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  06.09.05 Issue #170

Conflict is Burnin' Down the House

Sally Mckenzie, CEO
The McKenzie Company

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SLAM! There goes the back door of the office. Well, "you-know-who" has arrived. As usual, there's no doubt in anyone's mind what mood Sour Suzy's walking in with today. Clear the way, if she has to look at you you're likely to turn to stone. Forget the fact that she's trotted in 15 minutes late . again.

Just pretend nothing is wrong even though that jolt registered a 7.3 on the Richter Scale, and patients in the waiting room were startled out of their seats. Look the other way so you don't notice the tension that has just rolled through the practice like a thick fog that won't lift until closing time.

Disgruntled whispers, disgusted sighs, rolling eyes, and piercing stares punctuate staff "communication" for the rest of the day. Everyone is walking on egg shells. Morale is sinking. And what does doctor have to say about it? "Oh, that's just Suzy. You know how she gets sometimes. Just let it blow over".

HELLOOO doctor, you are the leader of your team, the captain of your ship. Don't just stand there! Do something. As much as you may dislike and try to avoid dealing with conflict, it is ripping through your practice with as much destruction as a five alarm fire. But you keep ignoring the sirens because you are terrified you will get burned, all the while practice productivity is going up in smoke. It's time to take a close look at those smoldering embers you've been long ignoring.

In the dental practice, conflict typically presents in the day-to-day routine - namely the systems. For example, the business employee constantly claims that she/he doesn't have time to complete important responsibilities such as confirming appointments or running key status reports. The doctor, busy with patients, doesn't question it because he/she can't assess whether the busyness claim is reality or a convenient excuse.

The scheduling coordinator continually blocks the day incorrectly. The doctor thinks he/she has repeatedly emphasized the importance of scheduling correctly, but the pattern of wrong appointments on the wrong days prevails. The hygienist is habitually late and generally unpleasant. These common sources of conflict are allowed to fester because they are not dealt with directly and employees are not held accountable. Consequently, hostility often becomes palpable.

The rest of the team is left to stoke the flames of discontent, pick up the slack, vent their frustrations, and pay far more attention to this week's internal crisis than to improving anything related to the patient or the practice.

Not only does conflict dramatically interfere in your ability to better your practice and your team, it is expensive. Conflict costs individual businesses hundreds of hours and thousands of dollars per year. It erodes team members' commitment to the practice and chips away at individual success and professional pride. Studies have shown that up to 30% of a typical manager's time is spent handling conflict. Multiply that by the number of employees in the practice and you start to see the financial toll conflict takes on a dental office. But that doesn't begin to account for the cost to doctor and team in terms of day-to-day stress.

A report in the Journal of Occupational and Environmental Medicine noted that healthcare expenditures are nearly 50% greater for workers who report high levels of stress, and numerous studies find that stress is commonly a result of conflict in the workplace. In addition, turnover is significantly higher in workplaces with ongoing or unresolved conflict. Some estimates indicate that it costs up to 150% of the employee's salary to recruit, hire, and train a replacement.

Next week, grab the fire hose, doctor; it's time to douse the flames of conflict once and for all.

If you would like more information on our Advanced Hygiene Training Programs, please email Sally at

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Change... a personal leadership lesson

Nancy Haller, Ph.D.

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Over Memorial Day weekend I experienced a powerful leadership lesson. The theme of my 'developmental challenge' was change. And you know the saying, There are only three things in life that are certain - death, taxes. and change.

Research shows that one's preference for - and response to - change runs along a continuum. For example, the Change Style Indicator (CSI) measures an individual's natural style in approaching change and dealing with situations involving change. "Conservers" prefer change that is gradual and incremental. They represent the protectors of tradition. "Pragmatists" accept change if it's functional and practical. "Originators" have faster and more radical approaches to change. They like things to be 'new' or 'different' or else they become bored and restless.

Well I'm not so big on change. In fact, I am a strong conserver. Structured and scheduled, I like routine. I seek it. I create it. Been that way my whole life. When things are in order, I feel in control. If you're honest, I suspect many of you will relate to this. You know the discomfort that change brings. It disrupts predictability. Things seem unstable. There's no doubt that a good part of my desire for certainty comes from my New England upbringing. The conservatism and tradition of New England had a big impact on my preference for consistency and the way I now live my life.

Now sometimes change is thrust upon us - it happens TO us, and we make accommodations. For example, no one chooses to have a heart attack but immediately nutritional habits improve, along with exercise. People even quit smoking. When misfortunes or tragedies happen, we are forced to change. There is no choice and we do our best to adjust, even if we do it with resistance.

But I'm talking about when we CHOOSE to change. Deliberately and intentionally choosing to disorder your life. For at least 75% of the population there needs to be a good reason to tip over the proverbial apple cart. Although all change does not bring improvement, all improvement requires change. Although it's hard work, effective leaders recognize the importance of self-improvement.

My change lesson took place when I moved my office last week into The McKenzie Company's corporate office. I have been a member of the McKenzie Team for about a year now, but I was working from a different physical location until Memorial Day weekend. Sally also relocated the company. We are now under the same roof of a new suite built out especially for our needs. All of us at McKenzie are excited about the opportunities this office will give us. Certainly it will enable us to serve all of you, our clients, much better.

The easy part of this decision was wanting to work more closely with Sally. I admire her leadership immensely. Sally truly does everything effective leaders do. After just a few days of watching her staff more closely - my McKenzie colleagues - I saw many displays of respect, loyalty and dedication from each one of them. (By the way, Sally's NOT paying me to write this. In fact she has no idea.) When the opportunity for us to share office space presented itself, I jumped at the chance.

The hard part of this decision was the actual doing. This is the same process as goal setting. Deciding on the target is always so much easier than performing the actual steps. Well since I don't like change, I lived in denial and avoided the obvious for months. After 16 years in the same 2,000 square foot office you can just imagine the stuff I accumulated. Yet I didn't start sorting through things until a few days before the moving date! Two, fourteen-hour days later I was waiting for the movers, madly packing the last of the files. What wasn't sorted or packed got thrown into a 'catch-all' box. Okay, boxes.

When the unpacking of furniture and boxes was done, I thought the worst was over. However, while the big things were in their places, all the little things were not. The insidious emotional enormity of the change hit me hardest on Tuesday. The parking lot was not empty as it had been during the weekend. I had to schlep a couple of residual boxes from my car to the office, making the no-nothing walk burdensome. My desk was disorganized. My post-it notes were in the wrong drawer. My phone line wasn't working. I felt like a fish out of water.

I am pleased to say that each day has been progressively better. I have calmed myself with the mantra, "Smile and breathe, smile and breathe". I admonished myself to be thankful for how blessed my life is, especially in comparison to most of the world. I encouraged myself to remember that I would recover from the disorganization and find my rhythm again. I put things away 'one box at a time'.

I am beginning to appreciate the new 'homes' I have found for my stuff. I also like the heightened sense of confidence that comes from ' surviving ' a life challenge. I take pride in my ability to step outside my comfort zone intentionally in order to create the work world I want. I value the personal determination and resiliency that got me through the move; although it was only a temporary disruption, it was emotionally and physically exhausting. Most importantly, I have a deeper respect for those who choose to change, to better yourself and your life.

For those of you I have coached or am coaching, I applaud your strides, now more than ever. Keep up the good efforts ! And for those of you with whom I may have a coaching relationship in the future, rest assured I will be VERY understanding!

If you would like to explore your preference and reaction to change, contact Dr. Haller at

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Are You A Rainmaker?

By Belle M. DuCharme, RDA, CDPMAThe Center for Dental Career Development

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According to Jeffrey J. Fox in his book, How To Become A Rainmaker, a Rainmaker in American Indian tradition used magical powers to bring the rain to nourish crops and to feed people. If it didn't rain, then there were no crops to feed the people and they would be forced to move elsewhere or die. Today, according to Mr. Fox, a Rainmaker is a person who brings revenue to an organization. In dentistry, patients and their acceptance of treatment is the "rain" that makes the practice grow. The success of any business is the customer base. In dentistry, the success of the practice lies in its ability to attract and keep patients for a lifetime.

In offices that are having problems with patient retention, I see much of the energy diverted away from the patients to communication problems between staff and doctors. It is easy to lose track of the reason we are there, the patients, when we are struggling to get along with each other. If you ask yourself with every patient " Why should this patient do business with us?" The Rainmaker would say, "This patient should have his treatment here because we can solve his problem and help him achieve optimum dental health. He will be able to chew, he will have better aesthetics and he will have a positive experience in our office". A Rainmaker asks himself, "If I were a patient in this practice, how would I want to be treated?" The Rainmaker makes the experience for the patient the best possible.

The Rainmaker's Credo written by Jeffrey J. Fox, I have changed to apply to dentistry as follows:

  • Cherish your patients at all times
  • Treat your patients as you would your best friends
  • Listen to patients and take the time to understand their needs
  • Give patients what they need.
  • Be fair and honest with the cost of treatment
  • Enhance the services the patient is receiving
  • Educate patients to want what they need
  • Give more than the patient expects
  • Thank the patient sincerely and often

Recently, I spent over an hour speaking to a doctor who wanted information about the Advanced Business Training for his Business Manager. He explained that much of his day was spent in a power struggle over why things weren't getting done faster and more efficiently. He had adopted a "micro-management style" that he no longer wanted. "I want to spend my day with my patients, but I find myself continually drawn to problems at the front desk. It is a small office and I am sure some of my patients have felt the tension". I can tell you from experience that patients do feel the tension and it is a reason to not return to your office.

At The Center for Dental Career Development, we teach all of the business systems that are necessary to operate a successful dental practice. We customize the training to meet the needs of any practice and staff member. The training is not generic and it is not a "seminar". Once the systems are in place and your business staff is working efficiently, you are ready to "make it rain" with your patients.

For more information, please contact us at

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Sally's Mail Bag

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Dear Sally,

I just attended one of your seminars last month and you were talking about measuring patient retention. We purge charts once a year of patients who haven't been in for recall in the past 18 months and I don't understand what the difference is between what you said and what we are doing. Please help me to understand.

Dr. Phil

Dear Dr. Phil,

The patient retention formula I gave you, recall patients treated divided by recall patients due, gives you the retention figures monthly while yours gives you information once a year. The power and timeliness of the information will be able to tell you every 30 days whether or not patient retention is increasing, decreasing or staying the same. With your system you have to wait 12 months to find out that maybe changes need to occur within your recall system and in the meantime your patient retention has dropped off. Also, a patient who has not been for the past 18 months has missed three, 6 month recall appointments. Chances of retaining that patient are slim to none. Timely decisions are very important in running any business.
Hope this helps.


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