Visit our website at
  05.19.05 Issue #167


“Help, I think I need to call Nanny 911 for my patients”.
How To Manage Difficult and Demanding Patients

Belle M. DuCharme,

An Office Manager by the name of Louise (not her real name) came in recently for Advanced Business Training at The Center for Dental Career Development. She was a very warm and friendly person who was also articulate and very serious about the issues now taking place in her office. She came in for training to improve her efficiency and to learn how to put systems for managing patients in place. “The patients rule the practice”. Louise said. Louise had managed the practice for five years and in that space of time the practice had grown to the point of taking on another dentist and more staff.

Louise’s personality temperament type was an ESFJ, one of the most common temperaments seen in a dental employee. Before the practice got so busy, she had time to chitchat with the patients and became friendly with most of them on a personal “first name” basis. When scheduling the patient’s next appointment, she would ask, “When would you like to come in for your next appointment?” instead of telling the patient when a time was available that fit the best times for the practice.

The practice had recently taken on an associate dentist and a new assistant. They had signed up for more PPO plans to give his practice a “jump start”. The dynamics of the practice changed with the addition of the new doctor and staff. Utilizing the other operatories that used to be available for “overflow” meant more accurate scheduling and less flexibility to accommodate patients that got to “choose” the time to come in for an appointment.

“Belle, I am at my wit’s end with some of our patients. I am afraid of upsetting them but several have gotten angry with me when I don’t have time to see them. They think that if they pressure me I will give in and sometimes I do making a disastrous mess of the schedule for the doctor and the assistants. Some of my patients say, “I have been coming here for ten years, surely you can find a spot for me”. When I do “work them in” and they have to wait, they come up to the desk and ask “When are you going to see me, I have been waiting for a half hour?”.

The doctor and the assistants don’t help much when they say, “This schedule is impossible!!”.

Having an absence of policies for appointment control can contribute to chaos and high stress for the dental office environment despite good intentions. During the training we developed new policies and worked on the dialogue that we would use when communicating with the patients. With coaching, I helped her prevent patients from dictating office policy. Appointment times were to be offered that best suited the needs of the practice first. Special dialogue was developed to support the appointment times and to help the patient understand the necessity for the suggested times. Patients were to understand that effort was being made to also accommodate their requests within reason. “Because of the nature of this procedure, Dr. Brown has asked that your appointment be scheduled in the morning”. Children and the elderly usually respond better to treatment in the morning when they are rested and fed. Saying “I will make every attempt to give you a time that is agreeable to your schedule and to that of the doctor. Due to the nature of the dental business it is not always possible to give you the time that you want. I know that Dr. Brown would be very happy if you would work with us on this matter. Thank you!”.

Demanding patients remain that way because they have been rewarded for their inappropriate behavior in the past. Once they understand why you need to schedule for both them and the doctor, they are more compliant. Offering to put them on a “short call” list for times that they have requested is favorable and says that you are doing your best to accommodate their requests.

If you want more information on Business Training for Front Office, please email

The McKenzie Company Seminar & Exhibit Schedule
2005 Location Sponsor Information Topic Speaker
July 21-24 San Diego, CA
IA of Comprehensive Aesthe 702-341-7978 Peak Performer Sally McKenzie
August 13 Topeka, KS Delta Dental Plan of Kansas 800-733-5623 Breakdown Sally McKenzie
Sept. 9-11 San Francisco, CA California Dental Association* 916-443-0505 TBA Sally McKenzie
Sept. 22 El Paso, TX El Paso Dental Society 877-777-6151 TBA Sally McKenzie
Sept. 23-24 Griffin, GA Endo Magic Root Camp 877-478-9748 Top Issues Sally McKenzie
Oct. 14 Riverside, CA Riverside Implant Study Group 951-279-7847 TBA Sally McKenzie
Nov. 18-19 Griffin, GA Endo Magic Root Camp 877-478-9748 Top Issues Sally McKenzie
Dec. 1 Cincinnati, OH Cincinnati Dental Society 513-984-3443 Breakdown Sally McKenzie
Dec. 9 Minneapolis, MN Minneapolis District Dental 877-777-6151 TBA Sally McKenzie
* The McKenzie Company will be exhibiting at location


The McKenzie Company

3252 Holiday Court, Suite 110

La Jolla , CA 92037

For more information, email
or call 1-877-777-6151

The McKenzie Company Newsletter Information:
To unsubscribe:
To discontinue receiving the Sally McKenzie eManagment newsletter,
click on the link at the very bottom of this page for instant removal,
To report technical problems with this newsletter or to request technical help,
please send a descriptive email to:
To request services, products or general inquires about The McKenzie Company activities
please send a descriptive email to:
If you would like to have any of your dental practice concerns answered personally by Sally McKenzie,
please send a descriptive email to her at:
Copyrights 1980-Present The McKenzie Company - All Rights Reserved.