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  12.23.04 Issue #146

Before you Give the Green...
Spell it out in Black and White

Sally Mckenzie, CEO
McKenzie Management

We're on the eve of 2005 and the days of the annual salary increase are long over. Today's pay raises are based on merit - not on longevity, not on across the board increases, not on the whims of doctor nor whines of the staff.

Individual salary increases must be based on the employee's knowledge, skills, attitude, values, and motives. When employees have clear priorities, when they've been given individual performance expectations, and when they know what action steps they can take well in advance to receive a raise, it puts the employees in charge of their own monetary success or failure and establishes the dentist as the leader - not the dollar dictator.

As the New Year dawns it is the perfect time to overhaul or perhaps establish a solid merit-based compensation policy in your practice. Start by implementing these steps. First, establish compensation guidelines and follow them. Based on the market, identify the pay range for each position in the practice. Spell it out to every team member exactly how the compensation system will work in the practice, what is available to the team member, what formulas are used, what it takes for them to earn more money and how much more they can earn in that position.

Employees must understand how compensation is established - including benefits, bonuses, special perks, and their role in influencing their level of pay. If the employee does not understand the fundamental elements of compensation, whatever the doctor dishes out will never be enough.

Give staff a general overview of the financial picture of the practice, so they can understand the real costs of operating a dental office. They need to recognize that the doctor does not take home all the revenue that the practice collects. Unless overhead and expenses are explained to employees they don't get it. Consequently, they fill in what they don't know with their perceptions - "Dr. is a miserly scrooge because I'm just sure - at least pretty positive - based on what I've seen - that the practice is raking in $XYZ in revenues every month and we get a paltry 2% pay raise." As team members, they need to understand the rules of the game and what happens when the team is winning as well as when things run afoul.

Make staff responsible for their success, their income, and their advancement.

  1. Develop results-oriented job descriptions for all staff.
  2. Involve each employee in establishing their own performance objectives that are consistent with the overall practice goals, such as scheduling to meet production goals, keeping the hygiene schedule full, eliminating the insurance backlog, improving the new patient process and materials, etc.
  3. Provide the job expectations in writing and explain to the employee that their performance will be assessed on those areas.
  4. Help the employee achieve success by securing training if necessary. When the employee is prepared to succeed the practice succeeds.
  5. Hold the employees accountable for their systems. It is imperative for team members to understand the importance of their role in the team's success. Mary, the scheduling coordinator, needs to fully comprehend that her performance affects the ability of the hygienist to meet production goals and the ability of the practice to achieve financial objectives and, consequently, her own ability to secure a raise.
  6. Give performance appraisals twice a year. At a minimum, appraise the employee's performance in the following areas:
    • Following instructions, cooperation, quality of work, initiative, innovation, time management, communication, and flexibility
    • Work ethics
    • Attitude
    • General characteristics, such as professional appearance, verbal skills, ability to work under pressure, organization skills, ability to prioritize
    • Attendance
    • Provide constructive feedback regularly

Establish a clear system and enjoy the financial perks of a team that is truly an asset not an expense.

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

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Do You Take The Health of Your Patients Seriously?

Dr. Allan Monack
Hygiene Clinical Director
McKenzie Management

When I see how some dental offices treat the patients that have been part of their practice for many years I wonder if they really have the patient's health as the first priority. Hear me out before you get annoyed by my comments. For the most part, dentists and hygienists are some of the most caring and compassionate health providers. They get upset when their recommendations are ignored because the patient's dental and general health will be at greater risk. However, sometimes their feelings get in the way of proper treatment.

Dentists as a group want to be loved by all their patients. They take it personally when a patient leaves their practice. They get upset if the treatment isn't perfect and agonize whether to tell the patient they want to redo the procedure. However, the most harmful reaction is not to tell a patient that a problem that has been untreated for years needs to be corrected.

Health professionals don't want to face the fact the problem was undiagnosed, misdiagnosed, or neglected. Will the patient be angry? Will the patient ask questions that confront the competency of the practitioner? Does the patient lose some trust in the practice? I guess the answer is yes if the dentist or hygienist isn't prepared to address the problem in a prepared and constructive manner. It doesn't have to be that way. Once you realize that treatment has been inadequate, you need to communicate responsibly with the patient. If you are honest and are ready to handle the inevitable questions, you will find most patients will not react as you feared.

The most common area is with periodontal disease. The dentist doesn't seem to have a problem telling a patient the four year old restoration has failed and now a full coverage restoration is the only option. Neither is it difficult to tell a patient that a tooth which was treated last year now needs an endodontic procedure even though there are no symptoms. Why? Usually, it is because we set up the possibility at the time the original treatment was performed. The patient was told that "the enamel was weak" or "the filling was close to the nerve." Why don't you tell patients that their bleeding "gums" are not healthy or normal? Why are four, five, and six millimeter pockets not risking the patient's dental and overall health by increasing the possibility for stroke, cardiovascular, pulmonary, and prenatal problems?

Overcoming Barriers
Most of the time the dental staff is trying to overcome the objections of the patient to accept the proper treatment. The dental office needs to overcome their barriers too, so proper treatment can be recommended. What are these barriers? A big one is fear of rejection (being unloved). Another is confronting past denial. Not believing the patient can afford the treatment. The dental insurance company will not pay for intra-pocket medications. These are the excuses the dental team uses to ignore the proper treatment protocol.

Bite The Bullet
Your patients trust you more than you think! Enable them to accept treatment by informing them of the disease they have. Educate them so they can identify with their problem and correct it. Tell them! Explain the treatment and expectations to return to a healthy status. They will thank you for your concern and excellent care. Your patients will be healthier and you and the staff will be rewarded by being the best you can be.

If you have any questions, please submit them to me at and I will answer them in future articles.

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

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Thank You's

From the Patient’s Perspective

Each year, retailers bank on the fact that, for most of us, the holiday season is the one time of year that we will go to virtually any lengths to express our thanks and appreciation to friends, family, and others. Malls, boutiques, and specialty stores have been crowded for weeks with breathless shoppers all searching for just the right gift. It is the season that makes or breaks the retail world year after year and many stores live or die based on holiday sales.

You've made your list; perhaps you've even checked it twice. No matter if they were naughty or nice, your goal is to make sure that no one is overlooked - staff members, loved ones, newspaper delivery persons, mail carriers, etc. are all lined up to receive gifts and tokens of appreciation.

Ironically, in many practices, those who've had the greatest impact on the individual success of the dentist and the prosperity of the practice are never acknowledged - they are the patients. The ideal gift you can give your patients doesn't require that you comb the early bird sales, fight the crowds, or carry the coupons. They are the simple gifts of appreciation and acknowledgement. While cash outlay is minimal, the investment of time and energy go well beyond a few short weeks at the close of the year.

Start with the obvious. It's a universal reality that virtually everyone desires appreciation. Thank your patients. When was the last time you looked your patient in the eye and said, "Thank you for choosing this practice." Or on their way out hand them a letter from the doctor and staff thanking the patient for their ongoing confidence in the practice and their commitment to pursuing excellent oral health. They will not only be stunned they will be thoroughly impressed.

At the next staff meeting with your team, develop a list of all the steps the practice takes to thank and show patients they are appreciated throughout the year. Then develop a list of all the steps the practice could take to achieve this. Begin at the beginning; consider the new patient welcome packet. Is it warm and inviting? Does it motivate the patient to desire the services provided? Does it help the patient get to know the team members they will meet before they ever walk in the door? Does it put them at ease? Does it thank them for choosing your practice?

Next, consider those who regularly help your practice grow. What are your procedures for thanking patients for referrals? Consider a four-step referral plan for those patients that consistently send new patients to your practice:

  1. For the first referral send a thank you note and a small token gift such as a lottery ticket, certificate for a specialty coffee at a local coffee bar, or pastry at a local pastry shop.
  2. For two referrals send a thank you note and a fruit basket or gift certificate to a local bookstore.
  3. For three referrals send a thank you note and bottle of wine or "movie money," which can be used at the local movie theater.
  4. For four referrals send a thank you note and a gift certificate for dinner for two to a local quality restaurant.

Give each patient the gift of your full attention when they are in your practice. Show the patients that you appreciate them by taking time with them. Encourage them to ask questions. Demonstrate to them that while they are in the chair or at the front desk they are the most important person in the office at that moment.

Whether retailers will celebrate or mourn the holiday shopping season of 2004 is yet to be seen, but thankfully your success or failure isn't contingent upon the numbers of individuals who line up at your front door the day after Thanksgiving through the day after Christmas. Rather, your success is dependent upon the investment of time and energy that you make in every patient throughout the entire year. Do more than appreciate your patients, over appreciate them and watch how they return your acknowledgment with referrals, treatment acceptance, and genuine thanks for the job that you and your team do throughout the year.


Performance Evaluation

Performance Appraisal - Quick and Easy
No more guessing on what to say or how do it. Areas to evaluate include: Cooperation, Initiative, Communication, Time Management, Quality, etc. Points are given based on Unsatisfactory, Needs Improvement, Good, Very Good and Outstanding. Areas for improvement and total point score is clear and understandable to the employee.

Use it today!

Missed Past Issues of Our e-Management Newsletter?

Sally's Mail Bag

Dear Sally,

I am not really sure what my front office employees are saying to patients. I just know that sometimes the results aren't what I expect. What do you think about scripts? Do they really work?

Dr. Tennessee

Dear Doctor,

Yes, scripts work because they give the employee some guidance and of course a clear expectation of what the practice wants said to patients with expected outcome. They are especially good when new patients call, presenting financial arrangements, handling cancellations, etc. Give the employees the script and then role play with them a few days later. It is okay for them to put in their own personality so they feel comfortable but the true meaning behind the script needs to be there. When they "wing" it... you don't know which way it's "wanged" and that can cost you business.

Happy Holidays,


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Job Descriptions

Finally...Job Descriptions That Can Be Customized For Your Practice!
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McKenzie Management Upcoming Events
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