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09.09.05 Issue #183
Does Your Practice 'Ring' of Success?

Sally McKenzie, CEO
The McKenzie Company

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“Good afternoon, doctor’s office.” It’s the first impression of your practice. In a matter of just a few words the person answering your phones has created an image in the caller’s mind and set the tone for how the patient views you and your team. When was the last time you listened to how your phones are answered? Or, better yet, had a friend call during a busy time of day and report back to you how their call was received?

Too many practices underestimate the power of the telephone and the profound impact just a few words and the tone in which they are delivered have on current and prospective patients. Answer the following questions and determine if all lines are open or if your number should no longer be in service.

How many rings does the caller have to sit through before someone will pick up?
After 2 rings, patients are wondering if the office is closed. A real human being should answer your phone by the second ring or it should go into your voice-mail system (NOT an answering machine) by the 4th ring. (Unplug your answering machine and sell it in the garage sale. They are outdated, sound embarrassingly unprofessional, and ring of the ultra-cheap. Voice mail is affordable, professional, and messages can be quickly and easily changed.)

How does your team answer the office phone?
The best approach is, “Thank you for calling Dr. Brown’s office. This is Amy. How may I direct your call?” This standard greeting gives the caller information and provides immediate assistance to address their specific concern.

At what point do you get the patient’s name and phone number?
As soon as the patient is finished talking (never interrupt), the patient’s name and phone number should be reinforced if they have been given. If they have not, name and number should be requested. Obtaining the patient’s name will often secure a commitment from them if they are uncertain about whether they should schedule an appointment. Also request the patient’s address.

Have you ever said, “Please hold” to a caller?
Never put a caller on-hold without asking for their permission, and waiting for their response. “Mrs. Jones, may I put you on hold while I check on that?” How many times have you placed a call to a business and been clicked almost immediately into hold? You cannot even utter a grunt without being cut-off. Putting customers on hold without their consent is rude and inconsiderate.

How long do patients typically have to wait on hold?
Studies show that after only 17 seconds, callers on hold become annoyed. How many patients have you irritated today? However, the patient is far more understanding if the front office employee explains why the patient is being asked to hold and provides the estimated time required. Knowing beforehand how long they can expect to wait reduces the chance of annoyance. Another option is to offer to call the person back within a brief and specific time period.

Do you provide patients information while they are on hold?
Educating the patient is essential in reinforcing the importance of professional dental care as well as informing patients about other services the practice provides. Use specially developed informative messages to tell callers about you, your team, and the services you provide. “On-Hold Messaging” allows you to choose specific messages for your needs such as promoting veneers, or porcelain inlays, or the importance of implan. You have the flexibility to change your message as often as you like. Most important, studies show callers will happily wait on-hold for more than three minutes if they are listening to useful information.

When you’re talking on the phone and a visitor walks in, who gets priority?
The patient who kept their appointment and is waiting to be greeted gets your attention. That means you need to interrupt the caller. The quickest way to get that caller’s attention is to say their name. “Mr. Smith, I have a patient who just walked in, may I ask you to hold for a moment?” Wait for their agreement. Then acknowledge the patient, tell them you’ll be a moment and wrap-up your telephone conversation.

Cut the line on sloppy phone etiquette, otherwise … “You have reached a number that has been disconnected or is no longer in service.”

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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Time Out For The Patient's Chief Complaint

Jean Gallienne RDH BS
Hygiene Consultant McKenzie Management

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What exactly does your patient perceive? Of course I cannot tell you the answer, but I can tell you ways to have them perceive you as the caring professional that they are seeking.

Let’s reflect on this scenario… you are running late. You seat your next root planing patient and they have an area that is sore in the lower left quadrant. You have to get them numb and get back on schedule. In the mean time, they tell you about how it was bothering them the last time they were in for root planing and the other hygienist told him we would watch it for now and that he should continue rinsing with chlorehexidine.

The thing I am not telling you is the tone in his voice while he is talking. He is not angry, but he has a tone that suggests the other hygienist was put off by his discomfort and just brushed him off.

What would you do next? Get the patient numb, and then address their problem or get the patient numb, do the root planing, and move the patient out of your chair so the doctor can do the exam in one of his rooms and you can get back on schedule? All the while you are thinking to yourself, “I need to be on schedule.” Tell the patient you will have the doctor look at it after you are done.

The next thing you do is going to make or break the perception the patient has about your office. Remember he already has an attitude about the other hygienist so, I hope you make the right decision.

Staying on schedule is very important. You need to respect your patients’ time so they will respect your time. However, as a professional, you must put yourself and your needs in neutral long enough to gain understanding and build trust. In this case, the best thing to do is to continue actively and empathetically listening to your patient. Empathic listening is transactional, the listener’s first priority is to understand the communicator. Empathic listening means listening to the whole person. You want to listen to what is being said by observing your patient’s facial expressions, tone of voice, gestures, posture, as well as body motion. Limiting your concentration and focus to words alone is restrictive and inhibitive. You should also have the patient sitting up in the chair, and you should be sitting at their eye level.

Once the patient is done communicating, and you are done listening for the time being, you should immediately take a look at the area that is bothering the patient. Inform the patient of what you see, what you think may need to be done, and make notations on the hard copy of what you see, and what the patient said. I suggest reading this out loud as you write it. This is a form of paraphrasing that your patient will appreciate. You will find that they will even correct and add to what you are writing verbally as you are writing. Part of being an empathic listener is taking the time to understand what your patient is saying.

Now, let the doctor know what you see, and what you have told the patient. This is not the time to worry about the schedule. You will catch up somewhere else, not here. This is the time to take care of the patient’s concerns FIRST! By doing this you have just let him know that he matters and you want him to be comfortable during his everyday life. You may have just saved the office the loss of a patient out the back door.

This patient happens to have 6-8 mm pockets around this tooth. The root planing was started in this area because of the discomfort. However, the root planing did not decrease the discomfort and now there is a fistula. You have informed the patient that you think the doctor will want to extract the tooth. However, you are not sure and he will have to look at it. You also have let the patient know that the doctor will want to evaluate what to do as far as replacing the tooth. You tell him he may need an implant, bridge, or partial but you are not sure.

By doing this you have already prepared the patient for the future treatment plan, and have prepared him with the thought that it will need to be replaced, not just removed and a big hole left there.

Everybody needs to take the time to listen to his or her patients and put to action whatever needs to be done. This will help leave the patient with the perception that you really do care. Which is exactly what you want since you do care.

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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Tom Limoli, Jr.

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Both the legal profession and the dental community seem to have an infatuation regarding fees and fee schedules. So as to shed light upon this very gray and confusing subject, let’s address several standard definitions that you may or may not have in your working vocabulary.

Your office has only one FEE SCHEDULE that lists the USUAL FEE for each procedure that you perform. State dental boards and other regulatory authorities frown on doctors that have multiple FEE SCHEDULES. (i.e.: one for insured and one for non-insured patients).

The USUAL FEE is that fee which appears in your office FEE SCHEDULE. The USUAL FEE is that amount of money which you charge in the open, free market, economy. It represents your full fee and has nothing to do with that amount of money contractually reimbursed by the patient’s benefit plan. This is simply the doctor’s baseline standard.

Benefit plan administrators statistically establish CUSTOMARY FEE levels. These levels are established based upon the dollar amounts and frequencies that are submitted on claims to the benefit plan or administrative entity. One hundred claims for $30 each has more weight than ten claims for $40 each. The more times the event occurs the more CUSTOMARY it becomes. Fee data are most often grouped into frequency percentiles.

In an insurance free fee-for-service environment doctors charge whatever they feel is appropriate. When a dental office modifies its USUAL FEE it is most often identified as simply being a REASONABLE FEE. Fees are and can be modified for any number of reasons. Charge more for a prophy due to patients’ previous neglect? Charge less for a pediatric extraction?

It is not an unreasonable action when a benefit plan contractually does not honor the doctor’s modified USUAL FEE. On the same note it is not unreasonable to deny a child chocolate ice cream for breakfast.

Your office may participate with various benefit plans and have several different TABLE OF ALLOWANCES. These are based on contractually agreed upon dental plans of which the practitioner is identified as a preferred or designated provider. The amounts identified on a TABLE OF ALLOWANCE are not to be confused with fees. The dollar amounts identified in a TABLE OF ALLOWANCE are nothing more than a representation of the total dollar obligation on the part of the plan. It has nothing to do with your usual fee or what you charge.

Both participatory and non-participatory benefit plans reimburse for specific services based on a MAXIMUM ALLOWANCE. These plans generally reimburse up to 100% of a predefined dollar amount. The dollar amount of reimbursement is based upon the financial strength of the plan as defined by the contract with the purchaser – not insurance company. The difference between that predefined level of reimbursement and your USUAL FEE is to be paid by the patient in a true fee-for-service environment.

Plan reimbursement based upon MAXIMUM ALLOWANCES should not be confused with the surcharges paid by the patient under a MAXIMUM FEE SCHEDULE plan. Surcharges apply only to those patients that are participating in specific, most often prepaid, benefit plans. The differences between MAXIMUM FEE SCHEDULE and MAXIMUM ALLOWANCE plans are, primarily, the levels of financial participation on the part of the patient. With both plans, your USUAL FEE is not taken into consideration by the plan. With MAXIMUM ALLOWANCES the patient is responsible to your office for your full USUAL FEE. Participating dentists cannot collect their full USUAL FEE from patients covered by MAXIMUM FEE SCHEDULE plans.

Remember the words of the great dental philosophers from Chicago: "the patient is responsible for the total cost of dental care".


The fee that an individual dentist most frequently charges for a given dental service.

A list of the charges established or agreed to by a dentist for a specific dental service.

The fee charged by a dentist for a specific dental procedure that has been modified by the nature and severity of the condition being treated and by any medical or dental complication or unusual circumstances, and therefore may differ from the dentists "usual" fee or the benefit administrator's "customary' fee.

The fee level determined by the administrator of a dental benefits plan from actual submitted fees for a specific dental procedure to establish the maximum benefit payable under a given plan for that procedure.

A list of covered services with an assigned dollar amount that represents the total obligation of the plan with respect to payment for such services, but does not necessarily represent the dentist's full fee for that service.

The maximum dollar amount a dental program will pay toward the cost of a dental service as specified in the program's provision.

A compensation arrangement in which a participating dentist agrees to accept a prescribed sum as the total fee for one or more covered services.

If you are interested in having a comparative Fee Schedule Review - 7 page report detailing 216 of the most often performed dental procedures compared to your existing fee schedule compiled for your zip code, please email

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Job Descriptions That Can Be Customized For Your Practice!

You’ve wanted them and now they’re available. Each job description comes complete with tasks performed most generally as observed by McKenzie Management’s Consultants. Download as a Microsoft Word document TODAY!

  • Scheduling Coordinator
  • Financial Coordinator
  • Treatment Coordinator
  • Patient Coordinator
  • Dental Assistant
  • Hygienist

An Added Bonus!

  • Scripts and letters to communicate with patients - Treatment Coordinator, Financial Coordinator, Scheduling Coordinator
  • Formulas to measure system/job success - Patient Coordinator, Financial Coordinator, Scheduling Coordinator
  • Meeting Reporting Items - Available on all job descriptions


Use them today!

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This issue is sponsored
in part by:
McKenzie Management's Seminar Schedule
2005 Location Sponsor Information Topic Speaker
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
Oct. 20-21 Santa Barbara, CA Dental Education Lab 877-777-6151 Max. Prod. Sally McKenzie
Nov. 10-11 Santa Barbara, CA Dental Education Lab 877-777-6151 Max. Prod. 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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