Why Facilitators are Key Practice Producers Sandy Roth ProSynergy Dental Communications

Two questions have come up as I have visited with several new clients in their practices. One is almost always on my mind. The other is rarely on my mind. See if you can guess which is which.

As it turns out, the answer to both questions is the same: a facilitator.

Most practices are still organized around a structure that divides staff between the “front” and the “back.” (Note: I put certain words in quotation marks when they reflect current, yet what I consider outmoded thinking.) The “front staff,” as they are generally labeled, is responsible for a seemingly endless and equally wide array of tasks:

• greeting patients as they enter either on foot or over the phone

• engaging in social interactions with patients either upon entry or at departure

• all things related to the schedule including making appointments as well as confirming and “filling holes”

• exercising the Wisdom of Solomon in determining where to put “emergencies”

• making financial arrangements and collecting overdue account balances

• collecting fees "over the counter"

• processing insurance submissions and follow-up

• billing and responding to patients billing inquiries

• data entry, reports, day sheets, deposits, filing, computer management, handling patient complaints

• and on and on and on. 
  

On the other hand, the clinical staff is responsible for seeing that:

• the practice’s clinical procedures flow smoothly

• patients are treated promptly and well

•  instruments are clean and ready

• the facility is managed within appropriate OSHA guidelines

• the dentist is supported properly in delivering care

• supplies are ordered and stocked

• equipment is maintained

• and on and on and on.
  

Without question, there are many tasks to be done in a dental office. Historically, employees and their work have been organized primarily around the tasks that appear to be all-important in making the practice work. While these tasks are very important, the emphasis on performing routine tasks begins to block the view. The trees loom large and the beauty of the forest is lost.

I see the implications of this in every practice I visit. Patients and their issues simply get in the way of the daily work. I think one of the reasons is that while many tasks and jobs are considered absolutely essential to the functioning of the dental practice, facilitation has not yet been given that distinction. It takes a back seat to the more routine obligations of running the business, managing the systems, moving the papers and instruments and maintaining the physical plant.

Typically, I see a group of employees that fall into the following categories: front desk, assistant, and hygienist. When the practice grows or gets busy, additional staff is added. Most often, an additional assistant or front desk person is brought on board. Usually, the front desk staff is divided into two roles: those who schedule and those who make financial arrangements. Sometimes there is a “floater” in the back to handle instruments, clean up or help when things get busy or there is a hygiene assistant to review medical history, take blood pressure and x-rays, chart and turn the room. Sometimes in larger practices there is an office manager or an insurance clerk.

But I have never made a first visit to a practice to discover a person dedicated to patient facilitation in the way an assistant is primarily dedicated to assisting or a hygienist is primarily dedicated to providing hygiene services.

In most cases, facilitation or patient care coordination (or whatever it may be called) is blended with other jobs and not singled out as an area of primary focus for anyone. When blended, it almost always gets second-string status. The assisting comes first; facilitation when there is time. Hygiene and OHI come first; facilitation if the next patient is late. Filling the schedule, confirming appointments, opening the mail, entering the payments and filing come first; facilitation only if the day’s tasks are complete (When are they ever complete?)

Why is this the case? Because adding a facilitator increases the staff size, realigns working assignments of existing staff, perhaps but not always raises the payroll, requires a private physical location, changes the systems, refocuses the energy and requires new skills and different strategies. And while this sounds like a lot, there is an enormous amount to be gained. If nothing else, I put it to you that a facilitator is a significant producer for your practice. That’s right...producer.

While a dentist and hygienist (and in some states an assistant) may actually perform the dental procedures for which a fee is charged, the facilitator is primarily responsible for what happens prior to the patient being seated in the chair for dental care. While many patients get there on their own, facilitators ensure that more people get there sooner for more complete and better care. This is a major advantage to every practice whether it is out-of-control busy or slow. I would go so far as to suggest that for most practices this position is as essential as any other, not just a nicety to be added when all the other things are working well. There are very few practices where an effective facilitator would not directly have a positive impact on the amount of dental care selected, the timing of that care, the way accounts are handled and the promptness of payments, the likelihood that patients would actually show up for appointments they made, and ensuring that opportunities are not missed or delayed.

A facilitator spends her (or his) day focusing not on paper, instruments, the schedule, charts, documents or insurance, but rather on the patients who are coming to, are present or have been in the practice for care. The facilitator is always asking important questions that ensure that patients are really heard, understood, related to, and responded to. The facilitator is responsible for creating a safe environment in the practice so that patients will tell you the truth rather than withhold important information or feel forced into dishonesty. While the facilitator may have a private office and a desk, she (or he) doesn’t have a chair affixed to the floor - that is, she roams around listening, checking in, observing, reviewing, and strategizing.

Contact me if you would like to know more about this role and what it could mean for your practice. If you have someone on staff that is behaviorally gifted and you would like to dedicate more of her (or his) time to the role of facilitation, we are forming a new Facilitator Study Club.