A Growing Role

As DSOs expand, so too do the responsibilities and opportunities for office managers.

By Laura Thill

To say that dental office managers have a lot riding on their shoulders is an understatement. Particularly as group practices and dental support organizations (DSOs) have expanded, so, too, has the role of the dental manager. “In dental support organizations and group practices, the office manager supports many of the administrative duties carried out in a dental office,” says DeAnn McClain, vice president of operations, Heartland Dental. In addition, the office manager is often the primary contact for other DSO support professionals with regard to supporting the office’s marketing needs, team training, patient relations and more, she says. “In a DSO-supported office, office managers generally have support in such areas as accounting, payroll processing and bill paying,” she adds. “Therefore, they have more opportunities to partner with affiliated dentists and focus on supporting patients and team members, rather than focusing strictly on administrative responsibilities.

“At Heartland Dental, affiliated offices are each supported by several administrators, including a regional director, regional administrator and practice administrator, as well as an office manager in many cases,” she continues. “All of these roles strive to support affiliated offices in operating as effectively as possible. With our ever-evolving industry, it is important for managers and administrators to stay current on advancements in technology, marketing and effective leadership standards.”

As the dental industry advances – and dentists have a greater impact on their patients’ health – dental office managers have played an increasingly important role, notes McClain. “In providing the best patient care possible, today’s offices have very high operational standards. Office managers and administrators need effective leadership and communication skills to meet these challenges.”

Given the expanding role dental office managers play, one might consider them more of a CEO than a manager. “The role of the office manager has drastically changed with increasing duties and responsibilities,” says Lorie Streeter, FAADOM, CTC,vice president, American Association of Dental Office Managers (AADOM). “Our office manager members report [overseeing] almost CEO-type roles, where they are handling all dental business in the office. They are true partners to the dentist in some cases. A well-rounded dental office manager must be a human resource expert, an OSHA expert, an accountant, a software guru and, in most cases, do the research for larger technology purchases in the practice. He or she must be a true mechanic for the practice – one that knows every nuance of the vehicle that drives patient satisfaction success.”

To do so, dental office managers must be better educated and more dedicated to their profession than ever before, Streeter continues. And, in her opinion, they are up to the task. “It is almost shocking how much ownership their roles require to ensure they successfully juggle all the moving parts of a well-run practice,” she says. “This is why I have loved working with AADOM. We provide the resources and tools that office managers need to succeed.”

Indeed, dental office managers who are willing to do what it takes to meet their growing responsibilities are most likely to succeed at their profession. “Depending on their personality, I believe most office managers and administrators do embrace growth,” McClain says. “These individuals do have more responsibilities to take on, but this will only help them develop personally and professionally. Heartland Dental supports many continuing educational opportunities for managers and administrators, which help them advance their knowledge and abilities. Many take advantage of these opportunities and are excited to advance themselves like never before.”

Multiple offices, multiple responsibilities
Although office managers may have similar responsibilities whether at a single-office practice or a large group practice or DSO, in a large group practice it follows that they have “more team members to coach, more administrative tasks to handle and more patient issues [to address],” says McClain. “An individual managing multiple locations will need to be even more organized, confident and positive.”

The office manager’s responsibilities might vary somewhat from one group practice to the next, notes Streeter, but as a general rule of thumb, she offers the following model:

  • Standalone practice. The standalone practice requires an office manager to adhere to the owner’s guidelines for success and job execution.
  • Multi-location practice. The office manager at a multi-location practice often acts like a CEO. He or she usually heads the administrative staff at all of the locations and oversees the success of multiple doctors’ production. “We are seeing more examples of this model emerge across the country,” she says.
  • Large group practice. Office managers at large group practices/DSOs adhere to a model built for them by the DSO. Generally, their training is methodical and perfected. The office manager requires a consistent message, in order that the vision for the entire group can be executed at a local level. Today, some groups/DSOs hire managers outside of dentistry and train them on the dental piece from the ground up.

Likewise, office managers in large group dental practices or DSOs may report to different individuals/titles, depending on the organization. “In the DSO model, most office managers report to a regional type – a level between ‘mother ship’ operations and the practice,” says Streeter. “The challenge with this is that the regional [supervisor] is not involved with the day-to-day [functions] at each practice. We are encouraging groups to utilize the AADOM group forum so that they can stay connected to one another and have daily access to those within their group to share challenges and solutions. The office manager should operate within the team, but the structure of accountability is usually well placed such that ultimately, the entire practice wins together, which trickles up to the DSO system requirements.”

“As dentists are the leaders of offices, many managers are given guidance and direction from them,” adds McClain. “At Heartland Dental, office managers and practice administrators uphold a specific job design and report to their regional administrators and regional directors. But day-to-day, their most important function is supporting the dentists in their office(s).

“Compared to a few decades ago, patient needs have changed, technology has changed and the industry has changed,” McClain continues. “Therefore, office needs have changed. Group practices and DSOs need to stay conscious of this ongoing change and support managers and administrators accordingly, through education and communication.”

“What we are seeing at AADOM is the pressure to keep up with all of the new and existing regulations,” says Streeter, referring to changes in HIPAA and OSHA guidelines, as well as new trends in human resources and marketing, and the integration of new dental technology. “The best thing about a DSO is the top down support of [its] teams. By comparison, a single-location practice must seek out extrinsic education resources, viable outsourcing and internal coaching. No longer can the single practice tackle these topics passively. There is just too much to know.”

That said, it makes sense for the industry to consider office managers the nucleus of the dental practice, she continues. “They sustain so much and touch all aspects of the practice,” she says. Increasing patient retention is but one example of the value office managers can bring to a practice, whether single- or multi-office, she adds, noting that the most successful office managers – as well as group practices and DSOs – are those “that embrace the patient as a long-term investment.”

Nor is the importance of office managers likely to diminish in years to come. They will continue to play an increasingly more comprehensive role in response to the increased needs of dental offices, notes McClain. In addition, she expects the number of group practices and DSOs within the industry to steadily increase, expanding the need for managers and administrators to support multiple offices. “So, as time passes, managers and administrators will need to become increasingly adept at supporting the needs of dentists and team members,” she points out.

Supporting the office manager
As the role of dental office managers continues to expand, it becomes increasingly important for group practice and DSO leaders to offer support and ensure consistency throughout the organization. “As the role of office managers advances, group practice leaders and DSO leaders must support this advancement,” says DeAnn McClain, vice president of operations, Heartland Dental. “This is especially important for DSOs with hundreds of affiliated offices. With so many managers and administrators to support, leaders must ensure all of them are continually prepared to handle the day-to-day office responsibilities they will encounter. The correct education and support systems need to be set in place so that managers and administrators have the tools needed to continually succeed.”

Key to supporting – and empowering – office managers is through education, notes Lorie Streeter, FAADOM, CTC,vice president, American Association of Dental Office Managers (AADOM). “Retention is key and a well-educated office leader is priceless to retain,” she says. “The disconnect often is in recognizing the difference between a job and a career. How can the corporate leaders let their office managers know they are making a difference, and that they not only value them but their career potential as well?”

Furthermore, how can leaders at a large group practice or dental support organization ensure consistency among all office managers across all locations? “Certainly not every dental office operates exactly the same way as others,” says McClain, “but there are specific skills and methods all managers and administrators can adopt to carry out their roles effectively. This goes back to supporting the right education and operational systems in order to create consistency across multiple scattered offices. Heartland Dental supports a variety of education opportunities and helpful information to keep managers and administrators up to date.”

Streeter finds that while many group practices and DSOs have systems in place to track performance and practice standards and ensure consistency across the group, an improvement might be to focus more on the development of office managers. “Group practice and DSO leaders should train their office managers for the long-term, with their advancement in mind,” she says.

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