Laboratories often experience the same problems on a daily basis, but rather than grumble about them, Mike Hill, President of 6-11 Dental Studio, Inc., Lake Forest, CA, decided to take a humorous approach. He started sketching cartoons related to real-world laboratory situations and writing commentary to explain how he handles the problem. Barry D. The Lab Guy was born.
What started as a fun way to express his frustrations has become his passion as well as a teaching tool for his technicians. Hill draws the rough sketches and has an illustrator create the final artwork.
LMT will be featuring Barry D. The Lab Guy in upcoming issues; here's the first in Hill's series.
We commonly receive two or more impressions for the same restoration; I'm amazed by this. The doctor may think he is being more diligent by sending us the extra impressions but in actuality, he's simply passing the liability of a remake to our laboratory.
These cases are fraught with uncertainty and we rely heavily upon our experience and expertise when selecting which impression/model to work from. But the fact is that uncertainty dramatically increases the likelihood of a remake and guessing is no way to run a business.
Recently, I was speaking with a local doctor who uses a CEREC machine in his practice. He told me that if he has a difficult case with a challenging margin he will "snap an impression and send it to his lab." He further explained, "My lab doesn't charge for remakes so it's easier for me to send problem cases out than to do battle with them in the chair." Now I realize that not all doctors act in this manner but I'm pragmatic as well; given the opportunity, some doctors will try to push the liability of a difficult case down the road.
Nobody wins when there are remakes and at our lab we use a three-step protocol to minimize the risk of shouldering their financial burden:
1. First we IDENTIFY high-risk cases as part of our daily quality control procedure. We rate each case on a scale of 1 to 10: for example, a case that's high risk for a remake receives a rating of 1 to 5 while a well-prepped case receives an 8 to 10. Because the ratings involve a high degree of subjectivity, one person--our production manager--is the one making the determination. Cases with a rating below 7 are considered high risk and set aside rather than put into production.
2. We COMMUNICATE the challenges of all high risk cases to the doctor. We very clearly state the case, day we received it, tooth number, prescribed restoration, problem and risks we see with proceeding as is. If the case comes back, we want to make sure we were crystal clear about our concerns.
3. Most importantly, we always DOCUMENT this communication. When we speak to a doctor on the phone, it's standard operating policy to make notes about the conversation afterwards. However, it's far more effective and better protection when we have the doctor's response in writing; we use email, text messaging or the type chat feature in Skype. This ensures everyone is on the same page and creates a written record that we always include with the invoice. If a dispute comes up later on, we make a quick phone call to the doctor reminding him of the challenges we discussed and documented.
In short, our approach is, "if we have to do a remake, let's make sure we get paid for it" and this system has dramatically reduced the financial cost of our remakes. We aren't perfect and of course when we make mistakes, we cover the cost completely. But we don't want to have to cover the costs of our clients' mistakes as well.
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