the Slippery Slope of Service Snafus
In the eyes of
the patient you are the practice, from the time you set foot in
the office until the moment you leave the building. This role carries
enormous responsibility as well as equally significant opportunities.
Superior patient service is not the result of excellent clinical
care alone. It is the culmination of every interaction the patient
has with every person in the practice. One person’s bad day
or poorly handled patient exchange affects every member of the team
and the total reputation of the practice.
Poor patient service is often the residual effect of harried schedules,
personal and professional stress, and frustrations with specific
patients and co-workers. When the day’s demands become particularly
intense take extra care to avoid these service
I don’t care. Patients are far more tuned
into your attitude than you would ever want to know. The labored
sigh; the piercing, annoyed stare; the rolling eyes may be your
“quiet” way of venting today’s frustrations.
But they scream POOR ATTITUDE AND DISRESPECT TO THE PATIENT.
If your expression, your tone, your approach, or even your appearance
sends the message that you are disgusted and really do not care
about the situation, about what people think – including
the patients - that is precisely what the patients hear. Loud
I don’t know. Patients expect you to have
immediate answers to basic questions. Track the common questions
that patients ask. Take steps to ensure that every member of the
team is prepared to answer them. If you cannot
answer the question yourself promptly locate another member of
the team who can. NEVER, EVER respond with “I don’t
Go away. Under no circumstances should a patient
ever be ignored when they come to the counter. Acknowledge
their presence immediately. Whether you are engaged in
a conversation with the doctor, a co-worker, another patient,
or your mother in-law it takes five seconds to look over at the
patient and acknowledge that they are there and you will be right
with them. If you pretend they are not there, you inform the patient
that they are an annoyance and unworthy of your time.
I talk, you listen. Wrong. The patient talks,
you listen. Even though you have heard the scenario 52-hundred
times and you are convinced you know exactly where the patient
is going with this, avoid that uncontrollable urge to blurt
out your know-it-all response before the patient can
even finish a sentence, which effectively shuts the patient down.
Beating them into submission with your intellectual prowess establishes
you as the overbearing individual who would not listen to what
the patient had to say. Listen first talk later.
When tensions are high, take extra care to show compassion,
understanding, and a positive and helpful demeanor. Both you and
the patient will be very glad you did, and the practice will benefit
significantly from your efforts.
you have any questions or comments, please email Sally McKenzie
in having Sally speak to your dental society or study club?
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Last week, [see
article], I discussed the steps necessary to track and report
your new patients. This week, I want to focus on the simple yet
incredibly underutilized feature called lab case tracking.
Somewhere in your practice management software (most of them have
there is an open lab case report. Even if you have never implemented
lab case tracking, I want you to print the report. The “header”
on the report will show you what it is designed to do. This will
help you set up your system properly.
In most practice management software, the ability for the software
to automatically open a lab case is in the ADA/production code database.
Bring up an ADA code (start with 2750) and look for an area on the
screen that allows you to open/close a lab case. The idea here is
that every time a 2750 is posted, the software
knows to ask if it should open a lab case for this particular procedure.
For every code that opens a lab case, you will need one to close
the lab case once the case is inserted. Some practice management
software allows you to use modifiers after the ADA codes while others
require you to make one code to close all lab cases.
Refer to your help manual, get training, or call your software support
if you need assistance with your particular software. Of the software
I have reviewed, they all have very easy to follow instructions
in their help index under “lab”.
Your software will also have a lab database. Add the labs
your office uses to this database so you have them to choose from
when posting an ADA code that opens a lab case. Make sure you fill
in the fields properly and completely. Some information in the lab
area will actually trigger future useful “events”.
Practice, play, and go through every scenario to test your setup.
If you have set it up properly, tracking your lab cases should be
Every morning, print an open lab case report. Post this report where
the lab cases are stored. As cases come in from the mail and courier,
usually an assistant is responsible for checking the case and highlighting
the lab case report. Use the color green highlighter
for cases that are in and ready to be seated.
Every evening, the assistant brings the lab case report to the front
desk. Open the window in your software that lists all of the open
lab cases. “Mark” all of the lab cases as “ready”
that are highlighted in green on the report. Rerun
the open lab case report for tomorrow morning.
When you run your confirmation list, confirm off the appointment
book on the screen, or go to the tickler file, or basically go anywhere
associated with that patient – you should begin to see the
software telling you that this patient has an open lab case.
The obvious benefit is making sure everyone on the team is on the
same page with every patient. Never being embarrassed by not having
a lab case for a patient who’s already in the chair is, well
I welcome any and all readers to email me with specific questions,
problems, requests and challenges. Who knows? Maybe your inquiry
will lead to a new Tips For Today article! Don’t
worry, your inquiry will remain anonymous.
in having Mark speak to your dental society or study club?
The Cold Shoulder
Giving Dentists And Their Staff Different Perspectives On Day To
It is interesting to hear you say what is obvious, in that we
as dentists should make it clear to
our staff what we would like to have accomplished, and the way
it should be handled. It drives me nuts when I do make a
suggestion or ask that something be done and the response I get
sounds like you’re desperate (re: calling a patient)
I know what to say........why did you hire me?
I did that already
I'm not calling him, I think it would be better coming from you
don't agree with that
the list goes on, and what I've come to LIVE with.
If I want to keep the peace and retain the staff, I have to take
the good with the bad and deal with it.
Yes.....I could fire, hire, and hope for the magical mix that would
indeed increase production and collections a bit, or I can deal
with and accept things the way they are. The practice is doing
well and the staff has been with me longer than any time in the
past. So we go on and I have to hope that the bursts of silent
aggravation during the work day don't kill me first.
We know that no one cares about the practice, or any business as
much as the owner, so my next move is to create ownership with the
staff and see if that may become self motivating. I would love to
hear from you with one or two of your favorites.
Dr. Dentist Owner
I would like to help by clarifying some very erroneous conclusions
and principles around which you run your business and, in all probability,
No. 1 - With a staff like this, you can look forward to limited
benefits from any practice management consultant or system.
No. 2 - While it may seem obvious that dentists should make it clear
to their staff regarding what you want to accomplish and the way
it should be accomplished, the truth is that based on the above
listed responses of your staff, you are not a team moving
in the same direction. You have a very adversarial relationship
with your staff. They enjoy a free license to maintain a bitter
status quo regardless of your statements.
3 - You have grown accustomed to being driven “nuts”
in the past, and therefore being in this state of mind, even though
it is painful, is a very familiar habit which you find comfort in
maintaining. Any reasonable person would not like to be driven
"nuts" by other people regardless of who they
are whether family, friends, or strangers.
4 - The staff responds to your requests with such insolence that
a reasonable person, I believe, would take great insult by these
responses. The truth is not debatable; you provide jobs
that permit these people to pay their bills. Your position
of power is one which should be recognized and honored. It is clear
that you have learned that you are not entitled to be special and
thus acknowledged for the positive service that you provide.
No. 5 - It is unreasonable that you should continue to live with
so much abuse in your own business. You choose not to exercise
any of your inalienable rights as an adult and a business owner.
6 - You do not have to take the good and the bad because you are
a business owner. This is not your family. These are people that
you choose to help you to make money. You have
learned to feel trapped and to live without options long before
you began this business. It should be clear that adults have the
option to choose their friends as well as their employees.
7 - It is clear from the current magical mix that you were quite
limited in the past, and it is reasonable to suspect that even with
a new mix in place, your production and staff harmony will also
be limited. The truth is there is nothing magical about this mix.
As the owner of the business, you determine what the goals for collections
and production are. This is all within your control.
If the people you choose cannot perform, that is simply an opportunity
to find people who can. There is nothing magical here. However,
we learn something about you in your perception that such power
is beyond your right. You consider it magical, but it is just business
No. 8 - With all of your expressions of pain and disappointment
in this e-mail, why would you want to continue to accept the way
things are, when it is reasonable that they could be improved.
This attitude is a testimonial to your habitual limited vision and
limited ability to experience true happiness.
No. 9 - Bursts of silent aggravation during the workday seem to
me to be a form of personal abuse and punishment. You are in complete
control and yet you continue to condone this experience
of pain through your lack of ambition to enjoy your business and
The essential point is that you are suffering under the pretense
that this interaction with your staff is the best that can
be. The truth is that with good practice management systems,
even the worst practice will make more money, but that will not
change your ability to enjoy your daily interaction with people,
your family, and provide you with a quiet moment of personal success.
are complacent and passive and you continue to suffer needlessly.
At least change the staff and find a new "magical mix ".
At least you can say that you are trying to feel good about your
life and business; however, the truth is that unless you change,
you will just find a new mix that will continue the abuse.
I have sought to clarify your message to me in hopes of helping
you to see that this type of suffering is created by you for purposes
that perhaps have yet to be discovered.
I wish you well.
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Insurance Coding Handbook
manual is an office essential!
Much more than just codes and definitions, this manual helps
you speed up insurance reimbursement, reduce requests for "more
information" and decrease payment delays! Additionally,
under the provisions set by the HIPAA Act, all dental offices
and insurance carriers that transmit health information electronically
must use the current version of dental procedure codes found
in this Handbook. In addition, you will receive information
on treatment estimates and how to talk to patients about insurance.
McKenzie Management Team looks forward to continuing to
provide the very best consulting services so that dental
practices in turn can perform at their very best.
I own a dental practice with an older partner. We were "lucky"
buy this practice with the original staff. It's been close to three
now, and neither of us feel like we “own our practice”.
The staff still
continues to run by their rules; and when I try to enforce the new
the staff does not like it, and run to my partner who, in turn,
backs down and
continues to allow them to run the practice the way "it's always
Our staff members have been here for 10-30 years. What can I do
to take control of our business - besides firing everyone and starting
Sincerely, Very Frustrated
The staff obviously feels as if they "own" the practice.
They have made the 10-30 year investment where you and your partner
have not. Change is difficult and can be frightening if understanding
and guidance are not made available. Using the "direct"
approach is certainly an option. That is, calling the troops together,
explaining that they have failed to institute changes to policy
or systems; they are "running" to the partner they know
will get them their way. Tell them it won't be tolerated and then
that must be reported to the two of you at the end of 30 days that
what you want done is done and if it is not, they will be making
a clear statement that they are insubordinate to their employers’s
wants and will be placed on probation and ultimately terminated.
A less invasive approach for the two of you as owners is to have
one of my consultants come into the practice and analyze over 20
systems that run the business operations, make recommendations (some
of which may be what you have tried to implement) of why the system
needs to be changed and how it will benefit them. This then puts
everyone (you and them) on the same playing field. It diffuses them
thinking they "know more than you". How the systems in
the practice should be run are coming from an "expert"
with a lot more in experience than what they have. They know you
haven't worked a day at the front desk and they know when you're
in an operatory you don't know what they are doing.
Email me back if you would like more information in our consulting
We would love to help you eliminate your frustration.
Center for Dental Career Development
Business Education for Dental Professionals
737 Pearl Street,
La Jolla, CA 92037