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  03.17.05 Issue #158


Staffing Issue or Productivity Concern?

Sally Mckenzie, CEO
The McKenzie Company

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So you feel you need to hire more staff. From your standpoint, it’s obvious. Anything beyond the absolutely necessary isn’t getting done. Collections are dropping because there isn’t time to follow-up with patients. No one has time to make appointment confirmation calls. Instruments aren’t ready when you need them. And on and on. By the time you make the decision that you can’t live without another warm body to “help,” the entire team is stressed to the max and you are pressured to solve this problem and now.

Hiring more staff, after all, is quicker and easier than pursuing alternatives such as streamlining duties, evaluating the time spent on tasks, as well as examining the mechanics and/or the materials involved in performing those tasks. And the team will be much happier, which will make your life much more blissful too. Or so you think. Oftentimes “solving the problem” with more staff ends up creating far more stress, more headaches, and costs a lot more money than you ever bargained for.

Before you toss someone else into the mix, look first at who’s responsible for what in your practice today. Frequently, dental teams that feel they are buried in busyness often suffer from a lack of clearly defined job descriptions. If you don’t have job descriptions, it’s time to establish them. For assistance, go here.

Provide an example description such as the one below. Although the dentist has the final say in each employee’s responsibilities, input from the team members is particularly beneficial in encouraging individual ownership and responsibility.

  1. Define the job. Scheduling Coordinator. Greets patients when they enter the office. Updates patient information such as address, phone, insurance, or provides new patient registration information. First in line to answer all incoming calls. Schedules appointments and handles daily patient records.
  2. Spell out specifically what skills are necessary for the position. Articulate, well organized, good listener, ability to manage multiple tasks and handle regular interruptions. Is comfortable politely directing patients to specific times in the schedule. Ability to work with computer systems and dental software. Enjoys working with and helping others.
  3. Outline the specific duties and responsibilities of the job. Schedules to meet doctor’s daily production goals. Notifies the clinical staff of patient arrival. Tracks unscheduled treatment for doctor. Reports regularly to doctor and team on the status of the schedule. Prepares patient records for doctor. Handles correspondence for the doctor and to the patients. Tracks all conversations with patients on the computer. Runs specific production reports from the computer. Reports on production as compared to the goal at daily and monthly meetings. Orders office supplies.

Before you hire more people to increase productivity, focus on improving the productivity of those you already have. Job descriptions are the cornerstone for virtually every system in the practice. If you are feeling pressured by all the tasks that just don’t seem to get done, look first at who is responsible for doing what. I guarantee that putting employee duties/responsibilities in writing will have an immediate positive impact on your income, your stress level, and the overall quality of your team.

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

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Surviving Team Meetings

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

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I stopped having staff meetings because they just cause negative feelings and nothing seems to get accomplished. They are a waste of time because I lose productive chair time with patients and time is money.”

-Anonymous Dentist

This same anonymous dentist nine months later said, “ I am running in the red. I have to scrape to make payroll. I don’t know why my schedule is not full. What happened to my patients?”

Have you asked your staff?” I replied. “I think it is time for a “Team Meeting.”

The much overdue Team Meeting revealed the following information:

  • Follow-up calls to patients were not being made.
  • No new marketing ideas had been introduced and the old ones were being ignored.
  • No one knew how many new patients were coming in but everyone felt that the numbers had fallen off.
  • The staff felt like they were working in a factory and the interpersonal aspect was being ignored.
  • No one knew how much treatment was being presented and how much was actually accepted. How could they improve if there were no set goals?
  • Some team members had ideas on how to improve things but there was never any time or encouragement to share these ideas with the doctor.
  • The team had become several independent workers who showed up everyday, did their work and left with no feeling of “ownership” or the feeling that they “make a difference” to the practice.
  • The plans to design an office Website had been abandoned and…the list went on.

The Team Meeting is an instrument designed to solve problems and critical issues that arise on a continual basis in every dental practice. Meetings are a critical link between team members that is lost when the fast paced, multi-tasking business of dentistry rockets you through the busy day. Many dentists are frustrated in ways to motivate employees but unless there is communication there can be no motivation. Participation in team meetings become automatic if each employee knows they have an area of responsibility for performance of a particular part of the practice and will be expected to present the status of their area. Assigning areas of responsibility to team members is related to their job description or job duties. For instance, the Scheduling Coordinator would be responsible for reporting the number of new patients that had been seen each month and the number of cancellations and failed appointments the practice had experienced that month.

Who is responsible for the failure of Team Meetings, the doctor or the staff? Usually both are at fault either because they have not properly prepared themselves for the meeting or did not perform their function during the meeting. If the doctor is an autocrat who dominates the meeting with his or her own ideas this will stifle the rest of the team who may have great ideas but are afraid to “rock the boat.” Taking turns running the meeting is the best way to insure that there is a fair exchange of ideas and energy.

Having an agenda and timing each area of discussion to make sure that every area is discussed and each team member have an equal opportunity to participate. No personal issues or gripes are to be part of the meeting. These issues need to be resolved outside the arena of the meeting. An AGENDA sheet is to be posted a month before the meeting.

Anyone who writes a problem for discussion must bring a possible solution to the team, this assures that careful thought has been given to the issue to be discussed. A copy of the agenda is given to each member at the start of the meeting. The goal is to encourage the group to improve lines of communication. Sometimes it takes time to get the team moving in the same positive direction. Evaluating the success of each meeting and determining how meetings can be improved for everyone is an ongoing goal. How to facilitate a productive team meeting is part of the Advanced Business Training offered at The Center for Dental Career Development.

For more information on our programs for success email

My Insurance Pays 100% for my Treatment: Answers to This and Other Patient Myths

Carol Tekavec, RDH

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Patients have many questions regarding their dental benefits. While it is actually the patient’s responsibility to deal with his/her own insurance issues; the fact is that few patients understand their plans. The dental office personnel often end up having to “fill in the blanks” as to what a patient can expect.

How can staff deal with common patient questions? Is there a way to prepare patients for the limited nature of dental insurance without focusing on the “negative”? One answer is to use “positively” written materials, such as a brochure or information sheet, that can address widespread patient misconceptions while supporting staff explanations. When a brochure discusses insurance in simple terms, the patient sees that the staff is not “just making this stuff up as they go along.” Patients can read the materials and take them home to go over later.

Let’s look at a few common questions/myths that might be addressed:

Q: Why doesn’t my insurance cover all the costs for my dental treatment?
A: Dental insurance isn’t really insurance (a payment to cover the cost of a loss) at all. It is actually a money benefit typically provided by an employer to help their employees pay for routine dental treatment. The employer usually buys a plan based on the amount of the benefit and how much the premium costs per month. Most benefit plans are only designed to cover a portion of the total cost.

Q: But my plan says that my exams and certain other treatments are paid for 100%!
A: That 100% is usually what the insurance carrier allows as payment toward the procedure, not what your dentist or any other dentist in your area may actually charge. Typically there is always a certain amount left for the patient to pay.

Q: If I always have a balance to pay, what good is my insurance?
A: Even a benefit plan that does not cover a large portion of the cost of needed dentistry pays something. Any amount covered reduces what you have to pay out of pocket. It helps!

Q: I received an Explanation of Benefits statement from my insurance carrier that says my dental bill exceeded the “usual and customary”. Does this mean that my dentist is charging more than he/she should?
A: What insurance carriers call “usual and customary” is really just what your employer and the insurance company have negotiated as the amount that will be paid toward your treatment. (This amount is typically based on the premium cost for the employee and how many services the plan will cover.) The “usual and customary” is usually less and frequently much less than what any dentist in your area might actually charge for a dental procedure. It does not mean that your dentist is charging too much.

Q: Why won’t my insurance pay anything toward some procedures, such as x-rays, cleanings, and gum treatments?
A: Your plan contract specifies how many of certain types of procedures it will consider annually. It limits the number of x-rays, cleanings, and gum treatments it will cover because these are the types of treatments that many people need to have frequently. Too many payments for these services would make the premium cost higher.

Q: If my insurance doesn’t cover it, I don’t need it…right?
A: It is important to know that each contract will specify what types of procedures are considered for benefits. Even if a procedure is medically and dentally necessary, it may be excluded from your contract. This does not mean that you do not need the procedure. It simply means that your plan will not consider the procedure for payment. It is a mistake to let benefits be your sole consideration when you determine what you want to do about your dental conditions. Your health is important!

Talking to patients about their dental insurance can be tough, but there are rewards. Current studies show that patients with insurance see the dentist more frequently, and have more treatment accomplished than patients without insurance. Without insurance, most middle class patients would be unable to afford dental treatment. Insurance helps patients receive the care they need.

For more information on “My Insurance Covers This….Right?” go here.

Sally's Mail Bag

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Hi Sally,

I am trying to determine how many active patients I have. Is that how many patients I have in the computer or how many charts I have in the file?

Oh, by the way, I really enjoy your newsletter each week. Don’t know how you do it but keep them coming!!!!!!

Dr. Texas

Dear Dr. Texas,

Thanks for your email. Actually neither of your two descriptions are correct. An active patient is a patient who is due to return for recall between today and one year from today. In other words, they are actively coming back at regular intervals. An “inactive” patient is one who was due yesterday but did not come in for their recall appointment. Your chances of retaining that patient are quite high but none the less, they are still inactive. In other words, they are “out of the system.” The same holds true for a patient that was due 4 months or 6 months ago that did not keep their recall appointment. They are inactive. So, to retrieve this “active patient” statistic, you will generate a recall report from your computer of patients due with and without appointments between today’s date and one year from today. That total is your active patient base. Hope this helps!


Missed Past Issues of Our e-Management Newsletter?

My Insurance Covers This...Right?

Do your patients understand their dental insurance? Most don't. How does your staff handle patient questions and complaints? This new brochure can help. Great for sending with statements and displaying at the front desk.

Presented in easy-to-understand terms, this high quality 6-panel brochure covers:

  • Why insurance doesn't pay 100% (even though it says it will)
  • Why many procedures are not covered
  • What "UCR" really means
  • Why carriers use negative EOB language
  • Much, much more

Written by Carol Tekavec RDH, nationally known insurance columnist for Dental Economics.

Sold in packages of 50


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in part by:

The McKenzie Company Upcoming Events
Date Location Sponsor Speaker
Mar. 17-19 Atlanta, GA Hinman Dental Society Sally McKenzie & Exhibit
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Apr. 21 Nashville, TN American Academy of Cosmetic Dentistry Sally McKenzie & Exhibit

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