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3.31.06 Issue #212

12-Steps from Adrenaline Dependent to Efficiency Addicted

Sally McKenzie, CEO
The McKenzie Company

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Always overwhelmed, constantly dealing with the urgent, the chaotic. Each day is a fast, frenetic ride on the practice racetrack. Daily stresses metamorphous into emergencies. You and the team dash from one thing to the next and each is more critical than the last. At the end of the day you promise yourself you’re going to make changes and try to get things more under control. But the fact is, it’s a rush. You’re living on chewing gum and caffeine and gulping at the fountain of adrenaline addiction, and with every near crisis averted, sudden emergency addressed, and urgent situation managed you high-five the team and congratulate yourself.

But that momentary thrill is creating long-term problems. Living in a constant state of crisis management typically means there is little happening in the way of real system management. The team is constantly reacting and scurrying in one direction one day and another the next depending on what seemingly random course your so-called urgent priorities happen to take. Your crisis addiction, urgency addiction, adrenaline addiction – whatever you call it – is being satisfied at a price.

The days are long and exhausting. What was once an exciting thrill is starting to feel a lot like burnout. The worst part, for all of your running, panting, and dashing to handle the latest and most urgent issue, practice productivity is teetering precariously between the “sorely lacking” and “barely good enough.” The problem is everyone is working hard but no one’s working smart. The focus is on dealing with whatever problem has to be managed right now and not on addressing what caused that problem and what can be done to prevent it in the future.

Had enough of life and work on the run? A mere 24 hours over the next year could transform a practice locked in a seemingly perpetual state of crisis management or lackluster success into one of superior efficiency and productivity. It also could go along way in weaning both doctor and team from an inefficiency addiction that is costing you thousands in productivity and an untold amount in long-term professional satisfaction.

It begins with one two-hour meeting each month and a genuine commitment to making a change. This is dedicated, uninterrupted time in which doctor and staff commit to continuously improving the practice. Follow this 12-step plan to practice efficiency and productivity.

  1. Create an agenda with input from the entire team.
  2. Include all areas that impact the profitability/success of the practice, such as: numbers of new patients, recall patients, collections, treatment acceptance, production, accounts receivables, unscheduled time units for doctor and hygiene, uncollected insurance revenues over 60 days, overhead, etc.
  3. Distribute the agenda at least two days in advance of the meeting.
  4. Assign each member of the team to report on the area for which she/he is responsible. For example, the Scheduling Coordinator reports on the monthly production as compared to the goal, the number of unscheduled time units for the Doctor, and the Doctor’s daily average production.
  5. Designate the amount of time you will spend discussing each issue and avoid getting bogged down on unrelated topics. Discuss only what’s on the agenda.
  6. Eliminate outside interruptions, and hold staff meetings off-site in a conference room. Many local libraries, community colleges, and other public facilities have public meeting rooms available for use. 
  7. Encourage team members to come prepared to participate in the discussion. For example, If there are more unscheduled time units than desired the team can discuss strategies for addressing the openings.
  8. Seek input from everyone
  9. Delegate responsibilities and establish deadlines for completing tasks identified during the staff meetings.
  10. Share ideas during staff meetings for improving the work environment, the patient experience, and the efficiency of the practice.
  11. Seek consensus from the staff as to the best time to hold staff meetings; meetings scheduled outside normal work hours should be paid.
  12. Hold meetings at least once per month, more frequently if you are implementing several changes.

Before long you’ll be amazed at your cravings for stability and predictable outcomes. You’ll also likely find you and your team all but addicted to the very real and measurable strides you are making in practice productivity and efficiency.

Next week, from the perfect storm to the perfect day.

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

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Got Pain?

Risa Pollack-Simon, CMC

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The human  body is a fascinating machine. The brain, spinal cord, and peripheral nerves regulate all functions of the body and together are the source of all power. Following the universal laws of gravity, the body relies on balance for spinal efficiency. 

Regrettably, in dentistry most clinicians constantly move from balanced postures to extremely unbalanced postures in an effort to access the oral cavity. The body, in its infinite wisdom, adapts to imbalances by twisting and turning other body parts to compensate for these deviations. This can cause vertebrae to get lodged into abnormal positions, create restrictions in motion and result in nerve interferences and hypersensitivity; all of which cause spinal weakness, instability, muscle spasm, physical strain and pain, and emotional stress - symptoms all too familiar to the dental profession!

Health & Fitness

Fitness (both cardio-respiratory fitness and muscle fitness), can be defined as the body’s ability to efficiently function.

Cardio-respiratory fitness is the most important aspect of a fitness program, as it regulates the heart and blood vessels ability to transport oxygen from the lungs to the body’s  tissues. When oxygen can be transported efficiently, blood can be transported more efficiently to the organs and systems of the body. Efficient blood flow is vitally important, as it is responsible for nutrient supply and for removing muscle metabolism byproducts, which supports optimum performance.

Muscle fitness plays a much different role in the function of the body. Good muscle fitness refers to the muscle’s ability to operate at maximum capacity with full range of motion. Muscle fitness can be greatly impaired by using poor positions that shorten structures or from muscular injuries.

Muscles can also atrophy as we age. In fact, it is believed that after the age of 35, all humans lose approximately a half-pound of muscle and gain a pound and a half of fat in its place each year!   That said, muscles need to be stretched and challenged to remain strong and healthy.  

Suggestions for stretching before performing dental procedures would include the distal forearm, the hand and finger muscles, and the muscles of the shoulder girdle, neck and back. While stretching is beneficial, over-stretching can cause tears in the soft tissue, which can also lead to injury – so be certain to stretch intermittently for short periods of time.

The real “prize inside” from moving and stretching your body is seen through improved blood cholesterol balance, lower blood pressure, stress relief, physical fitness and weight control - plus a perception of diminished stress and greaterjob satisfaction!

In other words, if you do things that make you ‘feel good’ and help your mind unwind at the end of each workday (such as cardio-respiratory exercise, muscle stretching and stress reduction techniques like audio relaxation and meditation three to four times a week), your body will no doubt show its appreciation through improved health, physical fitness and well-being. 

Listen to your body! Don’t wait for those aches and pains to affect the precision of the care you provide - or worse, cause you to leave the field entirely as a number of your colleagues have been forced to do. Learn from clinicians who had to leave the field and sadly express that the pain from leaving the field was far more debilitating than the musculoskeletal disorder itself! 

Now is the time to make a positive difference in your health! Begin by respecting your body as the most powerful resource for improved health. Next, commit to a renewed awareness of sitting in balanced positions, minimizing movement and optimizing the use of your auxiliaries for greater efficiency and comfort. Most importantly, seek to find the discipline to incorporate more efficient work habits into each day and make cardio-respiratory and muscular fitness a way of life. In doing so, you’ll be handsomely rewarded for many years to come! 

For more information how to work in a balanced position, optimize the layout of equipment and technology, maximize the use of chairside assistants, enhance time and motion efficiency, levels of productivity – and reduce musculoskeletal risks  click here to order All The Right Moves! By Risa Simon

Risa Simon, CMC is a professional speaker, published author and a certified management consultant who is passionately dedicated to helping dental professionals enhance team harmony, operational efficiency and practice profitability.  

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Dread Going to Work but Love to Work?
A McKenzie Management Case Study

Nancy Caudill
McKenzie Management
Senior Consultant
McKenzie Management

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This case study is an illustration of dental practice that may be similar to yours. The names have been change to protect the guilty!

Case Study #106

Wow…now this is an oxymoron, isn’t it?  But there are many of you in the field of dentistry that feel this way.  Ever wonder why?  Maybe these two examples will shed some light for you.

Dr. Jim Jarrett’s Story:

Dr. Jarrett contacted McKenzie Management for many of the same reasons that other dentist owners do:

  1. Increase profits
  2. Lower overhead
  3. Less stress
  4. More time off

His requests all appeared to be “within normal limits” until the investigation began!


  • Dr. Jarrett had just purchased his practice from the retiring dentist
  • The existing employees were retained
  • Dr. Jarrett was a non-confrontational, kind man who wanted everyone to “just get along”

The statement that uncovered the discovery was this:

“In the mornings on the drive to work, I always hope that the traffic lights will be red.  It keeps me from walking into my office for just a few more minutes!”

Dr. Anne Ferrell’s Story:

Dr. Anne Ferrell contacted McKenzie Management after reading remarks posted on DentalTown.  She felt it was time to take her practice “to the next level”.  This is also a common request from dentists, even though there is no clear understanding of what the next level is!


  • Dr. Ferrell had been practicing in the same location for 20 years
  • Her production had leveled off and hygiene production had diminished
  • Most of her staff had been with her for over 10 years

Her profound statement that uncovered her truth was:

“I am bored with my practice and dentistry.  I am not enthusiastic anymore.  I am not motivated to pursue challenging cases.  I feel stuck.”

The Discovery!...

Without boring you with the intricate details of these two practices, here is the good news!  Both of these dentists were able to enjoy going to work again and had a renewed interest in their patients and team members.  As a result, profitability increased, stress was reduced and they were happy humans again!

What was the common denominator?  An employee!

Don’t let yourself fall into this trap too, by allowing a staff member to make your life miserable to the point that you don’t want to go to work.  Chances are, they don’t want to be at work either, so you are both miserable.  Someone needs some relief and it should be YOU!  YOU are the employer and in order for you to provide the quality of dental care that you are capable of, you must be in a work environment where:

  1. The hygienist/s are excited about helping you to grow the practice.  They have the same vision that you do.  You actually like these people and enjoy working with them.
  2. Business employees are open to new ideas and a different way of performing their daily tasks to improve their aspect of the practice.  They are working for more than just a paycheck and are enthusiastic about their roles in the office.  You look forward to saying, “good morning” to them each day.
  3. Clinical Assistants that want to work hard so you don’t have to and enjoy the responsibility.  They know what you need before you know what you need!  They make your life easier in the office. You can’t imagine being as productive without them.

The most challenging aspect of owning your own business, whether you are a dentist, a baker or a candlestick maker, is working with the right people.  It is like marriage – the chemistry must be right and you know it if it isn’t.  The working relationship never worked from the first day but you thought things would miraculously get better, or; it was a good fit initially but you grew apart over the years and started driving each other crazy.  Either way, do yourself a favor and MAKE A CHANGE.  You will be glad you did and will wish you had done it a long time ago.

“Now, go do the right thing!”

For more information on how McKenzie’s Practice Enrichment Program can help you email

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