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  Sally McKenzie's
 Weekly Management e-Motivator
  7.23.04 Issue #124

Are You the ‘Dollar General’ of Dentistry?

Sally Mckenzie, CEO
McKenzie Management

       The 50th or 60th percentile doesn’t exactly conjure up images of great success. After all, in school those percentages would certainly be failing grades. If your car or computer only worked 50% or 60% of the time you would promptly dispose of it. If the cardiac surgeon were successful in 50% - 60% of all cases you wouldn’t hire him/her for your mother’s bypass surgery. If you were only being paid 50% to 60% of what your work is worth certainly you wouldn’t tolerate it … or would you?

In reality, many dentists are delivering highly skilled dentistry only to charge discount store fees. They have anchored their practices to the dock of poor or mediocre financial return.

It doesn’t take a financial wizard to figure out that if fees – the main artery to your practice lifeline – are getting the squeeze, everything else is choking as well. Pay raises and bonuses are gasping, new equipment purchases are practically code blue, production is non-responsive, and all other systems are likely flat-lining at best. Yet many doctors do not have a regular schedule for increasing fees because they are positively petrified to do so. They are convinced that if fees go up patients go out.

In reality, most dental practices have a solid foundation of loyal patients who trust the dentist and respect the quality of work provided. It’s not the fees that drive most patients from a practice. It’s also reality that fee increases do not go unnoticed. Some patients will comment. Yes, a few may actually leave, but it will not cause the mass exodus that many reluctant dentists fear.

Certainly you want a fair fee schedule, but fair doesn’t mean boxing yourself into being the “Dollar General of Dentistry.” If you are concerned your patients do not understand the value of your services and, therefore, would balk at any fee adjustment, make an effort at each visit to educate them about the dentistry you are providing. Clearly explain the procedures, what is being done, and why it is vital to their oral health and overall health.

Educate them on other services the practice provides that could further benefit both the patient and their family. Supply an itemized list of the dental care provided. Involve the entire staff in improving communication and the perceived value of services from the time the patient walks in the door to the moment they drive away from the office. You and your team are providing valuable dental care to each patient and every interaction your team has with patients should underscore that point.

Next week, increase fees and improve patients.

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

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The Good Doctor

From the Patient’s Perspective

         As a patient, I really do not know if a dentist does good work or bad work. I always feel good when a doctor relieves pain, but that doesn’t mean the doctor does good dentistry. How do I decide if a doctor does good work or not? I don’t investigate the dentist. I don’t even know what school he graduated from and certainly don’t

know where in the class he was rated. I guess it is how he cares and treats me that really matters.

Having surveyed a small group of patients who have received treatment from different dentists, let’s look at different scenarios that other patients have brought to my attention. To paraphrase, let’s look at “The Good, The Bad and The Ugly.”

A patient woke up one morning in pain. She took some over the counter medicine, but the pain did not go away. She called her dentist and asked if she could have the first available appointment. The receptionist informed her that the first appointment of the afternoon had cancelled and they could see her at that time. The patient came in ten minutes before the appointment, was handed some forms that had to be completed, which she did, picked up a magazine and waited for the doctor to call her in to the treatment room. When she realized fifteen minutes had passed her appointment time, she asked the receptionist when the doctor would be coming to get her. The receptionist said that he would be right with her. At thirty minutes passed her appointment, she asked the receptionist, “Where was the doctor?” The receptionist replied, “He was in the hallway talking to a colleague.” The patient knowing no fear of intimidation, walked into the hall and over to the doctor and informed him that he was already a half hour late. She said that if his friend were more important than a patient who was in pain, she would go somewhere else. The doctor quickly apologized and took the patient into the treatment room. His excuse was that he didn’t realize the time when he was talking. He did help the patient, but the patient never went back to him. She felt that his patients were not his first priority. Of course, she also relayed her story to her friends,….at least 10 of them, which is not good for the reputation of the doctor.

How could this have been handled differently? Perhaps the receptionist could have said to the patient that she would find out what was causing the delay and thank the patient for bringing this to her attention. She could have then politely interrupted the doctor’s conversation and reminded him that he had a patient in pain in the “waiting” room. He would have realized that time had passed, would have taken the patient earlier and apologized sooner. This would also have given him time to apologize to the other patients who would also be waiting longer for their appointments. You do not necessarily have to give a reason for running late. Patients like to know that you are thinking of them. They understand that a doctor cannot always be on time. Taking a few minutes to go into the reception room and apologize for running late, lets the patients know that you care.

So what have we learned from this incident:

  • Make sure the patients come first.
  • Take the time to make patients aware that you are taking care of problems that have come up and you have not forgotten them.
  • Train your staff to be able to handle problems in an efficient and caring manner.
  • Don’t forget that one unhappy patient can affect ten potential patients.

If you have a favorite patient story you would like to share email


Referring To The Periodontist

Dr. Allan Monack
Hygiene Clinical Director
McKenzie Management

         The periodontist is a very important part of any conservative periodontal protocol you establish in your office. I recently received an inquiry from Tricia an R.D.H. who works in a general practice. “When we refer a patient to the periodontist, what information should we include when we send a letter to the periodontist about the patient? Is there a way to print a referral letter with the Dentrix program? What steps should we take to be sure the patient does not fall through the

cracks if they never visit the periodontist?”

It is important that the periodontist knows exactly what you have discussed with the patient, any periodontal treatment you have rendered, the results you have achieved, and the reason for the referral. I would include a copy of your initial periodontal examination, any follow-up charting, all radiographs, and a detail history of all treatment you have performed including any placement of intra-pocket medications, systemic medications and home care instructions. Include intra-oral photographs if appropriate. The periodontist will appreciate your detailed treatment history. It makes it easier to communicate and reinforce the recommendations you made to the patient. The periodontist doesn’t want to tell the patient conflicting information that may confuse the patient, reduce the trust between the patient and the periodontist or between the patient and your office.. This will cause the patient not to follow through with the necessary treatment.

Jennifer Johansen, a Dentrix Coaching Specialist, says there are many ways you can use Dentrix to enhance your referral protocol. Dentrix provides several referral letters both to and from the periodontist. You can print the periodontal examination, dental history, charting and attach it to your referral letter. “Custom letters may be created, as well, and our Dentrix support department can assist in this process.”

The best way not to lose the patient is to prevent patient procrastination. Explain how important it is for the patient to seek specialist care. Have the patient fill out the normal recall notice at the appropriate interval as if they were not referred to the periodontist. Tell the patient they should keep the return visit with your office unless the periodontist recommends that the recare visit be delayed while they are undergoing treatment at the periodontal office. Tell the patient you will inform the periodontist of the next visit at your office. Place this information in your referral letter. Let the patient know that the periodontal office will contact the patient to schedule the initial visit with the periodontist. Don’t leave it up to the patient to contact the periodontist.

Jennifer Johansen says, “To ensure that patients do not “fall through the cracks” if they choose never to visit the periodontist, the patient may be attached to a recall (or Continuing Care) type in Dentrix. This will allow the office to track how often the patient comes into the office and keep the staff informed of when the patient is overdue for treatment.”

Your doctor and the periodontist should discuss your office’s periodontal protocol. The doctors should also consider having discussions about their mutual patients on a regular basis. In this way communication between the doctor, periodontist, staffs, and patients will be seamless and enhance the treatment and comfort level of the patient and improve their chance for successful therapy. Now isn’t that the ultimate goal!

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



QuickBooks 2004 In Your Practice

By Susan Gunn
Before you invest time, money, and energy taking a QuickBooks class from your community college, check out the QuickBooks In Your Practice workbook. Written by Susan Gunn, this workbook is the result of frustrated clinicians wanting a workbook designed specifically for their professional practices. A mandatory reference for any practice, this workbook allows practices to care for patients, not figure out their accounting software.
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737 Pearl Street, Ste. 201
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Sally's Mail Bag

Dear Sally,
My practice is growing too fast. I don't mean to sound arrogant or ungrateful, quite the contrary I can't believe how well things are going. However, I can't seem to run on time, my schedule is crammed with emergencies, my production numbers are good but could be better. I'm a pretty fast worker, so it is baffling to me why I have a 3 month + wait list.
Is there anything you can recommend to help increase practice efficiency. Not just "perfect scheduling" but back office efficiency, dentist efficiency all which would lead to increased numbers. I don't want to hire an associate until I am sure I have done everything in my power to maximize my potential.

Thanks in advance...
Official Townie
DentalTown Post

Dear Townie,
Congratulations to you for determining that perhaps clinical inefficiencies could exist prior to bringing on an associate. Adding on operatories and associates is usually quite frequent and is not always the solution. McKenzie Management performs clinical time and motion studies looking at the dentist’s efficiency and chairside utilization, instrumentation, treatment room turnaround as well as scheduling. It’s difficult to give you “self-help” tips but some areas of inefficiency that our team reveals are that most dentists have not had anyone watch them do a preparation since dental school,dentists talking too much, grabbing for instruments, not performing quadrant dentistry, non-delegation of duties to auxiliaries, no pre-day planning with meetings, unrealistic time for procedures, scheduling does not reflect doctor/assistant utilization just to mention a few. Let me know if we can be of more help.


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This issue is sponsored
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San Diego Workshop Series
Summer Schedule
 Date Seminar Instructor(s)  
 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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To Register 877-900-5775 or


Dental Trade Alliance - "One Voice, One Vision"
AUGUST 4-8, 2004

Saturday, August 7
8:00 - 8:15 am Edward B. Shils Entrepreneurial Education Fund Presentation (speaker tbd)
8:15 - 10:45 am "Future Vision of Dentistry"
Richard Fishbane, Vice President, Research, Strategic Dental Marketing Inc.
Dr. Tim Adams, Clinical Director, Las Vegas Institute of Advanced Dental Studies
Dr. Arthur "Kit" Weathers, President, CE Magic
Sally McKenzie, President, McKenzie Management & Associates
Dr. Howard Farran, President, DentalTown Magazine

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