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Stop Running Late. Now.

Dr Simon Hocken explains how time-keeping can affect the success of your practice.

I’ve always been curious about why some dentists are successful and some consistently underachieve (or just seem to stagger along from crisis to crisis). Over many years of observing and working with both ends of this spectrum, I realise that really successful dentists (by any measure) have adopted successful habits. Habits that, over many years, have supported them and eased their way through their day, allowing them to perform at a level that creates and supports their success. In fact, their behaviours create an effective virtuous circle of success. Some years ago, I put myself through Dan Sullivan’s three-year, Strategic Coach programme ( Early in the programme we were taught a simple set of behaviours that encourage word of mouth recommendation.

Strategic Coach refers to them as, ‘The Refer-ability Habits’ and they are very simple:
• Show up on time
• Do what you say
• Finish what you start
• Say please and thank you.

However, many dentists are hopeless at showing up on time, many have poor follow through, lots fail to finish projects and in this digital world, professional courtesy has mostly disappeared…
It’s really easy for patients (and staff) to measure a dentist’s ability to be punctual. And they do!

In my experience, people are chipped (genetically?) so that they are:
• Always early
• Just on time (that’s me)
• Reliably late.
And the gold-standard for this successful habit is, always early. Thirty years ago, my (very successful) mentor said, ‘Simon, if you’re the painless, on-time dental practice in town, you’ll always have plenty of high-value patients.’ He was right, we always did. Patients want and expect their dentist to be on time. They’re not really interested in the complexity and difficulties of delivering clinical dentistry or that sometimes the appointment doesn’t  go to plan. They simply want to see their dentist on time and be away and on with their day, at the time they were expecting to.

If you’re a dentist and you really want to increase the stress levels of your nurses and receptionists, then, run consistently late. (You know you’re doing it consistently when your patients enquire of your receptionists, ‘So, how late is he running today?’) Okay, so you know who you are!

So, here’s how late-running dentists behave:
1. They (genuinely) believe that it’s okay to run late. They believe that patients will tolerate this. They consider that their time is simply more important than their patients’
2. They arrive at the practice at the last minute
3. They start most sessions late, 10 minutes or so, getting changed, making a hot drink, talking to staff or messing with their phones
4. They spend too much time talking to their patients (they think this is a good thing)
5. They try and cram too much treatment into an appointment
6. They do their own stuff between patients including: go online, go off for a chat with a colleague or their receptionists (or even lock themselves in the loo with the newspaper)
7. They book patients in for too-short appointment times because they don’t know how long procedures are likely to take (in their hands). Or they are unreasonably optimistic about their own capabilities
8. They work into their lunch break (and their nurse’s) and then start the afternoon session late!
9. They finish late and spoil their nurse’s evenings

These dentists have lost control of their day and are seriously damaging the reputation of their practice.

Of course, patients can carry some of the blame for late running, particularly if you/your practice manage patients badly. Patients sometimes arrive late, they might not go numb, gag on the impressions, request that an unplanned item of treatment is carried out, or even ask an important question when they should be leaving. And, occasionally, receptionists: book patients in for the wrong appointment time, squeeze patients in and/or double book patients (often with the dentists connivance!).

If you are serious about and committed to running on time, here’s what you have to do. Firstly, you have to adopt the attitude of someone for whom running on time is important. Very important! Then do this:
Actively measure how long activities take. For example, measure how long it takes to get to work, not by how long you spend in the car, but how long it takes from leaving home to going through the door of the practice. Measure how long it really takes to do a crown prep or a crown fit.
Set yourself a standard. I suggest you aim to see all patients within five minutes of their appointment time. (That’s five, not seven, nine or eleven minutes!)
Add a buffer to all of your timings to allow for things to go wrong, For a journey time, or for an appointment time, add at least 15% buffer time.
When you’re at work, focus, focus, focus. Don’t get caught up in trivia or gossip or Facebook, no matter how attractive and distracting it seems.
Although you have to be accommodating, if a patient arrives late, either scale back the amount of treatment you planned to do in their appointment, or if this is not possible (you can’t do half a crown prep), reschedule them if they have lost more than 15% of their appointment.
Don’t rush clinical dentistry, it  simply isn’t worth the stress and the risk. Book out some buffer time half way through a session: 15 minutes or so. If you don’t need it to catch-up, enjoy a short break!
Don’t have long conversations with the patient before you start treatment, keep conversations brief at the start of an appointment and get the clinical element underway. Talk to your patients while you are both waiting for the local to work and/or at the end of the appointment (providing you finish early!)

If you are running late through circumstances beyond your control:
• Ask reception to apologise profusely and keep the next patient informed about how long you are going to keep them waiting
• Ask reception to reschedule the patient after them and apologise profusely
• Make reparations in some way to the patient you have rescheduled
Also, it’s a great idea have your receptionists ask your patients to arrive around 10 minutes before their appointment time so that they can get themselves settled before their appointment (go to the loo, have a drink, fill in a form etc etc…).

Running late is just a habit (and potentially a practice-harming habit). Like any habit you can change it and replace it with a habit which will support and grow your practice, rather than consistently annoying your patients! The Royal Navy teach their trainee officers this little aphorism, ‘If you arrive five minutes early, you’re 10 minutes late!’ Go figure.

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