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6.27.08 Issue #329 Forward This Newsletter To A Colleague

Nancy Caudill
Senior Consultant
McKenzie Management
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Where Is Your Lost Revenue?

Dr. Larry Short—Case Study #341

Dr. Short’s Concern:

With fewer new patients coming into the practice, production has slowed downalarmingly. What steps can be taken now to correct the situation?

Dr. Short’s Practice Facts:

  • 8-year old practice in a small town
  • $43,000 a month in net production
  • $43,000 a month in net collections
  • 11 new patients a month
  • 1 doctor working 4 days a week
  • 1 hygienist working 4 days a week
  • 1 business team member and 2 chairside assistants
  • No internal marketing


  • The morning meeting was ineffective and did not direct the entire team as to how each member would be participating during the day. The doctor conducted it by simply looking at the schedule and asking questions regarding the treatment that was scheduled for that day.
  • There weren’t any established production goals for the doctor or hygienist.
  • The hygienist was not reviewing the patients’ charts for diagnosed treatment that was not scheduled to be completed.
  • The chairside assistants were not seeing that the patients understood the recommended treatment after the doctor left the treatment room.
  • There were no dental presentation models, dental videos or other educational tools available to facilitate patient education and informed consent.
  • The doctor didn’t “close the sale” of his treatment recommendations but rather left it up to the Scheduling Coordinator.
  • Treatment presentations by the Scheduling Coordinator were presented as total treatment without the patient understanding the number of appointments and the time involved in each appointment.
  • The Scheduling Coordinator did not have a follow-up or tracking system in place to monitor patients that elected not to schedule recommended treatment.


  • The morning meetings were expanded to include reviewing any treatment that was recommended for a patient but not yet scheduled. Such information is available on the routing slip that is printed for each patient from the computer. The routing slips are reviewed by the Scheduling Coordinator with relevant information highlighted, including outstanding treatment. (Dr. Short’s practice is virtually paperless but the routing slips are used for communicating vital information between the business and the clinical team members at the morning meeting.)
  • Daily production goals were established for the doctor and the hygienist.

    Hygiene daily goal: 3x the hygienist’s daily salary
    Doctor’s daily goal: determined by reviewing the practice overhead percentages

    In Dr. Short’s practice, the hygiene goal was set at $840 and the doctor’s goal was set at $3035. It has since been increased to $864 and $3,091 respectively.
  • The hygienist and assistants were given scripts to use as guidelines to educate patients about recommended treatment. By increasing a patient’s perceived value you will usually increase case acceptance. Using models and educational videos assists in this process. Encouraging a patient to ask questions opens up the avenue to discuss concerns about treatment. Patients will say no to something they don’t understand or feel that they don’t need. It should be the team’s goal to alter the perception of the patient’s dental treatment from “need” to “want.”
  • Dr. Short changed his treatment presentations. After using the intra-oral camera and including the patient in his diagnosis, a decision was made by the patient AND the doctor regarding treatment options. The patient was no longer overwhelmed with too much information and rendered unable to make a decision. The treatment plan was then presented by the Scheduling Coordinator for only the next phase of treatment instead of the entire treatment plan. This approach makes treatment acceptance much easier for the patient, especially from a financial concern.

When the practice implemented recommended changes there was a considerable increase in the production and collection statistics as follows:

  • $71,000 in net production
  • $70,000 in net collections
  • 12 new patients a month
These numbers reflect a 65% improvement in net production and collections after the recommendations were implemented.

Dr. Short was diagnosing a complete treatment plan and then saying good-bye to the patient. It was left up to the Schedule Coordinator to sell the entire treatment plan and attempt to manage financial arrangements. Her acceptance rate was below 35%.

Now, Dr. Short asks the patient to “co-diagnose” their needs using the intra-oral camera and digital photos to determine what procedures are going to be addressed first. The most important question he asks is, “Mrs. Jones, do you have any questions for me regarding what we are going to do at your next visit?” If she indicates no, Dr. Short thanks the patient and tells her that he looks forward to seeing her at the next appointment.

Patients will complete their recommended treatment if they like and trust you and your team.
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