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12.23.05 Issue #198  
Do Patients Value Your Care or Your Fees?

Sally McKenzie, CEO
The McKenzie Company

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Congratulations! You did it. After much gnashing of teeth and cold sweats, you implemented a new fee schedule that is based on real information not gut feelings. You gathered factual data on the demographics of your patients. You collected information on the fees charged by other dentists. You evaluated the amount of time you want to spend in the office per week, the amount of money you want to make per year, and the quality of the dental services you provide. And lo and behold you developed a fee schedule that you are comfortable with that is fair…

Then the phone rings. It’s Mr. Hallahan and he is not a happy man. It’s not that he’s dissatisfied with the care he’s received in your practice; he just can’t understand why it costs so much. After all, he was only in the chair for about 30 minutes. He has what I’ll call the 15-minute oil change mentality. Mr. Hallahan has no comprehension of the value of the service you’ve provided. It’s a “routine” filling, just like a “routine” oil change. You’re in, you’re out. Fact is, the amount you charged him is irrelevant.  Your fee could have been reduced, and he still would feel he’d paid too much. It’s the value that is lost on Mr. Hallahan. 

You know the type – they just don’t get it. And why don’t they “get it”?  Often it’s because you haven’t given it to them. Perhaps it’s time you evaluated where your practice is losing value in the eyes of your patients.

Patients begin weighing the value of your care the moment they pick up the phone to schedule an appointment. If they are able to promptly reach the Scheduling Coordinator and book a convenient time, the value goes up. When the patient arrives at your office and they have to drive around for 15 minutes to find a parking space, the value of your practice is reduced. If the patient is greeted warmly and by name when they come into the office, the value of the visit increases. If they’ve had the opportunity to log on to your website and learn more about your practice or a specific procedure, the value of care increases further. If they have to sit in a disorganized waiting area with stained chairs, dirty carpet, outdated magazines, and poorly regulated temperatures, you can bet the value of your care is shrinking. If the patient receives a follow-up call from the doctor after a more extensive procedure, the patient’s perceived value of care shoots through the roof.

Get my point. You can charge patients a fee that is based on real data and is fair to both the patient and the practice, but you need to educate patients continuously on the value of your care. The lessons take place every time the phone rings. They stretch from the parking lot, to the prophy, to the treatment plan, to the financial arrangements, to the follow-up calls from the doctor. And everyone on the team, not just the doctor, serves as teacher.

Creating value in the eyes of the patient involves giving them the opportunity to learn about the condition of their oral health, the recommendations for improving it, and why you are making those specific recommendations. In addition, the entire team must recognize that it is their responsibility to routinely emphasize the excellent dental care delivered and the team’s commitment to provide that care to every patient.

The doctor and clinical staff take time to allow Mr. Hallahan to see for himself the condition of his mouth. He is given the opportunity to listen and understand the recommendations. He’s encouraged to ask questions, so that he knows exactly why you are making the treatment recommendations you are. He understands the course of treatment and precisely what is involved. When doctor and team clearly explain the “what,” “why,” and “how,” and when every member of the team takes the time to reinforce the practice’s commitment to providing Mr. Hallahan the best care they can, he isn’t walking into the practice with a 15-minute oil change mentality. He understands the importance of the care he is receiving, and, most importantly, he values it.

If you are interested in having a comparative fee analysis detailing 216 of the most often performed procedures compared to your existing fee schedule compiled for your zip code, please email

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

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The Power of Persuasion and Treatment Plan Acceptance

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

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Recently, I had a conversation with a successful dentist who had achieved a practice of 90% implant cases.  He was very busy and satisfied with his life yet frustrated with his peers who envied his success.  “If they would just stop worrying about what everyone else is doing and look to their own practices, stop being so uptight and relate to their patient’s needs they too would have more success.”  It’s the old “grass is always greener” syndrome. 

 A treatment presentation is persuasive in that we want our patients to achieve optimum dental health.  So why don’t they sign up when you tell them about what needs to be done.  Perhaps you have not convinced them that there is a problem.  In order to persuade, one must first isolate the “problem”.  As a clinician it is the dentists’ job to demonstrate that a verifiable problem exists in the patient’s mouth.  If the dentist cannot get the patient to recognize a problem exists, then the patient won’t find the reasons for correcting it very important.  Defining the scope of the problem and underlining the severity or urgency of completion is a necessary aspect of persuasion.  Using examples of similar cases and being able to demonstrate the success in a way that the patient can visualize the same success is important.

Identifying the cause of the dental problem with sensitivity and compassion.  What’s done is done and now we must correct it, heal it and prevent it from returning.  The patient must make a connection between problem and cause in order to act.   Don’t get caught up in the “horrors of cause” making the patient feel uneasy.  Establishing common ground by saying, “many patients have experienced what you are going through and there are solutions to these problems.”

Once you have defined the problem and the cause the next step is to create a solution.  A treatment plan that is easy to understand and offers options is the next step.  If there is an option that you feel is not in the best interest of the patient and you feel won’t work, then don’t present it.  Often patients will take that option even when you say the prognosis is a poor outcome.

The patient may be convinced that he needs to have the dental treatment completed, but are you the authority or the “best” dentist to do the task?  Appealing to your education, experience and your own personal case studies demonstrating your skills best supports speaking with authority on this subject of treatment and outcome.  Testimonials are powerful when it comes to persuading the patient that you are the best one for the task.  Many dentists don’t take the time to show the patient case histories similar to their own treatment diagnosis.  Building rapport with the patient is paramount to persuading them to accept the recommended course of treatment.  Funny and heartwarming stories can help to forge an emotional connection that for many patients is necessary to trust a dentist.  Many longtime patients have told me that the “friendliness factor” and genuine concern is what keeps them in the practice year after year and helps them accept treatment readily.

Developing and practicing persuasive techniques will improve your skills.  Take the time today to give that extra attention and see if it makes a difference.  Remember to stop worrying about how many “units of crown” you are doing and comparing with everyone else.  Get focused on improving communication with your patients and see the difference. 

If you would like help in improving your treatment presentations email Belle at

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Keeping Financial Records: Neatness Counts

David P.G. Keator, BA, MA, RIA - Partner
Keator Group, LLC of Wachovia Securities Financial Network

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Good order is the foundation of all good things.
- Edmund Burke, 18th-century British Statesman and orator

Even on a rainy day at home, you may not feel like putting some order into your personal records. It's not a chore that many people enjoy. But come next April, orderly records will make life a lot easier for you -- and your tax preparer.

Besides saving you substantial time and frustration spent looking for canceled checks, receipts, and other documents needed to prepare your tax return, there are other reasons to do something about that clutter. For example, you may suddenly need to find a warranty for a major appliance that has gone on the blink. Or you may need a birth certificate to obtain a passport. Or the time may come when you want to sell your house and you need documentation of major improvements, such as a screen porch that you added, which could lower your capital gain.

If you've ever spent hours searching for a document you just had to put your hands on, you'll probably agree that the effort it takes to get organized is small compared with the peace of mind it will yield. But a word of caution is in order: don't become overly zealous when the urge to clean strikes. Take time to carefully sort through your household papers before discarding any information, lest you throw out the useful with the useless. Knowing which is which and how long to keep certain records, is the first step toward putting your financial house in order.
At a minimum, you should hold on to copies of bills that support income and expenses for three years after the due date of each tax return. Included in that category are such documents as W-2s showing salaries and tax deductions, K-1 partnership returns, and 1099s showing dividends and interest. You also should save canceled checks in case the Internal Revenue Service questions your deductions for charitable contributions.
It's no secret that the IRS audits only a tiny fraction of the millions of returns filed each year. And the IRS normally doesn't audit returns more than three years old. However, if the government suspects that there is a "substantial understatement of tax liability" -- more than 25 percent -- the IRS can extend the time for an audit up to six years. And there is no time limit if the IRS suspects fraud or when no return has been filed at all. What better reason to keep tidy and accurate records? Without supporting papers, you may have a hard time proving your case -- and any deductions you can't document may be disallowed.

Some documents you should never throw in the trash. For example, you should keep copies of brokerage statements and mutual fund transactions virtually forever. They will enable you to determine the basis, or cost, when you sell securities or redeem mutual fund shares. It could be to your advantage to be able to identify which shares you sold and which shares of a particular security you bought at different times. If you lack the data to back you up, the IRS will take a first-in, first-out approach.

Hold on to any records you may need to support the cost of other investments or assets. If you contributed to an Individual Retirement Account or a Keogh plan, save the statements until all the funds have been withdrawn.

Taxes aside, certain personal records, such as birth and marriage certificates, should be kept indefinitely, and they're best kept in a bank vault. Other documents that fall into this category are trust agreements, your power of attorney, and pictures of valuables, such as your silverware and fine paintings, which you would need for insurance purposes in the event of a fire or other loss.
The one document that decidedly does not belong in your safe deposit box is your will. Keep it in a safe place, such as a fire-retardant strong box, and leave a copy with your lawyer or a trusted friend. Putting a will in a bank can cause problems if you live in a state where safe deposit boxes are automatically sealed when the owner dies.

David Keator holds his series 7, 63 and 65 securities registrations, and is licensed to sell insurance and variable annuities.  He currently serves on Wachovia Securities Client Strategy Group Advisory Council. In addition to his duties with the Keator Group, David is a frequent guest of the lecture circuit, offering estate and financial planning seminars to the Federal Reserve Bank and Fortune 100 companies as well as at the Las Vegas Institute for Advanced Dental Studies
Wachovia Securities does not render legal, accounting or tax advice. Please consult your CPA or attorney on such matters. The accuracy and completeness of this material are not guaranteed. The opinions expressed are those of the author(s) and are not necessarily those of Wachovia Securities or its affiliates. The material is distributed solely for information purposes and is not a solicitation of an offer to buy any security or instrument or to participate in any trading strategy.  Provided by courtesy of David Keator, a Partner with Keator Group, LLC in Pittsfield, MA. For more information, please call The Keator Group at 800-338-5209. Investment products and services are offered through Wachovia Securities Financial Network, LLC (WSFN), member NASD and SIPC, a registered broker-dealer and separate nonbank affiliate of Wachovia Corporation. Keator Group, LLC is a separate entity from WSFN. ©2005 Wachovia Securities, LLC. Investments in securities and insurance products: NOT FDIC-INSURED/NOT BANK-GUARANTEED/MAY LOSE VALUE

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Marketing Secrets

Howie Horrocks

Reveals 400 pages of already tested, proven patient-attracting ads, brochures, TV spots, press releases, direct mail letters, radio ads, how to do it right, like marketing to seniors, marketing on the internet, and why you must include the right amount of facts and emotions into your marketing.

In addition you will learn what to say in a simple letter that gets business people near your practice to choose you, how to double the effectiveness of your ad with only two lines of copy, and best of all find out how to write a patient letter that will yield a remarkable ROI!

All you have to do is pick up these secrets and before you know it, your own practice will be receiving the business you've always desired.

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