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  Sally McKenzie's
 Weekly Management e-Motivator
  2.06.04 Issue #100

California Dental Association Endorses McKenzie Management
It is a tremendous honor to receive this recognition from the CDA. To be among those companies singled out for their ability to provide the very best programs and services to California Dental Association members is a distinct privilege. McKenzie Management is one of the first practice management companies to be endorsed by any state dental association. Our sincere thanks to you for your friendship and continued support that have helped us to achieve such high levels of distinction.
Sally McKenzie, President and CEO

Clinical Efficiency - Add up the Olives

Sally Mckenzie, CMC
McKenzie Management

   In 1987 an international airliner saved $40,000 by eliminating one olive from each salad served in first class. That’s a lot of money wrapped up in a seemingly insignificant detail, wouldn’t you say? You could draw the conclusion that this airliner with tens of thousands of passengers, thousands of employees, and hundreds of systems was able to zero in on a virtually transparent detail, yet one that could directly affect the bottom line of the company. It also illustrates how major improvement can be made by stepping back and considering seemingly minor matters and everyday

procedures that are often overlooked because they have simply become second nature.

For example, perhaps the dentist is in the habit of explaining the post-op care to patients even though that’s the assistant’s job. Or maybe the dentist always sits down with the parent to discuss the importance of sealants for little Johnny even though this is the hygienist’s responsibility. Meanwhile, patients are booked out for weeks, the team is stuck in neutral because they are given only a sliver of the responsibility they could handle, and the doctor is so busy he/she is considering hiring an associate.

Rarely do dentists and their teams step back and examine the details of what’s driving the busyness. Most practices never consider anything but the obvious. “We’re too busy. We need more people to handle it.” Certainly demands on dental practices are increasing significantly, and while clinical quality can never be compromised, clinical efficiency can almost always be enhanced.

How much time is added to a procedure when an assistant doesn’t anticipate what instrument the doctor needs next? How much time does it add to a procedure when the doctor has to repeatedly adjust the light source? How much time does it add to a procedure when the assistant can’t see clearly what is happening in the patient’s mouth? How much does it cost the practice when the assistant is not given the responsibilities she is legally allowed to carry out? How much does it cost the practice when the doctor is performing procedures or explaining matters to patients that the assistant or other staff members could and should be handling?

How much are those seemingly insignificant “olives” costing you and your practice?

Next week, boosting clinical efficiency right before your eyes.

If you have any questions or comments, please email Sally McKenzie at

Interested in having Sally speak to your dental society or study club?
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DON'T PANIC ... WE CAN HELP! >click here<

Building On The Theory

How An Ailing Business Foundation Can Cause
“Digital Chaos”

Mark Dilatush
VP Professional Relations
McKenzie Management

Technology Tool Box

Last week, [see article], I finished discussing the scheduling coordinator position. This week, I will expand into the treatment coordinator position. Each dental office is different. You should consider the following responsibilities as “bare minimum” for the treatment coordinator position. Think of a treatment coordinator as a patient laison for your practice.

Your treatment coordinator should be responsible for the following ...

1. World class new patient experience

When your dental practice grows to the point of requiring a treatment coordinator, one of the first responsibilities and benefits is to improve the overall impact of the new patient experience. This doesn’t necessarily mean facials, warm towels, and a back rub. At the very least it means that every patient has a contact within the office that they have spent time with, have gotten to know, and can go to if/when they have any questions regarding their treatment. A treatment coordinator is responsible for monitoring the following. All of these should be compared to results from the month prior.

Total number of new (to the practice) emergency patients
Total number of new emergency patients who became new patients
Total number of new patients (total) per month

2. Internal and External Marketing

You know all those things you used to do when you originally started building your practice that you don’t do any more? You remember! The new patient welcome letters, thank you for referral letters, heck – you may have even sent out a newsletter or two. A professional treatment coordinator never stops marketing a dental practice. Here are some more of their reporting responsibilities.

New patient source (monthly)
New patient source (trailing 12 months)
Individual patient source return on investment (cost vs. # of patients)
Patient retention percentage
Professional referral source (monthly)
Professional referral source (trailing 12 months)

3. Treatment Plan Management

A good treatment coordinator never stops finding ways or new tools to make each patient experience better. A treatment coordinator is responsible for taking all of the information gathered in the operatory to create an understandable “plan” for the patient. GREAT treatment coordinators are like chameleons! They can use the gathered information and adapt verbally to almost any situation. Great treatment coordinators have excellent listening skills. They use the information gathered from the patient and the clinical team to present treatment that truly best fits each patient’s needs.

Total outstanding treatment plans
Total unaccepted treatment
Total accepted but not scheduled treatment
Total scheduled treatment plans
Number of outbound calls made (unscheduled treatment)
Number of currently active patients

If you have any questions about this, remember - we are here to help. Email me your questions or comments!

Interested in having Mark speak to your dental society or study club?
Click here

Getting The Cold Shoulder


Giving Dentists And Their Staff Different Perspectives On Day To Day Issues

The Concepts of Leadership and Management

A Continuing Discussion

To reiterate last week’s discussion [See January 30th issue] ... there is a great deal of talk these days about leadership. It is a big concept that is thrown around in national and international politics and corporate America.

Today, the concept of leadership from politics and economics has been rationalized down to the level of the small business. This process has led to ambiguity, distortion, and confusion over how it should or should not apply. These detriments not only confuse the office staff who pines for a great leader on horseback, but also is distorted by the business owners who perceive themselves to be more responsible than they really are or need to be.

This week's column is a continuing discussion of the difference between leadership and management. For the sake of clarity, I believe that all business owners must be managers first and leaders second. The reason for this definition is that the goal of the office practice is simply to carry out the product and services as promised, effectively and efficiently. The typical office practice is not challenged with the responsibility of guiding millions of people and billions of dollars. Ours is a very simple challenge: make money and enjoy the day.

New Ideas

Regardless of the business that you choose to be in, regardless of your position within any business, one of the challenges that everyone faces is the ability to perform the daily routine over and over again. The challenge comes from maintaining an attitude and an outlook that is positive for the business and sufficiently stimulating to maintain your ability to pay attention to all the details.

It is a natural response of the brain to become so familiar with the daily routine that it will begin to perform the tasks automatically. That is right. Your brain can perform your daily routine automatically. It is like flying on autopilot in an airplane or speed control in your car. The brain goes on autopilot when it senses a repetitive routine in order to conserve energy and to keep your attention-capacity ready for something new or different to come along which demands your full attention.

Recognizing how the brain reacts to the daily routine is important when anticipating exactly what you want to receive from your career. The career of a manager is about taking the daily routine, successfully implementing that routine, and supporting the efforts of the team members to carry out the day’s repetition.

Daily repetition can become very boring and it is for this reason that managers fulfill their job description when they create interest for their team to help them cope with the natural tendency for a decrease in the level of attention to the details of their daily work routine. The responsibility of the manager is to create interest in the daily routine such that business continues uninterrupted.

Every daily routine was at one time, not a routine at all, but a moment of innovation. There was a time in the beginning when a specific office procedure was introduced to the office team as a source of improvement in the production or efficiency of the business. At that time, the introduction of a new procedure was an innovation and it was introduced by the leader of the business.

The leader of the business is responsible for introducing the routine, the daily business routine, to the staff, and they are also responsible for introducing new components of the office routine in the interest of continuing to make money, and provide a product and service, which is the pride of the team and the business owner.

Recognizing that it is the business owner’s obligation to introduce innovation and it is the manager's responsibility to support and maintain the business owner’s routine clarifies everyone's role and responsibility. Managers who object to innovative ideas, and business owners who try to change things too frequently, are working against the natural inclination of their job titles. Managers must accept innovation and leaders must accept routine, if the office is to flourish emotionally and financially.

Take care of the House

Whose house is it? Every successful business is a testimonial to the collective efforts of the team. The success of the business is the success of the team, and they cannot be separated. Because they cannot be separated, the question of who is really running things is an important question to understand, to ask, and then to answer.

The idea for the house began with the education and licensing of the leader. It is reasonable to conclude that this must be his house, since there would be no house without the education and license. However, if you examine the logic, you can see that, while it makes sense, it is not completely accurate, because without the team there is no service. Without the service, you cannot deliver the product.

Thus, the provider of the product cannot make a claim to the house, because there is no house without the provider of the service. It is for this reason that the responsibility for sustaining the business falls on both the team and the leaders of the team. Yes, this is perhaps not a new insight for you, but it is essential in order to help your brain justify each role as an individual component to the whole.

The role of the manager is to maintain the house, to keep everything in order, to be certain that everything is in its place, and available to be used in the interest of the business. The role of the leader continues to be the provider of a product and to decide what products are going to be offered and to whom. The leader is responsible for implementing a process, to develop a direction, to create a system that not only works for the client, but also is workable for the team.

It is essential that the leader develop programs and daily routines that are doable and fulfill the functions that the house was constructed for. The manager is responsible for maintaining that function by addressing all the details of the program that was conceived by the leader. These role distinctions are critical.

Good managers take great pride in the maintenance of their house of business. They take great pride in paying attention to all of the details such that their daily operation proceeds efficiently. Good leaders take great pride in the system of procedures that they have initiated, which form the rooms and the layout of the business house. There is great pride in the design, as well as the selection of team members who make the house functional and productive.

Regards, Coach

Want your issues answered? Ask the


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McKenzie Management, Inc. has been named the WINNER in the DentalTown Magazine and 2003 Townie Choice Awards™ for Practice Management Consultants.

“It is an overwhelming honor to be singled out by literally thousands of dental practices across the country as the number one dental practice management firm,” said Sally McKenzie, President, McKenzie Management. “We know that dentists take great care in selecting only the very best products and services, and to be among this elite group is truly a testament to the commitment the McKenzie Management team has demonstrated over the past 23 years to provide consistently superior consulting products and services,” added Ms. McKenzie.

The McKenzie Management Team looks forward to continuing to provide the very best consulting services so that dental practices in turn can perform at their very best.


McKenzie Management, Inc.
737 Pearl Street
Suite 201
La Jolla, CA 92037

Sally's Mail Bag

Dear Sally,
I just found out that three patients cancelled from the hygiene schedule for today because they weren't confirmed!! My front desk employee was in the office on Thursday for 3 hours and Friday for 6 hours without me seeing patients. Her response to my office manager when questioned on the schedule not being confirmed for today was "Well if I had time I could've done it!!" When I left the office on Wednesday, I went over a list of things that needed to be done for this week. I will admit I never reviewed this particular aspect because IT IS SO OBVIOUS!!!!!!!!!! You pull charts and you confirm - top priority!!!!!!!!!!!!Am I facing a losing battle - I can't be in there watching and delegating every minute!!!
Townie Post

Dear Townie,
I know it's frustrating…very frustrating, but I am going to ask you to reflect on the training these employee's received when hired, their knowledge of the practice's expectations, and their accountability measurement of the system they are responsible for. Do you have written down training protocol and operating procedure that you can reference back to show they were not performing their job? You can also develop "skill" statements that they answer as part of their performance review. Such as, I confirm the next day's patients the day before and "speak to the patient". She answers, always, most of the time, sometimes or never. In order to get a good performance rating, you expect her answers to be in the “always” category. I would also sit down with “her" and go over why she didn't have time. You mention "they" weren't confirmed. Make sure you have definitive job descriptions in place and so it is one person's responsibility rather than "who ever has time". Once all of these things are in place and the same situation occurs again, record the offense, have the employee sign, and place it in their employee file.
You can view more about the skill statements I mentioned above on my web-site under Performance Measurements for the Dental Team
Good luck,

IN 2004?
Dr. Allan Monack,
Hygiene Clinical Consultant for
McKenzie Management,
develop a profitable
Hygiene Department

To find out more about the
Hygiene Clinical
Enrichment Program
[go here]
or contact us at:
or call:

Office Managers
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Hygiene Coordinators
For a FREE
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Missed Past Issues of Our e-Motivator Newsletter?

This issue is sponsored
in part by:
The Center for Dental Career Development
San Diego Workshop Series
Fall/Winter Schedule
 Date Seminar Instructor(s)  
 Feb. 6
 9:00 - 4:00
How to Become an EXCEPTIONAL Front Office Dental Employee Sally McKenzie, CMC.  
Mar. 5
 9:00 - 4:00
How to Become an EXCEPTIONAL Front Office Dental Employee Sally McKenzie, CMC.  

The Center for Dental Career Development has been approved under the Academy of General Dentistry Program Approval for Continuing Education (PACE) program. Starting 10/19/03 through 10/18/07 members of the Academy of General Dentistry can receive AGD credits for all seminars and workshops sponsored by the Center for Dental Career Development.

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