Callie Haynes

	You may not be a football fan, but hang in here for a minute with the analogy, because there are some important dental “plays” that you can implement when you have a change in your schedule.

	It is standard operating protocol for football teams to spend time practicing before a game. The major league teams do this in an orchestrated, technical way. In addition to physical practice, they study films and diagram and plan out their offensive and defensive plays before every game. They plan out what they are going to do before the situation arises. They even have a plan for everything that can possibly go wrong. The plans don’t always work in the heat of the moment, but they have a much better likelihood of working because they have been thought out and planned out.

	What happens when a planned play suddenly goes bad? The players scramble to quickly regroup and implement another plan. Good teams do this very well and go on to win more games.

	Whether your dental team formally prepares for your next patient day with dedicated administrative time and a planned morning meeting or “huddle,” or if your team does what it must do for the next day when there’s time (ready to jump right into the morning), we trust that there is some preparation before you see patients.

	Even when patients have been confirmed, their charts have been reviewed, what is on the schedule matches the treatment plan, lab cases have been checked off, account balances have been reviewed, remaining dental benefits have been checked, etc.-in other words, even when you have done everything possible to prepare for the next day to ensure it will run smoothly and your patients will have the best experience possible-things can change in a heartbeat, and winning teams have back-up plans.

	This is where scrambling comes in. Let’s say you are the Appointment Coordinator and in that case, most likely the “first responder.” You made sure the major treatment blocks for Monday were filled and confirmed when you left the office on Thursday. When you arrived on Monday morning and checked the messages, you find a patient has called and cancelled her crown prep appointment because of a family emergency. Now there is one and a half hours of prime time open in the schedule and there is only one minute before huddle. What do you do? It helps if it is not the first patient of the day, but regardless, the scramble starts now:

	Report to the huddle on time and let that be the first thing that is shared with the doctor and team. Why? Because they may have a patient in mind who they want you to call, or they may have other important uses for that time that you are not yet aware of.

		It is ideal to always have a back-up plan in case you get cancellations-be one step ahead if the “play” goes bad. Know the patients you can call beforehand so no time is wasted when you get an unexpected opening in the schedule. If there is no back-up plan at this time, read on.

		See if another patient on the schedule can come in earlier-“We have a change in our schedule, and Dr. Jordan thought of you and thought you might like to come in earlier today-will that work for you?” You have just bought yourself some time to work on filling the later opening.

		Is there another patient on the schedule who might like to save a trip back to your office and who may agree to more treatment today?

		Access your ASAP list of patients and contact them if their procedure is a fit for the time slot that is open.

		Are there patients scheduled in hygiene who could move over to the doctor’s operatory?

		Is there an emergency patient on the schedule who can come in earlier-there may now be time that would allow for a procedure rather than just palliative treatment.

		Are there lab cases ready and patients who could be called for an earlier delivery?

		Can the time be used to provide treatment to a staff member?

		Make sure to keep the clinical team informed of the status of the opening through instant messaging or by taking a note into the ops.

	What if the cancellation is in the dental hygiene schedule? It’s pretty much the same protocol except assistants will look for patients in the doctor’s schedule who are due or past-due for hygiene and offer to  save them a trip back to the office. Always make sure to first check with the front desk to ensure the open time is still available-things can change quickly! And, certainly check with the hygienist.

	When the schedule changes, each team member needs to know what their part in the scramble is and what specific actions they should take. It takes excellent communication between front and back so team members aren’t running around like keystone cops. Remember this is a team effort, not just the Appointment Coordinator’s responsibility.

	The dentist’s role is very important, too. He or she needs to:

		Set specific, clear guidelines and expectations based on vision and values for the protocol on how the team responds to openings in the schedule.

		Put this protocol in writing and train the steps in a staff meeting.

		Put this written protocol in your Systems Protocol Binder-it serves as a written reminder to the team as well as a training piece for any new hires.

	If you have to scramble too much because of too many cancellations, you may need to work on building value for optimal oral health and the role it plays in total health.

	We all know it’s impossible to have a zero cancellation rate, so protocol for scrambling must be in place. When the team gets good at it, you will be a Super Bowl caliber dental team! 

 Callie Haynes has more than 30 years of experience in dental practice management and has been a consultant for Pride Institute since 1996. Callie’s extensive experience in this wide variety of roles in the dental office gives her instant credibility with dental teams and enables her to understand the challenges that a practice may face from different perspectives. Callie specializes in relationship building with patients and teams, customer service and systems implementation. To ask Callie about this article or for more information about Pride Institute, go to 

prideinstitute.com/subpages/ask/ask_pride.htm

Articles

 You may not be a football fan, but hang in here for a minute with the analogy, because there are some important dental “plays” that you can implement when you have a change in your schedule.

The art of scrambling

	They are lurking in your office waiting to steal treatment plans and hide them in the unscheduled treatment reports in your computer. If you track case acceptance, you are one step ahead of these robbers because you can then start to identify and analyze your systems and communication skills to find your vulnerable areas and take steps to shore them up. Guessing or using your “gut feeling” about case acceptance will not serve you well. A good goal to aim for is 85% for new patients; 90% for patients of record.

	How do you secure your practice from losing countless opportunities to provide the clinical care that your patients need and the revenue needed to keep your practice financially healthy and viable? And, how do you save the countless hours and expense of “chasing” patients with follow-up calls and letters after a patient either says “no” in the office or later cancels an appointment and does not reschedule?
	
	As in clinical dentistry, prevention is the key. Like your home and car are armed with security devices to prevent theft, dentists and their teams can learn to identify and improve the systems and communication skills that will prevent the case acceptance robbers from “stealing” thousands of dollars from your practice.
	
	Assign this article to be read by each team member, then have a staff meeting. Explain the purpose of the following activity-to analyze systems and verbal skills related to case acceptance. Each team member, including the dentist is to self-assess and identify what is working successfully as well as identify areas for improvement. Inviting feedback from others is extremely helpful; we can’t always catch every opportunity for improvement by ourselves. If you choose this option, agree from the start that this is NOT a blame game; agree to be open to constructive feedback. Each team member needs to put on their “Sherlock Holmes” and start looking and listening for these robbers. Use the bulleted points as checklists and write down your findings.
	
	Let’s start with the dentist during the process of diagnosing and presenting treatment to patients:
	
	• Is enough time taken with patients so that they are not only told what treatment they need, but they are SHOWN with mirrors and intraoral cameras? Are they given pictures of the areas of concern?
	• Is the dentist firm in the recommendations for treatment? Or, is the dentist saying things like: “You ought to start thinking about getting this done”; “It’s kind of important to schedule this treatment”; “When you’re ready, you should set-up an appointment”; “We’ll watch this and check it next time”. Vague wording can leave patients confused and unmotivated to get their treatment completed
	• Are patients encouraged to ask questions? Is adequate time taken to answer those questions?
	• Is a specific timeframe for completing treatment given to the patient? If the treatment is “out there” with no timeframe, the chase for the administrative staff begins!
	• When a patient presents obstacles to committing to the recommended treatment, does the dentist have the verbal skills to effectively partner with the patient to overcome the challenges, or to effectively hand-off the patient to the staff member who can help?
	• If the patient does not bring up any obstacles, is the dentist saying, “Before I walk you up to the front desk to speak with Judy, do you foresee anything that will prevent you from scheduling the treatment we discussed?” This is a powerful and very important question and will give the team information to work with so that they can help overcome any challenges that may prevent the patient from following through with treatment
	
	Let’s take a look and listen to the clinical staff members who are in the op when the dentist presents treatment:
	
	• Are you fully present and listening carefully and entering procedures in the treatment plan? Are you taking notes while the dentist is talking about treatment? Are you noting important information/comments from the patient?
	• Is the treatment plan completed BEFORE the patient leaves the op so that the admin team doesn’t have to “tap dance” and the patient doesn’t have to wait at the front desk?
	• When the dentist leaves the op, what do you say if the patient asks for YOUR opinion? Are you enthusiastically supporting the dentist’s clinical recommendations? Robbers are waiting to hear you say things like, “I’m sure glad it’s not me, because I could never afford that treatment”
	• Are you doing an informative patient debrief that summarizes the appointment and emphasizes the importance of the next appointment?
	• Are you taking the time to invite and answer questions from patients?
	• Are you personally escorting patients to the front desk and giving pertinent information that will help the admin staff schedule the appointment?
	
	Now, it’s time to look and listen at what takes place at the front desk:
	
	• No matter how busy the office is, are you able to present a calm, pleasant, helpful attitude to patients and treat each one like a VIP?
	• Do you have a back-up system so that you can put your entire focus on the patient standing before you? Robbers love to see the patient slip out the door without going through the process of having today’s procedure/s and fees explained, collecting payment, and making financial arrangements and scheduling the patient for the needed treatment recommended today
	• Are you comfortable with partnering with the patient to overcome any obstacles standing in the way of their following through with treatment?
	• Are you comfortable with reinforcing the need for treatment?
	• Are you confident about presenting financial options for patients?
	• Are you encouraging the patient to ask questions and then really listening to them?
	
	Once you have gathered your findings, have a well-organized staff meeting. Remember, it’s about systems and verbal skills that can be improved, not about blaming each other. Develop action plans to improve or tweak your systems and verbal skills related to case acceptance. Track case acceptance and get statistical proof that your efforts are in fact keeping those robbers locked up!

 They are lurking in your office waiting to steal treatment plans and hide them in the unscheduled treatment reports in your computer. If you track case acceptance, you are one step ahead of these robbers because you can then start to identify and analyze your systems and communication skills to find your vulnerable areas and take steps to shore them up. Guessing or using your “gut feeling” about case acceptance will not serve you well. A good goal to aim for is 85% for new patients; 90% for patients of record.

Case acceptance robbers and how to stop them

One of the most frequent calls we get on our Hotline at Pride Institute is the dentist or team member asking when and how to dismiss a patient from the practice. There is usually a long story involved and lots of confusion.

Typically, they have waited far too long to take this action and have endured a lot of stress as a result. True, it can be uncomfortable. And true, it is easier to hope the patient just goes away. But that rarely happens.
	


To formally dismiss a patient from the practice, a letter must be written. Keep it short, simple and to the point using these components.

 “We have been unable to establish a commitment from you to complete your diagnosed and recommended restorative care. We have determined that our philosophy of comprehensive oral healthcare is not a match for what you want.”

“We will cover any emergency care that you need for the next 30 days to give you time to find another dentist.” Check your state laws. The amount of time varies from state to state.

 “We will transfer your films and any other information your new dentist requests.”

“We sincerely hope you will find a dentist who matches your philosophy of oral healthcare. We wish you well.”

Make sure a copy of the letter is made for the patient’s paper or virtual chart. Calendar in when to inactivate the patient’s records. Don’t do this until after the time period for the patient to engage another dentist has expired. 

The patient being dismissed could have an outstanding account balance or a delinquent account balance. This is a separate issue and should not be part of the dismissal letter.

Some offices prefer to turn delinquent accounts over to a third party for collection rather than sending dismissal letters. This often influences patients not to return. However, these patients will sometimes call for appointments, usually for emergency care, even though their accounts are no longer in the office.
This can be tricky territory. Make sure the practice is in compliance with state laws when deciding if you can tell the patient that the total cost of the delinquent balance plus the estimated cost of their emergency visit must be covered before being treated.

If the patient has not been formally dismissed from your care, you may be obligated to treat him or her even though the account is in arrears. It is important to check with your malpractice insurance carrier on this matter as well.

Examine your protocol and verbal skills regarding new patients. If the time and effort is taken to explain your philosophy of oral healthcare as well as appointment, financial and insurance guidelines starting with the new patient’s first phone call, you can prevent future misunderstandings.

The next step is verbally reinforcing these guidelines during the check-out process after the first appointment. It’s easy to just hand the patient your practice brochure or written financial policy, but materials must be accompanied by a verbal explanation, such as, “So that you can be clear about the guidelines of our practice, I’m going to review some important information with you and take time to answer any questions you may have.”

These steps will save you time and stress and may start a potentially less-than-ideal patient on the right path. If a mismatch is identified and addressed early on, stress can be eliminated for both the patient and the practice by formally dismissing the patient from your practice sooner rather than later.

Callie Haynes has more than 30 years of experience in dental practice management. Callie’s extensive experience in a wide variety of roles in the dental office enables her to understand the challenges that a practice may face. She specializes in relationship building with patients and teams, customer service and systems implementation. Callie can be at callieh@prideinstitute.com.

 One of the most frequent calls we get on our Hotline at Pride Institute is the dentist or team member asking when and how to dismiss a patient from the practice. There is usually a long story involved and lots of confusion.  Typically, they have waited far too long to take this action and have endured a lot of stress as a result. True, it can be uncomfortable. And true, it is easier to hope the patient just goes away. But that rarely happens.  Dismissal protocol

Dismissing patients from your practice

	You may be finding it more challenging to fill both the doctor’s schedule and the hygiene schedule and keep them filled. Many patients have had financial setbacks because of our still challenging economy, and many other patients seem reluctant to spend money on anything but what they consider essential. Maybe your number of new patients has declined too?
	
	Here are some steps that self-directed appointment coordinators can take to keep the schedule full and productive and also increase the number of new patients:

		Take more time with new patients during the first phone call to ensure that questions are invited and thoroughly answered

		Make sure you ask them who referred them-this plants seeds that your office appreciates referrals from patients; follow-up with a thank-you note to patients who refer

		Take time with each new patient at their first visit to explain appointment guidelines face-to-face; this will reduce the number of short-notice cancelations

		Make a courtesy call to the new patient after their initial visit to get their feedback on how their visit was and to ask them if they have any questions

		Enhance your confirmation calls-“Mrs. Williams, this is Diane at Dr. Smith’s office calling to see if you have any questions regarding your appointment with Dr. Smith on Thursday at 2:00?” End the call with “We’re looking forward to seeing you on Thursday."                                                                                                             

		Make sure that every patient who walks through your door is given a warm welcome and a big smile

		Work on scheduling due and past-due hygiene patients every day-don’t wait for holes in the schedule-run recall reports routinely and do calls and letters every day. Leaving a message one time on a patient’s voicemail isn’t all you do; you must identify and follow through with the next step until the patient is scheduled or is not returning to your office-document all contacts

		Work the unscheduled restorative treatment list too-“Dr. Williams has asked me to contact you because he is concerned that you have not scheduled the treatment that he diagnosed and recommended. How can I help you today?” If the patient will “call you back” is “not ready” or is “thinking about it”, create a little urgency-“It’s been our experience that when patients postpone needed treatment, they risk more complex and costly treatment in the future-we don’t want this to happen to you”.

		Create verbal skills scripts that project care and concern for the patient; make sure that follow-up letters do the same

		In September of every year, send a courtesy reminder to those patients who have remaining dental benefits and who are due or past-due for hygiene and to those patients who have unscheduled restorative treatment-encourage them not to lose these valuable benefits

	Through implementation of these steps, you will get more patients on the schedule, and you will get more new patients because of your going the extra mile with customer service. By being creative and pro-active, you are increasing your value to your employer as well as increasing your satisfaction with your job.

Callie Haynes has over thirty years of experience in dental practice management and has been a consultant for Pride Institute since 1996. Callie’s extensive experience in this wide variety of roles in the dental office gives her instant credibility with dental teams and enables her to understand the challenges that a practice may face from different perspectives. Callie specializes in relationship building with patients and teams, customer service and systems implementation. To ask Callie about this article or for more information about Pride Institute, go to http://

www.prideinstitute.com/subpages/ask/ask_pride.htm

 or call Pride Institute at 1-800-925-2600.

 You may be finding it more challenging to fill both the doctor’s schedule and the hygiene schedule and keep them filled. Many patients have had financial setbacks because of our still challenging economy, and many other patients seem reluctant to spend money on anything but what they consider essential. Maybe your number of new patients has declined too?  Here are some steps that self-directed appointment coordinators can take to keep the schedule full and productive and also increase the number of new patients:

Becoming a better appointment coordinator can mean new patients

	When we introduce the “Patient Debrief” to teams, their first response is, “We already do that.” And to a certain degree they absolutely do part of it!
	
	Typically, we see that hygienists always give patients oral hygiene instructions before during and after the prophy. Assistants give patients post-op instructions, often while removing instruments from the tray, lowering the dental chair and removing the patient’s napkin. How much of the information do you think the patient retains while all of this other activity is taking place? It’s no wonder that the patients develop “patient amnesia” and don’t retain a thing you said during the walk from the operatory to the front desk.
	
	There is so much to be gained from a structured, focused Patient Debrief that truly takes only 2-3 minutes to complete. A formal debrief offers so much more than just giving patients follow-up instructions on the fly. The benefits include relationship building and better informed patients- resulting in fewer call backs because patients didn’t hear or understand the instructions. Another benefit is higher levels of patient commitment to future appointments resulting in reduced numbers of cancellations and no-shows. Are all of these potential benefits worth spending an additional few minutes with each patient? You decide.
	
	

	Picture this scene. At the end of the hygiene or restorative appointment, leaving the patient’s napkin in place, the team member who will dismiss the patient says, “Before I escort you to the front desk, I would like to give you some important information.” This lets the patient know that the appointment is not over yet.
	
	Even though this assistant or hygienist is concerned about getting the room turned over and seating the next patient, it’s vital that she or he must not appear rushed. This patient deserves full attention and a thorough debrief, which includes the opportunity to ask questions or express any concerns.
	
	


	
	In this example, we will highlight an assistant conducting the patient debrief after a crown preparation. The assistant lowers the dental chair and sits the patient up. Pulling her chair close to the patient and facing him with complete, focused attention, the Patient Debrief begins using these seven Ws.
	
	WHAT was done today (brief description of the procedure/s): “Mr. Johnson, today Dr. Barrows prepared your upper left molar for a crown by shaping your tooth and placing a post in it to support your new crown. We then took impressions for our lab to use in making your new crown. You now have a temporary crown on your tooth until you return to get your permanent crown.”
	
	WHAT the patient can expect (includes post-op instructions/oral hygiene instructions): “You should not have discomfort with your tooth since the nerve was removed when you had root canal therapy. The tissue around your tooth may be a bit sore. Several warm salt water rinses each day for a few days will help. Take care not to bite down on hard things while you have your temporary crown because that can cause it to break. Brush carefully and pull the floss out from between your teeth rather than pulling up on it as that could dislodge your temporary crown. If, for any reason, your temporary crown comes off, please call our office right away so that we can arrange to either re-cement it or make a new one depending on its condition.”
	
	WHAT is next and WHO the patient will see (restorative appointment or hygiene visit with Dr. or Hygienist): “At your next appointment, Dr. Barrows plans to fit and adjust your new crown. If it meets his clinical and aesthetic expectations, he will cement it. This will take only about 30-40 minutes.”
	
	WHEN the patient needs to return: “It takes our lab about 2-3 weeks to make your custom crown and return it to us. Mary will set up your next appointment when I escort you to the front desk.”
	
	WHY it’s important to keep this appointment as scheduled: “So that your tissue stays in good condition and your temporary crown is removed in a timely manner, it is very important to keep your next appointment as scheduled.”
	
	“WHAT questions may I answer for you?” It’s important to ask an open-ended question with the assumption that the patient is expected to have questions. Be sure to thoroughly answer any and all questions or concerns before you escort the patient to the front desk.
	
	


	
	This structure should be followed consistently by all team members who dismiss patients-including the doctor. Create a one-page flow chart using the format in the example above. Place these pages in plastic sleeves and put one in each operatory. By using this flow chart, the Patient Debrief will flow smoothly, nothing will be omitted and “patient amnesia” will practically disappear.
	
	Schedule a staff meeting to practice the art of the Patient Debrief. First, each team member needs to create a scenario and plug that into the format of the Debrief. Pair off and go into the operatories. One team member will be the patient and the other team member will be the assistant or hygienist delivering the Patient Debrief. Use the flow chart so you won’t leave anything out. The Doctor can play himself or herself, because the time will come when it flows more smoothly for the Doctor to do the Patient Debrief, e.g., when the procedure/s or post-op instructions are more complex.
	
	Once you have completed the first scenario, switch roles so the other team member gets to practice. Now you each have had a practice session. For even more practice and better results, switch partners and do another practice using another scenario.
	
	Now, watch the benefits of a thorough Patient Debrief unfold. Better informed patients will make fewer call backs for information and you’ll see more patient commitment to keeping appointments because the importance of doing that has been communicated and stressed. Most importantly, patients will feel cared for and valued and will appreciate the time you spent with them. You will treasure the art of the Patient Debrief because of all the benefits it provides to patients and your practice.
	 

Callie Haynes has over thirty years of experience in dental practice management and has been a consultant for Pride Institute since 1996. She previously worked as a Practice Administrator, Systems Implementation Coordinator, Project Development and Management Director and Clinical Treatment Coordinator in high-functioning, high-performing dental practices. Callie’s extensive experience in this wide variety of roles in the dental office gives her instant credibility with dental teams and enables her to understand the challenges that a practice may face from different perspectives. Callie specializes in relationship building with patients and teams, customer service and systems implementation. She holds a B.S. degree in Human Services and has completed advanced studies in coaching at Coaches Training Institute. For more information about Pride Institute's seminars and consulting, call 800-925-2600 or visit 

 When we introduce the “Patient Debrief” to teams, their first response is, “We already do that.” And to a certain degree they absolutely do part of it!

Do you debrief?

	Nine months into a rough year, Dr. Everyman walks into his morning huddle, already feeling far from successful. He has been watching a lot of TV and has heard all the news about job layoffs, bankruptcies and other economic issues. On a personal note, last month he was unable to draw his normal salary and he has never been able to put away as much money in savings as he would like. At huddle, the team seems distracted and unresponsive to his concerns.

	When the first update Dr. Everyman receives is the cancellation of a patient who was to be his most productive procedure for the day-he snaps.

	“That’s it,” he says. “We are obviously another casualty of the economy, and there is nothing left to do but downsize and ride the vortex down.”

	Melodramatic? Yes. But other than that, what’s wrong with this picture?

	Dr. E has made a sweeping decision about the health of his practice based on his feelings-judgments based on perceptions, not facts. Before he throws out too many babies with the bathwater, he and his team must analyze the key statistics of the practice to discern what its true strengths and challenges are and, more importantly, to prioritize solutions to address the real issues.

	Can this practice be saved? Yes, if Dr. Everyman can let the numbers be his guide. When he and the team decided to truly analyze key practice statistics, they ran some reports. Here is what they discovered:

	Total office production
	At their staff meeting to analyze their Year to Date (YTD) practice statistics, the team looks first at Total Office Production (TOP). While both doctor and team are concerned that they are 10% under their Goal YTD, they realize they are 8% over what their TOP was for the same period last year. Dr. Everyman feels better already-this is quite good considering the economic challenges.

	Dentist’s production
	Again, a statistic that is below goal by 7% for the current nine-month period. This time, Dr. E holds his comments as they compare this statistic with the same period last year. More good news-up by 11%.

	Days worked
	Looking at the number of days Dr. E has worked so far, the team reminds him that he took an unplanned fishing trip on the spur of the moment, so three days of production were cancelled. Dr. Everyman recalls he didn’t catch a single fish that trip!
	
	Hygiene production
	“Okay,” thinks Dr. E, “now, it’s my turn to put the hygienists on the spot. They are 15% below goal.”
	Before he speaks, the dental hygienists gently remind him to compare their production with the same time period last year. They are a modest 2% ahead, but still ahead of last year.

	Collection %
	The whole team clearly sees the next statistic, collections, is down 5%. That amounts to $33,120.

	“No wonder I can’t draw my regular salary or put any money away for retirement,” Dr. Everyman thinks. The hair on the back of his neck bristles, but he takes a deep breath and realizes he needs more information before he starts the blame game. He calmly says, “Sandy, let’s run an aged accounts receivable report and sit down together to review it. Once we see where the money is, we can have a brainstorm at our next staff meeting to see how we can support you in collecting this money and getting back on goal. How does that sound?”

	Sandy feels relieved-she could use some help with the phones while she follows up on outstanding insurance claims and past-due patient balances.
	
	


	Next is the number of new patients-wow! They are seven over goal and have 34 more than the previous nine-month period. Dr. Everyman makes a mental note to start tracking where these patients are coming from, as the practice must be doing something right.
	
	


	The team immediately spots a huge variation: $607 per New Patient is $1,393 short of goal and is $893 short of the previous nine-month period. What does this mean?
	“Let’s look back on our appointment schedules and analyze how our new patients were scheduled,” Dr. Everyman suggests. He’s thinking they may have reverted back to scheduling new patients with the hygienists first. If that is the case, he realizes he would not have had enough time to do some very important relationship building.
	
	


	This statistic is 30% below goal and 2% down from the previous nine-month period. The doctor believes if he takes more time building relationships with new patients during the comprehensive exam, it will result in higher case acceptance. He acknowledges he may also have some work to do on his treatment presentation. There also may have been some treatment plans presented at separate consultation appointments that were not included in this statistic, which means the team may have some work to do on its tracking system.

	The team’s big realization is, had they gotten the case acceptance they expected (by creating relationships that promoted commitment and follow-through), the TOP and Dentist’s Production goal easily would have been met.
	
	


	Dr. Everyman prefers to look at this data in private. He sees this expense is 1% over goal, however it is 2% less than the previous nine-month period. He realizes that by increasing production, the employee expense percentage will be at goal or below.

	The doctor and his team spend the rest of their staff meeting developing an action plan to improve their statistics, with collections and case acceptance noted as priority areas. Specific action steps are assigned to team members along with timelines. Dr. Everyman and his team feel empowered to make improvements they know will improve their statistics.

	Dr. Everyman now knows his numbers don’t lie, and there is always a story behind them. He makes the decision to always let the numbers be his guide and to make decisions based on facts and not gut feelings or emotions.

 The subject  Nine months into a rough year, Dr. Everyman walks into his morning huddle, already feeling far from successful. He has been watching a lot of TV and has heard all the news about job layoffs, bankruptcies and other economic issues. On a personal note, last month he was unable to draw his normal salary and he has never been able to put away as much money in savings as he would like. At huddle, the team seems distracted and unresponsive to his concerns.