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
Efficiency – It’s Right Before Your Eyes
suffering from a serious case of busyness. Sounds like the ideal
small business dilemma – save one major drawback; busy
doesn’t translate to better production. In fact,
often dental teams will feel they are constantly on the run only
to find production at a crawl.
it treatment acceptance? Is it scheduling? Is it hygiene? Certainly
many factors can and do contribute to weak or uneven production.
But one factor dentists often overlook is clinical efficiency. It’s
like wallpaper. You walk by it every day but you
seldom if ever notice the details. Dentist and assistant fall into
a pattern of performing procedures the same way repeatedly, giving
minimal thought to efficiency. What’s more newer dentists
emerge from dental school with little or no training in how to effectively
use a dental assistant. Consequently, clinical inefficiencies develop
Those inefficiencies grow into work habits that become second nature
– so much a part of the routine that they are almost never
considered for improvement. The dentist may think nothing of stopping
a procedure to adjust the light, or the fact that they have to ask
the assistant for specific instruments, or that the assistant is
repeatedly trying to find a small opening to insert the suction
and craning to better see the procedure. Yet each of these minor
annoyances or seemingly insignificant details adds up in time, money,
and lower production. If the clinical efficiency is lacking,
the procedure takes longer, and fewer patients can be scheduled.
Consequently, patients are backed up, days are long, and tempers
Surprisingly, significantly improving chairside efficiency often
requires one simple change. Typically, the dental assistant who
isn’t adjusting the light source as necessary or isn’t
anticipating the suction needs, air and water needs, or medicament
needs is likely not sitting in the chair properly.
The assistant must be one head higher than the dentist and there
should be a hydraulic lift on the chair so she can see into the
mouth and properly anticipate the dentist’s needs.
Dentists are legendary perfectionists. It’s both a great strength
as well as a major weakness, particularly when it comes to maximizing
clinical efficiency. A dentist may change burs five times during
one procedure. Every change increases the time necessary to complete
the procedure. Then there is the matter of delegation.
If you feel you are run ragged day after day take a good look at
the tasks you are performing that should be the responsibility of
other team members.
Dentists must delegate every procedure, patient interaction, and
staff matter legally allowable in their state if they want to achieve
maximum efficiency. For example, most states allow dental assistants
to remove a temporary crown, clean the tooth and try on the permanent
crown. However, often the dentist is performing these procedures,
which is clinically inefficient.
clinical efficiency never involves compromising care. Rather the
focus is on improving the delivery of that care
as well as fully maximizing each hour of doctor and staff time.
you have any questions or comments, please email Sally McKenzie
in having Sally speak to your dental society or study club?
SEEN YOUR YEAR END NUMBERS ...
PANIC TO PROFIT - TURNING PANIC TO PROFIT
PANIC TO PROFIT - TURNING PANIC TO PROFIT
to improve management techniques through your technology platform
VP Professional Relations
Last week, [see
article], I finished discussing the minimum technology requirements
of the scheduling coordinator job description.
week, we start a whole NEW chapter in e-Motivator
history. The column has a brand new title! Management Technology…Tips
For Today will be a series of weekly practice management/technology
tips and to-do’s designed to improve your practice management
technique through the use of
your existing technology platform. Readers of the e-Motivator
have asked for these tips in small “bite sized” chunks
so they can print
and implement each and every week.
The business administrator or scheduling coordinator in your office
should run these calculations once per month. You might as well
start this week right! The whole team should know the results.
Confirm with everyone who posts procedures to a patient ledger that
ADA code 00150 is only used for new comprehensive examinations.
If this is not the case, take the steps necessary to make sure ONLY
ADA code 00150 is used on brand new comprehensive patient examinations
in the future.
Each month, run a Production by Provider, Practice Analysis or Production
by ADA Code (different names depending on your software system)
report for the past 12 months (exactly). For instance - 2/13/03
through 2/13/04. The report will tell you exactly how many 00150’s
were performed in your practice in the past 12 months. Jot down
this number on a piece of paper.
Each month, on the same day you run the production report, run an
overdue recall/continuing care report for the same exact date range
(the last whole calendar year – same as above). If your practice
management system tracks the number of recall notices received (some
systems call this motivated recall), make sure the “notice
due” range is a wide one. What we’re looking for here
is EVERY human being who was due back into the practice during the
past 12 months. When your computer system is done finding all the
patients, just print the report to the screen. Some practice management
software will tally all the patients on the report and tell you
how many there are on the last page. Some, you have to count. Simply
count the number of patients on one page and then multiply that
number by how many pages.
Jot that result on a piece of paper right next to the number of
Example: (300 new patients vs. 350 existing patients overdue for
You’ve just calculated your first patient flow ratio!
Healthy Patient Flow Ratio (established practice –
Example (300 new patients vs. 150 existing patient overdue for recall)
Healthy Patient Flow Ratio (newer practice – Years
1 through 6)
Typically a brand new practice will have an incredible ratio. Years
1 through 3, look for a healthy ratio to be at or above 4:1. Years
4 through 6, a healthy ratio will slowly work its way down to a
nice 2:1 ratio. Use these as benchmarks only! Compare these each
month to the month prior. You might even start a real simple spreadsheet
month by month.
hope you find the new format of this article series useful and something
you can implement immediately.
welcome any and all readers to email
me with specific questions, problems, requests and challenges.
Who knows? Maybe your inquiry will lead to a new Tips For Today
article! Don’t worry, your inquiry will remain anonymous.
in having Mark speak to your dental society or study club?
The Cold Shoulder
Giving Dentists And Their Staff Different Perspectives On Day To
Concepts of Leadership and Management
A Continuing Discussion
To reiterate last week’s discussion [See
Febuary 6th 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.
we take television and the role it plays in our lives for granted
because it is so interwoven into the fabric of our lifestyle. However,
there was a time, immediately after the invention of television,
that a question was asked, "So what do we do with it,
how do we use it, what is it good for? " Several formats were
discussed and, believe it or not, the idea of selling advertising
in between the programming was not one of the first ideas, but rather
one of the last and met with enormous doubt and opposition.
The meaning of this documentary anecdote is that everything in our
lives at one time was an isolated event. Over time,
that technological event integrated into a system that produced
a product or service that would pay for itself. A dental practice
consists of literally thousands of technological breakthroughs that
have been integrated into a business system.
challenge in every office is to manage, control, facilitate, and
advance the human relationship regarding all of the systems that
are in place in the average dental practice today. Running any business
today requires two levels of authority. One level
must focus on the systems in place and maintain them with great
certainty that the systems operate as designed. The judgment involved
in this responsibility amounts to recognizing when office systems
and business systems deviate from the prescribed format, and then
taking corrective action.
It is the manager's responsibility to understand the nature of every
system in the office. Such responsibility assures that decisions
which must be made, can be made effectively and decisively. Good
decision-making is essential if the overall integration
of all the systems is to continue to operate efficiently. Managers
keep the engine running smooth.
businesses, every system consists of materials and people. These
systems, in and of themselves, will not generate profitability.
These systems must be implemented in order that the exchange
of service for profitability takes place. It is the people
who operate the systems that make it all work. People are the most
important component. Good people can make up for faulty systems,
but the reverse will never be true in a service industry like dentistry.
leader of the team of any business is responsible for the selection
and elimination of personnel. The leader is personally responsible
for choosing the people who will run the systems. Accurate and effective
hiring and firing is perhaps the surest way of creating
a great team and guaranteeing a good working environment that will
lead to excellent production. It is the leader’s capacity
to know people and to assess their strengths and weaknesses, which
assures the success of the businesses and the team. Therefore, the
good leader must know themselves before any attempt to organize
their systems can be successful.
Trust and Control
are those who fantasize that they have power and influence; however,
deep down inside, they know of their own insecurities, despite their
best efforts to hide them. Within any work environment, that involves
the interaction of people, recognition of real power and real responsibility
is the first part of building a business. To be successful working
with other people, you must recognize who has the power,
who does not, who wants it, and what is your job description.
second part of building a business concerns the ability to maintain
and control the relationships which must interact as deemed appropriate
by the structure of the business. Within any business operation,
it is the manager who is responsible for controlling the
personnel. The topic of control is quite complex and beyond
the scope of this column; however, there is a frequent mistake regarding
control made by thousands of practices.
the name of power and influence, thousand of leaders desiring to
position someone in control choose their manager based upon the
presumption that “years in service” reflect upon the
ability to manage people. This is simply not true. Years
in service only reflect one's personal history and
need to earn an income. One's ability to control and influence people
has absolutely nothing to do with years of service.
The manager's job is to control the implementation of the systems
that have been put in place by the leader of the business. Managers
are responsible for controlling the movement in and out of the business
arena and this would include products, services, and personnel.
Years of service do not make a manager.
Managing people is about letting go of control when appropriate
and increasing control when necessary. This is about personality
and temperament rather than years of service. Managers who can run
things have the personality for it.
If the manager is responsible for control and maintaining the direction
of the business, then the leader is responsible for providing
an environment of trust so that everyone will move together.
When there is trust in the leadership, everyone on the team will
perform their jobs in a coordinated effort to move in a direction
for the common and individual good.
will move in a common or individual good if you give them what they
need. Such a presumption of direction will materialize under the
right circumstances. Leaders who are confident and convey direction
and purpose to their method will discover that their people have
little difficulty trusting them. For those leaders who fail to display
these essential qualities, they will be perceived as not warranting
the team’s trust. As a result, the manager will find
it hard to control, and the staff will find it difficult to maintain
a good working spirit.
leader is therefore responsible for the working spirit of the team
and the ability of the manager to control the day-to-day operations.
The leader exercises this influence through the ability to generate
a sense of trust. Perhaps this is the greatest responsibility
of the leader. The manager cannot create trust. In order to create
trust, the owner of the business must be believable. Leaders, who
do not like people, cannot be expected to generate trust, since
they do not understand what makes people move to the left and to
the right. Before the leader can know others, the leader must know
your issues answered? Ask the email@example.com.
Your Chairside Assistant Were More Efficient?
long have you been practicing inefficiently? Are all those compromises
you've been making worth the price of lost production and the
physical wear and tear on your body? Wish you could choreograph
your chariside team for optimal performance? If so, then this
DVD "Optimizing Team Performance" was designed for
you! This training resource was produced by Risa Simon, a certified
management consultant, published author and one of dentistry's
top clinical management speakers. Don't waste time watching
videotapes when you can dial up topics of interest from the
DVD's scene selection menu. Scenes include: Posture & Positioning,
Magnification & Illumination, Assistant Access & Visibility,
Ergonomic Work Zones, Chairside Efficiency Techniques, including
Instrument & HP Transfers for efficient 4 handed & 6
handed dentistry - a must for every office!
Management, Inc. has been named the WINNER
in the DentalTown Magazine and DentalTown.com
2003 Townie Choice Awards™
for Practice Management Consultants.
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.
THANK YOU FOR ALL THE SUPPORT AND VOTES!
We want to establish a bonus system based on collections and factoring
in overhead. Can you give me some ideas of a good bonus structure?
There is no formula that is completely fair to you or employees
but, if you are going to have one, my suggestion would be to know
for the past 12 months what your overhead costs have been and you
expect those costs to be 55% of x ( collections). So, if your average
overhead for the past 12 months averaged $35,750/month, that expense
is 55% of $65,000. It might behoove you to add a 10% surcharge on
top of the $65,000/collections for unexpected emergencies. Payroll
(gross) should be no more than 21% of the collections which is $13,650/month.
If collections go above the $65,000, say $70,000 you would allocate
21% of the $5000 overage or $1050 as bonus. Now...the question becomes,
do you divide it equally? Do they equally put out the same effort?
Usually not. I would also recommend that you NOT give them 100%
of the $1050 but give them (example) 75% of the $1050 and $262 goes
into a "savings" account for those months when collections
dip below $65,000 and you still have to meet payroll. That's when
the whole "bonus" structure becomes unfair. The employees
get rewarded if collections rise but nothing is taken away if the
collections take a dip. It's win/win for them and potential win/lose
for you. Hope this is helpful.
OUT OF YOUR
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CAN HELP YOU
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Center for Dental Career Development
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La Jolla, CA 92037
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