Whether it starts with a vague prescription, inadequate impression or wrong shade, add in some poor communication and you've got the formula for a remake. Remakes hurt your laboratory by cutting into the time you could be producing new work and eroding your relationships with dentist-clients. And, if you don't charge for your remakes or at least factor in the cost of remakes in some way, your laboratory's bottom line could suffer.
First and foremost in your quest to reduce remakes is to have an established policy on how you are going to handle remakes and clearly communicate that policy to your dentist-clients. "It's important to spell it out because if your account knows the rules up front, there's less likely to be a problem," says Robert Czerwinski, owner of 33-employee Accudent Dental Laboratories in Lansing, Illinois, who posts his remake policy on his website, along with other client information.
Also, share your laboratory's policy with your staff so that all employees are communicating a consistent message to your dentist-clients. Like any policy, there may be exceptions to the rule (i.e., new accounts, blatant fault), however, by setting either a standard or basic guidelines, you will be better prepared to handle a remake when it occurs.
Monitoring remakes per account helps you determine how much remakes cost and enable you to address a dentist-client with a growing remake factor before it gets out of hand. "We keep monthly and yearly date checks on remakes for all of our doctors and we also keep track of whether the problem was created in the lab or in the office," says Czerwinski.
After implementing a tracking system, Czerwinski decided to charge clients for remakes if they exceeded a 5% remake percentage. Once they hit the 5% mark, Czerwinski sends a letter to the dentist reiterating the laboratory's remake policy and asking him to call if he is interested in resolving the problem, otherwise he will be charged for all subsequent remakes. If the doctor doesn't call, the next time he has a case that has to be remade, he is charged.
Likewise, when Joey Breaux, owner of Breaux Dental Laboratory Services in Beaumont, Texas brought in a few big clients who often sent vague prescriptions, his remake percentage jumped from .8% to 2.1% in three years. His solution: charge only the clients who he feels have an unacceptable remake percentage of over 5%. Once Breaux began charging one of the accounts with a 6.5% remake factor for all remakes that were determined not to be caused by the lab, the client's percentage dropped down to 3.3%. "If the doctor says, 'but this laboratory will do it for free,' I'll say, 'ok, go to that lab.' That lab owner will go home at night with headaches; I'll go home on time."
Another option is to charge 50% for remakes—unless the laboratory is at fault— as does David Andrus, CDT, Diamond Dental Studio, Arvada, CO. "By allowing the dentist and technician to find the cause of the remake, we avoid the who-done-it scenario," says Andrus, who feels this policy helps turn a short-term loss into a long-term win. Andrus' annual remake percentage is 2%.
Other laboratory owners, like Jim Gorgol, CDT, president of Distinctive Dental Studio in Naperville, IL, choose to factor the costs of remakes into their prices instead of charging for remakes. The laboratory adjusts its fees annually and allows for a 5% remake factor, while also offering its clients a five-year unconditional warranty on every restoration it fabricates.
Your laboratory may choose to evaluate each remake on a case-by-case basis and charge accordingly. Russell Lederman, owner of Technical Arts Dental Studio in Berlin, Maryland, doesn't have a written remake policy, but insists on determining the source of a remake when it occurs. "I have worked in other labs with a 'no ask, no tell' policy and did a ridiculous amount of free work," says Lederman. "Now, I insist that we discuss and uncover the cause of a remake as part of our partnership." Lederman reports that his laboratory's remake percentage has been reduced to below 2% by following this policy.
Tackling inadequate impressions
Are inadequate impressions your number one cause of remakes? If they are, you're not alone. Sixty percent of laboratories surveyed by LMT cite inadequate impressions as one of the most common problems with their dentist-clients' work.
The cause of this frustrating statistic can be related to several different factors, including inadequate dental school training, untrained office staff or simply not reading the manufacturer's instructions. And, believe it or not, many laboratory owners say a large percentage of their dentist-clients have no idea that their remakes are the result of poor impression-taking techniques. This is an ideal opportunity to take a lead role in both communication and education.
"Doctors are very aggressive in telling the laboratory what they want. In the past it hasn't been the norm for a lab to do the same," says Duane Baluke, co-owner of 50-employee Baluke Dental Studios in Richmond Hill, Ontario. Above all else, be diplomatic when you contact your dentist-client after receiving a bad impression. Instead of "we have a problem" try "we need your help." By taking a team approach rather than an accusatory one, your dentist-client may be more receptive to working together to resolve the problem.
If your client tells you to proceed with the case without any adjustments, record the date and time of your conversation. If a remake does result, you have a documented reason for charging him for the extra work.
Also, get tips from another client who consistently takes good impressions. Find out what his techniques are and pass the information along to your not-so-successful dentist-client. In addition to providing your account with some good advice, this gives you the opportunity to pay a compliment to another client.
If poor impressions keep recurring, try to arrange a time to visit the dentist's office. Observing his impression-taking techniques gives you the opportunity to spot problems that may be very easy to correct. Czerwinski, who often visits clients' offices to resolve remake issues, finds that a major impression-taking flaw is simply not keeping the material completely still after taking the impression. Other clients hand the impression material to a staff member who is not properly trained in handling impressions. "Some assistants do one thing with the left hand while holding the impression in their right," says Czerwinski. "When we go out to the offices, about 90% of the problems are solved."
If you or your client are not comfortable with you observing his techniques, arrange for a sales representative from the client's impression material company to make the visit for you.
Here are some other areas to consider that may help prevent remakes before they occur:
Evaluate your Rx. Do your dentist-clients send in hopelessly vague prescriptions? Take a look at your prescription form. Is there a way to capture more information from your clients? For example, Gary Box, owner of a one-man laboratory in Richardson, Texas has found that by including specific questions like "does a porcelain shoulder need to be added?" he can avoid numerous problems from the very start. By asking more specific questions with simple yes or no or check-off boxes, you may be able to cut back on clarifying phone calls.
Continuing education. By maximizing your own technical knowledge through technical courses and clinics, you can train yourself to spot potential problems—an inadequate impression for example—before they become remakes. "We have to be educated enough to know what is good work and what is bad work," says Box, who regularly attends continuing education courses. "Attend some of the same courses that your doctors attend. Be knowledgeable of some of the same challenges the clinician faces in order to troubleshoot and communicate effectively toward a resolution." These types of courses can be especially valuable for a newer technician with little experience.
Host a seminar for your dentist-clients and their staff. For example, Baluke holds seminars on impression-taking and impression-reading techniques twice a year for his 250 clients and their staffs at his laboratory. The strategy seems to be working: the laboratory's remake percentage is usually under 1% a year, reports Baluke.
When remakes occur
Despite your best efforts to prevent remakes, they will undoubtedly occur. When they do:
Admit fault. If your laboratory made the mistake, fess up. When Czerwinski's laboratory is at fault, not only does it do the remake for free, it encloses a coupon for a free crown and a note apologizing for its error. "Doing this lets the doctor know he is important to the success of our lab and that we stand behind all of our work," says Czerwinski. "We look at it as a customer-service opportunity."
Arrange a meeting with your client. Face-to-face meetings are ideal because voice inflections can sometimes be misunderstood over the phone. Offer to take the doctor out to lunch to discuss what you both can do to resolve the problems. In the meeting, rather than stress how remakes are affecting your laboratory, focus on how they impact the dental practice. "When I meet with my clients, I concentrate on how remakes cause a loss of chairtime with other patients and can ultimately damage the doctor's reputation," says Lederman. Also, if your doctor delegates writing the prescription and that seems to be the source of your problems, include that staff member in the meeting as well.
If you repeatedly try to resolve inadequate impression-taking technique or other remake issues with no help on your client's part, determine whether or not that client is worth keeping. Maybe the time has come to send the remake artist somewhere else.