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  Sally McKenzie's
 Weekly Management e-Motivator
  2.27.04 Issue #103

Avoid the Slippery Slope of Service Snafus

Sally Mckenzie, CMC
McKenzie Management

       In the eyes of the patient you are the practice, from the time you set foot in the office until the moment you leave the building. This role carries enormous responsibility as well as equally significant opportunities. Superior patient service is not the result of excellent clinical care alone. It is the culmination of every interaction the patient has with every person in the practice. One person’s bad day or poorly handled patient exchange affects every member of the team and the total reputation of the practice.

Poor patient service is often the residual effect of harried schedules, personal and professional stress, and frustrations with specific patients and co-workers. When the day’s demands become particularly intense take extra care to avoid these service blunders:

  1. I don’t care. Patients are far more tuned into your attitude than you would ever want to know. The labored sigh; the piercing, annoyed stare; the rolling eyes may be your “quiet” way of venting today’s frustrations. But they scream POOR ATTITUDE AND DISRESPECT TO THE PATIENT. If your expression, your tone, your approach, or even your appearance sends the message that you are disgusted and really do not care about the situation, about what people think – including the patients - that is precisely what the patients hear. Loud and clear.
  2. I don’t know. Patients expect you to have immediate answers to basic questions. Track the common questions that patients ask. Take steps to ensure that every member of the team is prepared to answer them. If you cannot answer the question yourself promptly locate another member of the team who can. NEVER, EVER respond with “I don’t know.”
  3. Go away. Under no circumstances should a patient ever be ignored when they come to the counter. Acknowledge their presence immediately. Whether you are engaged in a conversation with the doctor, a co-worker, another patient, or your mother in-law it takes five seconds to look over at the patient and acknowledge that they are there and you will be right with them. If you pretend they are not there, you inform the patient that they are an annoyance and unworthy of your time.
  4. I talk, you listen. Wrong. The patient talks, you listen. Even though you have heard the scenario 52-hundred times and you are convinced you know exactly where the patient is going with this, avoid that uncontrollable urge to blurt out your know-it-all response before the patient can even finish a sentence, which effectively shuts the patient down. Beating them into submission with your intellectual prowess establishes you as the overbearing individual who would not listen to what the patient had to say. Listen first talk later.

When tensions are high, take extra care to show compassion, understanding, and a positive and helpful demeanor. Both you and the patient will be very glad you did, and the practice will benefit significantly from your efforts.

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 necessary to track and report your new patients. This week, I want to focus on the simple yet incredibly underutilized feature called lab case tracking.

Lab Case Tracking

Step #1
Somewhere in your practice management software (most of them have this feature),

there is an open lab case report. Even if you have never implemented lab case tracking, I want you to print the report. The “header” on the report will show you what it is designed to do. This will help you set up your system properly.

Step #2
In most practice management software, the ability for the software to automatically open a lab case is in the ADA/production code database. Bring up an ADA code (start with 2750) and look for an area on the screen that allows you to open/close a lab case. The idea here is that every time a 2750 is posted, the software knows to ask if it should open a lab case for this particular procedure.

Step #3
For every code that opens a lab case, you will need one to close the lab case once the case is inserted. Some practice management software allows you to use modifiers after the ADA codes while others require you to make one code to close all lab cases. Refer to your help manual, get training, or call your software support if you need assistance with your particular software. Of the software I have reviewed, they all have very easy to follow instructions in their help index under “lab”.

Step #4
Your software will also have a lab database. Add the labs your office uses to this database so you have them to choose from when posting an ADA code that opens a lab case. Make sure you fill in the fields properly and completely. Some information in the lab area will actually trigger future useful “events”.

Step #5
Practice, play, and go through every scenario to test your setup. If you have set it up properly, tracking your lab cases should be completely automatic.

Every morning, print an open lab case report. Post this report where the lab cases are stored. As cases come in from the mail and courier, usually an assistant is responsible for checking the case and highlighting the lab case report. Use the color green highlighter for cases that are in and ready to be seated.

Step #7
Every evening, the assistant brings the lab case report to the front desk. Open the window in your software that lists all of the open lab cases. “Mark” all of the lab cases as “ready” that are highlighted in green on the report. Rerun the open lab case report for tomorrow morning.

When you run your confirmation list, confirm off the appointment book on the screen, or go to the tickler file, or basically go anywhere associated with that patient – you should begin to see the software telling you that this patient has an open lab case. The obvious benefit is making sure everyone on the team is on the same page with every patient. Never being embarrassed by not having a lab case for a patient who’s already in the chair is, well – priceless!

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,

It is interesting to hear you say what is obvious, in that we as dentists should make it clear to

our staff what we would like to have accomplished, and the way it should be handled. It drives me nuts when I do make a suggestion or ask that something be done and the response I get is

  1. it sounds like you’re desperate (re: calling a patient)
  2. I know what to say........why did you hire me?
  3. I did that already
  4. I'm not calling him, I think it would be better coming from you
  5. I don't agree with that

Well the list goes on, and what I've come to LIVE with. If I want to keep the peace and retain the staff, I have to take the good with the bad and deal with it.
Yes.....I could fire, hire, and hope for the magical mix that would indeed increase production and collections a bit, or I can deal with and accept things the way they are. The practice is doing well and the staff has been with me longer than any time in the past. So we go on and I have to hope that the bursts of silent aggravation during the work day don't kill me first.
We know that no one cares about the practice, or any business as much as the owner, so my next move is to create ownership with the staff and see if that may become self motivating. I would love to hear from you with one or two of your favorites.

Dr. Dentist Owner

Dear Dr. Owner,
I would like to help by clarifying some very erroneous conclusions and principles around which you run your business and, in all probability, your life.

No. 1 - With a staff like this, you can look forward to limited benefits from any practice management consultant or system.

No. 2 - While it may seem obvious that dentists should make it clear to their staff regarding what you want to accomplish and the way it should be accomplished, the truth is that based on the above listed responses of your staff, you are not a team moving in the same direction. You have a very adversarial relationship with your staff. They enjoy a free license to maintain a bitter status quo regardless of your statements.

No. 3 - You have grown accustomed to being driven “nuts” in the past, and therefore being in this state of mind, even though it is painful, is a very familiar habit which you find comfort in maintaining. Any reasonable person would not like to be driven "nuts" by other people regardless of who they are whether family, friends, or strangers.

No. 4 - The staff responds to your requests with such insolence that a reasonable person, I believe, would take great insult by these responses. The truth is not debatable; you provide jobs that permit these people to pay their bills. Your position of power is one which should be recognized and honored. It is clear that you have learned that you are not entitled to be special and thus acknowledged for the positive service that you provide.

No. 5 - It is unreasonable that you should continue to live with so much abuse in your own business. You choose not to exercise any of your inalienable rights as an adult and a business owner.

No. 6 - You do not have to take the good and the bad because you are a business owner. This is not your family. These are people that you choose to help you to make money. You have learned to feel trapped and to live without options long before you began this business. It should be clear that adults have the option to choose their friends as well as their employees.

No. 7 - It is clear from the current magical mix that you were quite limited in the past, and it is reasonable to suspect that even with a new mix in place, your production and staff harmony will also be limited. The truth is there is nothing magical about this mix. As the owner of the business, you determine what the goals for collections and production are. This is all within your control. If the people you choose cannot perform, that is simply an opportunity to find people who can. There is nothing magical here. However, we learn something about you in your perception that such power is beyond your right. You consider it magical, but it is just business as usual.

No. 8 - With all of your expressions of pain and disappointment in this e-mail, why would you want to continue to accept the way things are, when it is reasonable that they could be improved. This attitude is a testimonial to your habitual limited vision and limited ability to experience true happiness.

No. 9 - Bursts of silent aggravation during the workday seem to me to be a form of personal abuse and punishment. You are in complete control and yet you continue to condone this experience of pain through your lack of ambition to enjoy your business and your life.

The essential point is that you are suffering under the pretense that this interaction with your staff is the best that can be. The truth is that with good practice management systems, even the worst practice will make more money, but that will not change your ability to enjoy your daily interaction with people, your family, and provide you with a quiet moment of personal success.

You are complacent and passive and you continue to suffer needlessly. At least change the staff and find a new "magical mix ". At least you can say that you are trying to feel good about your life and business; however, the truth is that unless you change, you will just find a new mix that will continue the abuse.

I have sought to clarify your message to me in hopes of helping you to see that this type of suffering is created by you for purposes that perhaps have yet to be discovered.

I wish you well.
The Coach

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Sally's Mail Bag

Dear Sally,
I own a dental practice with an older partner. We were "lucky" enough to
buy this practice with the original staff. It's been close to three years
now, and neither of us feel like we “own our practice”. The staff still
continues to run by their rules; and when I try to enforce the new rules,
the staff does not like it, and run to my partner who, in turn, backs down and
continues to allow them to run the practice the way "it's always been done".
Our staff members have been here for 10-30 years. What can I do to take control of our business - besides firing everyone and starting from scratch?
Sincerely, Very Frustrated

Dear Frustrated,
The staff obviously feels as if they "own" the practice. They have made the 10-30 year investment where you and your partner have not. Change is difficult and can be frightening if understanding and guidance are not made available. Using the "direct" approach is certainly an option. That is, calling the troops together, explaining that they have failed to institute changes to policy or systems; they are "running" to the partner they know will get them their way. Tell them it won't be tolerated and then develop measurements that must be reported to the two of you at the end of 30 days that what you want done is done and if it is not, they will be making a clear statement that they are insubordinate to their employers’s wants and will be placed on probation and ultimately terminated.

A less invasive approach for the two of you as owners is to have one of my consultants come into the practice and analyze over 20 systems that run the business operations, make recommendations (some of which may be what you have tried to implement) of why the system needs to be changed and how it will benefit them. This then puts everyone (you and them) on the same playing field. It diffuses them thinking they "know more than you". How the systems in the practice should be run are coming from an "expert" with a lot more in experience than what they have. They know you haven't worked a day at the front desk and they know when you're in an operatory you don't know what they are doing.

Email me back if you would like more information in our consulting services.
We would love to help you eliminate your frustration.

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This issue is sponsored
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 Date Seminar Instructor(s)  
 Mar. 5
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How to Become an EXCEPTIONAL Front Office Dental Employee Sally McKenzie, CMC.  
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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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