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  Sally McKenzie's
 Weekly Management e-Motivator
  8.27.04 Issue #129

What Not to Say

Sally Mckenzie, CEO
McKenzie Management

       Um, uh, nope, uh huh, ain’t, yep, nah, dunno, can’t do that, you’ll have to, hold, ya know … and the list goes on, seemingly innocuous utterances sprinkled in typical phone conversations that can in as few as three words or even two syllables leave a lasting impression on your patients, a lasting negative impression that says sloppy, rude, and untrained. Harsh assessment, you say? Patients don’t really evaluate an entire practice based on a three minute phone conversation. Wanna bet? Patients’ expectations are higher today than ever before. If they are contacting an office with the intent of purchasing services in the

near future they are immediately assessing if that practice is worthy of their investment.

Every time an employee is on the phone with a patient he or she represents the practice. They convey to the patient the doctor’s commitment to education, professionalism, and training. Yet too many practices pay too little attention to this most obvious link between the practice and the patients. Particularly when the office is busy, answering the phone is just one more irritating interruption. In fact, many practices don’t even consider the fact that the patient’s experience begins with the very first phone call. The process is on autopilot until something goes wrong and the alarms start blaring.

When was the last time you reviewed your standard operating procedures and training regimen for placing and answering patient calls? Does your practice even have a policy or provide training? Is un-polished talk costing your practice a fortune? Before untrained staff cut the line on your revenues maybe it’s time to dial up a few telephone do’s and don’ts.

Don't use slang or jargon. Instead of saying, "OK," or "No problem," for example, say "Certainly," "Very well," or "All right." Avoid stringing your responses together with fillers such as "uh huh", "um," or phrases such as "like" or "you know." Staff should be trained to avoid these when they are speaking on the phone.

Don’t ever say, "I don't know or I can’t."

Do say, "Let me find out about that for you."

Do offer to help the caller. If a patient calls and wants to speak to the doctor and he/she is not available, take this approach: “Doctor Mack is with a patient. This is Jane, could I help you?” If the patient insists on speaking to the doctor, politely ask, “Could I please have your name and number and I’ll see that Dr. Mack receives your message.”

Do take telephone messages completely and accurately. Ask the caller to spell their name. Unless you know all of the patients very well it may be difficult to distinguish if you are talking to Mr. John Carrigan or Mr. Jon Kerrigan.

Don’t rest until the message gets to the intended recipient.

Do ask for identification politely. “May I tell Dr. Mack who is calling?”

Don’t put the patient on the defensive by asking: “Who is calling?” “What’s this regarding?” Or “Why are you calling?”

Do gather information with skill. “Mrs. Smith, if you could give me just a bit of information, I’m sure I can help you.”

Don’t bounce the patients around the office by sending them to the financial coordinator, then to business manager, and so on. Check on the matter yourself and call the patient back promptly or personally go get the employee they need to speak to.

Do offer solutions. “Let me see what we can do to help.”

Don’t use a speaker phone.

Do ask permission before putting the patient on hold.

Don’t give the patient orders. “Mrs. Smith you’ll have to …”

Remember the telephone is your single most important link to your patients. It’s the initial point of contact and the first impression of the doctor and the team. Make it ring with enthusiasm and professionalism.

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

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Don’t Let Your Office Become a Battleground

Dr. Nancy Haller
Executive Coach
McKenzie Management

        Ignoring employee conflicts puts you and your practice at risk. The ‘war’ might be a lawsuit against you for a hostile work environment. More likely, the ‘combat’ results when feuding staff fail to communicate vital information about scheduling or billing.

Bottom line: Ignoring conflict costs you money!

Do yourself – and your wallet – a favor. Address

disagreements and problems as soon as they occur. Here are some recommended steps.

1. Adjust your belief about conflict.

Conflict itself isn’t the problem; it’s the way you respond that escalates or resolves conflict. Certainly we know what ‘bad’ conflict looks like – verbal, emotional, physical violence. But remember that conflict can result in positive change – we gained freedom as a nation in 1776, it enabled us to abolish slavery, women gained the right to vote. Accept that conflict is a natural part of life and deal with it upfront.

2. Know your ‘hot buttons’ and response to conflict.

In my last article, I listed five styles of conflict. If you are avoidant, competitive or accommodating more often than compromising or collaborative, take a class in assertiveness or mediation, or work with a coach to improve your ability to handle conflict constructively. Become more comfortable staying engaged and composed, regardless of how difficult the situation might be.

3. Communicate, communicate, communicate.

Nothing gets resolved if people stop talking. Rather than trying to stop conflict, meet it head on. Explore what’s behind the frustration or anger that people are expressing in their words or actions. Ask open-ended questions.

4. Listen, listen, listen.

It has been said that we have one mouth and two ears because we are supposed to listen twice as much as talk. The power and value of listening, especially in conflict situations, is monumental. When you are in a discussion about conflict, rephrase what you hear to show that you are listening and to assure you heard correctly. Refrain from trying to ‘fix it’ too quickly. Strive for understanding before resolution. Show empathy. Acknowledging employees’ feelings and motives is not the same as agreeing with them.

5. Be curious not furious.

Our natural reaction to conflict, especially if we feel threatened, is to become defensive. Manage yourself. Stay calm. Use a neutral voice, even if the other person is heated up. Move the discussion to a private area, especially if there are patients in hearing range. Give the other person time to vent. Don’t interrupt or judge what they are saying. Thank them for letting you know how they are feeling and what they are experiencing. Rather than attempt a premature remedy, agree to talk about it after a ‘cooling off’ period.

6. Work the issue not the person.

When you are convinced that you fully understand the problem, acknowledge where you agree and disagree. Avoid blaming. Use “I”, not “you”. Talk in terms of the present as much as possible. Ask, “What can we do to make things better?” Identify at least one action that each person will do, and get commitment for the plan. Set up a future meeting to discuss progress.

7. Develop a feedback-based culture in your office.

Make frequent, two-way communication a natural part of your daily practice. Just as it’s important to praise and reward people when things are ‘right’, it’s essential to give feedback when we want something to change. Feedback is nothing more than data or information. Get individual ego out of this exchange. Learn to de-personalize and help your staff to do the same. Ask them to give you feedback by using a simple process – what should I continue doing; what should I stop doing, what should I start doing.

Keep the attitude that holding different views is both normal and healthy to a group. Use patience, persistence and good people skills. Model open communication and feedback. Make your office a peace zone.

Dr. Haller offers basic training for interpersonal communication, conflict management, and team building. If you would like information about any of her practice-building seminars, contact her at or 1-877-777-6151 Ext. 33

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Could’ve, Would’ve, Should’ve

From the Patient’s Perspective

         When it comes to treatment acceptance – or lack thereof – hindsight is often 20-20. You can spend hours analyzing how things could have been if you had just used a different model, how things would have been if you had listened more carefully to the patient, how things should have been if you had just taken more time to educate

the patient on why the treatment was necessary.

Why, oh why don’t patients seem to grasp the need for the care you have to offer? Many patients are visual learners. Certainly they trust you, and some patients are motivated to pursue treatment merely because they believe the doctor is recommending the best care for them. But for the others who don’t automatically accept treatment, often they simply don’t comprehend the need for the treatment, the importance of the procedure, or the true ramifications of their treatment procrastination.

Meanwhile, you’re listening to those motivational tapes, trying to exude high energy and confidence, rehearsing various treatment presentation approaches, tailoring the case discussion for this patient and adjusting for that. But in the end, no matter how charming, charismatic, and thoroughly prepared you are, the patient still sits across from you waiting to be convinced that they really need the work performed at all.

And therein lies the biggest obstacle to consistent treatment acceptance. Many patients must see and understand the problem for themselves. It’s not that they don’t respect or believe what you have to say. It’s simply that in their minds it is not real until they can ascertain the problem for themselves. Commonly referred to as co-diagnosis, more and more doctors are taking steps to actively involve patients in the discovery process, and one of the most effective and efficient tools I’ve seen is digital radiography. When you take a digital image and before the sensor is even removed from the patient’s mouth that image is blown up on a 20” screen right before the patient’s eyes, not only has the WOW factor begun, so too has the understanding factor.

For the first time they can actually see the bone loss, the decay, the fractures that they could never see before on those itty, bitty, little films. The abstract is now real and in black and white right in front of them. Throw into the educational benefits of digital X-rays the physical and time management benefits as well. The patient didn’t have to endure that uncomfortable film jabbing them in the gums. They didn’t have to sit there and cool their heels waiting for the film to be processed while the meter and the day are ticking away.

As you further explain what the image shows, the patient is beginning to understand the true extent of the problem and begins asking you what can be done to fix it. They are engaged, involved, and more open to treatment than they have ever been before. You are doing what you do best – recommending the ideal treatment to address the patient’s oral health concerns. You’re not pitching a plan. You’re not selling. You’re providing a solution. The patient wants it and you didn’t even have to make sure that you were exuding maximum charm, unsurpassed charisma, unquestionable trust, all cinched in a neat little package with your firm but perfectly compassionate handshake.

In the end, patients don’t want to be “sold” they want to be educated. They want to make informed decisions because this choice will impact their oral health, their personal and professional lives, and their pocketbook for sometime to come. They need to understand the “why” before they can even consider the “how.” Digital X-ray systems spell out the why often before you ever have to utter a word.

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Sally's Mail Bag

Dear Sally,
I think we are taking too long for procedures. What would you suggest we look at?
Dr. Thom

Dear Dr. Thom,

1. Do you have a daily schedule in each treatment room?
2. Do you have a clock in each treatment room?
3. Do you talk too much?
4. Do you perform more treatment than was scheduled?
5. Do you state the time needed for each procedure to your assistant and is it realistic?
6. Do you spend too much time with the hygiene exams?
7. Do you, as a rule, allow more than two emergencies per day to be seen?
8. Do you spend too much time on personal telephone calls or the internet?
9. Are you doing treatment planning?
10. Are you communicating to the scheduling coordinator the exact time needed?
11. Do you have a lot of emergencies and if so, why?

Hope this helps,

Office Managers
Financial Coordinators
Scheduling Coordinators
Treatment Coordinators
Hygiene Coordinators

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This issue is sponsored
in part by:
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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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