Dental management Tag Archive

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ADA Benefit Plan Analyzer


The ADA Benefit Plan Analyzer is a tool meant to help you analyze the financial impact of a payer’s rates to your practice. It is based on information and assumptions provided by you regarding the payer’s reimbursement rates and restrictions as well as your practice’s goals and its financial situation.  via CPS-APP12 – ADA Benefit Plan Analyzer 12 Month

Features of the Dental Benefit Plan Analyzer include:

  • Running analysis models based on actual practice data taken from the dentist’s practice management system. The plan analyzer automatically displays the top 20 procedures based on revenue and the average number of weekly hours they and their hygienists work.
  • Saving those results for future review and comparison.
  • Analyzing preferred provider organization and dental health maintenance organization benefit plans.
  • Configuring variable inputs like practice overhead; time spent by dentists not treating patients; number of estimated new patients; number of restorative operatories; number of hygienist operatories; and the capitated fee being offered by DHMO providers.
  • Installing the Sikka Platform Utility on one computer in the office and being able to run the analysis from any other computer or tablet with an Internet connection.
  • Reviewing plan score data based on the financial impact of adopting the plan and how the plan’s patients compare against cash-paying patients.
  • Viewing a visual indicator plan score for quick analysis.
  • Seeing available staff and operatory hours as well as the hours required to handle the estimated new patients.

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Saved by the Cloud… or not

saved by the cloud... or not

When you visit a medical or dental office in the future you won’t be handed a clip board and paper forms, all your personal and medical data will be stored on the cloud. The medical / dental office will merely request a download and all the data will be available instantly. No forms, no guessing about medications, no forgetting your last visit, no confusion about insurance.

Isn’t that great all your highly personal medical data will be available to anyone with access through the cloud!

That will be really great because we wouldn’t want out personal stuff available to any old hacker so we will have the same level of protection that people had for their nude photos or that Target had for purchases or …well maybe it won’t be so great.

As much as I love technology and see the incredible potential of cloud based data and want it to be safe and secure, clearly it is not.

As digital technology and electronic health records stored in the cloud continue to develop they generate legal, moral and philosophical questions our existing ethical framework is simply not equipped to handle.

Most of these ethical questions can be summed up as:

Who owns the data?

Patients? If you ask patients the immediate and unequivocal answer is that they do. That seems right, each patient should have control of their medical information. That is what the HIPAA privacy rules are supposed to address. Yet that is not how the system works.

Doctors? If you ask a dental practice management software company (PMS) who owns the data the immediate and unequivocal answer is that you do the doctor owns the data.
Yet again this is not how the system works.

If as a dentist I own the data, I should be able to exercise the basic rights of ownership including using or transferring the data. However current systems do not allow me to transfer the data to another dentist or to use it as I wish for analysis. Plus as a dental professional I am obligated ethically and legally to protect the data as confidential.

If I have the data but can’t access parts of it or more commonly can’t transfer parts of it do I really own it?

Public? One of the most significant benefits of large online data bases of medical information is the aggregation of data for medical research purposes. Already there have been important findings resulting in improved patient care based in data base analysis. It seems axiomatic that more data from a wide range of sources will ultimately lead to better results. That is a good thing, but.
Is it OK to use personal medical data in a study without the patient’s permission? What if the personal identifiers are removed?

Then there is the issue of privacy. The primary issue driving HIPAA privacy rules is that a patient’s information must be protected. HIPAA is not about speaking a patients name aloud in the waiting room, it is about electronic medical data and making it available to others is wrong. Wrong morally and legally. That seems to be obviously true on the surface. Our personal data should be held in confidence. But what if we choose to make it public by participating in a study? Do we still own that data? Who does; the researchers, the web aggregator or the public, as in the public good?

In an ideal world all our medical data could be accumulated in a huge national (or for that matter global) data bank. This mass of data would be used by benevolent researchers to delve into disease patterns and treatment outcomes to provide a vastly improved understanding of the human condition.

But of course in the real world we have fear, politics, hackers, bureaucrats, proprietary data bases, the nightly news and less than benevolent people.

Check out more articles on Dr. Emmott’s Blog >


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Managerial Discretion: Its Privileges and Obligations

managerial discretion

Credit for this article’s topic goes to Steve Cobb, Chairman of Henny Penny who shared with us this idea during a workshop that we recently did with his executives. An hourly employee stuffing sausages at a sausage factory is expected to put in 40 hours a week and get paid for 40 hours of work. Occasionally, if the supervisor wants him to work extra hours to meet a deadline of sausage shipments, the hourly employee might agree to do so and be paid overtime. When the hourly employee takes time off or goes on a vacation, he expects somebody else to be stuffing sausages while he is gone and does not expect a backlog of sausages to be stuffed left at his workstation. In contrast, most – if not, all – of you that read this article simply put in the hours needed – often, more than 40 hours a week – to get the job done. You have managerial discretion to prioritize your work and schedule it based on the combined needs of the business and your personal life. There are privileges and obligations that come with that discretion. There is value to underscoring both the privileges and obligations to your exempt employees and management.

I once sent an email to a group of employees in the office, expressing my frustration at a behavior that I had observed. These employees had total freedom in their work hours. They could come and leave at any time. They could take time off whenever needed. They had unlimited vacation time. Each of them had individual responsibilities, much of which was self-imposed and self-managed. All they had to do was to make sure that their work got done and do a good job of it. Yet, I observed that every afternoon they all left at the same time, around 5 pm. This bothered me. Did they all come to a reasonable closure on their day’s work at the same time? Did it just coincide with 5 pm? Or were some of them tired at 4 pm and did not feel comfortable simply calling it quits for the day? Likewise, did some of them have pressing work beyond 5 pm and did not feel obligated to stay late and get it done? Did the en masse departure – and, that too, at 5 pm – indicate a lack of comprehension of the privileges and obligations of managerial discretion?

So, what are those privileges and obligations? In contrast to a sausage stuffer that is expected to stand in a production line and stuff sausages, management has considerable discretion on the hours they keep, the quality of their work product, and the scheduling of that work. They decide when the amount of research they have done or data they have collected is adequate to make the decision. They decide when the report is good enough to be shipped out. They decide what needs to be done now and what can wait, or even simply ignored. If they need to attend to a sick child or leave early for their child’s baseball game, they do so and manage the impact. If they choose to work from home one day to get that project completed, they do so. With all that privilege come obligations. You are expected to err on the side of higher quality in your judgment of what is good enough. You are expected to work late, take work home in the evenings or work on weekends to ensure that critical projects are completed on time. You are expected to take on that extra workload when the unexpected happens, even though you already have a full workload. You define your hours not by the clock but by the work that needs to get done; and, it is always more than what the clock says.

work_hoursWhile the privilege gives you a lot of freedom, the obligations impose a workload that adds up to more than 100% of your time. And, the higher you rise in management, the more your privileges and your obligations, resulting in greater disparity from 100%. We have tried to provide a rough idea of that disparity in the adjacent picture. Is it fair to expect management to spend much more than 100% of a work week on a regular basis? Is this a recipe for burnout? Should this expectation be implicit or should leadership explicitly discuss this expectation with management? Would an explicit conversation lead to problems and resentment? If executive leadership does not exhibit this practice, can they expect lower level management to do so? In a private company with an operating owner, can the owner expect this behavior without he or she walking the talk?

We believe that management needs to fully understand this concept by cherishing the privileges and rising to the obligations. Top leadership raising awareness of these privileges and obligations will cause management to become intentional.

via Balaji Krishnamurthy, LogiStyle, LLC

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Performing vs. Engaged Employees


Performance management has become an over-used buzz word in the corporate world. Most companies understand the value of setting clear performance goals for employees, evaluating the employees’ performance against those goals and providing the employees with feedback on what they have done well and where they might need improvement. We value highly performing employees. But do we value highly engaged employees? What is the difference?

Performing employees give to get. Their focus is on the getting. They value what they get from the company. They get a good salary. They get to work in the town where they have social ties. They get good working conditions. They get good working hours. They value all that they get. They understand that to get all those things, they must give to the company. So, they do. They give to the company their best efforts towards the company’s goal. They do a good job so that they can get all those things they like. They are more likely to be lured by another employer from whom they can get more, than one to whom they can give more. Their focus is on the getting. Giving is the means by which they get. They give to get.

In contrast, engaged employees get to give. Their focus is on the giving. The engaged employee is proud that they help people; they save lives; they teach others; they invent new things; they work on challenging projects; they lead a team; they make a difference. Their pleasure is in the giving. Getting is incidental. Yes, they have to pay bills; so, they like that they get a decent pay to live. But they work because they like what they do. Giving is the reason. They are more likely to be lured by another employer where they can give more than one from whom they can get more. Their focus is on the giving. They get to give.

Would you rather have a performing employee or an engaged employee? No doubt, you probably would like an engaged and performing employee. Likewise, you will probably not tolerate for long a dis-engaged and non-performing employee. Those are the easy cases. How about the hard cases? Would you rather have a well-performing employee that is struggling to be engaged or a well-engaged employee that is struggling to perform? And, why is that? An engaged employee that is not performing is usually lacking some necessary skills. A performing employee that is not engaged is usually lacking necessary attitude. This brings to mind a favorite quip: If you have an employee that does not have the skill set needed to do the job, give them a year to learn the skill set; If you have an employee that does not have the attitude needed to do the job, give them the entire weekend.

Should we be evaluating our employees just on their performance, or also on their engagement? How do you evaluate people on their engagement? Does engagement change over time, just as performance does? How frequently should you give employees feedback on their engagement? These are all questions worthy of consideration. Ask yourself: Do you have performing employees or engaged employees?

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Variable Compensation: Incentive, Bonus or a Reward?


Let me start by wishing all of our readers a happy and prosperous New Year. I hope you had a wonderful holiday season, hopefully had some relaxing time with family and friends, rang in the New Year with good cheer and are back to work with a positive outlook. This month’s topic is inspired, in part, by a discussion I had with my staff on this topic at our planning meeting a month ago, as we were massaging our variable compensation program for this year. A week or so later, my friend, Gerhard Beenen, sent me an article, Why Not Give Money Instead of a Gift  that added some fodder. Finally, given that many of you might be planning your compensation programs for this year, I thought this topic might be apropos.

Is there value to supplementing base compensation with variable compensation? Do you have a variable compensation program in your company? Although the employer benefits by indexing a portion of the employees’ compensation to the performance of the company, does it drive the intended behavior in the employees? Is variable compensation an incentive, a bonus or a reward? To explore this, let us focus on the distinction between an incentive, a bonus and a reward, in the context of variable compensation for employees.

An incentive is a contractual agreement (written or verbal) between the employer and the employee in which the employer sets certain predetermined goals upon achieving which the employee is entitled to a predetermined amount of compensation. The presumption is that the opportunity of this compensation will incentivize the employee to work harder to achieve the goals. Typically, incentive compensation is not paid for trying hard or for “almost” meeting the goal; but when the goal is met the employee is entitled to the agreed compensation. So, in an incentive compensation there is an a priori contractual agreement, an expectation that the employee’s behavior will be influenced and the employee has a sense of entitlement when they meet the goal.

A bonus is a contractual agreement between the employer and the employee that allows the employee to share in the “profits” of the company. Although the amount to be shared is usually pre-determined and agreed, there is no expectation that the employee’s specific behavior (drive, motivation, etc.) will be influenced by the bonus program. Nevertheless, both the employer and the employee feel good when the bonus program pays out, and they all feel part of the team. As in the case of an incentive, if the company does well, the employee feels entitled to the bonus. So, a bonus is similar to an incentive but there is no expectation of influencing the employees’ behavior.

A reward has no a priori contractual agreement and, as such, there is no expectation of influencing the employees’ behavior. Nevertheless, the employer, ex post facto, offers the employee(s) some compensation for a job well done – e.g., completing a project, finishing the year with a bang, achieving superior business results, etc. In this situation, the employee has no expectation, and is pleased by the magnanimity of the employer.

To drive home the distinction between the three, let us highlight a subtle point. When an incentive is paid out the employer thanks the employee. When a reward is paid out the employee thanks the employer. When a bonus is paid out they both thank each other.

What works best – incentive, bonus or a reward? Do incentives work? Do people’s behaviors really change? Are people motivated by money to the extent that their behavior can be affected? The article mentioned above has some interesting insight into these questions. Is there value to a bonus? If it is not intended to change behavior, why create the sense of entitlement? Do rewards have long term value? Are they forgotten the next week? Do you have to reward everybody? Do you have to reward every year? If you do, do they become an entitlement and degenerate into a bonus?

These are all questions you should ask yourself. You should have clear convictions and expectations in setting up a variable compensation program. As a proponent of intentional leadership, I posit that at a minimum, having clarity of intent and purpose creates intentionality.

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