Practice Evaluation/Analysis Survey

15-Minute Practice Evaluation Survey

Welcome to the Practice Evaluation Survey. There are no right or wrong answers. The purpose of this battery test is to generate valuable insights to help make your practice better. The data will be analyzed using SPSS statistics. The evaluation takes about 15 minutes to complete. This 15-minute survey could add 15% more new revenue to your practice month after month. Let's discover the hidden treasures together. Good luck!

Instructions:

  1. This is a 'YES', 'NO', or 'N/A' evaluation survey
  2. It is designed for quick response ~2-3 sec./question
  3. The system will not allow more than one answer
  4. You will not be able to change your responses
  5. Click the "next" button to advance to the next question
1.

What are the major needs (at this time) for your practice? Choose only one major need. Use the comment field below to list more of your needs (if applicable.)


1 out of 129
2.

Please rate the current status of the following: (1 = Ineffective, 5 = Very Effective, n/a = Not Applicable).

a) Public Relations

2 out of 129
3.

Please rate the current status of the following: (1 = Ineffective, 5 = Very Effective, n/a = Not Applicable).

b) Practice Website and Software

3 out of 129
4.

Please rate the current status of the following: (1 = Ineffective, 5 = Very Effective, n/a = Not Applicable).

c) Phone Management

4 out of 129
5.

Please rate the current status of the following: (1 = Ineffective, 5 = Very Effective, n/a = Not Applicable).

d) New Patient Marketing / Intake

5 out of 129
6.

Please rate the current status of the following: (1 = Ineffective, 5 = Very Effective, n/a = Not Applicable).

e) Patient Education

6 out of 129
7.

Please rate the current status of the following: (1 = Ineffective, 5 = Very Effective, n/a = Not Applicable).

f) Initial Diagnosis / Education

7 out of 129
8.

Please rate the current status of the following: (1 = Ineffective, 5 = Very Effective, n/a = Not Applicable).

g) Treatment Plan Presentation

8 out of 129
9.

Please rate the current status of the following: (1 = Ineffective, 5 = Very Effective, n/a = Not Applicable).

h) Cash Plan Management System

9 out of 129
10.

Please rate the current status of the following: (1 = Ineffective, 5 = Very Effective, n/a = Not Applicable).

i) Patient Tracking System

10 out of 129
11.

Please rate the current status of the following: (1 = Ineffective, 5 = Very Effective, n/a = Not Applicable).

j) Recall System

11 out of 129
12.

Please rate the current status of the following: (1 = Ineffective, 5 = Very Effective, n/a = Not Applicable).

k) Missed Appointments System

12 out of 129
13.

Please rate the current status of the following: (1 = Ineffective, 5 = Very Effective, n/a = Not Applicable).

l) Financing (Billing) & Collections

13 out of 129
14.

Please rate the current status of the following: (1 = Ineffective, 5 = Very Effective, n/a = Not Applicable).

m) Insurance System

14 out of 129
15.

Please rate the current status of the following: (1 = Ineffective, 5 = Very Effective, n/a = Not Applicable).

o) Referral System

15 out of 129
16.

Please rate the current status of the following: (1 = Ineffective, 5 = Very Effective, n/a = Not Applicable).

p) Patient Reactivation System

16 out of 129
17.

Please rate the current status of the following: (1 = Ineffective, 5 = Very Effective, n/a = Not Applicable).

q) Staff Hiring / Training Systems

17 out of 129
18.

Please rate the current status of the following: (1 = Ineffective, 5 = Very Effective, n/a = Not Applicable).

r) Staff Meetings

18 out of 129
19.

a) Are you satisfied with your income level?

19 out of 129
20.

b) On 1-10 scale (10 being high), is your stress level below 5?

20 out of 129
21.

c) Have you had leadership training?

21 out of 129
22.

d) Do you have a written practice philosophy?

22 out of 129
23.

e) Do you create a strategic plan each year?

23 out of 129
24.

f) Do you have a personal business coach?

24 out of 129
25.

g) Do you have business marketing training?

25 out of 129
26.

a) Does your practice have an organizational chart?

26 out of 129
27.

b) Does each staff member have a list of job responsibilities that everyone knows about?

27 out of 129
28.

c) Is it easily apparent who is responsible for certain duties and responsibilities?

28 out of 129
29.

d) Is your practice prepared to cover for a staff member who leaves unexpectedly?

29 out of 129
30.

e) Does staff know who their supervisor is and who is responsible for evaluating them?

30 out of 129
31.

a) Does your practice have departmental leaders?

31 out of 129
32.

b) Do members of the leadership team have authority as well as responsibility?

32 out of 129
33.

c) Do they make, communicate and stand by their decisions?

33 out of 129
34.

d) Are staff members’ complaints and concerns always addressed to the correct person?

34 out of 129
35.

e) Are leaders supported by the practice top management?

35 out of 129
36.

a) Is there a clear decision-making process in the practice (e.g., certain decisions are made by consensus, others are made only by doctors, and still others are reserved for “the boss/owner”)?

36 out of 129
37.

b) If a process does exist for making decisions, is it followed each time?

37 out of 129
38.

c) Does staff know how decisions are made?

38 out of 129
39.

d) Are decisions communicated by the practice’s leadership to all staff?

39 out of 129
40.

e) If a staff member has an idea about an improvement or change to the practice, is there a clear process for gathering suggestions and submitting them to management?

40 out of 129
41.

f) Does the practice make decisions quickly?

41 out of 129
42.

g) Is the practice flexible and cooperative?

42 out of 129
43.

h) Do you have methods for communications among all levels of the practice?

43 out of 129
44.

i) Do all providers and employees understand the patient’s needs and place priority on those needs?

44 out of 129
45.

j) Does the practice culture encourage and reward continuous improvement?

45 out of 129
46.

Please indicate which of these services your practice now outsource to other organizations. Use the comment field to list more (if applicable.)


46 out of 129
47.

If applicable, do you currently have an online interface with any of the outsourced services listed below? List more in the comment section below.


47 out of 129
48.

a) Do you have recruitment and hiring process for your practice?

48 out of 129
49.

b) Is your staff provided with copies of the employee manual?

49 out of 129
50.

c) Do you conduct a performance evaluation for your staff on a periodic basis?

50 out of 129
51.

d) Do you have salary administration guidelines and schedules for your practice?

51 out of 129
52.

f) Do you have an active employee incentive plan (bonus system)?

52 out of 129
53.

g) Does your HR department properly document disputes (if any) that occur between staff members?

53 out of 129
54.

h) Do you have a corrective action system?

54 out of 129
55.

i) Does your human resources department have standardized Termination / Separation Forms?

55 out of 129
56.

a) Do you have a dedicated staff that handles your regulatory and compliance issues (OSHA, HIPPA, DEA, etc.)

56 out of 129
57.

b) Do you have the required CE credit for staff and doctors properly recorded?

57 out of 129
58.

c) Do you have a CE calendar for all doctors and staff?

58 out of 129
59.

a) Do you have an online backup of all practice computer data?

59 out of 129
60.

b) Are your backups verified daily?

60 out of 129
61.

a) Do you have written job descriptions?

61 out of 129
62.

b) Training program for each employee?

62 out of 129
63.

c) Written system for every procedure

63 out of 129
64.

d) Written scripts to train new employees?

64 out of 129
65.

e) Scripts for every routine patient question?

65 out of 129
66.

f) Written customer service protocols?

66 out of 129
67.

g) Customer service training program?

67 out of 129
68.

h) Do you have a self-managed team?

68 out of 129
69.

i) Would you consider each member of your team to be a 7 or above on a scale of 10?

69 out of 129
70.

j) Is there any individual team member with whom you truly dislike working?

70 out of 129
71.

k) Does staff function like a team with each person having a stake in the success of the practice?

71 out of 129
72.

a) Do you have a KPI (Key Performance Indicators) System?

72 out of 129
73.

b) Do you have a Personalized New Patient Experience?

73 out of 129
74.

c) Do you have a Non-Surgical Perio Evaluation and Treatment System?

74 out of 129
75.

d) Do you have a TMJ Evaluation System?

75 out of 129
76.

e) Do you have a Reconstruction Checklist?

76 out of 129
77.

f) Do you have an Ortho Evaluation System?

77 out of 129
78.

g) Do you have an Implant Evaluation System?

78 out of 129
79.

h) Do you have a Cosmetic Analysis and Planning System?

79 out of 129
80.

i) Do you have a Smile Analysis Form?

80 out of 129
81.

j) Do you have a Staff Bonus System?

81 out of 129
82.

k) Do you have a Team Results System?

82 out of 129
83.

l) Do you have an Office Maintenance System?

83 out of 129
84.

m) Do you have a Medical Emergency Plan of Action?

84 out of 129
85.

n) Do you have an Employee Hiring System?

85 out of 129
86.

o) Do you have an Employee Firing System?

86 out of 129
87.

p) Do you have an Inter-office Communication System?

87 out of 129
88.

q) Do you have a GAP Analysis System?

88 out of 129
89.

r) Do you have a Photo & X-ray Assessment Form?

89 out of 129
90.

s) Do you have a Marketing system?

90 out of 129
91.

t) Do you have a ROI (Return on Investment) Analysis System?

91 out of 129
92.

u) Do you have a Doctor Compliance System?

92 out of 129
93.

v) Do you have a Marketing Action Plan?

93 out of 129
94.

a) Does your orientation process include communication of the “unwritten rules”?

94 out of 129
95.

b) Are experienced staff members asked for their ideas and opinions on how things may be improved?

95 out of 129
96.

c) Are staff members comfortably communicating both successes and failures?

96 out of 129
97.

d) Do all team meetings have agendas, notes, follow-ups?

97 out of 129
98.

e) Is there an organized way in which feedback is obtained from staff members?

98 out of 129
99.

a) Does your practice have a specific written vision statement, mission statement, and culture points?

99 out of 129
100.

b) Do staff members know what the mission is, their role in achieving it?

100 out of 129
101.

c) Is your practice organized around the practice vision, purpose and mission?

101 out of 129
102.

a) Does your practice have policies and procedures (P&P) that describe “how things are done”?

102 out of 129
103.

b) Are policies and procedures up-to-date?

103 out of 129
104.

c) Is there a process in place to ensure that policies and procedures are regularly updated?

104 out of 129
105.

d) Does your team have a written copy of your policy & procedures?

105 out of 129
106.

e) Is someone in charge of drafting, updating and approving policies and procedures?

106 out of 129
107.

f) Do policies and procedures (P&P) meet the test of 4 Es: evidence-based, effective, efficient and entirely clear?

107 out of 129
108.

g) Do you have a uniform dress code/grooming protocol for the staff and doctors in your practice?

108 out of 129
109.

a) Have you moved from a paper to digital records?

109 out of 129
110.

b) Do you have a written, clearly defined workflow that every staff understands?

110 out of 129
111.

c) Has your practice established a commitment to re-evaluate and optimize workflows?

111 out of 129
112.

a) Do you know your staff and what is important to them?

112 out of 129
113.

b) Is the practice set up to promote good relationships between staff members?

113 out of 129
114.

c) Is there a sense of loyalty among staff and an assumption of good will?

114 out of 129
115.

d) Do staff members enjoy time together outside of work?

115 out of 129
116.

e) Have you had a team function after work within the last 6 months?

116 out of 129
117.

Do you provide any of these benefits to your employees? Please choose one option. Select option 't' if you have three or more of the listed benefits for your employees. Use the comment field below to list more benefits (if applicable).


117 out of 129
118.

s) Are employees given a total benefits statement annually?

118 out of 129
119.

t) Do you know what percent of practice overhead is employee benefits?

119 out of 129
120.

a) Has your annual practice revenue grown at least 7% for the past 3 years?

120 out of 129
121.

b) Are you collecting 98% of your production on an annual basis?

121 out of 129
122.

c) Are 90% of your active patients currently scheduled for their next hygiene or restorative appointment?

122 out of 129
123.

d) Is hygiene responsible for at least 30% of your practice production?

123 out of 129
124.

e) Is your overhead 60% or below?

124 out of 129
125.

a) Do you have dedicated sales staff or marketing coordinator for your practice?

125 out of 129
126.

b) Do you have a practice website?

126 out of 129
127.

c) Have you published a book or an eBook?

127 out of 129
128.

d) Are you using your website to generate new patients?

128 out of 129
129.

e) I am actively seeking referrals from existing patients and it is successful

129 out of 129


Whew! Congratulations! This evaluation seems to have taken forever! Now, enter your name and email address. The result will be delivered to your email. Based on the result of your survey, you may be automatically redirected to a certain relevant section of our website for a followup. Again, thanks a lot for your time.



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