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  Sally McKenzie's
 Weekly Management e-Motivator
  2.20.04 Issue #102

Service with a Sneer Smile

Sally Mckenzie, CMC
McKenzie Management

       There’s Mrs. Smith standing in front of you. She pays her bills about as often as NASA lands a rover on Mars, and now she’s supposed to schedule two endos and a crown!

Meanwhile, the phone is ringing and ringing and ringing. You grab it; move the caller into hurry up and wait zone as fast as you can get out the words “Dr.’s office please hold.” Just when your blood pressure is ready to boil over, Mr. Busy Executive strolls in a full 20 minutes late with nary so much as an apology. Eeeeooowww! It’s about to get ugly.

Let’s face it, staying positive and “on” hour after hour can be a drain. Being helpful and understanding with patient after patient some days can feel almost impossible. After all, patients come in all shapes, sizes, and challenges. At those times, it’s easy to become overwhelmed and take it out on the patients in the form of poor attitudes, exasperated sighs, rolling eyes, and worse.

Take three deep breaths and look for win-win opportunities in difficult patient interactions. Educate the patient. Offer solutions that benefit them while keeping practice systems running smoothly. Does Mrs. Smith’s failure to pay result from a misunderstanding about the practice payment policy? Has the doctor given her permission to ignore the policy thus undermining your collection efforts? Make sure the Mrs. Smiths of your practice fully understand the payment guidelines. Provide payment options such as patient financing through CareCredit. Establish an internal policy that removes the doctor from difficult financial discussions with patients.

If the ringing phone is driving you crazy it’s also driving patients to another practice. After two rings, patients are wondering if the office is closed. A real human being should answer the phone by the second ring or it should go into the voice-mail system by the 4th ring. A ringing phone can be a powerful urge to drop what you’re doing to silence it, but the patient in front of you comes first. How can you respect both the patient and the caller simultaneously? Answer the phone, ask the caller for permission to put them on hold. Never put a caller on-hold without asking for their permission. “Thank you for calling Dr. Carey’s office. This is Michelle. May I put you on hold for just a moment?” Utilize “Information on Hold” services to educate patients about new and existing services, the practice mission, philosophy of care etc. The patients and the practice benefit from what would otherwise be considered an inconvenience.

Finally, if Mr. Busy Executive is blowing off his appointments or strolling in 20 minutes late. First consider the schedule. Does the doctor frequently run late? Did you confirm the appointment? In addition to confirming the appointment two days in advance, consider calling Mr. Busy Exec an hour or so before his appointment. Let him know that the doctor is running on time today – if that is the case – and looks forward to seeing him at the appointed hour. This shows respect for Mr. Exec’s schedule as well as the doctor’s.

Next week, steer clear of the most annoying patient service snafus.

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

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Tech Tips For Today!

Designed to improve management techniques through your technology platform

Mark Dilatush
VP Professional Relations
McKenzie Management

    Last week, [see article], I discussed the steps to calculating your patient flow ratio. Remember, even though this article series is called Tech Tips for Today – I want you to run that calculation every month and track it month by month either on paper or (for extra credit) an easy Excel spreadsheet.

This week, let’s focus on new patients and where they are coming from. The idea here is to make sure your practice KNOWS the source

of new patients so you can make better business decisions down the road.

New Patients

The person(s) responsible for greeting incoming new patients is ultimately responsible for the accuracy of the collected information.

Step #1
Take a good long look at your “Welcome to our Office form that new patients fill out before you see them. How prominent is the area that asks how they learned about your practice? If it is not prominent or not there at all – make necessary changes to that form.

Step #2
When a new patient doesn’t fill in the information on the “Welcome to our Office” form, the person greeting at the front desk should ask. Asking is a requirement – not a choice. “Mrs. Jones, whom shall I thank for referring you to our practice?” is simple to say. Mrs. Jones may not have been referred and will correct you if they found the office through the yellow pages or some other marketing source.

Step #3
Your referral source database should have every possibility already added to it. This makes it easy to select from a drop down window. If a patient referred the new patient, confirm with the new patient that you have selected the proper referral source.

Step #4
Run your practice management software’s referral reports. You are looking for total number of patients referred (last month), referral sources, and a production tally from each referral source. The production tally from individual patient referrals is not as important as the production tally from PAID referral sources such as yellow pages, welcome wagon, direct mail, etc on a month by month basis.

A healthy, growing practice will receive 80% to 100% of their new patients organically (through direct patient referral). This results in lower marketing (advertising) expense and increases profitability

Step #5
Always, always, always remember to send every patient who refers, something nice. It can be a letter, video rental vouchers, movie vouchers, whatever. Use the monthly report and check off the patient’s name as these referral rewards are distributed. Make a note in the referring patient’s contact note area that a reward was distributed so the rest of the team knows.

I 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.

Interested in having Mark speak to your dental society or study club?
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Getting The Cold Shoulder


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

Dear Coach,

I've had multiple occasions in which the remainder of my staff has had problems with

my office manager. It's been small things here and there and the other girls who feel a loyalty to me have finally taken a stand. How do you handle this? I know I'm happy with my office manager in every aspect except a couple. One problem is the way she talks to people. She tends to be "snappy" and of course, no one likes that. How does one handle something like this WITHOUT getting the other girls involved? HELP.

Dear Helpless,

The office staff is in a position to look up at the office manager, whereas the dentist is in a position to look down at the office manager. As a result, the perceptions of each must logically vary with their perspective. The first perspective concerns the women in the office evaluating another woman. The second perspective involves a man evaluating a woman. These two perspectives are going to be different.

The staff will evaluate the office manager based on her ability to not only do each of their jobs, but to make decisions that are consistent with the direction of the business. The staff will look at the office manager for a demonstration of competency. If the office manager is competent, then the office staff will follow her dictates. However, if the office manager is in some way sloppy, inappropriate, or makes frequent mistakes then their trust will be diminished and their ability to follow her dictates will be compromised.

Once the staff has lost faith in the manager, they will talk amongst themselves and diminish the importance of the manager in order to feel more secure. In other words, if their leader is weak, they will form a stronger alliance amongst themselves in order to endure the daily work routine and her presence. This alliance forming is very feminine and very powerful. A sense of camaraderie is fundamental to the ability for women to work together. This is not a sexist remark. This has been validated in group studies of the sexes. Women must like each other in order to work and play together, whereas men do not.

In your question, you state that there are “multiple occasions”. The simple fact that there are multiple occasions is troublesome. While you, a male brain, may characterize the incidents as a “small things here and there”, to the women, multiple occasions is problematic, because they depend on her for a model of the quality of work performance that is expected. Therefore, small things to your brain may be very large things to their brain.

The fact that the girls loyal to you took a stand is a demonstration that the office manager’s behavior is sufficiently infuriating and annoying that the cohesiveness of the team is being severely damaged, and they could no longer stand by and watch her behavior undermine your professional efforts. It is understandable that you might not see these problems as large or significant, because of your perspective from above; however, I do not have any faith in your ability to assess what is problematic.

In your question, you state that you are happy with every aspect of her behavior except “the way she talks to people.” It is astounding, it is absolutely astounding that you, a businessman, an important man in the community, can not immediately recognize that in a health-care business where we talk to people in pain and relieve pain and spend so much time engaged in communicating with people, that your number one person in the company, other than yourself, the No. 1 person who is in charge of the image of your business “cannot talk to people... she tends to be snappy "

Your blindness to the seriousness of this incredible business flaw only serves to support my belief that your staff is reasonable and your office manager, in all likelihood, is very dysfunctional and you cannot see the dysfunction for some personal reason.

It is reasonable that you look at the office manager and do not see the severity or intensity of the problem, because you are in the back room; however, your inability to see the damage that having an office manager who “tends to be snappy” will cause to your business only makes me inclined to conclude that, while the office staff may have a point about this inappropriate office manager, your support of this office manager is probably more problematic with the staff than the office manager’s behavior.

I propose the following steps:

  1. There is no need to involve the staff, since this is a business owner problem.
  2. Have the staff draw up a list of complaints and determine to your own satisfaction whether they are legitimate.
  3. Make your own list of complaints. These are automatically legitimate.
  4. Consolidate both lists and ask yourself, do these complaints affect my ability to do business. Do these complaints affect staff, affect me, do they affect my client base.
  5. If the answer to any of these questions is yes, then you are faced with the choice.
    1. You can thank her for her service to the business and tell her that you will be looking for new office manager and that she can remain in your employ until she finds another job.
    2. You can present a list of complaints and tell her that all of these complaints must disappear and she has 30 days in which to make them disappear. For the next 30 days, she is on probation. Should she not be able to eliminate all of these complaints, then she will be asked to leave the practice. She will either clean up her act or begin looking for a job.

My greatest question after making this recommendation is whether you, the doctor, have the personality to take control of your business. Your ability to ignore an office manager that “tends to be snappy” makes you a major part of the problem. I believe that a good businessperson would rather have an office manager that is wonderful, charming, friendly, gentle, and firm but soft when talking to the clients. Why has this escaped you? You have to ask yourself what is the quality of your leadership in this business. Why would you be blinded to something as important as the quality of your customer-service?

Regards, Coach

Want your issues answered? Ask the


It is a tremendous honor to receive the endorsement from 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 achieve this high level of distinction.

President and CEO

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

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Sally's Mail Bag

Dear Sally,
I’m tired of sending out those generic thank you cards that provide a line to write in the patient’s name. I want to send out a handwritten thank you from on a nice note card or stationery. Do you have any ideas on what I could say?
Dr. Justin Note

Dear Dr. Note,
Here are some different examples for you to use.
1. Just a little note to acknowledge my appreciation of the confidence and interest you displayed in my office and services by referring ____________to me. Thank you.
2. I wish again to convey a sincere “Thank You” for your referral of ____________ for our professional services. The confidence you have in our office is sincerely appreciated.
3. Just a word of appreciation for referring _____to our office for dental service. The confidence you show by referring your friends is very gratifying. Thank you so much.
4. Just a note to thank you for referring __________to us. We’re certain __________will be an excellent patient, and we will do our best to warrant your confidence. Thank you again.
5. Just a note to thank you for your referral of _________for dental care. I’m sure we will enjoy having _________in our practice.
6. On behalf of our entire staff, I want you to know how much we appreciate your confi-- dence and friendship in your referral of ________. We shall do everything possible to give them the highest quality of dentistry with the greatest amount of comfort.
7. On behalf of my staff and myself, I thank you for your expression of confidence in referring ____to our office for treatment. It is through your assistance by referral and also your personal cooperation that we are able to enjoy the fine clientele of pa- tients who understand and appreciate the quality of care that we seek to provide.
8. Your referrals are always appreciated. It reflects the confidence you have in us and encourages us to strive for further improvement. We will endeavor to continue to merit the confidence you have placed in us. Again, please accept our sincere “thank you.”
Best regards,

Office Managers
Financial Coordinators
Scheduling Coordinators
Treatment Coordinators
Hygiene Coordinators
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 Date Seminar Instructor(s)  
 March 5
 9:00 - 4:00
How to Become an EXCEPTIONAL Front Office Dental Employee Sally McKenzie, CMC.  
 April 7
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How to Become an EXCEPTIONAL Front Office Dental Employee Sally McKenzie, CMC.  
 May 7
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How to Become an EXCEPTIONAL Front Office Dental Employee Sally McKenzie, CMC.  
 June 4
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How to Become an EXCEPTIONAL Front Office Dental Employee Sally McKenzie, CMC.  

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