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1.25.08 Issue #307 Forward This Newsletter To A Colleague

Nancy Caudill
Senior Consultant
McKenzie Management
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Who is Carrying the Football?

Dr. Ronald Pace – Case Study #167

Dr. Pace’s practice concerns:

Dr. Pace was very anxious as he expressed his concerns regarding his team’s performance.  “I feel like no one is working except for me.  I am so tired by the end of the day and no one seems to care if we met our practice goals or not.”

Dr. Pace’s practice facts:

  • 5-year old practice in the same location
  • $70,000 a month in net collections
  • 15 new patients a month
  • 1 hygienist working 4 days a week
  • 2 business team members and 2 chairside assistants
  • Wages are at 21% of collections
  • No internal marketing


  • There is a practice goal for the day but not a specific goal for the doctor or the hygienist.  It is vital that the providers have their own goal so one doesn’t assume that the other is carrying the load.  It also makes it impossible for the Hygiene and Schedule Coordinator to schedule their providers to a goal when they don’t know the goal.
  • There are no morning or monthly meetings.  This means that there isn’t any communication going on in the office regarding how the practice is performing.
  • There are no job descriptions for the business team.  Both team members are running on auto-pilot and just “doing what needs to be done”.
  • Dr. Pace doesn’t feel comfortable discussing concerns with his team members. His temperament type is ISFJ so he avoids confronting his employees. They don’t know if he is pleased with their performance or not. It is difficult for him to implement new ideas or systems, even when he feels there is a better way of accomplishing a task.


  • The providers (doctor and hygienist) must have their own daily production goal.  Hygiene industry standard production needs to be 3x the hygienist’s salary. PPO reduced fees, low fees, openings in the schedule; poor hygiene treatment acceptance and not enough periodontal services can affect the ability of the hygienist to meet her daily goal. 
  • Job descriptions are to be established for the business team.  Sue will be the Schedule Coordinator.  She will answer the phones, check the patients in and out and is responsible for scheduling doctor to goal.  Jane will be the Hygiene and Financial Coordinator, responsible for the recall system, scheduling hygiene to goal and the financial tasks of the practice.
  • Morning and monthly meetings must be put in place in order to get everyone “on board”.  It is necessary that all the team players know how the team is doing…are we winning or losing? 
  • Dr. Pace was encouraged to communicate with his team members.  Because he didn’t want to “hurt anyone’s feelings” he was jeopardizing the success of his practice and the cohesiveness of his team.  Employees need feedback, positive or negative.  The morning and monthly meetings are the perfect time for him to start “calling the plays” and communicating with his team regarding his concerns. An agenda was established for the meetings with an established format.


Dr. Pace was carrying the weight of the practice on his shoulders because he was unsure as to how to communicate his concerns. Systems were absent that would have allowed his team members to be accountable, and he had no “play board” for his practice with no roadmap for the journey.  By empowering him to become the “quarterback” of his team, call the plays and keep score, his employees became a viable part of the team and every day each player knew what the score was.

If you feel that you are the only player carrying the ball, contact McKenzie Management to learn how to develop systems to make your employees team players for a winning team!

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

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