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08.12.05 Issue #179
To Catch a Thief

Sally McKenzie, CEO
The McKenzie Company

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Yours is a tight knit group. These people have been with you a long time, and you're proud of that. You've heard the horror stories about embezzling employees, but you don't have to worry about a thief among your team. After all, you're a good judge of character, if there were a shady member of the crew you'd spot 'em in an instant and they'd be gone.

What you don't realize is that the profile of an embezzler reads like a character out of a best-selling Who Done It novel. The enemy among you is your seemingly most loyal, apparently most honest, and outwardly most dedicated employee. She's got you so buffaloed that you wouldn't suspect her of taking an extra hors d'oeuvre at the holiday party let alone several thousand dollars from your practice.

Certainly, I don't mean to disparage every hardworking, dedicated employee, but the common refrain heard again and again in embezzlement cases is the most trusted employee is the one pilfering the practice. And as a small business owner you are a prime target for embezzlement. In fact, the Association of Certified Fraud Examiners found that small businesses were hit with the same median losses as large employers. While the Fortune 500 will likely bounce back, embezzlement can cripple your practice.

In the dental office, the most common type of embezzlement is the misappropriation of the practice's cash and checks by the office manager or individual responsible for day-to-day accounting. The office manager knows the systems, the practice, and the patients. She knows the deposits, the vendors, who pays with cash, who pays with check. She knows what goods the suppliers provide and she knows what they charge. Her greatest asset is that she understands your practice so well. Your greatest liability is that she understands your practice so well. When it comes to practice finances, follow the Ronald Reagan maxim, trust but verify. Take steps to make sure you're not taken to the cleaners.

  • Review your deposit tickets on a regular basis. The average amount of cash in a practice is 2-5%. Yours may be more or less, but whatever the amount it should not change significantly from month-to-month.
  • Do not depend on just one person to handle the practice accounting. Insist on cross-training staff to work at the front desk.
  • Establish a system in which all employees who use the computer must log on with personal identification codes.
  • Remember embezzlers love the "hands-off" dentist because they know you are never looking over their shoulder. Learn how to access key reports. And only you should have exclusive access to certain reports such as the Audit Trail and other production/collection reports that your staff doesn't need on a regular basis.
  • Review all your invoices and sign all checks. Make sure there is an invoice for every check written.
  • Do not have a signature stamp for signing checks unless you keep it under lock and key and only you have access to it.
  • Keep your practice checkbook under lock and key until the bookkeeper needs it.
  • Randomly conduct spot checks every few days and compare your schedule with your day sheet. Verify that all the treatment delivered was posted and scan the adjustments to ensure there was a valid reason for making them.
  • Carefully review the practice charge card for suspicious activity.
  • Compare your bank deposit with the day sheet and make bank deposits daily.
  • Never allow the same person to prepare the bank deposit and take it to the bank.
  • Have bank statements and cancelled checks sent directly to the doctor's home.
  • Ask questions and make sure your employee knows that you are interested and monitoring the accounting.

If you suspect an employee is engaging in questionable activity take action. Do not share your suspicions with anyone else in the practice. Bring in an outside consultant or computer trainer to review reports. Seek assistance from your accountant and your attorney. Do not wait and hope that you are wrong, if you smell a rat, it's likely you've got an infestation.

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

Interested in having Sally speak to your dental society or study club? Click Here.

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Employees.Are YOU promoting Your practice?

Jean Gallienne RDH BS
Hygiene Consultant McKenzie Management

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Are you promoting your practice in the community you live and work in? Yes, I said, your practice. Even as a dentist, hygienist, assistant, front desk, or office manager, you should look at the practice you are working in as your own.

Why, you ask? Well, if the practice you are working in does not have the cash flow that is needed to pay the bills, then your salary may not be available either. Therefore, it is imperative that when it comes to promoting the practice, you realize that it is as much your responsibility as every person in the practice.

The doctor may be the owner-operator, but his or her practice can only pay what it can afford. So, if you want to possibly get a raise, increase your hours, become fulltime, or receive more benefits, I recommend that every person in your practice be responsible for promoting and marketing the practice in the community.

There are many ways the staff can help do this that are very easy and low cost or no cost to the doctor and staff. First, every employee should have their own business cards with their name on them. This way, if they meet somebody at church or little league baseball that is looking for a dentist, they can extend an offer for them to come to their office, simply by handing them a business card. Now, if that card only has the doctors name on it, the person they handed it to may forget where and whom they got it from, and just toss it. However, if they look at the card, and remember that Jean works there, they are more apt to come see a friend.

At the same time, give the staff the power and protocol needed to offer a discount of $20.00, $30.00 or even $50.00 off the first visit with the doctor. Have the employee write it on the back of their business card just as they are handing it to the person. This gives the person receiving the card the feeling of being special to the practice immediately.

The amount given and the protocol is something your office members will have to agree upon. An example may be to give $50.00 (a common deductible amount) towards the first visit with the doctor costing more than $100.00. So the back of the card may read, $50.00 off, 1 st $100.00, on first visit. This amount should only be offered to new patients.

Another way to promote your office is by attending fundraisers that your patients are promoting. Yes, I pay for the tickets myself when I do this. Of course I pick things that my husband and I will enjoy. When the patient sees me they immediately turn and introduce me as their hygienist to their friends. What a great impression this leaves on them. Every person I meet at the fundraiser I look at as a potential new patient and friend. The good news, in many cases, the amount paid may be tax deductible. This is something you will have to check out on an individual basis.

Promoting the practice can be as easy as doing a walk or run in the area of the office, even if you don't live in this area. Patients like seeing their dental staff participating in the community.

I just recently went to a play that four of my patients were in. I had a great time and ran into three other patients that were there to watch the play as well. Even then, they mentioned to the people they were with that I am their hygienist and how much they love our office. The beauty of it is, many times the people they are with will say, "I need to find a good dentist or hygienist." This is my cue to get a business card out of my purse and hand it to them. Making sure to let them know how great it would be to have them as patients.

Not only are new patients the lifeblood of your practice, but so are the existing patients. It is equally important to keep the existing patients, as it is to get new patients. Promoting the practice by participating in community events is a fun, easy way to promote your practice. Take pride in ownership.

Your ownership is in the satisfaction of helping others, providing quality care, and knowing you are helping to build a prosperous future for yourself and your practice. Don't practice "Out of sight. Out of mind." Get out there and put yourself in the sight of your patients and future patients.

Jean conducts 2 day Hygiene Performance Enrichment Programs for The Center for Dental Career Development and McKenzie Management in La Jolla/San Diego, CA. Contact her at or call 1-877-777-6151 for more information on her Advanced Hygiene Training Programs.

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

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All The Right Moves

Risa Pollack-Simon, CMC

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Over 45 years ago, it was no surprise to witness a multitude of musculoskeletal disorders in the dental profession. After all, dentists shared space with barbers, as they provided services on their feet all day. Paradoxically, in the mid 50's, (even after the evolution of sit-down dentistry became the standard of care), musculoskeletal stress factors continued to develop.

To make matters worse, organized dentistry continued to ignore the scientific evidence that linked musculoskeletal disorders to poor postures and work habits. This encouraged dental professionals to look the other way, as the numbers of those inflicted multiplied.

In fact, awareness only increased when dentists, hygienists and assistants, personally experienced chronic pain, and then were forced to pay attention. This led to University studies, which revealed musculoskeletal stress to be a much bigger problem than anyone was willing to admit. Take a good look at the numbers from a study out of British Columbia , Vancouver , to see if you'd increase these percentages:

Pain Experienced By Dentists
61 % neck
51% lower back
44 % shoulder
43% upper back
38 % hand
30% mid back
14% arm
10% leg

Our profession was fascinated by this study, which also revealed that dentists actually experienced less pain when they understood how to optimize their treatment room equipment, and the proper use of surgical magnification. Furthermore, this study found dentists practicing four-handed dentistry to have much less shoulder pain.

Adjunctive studies also proved that a fully trained chairside assistant could increase the doctor's level of productivity up to 100% - while improving the quality of care provided and significantly reducing operator stress.

Yet, while these somewhat simple modes of operation are readily available, most clinicians take the path of least resistance, which is to do nothing but proclaim that "pain and suffering are a 'packaged deal' in dentistry, that comes with the territory" - and, if you believe that, indeed it does!

Moreover, physicians, chiropractors and even physical therapists ignorantly reinforced these assumptions, by also believing that pain was a byproduct in the dental profession. Shamefully though, as they promoted their services to relieve the pain, the relief was found to be only temporary.

While holding good intentions, most of these healthcare professionals simply don't have enough information about dental practice operations to "crack the mold" on our bad habits. Bottom line, they've been trained to treat the symptoms; not to diagnose and correct problematic 'habits' that cause the symptoms in the first place!

While pain can be akin to 'Morris Code,' in that it signals the body to alert us that a problem exists, when we ignore the message, structural changes can occur, which can end up damaging tissue and cause varied degrees of musculoskeletal disease over time. If intervention efforts are not employed quickly (to reduce inflammation) healing will not occur at the initial stage of soft tissue damage, which then causes chronic disease to develop.

Combine these unknown risks with the "fuzzy math" we've been told are "associated costs" in developing an ergonomic program - and it's no wonder our profession waits until they are literally forced to hang-up their handpiece, prophy jet or suction tip for the very last time before action is taken.

The sad truth is that no one even talks about the hidden gem of increased revenue, for ergonomics is as much about achieving optimal levels of efficiency, as it is about supporting musculoskeletal health - if not more!

Ironically, if you think you can't afford to buy a telephone headset for your appointment coordinator, a new stool for your assistant, or surgical magnification for yourself (or hygienist); the inefficiency you continue to create, will end-up costing you 10x's more!

Truth be known, over 85% of what's called for here is behaviorally modifiable. Simply put; it boils down to changing habits - poor work habits to be exact. The good news is that changing habits (even though they take time to 're-wire' themselves) - are free for the asking!

The choice is yours. You have the power to be proactive . You can either act now, or pay later. Stop looking the other way. Listen to what your body is telling you. Hear the cry of those clinicians who were forced to leave the field, as they remind us that, "the pain of work restriction (and loss of income) are far greater than the pain suffered from the musculoskeletal disorder itself!" Embrace an ergonomic philosophy as if your life depended on it. At the very least, your level of efficiency and profitability does!

Risa Simon is a certified management consultant, national speaker and published author of "All The Right Moves" dedicated to supporting team harmony, organizational efficiency and increased profitability through a higher level of ergonomic awareness.

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This issue is sponsored
in part by:
McKenzie Management's Seminar Schedule
2005 Location Sponsor Information Topic Speaker
August 13 Topeka, KS Delta Dental Plan of Kansas 800-733-5823 Breakdown Sally McKenzie
Sept. 9-11 San Francisco, CA California Dental Association 916-443-0505 Successes Sally McKenzie
Sept. 22 El Paso, TX El Paso Dental Society 877-777-6151 Breakdown Sally McKenzie
Oct. 14 Riverside, CA Riverside Implant Study Group 951-279-7847 Top Issues Sally McKenzie
Nov. 18-19 Griffin, GA Endo Magic Root Camp 877-478-9748 Top Issues Sally McKenzie
Dec. 1 Cincinnati, OH Cincinnati Dental Society 513-984-3443 Breakdown Sally McKenzie

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