09.15.06 - Issue # 236 Forward This Newsletter To A Colleague

No Job Descriptions = No Accountability = No $
A McKenzie Management Case Study

Nancy Caudill
Senior Consultant
McKenzie Management
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Case Study #28
Dr. Sandra Short

Dr. Sandra Short called in and expressed her concerns about the practice needing some guidance to help improve production.  Not an uncommon comment from our inquirers.  The culprit(s) causing the practice malady is not as easy to diagnose, however.  A visit to the office is in order.

Office Facts:

  • Paperless office
  • Practice is over 20 years old
  • 7 days of hygiene
  • 2 doctors and 2 assistants
  • 1 front desk employee who is also an assistant
  • 1 Office Manager


  • Doctors only scheduled a few days in advance and averaged 3 openings per day per doctor
  • Hygiene scheduled months in advance and averaged 3 “openings” per hygienist per day
  • No confirmation calls made
  • No morning meetings to review the day
  • No routing slips
  • No communication!

All of McKenzie Management’s consultants have lunch with the staff (no doctors) only on the first day after our arrival.  It gives us an opportunity to get feedback about the doctors (yes…they will tell on you, Doctor!)  It is okay, however.  We need to know what is on their minds and they also need to know that we are there to support them and their ideas as well as the doctors’.

They shared with me that they were unclear as to what the doctors expected of them, and as a result, they felt that they were reprimanded for poor performance.  They were not recognized for accomplishments and positive results.  True or not, “perception is reality”.

As I monitored the next two days in the office, I quickly realized that there was no employee assigned to any particular task.  The front office employee answered the phone, scheduled patients if they called, sent statements, entered information into the computer, and called recall patients “when she had time”, etc.

The assistants and hygienists scheduled all the appointments for the patients chairside, posted the charges chairside, called past due recall and unscheduled patients when they “had time”.  They were expected to sell dentistry chairside, arrange financing and answer insurance questions.  They were confused….clinical or business?  Business or clinical?  What hats do they wear?

Here is a list of systems that I found non-existent in Dr. Short’s office. 

  • Hygiene/Perio - the office has no periodontal program
  • Recall – appointments were made but no follow-up was made for non-scheduled patients
  • Treatment Presentations – there was no one “selling” the dentistry
  • Scheduling – there were no daily goals for the doctors or hygienists

Not only did the office not have systems, there was no one responsible for the tasks that they were attempting to perform.

The first obvious strategy was to establish 2 specific job descriptions for the following positions:

Schedule Coordinator
This position was accepted by the existing front office employee.  She learned that, in addition to her current tasks, she was directly responsible for the following tasks:

  • Scheduling the doctors to goal every day
  • Confirming all the doctors’ appointments
  • Preparing routing slips for the morning meeting
  • Posting the patients’ charges – collecting money – discussing the next appointment and informing the patient of their investment for that appointment

Hygiene/Treatment Coordinator
This position will be filled by a new employee that has experience in the dental field in order to discuss various treatment options AND someone that enjoys “dialing for dollars” and SELLING dentistry!  She will be directly responsible for:

  • Scheduling the hygienists to goal every day
  • Maintaining the recall system
  • Contacting all past due recall patients for “reactivation”
  • Present treatment plan options to patients and assist them with financing

By having these job descriptions defined and assigned, there is accountability for the doctors and there is no more confusion for the staff regarding “who is doing what”. 

As a dentist and the leader, it is imperative to define who is performing the various tasks in your office.  How can you expect jobs to be completed when no one knows who is going to do it?  When you make a blanket request such as, “I need someone to send out the lab case” during your morning meeting, who will you thank when it is done?  Or, if the task isn’t performed, whom do you question?  It is not fair to expect your team members to delegate tasks among themselves.  However, in many offices there is that one employee that takes on all the responsibilities with no recognition because the doctor isn’t aware that she/he is doing it.


Along with a monthly statistical report, Dr. Short now has the tools that she needs to monitor the performance of her staff members and enjoy the results that this brings.  Her employees will develop self-confidence and create recognition for themselves by performing these tasks as delegated.  It becomes a win-win-win situation for everyone…the doctor, the staff and the patients.

If you would like more information on how McKenzie's Practice Enrichment Programs can help you IMPLEMENT proven strategies….. email info@mckenziemgmt.com.

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McKenzie Management
A Division of the McKenzie Company, Inc.
3252 Holiday Court Suite 110
La Jolla, CA 92037
Email info@mckenziemgmt.com
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