Causes of Scheduling Stress: Part 2

Article continued from Spring 2010 Issue


There is NO WAY that a doctor can be in two rooms at once! That seems like a silly thing to say, I know, but in thousands of practices across the world, we find that type of scheduling problem to be common. Instead of allowing a scheduling overlap, keep the dentist(s) moving smoothly and carefully from room to room with clear allotments of when they’re to be where. The doctor is given the desired amount of time for each aspect of each procedure. Thus, he or she is able to sit down, concentrate on that procedure, get it done and then move on when the clinical assistant takes over.


Each state has its own unique rules, regulations, and laws determining which aspects of a procedure can be performed by the clinical assistant. Abide by those guidelines at all times. Study your own state guidelines and see what can be delegated. Then do so!

Steps for proper delegation are as follows:

  • Determine assignable steps of each procedure using the Procedure Analysis Sheets.
  • During patient time, explain what and why you’re doing each step. Demonstrate what you want the assistant to do, and explain why. (Caution: At the chair, be aware of your verbal skills. Be kind and diplomatic, and not too technical.)
  • Spend non-patient time in hands-on training.
  • Next, spend time at the chair with the patients. Have the assistant perform the new task while the doctor carefully guides. (Tell the patient what you’re doing, and ask permission to teach during the appointment. They’ll know how carefully everything is being done and will appreciate your special attention.)
  • Then, let go. Let the assistant take over when appropriate. (This may be the most difficult of all steps!) Note: Once you have delegated, trained, and let go, change the necessary steps on your procedure analysis sheets. Your scheduling coordinator must know when both the doctor and assistant are occupied in order to “interface” properly.
  • Evaluate on a regular basis to make sure things are going smoothly. Clinical assistants want to do all that they can legally do! Given more responsibility, they will stay in the profession longer and will enjoy their work even more.

Feedback is essential. Don’t assume that they know they’re doing a good job. Tell them. In addition, if you want something done differently, share that also. They want to know. How can they improve if they don’t know there is a problem?


The schedule must be specifically detailed such as the following.

  • Name: John Jones
  • Specific Procedure: Crn Prep #14
  • Telephone #: 369-2501
  • Fee: (0495)

With this information in the schedule and on the posted schedules, the clinical assistant can have the room properly prepared before the doctor arrives. In this manner, both can sit down, concentrate, and not be disturbed by getting up to get something.

In some instances, the particular material needs to be identified to prevent inaccurate tray/room setup. (i.e., Amalgam or composite)

This detailing serves everyone on the team. 1.) The clinical assistant can be prepared. 2.) The scheduling coordinator can schedule for the daily production goal. 3.) She can confirm easily. 4.) She can answer patient questions about what’s going to be done should this re-information be necessary at the time of the confirmation. (5) The doctor knows what he/she is going to be doing on each patient before entering the treatment room.


Your paperwork and/or all electronic files should be so carefully constructed that your business team never have to ask questions like the following of you and your clinical team:

  • “What did you do today?”
  • “How much was it?”
  • “What do you want to do next time?”
  • “How long do you need?”
  • “How much time do you need between appointments?”

If you are asking these questions and if there are constant interruptions, study your paperwork and the flow of your patient dismissal. It may need to be redesigned. Your business administrator should not have to leave the patient during dismissal to come back to ask questions of the clinical team.


Personal telephone calls need to be handled before work, at lunchtime or at the end of the day. Facebook updates, Tweets, mobile phone texts, and other easily accessible distractions need to be clearly understood as unacceptable interruptions to the workflow of each day.

Good old-fashioned phone calls can be screened carefully and diplomatically. Place the completed messages on a message board or in assigned message baskets. Make sure the person receives their message. The doctor can let it be known for whom he/she can be called to the phone. There will be some exceptions, but these need to be identified.

If your doctor receives many calls during the day, he/she may find it more time-efficient to schedule half an hour each day for management; perhaps the 30 minutes after lunch. People can be informed that the doctor takes or returns calls at that time.

Come up with a basic expectation for the rest of modern communication so everyone is clear on what is and isn’t acceptable and how to help one another be successful and on schedule.

Some practices have had great success by requiring all mobile phones to be checked in at a central location when they’re on duty. That way everyone can check messages and respond on breaks, but isn’t tempted during work time. It also makes it easier for their friends and family to get out of the habit of contacting them during the work day. Many practices have also locked out Web sites that cause inefficiencies (like Facebook and Twitter), whereas others have set a computer up that’s not connected to the main server (for extra virus protection) and allotted certain break times when such sites are a commonplace favorite stop for team members. This also allows team members to make updates to a practice-associated page, which becomes a valuable marketing tool. Work together to discuss different options and then make a decision about what’s best for the practice.


Knowing your patients on a personal level and knowing special things about them is important for practice/relationship building. However, when discussions of non-dental issues have a detrimental effect on the schedule, this can have a negative impact on other patients. Someone eventually loses. Therefore, do an appropriate amount of “personalizing,” and then be about the business of talking about or performing the dentistry. That’s why everyone is there. Focusing on the business at hand is called “compartmentalization.” They expect to see you as a professional so while friendliness is a plus, you’re most respected as a healthcare provider and not just a buddy. This focus will keep you on course, streamline your time management and enhance your patient relationships.


I have identified ten reasons for poor scheduling or for running behind schedule, a major source of stress for many practices. I have suggested a few solutions for those ten problems and look forward to speaking with you more on the November 9th webinar “Scheduling for Productivity, Profitability and Stress Control”. Dentrix customers, register now by clicking here: Not a Dentrix customer yet? Visit now.

Cathy Jameson is founder and CEO of Jameson Management, Inc., an international in-office consulting firm helping improve dental practices. For more information, call 877.369.5558.