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PROACTIVE
PRACTICE MANAGEMENT
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“I’m still trying to configure a budget for 2009. I wonder which expenses I should really focus on to create a healthy profit. One of my first thoughts is to consider how to pay staff for attending Continuing Education courses, especially since the Western Regional Dental Convention is coming up. What is your recommendation?” Believe it or not, I
have come across dentists who want to save money by eliminating all C.E.
course benefits for their staff. In my opinion, this is not a wise move
to create more profit. The argument that was brought up by one
particular dentist was that since hygienists have a requirement for a
certain number of C.E. hours to keep their licenses current, the cost
factor should fall on their shoulders. It is their responsibility to
fulfill requirements in order to remain valid practitioners. Sure, it’s true that
employees need to be responsible for keeping licenses current, but what
example does not assisting with C.E. costs set? I feel it shows that
“doing the bare minimum, just to squeak by license requirements is
fine by me.” A better example for all employees is “I believe in
your talents, and I want to make an investment in all of you to not only
better and empower yourselves, but to also benefit our patients.
Attending continuing education courses helps to assure that we
are providing care and service to the best of our abilities.” Team members must be
made aware that continuing education is an important part of career and
practice development. It is also an important investment in time on
their part and resources on the part of the practice. Together, the
employer and team will benefit from C.E. when approached sensibly. All this being said,
there are some tips I can share regarding expectations not only about
C.E. reimbursement, hourly pay for staff to attend, but also
expectations for employees. The
issue regarding pay and travel for continuing education comes up quite a
bit, and since there is no “rule” or industry standard, a dentist or
employer should consider an approach based on what the business can
afford financially and what philosophy the owner has regarding C.E.,
while being fair and reasonable. Once a protocol or policy is formed,
commit it to paper and have each member of the staff acknowledge and
sign off on the policy. Finally, include it as part of the office’s
personnel policy manual. A
general “rule of thumb” to follow is if one requires an employee to
attend a lecture, meeting or training seminar, then expect to pay for
that employee’s time. Situations in which paying for the employee’s
time would be an option are if:
With
this background information, here are a few recommendations. How
much should I compensate my employees for Continuing Education? When
the team is required to participate in continuing education either
during regular working hours or outside the normal schedule and they are
not utilizing their core competencies and not creating revenue,
compensate employees at a Continuing Education, or C.E., rate of 50% of
their regular pay. Each employee will be responsible to note on his/her
time log the hours that are accumulated for C.E., and travel time if
away from the office. If an employee is salaried, the compensation
remains the same, regardless of when the continuing education course is
in session. For
hygienists and employee dentists, I suggest offering to help pay for
courses they need to complete their requirements, but not compensate
them for time spent while at the course. Require pre-approval of the
course, and offer tuition reimbursement for hygienists; say up to $200
annually. Use your own discretion as to how much reimbursement you wish
to make available for employee dentists. Again, this is optional, and is
dependent upon the employer, his or her philosophy, and budget. In
reality, the employer is assisting in keeping employee dentists and
hygienists up to date with CE and licensure compliance, which is
ultimately the responsibility of these professionals, and in turn they
accept the day off without pay. How
should I handle continuing education away from home, especially when
travel is involved? For
continuing education courses where travel outside of the immediate
metropolitan area is necessary, and the course takes place outside the
normal business schedule, consider these guidelines. When
a significant investment in continuing education and travel is made and
the employee’s are reasonable and cooperative, then the employer may
elect to pay course tuition, travel expenses including airfare, ground
transportation to and from the hotel, lodging, any meals sponsored by
the employer, and a $40 per day allowance for supplementary expenses to
each employee, including hygienists. The per-day allowance will also
help cover gas to and from the airport. Under these circumstances, wages
for hours worked will not be paid. The employee will be responsible for travel to and from the airport. If group shuttle arrangements can be made, then encourage employees to car pool to and from either the airport or the course venue. How
would I handle a “Hands On” course when I consider one of my
employees as my patient for the restorative dentistry? On
occasion, doctors have taken employees to courses and provided them with
a significant amount of restorative dentistry; even “Smile Designs”
in some instances. The employee becomes a great spokesperson for
restorative and cosmetic dentistry and patients take well to witnessing
the excellent results from the doctor’s work. Unfortunately, I
witnessed an occurrence where after a short period of time, an employee
decided, “The commute to the office is too far” and quit because she
“found an office closer to home”. <<OUCH>> Without
any prior formal arrangement, the employee is certainly free to go; but
it’s discouraging to know a person would be selfish enough to take
advantage of the generosity of the employer by leaving shortly after
major restorative work was done for free. Strange, the employee had no
qualms making the commute prior to the course (and major restorative
treatment provided) and didn’t mention any concern over travel time to
and from the work place. To
ensure employees stay on board after a significant investment in
continuing education is made, I suggest considering a policy where the
employee agrees to remain employed with the office for a period of one
full year after the course is completed. If the employer terminates the
employee because of a violation of company policy, or the employee
resigns, then the employer may, at his or her sole discretion, require
the employee to reimburse part of or the entire cost of tuition,
lodging, and airfare. Prepare
this policy in clear terms and in writing ahead of time, prior to
leaving for the course. Supplement your employee manual with the new
policy. Make sure employees acknowledge and sign off that they
understand the policy. I’m
not trying to overstate the obvious, but one aspect of the employee’s
job is time spent learning how to improve his/her own performance so
that the business will grow and develop along with the entire team’s
performance. What
if an employee chooses not to participate in a continuing education
“trip” away from home? It
may occur that an employee chooses not to participate in a continuing
education trip away from home. Certainly, family issues, health issues,
or personal reasons may result in the employee choosing not to attend.
In this case, the employee must take time off from work if the course is
during normal working hours. They may choose to use their accrued and
unused paid time off to receive pay, or not work and not be paid. An
alternative is to allow the employee to work in the office, if the
course takes place during the normal work schedule, and receive the
regular rate of pay. However, be precise as to what is required of the
employee, make a list of tasks that must be completed, and require the
employee to be accountable for completing the tasks. A good idea is to
have a briefing of what is to be accomplished prior to leaving, and what
was accomplished on the first business day back from the course. If the
tasks were completed, “Hooray!” Recognize the employee for a job
well done. If the tasks were not completed, discuss this with the
employee and find out why the work was not completed as required. The
privilege to work unsupervised should not be offered to this individual
in the future. I trust my staff to go to courses, be responsible adults and not duck out early while claiming they attended the entire course. Am I being naive? I have to play the
devil’s advocate, and hopefully this does not pertain to any employee
in your office! We all want to believe in staff honesty, but let’s
face it; unless there are stipulations in place to show attendance, time
spent at conferences can be iffy. If the dentist and staff travel to
each event together, there of course is no question, but if the staff
members are off on their own, then steps can be taken to get the most
out of your continuing education dollars. After the convention,
meeting, or C.E. course, require a short presentation from each person
and each course attended. The presentations could be the focus of an
office meeting pre-scheduled the week following the course or
convention. Allow each team member adequate time to present their
portion, say five to ten minutes, and allow time for discussion,
questions and answers. Use the material from the team’s presentations
to initiate new policies or procedures to help better the practice and
apply them as soon as possible. In addition, if it is
expected that the staff circulate among the booths at the convention,
have a “shopping list” for items and require business cards to be
brought back, with names of the representatives at the booths that they
spoke to, even requiring the staff to explain what was unique about each
company and how each company could benefit the practice. Make sure that
the staff understands the importance of company representation at dental
conventions by showing good taste and exercising good manners To sum up, examine
your own practice in regards to continuing education benefits. Consider
your philosophy of practice and how it can be supported with useful C.E.
and what courses would help make your business plan come to fruition.
Consider your financial resources and prepare a budget for how much
money the practice will invest in 2009 and beyond for C.E. Construct
clear policies regarding C.E. and how the team is compensated. If
courses require a significant investment in time and resources, prepare
a policy ahead of time and obtain the acknowledgement of the team, so
there are no surprises. Have a meeting shortly after the course or
convention and put into action recommendations that will help better
your business. Here’s to seeing you
at the 2009 Western Regional Dental Convention!
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