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4.07.06 Issue #213

Your Ideal Day in 15 Minutes or Less

Sally McKenzie, CEO
The McKenzie Company

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Ever feel like your days resemble some sort of Olympic downhill skiing event. You’re frantically dashing down the slope trying to beat the clock, maneuver your way around the obstacles – scheduling snafus, miscommunication, not enough time, emergencies, missed opportunities - constantly aware that one misstep will send the delicate balance of minutes and hours spinning wildly out of control. At the end of the day, you breathlessly cross the finish line having survived yet another run. 

Days in the dental practice often feel like the ultimate test of endurance. The dental team dashes from one patient to the next, one project to the next, one crisis to the next. With a labored sigh at the end of the day, the week, the month, the common refrain is heard, “We’re working as hard and as fast as we can. Why can’t we ever seem to get ahead?” Most likely it’s because you haven’t identified where you want to go. That requires you make sure everyone is on the same page – daily.

Take 15 minutes upfront when you and the team assemble to address potential problems before they have the opportunity to turn your perfect day into the perfect storm. Just a few minutes every day can go a long way in increasing your production. It can enable you to improve your patient retention. It can energize and enhance your team, and above all else, it can significantly reduce your stress.

Beginning on Monday, commit to take 15 minutes to make the most of every day. Schedule the meeting to start 15-20 minutes before the first patient arrives. Use that time to frame a highly successful and productive day and energize your team. Here’s how: 

  1. The Scheduling Coordinator distributes copies of the daily schedule and don’t forget the next two day’s schedules to every member of the team. Make personal notes regarding each patient, including births, deaths, marriages, patients they have referred, treatment plan, etc.
  2. Note the amount of scheduled production for the day. Identify patients with unused insurance benefits.
  3. Identify those patients that have outstanding balances/financial conditions that could affect treatment scheduled for that day.
  4. The doctor and clinical staff identify where in the schedule emergency patients should be placed.
  5. The Clinical Assistant evaluates the Doctor’s schedule to determine where potential traffic flow problems might occur and if additional assistance will be needed for specific procedures.
  6. The Hygienist reviews individual patient charts for periodontal therapy that should be discussed as well as any unscheduled treatment plans that can be reinforced with the patients.   
  7. The Doctor wraps up on a positive note emphasizing the contribution that each team member makes to ensuring that patients are given the highest level of care and consideration possible.

Daily business meetings are among the most cost effective practice improvement techniques you could implement. Use them to address kinks in systems, explore potential opportunities, and identify the best means to tackle day-to-day practice challenges. It will make for a much more enjoyable run on your particular slope.  

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

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Make Your Office a Practice of Authenticity

Dr. Nancy Haller
Executive Coach
McKenzie Management

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The program flyer sat on my desk. The words caught my eye.

“Give yourself the gift of time”.

A gift of time. Where do I sign up for that? I wanted to be first in line, especially as the daylight savings change was about to steal 60 precious minutes of my life.

A mindfulness retreat. Hmmm. Years ago I had participated in an eight-week Mindfulness Based Stress Reduction Program developed at the University of Massachusetts Medical Center and described in Jon Kabat-Zinn’s Full Catastrophe Living. It was invaluable, professionally and personally.

I thought it might be good to get a ‘tune-up’.

But it was a FULL DAY retreat. How could I possibly take a whole day to sit around and meditate? I had too many things to do. Among them, writing this article.

Thankfully I listened to my inner voice. Its volume reduced to a mere whisper by the noisy-ness of all the things I was doing. I had become so caught up in the rat race we call life; I had temporarily forgotten the practice of authenticity.

No, I don’t mean Enron-level lack of integrity. I’m talking about trueness to self. Living the life you want to live, not someday, but now. I had become so busy doing – with the intention of getting someplace else - I forgot to enjoy being.
This is not my feeble attempt at Zen mastery. It’s about authenticity and leadership. There’s a lot written about authentic leadership lately for good reason. Authenticity is not a nice-to-have; it's a leadership requirement as I realized during the retreat.

  • When the buzz of the alarm goes off in the morning and your eyes flutter open, do you start the mental list of everything you need to do that day?
  • Do you sometimes feel stressed, worried about how you will ever get it all done?
  • Have you noticed that even on the days when you get most things done, you still feel a lack of satisfaction?  

You’re not alone.

Seems to me that we are all here on the planet to serve a purpose. Life is the journey through which we explore and discover the meaning of our lives. You can say that you practice dentistry because it pays for the life you want to live. You can think of dentistry as a role you leave behind when you go home to your real life.

If so, you might find yourself going through the day on automatic pilot. Irritated by your staff or angry at an emergency patient who should have followed your treatment advice months ago. Fighting to gain a sense of control over your life only to fear that you’re losing the battle.

Authentic leadership is about listening…first and foremost to yourself.  It’s setting aside reflection time to be still, to hear the inner voice. Not the one screaming about everything you should be doing but the voice that wants to live a life of contribution, friendship and kindness. A life of being.

So start tomorrow and everyday thereafter with mindfulness. Pay attention to what you’re doing as often as you can. Be present in your work, in your home, in your life.

Before your feet hit the floor as you get out of bed, pause and identify your intention for the day…perhaps to be more patient with yourself and others. Or maybe to be more aware of the things you encounter during the day, to experience the day with wonder. To have more compassion for yourself, knowing you’re doing your best and that’s all any of us can do. 

Your reward? A sense of purpose, confidence and meaningfulness that only you can give yourself, and no one can take away from you. Better yet, the rewards get passed along with every interaction you have throughout the day. You’ll feel better, and you’ll have more loyal employees and patients. Give yourself the gift of time. The gift of now…each and every moment.

If you would like to be more fulfilled and authentic in your work, contact Dr. Haller at

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Selling Ancillary Products

Jean Gallienne RDH BS
Hygiene Consultant McKenzie Management

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Selling ancillary products is just one more way that a Hygienist can help increase their production. It is also another way for your practice to provide “knock your socks off” customer service. What exactly is an ancillary product when it comes to dentistry? It is a product that is sold in addition to the treatment or product initially sought. Some of the products that may be considered ancillary when it comes to a hygiene appointment would be fluoride, take home products, and bleaching. In today’s society, where our lives are just getting busier, one stop shopping is a very important attribute.

It is erroneously assumed that fluorides are only beneficial during childhood. Professional fluoride applications, although not routinely recommended for every adult patient, are appropriate for moderate and high-risk individuals.

What makes an adult at moderate risk when it comes to caries? According to the American Dental Association Council on Access, Prevention and International Relations any of the following would be qualifying factors:

  • One to two new, incipient, or recurrent carious lesions in the past three years
  • History of numerous or severe caries
  • Decreased salivary flow
  • Malformed enamel or dentin
  • Compromised oral hygiene
  • Frequent consumption of refined carbohydrates.

Then to be considered at high risk as an adult the only additions would be:

  • Active dental caries
  • Three or more carious lesions in the past three years, or two or more of the following:
    • History of numerous or severe cavities
    • Frequent consumption of refined carbohydrates
    • Inadequate fluoride exposure
    • Root surface exposed by gingival recession
    • Orthodontics

Caries risk assessment is difficult because it attempts to account for multiple factors. There are many different models that have been developed in order to assess risk. Those models that include the most factors predict risk most accurately. One thing you must remember when assessing a patient’s risk factor is that caries risk can vary over time, perhaps many times during a person’s lifetime. Therefore, the patient’s caries risk will need to be determined at every hygiene appointment.

According to the Center for Disease Control (CDC) if you are uncertain of what classification a person falls into, treating a patient, as high risk is best until proven otherwise. Now, keep in mind that the CDC recommends that people ages six to nineteen should receive professional topical fluoride applications twice per year regardless of risk.

So, when we really look at the patients in our practices, according to the CDC guidelines, the minimal treatment we should be providing is a professionally applied fluoride treatment on our patients that are at high risk. We should even be sending them home with a prescription strength rinse or toothpaste. Notice I said sending them home with a prescription strength rinse or toothpaste. Not writing a prescription or telling them to go get a specific product. The reason is they probably won’t go buy it. It is best that the ancillary products not be available to the patient in the store.

Another ancillary product is bleaching. Why not have the bleaching appointments scheduled in hygiene? The hygiene curriculum includes dental materials and we all learned how to do impressions in college.

 Some of you are thinking she must be nuts, I have not taken an impression in twenty or thirty years. Why would I want to start doing them now? Well, industry standards say that hygiene salaries should be no more than 33% of their adjusted production not including doctor’s exam fee. Usually, it’s not the salaries that are too high, but the production that is too low. This is one more way to help increase the hygiene production. Seeing how everything in dentistry is a team effort. I am sure the assistant or doctor would be thrilled to have the opportunity to teach you how to take an impression, pour up the models, fill out the necessary paperwork, and clean up after yourself.

There will need to be an office protocol established when it comes to how much time will be allotted in hygiene for this appointment. If your office does whitening check appointments, it will have to be determined where and who will do them.

Adult fluorides, take home fluoride products, and bleaching are just three ancillary products that can help to increase your hygiene department’s production.

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