Jodena Consulting Blog

In my last two blog posts, I discussed the many reasons for obtaining professional help with the HR side of your dental practice. I’d like to conclude this series by focusing in on the details of HRIS software–the acronym for human resource information system.

All four of the companies that I mentioned in those posts offer their own version of HRIS software. This is a state-of-the-art, end to end, online solution to manage and track all employee data including – but certainly not limited to – benefits, time and attendance, time off requests, sick time, vacation time, license or certification renewal, and new hire paperwork.

Probably one of the most important features of the software is that it provides an easy and effective and time stamped way for you to document performance. Wage and hour lawsuits have grown out of control, and now eclipse malpractice cases brought against dentists. Wrongful termination claims are also on the rise. In my experience, I find that  doctors are often very lax and undisciplined when it comes to documenting inadequate and/or poor employee performance.  Lack of documentation opens you up for risk of liability. Paper documents don’t seem to hold up very well in court since they can be easily fudged or fabricated.

HRIS software will also act as the time clock to assure that time is accurately tracked, and that breaks and lunches are documented. An IP specific time clock uses the doctor’s modem to create a digital fingerprint, assuring that punching in and punching out happens when and where it is supposed to. Individual password protection is included to eliminate buddy punching.

Every state has a list of documents that employers must have on file for its employees. A big advantage of HRIS software is that it makes this easy with federal and state compliance checklists.

The list of what this software can do goes on and on. I’ve probably only scratched the surface here, but I hope I am making the point that it is time to get into the 21st century. Investigate–perform your due diligence – make some phone calls and take some demos – and then take the necessary action to make your life so much easier and reduce your liability.

In my last blog post, I promised to share some recommendations to help you overcome the burden of “administrative overload” related to the human resources (HR) side of your dental practice. With the New Year’s mentality of making and following through on resolutions hopefully still in play, I would like to suggest something to go right to the top of your list. And that “something” is to hire a company that specializes in organizing and managing and administering all of these HR functions with the goal of keeping you compliant and minimizing the risk of HR liability.

The question, of course, is whom do you hire? There are a large number of companies to consider, but basically they fall into one of two categories: a professional employment organization (PEO) or an administrative services company (ASC).

The PEO model is more revolutionary and not that well known in the dental community. The model is based on the concept of co-employment, where your employees become part of one huge group with one Federal ID number. The PEO claim is that you might realize significant savings on the cost of benefits because you are part of a group of 100,000+ rather than 10 to 20. But if you do partner with one of these companies, they require and stipulate that they must manage three important areas: health care, payroll, and workmen’s comp insurance.

The two leaders in this PEO space are Insperity and TriNet. Definitely solid and respected companies. My concern – if you decide to go this route – is that you will have to sever relationships with your existing health care broker, payroll company, and insurance agent. Those relationships could be long-standing and personal, so I can see this as essentially a difficult hurdle to overcome. But it is certainly worth investigating if you don’t have those concerns. Call Brian Rooney at TriNet at 781-906-0015.  My contact at Insperity is Tony Silvestro at 781-565-2849.  Both of these people are knowledgeable and experienced in the industry.

The administrative services company model is more traditional because you, the dentist, are still in control and have freedom of choice for healthcare, payroll, and workmen’s comp insurance. I feel comfortable recommending Administrative Business Resources based in Westborough, MA. Please call Sheldon Prenovitz at 508-380-5044. Sheldon started his company 10 years ago. He has a wealth of experience in this field. I also very much like HR for Health. This is a five-year-old company with over 1000 clients doing business in all 50 states. The company was founded by a lawyer and a technology guy who are both married to dentists! You should call Ted Treat at 410-903-6949 to find out more.

All of these companies provide excellent support with HR and employee relations. They all, to some degree, offer unlimited advice and problem solving by telephone with HR specialists. They all integrate payroll with a state of the art cloud-based HRIS (human resources information system). This is like an online file cabinet with everything stored in one place. The software is very impressive.

I would suggest that you begin your search by visiting the websites of the companies I have highlighted. As a sidebar, I was impressed with their blog content that is available at no charge. Then make some telephone calls and get educated regarding costs and contracts so you can make an educated decision on what would be best suited for your practice.

You simply can’t afford to sit back and not do this. There is too much at stake. As always, I would really appreciate your feedback on what you discover.

Administering and coordinating the human resources side of a dental practice continues to be an increasingly daunting challenge. There are many pieces to the puzzle.

• There is the need to monitor ever changing state and federal labor laws.

• There is the need to be compliant with OSHA and HIPAA regulations.

• There is the need to maintain proper employment verifications.

• There is the need to understand and manage workers’ compensation coverage and claim resolution.

• There is the need to administer employee benefits such as medical, health care flexible spending accounts, 401(k) retirement plans, and life and

disability coverage.

• There is the need to process payroll and tax reporting.

• There is the need to manage vacation time and sick time.

• There is the need to have an effective, up to date, and well-written office policy manual.

The list goes on and on and on. And so – simply stated – I see most dental practices struggling with administrative overload. It is not that these functions don’t get done. Somehow they do get done because they have to. Some are performed by a payroll company. Some are performed by the doctor. Some are performed by the office manager. Some are performed by an accountant.

There is no question in my mind that it would be such a huge benefit to have these tasks organized and coordinated. I also feel that in the area of human resources so many policies and systems are evolving, that there is a continuous need for updated and current knowledge and information. As they say, “you don’t know what you don’t know”.

I have done some extensive research in this area, and in my first blog post of 2016, I plan to share some different solutions that will make your life easier. Wishing all of my readers a very Happy and Healthy New Year.

In late October of this year, a 66 year old general dentist in solo practice in Putnam, CT died unexpectedly while piloting his own small plane. The dentist was an experienced pilot who at one point had flown for US Airways. I learned about this tragic event from one of my clients who owns a dental practice less than two miles away from the doctor who died. Within three days of the accident, my client started receiving multiple calls a day from the deceased doctor’s patients requesting appointments to be seen.

Coincidentally – at about the very same time period – another client of mine in Framingham, MA told me about a general dentist in his town – solo practice – late 60’s – who had died suddenly from a massive stroke. The telephone calls from patients of the deceased doctor started almost as soon as that obituary was published.

According to the most recent statistics I could find from the American Dental Association, almost 70% of all dentists in the US are in solo practice. From my observations over these past twenty years of coaching and consulting, the value of a dentist’s practice represents a significant piece of his or her overall net worth. The fact remains, however, that if you are not able to transfer the goodwill of your dental practice to a prospective buyer, the value of that dental practice could easily drop to twenty five cents on the dollar. Obviously, you can’t transfer that good will from the grave.

My suggestion is not to advocate that you bring in a partner. I see far too many unhappy partnerships. Partners, as someone recently told me, are for dancing! But it would seem very necessary and important and prudent to protect yourself and your family in the event of something catastrophic. I suggest that if you want to continue working as a solo practitioner – that at 45 or 50 or in that age range – with probably twenty years still to go – you purchase a 20 year term life insurance policy in an amount that aggressively values the potential sale of your practice. This policy would be in addition to whatever amount of insurance you currently have on your life. Term insurance at that age is surprisingly affordable.

We all feel that we are bullet proof. That is human nature. But life, as I hope I have illustrated, is not always fair.

A few weeks ago, my wife and I treated ourselves to a quick two day trip to New York City. Immersing yourself in the city is always an exciting high energy jolt to the system–and we just love the experience. One of our most interesting adventures was taking a subway for a visit to the Tenement Museum on Delancey Street on the lower East Side of Manhattan.

The Museum offers a number of walking tours all of which examine the period of time from the 1880’s to the 1920’s when hordes of Irish, Italian, and Jewish immigrants came to the United States to escape persecution and seek a brighter future. This influx of immigrants to New York City, more specifically the Lower East Side, sparked unprecedented demand for supplies and amenities to keep the city’s workforce clothed, fed, and able to survive this strange new land.

We took the Sweat Shop Tour where you get to spend some time in an actual restored tenement house. Five floors with four 300 sq ft apartments per floor. No electricity – no running water – one window. It was the norm that each of these tiny apartments served as the home for a family of five to seven people. As you can see from the photo, the street in front of these tenements was unbelievably crowded and congested. The work week was six days – 10 to 12 hours per day!

It was such a wake up call to actually see these apartments and realize how difficult life was back then. These people were amazingly tough and resilient, and it is only because of their fortitude and strength that many of us are here today.

And so at this Thanksgiving, along with everything else that I am grateful for, I will also be thinking of my ancestors, and giving thanks for all the bounties I have because of the sacrifices they made.

I would like to share information with you about a new extended financing option that should absolutely give Care Credit a run for its money–no pun intended. Prosper Healthcare Lending has just entered the dental financing marketplace. The parent company, Prosper Marketplace, has been providing financing for other healthcare verticals such as cosmetic surgery, bariatric, and fertility since 2009.

The big difference with Prosper is that you are not submitting an inquiry for a credit card. Loans at Prosper Healthcare Lending are simple installment loans with no retroactive interest and no prepayment penalties. Their online automated system makes it simple. You can fill out, submit an inquiry, and receive a decision in less than two minutes.

The provider fees to your dental practice are significantly less with Prosper. For extended plans, there is NO merchants fee to the practice compared to a 5% merchants fee with Care Credit. The interest free plan fees are also lower cost. For 6 months interest free to the patient, the practice pays 4.9% with Prosper and 5.9% with Care Credit. For 12 months interest free, the practice pays 8.9% with Prosper and 9.9% with Care Credit.

Care Credit                                                        Prosper Healthcare

$200-@20,000                                                  $2,000-$35,000

Revolving Line of Credit                                   Simple Interest Installment Loans

6 and 12 month 0% Interest                             6 and 12 month 0% Interest

26.99% Retroactive Interest                            No Retroactive Interest

No Pre-Payment penalties                               No Pre-Payment Penalties

Terms up to 60 Months                                   Terms up to 60 Months

Patient Rates from 14.9%                                Patient Rates from 9.99%

Inquiry Affects Patient’s Credit                      Inquiry does NOT affect Patients Credit

Patient must be on the loan                            Patient is not required on the loan

5% Practice Fee for Extended Plans              No Practice Fee for Extended Plans

When you review this information, I think you can clearly see significant benefits to your practice and to your patients. There is no question that for over 25 years, Care Credit has been the gold standard for outsourcing dental financing. But for treatment amounts over $2000, I suggest that you add Prosper to your armamentarium of financial options. You can call Cameron Crawford at 801-335-9188 or email him at ccrawford@prosper.com for more information.

In my experience, dentists do not understand the value of Facebook marketing and often minimize it as unprofessional or a nuisance. They almost always do not have the time or the interest to manage their Facebook page.

Well it is time to wake up and realize that Facebook can and should be an important driver of new patient traffic to your practice. The key is to understand how to use it. Posting information on office activities, charity events, “cutesy” photos, Halloween candy buybacks, etc.–while demonstrating an “active” Facebook presence–rarely seems to bring in new patients.

Facebook as a business service is no longer free.  There are two kinds of ads that you can pay for on Facebook. One type is a pay per click or pay per impression ad that can be seen both in a newsfeed on a mobile device or on the right-hand side of the desk top device.  These ads can be highly targeted to geography, age, gender, and income level. Over the last few years, Facebook has done an amazing job of collecting data on all of us!  The ad can promote a particular service like invisible braces, or sedation, or cosmetic procedures like whitening or veneers. You have to be careful with these subliminal ads because Facebook will not run them if they are considered too promotional.

The second option for an ad is what is called a “promoted or boosted” post. These posts appear on your Facebook page and discuss the same services or treatments as the subliminal ads. However, these posts cannot be as highly targeted as the pay per click or pay per impression ads. For these posts,  Facebook only allows age and geographical range.

So what is your strategy? I believe that these ads should be used as a two pronged approach. Use the subliminal ads to get the highly targeted people in your geographical area to Like your page. You can port these people to your Facebook page hoping that they will Like the page, or you can port them to your website. When you have increased the number of Likes – say to over 600-700 –  then you should start using the boosted posts to show prospective patients the services you are hoping to promote.

These days, I am comfortable with a marketing budget of 2-3% of annual collections. Facebook advertising definitely should be a part of that allocation. The costs for Facebook advertising are very reasonable, and you can set your own budget to your comfort level. This should be a slow and steady process, and in the beginning, be more about branding and name recognition. An interesting observation is that Google and Facebook actually work together. For instance, if you are branding your practice on Facebook using subliminal ads in your service area, and someone sees them continually,  when they go to Google to do a search–and see your practice listed–they will have familiarity which increases the odds that they might choose your practice.

I don’t believe that this is a job for a staff member.  It is technical and time-consuming and probably should be outsourced to a media professional. I am sure that you can find people in your town who do this. I certainly am also happy to make a recommendation.

We all recognize that our world and our life as we know it is changing dramatically and quickly. Politically, economically, socially, culturally – you name it–nothing is the same as it used to be. So we all need to adopt new strategies to remain successful and competitive in the marketplace of public opinion.

I recently read a wonderful article by Saul Kaplan entitled Reinvention As A Life Skill. Saul is a friend, a successful entrepreneur, and the founder of the Business Innovation Factory. “If anything is clear about the 21st century, it’s that change happens faster than it used to. Reinvention isn’t something to be done only as a last resort. It is something we need to do all the time in order to stay relevant in a rapidly changing world.”

Dental practices are certainly not immune from the need for reinvention. If you hope to thrive in this current environment, you probably have to leave your comfort zone. Same old–same old–is simply not going to cut it. Here are some suggestions for your consideration.

1. Get more involved in your community as a volunteer. Perhaps your local hospital or your local Chamber of Commerce. The idea is to focus on meeting business leaders rather than limiting your out of office contacts to Dental Society meetings. You definitely have to increase your visibility.
2. Reach out to the HR department at two or three of the largest employers in your area. You probably have many patients that work at these companies. Ask them to connect you. Perhaps you can offer emergency care or complementary new patient exams.
3. Get way better at social media. This is especially important for doctors over the age of 50. I find that older doctors are very resistant to this path. But your existing and potential patients live in this world, and you have to join it and excel in it. Professional help in this area is certainly available.
4. Have some meetings with your staff and challenge them to help you develop new and exciting customer service ideas that truly separate you from your competition. Focus on great telephone communications. Take follow up care and concern for your patients to an even higher level. Write lots of personal notes. Make sure never to  forget to recognize someone for a referral.
5. Consider investing in technologies and services that so many patients are demanding–like same-day crowns, implant placement, sedation dentistry, Invisalign, and Six Month Smiles.
6. Take a hard look at your practice data regarding numbers of new patients. Dr. Mike Abernathy wrote an excellent article that will help you evaluate where you are and where you could be.

The bottom line is that reinvention takes courage. According to Mark Twain, “courage is not the absence of fear; it is acting in spite of it.” John Wayne put it another way: “courage is being scared to death and saddling up anyway!” The optimist in me believes we are all capable of expanding our horizons if we make the necessary commitment of time and energy. One day at a time. This is a marathon, and not a sprint.

In my last post, I discussed how Google has made it so much more difficult to be seen on their Map.  I suggested that adding new content to your website using a Blog was more important than ever and one of the best ways to fight back. After all, Google still rewards relevance (new information) with higher placement. That has not changed. I received a lot of questions about the mechanics of how to do this, so let me share what I suggest to my clients.

Ask your webmaster to create a WordPress Blog. This then gives you access to a dashboard from which you write and publish posts. The stock format of a WordPress blog is free, but without modification, it is very basic and amateurish looking. Your webmaster can make the Blog Page the same color and format as your website. Your blog then becomes seamlessly integrated within your website in a way that the casual observer has no idea whether they landed on a page of content that is part of your website, or they are viewing an article that is part of your WordPress blog. Click here to see that the Jodena Consulting Blog Page looks exactly like my website.

Adding new content using a Blog serves two purposes. The first is that it satisfies Google’s aim to always bring new and updated material to the attention of the world, and thus reward you for your efforts with higher placement on the local Google business map. Examples I see frequently are articles about the need for regular check ups, or the benefits of fluoride, or why you need to floss your teeth – pretty basic and boring stuff.  But the second and far greater benefit to your practice is if you add specific information about dental services for which a prospective patient would be searching. Best examples are whiter teeth, straighter teeth, cosmetics, sedation dentistry, and same day crowns. These are all procedures you would like to do more of. When you write about these topics, Google does an amazing job of connecting to your website prospective patients in your geographical area who are searching for these services.

So choose a procedure. Then sit down with a glass of wine or your favorite scotch and dictate information into a tape recorder. Take an hour. Just talk about your topic with no attempt at creating an actual blog post. Let it all hang out! Then pay a stenographer $50 to have this material transcribed. You will probably end up with at least 7500 words. Either you – or someone you can hire – will now have enough solid material to carve out eight to ten posts.

Maybe you are good at Invisalign and would like to do more cases. So start with a post about what the technology actually is. Then another post about how the technology has evolved. Or how it has changed over the years. Describe life altering patient experiences that you were able to facilitate. Talk about all of the advantages over full banded orthodontic treatment.

In each post you should add links to before and after photos. Google loves it when you also add links to other relevant articles that reinforce your positions. A good length for a post is 300 to 500 words. Commit to a schedule of a new post every 10 to 14 days. Develop a casual style. These blogs are not intended to be published as  a professional article in a dental journal. It is fine to add a bit of humor.

This is not easy. It is a challenge that requires discipline. Don’t be too harsh on yourself or your writing style. You are not aiming to be number one on the best seller list! But no question that your efforts will pay big dividends in the quest to conquer the online marketplace. And to your delight, you will attract many new patients who otherwise never would have found you.