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10.28.05 Issue #190  
Performance Measurements: Your Practice Compass

Sally McKenzie, CEO
The McKenzie Company

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What are your responsibilities? What are you trying to accomplish? What is expected of you? What are the goals of the practice and where do you fit in?

If you’re the doctor, you just might know the answers to those questions, and you may feel you are headed in precisely the right direction. However, if you are a member of the staff, you may very well be shaking your head, shrugging your shoulders and thinking, “I couldn’t answer any of them. I just come here and do what I think the person before me did and try not to mess anything up.”

Between the busyness of the dental business these days and the chronic employee turnover experienced by many offices, ensuring that everyone is headed in the same direction is no simple challenge. Too often dental practices are staffed by employees who want a career but are locked into just a job. Everyone is doing their own thing - the same thing day-in and day-out - without a lot of thought for what course they are on. They just drift along seriously in need of a compass.

The compass I’m referring to doesn’t point North, South, East or West. Rather it guides everyone on the team in the same direction, and it comes in the form of a performance measurement program. While there are a number of models out there, systems that are based on individual jobs and focus on specific job-related goals and how those relate to improving the total practice are the most effective. In implementing a performance measurement system, you’ll want to take a few steps to establish a strong foundation:

Step #1 -Create specific job descriptions for each employee. It’s time to spell out what each member on your team is responsible for, and resist the temptation to overlap job duties. But Sally if I don’t overlap duties what happens when Jill is out? You cross-train, so that each area has coverage when the point person is out ill or is unavailable. If you overlap duties, employees are given tasks but not responsibility.

What’s more, the team member trying to fulfill her/his job duties effectively quickly becomes frustrated. She/he wants to take ownership for a particular system, but can’t because it’s not “her/his system” to oversee. It’s simply not in the practice’s best interest to have multiple people responsible for areas such as collections or scheduling.

Step #2 – Lay the groundwork for success:
Provide the necessary equipment and tools to perform the job.
Provide training to help team members carry out the job duties most effectively. Explain what is expected of the employee and how their performance will be measured. Evaluate the number of staff and if that number is adequate.

Step #3 – What gets measured gets done. Appraise employee performance using an effective performance appraisal instrument that evaluates key areas such as:

  • The employee’s ability to follow instructions
  • Their willingness to help others and cooperate with others
  • The incidents of errors in their work
  • Their initiative, commitment, and innovation in carrying out their responsibilities and improving work flow
  • Their work ethics, their attitude, and their individual productivity

The vast majority of employees want to deliver a quality work product. They want to feel they are part of a harmonious team that not only enjoys working together but also is committed to succeeding together. And they want to feel that they are rewarded based on their individual ability to achieve what is expected of them. In fact, a McKenzie Management study based on hundreds of personal interviews and auxiliary personnel surveys revealed that dental employees want the opportunity to take ownership of their responsibilities. They want to be able to maximize their intelligence and their abilities. They seek to be challenged, to be given the opportunity to pursue innovative approaches in their work, and to be held accountable and appropriately rewarded for results. All are characteristics of both a thriving team and a solid performance measurement program. 

Maybe it’s time you checked your compass and made sure you are heading in the right direction.

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

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SETTING A NEW DIRECTION: Training for Peak Performance

Dr. Nancy Haller
Executive Coach
McKenzie Management

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Jane was hired for the front office job two months ago. She’s trying hard but struggling to answer the phones, collect at dismissal, schedule patients, handle insurance filings on some days and billing on others. Since her arrival, collections are off 15 percent and some insurance claims were mishandled. Her co-workers like her very much but are annoyed because she keeps asking questions. On the positive side Jane has never missed a day of work. She arrives at the office 15 minutes early every day, and she’s the last to leave. She’s eager to learn. Her customer service is outstanding - patients love her.

Perhaps you are thinking, ‘get her some help’. Or maybe you believe she should be fired. Not so fast. It’s expensive to bring on more staff. Throwing more people at the problem is not necessarily the answer. Recruiting, selecting, and hiring a new employee takes time and money. And the last thing you want to do is lose another employee (more on turnover in next week’s issue). So what’s the solution?

It makes sense to stabilize your workforce as much as you can for stronger profit. Let’s start with Jane’s strengths. She is well-liked, conscientious and extremely dependable. Those are priceless traits in an employee. In fact research indicates that these are the MOST important predictors of job success. Since Jane has demonstrated exceptional commitment and loyalty to her job to date, the solution rests less in WHAT she does (or doesn’t do) and more in HOW she does it…her work preference. In other words, her personality style.

Now for the first time in the dental industry, you can compare Jane’s personality to existing front office dental personnel who have been identified as peak performers. The Staffing Solutions On-Line Employee Assessment Test is effective for new hires as well as existing staff. Here’s what happens when Jane takes this 20 minute web-based questionnaire.

Her Fit to the Job Profile matches 65%. In terms of her behavioral strengths, she is similar to the desired dimensions for the job on nine of the 12 personality factor scales. Although this seems like a good ‘match’, it is important to determine where she is not ‘fitting’.

The report indicates that Jane is low-average in Dominance meaning that she tends to be agreeable and deferential. She has a high-average level of Calmness, Livelinessand Warmth. Indeed Jane is cheerful and engaged with people at work. She handles stress and pressure well.  Jane’s score on Rule-Consciousnessis average, indicating that she follows established rules and regulations. She also scores in the average range on Trust, Self-Assuredness, Organization, and Social Boldness.

But the scales of Open-Mindedness and Imagination are high-average in Jane’s test results. She also scores low-average Self-Reliance. These last three scales explain why Jane is struggling in her work.

The Employee Assessment Test indicates that Jane tends to be more creative than peak-performing front office personnel. She is more innovative than traditional. Her preference also is to do activities with others. She doesn’t particularly like to make decisions by herself. No wonder she is asking so many questions.

Jane needs to develop a systematic way of working. As her boss, you can share these personality results with her. First and foremost, acknowledge her strengths and appreciate her talents. Then coach her to find solutions that balance her interpersonal skills/preferences with finite periods of focus on data, details and practical matters. Meet with Jane briefly on a bi-weekly basis to follow-up on her development plan. As she makes progress, taper off to monthly, then quarterly meetings.

It used to be enough to hire the best people for the job. But that’s no longer enough in today’s business world. Creating peak performance teams is what separates the best from the rest. Leaders need to be coaches to help people gain confidence and experience in meeting challenges. Let the Employee Assessment Test help you in providing the spark that prompts your staff toward successful results.

If you want to know more about to use the Employee Assessment Test to coach your staff to peak performance, email Dr. Haller at

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The Time to Market is Now

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

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Dear Belle,
My schedule has always been full up until the last few months. Production is falling off and I have noticed more holes in the schedule and less money to pay my bills.  I had to let one of my assistants go and I cut the office hours by a half day.  When I asked my business manager she said it was just a slow period and things would pick up.  Frankly, I am worried.  What should I do?
Dr. Doomandgloom

The first step in growing a new practice is to establish a marketing program.  Once the patients start coming in and the practice is running at a comfortable pace, it is common for us to see marketing programs being dropped and internal efforts to generate new patient referrals stop. If you think that you have enough patients because you are “too busy” to market your practice, you need to think again.  There may come a day when the phone doesn’t ring and the monies coming in are lean.  If you don’t capture the moment, the moment can be gone as quick as you had it.  This is not the time to think of starting a marketing program.  You must never stop marketing“Do you know how many new patients you have per month?” I asked Dr. Doomangloom. “No, but I feel I have enough.” She replied.  Remember…you can’t run a business on “I feel”.  Successful businesses are run by having the information.

You can produce a report from your software program that will give you a monthly number of new patients.  However, because these are patients entered for the first time, they may have been an emergency patient which does not allow them to be retained through the recare/recall system.  This can give you a “false sense” of patient growth. 

A true new patient is one that comes in for a Comprehensive Exam.  Printing a Procedure Code Utilization Report for the past 12 months will give you the number of Comprehensive Exams you performed.  This will help you track the true growth of your practice.

Whether or not you are retaining these patients once they have had the comprehensive exam is measured by how many active patients you have in the recare/recall system. Active patients are patients that are due to return for recare/recall in the next year. If you are losing or not retaining more than 50% of the comprehensive exams coming in the front door, your practice is shrinking, patients are leaving your practice and you need to find out why. 

Studies have shown that patients can leave a practice due to even the smallest perception of poor customer service.  Making daily calls from a one to 12 month past due recare/recall report and unscheduled treatment-planned report is necessary to make sure you are capturing what at least once was.  Remember it costs 5 times the money to market one new patient as it does just to keep the ones who came to you in the first place.  Word of mouth referrals is the least expensive means of marketing.

Being aware of the environment around you is also vital.  Have new dentists moved into the area offering more convenient hours or other incentives making it inviting to leave your practice?  Have you dropped PPO plans without considering what percentage of your patient base carried that insurance?  Are you tracking all referral sources with your software and sending out thank-you cards to all that refer to your practice?  Are you giving your patients the VIP experience in your office or have you taken for granted why they keep coming back?  Are patients seated on time?  Are they told when you are running late?  Do you stop and say hello even if the patient is here to see the hygienist?  Do you call your patients that had a difficult procedure at the end of the day to see how they are feeling?  The list goes on and on in ways that you can market your practice both externally and internally.  We must never lose sight of why we are busy in the first place, our patients.  Without them there isn’t any way to “practice”.

To learn more about improving the customer service in your systems, email

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