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  Sally McKenzie's
 Weekly Management e-Motivator
  4.23.04 Issue #111

Going...Going...Back to Your Practice

Sally Mckenzie, CMC
McKenzie Management

      When you consider that it costs five times as much to attract a new patient as it does to keep an existing one it becomes abundantly clear that investing time and effort in a patient retention strategy is far more than just a good idea. Certainly, today’s “high expectation” patients may check out the doctor they heard about from their coworker or friend. But don’t assume that inactive patients won’t return to your practice. Patients appreciate it if you value them enough to make the effort to reconnect.

Start with your targeted patient list. This is the report you generate from your computer of all patients past due for recall appointments in the last twelve months. Give your inactive patients a good reason to return.

Send a direct mail letter to every adult in your active and inactive files who is or was a patient in good standing. Be sure to include information about the importance of ongoing professional dental care. Also take the opportunity to educate patients about new techniques and procedures available in your office, options for achieving that beautiful smile, continuing education programs you and your team have completed that will benefit the patient directly. If you’re sending to families, include information appealing to parents’ desires to provide the best care for their children.

Offer reasonable financing options for patients. Establishing a relationship with a patient financing company makes treatment more affordable and more likely patients will proceed with both necessary and elective dental treatment. Send an announcement to your inactive patients informing them that patient financing is now available and this is one of many steps your practice is taking to ensure your patients receive the care they want and need.

Put the patient’s schedule first and the six month schedule last. Six month scheduling is the “bait and switch” of dentistry. Dentists take the bait – The schedule is so packed. I’m so successful. Patients are lined up for blocks. Then the switch – another 2 p.m. hole in the schedule today, the hygienist is stacking inactive patient charts instead of treating active patients. And once again, doctor, you’ve been duped into thinking that this low payoff system actually works. Practices scheduling patients six months out average only 76% patient retention and have a nearly 50% higher loss of patients than similar-sized practices that do not pre-appoint.

Get a real schedule with a real recall. The hygienist explains the need for follow-up prophies and exams to the patient. The patient addresses the envelope in which their recall notice will be sent. The hygienist instructs the patient to schedule the next appointment when their notice arrives in the mail.

Appointments scheduled two-to-three weeks ahead are less likely to be cancelled or result in no shows. Use a professionally written and printed recall notice – no postcards. Why no postcards? They tell the patient that you are cheap. You want the patient to invest in a $5,000 treatment plan, but you won’t spring for more than 23 cents in postage and a one line message? Think about it.
When the recall notice is sent to the patient include information on the latest practice news, including new equipment, new techniques, continuing education updates on the doctor and staff – it’s the added value of your practice that sets it apart from the one down the street.

Make daily patient contact a priority. Assign a patient coordinator to:

  • Make a specific number of calls to past due patients each day.
  • Schedule a specific number of appointments.
  • Ensure a specific number of patients complete treatment.
  • Schedule so the hygienist achieves a specific daily or monthly financial goal.
  • Manage a specific number of unscheduled time units in the hygiene schedule per day.

Each month monitor recall and ask your patient coordinator to provide a report to the team during the monthly meeting. Give your inactive patients a reason to try your services again, chances are they never really wanted to leave in the first place.

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

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SPECIAL DELIVERY from Sally McKenzie, President & CEO, McKenzie Management & Associates, Inc.

I am pleased to announce that Dr. Nancy Haller has joined the McKenzie Management Team as Executive Coach

Dr. Nancy Haller
Executive Coach
McKenzie Management

      Dr. Haller holds a doctorate degree in psychology and served as a Commissioned officer in the United States Navy where she provided personnel screening, team building, and managerial effectiveness training. Following her honorable discharge, Dr. Haller founded Applied Psychometrics. She has worked with Fortune 500 managers and executives at the Center for Creative Leadership. Dr. Haller also is a valued resource in change and conflict management situations. Her understanding of

human behavior and business dynamics combined with her engaging style make her a trusted advisor to managers and executives.

Over the past 14 years, Dr. Haller has worked with a diverse group of companies in the public and private sector, from large corporations to family-owned businesses. Dr. Haller’s expertise has benefited businesses from dental practices to service industries in bolstering employee productivity, reducing turnover, and improving customer service.

Dr. Haller’s assistance to the dental profession will include: pre-employment testing, conflict management and dispute resolution, job analysis and employee review, change transition, communication skills training, departmental and organizational team building, executive coaching and leadership development, counseling for life issues and work performance.

Dr. Haller will be a featured columnist in our weekly e-Motivator Newsletter. And can be reached at McKenzie Management 1-877-777-6151 Ext. 33 or

Dear Dr. Haller,
I pay my office staff very well but I am so frustrated that I still have to tell them what to do. It takes up way too much of my time when I should be seeing patients. Do you have any advice about how to motivate them?

Dr. Frustrated

Dear Dr. Frustrated,
Your office sounds busy, which is both a blessing and a challenge. Managing the demands on your time becomes even more crucial when business is booming. It’s natural that you expect your staff to help you out when the pressure is on. But productivity and efficiency in your personnel team are the result of consistent training and coaching. Unfortunately because developing employees takes time, it generally gets neglected…until problems arise. By then emotions can flare up and it feels like you’re putting out fires.

Building a strong, cohesive office requires time upfront, but the investment yields long-term gains. The foundation of a good staff begins in the selection process hiring the right people, matching their skills and work styles as closely as possible to the responsibilities of the job. Pre-employment assessment can be an invaluable tool to strengthen the processes you already have in place.

Even if you hire the right people, hiring is just the first step. Since there are no perfect job candidates, it is much more realistic to expect that your employees will have strengths and talents, as well as areas they need to improve. Those are referred to as developmental needs. Once they are on-board, it is necessary for you to train your staff. Help them understand not only the concrete parts of their job, and even more importantly, how you expect them to do those tasks. In turn, you are coaching your staff to assist you in achieving organizational objectives.

Here’s an example.

Joan was hired as the scheduling manager. Her socially poised, enthusiastic personality made it easy for her to talk with patients. However, Joan is not a strongly detailed person working in a job that requires more precision than is natural for her. When the office is quiet, Joan is accurate with appointments. However, on days when the office is hectic and there are lots of distractions, Joan makes errors. She writes down the wrong procedure, or the wrong tooth number in the book.

Initially Joan seemed like the ‘right’ hire for this job. Her strengths/talents are her outgoing, personable style. She interacts with others easily. Her developmental challenge is to pay more attention to details. If Joan is going to be a productive member of the dental team in her office, she will need to learn processes about scheduling that maximize accuracy. This requires her boss to ‘coach’ her. Through consistent discussions, Joan and her boss can identify the issues and/or distractions that reduce her precision. Together they can implement strategies and policies that enable Joan to maximize her strengths (her wonderful people qualities) AND improve her attention to detail.

Coaching employees need not take lots of time, especially if it becomes part of the normal day-to-day functioning in the office. Make it a habit to tell your employees when they do things right. Every day. Verbal appreciation and recognition is far more valuable than bonuses and tangible rewards.

When employees err, remind them in private of what you want them to do, or how you want them to do it. Performance-based feedback is essential. It tells your employees that they are ‘on track’, or it gives them information that they are off-course. Be brief and objective. Stick to the matter at hand. Ask them what kind of help they might need to perform better. Voice confidence in their ability to succeed. Give them encouragement. And remember to praise them. It is very important to notice even the smallest efforts they make toward their identified goal. If you repeat this cycle over and over, in time your employees can be star performers.

Dr. Haller

For more information on Executive Coaching and Leadership Development… Go Here



Belle M. DuCharme, RDA, CDPMA
Director/ The Center for
Dental Career Development

      At The Center for Dental Career Development in La Jolla, California, we offer advanced business office training for Dentists, Office Managers, Business Administrators, Financial Coordinators, Treatment Coordinators, Scheduling Coordinators or any other position that has to do with the business of managing a dental practice. The uniqueness of this training lies in “customizing” the experience based on the data collected from the office that is here for training. The training is not “canned” or strictly from a textbook. The training is designed to teach the twenty systems that operate your office and what can be done to make it more profitable and a more enjoyable place to work. An intensive program of two eight-hour days covering

every operating system in your practice is presented to your front office person or staff by one training facilitator. The training room is designed for concentration. No ringing phones or interruptions are allowed during the training period. This is not a seminar where you listen to new and great ideas go back to your office and forget about it a week latter. This is the real information your staff needs to manage your practice. Study guides and management forms are provided or developed at that time to be used in your office for your specific needs. Before coming to The Center, your office is given a list of reports to provide for the training. A questionnaire about the office and a temperament profile for each staff member is requested before the training commences. It is necessary that the training facilitator be able to examine these reports to provide information to improve the performance of the practice.

As Director of The Center, I have developed a Case File of experiences with clients that I feel I should share with you for the betterment of the business of dentistry.

CASE FILE 120: A front office staff of three joined me for training from Indiana. Upon looking over the information prior to their arrival I had determined that the production and scheduling required only two front office personnel to manage the practice. During the initial introduction period of the training I discovered that all three had the same title “Patient Coordinator”. “Who is responsible for recall?” I asked. “We all are,” was the answer in unison. “When is the last time you called some one on the list?” They all looked at each other. “Probably last week”, the senior member said. “Who is responsible for follow-up on unscheduled treatment?” “What’s that?” they inquired. “Patients that have been presented treatment plans and have not scheduled or have cancelled or have stopped in the middle of treatment. Can you produce a record of these patients?” I answered. “No, our computer doesn’t do that and we don’t give patients treatment plans, we just schedule it.” Answered again in unison. The senior member of the staff did most of the talking unless I directed the question to another staff member. “Doctor doesn’t do any large or difficult treatment that would require a treatment plan be given to the patient.” I had observed by looking at a weeks worth of scheduled treatment that Dr. Yuha had performed a couple of single crowns, several resin fillings and sealants.”How about informed consent?” I asked as I continued to gather information on this practice. “What’s that?” the senior member of the staff answered. I explained informed consent and how important it was that the patient understands the treatment and possible risks. I then produced a copy of an “informed consent” form and showed it to them. The senior staff member commented, “In the five years that I have worked for Dr. Yuha, I have never seen anything like that. Do you suppose he does only easy dentistry so that he doesn’t have to deal with that form?” I moved on. “Are any of you former dental assistants or have you had any formal training in dentistry?” They all answered “No”. They all had excellent backgrounds in customer service and fully understood the financial arrangement aspect of the business, however.

Dr. Yuha had indicated that he wanted his staff to have definitive job descriptions and areas of responsibility clearly defined so that he knew who to go to when he had a question. He had never given a performance review to any of his staff because he didn’t know how to measure their performance. He wasn’t sure what they did at the front all day.

After temperament testing the staff, I set out to give them separate job descriptions and areas of accountability. Each one of them was responsible for presenting to the doctor a monthly report having to do with their area of expertise. They were all cross-trained to be able to “fill in” during illness or vacation periods. I included clinical training in their program because they were lacking general knowledge necessary to guide patients to accept treatment. Dr. Yuha clearly lacked confidence in his treatment presentation skills but worse yet, he did not have a trained staff member to “sell” his dentistry. I recommended the Treatment Coordinator Training here at The Center.

It was an intensive two days but the staff left happy and with purpose and direction as to what they needed to do to organize and lead the practice to new goals of productivity.

The names, state of residence and personal information of clients mentioned above have been changed to protect their identity.

See you at The Center.

Belle M. DuCharme, RDA, CDPMA, Director

Are you feeling
your practice
could become
than it is?. . .
. . . but not sure
where to start?

Stop Sending Those "Cutesy" Postcards! Go 1st Class!!!

Recall Cards

Cheap is not the message you want your patients to receive. A professional notice sent in an envelope invites serious consideration as well as providing an ideal opportunity to enclose a pre-med prescription or an educational brochure that will help raise the patient's awareness. This investment in patient retention gets existing patients to stay active and active patients means more word of mouth referrals.

e-Newsletter special: $198



  Fee Setting Strategies
  Analyzing your practice’s
  Examining production
per hour
  Determining when you
should raise your fees
  Human Resource &
Staffing Issues
  How to handle team conflict
& foster cooperation in
the workplace
  Relationship of production
level to number of staff
  Making the most of
performance reviews
  How to handle cancellations
and no-shows
  New & powerful ways
to schedule
  The power of block scheduling
  Continuing Education: Absolutely NO CE FEE’s of any type!
  6 CE hours in the mini-series (ADA
& AGD). These hours can be used
by the entire team
  CE tests can be taken online
(NDN CE OnLine)


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

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Sally's Mail Bag

Hi Sally,
I’ve got a really smart office manager that has been with me for nearly a year. Her annual review is coming up and I would really like to give her a nice raise, not only to reward her but also as a means of keeping her for the long run. I’ve had a few office managers in my 28 years of practice, and this one by far is the sharpest. My collections alone have gone up substantially because of the policies that she has initiated. Would you give her a percentage raise and what would be considered an adequate percentage? Or would you just give her a substantial one time bonus and a smaller, more modest raise?
Mid West Dentist

Dear Dr. ,
Standard business practice for salary % increase is 5-6% year. That may vary 1-2% depending on the economy in any given year. To keep your payroll in line, remember that no more than 22% of your collections are for salaries and 3-5% for payroll taxes and any employee benefits you provide. While she’s done a great job in instituting collection policies that brought in more money, that will eventually become the norm (as it should be). Whatever raise you give her now is permanent and not easily taken back. Be honest and fair not only to her but… to your business for the long term.
Good Luck,

Office Managers
Financial Coordinators
Scheduling Coordinators
Treatment Coordinators
Hygiene Coordinators

The Center for Dental Career Development
Advanced Business Education for Dental Professionals
737 Pearl Street, Suite 201
La Jolla, CA 92037

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

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Enrichment Program
or contact us at:
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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
Spring & Summer Schedule
 Date Seminar Instructor(s)  
 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.

Please visit to view a list of upcoming seminars and workshops.

To Register 877-900-5775 or
McKenzie Management Upcoming Events
Date Location Sponsor Speaker
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 13-15 Washington, D.C. District of Columbia Dental Society Sally McKenzie & Exhibiting
May 21 New York , NY Greater New York Study Group Sally McKenzie

For more information, email
or call 1-877-777-6151

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