Working Interviews, Clearing Complaints and Purchasing a Practice

Issue #180-7.16.13

In This Issue: Working Interviews, by Mike Moore, Esq. 10 Steps to Clearing Complaints, by Sally McKenzie, CEO The ABCs of Purchasing a Practice, by Tom Snyder, DMD, MBA Michael Moore, Esq. Director McKenzie HR Solutions Printer Friendly Version Working Interviews By Michael Moore, Director McKenzie HR Solutions Despite the economic recovery that we are told the country is now well into, it remains a difficult and somewhat risky affair for a dentist – or any employer – to hire a new staff member. When jobs are at a premium, the incentive for someone seeking work to exaggerate their skills is high. No question, there is always some “resume fraud” no matter how strong the job prospects are. It can cost a great deal to hire someone, only to find out she/he doesn’t have the hands-on skills you expected, leaving you back at square one on the candidate search. What many doctors are asking is whether or not they can use “working interviews” to really gauge the quality of an applicant. The term, however, means different things to different people. Bringing an applicant in to work a full day’s work is the idea most people have about it. A quick review of the web reveals that some companies use “working interviews” extended up to 30 days and more. But the question that immediately follows is “What liabilities might I be getting into?” Sometimes the question is “Do I have to pay the applicant?” And then, there are the questions most likely to be raised by a lawyer, such as “What are the consequences if the applicant doesn’t get hired, and is upset?”             There are a number of areas that you should consider when using this method. First, what are the consequences under labor law for having someone come into the office and actually work? The Fair Labor Standards Act provides that if an applicant is brought into the workplace primarily for their own benefit, and have a prior agreement that they will receive no compensation, the employer doesn’t create an “employee.” Hence, there is no obligation to put the applicant on the payroll, withhold money, etc. Given the interplay between labor law and workers compensation statutes, it would also be highly unlikely that if the applicant should claim injury while engaged in a working interview, the employer would be liable to respond under the law. This does not mean that the non-employee would be precluded from asserting a common law negligence claim, however the likelihood of someone suffering injury in a working interview is remote.             Of course, if you choose to implement a working interview program that satisfies the FLSA interpretation, it would not be wise to (for example) turn an applicant for a dental hygienist position loose on patients for a full day’s work without supervision or monitoring. After all, what you as the employer want is a feel for whether or not the applicant’s paper credentials dovetail with their actual skills. A full day’s work is not necessary to see if the paper and real work have a good “fit.” These, therefore, are the suggestions for the implementation of the practice: 1. Do not use the term “working interview.” Use the term “skills assessment.” 2. Obtain the signature of the applicant on a paper stating that as part of the interview process, you offer the opportunity for a “skills assessment” that is not mandatory for success in getting the job, but provides you with more information about the applicant. Advise that during the assessment, you will be offering any tips or guidance that you believe may help the applicant’s skills. As part of this document, make clear that the assessment does not guarantee the applicant a position, and that the time spent by the applicant is not compensated. 3. Limit the assessment to no more than one half-day. If you can make a valid assessment in a shorter time, set that as the time limit. Make sure the limits are included in the document the applicant executes. 4. Monitor the applicant. If the position is chairside assistant, of course you or an associate will be present. If the position is for a hygienist, you should have one of your staff present during the assessment – evaluating the skills, if you like, or simply being available. You should, of course, look in as frequently as convenient. For hygiene patients, it is a good idea to let them know who it is that will be performing services on them that day. All you need to tell them is the name of the applicant that will be doing the work that day, and that the applicant comes with a good skill set. As always, I strongly recommend that the skills assessment be combined with a hiring program that includes fully documented history and resume, background review as needed, and full consideration of other factors. The skills assessment should not be used to the exclusion of these other avenues of information. Good luck! Mike Moore is ranked among the best in employment law and has been named one of the top 10 lawyers in Ohio. As Director of McKenzie's HR Solutions, Mike is the creator of the Employment Policy and Handbook, geared to providing dentists who are unsophisticated in the legal arena with a step-by-step policy manual. Click here to hear Mike present “7 Elements of an Effective Employment Policy.” Email Mike at mike@thedentistsnetwork.net. Interested in having Mike speak to your dental society or study club? Click here. Forward this article to a friend Sally McKenzie, CEO McKenzie Management Printer Friendly Version 10 Steps to Clearing Complaints By Sally McKenzie, CEO As soon as Dr. Chris looked at Mrs. Connor, he knew something was wrong, but it had absolutely nothing to do with her oral health. Mrs. Connor was mad. Actually, she was furious. Evidently one of the business employees had mistakenly taken her to task about an account balance that the employee tersely stated was long overdue. But Mrs. Connor didn’t owe the practice a dime. In fact, there was a credit on her account. It was a human error that occurred somewhere along the way. Although the business employee eventually realized her mistake and backed off, Mrs. Connor felt that she was rude and inconsiderate throughout the entire exchange. So, Mrs. Connor decided that she would address the matter directly with Dr. Chris, lucky guy. Lucky indeed. Certainly, it’s no treat to be on the receiving end of a patient complaint. But when someone takes the time to express a concern, vent a frustration, or alert you to a problem, that disgruntled patient is doing you a huge favor. They are also telling you that they actually care about you and your practice. Consumer advocacy groups report that more than 50% of the buying public have problems or complaints with the products and services they purchase. However, it is estimated that only about 2-10% complain. The other 90-98% just go away because they believe that complaining is a waste of their time and energy. The good news: The majority will not bail out immediately, because that too takes time and energy. And lucky for you, finding another dentist is not like finding another place to get the oil changed. Most people do not want to leave their dentists on a whim, which provides practices an opportunity that many other businesses don’t enjoy. The bad news: Even though the disgruntled patient isn’t going to fire you and your team on impulse, they are likely to detail their version of the negative experience to many others. Conversely, they will also happily share the news with others if their complaint is handled with care and concern. Look at complaints and negative comments as the experience or opinion of at least 24 other individuals who would also express the same feelings as the one grumbling – they just don’t have the courage. It’s not an isolated incident. Rather, it’s an indicator of other potential problems in the systems, problems that likely can be fixed. When you are forced to stand toe-to-toe with a disgruntled patient, view the person as your ally, not your enemy. This individual is providing you with a window into a situation that you need to be aware of. If you can change your attitude, oftentimes you can turn the exchange into a positive and productive opportunity to improve patient care and/or patient service. Follow these steps. 1. First, don’t speak; listen carefully to what the person is telling you, don’t interrupt. Allowing them to vent their frustrations will help the patient to get past the incident.  2. Watch your nonverbal communication. Your mouth may be silent but that condescending look on your face is pouring fuel on the fire. If you think of yourself as calm and concerned, it will come across to the patient. 3. Pay attention to your own prejudices. In other words, just because Mrs. Connor can be “difficult,” doesn’t mean she’s wrong. She may be among the very few with the guts to tell you what you need to hear.  4. Take notes detailing the experience or situation. This is an indication to the patient that s/he is being heard. 5. Apologize sincerely for the problem, even if you do not feel the practice is at fault. Blame isn’t your chief concern, addressing the problem is. 6. Tell the patient that you will look into the matter, and follow through on that promise. 7. Investigate to get the full picture. 8. Fix the problem. You will likely keep the patient who made the complaint as well as many others who have never mentioned similar experiences. 9. Thank the patient for bringing the issue to your attention. 10. Better yet, give them something for their trouble, such as a gift card for lunch or an in-home whitening kit. The patient will be more than happy to tell others how you turned around a difficult situation. Encourage patients to share details of their experiences; what you will learn will be worth a gold mine in improved practice/patient relations. Sally McKenzie is CEO of McKenzie Management, a nationwide dental management, practice development and educational consulting firm. Working on-site with dentists since 1980, McKenzie Management provides knowledge, guidance and personalized solutions that have propelled thousands of general and specialty practices to realize their potential. Interested in speaking to Sally about your practice concerns? Email her at sally@thedentistsnetwork.net or call 1.877.777.6151. Interested in having Sally speak to your dental society or study club? Click here. Hear Sally’s FREE podcasts at The Dentist’s Network - HERE Forward this article to a friend Thomas L. Snyder Director, Practice Transitions The Snyder Group Printer Friendly Version The ABCs of Purchasing a Practice By Thomas L. Snyder, DMD, MBA Director, Practice Transitions The Snyder Group Will 2013 be the year for you to purchase a practice? Whether the practice is purchased through a broker or you find one through your own efforts, there are several key factors you must consider in order to ensure you make the right choice. From my years of experience, there are three key factors to a successful practice transition: (1) location, (2) size of patient base, and (3) above average net profit. If these key factors are reflected in the practice you are purchasing, chances are your acquisition will be a successful investment. In addition to these key factors, you will need to consider other factors such as: practice type, service mix, condition and size of the facility, and new patient flow.             1. Location In any successful business venture, selecting the proper location is critical. If you are unfamiliar with the community, we strongly recommend that you invest in having a demographic analysis prepared. This analysis will provide data about the community’s economics, characteristics of the population, unemployment rate, average housing costs, education and schools, as well as potential growth. We recommend that your demographic study also include dentist-to-population statistics as well as number of dentists in your area. 2. Size of Patient Base The size of the patient base is a critical component to your success. For example, there is a significant difference between purchasing a practice with 500 active patients versus a practice with 1,500 active patients. It goes without saying that the second scenario will afford greater revenue opportunity. Since most general dental practices have grown from successful internal marketing, purchasing a larger “referring patient base” to start with can ensure long-term success. We do not imply that you should not consider purchasing a practice with 500 active patients, but if so, take a careful look at the composition of these patients, such as age and where they live. Two reports that should be prepared to help you better understand your patient base are a zip code analysis and age analysis. Zip Code Analysis - Knowing how far your patients travel is important. If you are purchasing a practice in a smaller town or community where the owner has practiced 25 to 30 years, it is very likely that a number of patients are second generation patients who may have been willing to travel some distance to visit their dentist of many years. If the distance is substantial when the seller retires, there is a high probability that some of these patients will opt to find a new dentist closer to home since there is no longer a connection to their former dentist. This scenario is more likely to happen if the seller leaves immediately after the sale. Age Analysis - Another key report to analyze is the age analysis report. What is the age distribution of your patient base? Depending on the type of services you want to provide, it may be a problem. Is it an older patient base or one that has a good cross section of ages? Patient Flow - New patient flow is a clear indicator of a practice’s vitality. In practices where the owner has been reducing clinical time and possibly not accepting new patients, it may be a real problem. For example, purchasing a practice with 3-5 new patients per month will assure that a substantial investment in internal and external marketing strategies must be made. Conversely, a healthy rate of 20-25 new patients monthly is preferable. 3. Profit Margin Purchasing a practice with operating overhead in excess of 70% versus one that has a 55% operating overhead ratio will usually command dramatically different practice values. More profitable practices are usually valued higher. Practices with healthy profit margins allow you to easily service your practice acquisition debt as well as maintain a comfortable lifestyle. 4. Other Factors to Consider Service Mix - Analyzing the practice’s production reports is a very critical component of your due diligence process. For example, if the retiring dentist has been focusing on complex restorative dentistry, it is not surprising to see 50-60% of the seller’s production relating to this category. For especially smaller patient bases, this may imply that many of the clinical procedures have already been performed. Consequently, you may be purchasing a “maintenance” practice. Conversely, if you analyze the production report and see minimal perio and endo services, this provides an excellent opportunity for growth. Nonetheless, carefully reviewing the last two years’ production reports will give you a good picture of what is happening in this practice. Condition and Size of Facility - With most recent grads being trained in state-of-the-art clinical facilities, their preference is to purchase a practice with updated equipment and technology. Absent this, practice values will be considerably lower if you have older equipment and minimal or no technology. The rationale is simple; more funds must be borrowed in addition to the practice acquisition loan, to purchase new equipment and/or technology. Paying attention to these key factors and assuring that they are part of your practice purchase acquisition will make your practice acquisition a sound business investment. If you would like additional help, email Dr. Snyder at drsnyder@thedentistsnetwork.net   Interested in having Dr. Snyder speak to your dental society or study club? Click here. Hear Dr. Snyder’s FREE podcasts at The Dentist’s Network - HERE Forward this article to a friend

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