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1.6.06 Issue #200  
Develop Your High Performance Team

Sally McKenzie, CEO
The McKenzie Company

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The holidays have come and gone and we are at the dawn of 2006. The start of the New Year sets the stage for new beginnings. It marks the best opportunity of the entire year to create a vision, set goals, and make a commitment to building the practice you’ve long dreamt of, a practice with a cohesive, fully functioning, and highly effective team. Yes, it is possible. And, no, I haven’t been sipping the left over eggnog.

But, Sally, my staff and I work pretty well together, and I don’t want to spend time on intangibles.” Intangibles? Consider the following questions:

  • How many times during 2005 did you wish a member of your team would handle a patient, a procedure, or a situation differently? How much do you think it cost your practice?
  • How many times during the year were you managing conflict between team members? How much do you think it cost your practice?
  • How many times did you feel like one or more members of your team were heading in the opposite direction of the rest of the group? How much do you think it cost your practice?
  • How often were you frustrated by team members’ inability to solve problems or take necessary action? How much do you think it cost your practice?
  • How often were staff meetings either dead with silence or dominated by one or two people?  How much do you think it cost your practice?
  • How many good ideas surfaced but were never implemented? How much do you think it cost your practice?
  • How many times did you hear the words, “It’s not my job.” Or “I thought that was Jane’s responsibility”? How much do you think it cost your practice?
  • How often were you faced with a two-weeks notice? How much do you think it cost your practice?
  • How many patients did you lose in the last 12 months? How much do you think it cost your practice?
  • How many times did you feel like the practice should be doing better financially, that work should be less stressful and more rewarding? How much do you think it is costing you personally?

An ineffective team is expensive. It costs time, money, patients, staff, and stress – five pretty tangible things, wouldn’t you say. 

Effective teams produce concrete and measurable results. But it doesn’t just happen. People working under the same roof for 8-10 hours a day does not make a team. Oftentimes, practices have employees that together could become an outstanding, highly effective team. Individually, most of the members are dedicated, hard working, and knowledgeable, but they simply don’t know how to function effectively as a group. Consequently, they become mired in conflict, turf wars, and pettiness.

They don’t know how to establish team goals and to identify the strategies to achieve those goals. But show them the possibilities of working as a team and give them the tools to function as a one, and you begin to build the high performance dental team.

Effective teams have a few fundamental needs that have to be addressed. Individuals need direction and a fundamental understanding of how their day-to-day work fits into the practice’s overall goals and objectives. Team members need to know they can trust each other. They need a process for managing conflict, which is inevitable and occurs on every functioning team. They need to understand what their individual strengths and weaknesses are as well as those of their teammates. Team members need to feel included in the process. They need to feel valued for their contributions, and they need to feel empowered to make decisions and take action when it is in the best interest of the practice.

Team members need to know how to communicate with each other. A true team environment encourages individuals to risk speaking up, to ask for help, and it gives them a safety net to make mistakes. It also creates a strong environment for solid constructive feedback. Effective team members turn team priorities into individual priorities. They understand that their role affects not just themselves but Jane, Mary, Tom, the doctor, and everyone else.

Kick off 2006 with a commitment to solidify your team, and when the holidays roll around again in 12 months you’ll be celebrating your best year yet.

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

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Will the New Year be a Dream or a Nightmare?

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

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Dear Belle,
“I am not looking forward to Monday morning, January 2nd after the nightmare I had last night.  In my sleep state it was 8:00 am and the phone rang.  It was Mr. Brown my 2:00 PM, 2 hour bridge prep appointment.  He was canceling.  As soon as I hung up, the phone rang again and it was Mrs. Higgins canceling her hygiene appointment for 10:00AM.  I woke up in a cold sweat before anyone else cancelled.  What can I do this year to prevent so many cancellations?”

Sandie, Scheduling Coordinator

Unfortunately, this scenario is typical in offices where systems to prevent or correct the effects of cancellations are not in place.  There will always be cancellations and failed appointments because there are events in our patients’ lives that are unforeseeable.  The goal here is to limit the number to a manageable few. To truly manage your schedule, look at the next three days scheduled.  Check to see that all appointments are qualified. 

A qualified appointment meets the following criteria:

  1. The patient understands the procedure to be performed, the length of time in the chair and the recovery time if any.
  2. The patient has been told that the time is “reserved just for him” and that the team is expecting him/her.
  3. The patient has received in writing and understands the policy for cancellations in your office.
  4. The patient has received a written treatment estimate and has secured financing with cash, check, credit card or CARECREDIT financing.
  5. The patient does not have an overdue balance or has moved away.
  6. The patient does not have medical concerns that need to be addressed prior to the appointment (pre-med, Coumadin).

If the appointment was made without a firm financial commitment, there is a high probability of a cancellation.  If the appointments don’t meet the criteria, then call the patient and confirm the details of the appointment.  Remember, a regular confirmation call is a “courtesy reminder” for a qualified appointment.

The value of the services to be rendered and the responsibility of time commitment to deliver these services successfully is communicated by the clinical team and reinforced by the Financial Coordinator and the Scheduling Coordinator.  In other words, a qualified appointment is a “team effort”. 

A very important tool to help fill those open time slots is the Short Call List or ASAP List that you can create by using your computer software program.  As you schedule your patients, ask the patients if they would like to be called should a sooner appointment become available.  If the answer is yes, then mark the appointment and place any special notes about the appointment in the note section such as “wants a Thursday after 2:00”.  You will be able to create this list at any given moment.  Make sure that you get all phone numbers and e-mail addresses where the patient may be during the day.

Another important tool to prevent cancellations, are written and rehearsed scripts of what to say to patients who are canceling appointments.  These scripts need to be placed in the Office Procedural Manual for training existing and new team members.  If one team member is not familiar with the scripts and allows the patient to cancel without resistance, the patient will “ask to speak” to this person in the future whenever he/she wants to cancel.  The following is a sample script:

“Hello, this is Mrs. Smith, I have an appointment today that I need to cancel.”

“Good morning, Mrs. Smith.  We are looking forward to seeing you today.  As you know we require a 24-hour notice to change an appointment.  While I appreciate your calling, you have unfortunately not given me enough time to find someone to take your reserved time.  Are you sure there isn’t some way you can keep your appointment today?”

 Reinforcing your policy and your commitment to the patient will cause them to keep the appointment or will give them reason to avoid canceling in the future.

To learn more about creating a “dream schedule” and writing custom scripts for your practice, contact me at and visit The Center for Dental Career Development.

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Tax-Saving Tactics

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

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Taxes. No one likes to pay them, but there isn't anything you can do about them.

Or is there? Fortunately, there are several tax‑saving strategies that you can use right now to cut your tax bill.

Consider municipal bonds. Municipal bonds used to be the domain of the wealthy, but not anymore. Many middle‑income investors find themselves paying enough tax each year to make municipal bonds a worthwhile investment.

Are municipal bonds right for you? To find out, identify the percentage you'd need from a taxable bond to equal the after‑tax yield you can earn from a comparable municipal (one with the same maturity date and credit rating). To do this, divide the tax‑free yield by 1 minus your tax bracket.

For example, assume you're looking at a municipal with a 5 percent yield and you pay 28 percent of your income to the federal government. You would divide 5 percent by 0.72 (1‑.28) to obtain your answer. You'd have to earn 6.94 percent from a taxable investment to equal the 5 percent tax‑free yield from a municipal. If you can't find a taxable bond you like that can generate a yield of 6.94 percent or better, a muni may be right for you.

Contribute the maximum to your retirement plan. Contributions to a corporate retirement plan are generally made on a pre-tax basis, which means you will receive a portion of the money you contribute after filing your tax returns. For example, assume that you're in the 28 percent tax bracket and you make pre-tax contributions of $10,000 annually to your employer‑sponsored retirement plan. To better understand the benefits of pre-tax retirement investing, in order to invest $10,000 after tax, you would have to earn $13,889 ($10,000 divided by 0.72).

Retirement plans also have another valuable feature. Earnings grow tax‑deferred as long as they remain in the plan. When earnings are free from immediate taxation, they grow much faster than if taxed every year.

For example, a $5,000 annual investment in a tax-deferred account would grow to more than $566,000 (approximately $408,000 after taxes) in 30 years (assuming an 8% annual return) -- but the same amount invested at the same rate in an account taxed at 28% would grow to less than $379,000. This is a hypothetical example used for illustration purposes only. It does not represent any specific investment.

Discover the world of annuities. If you're seeking tax‑deferred income, annuities can be prudent choices. An annuity is a contract between you and an insurance company that provides periodic payments for a specific period of time. Issuers of fixed annuities guarantee principal and interest. The guarantees, however, are based solely on the financial strength and claim-paying ability of the issuing insurance company. Unlike retirement plans, there's virtually no limit to the amount you can contribute in an annuity, and you're not required to start withdrawing money at age 70½.

Get the professional help you need. These are just a few of the many tactics that may help you reduce your taxes significantly. Before taking any action that would have tax consequences, talk with your tax professional as well as your financial advisor.

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

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