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  Sally McKenzie's
 Weekly Management e-Motivator
  6.25.04 Issue #120

Feedback – Give it. Get it. Good.

Sally Mckenzie, CEO
McKenzie Management

       Most dentists pat themselves on the back if they give employees feedback once or twice a year. More often than not it’s a perfunctory exchange that is commonly attached to the annual salary review. If there are no problems you tell the employee they are doing a fine job, slap a couple extra percentage points on the paycheck and quickly get this routine matter off your to-do list.

If there are issues of concern with the employee you might dance around them, give a little hint here and there that maybe a few things could quite

possibly be ever so slightly improved. All the while you are extra careful not to be too specific about anything so as not to offend the staff member who just might get mad and – heaven forbid – walk out. In the end you give the employee the same percentage increase you are giving everyone else and call it a day.

The staff member leaves the meeting assuming everything is fine and convinced they are an effective and contributing member of the team. Meanwhile, you are sure they are going to take some real steps to improve their performance. Six months later nothing has changed. Why not? Feedback once or twice a year is not feedback. It’s an exercise in futility. So how does the dental practice actually incorporate effective feedback into its systems? First drop the notion that feedback is part of the performance/salary review. They are separate issues. Performance rewards must be based on performance measurements, but that is another article.

Constructive feedback should be given and received daily to help employees continuously fine tune and improve the manner in which they carry out their responsibilities. And just as dentists must be committed to giving feedback often and clearly, staff members must be open to receiving feedback and making improvements. It becomes another aspect of the regular doctor/staff daily routine.

Feedback given and received constructively is professional sustenance for the employee, the fuel that drives them to improve and to grow. It’s also the dentist’s most vital tool in shaping and guiding average employees into effective, high-performing team members. But expecting anything constructive or positive to come out of annual or biannual doses of feedback is like having a patient who brushes their teeth once every 6-12 months yet expects to have excellent oral health. Doesn’t happen.

Verbal feedback can be given at any time but it is most effective at the moment the employee is engaging in the behavior that you either want to praise or correct. If Sue at the front desk negotiated payment from the ever difficult Mrs. Jones with the deft and political acumen of a highly trained peace keeper/financial genius, tell her! Similarly if her handling of a situation is not consistent with the practice’s overall performance objectives and/or your practice philosophy explain to her constructively how you would like for her to handle similar situations in the future. Verbal, on-the-spot feedback should be the goal. The environment of the practice should be one that encourages positive feedback and openly provides constructive feedback when necessary. Choosing to avoid opportunities to give employees feedback is like choosing to help them to fail.

Next week, feedback – it’s just as important to receive as it is to give.

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

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



I See You Talking

From the Patient’s Perspective

         Communicating is one of the best skills that humans have to touch other humans. Most people think of only verbal communication and forget about the non-verbal aspects of communication. Dentists and dental offices do a lot of non-verbal communication which impacts on the patient perception of the dentist and

dentistry. Have you ever walked into your office as if you were a patient vs. a high speed sprint to start your day? Take a few minutes and walk into your reception area as if you were coming as a patient.

  • Is your reception desk neat and free of clutter?
  • Is there a clear place for your patient to talk to the receptionist?
  • Is there a clear place to write down the next appointment?
  • Is there a clear place to write a check?

A cluttered reception area conveys a cluttered office and a cluttered mind. Will the patient think that the doctor’s mind is so cluttered that the doctor won’t remember what they had discussed? Look around the reception area and see what your patient sees when they sit down.

  • Are the magazines neatly put away?
  • Are the magazines and educational material easily available to the patients?

Someone on your staff should be straightening the reception room or at least checking to make sure that the room is neat a few times a day. It only takes a few minutes, but it communicates to the patients that you run a neat and orderly office.

  • Sit down in one of the chairs in your waiting area and look around. What do you see?
  • Is there dust on the windowsills?
  • Are there tissues under the chairs?
  • Are there toys or books on the floor where someone can slip on them?
  • Do the walls need repainting or new wallpaper?
  • Are the chairs in good condition?
  • Is the flooring in good condition?

The waiting area is the first area that the patient actually has a good look at and is the first area of communication from the office. A sloppy reception area can convey a sloppy doctor.

The next area of importance is the operatory. Sit in the patient seat and look up. The patient sees the ceiling during most of the visit. Make sure that the lighting is clean and free of insects. Make sure the ceiling has no webs or dust hanging from the lights and corners. The next thing the patient looks at most is the doctor’s face and especially the eyes. Make sure that your safety glasses are clean. You should check them in between patients. You don’t want to communicate to your patients that you or your office is not clean.

If you think that your private office, which is often used as the consulting office, is really your private office, you are wrong. As long as patients come in your office, your office is communicating your outlook to the patient. A neat, clean and orderly office says to the patient that you have put everything in order and there is nothing that will keep you from listening to your patient. Listening to a patient is one of the most important skills that a doctor should learn. Many doctors want to put the patient at ease and start by calling a patient by their first name. This should never be done unless the patient has told the doctor that they want to be addressed that way. If the patient has not given a preference, the doctor should ask the patient how the patient would like to be addressed. Body language is also important when you are talking to the patient. Talking with your hands folded in front of you puts a barrier between you and the patient. When you shake hands with patients, do not wear your plastic gloves. Shake hands with both hands. Some patients like to be touched and some don’t. Putting your hand on a patient’s back as you are walking can be reassuring to some patients and offensive to others. The only way is to watch the reaction if you do it. It is important to look in the patient’s eyes when you talk whether it is a social conversation or a consultation. Patients feel that they can trust someone who “looks them straight in the eye”.

There are many aspects of non-verbal communication that you should be aware of in your office. Take a few minutes to look at your office, which is an extension of you, and make sure that things are the way you want them to be. Are you communicating to your patient what you want them to know about you?

Simply ... a concerned patient’s perspective.


Enrich Your Hygiene Department

Dr. Allan Monack
Hygiene Clinical Director
McKenzie Management

         A lot of people feel going to their beautician is more important than going to their dental recall appointment. “Why should I go to the dentist if nothing hurts? If it isn’t broken why fix it? If it doesn’t smell or look bad why show up?” When these are the prevailing attitudes of your patients then you have failed in your efforts to communicate the value of the return visit. Patients will only show up when their dental insurance pays in full, they have nothing better to do that day, they want to look better, or they are in

pain. How do you know if you have a problem hygiene department? Pay attention to the indicators. Do you have more than one opening per hygienist per day on average? Has your hygiene department not grown steadily the past couple of years even though you are getting your usual number of new patients? Is your hygiene department profitable? Does your hygienist produce at least three times their salary including benefit costs? Do they produce 30% of the hygiene services offered with ancillary services such as scaling and root planing, bleaching, halitosis correction, and other treatments that your hygienist is qualified to perform? Do you have a very short or nonexistent list of patients who can fill in hygiene openings? Just as bad, do you have no where to put someone who had to cancel a hygiene visit less than four weeks ahead and still have some of the problems discussed above?

These are the all to common problems I must solve when analyzing hygiene departments. Actually most of these problems are connected. They usually are caused by inconsistent and poor communication with your patients. Patients don’t understand the value of their hygiene visit. No one told them that their visit involves a lot more than a “cleaning”. They “clean” their teeth every day. We hope! Why do they need you to “clean” them? Does the hygienist give the right message during their visit only to be sabotaged by the front desk or the doctor? Yes, doctors sometimes do sabotage the hygienist’s communications with the patient. Is everyone in the office giving the same consistent message on how important it is to return at the appropriate interval?

These same consistent communication skills also improve treatment acceptance. Your hygienists are great educators. They teach the patients the proper home care and preventive skills. They have the time to show the patient the health status of the periodontal and restorative condition. They discuss the patient’s concerns and suggest treatment options that may be appropriate. Your hygienist should also inform the patient of cosmetic improvements to the patient’s smile that are available in the office or available at a specialist’s office. Bleaching, veneers, orthodontics, implants, and gingival reshaping can also be discussed. The hygienist can also discuss overall health concerns such as halitosis, snoring, high blood pressure, temporal-mandibular disease, diet and smoking.

Now it is important for the rest of the staff to know what your hygienist has told the patient. The office needs a plan that will allow the doctor and staff to reinforce the information presented by your hygienist to the patient. This information needs to be repeated in the proper way so the patient will understand and retain what has been told to them. The patient needs to own their problem and then they will be more likely to accept treatment. Once the protocols and communication skills are learned by the office, the patient will have a greater appreciation of the hygiene visit, more readily accept necessary treatment and be aware of the need to return at the proper interval for their hygiene professional cleaning or periodontal maintenance visit.

I teach the skills that will solve a lot of the problems you encounter in the hygiene department. In most cases, the typical dental office increases hygiene production from 20-30% within four months of learning HOW to ENRICH their hygiene department. The doctor’s production also increases because of the higher percentage of treatment acceptance. Consider enriching your hygiene department.

If you have any questions concerning your hygiene program submit them to me at allan@ and I will answer them in future articles.

Interested in having Dr. Allan Monack speak to your dental society or study club? Click here

McKenzie Management’s Hygiene Clinical Practice Enrichment Program is designed to improve Hygiene Clinical Skills and develop and implement a step-by-step Interceptive Periodontal Therapy Program that will immediately bring greater productivity, with enhanced patient care. For more information...GO HERE

McKenzie Management welcomes Bob Ankrom, RDH, BS as Director of Consulting Services

Bob and I worked together in the early 90’s when McKenzie Management was located in Ohio. Over that time we never lost touch with each other and I’m pleased to have him back as part of the McKenzie Management Team. Bob can be reached at:


to find out about



Is your hygienist producing at least 33% of her total production in periodontal services? Are the majority of your patients on 6 month recalls?

Most hygienists perform way below the industry standards. Why? Because they can lack disease assessment skills or performance skills, or because they don't know how to communicate to the patient they have been treating every 6 months that they now have gum disease.

This "how to" manual will help you to establish a protocol for your hygienist to implement new strategies, formulas, and techniques for developing an ultra-successful hygiene department. Scripting and Treatment Plans
by Dr. Allan Monack, DMD, FAGD, Hygiene/Clinical Consultant

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This issue is sponsored
in part by:
The Center for Dental Career Development
San Diego Workshop Series
Summer Schedule
 Date Seminar Instructor(s)  
 August 6
 9:00 - 4:00
10 Vital Skills to Master Management of Your Dental Practice Belle DuCharme, RDA, CDPMA  
 August 27
 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). 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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SALLY MCKENZIE, President of McKenzie Management and the Academy of General Dentistry presents:

Anaheim Convention Center - Anaheim, CA
FRIDAY - JULY 9TH, 2004 -- 8:30am - 4:15pm

Straight up and straight forward from a straight shooter. Learn the top "current" practice issues affecting dental practice growth. Learn the most common causes and effective building techniques as a result of practices analyzed by McKenzie Management.


  1. STAFFING - You can't do it alone. Recruitment, retention, performance measurements, personality conflicts, accountability
  2. BUSINESS - Growing Pains. Quit suffering and grow smarter.
    Scheduling, associates, facility
  3. HYGIENE - Where is that 33%? Patient retention, accountability, perio, ancillary services
  4. STAGNATION - Production, efficiency, treatment presentation, marketing

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