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2.17.06 Issue #206  
The Cost of Control

Sally McKenzie, CEO
The McKenzie Company

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If you want something done right, you have to do it yourself. That saying has been around a long time. How many employees were never given the opportunity to shine because the boss pledged allegiance to that tired maxim? How many CEOs took their companies and themselves to an early grave living those words daily? How many dentists are stressed to the extreme, working and working yet never able to actually get ahead because they simply can’t relinquish control of even the most minute details? And the staff has simply come to expect that doctor will handle it …eventually. How many dental teams envision opportunities that will never be realized because the dentist is simply unwilling or unable to let them do their jobs?

Take the wholly un-empowered collections coordinator for example. Dr. Smith is not happy with collections; they are not where they should be. When Dr. Smith took over the practice, the patients were accustomed to receiving statements in the mail and were never asked for payment. Even though the majority of dental offices no longer engage in this practice, even though the team is trying to implement a strategy to apply a new policy, the doctor, often without even realizing it, is continually usurping the collections coordinator’s ability to address the problem.

Patient Mrs. Jones comments to Dr. Smith that sending statements was never a problem for the other dentist. Patient Mr. Jackson asks Dr. Smith if he’s having cash flow problems and needs to get money from patients right away. So Dr. Smith makes exceptions for the patients, one-by-one. He justifies his actions thinking a few exemptions can’t have any real impact.

Before long, Dr. Smith has a line of exceptions that could snake around the block, down the street, and into the next county. And that collections coordinator who’s supposed to address the collections “problem,” her chances of success are fading fast. She’s been given a responsibility to carry out, however, she does not have the authority to get the job done. Consequently, she cannot be held accountable for the system and its failings.

Then there’s Dr. Edwards who spends an inordinate amount of time explaining post-op procedures and other basics of patient education that his assistant has repeatedly encouraged him to allow her to handle. But he’s so convinced that the patients really want to hear it from him that he is sacrificing hours upon hours of production time each year. 

Or take the case of Dr. Collins, her practice has needed a new patient packet for months, but she insists on handling this responsibility herself rather than assigning it to a capable member of the team. She wants the documents that cover certain policies to be “carefully worded,” she wants to introduce her staff a “certain way,” answer key questions “just so,” convey a “certain feeling about the practice” – and she’s convinced no one can do that as well as she can. But Dr. Collins, understandably, does not have time to take care of it. Even though something would be better than nothing, she simply cannot hand over control. New patients, meanwhile, inevitably cause unnecessary bottlenecks in the scheduling system because information must be explained that could have been covered in detail in the new patient packet. Forms must be completed, routine questions must be asked and answered, and what should be an efficient, seamless system is fraught with inefficiencies.

Dentists are legendary for their need to control. Trusting that others can perform a task as well as they can is no small barrier for many to overcome. But there are only so many hours in a day and superior clinicians need to focus on those activities that enable them to demonstrate their clinical excellence, and not on presenting treatment plans, bartering over payment plans, providing basic patient education, or developing marketing materials.

Facing both the fear of relinquishing a sliver of control and accepting the potential for some measure of failure in delegating certain tasks is a challenge many doctors must overcome if they are ever able to take their practices to the next level. Certainly when delegating authority to manage specific systems in the practice the dentist has ultimate authority, but capable employees crave the opportunity to address challenges, they want the chance to demonstrate their competency.

Next week, determine the “who,” “what,” and “how,” of delegating.

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McKenzie Management's Seminar Schedule
2006 Location Sponsor Information Topic Speaker
Mar. 9 Vancouver, BC Pacific Dental Conference 604-736-3781 Overhead Sally McKenzie
Mar. 24 West Branch, MI Northland Dental Study Club 989-345-7750 Breakdown Sally McKenzie
Mar. 29 Long Island, NY Suffolk County Dental Society 312-440-2908 Breakdown Sally McKenzie
Mar. 31 Las Vegas, NV Dental Town Meeting* 877-777-6151 TBA Sally McKenzie
April 14 Santa Rosa, CA Redwood Dental Society 877-777-6151 TBA Sally McKenzie
April 27-30 Anaheim, CA California Dental Association* 877-777-6151 Peak Perf. Sally McKenzie
* The McKenzie Company will be exhibiting at this location

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