Resist Your Growing Admin Payroll, Fix This First

We break down why a “slammed” front desk is often a symptom of broken systems, not true patient volume. We show how tighter first conversations, better phone control, and clearer financial expectations eliminate repeat work and reduce burnout.
• redundant admin work as the hidden killer of efficiency
• cancellations as an upstream conversation problem that creates multiple downstream tasks
• phone training as the difference between long meandering calls and confident appointment closes
• clear financial presentations to prevent repeated questions and follow-up work
• a leadership mindset shift from hiring to system precision
• a baseline staffing metric of collections per full-time front desk team member
• collecting the full patient portion at scheduling to reduce no-shows and friction
• homework question for the team to identify repeat tasks and remove them at the source

So if that's something that interests you, please reach out to us, set up a strategy call. Let's talk about it.
And if you like what you hear, please give a five star review on Apple for the podcast.

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Transcript

The Real Cause Of Front Desk Chaos

Paul Etchison 0:01

Okay, doctor, let me ask you a question. If you were to walk up to your front desk right now and ask, how is it going? Most of them will likely say something like, We're slammed. It's crazy. The phones won't stop today. And you, as the owner, might think, maybe I need to hire another person up here. But here's the question I want you to ask yourself instead. Are they overwhelmed because of true volume or because of redundancy? And that's what we're going to dissect today. Is your front desk overwhelmed and busy because of the volume of patients coming to your office, or is it something systematic? I think the answer will surprise you. Now you're listening to the Dental Practice Heroes Podcast, the podcast for practice owners who want to work fewer clinical days, increase profits, and build a team-driven practice that runs without them. I'm your host, Dr. Paul Etchison. I'm a dental coach, author of two books on dental practice management, and the owner of a multi-doctor practice in the south suburbs of Chicago. And today we are going to be talking about one of the biggest hidden killers of efficiency in your practice, redundant work by your admin team. Now let's talk about the real problem here. Most front desk burnout, in my opinion, is not from too much work. It is from doing the same work multiple times. And most of that redundancy is coming from weak systems, weak conversations that we're having, very weak phone skills, and more or less from you as the practice owner, a lack of training that you're providing for your team. If we handled a lot of things at the front desk correctly the first time, we wouldn't be redoing it all week long. So first, I want to talk about cancellations and what they really do to your practice. When we look at a cancellation in our schedule, we see that as a hole, right? It's just a place in the doctor's schedule or the hygienist schedule that they were supposed to see a patient and now they're not. But let's look a little bit more upstream about that because the fact of the matter is it's one week confirmation conversation that will create that hole. And once we have that hole, we've now got to scramble to fill it. We got to answer the call from the patient who canceled. We got to call people to see if we can fill that hole. We have to reschedule that patient that canceled. We have to reconfirm that patient that now canceled. It's a huge reshuffle. So it's really like one week conversation about your cancellation policy that should have been happening when the appointment was made creates four or five additional tasks. Now, multiply that by 10 to 15% of your schedule. And you see how you can possibly not have a staffing problem, but you have a more of a precision problem that you're not precisely attacking the problem where it should be attacked. Let me give you another example. Phone skills. Now, there's so many offices I work with, they have never provided phone training to the front desk. And even if they did provide it, they're not monitoring it, they're not coaching on it, they just did it one time and they forget about it. And then they start listening to phone calls and they say, Dear Lord, what is going on at this office? Nobody knows what they're doing. So if your front desk team hasn't really been properly trained on the phones into how to control the calls, how to ask the direct questions, how to close appointments confidently, setting the financial expectations and redirecting conversations when they get off the rails, you are going to have them spending a lot of time on the phone. And this is what we provide for our clients. This is the kind of stuff that we walk you through when you become a coaching client of ours. So if that's something that interests you, please reach out to us, dentalpracticeherous.com/slash strategy, set up a strategy call. Let's talk about it. So without the front desk phone training, the calls become long. There's a lot of meandering, there's no structure. And if you listen to the phone calls, you will hear this. You will hear calls that last 12, 15 minutes. Why? Because they don't know how to land the damn plane. They're up in the air and they can't bring it down for a landing. Someone might call and ask about pricing, and it turns into a vague answer that may or may not turn into a new patient appointment. It may result in a follow-up call, something they need to find out and get back to them. It might result in them having to call the insurance company again to ask for a very specific question because the insurance wasn't verified properly in the first place. It might require another follow-up, maybe no appointment at all, and there's nothing to show for all this time that we put into it. And the thing is, is if we would have handled it cleanly and confidently the first time, it would have been one call, a booked appointment, done. So training in these areas reduces the repetition that can come from not having the proper skills. Let's talk about the financial conversations that are happening at your office, because this one is huge. If your treatment isn't clearly presented with clear fees, clear payment expectations, and clear next steps, then the patient might go home. They might go think about it. They might call you back and ask more questions. They're gonna hesitate. They might need to talk about their insurance again, even though you've already presented it one time. They might need the treatment plan explained again, even though you've already presented it one time. Now you've touched this case three or four times when you should have just touched it once. So every unclear financial conversation becomes more and more follow-up work. And follow-up work, it compounds on itself. And this is what we see in offices with really weak front desk systems. All these incomplete systems turn all of the front desk stuff that they do. It turns them into a repair department. And nobody wants to be part of that department. Because if the insurance isn't fully verified, if notes aren't detailed and we've got to go asking people, if expectations aren't even set at all, then your front desk becomes the people that are constantly having to fix these misunderstandings with the patients. They're fixing insurance confusion that doesn't need to be there. They're constantly talking about balance disputes, like the patient didn't think they had to pay this. Or we told the patient they were supposed to pay this, but then after the insurance claim closed, it was wrong. Now I have one coaching client where their solution to that problem was let's send a pre-authorization for everything. Now, even more additional work when you can just estimate it correctly the first time. We're gonna send the patient home, we're gonna send a pre-auth, we're gonna wait for the pre-auth to come back, we're gonna enter it into our system, we're gonna reach out to the patient and plain phone tag, and then we're gonna schedule them. Then we're gonna try to take a payment. Oh my dear lord, this is all this extra work. Let's just make sure everything's tight. Our systems are working and everybody is doing what they're supposed to be doing so we can do it once and be done with it. It's not a work harder issue, it's more of a let's do it right the first time issue. So here is the leadership shift that I want you to experience. I want you to have this mindset shift in the way that you look at all the things that happen in your admin department. When you see a busy front desk, when you start thinking we need more people, well, sometimes you do, okay? But most of the time, I don't see it. And if you're looking for like some kind of baseline metric for how many front desk team members you should have, approximately$670,000 to$700,000 in collections per full-time front desk team member. That will get you baseline right in the right spot. That is with them doing everything from verification to putting in the payments. You're not outsourcing a damn thing. So I want you to look at your front desk team and say, do they need better scripts? Do they need better training? Do they need some better systems, maybe some clearer standards? Because when you can create that precision, that's gonna reduce the chaos. But even more so, it's gonna reduce the amount of busy work that they have to do. And if you had to pick one, like what is one thing that will make one of the hugest differences for you? Is collecting the full entire patient portion when you schedule the appointment. Because think about that. You collect the whole patient portion when you schedule it, that patient's gonna show up. So you're not gonna have to reschedule them. They've already got the financial stuff out of their head. So they're not gonna ask any more questions about their treatment plan. They're not gonna ask any more questions about what the coverage is, what the out of pocket is. It's all over. So by collecting that 100% of that portion, it makes it done. You're done with it one time and done. So here's your homework. I want you to ask your team, what are we doing multiple times that we should only be doing once? And I think you need to kind of prompt the things that I've talked about in this episode because really a lot of people don't see it that way. They just think we're overwhelmed, we're understaffed, and they don't realize all the redundant work that they're doing. So are they re-explaining fees? Are they re-verifying insurance? Are they calling people back repeatedly, communicating with patients repeatedly when you don't need to? Are they reconfirming patients who should have been firm or rescheduling people and then trying to fill the schedule because our systems for cancellations aren't in place? What would we need to do right the first time so that these other steps become unnecessary? And that is where your breakthrough will live. So, in closing, your front desk isn't burnt out because dentistry's hard. They are burnt out because repetition is exhausting. Fix the first conversation, fix the first phone call, tighten the systems, and you can reduce the stress without hiring another body. Because most of the time, it is not too much work. It's the same work over and over again. And when you put another body into the mix, the work just expands to fill that up. It is a never-ending cycle that could go on for infinity. I truly believe if we had 30 people working at our front desk, there would still be too much work to do if you don't fix the systems. And if you're looking for help with all of the systems of your practice or getting yourself down to fewer clinical days so that you can have more time spending on the business or more time spending with your family, please reach out to us at dentalpracticeheroes.com/slash strategy. I will personally have a strategy call with you. It is free. There is no pressure. I want you to leave that call with clarity. And if I think dental practice heroes can help you, I will share with you what that looks like. If I don't think we can help you, I will share that as well and at least give you some tips for moving forward. And if you like what you hear, please give a five star review on Apple for the podcast. It means the world to me and it helps more people find this resource. Thank you so much for listening. Have a great week at work, and we will talk to you next time.