Working a four-day week

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four-day week
There’s much to recommend working a four-day week

Working a four-day week has become a lot more common in the corporate world so does that mean it is a viable option in dental practices too? Angela Tufvesson reports

When New Zealand firm Perpetual Guardian announced in November that its 240 employees now have the option to work four days a week while still earning their regular salary for five days, the internet went into overdrive. The company, which manages wills and trusts, says a successful two-month trial period saw dramatic improvements in leadership, commitment, stimulation and empowerment—and employees maintained the same level of productivity. 

Swapping the Monday-to-Friday grind for a four-day work week has been touted as a solution to everything from high staff turnover to declining mental health in the corporate world where work is less about face time and more about output. But with dentists responsible for all practice revenue and still averaging 36 hours of clinical time a week, it begs the question: can dentists work a four-day week?

The business case

Along with eight colleagues, Dr Stephen Liew—a partner at Camberwell Dental Group and Monash University Health Services, and a federal executive councillor at the Australian Dental Association—works four days a week in the practice. Non-clinical staff work a nine-day fortnight. 

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It’s been this way for the 11 years Dr Liew has worked at the practice, and he says this way of working provides a competitive advantage because staff have the time and energy to provide a very high level of patient care. 

“The night before, I try to read all of my patient notes to be 100 per cent across them,” says Dr Liew. “We are well aware of our patients’ family situations, number of children and employment status, so we’re able to consider their life situation as well as their dental situation in harmony. 

“If you’re going to provide a level of care where you do a substantial amount of after-hours work to get ready for your patients to be treated in the best way possible, by day five of that week your eyes, neck and back start to suffer. Mentally, the process of keeping your energy and accuracy up for that amount of time can reduce your compassion bank and the second that goes down, your care for your people—patients and staff—will decrease.”

And if the compassion bank is empty too often, staff will become unhappy and patients will leave, says Dr Liew. “We know this because a number of patients have shopped around different practices and come to us on recommendations from friends or family based on the fact that they find us to be accurate and caring enough every single time,” he says. “It feeds into a consistent practice experience for all the dentists and staff.”

Thirty years ago, Dr Phillip Palmer, founder of dental consultancy firm Prime Practice, worked four days a week in his practice, and he says shorter work weeks are still popular with older, more experienced dentists. He agrees that improved work-life balance allows for better patient care.

“Dentistry is a tough job and it’s a stressful job; doing it five days a week is difficult,” he says. “I found—when I understood a little bit about management and I could organise my appointment book optimally—that when I went to four days a week it made all the difference in the world to my work-life balance and my patient care.”

The financials

Understandably, many dentists worry that a reduction in clinical hours will lead to reduced production, but Emanuel Recupero, CEO of dental training and practice development firm Dental ED and co-owner of the Practice Entrepreneur Network, says higher patient numbers isn’t the key to higher production.

“When I went to four days a week it made all the difference in the world to my work-life balance and my patient care.” 

Dr Phillip Palmer, founder, Prime Practice

“There’s a belief that the more patients you put in the practice, the higher your production,” he says. “We find it’s actually contrary to that: if you slow the practice down a lot, you actually increase production.

“The only way to move your practice into higher production is to slow your appointments down and not book them so short. Spending more time on patients and proposing more thorough treatment plans … you need time to do that. The focus should be on production, not the number of patients or worrying about reducing the number of practice hours.”

Indeed, Dr Palmer says to make a four-day week work financially, dentists should see fewer patients who need higher value work. “A dentist’s income can be influenced far more by the work they do rather than by the number of patients they see,” he says. “For example, you’d have to do probably 30 smaller fillings compared to what an orthodontic case would be worth.”

In practice

Even though some dentists leave their practice unattended on days they don’t work, most practice management experts say it’s best to arrange the schedule so there’s always a dentist working—or at least someone at the front desk to answer calls. 

Dentists considering a move to a four-day week should speak with staff before implementing the change, says Bethan Flood, general manager at Prime Practice HR. “Have a discussion with the staff so they don’t think you’re about to reduce their hours from 38 hours a week to 32 hours a week,” she says. 

“Ensure they understand what’s happening and how it affects them rather than just announcing the decision. You will not only gain their support, but possibly some ideas on how better to transition the change.”

In fact, Dr Palmer says dentist-free days are a great opportunity for staff to catch up on work that’s put aside when the practice is busy. “There’s usually a lot of jobs to do in the practice when the dentist isn’t there. It’s important to leave instructions for your team on the days you’re not there. If they have spare time, there should be a list of jobs that can get done.”

And at multi-dentist practices like Dr Liew’s where many staff work part-time and share patients, solid handover procedures, flawless systems and excellent communication are essential to ensuring the day-to-day runs smoothly. 

“It comes down to having clinical notes so good that no matter who reads them next they’ll be able to work out where the patient sits and what they need,” says Dr Liew. “When you rotate staff, you must have a system of the previous day’s staff communicating with the next day’s staff that’s infallible.” 


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