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09.02.05 Issue #182
On Hold? Silence isn't Golden

Sally McKenzie, CEO
The McKenzie Company

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Wanna know how to tick off about 60% of your calling patients? Actually, you are already doing a darn good job of this without any extra instruction from me. In fact, it’s pretty much standard operating procedure in practice after practice across the country. What’s more, most of you have mastered this technique so well you can usually accomplish it in about 30 seconds or less.

Thirty seconds – seems like no time at all, yet when you are waiting for something to happen - be it sitting in the drive through lane at the fast food joint, waiting for the results of a medical test, idling at a stoplight, or stuck on the telephone waiting on hold in silence - 30 seconds is an eternity. And the majority of callers – your patients – won’t sit and wait for long. In that short half-a-minute time span, your practice is likely to exasperate 60% of callers. In fact, after a mere 17 seconds of silence callers are annoyed.

Even worse, more than half of those tossed into on-hold oblivion will not give you the chance to prove you or your team is worth their wait. In fact, a survey of 10,000 callers found that of those who were placed on silent hold for just one minute, more than half hung up. And how can you blame them, you know what it’s like. The deafening silence of “on hold” screams that time is slipping by and there are much more important things to do than sit and wait for someone, anyone, to retrieve you from this state of telecommunication limbo.

But what are you supposed to do? Placing callers on hold is a necessary element in any business, so how can you keep the patient on-hold holding on? While you may consider on-hold music to be a step in the right direction, your idea of beautiful melodies may be my idea of fingernails across a chalk board. And if you happen to forget to pay those licensing fees to air the local radio station or music CDs then you’re breaking the law. Instead of pushing your patients’ buttons, try piquing their interests. Use the opportunity to educate them about you and your services.

Overwhelmingly, callers who receive information while they are on hold will stay on the line. In fact, 98% will not only remain on the line, they will estimate their wait time to be considerably less. What’s more, they are willing to wait up to three minutes longer – now there is a captivated audience. But they won’t sit and listen to just anything. A generic catch-all message can fast become audio wallpaper that is as much an annoyance as that continuous loop of elevator music.

Use on-hold to hold your caller’s attention. For example, during the on-hold message educate patients about the doctor, where she/he went to school, what continuing education programs he/she recently completed. Give a synopsis of special services such as whitening or veneers that the practice may offer. Note continuing education programs that employees have recently completed. Use the messages to talk about what doctor and team do best, such as offering the gentlest dentistry, comprehensive services, a spa-like atmosphere, etc. As a team, evaluate what you do well and share that information with callers. Work with a reputable company, such as On-Hold Messaging, which specializes in on-hold messages that are tailored specifically for your practice. The company you choose should help you pinpoint the most effective messages for your callers and ensure that the content is kept current and captivating.

Break the silence for your patients, it’s certainly not golden for your practice. Next week, what does your phone communication say about your skills and your services?

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

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Are You a Great Leader?

Dr. Nancy Haller
Executive Coach
McKenzie Management

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True or False….

Leadership is a rare ability only given to a few.

Leaders are born not made.

If you answered ‘True’ you really need to read this article.

Most people have the potential to become good leaders. Leadership is not like a diet pill. Like most learned skills, it takes time, training, and practice.

If you want to be a better leader, identify your strengths and weaknesses equally so you understand how to operate, both positively and negatively. Observe how you treat others and how they respond to you. Coaching can provide the structure for you to do that. In the meantime, here’s a way to evaluate yourself.

For each area, rate yourself on a scale of 1 (low) to 5 (high). Be honest. If you are really courageous, ask your staff to rate you and compare.

  1. Are you fair and considerate? Do others enjoy being around you and find you easy to talk to? Do you treat employees as you would like to be treated? If so, score a ‘5’. However, if you are abusive or intimidating toward any of your staff, you must take a ‘1’.  
  2. Are you sensitive to others? Do you criticize employees only in private? If not, give yourself a ‘1’, and stop doing that immediately. While praising in public encourages people to excel, public criticism will only embarrass and alienate everyone.  
  3. Do you take the time to share your vision, your mission and your goals? If you consistently give your team a clear vision to follow, you can rate yourself a ‘4’. If you also help them to understand how that vision is valuable to them, take a ‘5’.
  4. Are you open minded? Do you stop and listen to suggestions from your staff? Do you quickly implement those good ideas? If so, you get a ‘4’. If you also invite/ask for input, you score a ‘5’. However, if you are self-centered, you get a ‘1’.
  5. Do You Work Under A Relaxed Environment? A score of ‘5’ will require you to have an atmosphere where your team feels comfortable and has fun while doing business with you. If your practice operates with high levels of pressure on a regular basis, that’s a ‘1’. No one wants to feel constant stress on the job, although they will sometimes be there. Take time to have fun and let the people around you do so as well.
  6. Do you show interest in others? Do you take the time to smile and say hello, or to ask how their day is going? If you treat your staff as real people not just worker bees, give yourself a ‘4’. If you also respect their differences, take a ‘5’. However, if you judge people quickly and make critical assumptions about them, that’s a ‘1’.
  7. Are you an effective communicator? Clear communication is the signal of great leadership. Do you expect others to know what you are thinking? If so, you score a ‘1’. If you consistently inform, explain, and clarify, you get a ‘4’. To rate a ‘5’ you need to be packaging information and delivering it to the right person(s) at the right time for the right reason(s).
  8. Do you have a climate of feedback in your practice? When employees do something well, do you tell them? If so, that’s a ‘3’. Do you also hold them accountable when they fail to deliver on expected responsibilities? If so, you rate ‘4’. Do you ask employees to tell you what you’re doing well, and not so well? Congratulations. That’s a ‘5’.

So, how’d you score? If you had less than 24 points, it’s likely that your leadership is negatively impacting your practice productivity. You might have high staff turnover, or poor performers on your payroll. Stop looking outward and start improving yourself. Focus on only one of two behaviors and make a concentrated effort to be consistent.

If you scored above 24, you’re doing a lot of things right. Give yourself a pat on the back. And remember that effective leaders always strive for improvement. They continue to learn and grow. Take note of the skills that you could strengthen. Set 1 or 2 specific goals and move from being a good to a GREAT leader! Your practice production will be the reward.

If you would like to enhance your leadership effectiveness and take your practice to another level, contact Dr. Haller at

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Dental Charting, Insurance Narratives and The Business Administrator

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

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Dear Belle,

Please help me with this problem; I have been filing insurance for a large practice for a number of years. When I am asked to bill for a crown or bridge there is seldom enough evidence written in the chart to warrant the procedure. I have to go back and ask the doctor why the crown is recommended and what is wrong with the tooth. If there is an existing crown, the clinical staff never writes the age or approximate age of the existing restoration. Sometimes I just wing it by putting a reason for the crown from what I can see in the x-ray or by saying the amalgam is fractured, decay is under restoration, etc. just to get it through for payment. Now I am hearing that insurance companies may ask for audits and if the evidence is not clearly demonstrated in the record they may want their money back. How can I get my clinical team on track and make them accountable for this important information?


Office Manager

I often receive questions from clients attending our ADVANCED DENTAL BUSINESS COURSE about formulating the “perfect narrative” to support a claim and get it paid. There is no “canned” single narrative that guarantees payment every time. However there is a system that you can use that will insure payment most of the time. In order to get your clinical team compliant, these questions need to be added to the chart (if paper) or you need to check your software system as many have the screens available to text information. The clinical team may need to be trained so that they understand the importance of detailed charting and that everyone is documenting in the same fashion. A training module offered during a Team Meeting is appropriate and adding this system to your office policy manual will make it official. The information necessary is as follows:

    2. SURFACE/SURFACES-modb, mif, etc.
    3. CONDITION—fractured DB cusp, leaking M margin, hole in occlusal of crown, prior endo and when endo was final
    5. AMOUNT OF REMAINING TOOTH STRUCTURE—1/3 natural tooth etc
    6. AMOUNT OF LOST TOOTH STRUCTURE—2/3 natural tooth lost etc.
    2. DECAY-NEW OR RECURRENT—location of decay—MD, GF etc.
    1. TAKE INTRAORAL PHOTOS-if possible-or draw a picture

This information needs to be attached or written on a claim when submitting or as an attachment when e-mailing claims. Make sure that the patient’s information and the billing doctor’s information is on this sheet. It is not necessary to write a long detailed narrative when you give the information in a concise, accurate and brief format.

Never give up on informing your staff of the importance of careful clinical charting. It is important not only for insurance processing but for the risk management of the entire team. We live in a litigious society where patients are more informed than ever of their rights. The courts will not favor sloppy inaccurate records should you have to defend your treatment in a judicial setting.

For more information about improving your practice, contact McKenzie Management AND The Center For Dental Career Development today.

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