Nimble & Adaptable to Change: An Interview with Allison Parks Hale

Allison Parks Hale (APH): I am Allison Parks Hale. I am the Chief Operations Officer at Parks Orthodontics in Yorktown, Virginia.

Blu Nordgren (BN): So we find ourselves in a very strange landscape right now, and how do you think the orthodontic industry in the US has done as a whole in tackling these new challenges?

APH: Well, overall I think the leaders in our industry are incredibly nimble and adaptable to change. Ortho has changed so much over the last five years. I think those that are leading in the field are really able to tackle these challenges when it comes to safety. I know that the dental field has very high standards for infection control. So I think overall we were very well prepared for the challenge to keep our patients safe.

BN: And what hurdles have you personally, or your practice, faced in the recent months and weeks and how have you dealt with those?

APH: Well, I think one of our biggest hurdles has been to try to figure out how to deliver the highest level of service without some of the really cool things that we do in our office to get patients excited. We have the refreshment station, the game room, the kids’ play area, and all that right now is closed down. So trying to continue to convey that positive energy while wearing a mask has been a little bit of a challenge. We are very lucky. Our team has done a great job at keeping their energy up and telling our new patients when they come in, “Hey, we’re not normally like this. Usually this is our brushing station. Right now we have it converted to a hand-washing station.” But those who have not met us before, we’re really still trying to give them a flavor for what we’re like. We are also inviting our existing patients who’s parents are currently not coming into the clinic. We’re inviting them to FaceTime their parents during their visits so the parents don’t miss out on anything important. We are also leveraging text messaging very heavily during this time to keep our patients and parents up to speed. So if anything, I think our communication has improved, because literally with every single patient that walks out the door, we are writing, sending a text message with a summary of what happened and what’s next. So I think parents actually know more now than they did when they were coming in. So, it’s been good.

BN: That’s great actually. Now did you have to add more time in the calendar to give yourselves that opportunity to write those text messages and to add that follow-up?

APH: We have not added any additional time into our schedule. I think that originally our concern was that the additional PPE and donning and doffing that PPE would take more time. But what we’ve done is we’ve moved some team members around within the practice. So we have someone now who’s dedicated to sterilization. So we don’t have as much time spent on clearing the stations and stuff. We have a gal doing that. Likewise at the front desk, we have an additional person there who’s responsible for all those text messages. So really we have been able to do it with the staff we have in the time we have, we’ve just reallocated some of our resources. One of the things that Dr. Parks was very adamant on is that we would not have to let anyone go during this time. Our team, like most ortho teams, is a family. So letting someone go was not really what we wanted to do. So we found a way. Excuse me, to use everyone in a really positive way.

BN: What are some new challenges that you’re anticipating might come our way in the coming months? And how are you preparing for those?

APH: Well, one of the things that I’m anticipating is that our personal protective equipment we may run into some shortages, especially with gloves and masks, as more people are wearing masks. We have found that we’ve had to start to increase our normal quantities on ordering so that we have a reserve supply. Likewise, prices are going up. So ordering things ahead of time has really helped us sort of have a stockpile of PPE in case we have shortages. We also started out with disposable isolation gowns, and we were plowing through those so quickly, and the pricing was astronomical as they became more and more scarce. So we ended up ordering launderable isolation gowns to cut down on the waste of the disposable ones. And we just do all that laundry in-house. So that’s been a really good way that we can sort of surmount that PPE question. Another challenge that I fear, but I hope will not happen, would be a mandatory office closure. We went through that for a month in May or April… March and April, and having to do that again, I think, would be a challenge. But I think that doing what we did last time, making sure that we keep open lines of communication with our patients, of course, but also with our staff, we did a really good job of even though some of our team was not working in the office during that closure, we really kept everyone together. We had weekly meetings online so that we could keep everyone on the same page, and everyone still felt a part of things, even though we weren’t seeing each other. Another way to overcome the challenge of having a closure, I think we kept all of our marketing efforts going a 100%. Obviously some of our professional relations activities had to be put on hold, but in terms of marketing our message to new patients, we kept all that going. And we were still able to get patients booked for new patient exams way, way out in the future. So I think keeping those lines of communication up and keeping your marketing going strong is a good way to weather another temporary closure.

BN: In the event that there is another closure, do you have any, I guess, tasks lined up for staff to be able to work on or for you to be able to… Like what would you focus on, I suppose, while-

APH: Sure, sure. I think that this is if you do basic closure it’s a really good time to tackle tasks that you never seem to have time to do during your regular workday. And every practice is gonna say, “Oh, well, yeah. We’d really like to get around to doing that, but there’s no time.” So some things that we did, and I would definitely do again, those few people who are in the office are responsible for a deep, clean, deep purge, total reorganization of the office. For those that are at home using that time to do professional development, webinars like this, online training courses, those are great things to assign out to your folks who can’t be in the office with you. Another project would be to have each team member create an in-depth job description for their position. Write up as many of their master systems as they can. What does my job look like on a daily basis? Here’s what I do. Here’s how I do it. That way you can put all of these together into a master book, if you will, when everyone returns together. Other things to do, revising the team member handbook. Wow, if I had a nickel for every person in ortho I talked to who was like, “Oh yeah, don’t ask me about our handbook. It hasn’t been touched in years,” great time to go ahead and do that. Create a training manual for new hires. That’s a really fun task. And also perhaps creating evaluation systems for each position. Here’s how we know you’re hitting your targets and write those down.

BN: Great, that’s a really fantastic well of different activities right there. I really appreciate you sharing that with us. Do you currently have any staff members who are working remotely? And can you tell me more about their positions and kind of what tools you have equipped them with to complete those tasks?

APH: Absolutely, we actually have two employees who work remotely regularly. The first is a financial coordinator. The second is a public relations coordinator. As I said earlier, some of our PR activities have been put on hold. So that public relations coordinator is actually now back in our office, helping with those text messages. And she was one of our reallocations. But when we’re in normal operations, she is an at-home worker. Both of these physicians have at-home workstations. They have telephone extensions. Their desks are set up at home just like a workstation would be in-office. We really like having an offsite financial person. Obviously, she has full access to Cloud 9 at her home, and that allows us to avoid the pitfalls of addressing touchy financial issues in the office. So if anyone comes in, has a financial concern, we can address that privately over the phone, not face-to-face. This helps us keep our office happy and positive that we can defer some of those tricky conversations to our financial director who’s out of house.

BN: And can you walk me through a new patient exam and the way that you do it right now?

APH: Yes. I love this question. This is one of my favorite things that we do in our office. It’s obviously very important, but it’s something that we have really, really worked hard on and I love it. We start the experience with a very… The new patient experience with a phone call. Obviously that’s their first in-person or over the phone exposure to us. The phone call is pretty heavily scripted and it’s designed to evaluate that new patient’s potential. Are they ready for treatment? Are they going to accept treatment when we propose it? We very quickly set our expectations for this appointment. And then we invite them to follow a secure link to complete their new patient form. Having that be a digital flow has been a real game changer for us. We have found that patients… We have over 50% of our patients now completing their new patient paperwork in advance. That’s a really big, I think, concern for a lot of practices. How do we get these patients to fill out these forms? I think the key there is making sure they’re super user-friendly, easy to access. You don’t have to set up a username or password for it.

BN: That’s my nightmare, is having to remember another password.

APH: Right, right. And that’s the last thing someone who’s just meeting you wants to have to do. So from that paperwork, we start working up a patient profile. We check any insurance benefits they may have in advance. So when the does appear in the office for their visit, they are immediately welcomed by our new patient coordinator who has a dedicated position. That is all she does, is meet with and follow up with new patients. She gives them a tour. The tour is of course, a little bit of abbreviated now during COVID. She does try to point out some of our open areas, which are now, of course, closed off for visitors. But she tells them a little bit about the feeling of our office, the experience they’re gonna have. And then takes them back to one of our records rooms for records. For us, we take the same records on every new patient. We do facial and intraoral photos. We do a panoramic x-ray and also a scan using the itero scanner. During this process the new patient coordinator is talking to the patient, learning as much as she can about them and conducting a little interview so she can complete that new patient profile for the doctor. The new patient coordinator then takes her profile and briefs the doctor. Doctor reviews the patient records and develops a treatment plan while the new patient coordinator is bringing up these images that we took on a big screen. This was a huge breakthrough for us. We did this about, I wanna say 10 years ago. We started using this big, giant screen and putting patient images up there and the look on their faces when they see their teeth. They’re like, “Do I really look like that?” And we’re like, “Yes, you do and we can fix it.” So that’s been really fun. So we bring these images up on the big screen. The doctor spends about seven to 10 minutes talking to the patient about her proposed plan, answers questions, builds a report, and then sends the new patient coordinator back in to go over the details of treatment, discuss fees. And finally, we do have the new patient coordinator going over the steps of treatment to get started, the fees for treatment, options for payment. And then once she addresses any questions or objections, her job is to get that patient started. So luckily it happens a lot for us. So we’re pretty pleased with that process. But yes, I think having a smooth, streamline predictable new patient process really helps the day go by smoothly and helps us convert those new patients to start.

BN: Does every office have a new patient coordinator? Is that a common position? I’m speaking from someone who works in marketing outside of-

APH: Sure. Actually, I think it’s probably a toss up. Most ortho offices have a treatment coordinator and that treatment coordinator wears a lot of hats. Typically they’re the person who conducts the new patient exam. They do take care of all specialists and dentists correspondence. They are sort of the doctor’s right arm when it comes to monitoring treatment, making sure patients are staying on time and coordinating any care with outside doctors. They also typically run their clinic. They are tasked with keeping the clinic running on time, jumping in, helping assistance in the back. So with the size of our practice, we felt that it would be helpful and more smooth if we separated the two jobs. So we do have a TC and she does exactly that. She coordinates treatment with Dr. Parks, and she makes sure that the clinic runs on time. Once the patient is an active patient, they’re turned over to that TC to make sure everything goes smoothly.

BN: Do you have some sort of a scripted or specific way to do the handoff from the new patient coordinator to treatment coordinator to increase the trust value for the customer?

APH: That’s a really great, great question. We do that through a series of emails and from printed material when the patient starts treatment. So we give them their… Depending on which treatment modality they choose, let’s say it was you, for example, you’ve chosen Invisalign. We would give you a little book about what to accept with Invisalign, all of your wear and care instructions. In the back of that there’s the card for the treatment coordinator. So you know if you have any questions going forward, that’s the person that you need to contact. If we have time during that first visit, our new patient coordinator will introduce the treatment coordinator, but the treatment coordinator does send out an email and a text message after that start appointment to welcome that patient to the practice, and again, introduce herself digitally.

BN: It sounds like you haven’t had to change your new patient intake all that much during this pandemic. But during your forced closure, were you doing any virtual new exams at all?

APH: We were. And that’s what I think. That’s the part where really having this cloud-based software knocked it out of the park for us. We had a small staff that came into the office to me and the phones. Our doctors stayed at home, which was wonderful. She has a small child and juggling all that was not going to be possible during the closure. So what we were able to do is using Cloud 9, she would have Cloud 9 up at her home. We were seeing virtual exams through our text messaging platform. When patients queried us about the new patient exam, we asked them to send us some photos. We then uploaded those photos right into Cloud 9. Dr. Parks looked them over just like she would if they were in person. And we would give a provisional treatment plan. We knew that we might when we win. We win some and we would lose some, especially once we got them in person and kind of saw what was happening, to do an x-ray and a scan. But we felt like giving a provisional treatment plan just reinforced our relationship. And when we were able to resume normal operations, we gave those people a call and got them right in for a more formal records appointment. But she was able to see a lot of our Invisalign cases that very same way, retainer checks. We did some phase one fixed appliance checks that way. Patients that were in braces, who had questions, we tried to triage every single person scheduled on our schedule with a text that says, “Hey, send us some pictures. Let us check on you during this closure. We’re still here for you. Your treatment’s still progressing.” And being able to do that virtually by having them send pictures and we keep them in Cloud 9 so we can go back and look at the pictures that they took and then show them those pictures when they come back in, take some new ones. And it was a really neat way to keep in touch with our patients while being at home.

BN: That’s great. And I think you use Rhinogram. Is that right?

APH: Right.

BN: Yeah.

APH: Amazing. They’re awesome.

BN: How are you leveraging the tools in Cloud 9 to help you prepare for the possibility of having to close your practice in the future?

APH: Well, obviously, as I said, the biggest asset to having Cloud 9 is being able to use the full software, all of its features from anywhere on the planet that you have an internet connection. During our COVID closure, as I said, Dr. Parks did not have to come into the office to review her charts to conduct these virtual visits. Using the texting capability of Rhinogram and Cloud 9, she did all of her work from her couch. She updated all the treatment plans. She communicated with us and it was beautiful. I know that as the Operations Officer, I’m in charge of things like timecards and payroll. And I have been in Italy and had to run payroll, and as long as I have an internet connection I can get in there and view the timecards, get everyone checked out and get that payroll submitted. I’ve done it from the Bahamas, the outer banks, you name it. As long as I have my little laptop with me and a internet connection, I can work.

BN: That’s amazing, because I’ve had to run payroll a number of times in my past life. And the idea of doing it on the beach, in The Bahamas with like a piña colada in my other hand makes me very excited.

APH: It’s not a bad way to live. I’ll tell you that.

BN: Great, so moving onto the next question here, whether it’s an anticipation of future closures or maybe just an effort to increase employee engagement or even satisfaction, what advice would you give to someone wanting to increase their teleworking capabilities?

APH: So we did talk about some of the things that team members could do from home. But for us, I think that sending financial out of house has been one of the best moves we ever made. I want to say we did this about seven or eight years ago. We still handle all of our checks and our cash in-house, but all of the insurance work, the collections activities, all of that can be done from a home office. And that has been a real good way for us to compartmentalize that financial aspect and keep it independent from what we’re doing daily. Marketing is another great at-home task. I know that’s your wheelhouse. Again, as long as you can communicate with the office and you have an internet connection at home, a lot of this marketing work can be done from home. Another thought I had is that if you did have a dedicated technician or assistant who was familiar with the Invisalign process, you could have them work exclusively on virtual appointments from home. They can enter patient prescriptions for the doctor. They could handle a liner intake. They could handle questions from patients about wear and care, and it wouldn’t even need to be necessarily a full-time position. You could have someone at home taking care of all this virtual visits, communicating with the doctor, and providing provisional treatment plans and inviting that patient to come in if they’re a candidate.

BN: Actually, that brings me to another question about your new patient coordinator. If you were to have to close again, what would you have her doing?

APH: She would do as much work as she could the way she’s doing now, except she would take… She would be inviting those people that are scheduled for new patient exam. She would be inviting them to send us photos. As I explained before, she would be uploading those photos to Cloud 9, letting Dr. Parks know via text message what the patient has in mind. And then together they would work up again that provisional treatment plan with as much detail as they can. And then again, inviting them to come back to visit our office when we’re able to regain normal operations. She can keep on trucking.

BN: What’s a common myth of remote work in the orthodontic industry, and can you debunk it?

APH: Well, that was a good question. I kind of think that it’s a myth of all work from home or remote work. I think the myth is that people that work from home don’t really work. And I don’t believe that because I’ve done it. I think that if you’ve got someone who you know would be a good candidate, who has a great work ethic in-office, I think if you can come up with expectations and systems, put those in place for someone, work at home can be very successful and flexible. I think you’ve got to set up regular check-ins, make sure there’s full transparency and accountability to help make certain the work is done. But I think that with the right person working from home, remote work can be a win-win for the practice.

BN: Are there resources that have really helped you on your journey?

APH: Yes, absolutely. As I mentioned earlier, some of the Cloud 9 integrations that we have, like Rhinogram for texting and Rooster Grin for online scheduling, these have been real game changers for us in our practice. Having new patients be able to schedule their appointment live on our schedule with Rooster Grin integration has been awesome. And again, as I’ve mentioned multiple times, Rhinogram for texting, we could not have survived COVID without it. If I could pick the most valuable integration with Cloud 9, it is for sure Rhinogram. One thing that I think is highly underrated and a huge, huge bang for your buck is the Cloud 9 Users Meeting. Not only do I always have a great time there, but you can see literally all of the top consultants in the profession, some of the top doctors and learn from your peers and the pros. I absolutely love this meeting and I would not miss it unless there was a pandemic. So the Users Meeting is a huge resource for me. And also the people that I’ve met at the meetings, having them as a network has been really, really helpful. You know, if you think about it, there are practices all over the world doing what we’re doing. There’s no need to reinvent the wheel. If you can make a connection with a practice manager or a doctor from another practice, it can really go a long way to help you solve problems within your own practice.

BN: What are some specific roadblocks that people should watch out for when it comes to teleworking and working remotely?

APH: I think that setting hours for work time and non-work time is really important. Setting those boundaries for yourself. I think some people when they remote work, they fall into a trap of, oh gosh, I really need to be working all the time. We’re always connected to the internet. We have our computers and our phones and our iPads with us all the time. I think setting out specific work time and making sure that the practice knows the times that these teleworkers are available is crucial. Also, this is sort of one that you hear all the time, but it’s worth repeating. Have the dedicated space for your work. If you’re trying to work from your bedroom, your couch, your kitchen table, it’s likely that you’re going to get distracted if you’ve got kids or pets running around. So I always say, make sure you have a dedicated space set aside that your family knows, hey, this is work time. And just set boundaries for yourself with working from home and stick to them.

BN: What’s been the biggest surprise to you in the last few weeks and why?

APH: I think it was easy during our closure to worry that people wouldn’t understand that we needed to make changes. I have been so pleasantly surprised at how flexible our patients have been. They have been understanding, they have gone with the flow. They have been going right along with our new protocols. Of course, there’s always someone here in there who might buck the system. But overall I think our parents and our patients have been really, really happy with how we handle things. And they’ve embraced the process, even though now there’s some distance between us. In ortho we’re very friendly and we’re hugging our new patients and shaking hands. And I do think that it’s been difficult, but I’ve been very pleasantly surprised at how understanding our patients have been. It’s great when they say, “Hey, that was so cool. I love that you just texted me to come in when it was time to come in.” And I don’t even think they mind that much being in their car. In fact, we might have people that continue to prefer it that way rather than coming in. But we do know people miss their cup of coffee when they come in.

BN: Are you open to sharing your contact information so that people have the opportunity to reach out to you after listening to this or watching this?

APH: Of course, absolutely. I’d love that. I am sort of all over the place. I do work remotely sometimes, but the best way to reach me is by email. And that is Allison at parksortho dot com. Shoot me an email and I’m happy to chat.

BN: Fantastic. Thank you so much. This has been absolutely wonderful. I love talking to you because you’re always such a positive and joyous energy.

APH: Aw. Thank you very much. You guys are my favorite.