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3.03.06 Issue #208  
To Have...or Not To Have an Office Manager
A McKenzie Management Case Study

Nancy Caudill
McKenzie Management
Senior Consultant
McKenzie Management

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This two doctor, middle America, general practice contacts McKenzie Management with concerns of “things not getting done.”  The names have been changed to protect the guilty and the innocent!

Drs. Bowman and Jones’ Story:

Dr. Bowman called and was very stressed and anxious!  “We have three employees at the front desk and nothing seems to get done.  Cheryl, one of the three, is our office manager. She has been with us for a long time and is very loyal but……. she doesn’t seem to really know what the other two are doing.”  “We never know if tasks are getting accomplished.  We communicate our concerns to her so she can address them with others but we don’t see any improvement.”  “We realize that she is busy scheduling patients and answering the phone but she IS the Office Manager!  That’s what we hired her to do!”

The “facts: of the matter:

  • 2 dentists, 2 hygienists, 4 assistants, 3 business staff
  • Dentists also own small apartment complex
  • $300,000 in outstanding insurance claims
  • 4 days of hygiene
  • In practice 22 years
  • Low production by all

In-office Observations:

Cheryl had been working with the doctors for a few years and the patients liked her.  Her work station was the “hot seat” where patients are checked in and out.

Inquiring about her daily routine, Cheryl indicated that some duties had been passed down to her from a previous office manager and she was not comfortable performing them without proper training, i.e., accounts payable and managing the small apartment complex.  “There just isn’t enough time in my day to get it all done”, she cried.  “I don’t enjoy confronting other staff when the doctors come to me with business concerns.  I would rather just take care of it myself.”  It was obvious that Cheryl was sinking in quicksand!  Just because Cheryl had previous years of working in a dental practice before coming to this office, did not necessarily make her a human resource manager.  Her inability to confront employees would have been identified through pre-employment testing.

The other two front desk employees, Kathy and Janet, were also located in the same area at the front desk.  It was observed that none of the three knew what the other was doing or what they were responsible for.  Cheryl, Kathy and Janet were all answering phones, making appointments, posting checks, filing charts and anything else that needed to be completed throughout the day.

“Who is responsible for managing the hygiene recall system?” I inquired.  “Whoever has a few minutes,” was the response.  Oh my, the entire business staff was sinking in quicksand!

Recommendations to Drs. Bowman and Jones:

  • Office not large enough for an office manager.  Not necessarily physically, but providers and employees.
  • They needed to departmentalize the business office:
    • Schedule Coordinator – Cheryl
    • Financial Coordinator – Janet
    • Hygiene Coordinator – Kathy
  • Definitive job descriptions for all 3 positions with no overlap in duties
  • Training for all 3 job descriptions.
  • Each coordinator was to report at the monthly meeting on the performance of their own department with statistics relative to their job descriptions by using McKenzie Management’s Methodology.
  • Hire a part-time bookkeeper to manage Accounts Payable and the apartment complex.  While these are tasks that need to be done, the effort put to them does nothing to improve the growth of the practice.


The doctors now go directly to the coordinator of the department they have a concern with.  The business staff is empowered to perform to specific expectations and is held accountable. 

What gets measured……will get done!

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