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  Sally McKenzie's
 Weekly Management e-Motivator
  4.16.04 Issue #110

‘I Think’ vs. ‘I Know’
Add up the Difference

Sally Mckenzie, CMC
McKenzie Management

      I want you to stop thinking about your practice. That may sound like a tall order, but when you go home at the end of the day I don’t want you to be saying to yourself “I think we had some problems with the schedule.” Or “I think collections have been good lately.” Or “I think the Baker family was in here within the last year.” Dentists think about their practices all the time - wondering about this system or that situation.

But not enough dentists really know what is happening, and the difference between “I think”

and “I know” is usually several thousand dollars in practice revenues. Take patient retention, often doctors are oblivious to a patient retention problem for months before it manifests itself in serious scheduling/revenue troubles. The typical line is “Well, I’m busy so I think we’re doing ok.” But you’re not thinking about the fact that there are so many inactive charts the staff has to move them out of the microwave before they warm up their lunch and shove them along the walls so no one trips over them in the hallway, but hey you’re busy ... or so you think.

Patients slip away quietly, taking their spouse, significant other, children, and sometimes friends with them. Seldom is there any fanfare in their departure just a sudden realization one day that you haven’t seen so and so for a very long time, or you run into Mrs. Such and Such in the grocery store and after some small talk you realize that you cannot remember the last time you saw her in the chair.

It’s time to get to know patient retention in your practice. Answer the following questions.

  1. How many inactive patient records are hidden away somewhere?
  2. Have you increased hygiene days per week in the last year?
  3. Is your hygienist’s salary more than 33% of what she/he produces?

If the number of inactive charts is enough to open a second practice or if you answered yes to question two or three, you have patient retention issues. So what can you do right now to stop the patient exodus? First, get out of the “routine” mindset.

Doctors and their teams see patients day after day. You perform dentistry well, but it can become routine. You may be an excellent clinician but today’s “high expectation” patients want to feel they are more than just a routine patient otherwise you quickly become just another routine dentist.

Practices that make even a minimal effort to take the ordinary appointment and offer a bit of extraordinary service and patient attention see a very real impact on the value patients place on returning to the practice. For starters, try these simple strategies today and watch how well your patients respond

1. Show appreciation. Don’t assume patients know you value their trust in your practice. Tell Them! Tell them verbally, tell them in writing, it doesn’t really matter how, just do it.
2. Encourage patients to ask questions and answer them completely.
3. Anticipate needs and concerns and address them. If the patient appears to be cold give them a blanket or sweatshirt before they start shivering.
4. Be considerate of the patient’s time. If the doctor is running 30-45 minutes behind schedule let the patient know.
5. Make sure the patient feels they are your number one priority when they are in the chair. Discourage staff and personal interruptions that are not absolutely necessary.
6. Follow-up with the patient. This is absolutely the cheapest most effective patient retention protocol you can implement. Nothing says “I care” more than a personal phone call from the doctor to the patient.

Next week reactivate those piles of patient records and reconnect with patients who never really wanted to leave your practice in the first place.

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 insurance estimation and why many of you struggle with keeping it clean and accurate. It is my hope that you are well on your way to providing a faster more enjoyable experience for both you and your patients when it comes to the business reality of dealing with insurance processing.

This week I want to respond to two emails I received from e-Motivator readers. The topic this

week is hygiene recall. Both questions had similar themes. They came from business administrative staff who were unsure of how to “set up” their system to do whatever it is the doctor wanted them to do. In both cases, we discovered there was no overall “game plan”. So, they were winging it.

When dental offices call me to discuss their particular practice goals, objectives, and challenges, about half of them don’t have a game plan for their recall system. Today’s installment is about how to establish that game plan.

What you want to happen
This seems to be a big hang-up in most offices. Below is an example game plan. If you don’t have a written game plan, how is the person responsible supposed to follow through? The following isn’t necessarily our recommended perfect game plan for your office - just one to use as a reference. Even if you just document your existing recall game-plan, you will be moving in the right direction.

  1. Pre-appointed patients receive an appointment reminder in the mail 3 weeks in advance of their recall appointment. The appointment reminder tells the patient their scheduled appointment day and time. The appointment reminder asks the patient to call the office and confirm the appointment.
  2. Non pre-appointed patients receive a recall notice 4 weeks prior to their due date that explains the need for them to call the office to book their next appointment.
  3. Non confirmed pre-appointed patients are called one week prior to their appointment date and time.
  4. Non confirmed non pre-appointed patients are called one week prior to their due date.
  5. All overdue recall patients are called one week after they become overdue and continued calling at diversified times to make contact.
  6. All overdue recall patients are sent a reactivation letter one month after they become overdue if no telephone contact.
  7. All overdue recall patients are sent the final reactivation letter three months after they become overdue.
  8. Non-compliant patients are inactivated after 6 months.

For reference of letter examples go here

For reference of recall notices go here

Who makes it happen?
This is a culprit in some offices. Someone has to be responsible for implementing the game-plan. It can’t be everyone. It shouldn’t be more than one person. Someone in the office is responsible and accountable for the recall system – period! If this isn’t established in your office, stop here! This is your step #1.

How to set up your computer system to make it happen
In the example game-plan above, the person responsible for the recall system would continually run recall reports, letters, every week as part of their everyday work routine. Manually setting up those reports to run every time can tend to be a waste of time. After all, you keep setting them up the same way every time, right? Many practice management software packages have a way of “saving” a report run setup so that all you have to do is click on it and tell it to run. Some software packages can “prompt” or “alert” the person responsible for the game-plan to remind them to run the reports. There are even practice management software packages out there that actually “pre” run the reports based on your game-plan and bring up everything you need when you log into the computer system in the morning!

Like everything else involved in running the operational business systems of a dental practice – you have to have a game-plan and someone responsible for implementing the plan first. Then you get to use the “cool” features of your software to make your life easier and your business more profitable.

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 unless you want credit for the question.

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



         The following email was sent to me from one of our readers regarding MY article on Sky High Facility Costs. His honesty is refreshing and with permission I wanted to share it with you.

Dear Sally,
I read with interest your articles the last two weeks about the danger of overbuilding a facility.

I couldn't agree with you more regarding your assessment that an over built office and under planned management system will result in a cloud of debt that seems impossible to escape from.

I lost my lease after 10 years and had to find a new facility. Fortunately, a space was available in a beautiful new building less than two miles away, and a lease agreement was negotiated. My goal was to build a "cost-no-object" office which would "cause patients to spontaneously appear and schedule full-mouth reconstructions."--as you said.

All told, our leasehold space with build out, equipment, and furnishings was $876,000. Even though this was financed at 5.125% (through the equity in our home), I feel as though I am making no headway at all on the debt re-payment, even after two years of occupancy. It has been a tremendous stress financially and I'm taking home a fraction of what I used to earn before the move (we actually had about a 60% overhead). The overhead now is in the 80-85% range.

Yes, our production has gone from 75K to over 100K, and that's really exciting. And our new patient volume has increased about 15%, but we've lost a bunch of patients also because they think the new facility has made their cost of dentistry go up, and many are intimidated by the anticipated expense of treatment, based on the appearance of the office.

We also had to increase the number of staff to handle the new business, and the payroll has gone from 170K to 250K. And now, with a gorgeous new facility and the accolades that come along with it, one must advertise and get the word out about why it's necessary to come see the world's best dentist, etc. The opportunity for spending money never seems to stop.

We didn't have a choice in moving, but we did have a choice in the level of design and integration of technology. I went overboard because I have a penchant for buying the best "and only crying once". I second the thought that if you're not careful, you may have an opportunity to cry many times. . What buried me was the Dentist Gone Wild approach to purchasing new digital panoramic x-ray, computer, video & camera equipment which was not in the original plan. That added an extra $260,000 before it was all said and done.

The bottom line here is that it was ME who was the problem. It wasn't the supply company, the contractor, the computer rep or anyone else who was to blame--just my lust of the eyes.

Don't let me convince you that I hate our new facility. It's wonderful to work in an office space like this, and it's a bit of a staff magnet. It's also a big pride thing to have so many colleagues come around and oogle, but that doesn't fund the pension and it sure doesn't lead to early retirement. This plan needs to be a conscious decision to work an extra 10 years in practice--or maybe longer! Who knows? Oy Vey!

Sally, you would be remiss if you didn't take the opportunity to reply back and say "You need my services".

A Loyal Fan

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Missed Past Issues of Our e-Motivator Newsletter?

This issue is sponsored
in part by:
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San Diego Workshop Series
Spring & Summer Schedule
 Date Seminar Instructor(s)  
 May. 7
 9:00 - 4:00
How to Become an EXCEPTIONAL Front Office Dental Employee Belle DuCharme, RDA, CDPMA  
 May. 14
 9:00 - 4:00
10 Vital Signs to Master Management Of Your Dental Practice Belle DuCharme, RDA, CDPMA  
 May. 28
 9:00 - 4:00
The Top ADVANCED Management skills for a Successful Practice Belle DuCharme, RDA, CDPMA  
 June 4
 9:00 - 4:00
How to Become an EXCEPTIONAL Front Office Dental Employee Belle DuCharme, RDA, CDPMA  

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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McKenzie Management Upcoming Events
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Apr. 16-18 Anaheim, CA California Dental Association Exhibiting
Apr. 23 Philadelphia, PA Larry Smedley, D.D.S. Sally McKenzie
May 1 Myrtle Beach, SC South Carolina Dental Association Sally McKenzie
May 3 Des Moines, IA Iowa Dental Association Sally McKenzie
May 6 Columbus, OH Ohio State University Sally McKenzie
May 7 La Jolla, CA Center for Dental Career Development Belle Ducharme

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