The Tale of Discount Dental

At work we offer two dental plans. The first one is the plan you hear jaunty radio ads for; the name-brand plan. Nearly all of our employees choose it. The second plan is the discount, HMO-type dental plan that yeah, we offer, but very few employees select. The second plan has a bad reputation.

A representative from the second plan visited our office for the first time last week. She was nice, knowledgeable, and clearly on an image-repair mission. She told us her organization had recently reviewed and improved every aspect of its operations.

The #1 objection to the discount plan I had heard was that patients had to wait a ridiculously long time to get an appointment. The rep said the organization’s leaders had heard that too and couldn’t figure out why it was. The number of patients per clinic or scheduled appointments per week didn’t support this claim, yet they heard it time and again.

A close look at the operations of their centralized appointment center explained it: long ago, the dental providers had instructed the appointment setters to schedule only one type of appointment each day. Monday would be set aside for hygiene appointments, Tuesday for fillings, etc. This established a stable routine for the dental clinics which the providers enjoyed, and it probably worked fine when the business was new.

An unknown number of years later, however, this practice meant that if you were a patient of Dr. Smith’s who needed a crown, and Dr. Smith also had 10 other patients who needed crowns, and Dr. Smith only did crowns on Thursdays, well . . . how does five Thursdays from now sound?

So — in what had to have been an enormous cultural change — the top brass blew the old appointment-setting system up. All dental providers now provide all services on any day of the week. The rep beamed at us as she finished this tale, saying, “You can get an appointment the same week you call! We even have same-day appointments!”

How many years did Discount Dental shake its collective head as patients walked out the door and annual enrollments declined? How many years did clinic staff say, when leadership asked, “I don’t know why people think they can’t get an appointment – why, we had three openings this week!”

 How long did it take before someone with the power to change it thought to ask how the appointments were scheduled?

This story is a perfect (and entertaining) reminder for Human Resources professionals to step back and examine our systems. Is a decision made years ago about a routine process holding back our success today? What don’t we see because, as Madge used to say, we’re “soaking in it?”

Over the years I’ve seen several systems theory problem-solving models. The one currently pinned to my bulletin board is the Waterline Model by Roger Harrison. In the past I have used it when talking to supervisors about “difficult” employees, because it encourages the supervisor to step back from blaming the employee and look at the surrounding situation first. This year I am going to use it to analyze the systems around our department’s tough problems.

I know we’re soaking in something – and it’s not Palmolive.