Clone and Organize Your Practice with High Tech(nique)

Ask a group of doctors what the number one problem in dentistry is today and they answer with one simple noun, “staff”. Ask them to elaborate and they convert the noun to an adjective and answer with simple two word combinations, “staff turnover, staff shortage, staff training, staff motivation, or staff management”. The bottom line is, “how do you create, develop and maintain a skilled workforce even through periods of staff transition?” Despite dramatic improvements in dental materials and technologies, there have only been minor improvements in the way people learn and work in the dental practice.


A new technology-based system that clones the practice can be implemented by anyone who has the desire to learn and change. Cloning creates a stable infrastructure and easy to access knowledgebase about clinical and administrative procedures and protocols in the practice. Existing staff or former staff produces intuitive, highly visual, self-teaching materials about what they do and how they do it. They may choose to write a simple document, include photos, and/or make a video clip that illustrates with sound and motion how they perform their tasks.


When someone leaves the practice, the successor learns specific detailed information about how the practice works rather than attempt to fill the knowledge vacuum created by the former staff member. Stress is reduced because training a new person requires minimal involvement from other staff members who are already occupied with their existing duties.


Cloning, therefore, refers to making the knowledge that already exists in the practice accessible to anyone at any time. It uses standard off-the-shelf technologies such as Microsoft Word, digital still and video cameras, and Adobe Acrobat. This makes cloning affordable and supportable. The greatest implementation challenges are establishing the vision for your practice, preparing a plan, and executing the plan. The following examples illustrate how cloning works.



In many practices, an office manager who takes a vacation may be out of the office for two weeks but upon returning discovers that she has merely deferred the work. Everything that can be postponed is waiting for her when she returns. Other people may wish to fill-in while she is gone, but they don’t know how to do her job.


Kimberly the office manager, who works for Dr. Vincent Paolino in Haverhill, MA, was determined to have a great vacation and have all of her normal work completed in her absence. Using a digital video camera (cost: $400), Kimberly created a multimedia office procedure manual consisting of digital video clips depicting various tasks she performed in the office. She was the “actress” and another staff member was the videographer.


For example the video instruction, about how to use the credit card authorization terminal, discusses the end-of-day procedure as well as a helpful warning to wait until the first ticket prints before printing again to avoid jamming the printer. After recording the video clip, Kimberly plugged a wire from the digital camera using a high speed firewire interface (IEEE 1394) directly into a Dell PC that had a firewire interface card and video editing software pre-installed at the factory (Cost: $110). The 90-second video was transferred from the camera to the hard drive on the PC in seconds. Then, Kimberly spent less than five minutes with the video editing software cleaning up starting and ending points in the video.


Anyone who wants to learn a skill, for example, how to use the credit card machine, clear a paper jam in the copier, or add postage to the postage meter, simply clicks on the appropriate icon on the computer and the office manager trains them, with infinite patience, until the skill is mastered.


In addition to creating video clips, Kimberly used Lotus ScreenCam (Cost: $89) software to produce multimedia instructions for using the practice’s dental billing software. ScreenCam electronically records everything that happens on the computer screen along with Kimberly’s voice narration and saves it on the hard drive. Kimberly recorded instructions about generating e-claims, posting treatment, and end-of-day routines as she performed the tasks and spoke as though she were teaching someone sitting next to her. Rather than read through a cumbersome manual, anyone who wants to learn these skills watches the actual screens, mouse clicks and menus that ScreenCam faithfully recorded along with voice narration.


Before she left for vacation, Kimberly cloned herself. The other people in the office will learn her job in small, easy-to-digest bites, as they need to know it. They will have less stress during the learning process and take great comfort knowing that they can always update their skills or fill in missing pieces of knowledge anytime by reviewing the electronic video clips or ScreenCams.


Cloning staff is the most powerful way to build and retain the knowledgebase in a dental practice. While Kimberly is on vacation, or working her “day job”, she is available 24/7 to impart her knowledge to others. If she leaves the practice, her knowledge remains behind for others to benefit from her knowledge and experience.


Cloning offers phenomenal knowledge transfer mechanisms. How much would you be willing to pay if a new dental assistant reported for her first day of work and was already familiar with your equipment, instruments, and style of practice?


Cloning with multimedia video clips allows you to give the new assistant a CD-ROM containing hours of quality instruction about your practice to study during the two week period between giving notice to her former employer and starting work in your office. She spends one hour a day observing “over the shoulder” instructions that you and your ace dental assistant developed. In two weeks elapsed time and ten hours of studying (Cost: $150-200 to pay her for her time), she arrives in the office and performs as though she has worked with you for three months. You didn’t have to pay anyone to train her, spend your own time training her, or repeat a single word.


Cloning also allows you to employ part-time or temporary staff without incurring substantial training costs or persevere through arduous “break-in” periods for new staff members.


Cloning is a useful knowledge transfer mechanism for most office activities including office procedures, clinical procedures, case presentation skills, patient education skills, patient management, and verbal skills. It is the ultimate way to benefit from the knowledge accumulated over time irrespective of who is working in the office.


Paul and Joany, the management team at DiPietro Family Dental Care in Revere, MA, implemented Stage 1 cloning for dental assisting. They worked with Nicole, a dental assistant who was leaving to have her baby, to create visual tray setups along with step-by-step instruction sheets for more than a dozen procedures. Her replacement learned how to setup a tray and assist the doctor with less than ten minutes of self-study. Stage 2 cloning will contain video clips of the assistant working with the doctor and stored on a CD-ROM. New assistants will take a home-study “over-the-shoulder” course about assisting in the office with the doctor’s specific techniques prior to her first day at work in the office. Imagine how effective she will be after observing procedures in a distraction-free environment for more than ten hours before her first day as the doctor’s assistant. Compare her knowledge level with an assistant who has no prior knowledge of the office.


It is obvious that cloning changes the way you think about training, education and staff transition. A subtler, yet extremely significant benefit is expanding the universe of prospective staff members. For example, you may choose to hire part-time staff if they can learn how to setup trays and help with other more complex office tasks if the can learn on their own in a brief period of time. With a visual tray setup, anyone can learn the task and perform it with consistent accuracy, whereas using mentor training is painful, time consuming, and expensive. Some offices avoid mentor training by providing “sink or swim” training which is also painful and expensive. Cloning is the best solution for creating and maintaining a stable, knowledgeable workforce.

You probably already have most of the technology you need to begin cloning your practice. Make this the year to give the gift of knowledge and personal satisfaction to everyone. There is nothing more rewarding.