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  Sally McKenzie's
 Weekly Management e-Motivator
  7.16.04 Issue #123

Did Somebody Yell ‘FIRE(D)’?

Sally Mckenzie, CEO
McKenzie Management

       Too many sleepless nights, too many gray hairs, too much antacid, too many unfulfilled chances to correct the problems. It’s time to let a difficult employee go. First make sure the employee file is chocked full of documentation demonstrating a system of progressive discipline. This makes it clear that the practice has made an effort to help the employee improve. It’s also advisable to check with your attorney regarding specific labor laws that may be in place in your state.

A typical progressive discipline plan should include:

  • Documentation of every conversation the supervisor/doctor has had with the employee regarding their performance.
  • Specific explanations provided to the employee both verbally and in writing that spelled out explicitly the performance issues that were not meeting expectations and what the employee needed to do to change their performance.
  • A signed document spelling out what the doctor and employee agreed needed to be done to improve the employee’s poor performance.

Ideally a problem employee placed on a progressive discipline plan will improve over a two-to-three month discipline period. But what’s real and what’s ideal are often worlds apart. When the time comes to send the employee on their way, follow a consistent, well-prepared plan:

  • Employees should be let go when patients are not in or expected in the office.
  • Meet with the employee in private, but have a witness present such as your attorney, office manager or spouse.
  • Tell the employee that the purpose of the meeting is to release them from their position.
  • Don’t feel compelled to get into the details of the performance problems. Through the progressive discipline procedures, the employee has been provided numerous opportunities over the past 60-90 days to understand and address the performance issues.
  • Give the employee a check on the spot for earned salary and benefits or tell them to expect payment within a certain number of days.
  • The person then should be escorted to collect their personal belongings and hand over the office key.
  • When the employee is gone, call the team together and inform the team that the employee is no longer with the practice. The doctor should not get into any details regarding the dismissal. It’s important that the team hear from the doctor as soon as possible to avoid speculation and gossip.

Although firing an employee is something most dentists will avoid almost at all costs, once the job is done they consistently find that it was the best action they could have taken for both themselves and the practice.

If you have any questions or comments, please email Sally McKenzie at

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Is Your Glass Half Full or Half Empty?

Dr. Nancy Haller
Executive Coach
McKenzie Management

        There’s a story about two shoe salesmen that sailed to a faraway island to sell shoes. After the first day, each of them sent back telegrams. One said, “This place is a disaster. No one wears shoes.” The other telegram read, “This place is a gold mine. No one wears shoes.”

Research has shown us that from the ability to sell to higher immune responses to illness, optimistic people are more successful – in business endeavors, athletic performance,

personal relationships. Remaining positive in the face of adversity could mean big bucks for your practice and it is likely to improve your overall sense of well being too! The really good news is that you can learn to be more optimistic!

Optimism is the frame by which you see the world and define what happens to you. Perhaps you remember reading The Little Engine that Could. The little train competing with the powerful new locomotive. Although this children’s book has become the “popular” view of optimism, the story provides an inaccurate image of the concept of positive thinking. Optimism is far more complex than simply saying “I think I can, I think I can”. The way you explain both bad and good events, your explanatory style, goes beyond the words you mouth when you fail or succeed.

During childhood and adolescence you developed thinking habits based on your life experiences as well as the role models around you. Your explanatory style was formed directly from your view of your place in the world – whether you thought you were important and deserving, or insignificant and doomed to failure. Over time you constructed a belief system about how the world operates, and your place within that world. It is the foundation upon which you make judgments and decisions. Even if that belief system helped you to survive a difficult start in life, it may not be working any longer. Stop and examine your thinking.

There are three crucial dimensions to your explanatory style – permanence, pervasiveness, and personalization. Let’s look at each of these in the context of successful experiences as well as adversities.

When good things happen:

Optimistic people tend to think, “Success is here to stay”. They believe that their good fortune is permanent. Pessimists believe that success was just a fluke happening.

Optimists maximize their success by allowing it to enhance everything else they do (pervasiveness). Instead of leveraging their successful experiences, pessimistic thinkers let good events die on the vine.

Most importantly, optimistic thinkers take credit for their successes – they own it (personalization). Pessimistic people dismiss their success to good luck.

When setbacks occur:

Optimists are able to attribute causation in ways that preserve their self-esteem and energy. Adversity is temporary to them; “My practice always slows down in the summer. It will pick up in the fall when people return from vacation”, not “I’ll never get my revenue up to where it needs to be.

Optimistic people also are able to limit the extensiveness of negative experiences. They put a ‘psychological tourniquet” on their thinking so that setbacks are specific and not pervasive; “Mr. Jones is a noncompliant patient – the rest of the day is bound to get better”, not “Here we go again…another lousy day”.

Lastly, optimists allow themselves to see outside factors as contributory to bad events; “That procedure was difficult because I have a new chairside assistant”, not “I’m a terrible dentist”.

Remember your thoughts affect your actions and your emotions. While it’s normal to feel angry, sad and fearful, successful leaders don’t dwell on these emotions. Resiliency is about finding temporary and specific causes for misfortune. This is the “stuff of hope”. If you have been experiencing poor health, lowered productivity, poor self-esteem and/or a tendency to become overstressed with life’s inevitable downturns, evaluate your thoughts. By changing your beliefs, you could improve your practice and your life.

As the saying goes, “As you think, so shall you become”.

Keep in mind that optimism cannot be determined accurately by merely your own perception. If you are interested in assessing your explanatory style through a scientifically validated test, contact Dr. Haller at

Nancy Haller, Ph.D.

Interested in having Dr. Haller speak to your dental society or study club?
Email her at


The Importance of a Written Payment Agreement

“At some time in the life cycle of virtually every organization, its ability to succeed in spite of itself runs out.”
Richard H. Brien, The Education Record, 1970.

Belle M. DuCharme
RDA, CDPMA, Director
The Center for
Dental Career Development

        At break time, during my presentation on How to Become an Exceptional Front Office Employee, a doctor, who had come for the workshop and had brought his front office staff, approached me and said. “My patients love me, the parents always thank me for giving their children such good care, but they don’t want to pay me. I don’t understand. I bend over backwards to please them yet my accounts receivables are way too high. They want to make payments, but don’t keep the agreement. When the insurance pays they don’t send in their balances. I thought if I were the best dentist in

town, I would get paid. What am I doing wrong”? To answer his question, I replied. “You aren’t doing anything wrong in the delivery of your dental procedures. It sounds like you have a great chair side manner. What hasn’t been made clear is what is expected of the patient or responsible party for payment of your services. If there isn’t a firm financial arrangement in place for each patient before treatment begins, then the patient or responsible person will have a preconceived idea of how they are going to pay. Many patients bring the “bill me” attitude from their previous dental office. If the procedure has already been completed, this is the worst time to set up a financial arrangement because you have already delivered the goods. Experience has shown me that if you don’t ask for the money, you won’t get the money. As a dentist with a busy practice, you should not be involved in collecting for your services. Your financial coordinator should be collecting co-payment percentages and deductibles from each insurance patient at each visit. If you are accepting assignment of benefits as a PPO network provider then you are already doing “discounted dentistry.” If the patient wants to make payments, that can be arranged through CareCredit services, an outside financial organization that specializes in lending money for health care services. The patient will be able to make affordable monthly payments and you will be paid in full minus a small fee. Everyone wins. You should not be carrying any accounts on your books because you are a small business and not a lending institution.

At THE CENTER FOR DENTAL CAREER DEVELOPMENT, we have a two day FINANCIAL COORDINATOR Training Course for your front office financial person. Together we develop a written financial policy customized to the needs of your practice. We establish written dialogues for treatment presentation along with ways to overcome objections. We cover the most common reasons for rejecting treatment and how to overcome these pitfalls and schedule the patient. Your financial coordinator will come away knowing how to measure the success of your practice and how to increase treatment acceptance and payment of services when rendered. Don’t continue to flounder with high accounts receivables and unpaid bills. Take your staff to a new level of competency and get the respect you deserve from your patients. Remember the quickest way to lose a patient is to have him owe you money. Call us today to schedule your Financial Coordinator/Business Administrator for one-on-one customized training.

For Advanced Front Office Business Training call, THE CENTER FOR DENTAL CAREER DEVELOPMENT

Belle M. DuCharme, RDA, CDPMA

Exceptional Front Office Employees?
The Center for Dental Career Development can provide your team with “customized” expert training to improve the performance of your practice ...Go Here Now...



Dental Insurance Coding Handbook
4th Edition

By Carol Tekavec

This 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. Also, you will receive information on treatment estimates and how to talk to patients about insurance.

e-Newsletter price: $97

is endorsed by

Sally's Mail Bag

Hi Sally,

My staff has been bugging me about getting some type of message on the telephone when patients are put on hold. I told them that patients shouldn’t be on hold very long but they are disagreeing with me…the boss…who signs the paycheck…imagine that! Please give me your advice.

Dr. New York

Dear Dr.

It is a fact that patient’s are put on hold and sometimes longer than we would want. Patient’s are checking out, checking in, phones are ringing and clinical staff want to know if their patient has arrived. I do advise that if the patient is on hold more than two minutes, connect to the patient and explain you are still with a patient and do they mind continuing to hold and wait for the answer!!

Educating the patient is essential in reinforcing the importance of professional dental care as well as informing patients about other services the practice provides. No matter what size your practice, it’s likely that, at least occasionally, patients must be placed on hold. Use this time to educate your patients with specially developed informative messages that enlighten the patient about services you provide. Having information on hold allows you to choose specific messages for your needs such as promoting veneers or porcelain inlays, or the importance of sealants for young children. You have the flexibility to change your message as often as you like and it just plugs into your phone system. Patients have come to expect this as most businesses now provide this feature.


Office Managers
Financial Coordinators
Scheduling Coordinators
Treatment Coordinators
Hygiene Coordinators

For a FREE
Educational Video
e-mail us at:
The Center for Dental Career Development
Advanced Business Education for Dental Professionals
737 Pearl Street, Suite 201
La Jolla, CA 92037


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Missed Past Issues of Our e-Motivator Newsletter?

This issue is sponsored
in part by:
The Center for Dental Career Development
San Diego Workshop Series
Summer Schedule
 Date Seminar Instructor(s)  
 August 6
 9:00 - 4:00
10 Vital Skills to Master Management of Your Dental Practice Belle DuCharme, RDA, CDPMA  
 August 27
 9:00 - 4:00
How to Become an EXCEPTIONAL Front Office Dental Employee Belle DuCharme, RDA, CDPMA  

The Center for Dental Career Development has been approved under the Academy of General Dentistry, Program Approval for Continuing Education (PACE). Starting 10/19/03 through 10/18/07 members of the Academy of General Dentistry can receive AGD credits for all seminars and workshops sponsored by the Center for Dental Career Development.

Please visit to view a list of upcoming seminars and workshops.

To Register 877-900-5775 or

Southern Oregon Dental Society Presents
Ms. Sally McKenzie
“The Hidden Signals of Practice Erosion”

Friday July 16, 2004 from 8:30 am – 4:30 pm at the Smullin Center
2825 E. Barnett Road, Medford Oregon 97504

Reservations may be made in advance by calling SODS at 541-773-6215

Be sure to plan on enjoying Rogue Valley’s many fine attractions. Choose from: Shakespeare, Britt Festivals, Rafting, Golf, An Italian Cooking Course and much more!

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