one else touches the appointment book—including the doctor.
This alone will clear up a lot of confusion on what’s happening with the appointment book. Make one person responsible for the daily production goal. In many offices this person is given the title of Appointment Secretary.
In dentistry it is a very popular idea to have everyone ‘crossed trained’. This helps you cover for staff that are sick, on pregnancy leave, etc. This works out fine when used to cover for someone – but just because people are “cross-trained” that doesn’t mean that organizationally they are “cross-responsible.” Everyone in the office should have a specific assigned area of responsibility. If you don’t make someone responsible for the appointment book, then ultimately no one is responsible for the production goal.
For example: It is common for many chairside computer systems to allow the assistants to schedule appointments. Let’s say that no one is paying attention to the overall daily production and that all staff are just “filling the book.” This will lead to a highly productive day with a few patients followed by a low productive day filled with patients scheduled every thirty minutes. At the end of the day, after seeing twenty-five patients to do $750 of production, you will ask “Who scheduled this mess?” You will have three staff pointing fingers at one another. Why? Because no one was responsible for paying attention to the goal and controlling the appointment book.
If others are involved in scheduling, then one person must be responsible for the goal. Any mistake made by another will be considered the mistake of the one responsible. This accountability is the only way any of the scheduling policies that follow have any chance of being effective.
SCHEDULING POLICY #3: The doctor never does more work than is scheduled unless a previously scheduled patient will not have to wait.
It’s tempting to do more than what is scheduled. We are trying to have a productive day so we do two quadrants instead of the one that was scheduled. If you have the time to do it – great – by all means go ahead. But, if it ends up causing other patients to wait and makes you run behind, it becomes destructive to morale and your public relations with patients and staff.
SCHEDULING POLICY #4: The doctor doesn’t change the treatment plan that has been scheduled for that day.
Obviously, if you’ve had a cancellation and the time is available, then this wouldn’t apply. The point is that any change of treatment being delivered needs to be coordinated with the Appointment Secretary. This would be in alignment with my first recommendation of having only one person responsible for the daily production.
This is similar to the previous policy; but different to the degree that the doctor shouldn’t change what is being done and lower the amount of production being done or change the time allotted for the procedure. Doing a lesser productive procedure and making other patients wait is not good for the office or the patients.
For example: The patient is scheduled for a crown and presents with a lost filling in another area since the last visit. The doctor shouldn’t do a filling and not the crown prep. This kills production for that patient. The proper thing to do would be to do both procedures—the crown and the filling—and stay on time.
SCHEDULING POLICY #5: The doctor never tells the patient a specific date and time they need to be seen unless he or she knows what time is available and it follows all scheduling policy.
Once the doctor says “I want to see you back on Wednesday next week,” the patient believes it has been written in stone by a lightning bolt from above. If next Wednesday is already packed, then the Appointment Secretary has a big problem. Squeezing this patient into the day will cause everyone after them to have to wait and create stress and bad public relations with the patients.
There are very few procedures that need to be done on a specific day or time. Suture removal, crown prep or delivery, periodontal therapy etc., all have a range of times when they can be done in the future. The doctor might say something along the lines of “early next week” or some such broad and general statement. This gives the Appointment Secretary a degree of latitude as to when to have the patient back in and control the time and day so that all patients are properly taken care of.
This series will continue next week, beginning with “SCHEDULING POLICY #6: Today is the most important day in the appointment book. Tomorrow is the next most important day.”