12.08.06 - Issue # 248 Forward This Newsletter To A Colleague

Nancy Caudill
Senior Consultant
McKenzie Management
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Can We Talk?

A McKenzie Management Case Study

Dr. Matthew Fox – Case Study #256

Dr. Fox was not unique in his daily challenges of managing an efficient and productive office.  Also not unique were the obvious struggles that the team had in regard to the same challenges.

Guess what?...the doctor and the team had no idea how to solve any of the issues they faced because there was no effective communication taking place among anyone! 

Dr. Fox’s concerns:

  • Employees were not making day to day decisions regarding scheduling and patient questions regarding treatment.  He always felt they needed to speak to him about everything.  He felt like he was working the deli department in the grocery store where the customer takes a number and waits until their number is called in order to get served.
  • The schedule was stressful and not productive on many days.  The doctor and staff found themselves working into lunch and late in the evenings.
  • Dr. Fox and his clinical team felt like they were “flying by the seat of their pants” many times throughout the day regarding patient care and treatment.

Business Staff’s concerns:

  • It was difficult to find time throughout the day to talk with the doctor about scheduling questions as well as patient questions.
  • Treatment plans were not being followed so it was difficult to explain to the patient what they were being scheduled for.
  • Difficult to collect patient’s payments because the recommended treatment was being changed mid-stream.

As I observed the activities throughout the day during my first two days of my visit, it was obvious to me what was causing such “mass confusion” between the doctor and the staff.  There was NO communication taking place that was effectively resolving the issues of the day.  There were also no tools for doing so.  In other words, no one really knew how to talk to one another!


Morning meetings – Dr. Fox and his clinical team would gather in the hall while the hygiene patients were being walked between them to briefly “chat” about the day.  The meeting was non-productive and did not completely cover the areas that needed to be covered in order to have an efficient and productive day.
Morning meetings should include the following:

  • Review of all the procedures that are scheduled to confirm the accuracy of the information
  • Review medical alerts
  • Determine any patients who have birthdays that week that are coming in for celebration
  • Share production goals for the previous day, as well as scheduled production for this day and tomorrow
  • Look for good times for emergencies that may need to be seen for the day
  • Make sure that all lab cases that are scheduled for the day are in the office and ready for delivery.
  • Review tomorrow’s schedule if time allows

In conjunction with the morning meeting, the hygienists and assistants should have access to their patients’ records for the next day by lunch-time in order to have time to review the information prior to the morning huddle.

Monthly MeetingsThere was some form of monthly meetings held but it was felt by the staff that they were not productive.  They were held during lunch without an agenda and no “old business” was discussed from the previous meeting. Monthly meetings should include the following:

  • Monthly statistics for the practice for the previous month – this is extremely important so everyone is aware of how the practice is performing.

Trends should be noted by the doctor (up or down) and discuss with the team

  • A “To Do” List should be reviewed each month that includes tasks that were discussed and need to be completed by assigned team members.  Monthly meetings can be productive and information and ideas are shared but nothing is followed up on because no one is held accountable for the tasks that are discussed, and no notes are made so this information can be reviewed at the next monthly meeting for completion of the tasks.
  • New agenda items should be discussed.  These items are accumulated by the “Monthly Meeting Coordinator” from the staff.  A bulletin board, an envelope, a suggestion box, etc. can be used as a mechanism for the team to make suggestions for agenda items throughout the month.

“Walkie Talkies” could be used by all team members and doctors to improve inter-office communication.  Staff members were running around the office like “chickens with their heads cut off” trying to find other staff members to ask questions or share information to. Team members were constantly playing “hide and seek” with the doctor or each other.

New Patient Time to make an accurate treatment plan is a necessity in order to have continuity of information between the doctor, the clinical staff and the business team.  Everyone must be on the same page regarding the patient’s treatment, the fees, how the appointments need to be scheduled and how much time is needed for each appointment.  This would eliminate many of the questions for the doctor throughout the day regarding patients’ treatment.


There is “talking” to make noise and there is “talking” for a purpose.  Communication must be clear and concise between the doctor and the staff.  If the staff does not completely understand what the doctor is saying,…ask for clarification.  Some doctors communicate more clearly than others.  Dr. Fox was a friendly and very likeable doctor, but he did not always communicate his thoughts clearly and with a definitive conclusion.

It takes practice to improve communication in an office. By implementing the tools listed above, the practice day will be more productive and less hectic.  Everyone will be aware of the “page” that the practice is on for the day.  Start the day on the right foot and it will continue to march on efficiently until it’s time to go home.

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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