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  05.05.05 Issue #165

The Single, Biggest Contributor to Patient Frustration

Sally Mckenzie, CEO
The McKenzie Company

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For years, marketing and customer service gurus asserted that for every person who complained, 12 more would have liked to but chose not to say anything. Today that figure is more than double. One complaint equals 26 unhappy patients. Pretty scary, eh? You get a single patient who comments that your practice hours make it difficult for her to keep appointments and you have nearly 30 others who feel the same way but are mum on the issue. Or maybe there's that recurring situation with one of your front desk employees. You know the one, occasionally she'll take an abrupt tone with a patient or two - make that two dozen.

The bottom-line, unhappy patients typically don't say a word to you, but they do discuss lippy Linda your sassy front-desk person over dinner with friends and your "ridiculously inconvenient" hours with their colleagues and coworkers.

A few years ago, the Better Business Bureau reported that the single biggest contributor to customer frustration was the "lack of a visible and continuing means to communicate concerns". In other words, your customers/patients want to give feedback. They want an outlet to express a problem or comment without creating an awkward situation for themselves, the doctor, or the employees. In the absence of that, they are much more likely to broadcast their irritations and/or transfer to another dentist.

A simple, straightforward patient questionnaire is the most cost effective and efficient tool dental practices can use to provide patients with an outlet to give feedback and raise concerns long before they become serious practice problems. Surveys are windows into specific areas of the practice that you seldom, if ever, have the opportunity to personally see. They are a means of gaining valuable feedback and insight from your "customers". They are your crystal ball into the practice that enables you to anticipate the future and reexamine the past. They allow you to better understand what patients find to be helpful or frustrating.

Consider the survey as an essential component of a much larger patient relations effort:

  • It allows you to encourage your patients to communicate their concerns, as well as those things that they most appreciate, directly to you.
  • It clearly demonstrates that you are committed to patient satisfaction.
  • It gives patients confidence in your willingness to identify and address potential problems.
  • It allows you to solicit input on specific aspects of your office that directly relate to the patients, including: financial policies, billing practices, appointment scheduling, infection control measures, staff courtesy, or even how well they believe dental procedures are explained to them.
  • It enables you to identify if there are employee training issues that need to be addressed.

Patient surveys promote goodwill among your "customers". But, most importantly, they enable you to recognize those office practices and procedures that are working well and promptly address issues that you would never have realized were creating a problem.

Next week, the simple, straightforward and effective patient survey.

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.

A Person with Dreams Can Achieve Great Things

By Nancy Haller, Ph.D.

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During a recent inquiry call, a prospective client described his practice. Having spent a substantial amount of money and time in training, software systems and technology, he was mystified why his office productivity and revenue were below average. He was plagued with employee turnover. Although he enjoyed the dentistry part of his work, he felt stressed most days. His goal was to create a culture where people 'want to work' but despite all his efforts, the results were not coming to fruition. Day after day he was driven by patients, scheduling conflicts, and staffing problems. Frustrated by a lack of forward progress, he called to find out what to do.

When I asked this dentist what he wanted for himself, the phone was dead with silence. Finally he spoke. "I don't know", he said.

I suspect that many of you reading this might be in the same position. If I asked you, 'what do you want for your practice', what would you say?

Although I am a coach not a therapist, my background is in clinical psychology. Now I have only two things in common with Freud - I have a couch in my office and I ask people to tell me about their dreams.

Freud believed that dreams were the windows to the unconscious. There in the basement of the mind were childhood traumas, parental errors and unrestrained impulses.

But those are NOT the dreams I am interested in hearing. The dreams I ask people to share are the ones of passion and perseverance. They are more than goals. The dreams I want to discover with coaching clients are filled with emotional fuel... the energy that helps them take control of their lives and be what they want to be. Without dreams, a person has consigned him or herself to a life of mediocrity and frustration.

Successful people in business, sports, and life have clarity about their dreams. And they make a long-term commitment to chase those dreams with tenacity. Unfortunately most people use only a small percentage of their true potential because they have no dreams.

Do you go through the day with no expectations? Do you simply battle out whatever life hands you? If so, it's time to stop being a victim of life and map out a vision of what you want.

Set aside a couple of hours for quiet reflection. Think about a time when you felt most alive, most fulfilled, or most excited about your work.

What made it exciting?
Who else was involved?
Describe how you felt about it.

Think about what you really love. Avoid being practical - there's plenty of time for that later. For now, let your imagination soar.

Think about some of the things you value deeply ... specifically the things you value about yourself, about the nature of your work, and about your practice.

And when you are dreaming, pay attention to the feelings that surface within you. Maybe these are emotions you haven't felt in a while. Exhilaration, happiness, enthusiasm.

Over the years, I have been called a 'shrink'. Though the label makes me smile, it really is quite inaccurate. I am not a shrink - I am an 'enlarger'. I help people to open doors to lives they sometimes haven't even considered.

Stop justifying a so-so existence. Get into the driver's seat of your practice, of your life! Call me... I want you to wake up each morning excited, to see each day as an opportunity to chase your dreams.

Dr. Haller is available to coach you to higher levels of performance in your practice. Contact her at

Interested in having Dr. Haller speak to your dental group? Email us at or call 1-877-777-6151

Do You Have An Exceptional Front Office Employee?

Belle M. DuCharme,

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If you ask a working dentist "How do you know if you have an exceptional dental assistant?" He or she will usually say, "That's easy, I work right next to her/him all day. I can measure her/his performance by the manner in which she/he assists me and if she/he is prepared for each procedure by having the instruments and materials I need without asking. I can see how she/he interacts with the patients and whether my instructions are followed or ignored. I can readily measure performance in the x-rays and photos that are taken or by the quality of the temporary crowns that are placed".

If you ask a working dentist "How do you know if you have an exceptional front office employee?" There is usually a pause then, "I'm not sure, I don't know exactly what she/he does all day, as long as my schedule is full and there is enough to cover the bills and no one complains about her/him, then I assume the job is being done".

Most dentists are fine clinicians but few are savvy businessmen or women. Since the average turnover in dental offices is about two years you may or may not find out if your front office person was fulfilling their job responsibilities until the next person you hire takes over their job duties. Then you may hear, "Dr. Smith, I want to do a good job but you need to know that it will take me awhile to clean up this high accounts receivable." Or you may hear, "Dr. Smith, it looks like I am going to have to put in some overtime because there is $55,000 in unpaid insurance claims that are six months old". There is this one too, "Dr. Smith, why are there so many write-offs and patient accounts sent to collections?"

You may have had enough to pay the bills but have you made enough to improve the practice with new technology or has the practice grown enough to take on an associate or even another hygienist? It is not enough to make ends meet, growth is inevitable in a healthy practice. Maybe you are growing but the profit does not match the growth. In this case, people are coming to you in droves but not paying for services when rendered or are dribbling in small payments inconsistently. There may be a huge backlog of unpaid insurance claims that have caused the accounts receivables to double or triple beyond their healthy state.

Patients don't complain if money is not collected at the desk or if they are allowed to "make payments" according to their liking. Patients don't complain if they can cancel and fail appointments without consequences for their actions. Patients don't complain if you accept what the insurance pays and they never see a statement for their share of costs. It's no wonder everyone liked your former front office person. Many a well-intentioned front office person has moved on because she/he is in over her/his head and doesn't want to admit that she/he needs help. As the Dentist/CEO of your business it is insanity not to know what your front office business manager is doing or not doing every day. As with your dental assistant you need to have performance measurements in place to monitor the state of the systems that run your practice. An exceptional front office employee has the business sense and skill to communicate the state of your practice to you on a daily, weekly, monthly and yearly basis.

For more information on advance training for your business staff please contact us at or 1-877-777-6151.

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