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11.4.05 Issue #191  
Managing a Raise without Maxing-out Payroll

Sally McKenzie, CEO
The McKenzie Company

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“Doctor, I need a raise.” You can feel the hairs stand up on the back of your neck, your heart starts to pound, and fear is racing through your bloodstream. Halloween may be over, but few things will cause bone-chilling terror faster than when an employee asks for more money.  It’s one sentence that will send the most rational doctors into the most irrational, emotional tailspins. The imaginary scenarios flood your mind, what if she quits, how can I afford it, what will the other employees expect … and on and on.

Unfortunately, when an employee asks for a raise, the dentist is a day late and likely to be several dollars short at this point. When it gets to this stage, doctors can feel backed into a corner. Consequently they go into reactionary response mode, rather than addressing the request logically and thoughtfully.

Step back, take a deep breath, and avoid the urge to respond immediately. Take control of the conversation and avoid replies, such as, “I can’t afford it right now.” In the employee’s mind, those large veneer cases you just completed should finance her/his meager little request with barely a scrape to the bottom line. “You haven’t been here long enough.” How long is long enough? And why doesn’t the employee know the answer to that question. “I need to be fair to the other employees.” This implies that hard work and dedication won’t get the employee far in your practice because there might be someone else on the team who doesn’t work as hard but would feel slighted by any hint of inequity. No better way to squelch a high achiever than to tell them their efforts won’t be rewarded.

Managing requests for more money begins with managing employee expectations at the outset. It starts day one, not six, eight, or twelve months after the employee is working for you.  Spell out the guidelines the first day the employee becomes a member of your team. Explain when raises will be discussed and under what circumstances a raise will be given. Follow the same script with every employee and you’ll ensure everyone knows their lines and yours. I recommend this type of approach: Betsy, your yearly salary will be reviewed on your one-year anniversary date. At that time, any increase in your salary will be dependent upon your performance and contributions to the practice as well as the financial condition of the business.

This makes it clear that more money isn’t just handed over because the employee has marked 12 months on the payroll. Enhanced compensation is contingent upon the employee’s performance as well as the financial health of the practice. There are expectations to be met. It’s about commitment, results, and a willingness to do more than hang around for a year. Which means you will need to provide performance reviews and measurements that enable employees to see the direct relationship between their performance, the success of the practice, and ultimately their potential for increased compensation.

Next week, respond to raise request without compromising the employee or the practice.

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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Setting a New Direction: Leading for Peak Performance

Dr. Nancy Haller
Executive Coach
McKenzie Management

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I’ve worked with a lot of leaders in a wide variety of industries. Teamwork is essential in every sector of the business world, especially in today’s economy. But aside from emergency room personnel, fire and police departments, nowhere is teamwork more crucial than in a dental office.
If you are going to run a successful practice, your employees must be functioning like a well-oiled machine. When one part of the ‘dental engine’ stalls, it impacts everyone and everything. Just like the quarterback in football or the coxswain in rowing, a high performing dental team requires peak performance leadership.
I’ve written about the age-old question, ‘Are good leaders born or made?’ before. Most experts agree that some people are gifted with natural leadership traits. They are the fortunate ones. Motivating others comes more easily to them. However, research shows that leadership is a skill that also can be taught and learned. And regardless if born or made, personality is an important element that impacts leadership.

In a recent article, I wrote that when strengths are overused they become weaknesses. What’s important for effective leadership is keeping the right balance. That requires self-awareness of the behavioral tendencies linked to personality make-up.

Effective leadership requires an awareness of the situation too. Sometimes certain personality characteristics need to be reined in. For example, a gregarious dentist needs to stop talking and listen to a patient’s concerns. Peak performance leadership also means that from time to time some personality tendencies need to be magnified. Orderliness can be overdone in the office, but not when it comes to sterilization guidelines. A good leader in a dental practice must ensure safety for staff and patients alike. Errors are life threatening.

The bottom line is if you are going to take your practice to a new level, you need to know your personality. Whether you want your staff to perform more efficiently or your patients to be more amenable to treatment recommendations, your capacity to consistently motivate others depends on your personality!

The good news is that you don’t need to spend years ‘on the couch’ analyzing your early childhood to figure out what makes you tick. Now you can learn about your personality in the comfort of your own office or home with Staffing Solutions On-Line Employee Assessment Test – Dentist Profile. You’ll answer 107 true-false questions. It takes less than a half an hour. It’s incredibly affordable. In minutes you’ll have a comparison of your score with those of working dentists who have been identified as peak performers.

Before you take the test, however, assess yourself informally. Rate yourself on a scale of 1 to 10, with 10 being high. How strong are you on the following 12 personality dimensions?

1. Cool, Reserved

Warm, Easygoing

2. Easily Upset

Calm, Stable

3. Not Assertive


4. Sober, Serious


5. Expedient


6. Shy, Timid


7. Suspicious


8. Practical


9. Self-Doubting


10. Traditional

Open Minded

11. Group-Oriented


12. Undisciplined


Then evaluate yourself on these five global factors of personality. Use the same 10 point rating scale as you did before.

1. Introverted


2. Stress-Prone


3. Receptive

Tough Minded

4. Accommodating


5. Unrestrained


Now click onto the Staffing Solutions web page and order the Dentist Profile. When you receive your report, do a comparison between your self-assessment and the formal results. If you know yourself well, there should be close alignment. If there are gaps, identify areas where you can begin adjusting your behavior.

I have been working with testing for over 25 years in numerous applications. I assure you that the Staffing Solutions On-Line Assessment may seem simple, but it is based on nearly 50 years of research done by the Institute for Personality and Ability Testing (IPAT). IPAT has partnered exclusively with The McKenzie Company to create this exciting and specialized application for the dental field.

If you wish you could have a team of employees who perform to your expectations, turn that dream into a reality by taking the first step. Assess your personality and determine the fundamental drivers that influence your behavior. Become a peak performing leader starting today!

Contact Dr. Haller at For each Dentist Profile you purchase in the month of November, she’ll give you a complimentary test for a member of your staff. 

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The Periodontal Examination

Jean Gallienne RDH BS
Hygiene Consultant McKenzie Management

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Is it possible you have undiagnosed treatment in your existing patients charts, because you do not have a ‘written’ interceptive periodontal therapy protocol established for your hygiene department? Establishing protocol will enable you to identify problems and treat your recall patients in the proper sequence to maximize their oral health.  This protocol, for example, could be an evaluation before the professional cleaning and having all necessary diagnostics available.  Think of it this way…the dentist wouldn’t place a crown before treating a periapical abscess associated with the tooth. In this same venue, why would a hygienist do a professional cleaning before correcting periodontal pockets?

Hygienists are skilled educated professionals trained to identify and conservatively treat periodontal disease. Therefore giving them the responsibility to help the dentist with the diagnosis of periodontal disease and communicate their findings to the patient is a positive step towards moving to a successful hygiene department. The hygienist, of course, is not responsible for the diagnosis of the disease, but the hygienist gathers much of the information. Although, in most states, the dentist makes the actual diagnosis, the hygienist can be held liable if these issues are not disclosed with the patient.

As a practicing hygienist, it is my responsibility to the patient to do everything I can to help treat and prevent periodontal disease.  Therefore, probings should be done on every patient using the six point probing method.

Part of your written protocol will be making decisions regarding what probe should be used by the hygienists. All of the providers need to be calibrated. Making sure that the doctor and all the hygienists agree on what a three-millimeter, four-millimeter, and five-millimeter pocket are. This protocol would also be done whenever a new hygienist is hired into the practice or a temporary hygienist is there for the day.

In a “multi-hygienist” office, standardize your documentation as much as possible. The periodontal chart should be easy to read and have a legend that is easily followed and that everyone in the office including the front office understands.

     The examination would include gathering information regarding:

  • A medical history
  • A dental history
  • Extra oral structures
  • Intraoral tissues and structures
  • The teeth
  • Radiographs as needed to diagnose
  • Presence and distribution of plaque and calculus
  • Periodontal soft tissue
  • Presence and type of exudate present
  • Probing depths (clinical attachment levels)
  • Bleeding sites
  • Furcation involvement
  • Color and contour of gingiva
  • Presence of inflammation
  • Areas of recession
  • Mobility

Note this information in the patient’s record with a standardization of symbols.
Once the evaluation information has been obtained, establishing a game plan of orderly sequence of treatment and appointments is next.  A well planned protocol will adapt to the needs of your patient’s condition. Not only will the patient actually receive a personalized approach, but also they are more responsive to treatment.

Explaining to the patient what pocket charting is, what all the numbers mean and why you are doing it before you start is recommended. Speak about the pocket charting in front of the patient will enable them to co-diagnose with you. Allow the patient to watch you as the probings are done. Show the probe to the patient. Explain that the measurements will tell whether there is disease or health. Explain that bleeding upon probing is not normal in healthy tissue. Point out any significant problems as the probing is being done. At this point, the patient will have an idea of their periodontal health and identify with the results obtained. Allow the patient to ask questions so you can ascertain if they understand the results of the test.
Scripts and verbiage can be gone over with the entire team in order to establish continuity when talking to the patient about periodontal disease and the commitment the office has made to help in the prevention and slowing the progression of the disease.

Establishing office protocol is essential in order to deliver optimum dental care thus, maximizing the health of your patients. It is important to properly diagnose acute and chronic problems before any treatment is initiated.

If you are interested in one-on-one instruction to enhance your hygiene skills Email

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