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Robert Elsenpeter is a freelance writer and frequent contributor to Dental Products Report and Digital Esthetics. He is also the author of 18 technology books, including the award-winning Green IT: Reduce Your Information System's Environmental Impact While Adding to the Bottom Line. As such, he’s particularly interested in the technological side of dentistry.
There was a time when the purchase of a new piece of software came with a user’s manual the size of a phone book. Now, both phone books and instruction manuals are all but extinct. Instruction duties have been transferred to trainers, online classrooms and tutorials. Unfortunately many dentists don’t take advantage of training opportunities, which is a big mistake.
“Doctors often buy technology because they heard a dentist in their study club bought it or they were sold something at a trade show or they are trying to beat an expiring tax incentive,” says Dayna Johnson, Dentrix practice management software trainer and dental practice consultant. “What they forget is that it is not the doctor who is vowing to implement this new piece of technology-it’s going to be his team.”
Without proper training, that piece of new technology starts to collect dust.
They buy this amazing piece of equipment or this new technology, and then it sits on the shelf because the team does not have time to train themselves,” Johnson says. “They need to be coached and taught on how to use it.”
Why is training snubbed? Like so many other subjects, money matters.
“Doctors look at things thinking, ‘My profitability is not what it used to be,’” says Practice Management Consultant Virginia Moore. “They’re looking more closely at their dollars. I think it’s dangerous to shortcut or try to gain more profit by cutting out training because there are countless examples of people that you interact with in different businesses who are not fully trained, and what do you end up with? It’s as simple as going to Starbucks, and if you’ve ordered a certain type of drink but the person hasn’t been fully trained and you walk out the door, take a sip and say, ‘My goodness, this is not what I ordered.’”
While there is a cost to training, there is a higher cost for lack of training, Moore observes.
“For example, bonded resins,” she illustrates. “I can’t tell you how many times assistants don’t understand the process behind it. There is a chemical interaction going on, and that’s why the tooth needs to be dry, or the bonding materials will not do their job.
"So if you have somebody who is just doing a task on the other side of the chair, you’re going to end up wondering, ‘Why are my composites failing?’ Because the tooth wasn’t dry enough. Or, ‘How many drops do I put on this?’ and the assistant doesn’t understand that every drop out of that little container is $20.”
But not wanting to spend money isn’t the only obstacle. Simply not realizing the benefit to be had from training is also an issue.
“Unless you do it, it’s really hard to realize how much you don’t know,” says Dr. John Flucke, DDS, technology editor for Dental Products Report. “A lot of doctors don’t do regular training just because they just don’t know the benefit they’d realize.”
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An issue for the whole practice
Lack of training is a pervasive issue. It happens not only in software implementations but also throughout the office.
“I see it in all aspects of the practice, whether it’s purchasing, utilizing equipment, technology, how to answer the telephone, how to conduct a payment arrangement, you name it,” Moore says. “I think one of the reasons training is overlooked is that the doctors are thinking, ‘I don’t have time for this.’ Their focus is on doing the dentistry.”
Software is especially susceptible to underuse.
“I see dentists jumping to a new product because the product that they’re using doesn’t do what they want it to do,” Johnson says. “For example, practice management software. I see doctors jumping off their current software to purchase new software because they think that this software is going to be better, when all they probably really need is some training on their current software.
"Dentists say, ‘I’m going to switch my software,’ and I’ve always said, ‘Give me 10 minutes of your time and tell me what’s frustrating about your software, and I bet that I can turn you around.’ They usually just need a little bit of training. Usually if they get a trainer in there for just half a day that will probably solve 99 percent of their current issues with the software.”
Regular fine tuning
Dr. Flucke conducts regular, yearly training sessions with his team. He started the practice in the early 2000s when he heard about how the features of Microsoft Office were underutilized.
“When Microsoft came out with a new version of Office, they watched people work with it, and what they found was the average user only knew 20 percent of the features,” Dr. Flucke says. “I thought, ‘If the average user only knows one-fifth of Office, how much are we missing of the software that we use?”
Having a trainer come in and go over the practice management software with him and his team proved to be a wise move.
“We learned a lot of shortcuts and a lot of things that sped things up or increased our efficiency,” he says.
Dr. Flucke polls his staff every year about the topics they want to retrain on, and it can be anything from a software package to a piece of equipment or patient relations.
“All these companies have trainers, so we just pick something as a group and retrain on it,” Dr. Flucke says. “It’s amazing when you do that. We’ll spend one afternoon with a trainer, and when you spend five hours with the trainer, you pick up a bunch.”
The composition of your team also tends to be dynamic, and after a year or two, it is likely that there will be new faces that don’t know how to use that equipment.
“One of the big issues that doctors don’t stop to think about is when there’s a change in staffing,” Moore says. “‘Of my six staff members who originally went through the training, I now have two that didn’t.’ The evolution of that is you can end up with one person out of six who really knows the ins and outs of the software, and the other five are making it happen, but they’re kind of hanging on by the skin of their teeth.”
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The necessity of regular training
New hardware or software purchases are more apt to get initial training, but more frequent training can fall by the wayside. In some practices, training sessions occur even more than once a year. For instance, Moore suggests quarterly training to her clients.
“One quarter will be making sure we’re up to date with OSHA and HIPAA compliance,” Moore says. “Another quarter will be, ‘Let’s go over our technology. Is it the CEREC machine or the intraoral camera?’ Another quarter will be, ‘Let’s have a training emphasis on our verbal skills.’ The other quarterly component would be our software, and that’s huge because I’ve never seen any dental practice use even 90 percent of the ability of the software.”
Moore says the initial sell on quarterly training can be tough, but once doctors see it in action, they tend to see the value in it.
“When I first mention it, I get a look like they just bit into a lemon,” Moore says. “But the approach I use is to show ROI, and I can use examples from client situations to say, ‘This is the cost; this is the expense to you of not having the training.’ So if a training has X expense, then your return on investment obviously has to be greater than that, and here’s how that’s going to happen.”
It isn’t just hardware and software that are moving targets.
Regulatory issues are also constantly changing and in need of continuing education.
“If your team isn’t updated on the new HIPAA regulations, then they could potentially be audited and in the dark about a rule they should’ve known about a year ago,” Johnson says. “Same thing with OSHA training. Offices are required to do OSHA training once a year because they have to keep up with the new rules and regulations.”
Doctors are highly trained on the treatment side of their practices but not as much on the business side. That can be another source of disconnect for the value of training.
“They might not understand that if someone sits at the front desk and it takes them a half hour to do the task, but if I can spend $100 or even $1,000, and they can do that task in five minutes, suddenly my cost of labor changes with more productivity,” Dr. Flucke says.
Doctors may also balk at training because they think the office has to close down for a few days, but there are other options.
“With all the trainings you should be doing–OSHA, HIPAA, hardware training–the doctor thinks, ‘Oh, I have to shut my office down. I have to send my team out of state to this course,’ and that’s not the case,” Johnson says. “What the team and the doctors really need to look for is, ‘What kind of training can I do online during my regular course of business?’”
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There are many options for online training, including materials produced by manufacturers or even courses that are customized to an individual audience via a remotely located trainer.
“They should look for some kind of training that can be customized specifically to their office,” Johnson says. “If you look at a YouTube video, it’s going to be pretty generic. It’s going to be a broad-based kind of video. When I do my training online, I am one-on-one with the office. I can have up to 25 people in my classroom at a time, so my training is geared specifically toward that office.
"Every office is unique, and every office has different ways of customizing its software for the way their patients flow through. You want to be able to have a question-and-answer session. It can be really cost-effective to train that way.”
For Dr. Flucke, the best training is still in-person.
“The best bang for the buck is having a human being here,” Dr. Flucke says. “I’m also lucky that we have a conference room here, so I have a classroom built into my building, but for a lot of offices, space might be an issue. But you can certainly reserve a conference room at a local hotel.”
Get the training you need
It may not be abundantly obvious that you and your staff need additional training, but there are red flags to be aware of.
“If the doctor is asking the front office team for a report, or ‘Can we go over last year’s numbers?’, and the team can’t pull those numbers out of the software, that’s a big sign because almost any practice management software can pull the numbers on almost every report you need,” Johnson says. “Another indicator is if that intraoral camera is sitting in the corner collecting dust and your insurance companies are requesting images, someone needs to learn how to use that intraoral camera.”
Trainers can also help smooth out inefficiencies, making the practice more productive and effective.
“If the team is requesting additional time for appointments because it’s taking them longer to take X-rays or images, or implement something, I would get a trainer in there because usually a trainer can help with those inefficiencies,” Johnson says.
But if the big obstacle to getting regular training is money, spending a few dollars up front can save much more in the long run.
“When the doctor says to me, ‘I can’t afford the training,’ my answer is, ‘You can’t afford not to because you will see a greater cost when people are not efficient in what they do,’” Moore says.