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4.21.06 Issue #215

Scripts - Controlling The Outcome

Sally McKenzie, CEO
The McKenzie Company

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Doctor, I’d like you to spend a little time eavesdropping over the next week or so. Listen carefully to how members of your team handle day-to-day patient communication. Chances are pretty good that you’ll hear exchanges similar to the following: “Mrs. Jones, would you like to make a payment on your bill today?” “No, just bill me.” Or perhaps, this will be more common in your practice: “Mr. Collins would you like to schedule that crown appointment now?” “No, I’ll give you a call when I’m ready.” Or maybe the typical exchange will be more like this: “Hello Carol, this is Marlene from Dr. Thomas’s office. Will you be able to make your appointment Tuesday?” “No, I’m sorry, I have a conflict. I’ll let you know when my schedule frees up.” 

You may hear variations on all of the above, but one thing will be consistent – the negative impact each exchange has on the profitability of your practice.

No to collections. No to an appointment. No to recall. Now what? The dental team runs into resistance from patients every day, and often they have absolutely no idea what to say or how to handle the situation when a patient says “No.” In each scenario, the patient is controlling the outcome whether it’s your collections, your schedule, or your recall system, and the team member has relinquished that control without blinking an eye and often without realizing there’s a better way to handle it. Are you ready to retake control of your practice? If so, it’s time you and your team got on the same page, or more specifically, the same script. 

Scripts ensure that when it comes to day-to-day patient communication everyone is saying the same thing. For example, when new patients call the practice, a script helps the team ensure that no matter who takes the call they are prepared to gather necessary information. When it comes to collections, a script enables even those most reticent to request payment from patients to do so more effectively. The schedule has fewer gaping holes because team members understand how to consistently reinforce the value of each visit with the patient.

Patient retention is robust because team members understand how to effectively communicate with past due patients, with those who have unscheduled treatment, and with those who have failed appointments.  They know what to say, how to say it, and when to say it because they are prepared. They aren’t in a situation in which they have to think on their feet, but the communication is as natural and comfortable as it would be if they were chatting with the patient over coffee. 

The best scripts use words, phrases, and questions that prompt patients to respond the way you want them to respond. Those who are able to use scripts most effectively understand the message they need to convey. They know the information and material thoroughly and are able to adapt the scripts so they come across naturally. What’s more, those teams that use scripts to their full advantage practice, practice, practice and regularly engage in role playing.

Role playing is essential in helping staff with average communication skills raise their level of performance. In addition, it enables the team to determine how to best phrase questions and determine the most appropriate sequence for statements and questions. For example, you would carefully script where you place questions involving insurance or statements regarding the financial policy so as not to send unintended messages to patients.

What ’s more, role playing enables the team to pay close attention to their tone and how their words come across to others. Are they perceived as being warm and caring yet still assertive? Do they come across as timid and easily flustered or manipulated? Or might they come across as abrupt and cold. Listening to responses and coaching each other on how to improve those responses ensures that team members are well-prepared to handle routine patient communication as well as the occasional difficult exchange. Moreover, it enables the doctor to hear how staff would react in specific situations and to redirect that approach if it is inconsistent with practice protocol or policies.

Scripting and role playing empower the team to respond to patients cordially yet effectively and, most importantly, empower the doctor to monitor those day-to-day patient exchanges that have a direct and lasting impact on the success of the practice.

Scripts are now available for Scheduling, Collections and Patient Retention. Go Here.

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

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Are you a manager or a leader?

Dr. Nancy Haller
Executive Coach
McKenzie Management

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Although many people use the terms interchangeably, there really is a difference between managing and leading. Take a look at the chart below.



To do

To influence

To give direction

To show the way

To plan the details

To set the direction

To tell

To sell

To blame others

To take blame

To manage work

To lead others

To have subordinates

To have followers

To be reactive

To be proactive

To set objectives

To have vision

To stabilize

To promote change

To be cautious

To be confident

To focus on tasks

To focus on people

To control

To transform

The conventional wisdom in business is that managers need to keep a close eye on what their employees do. Managers monitor, supervise and control.

They need to make sure that things are being done right.

Leadership is the art of influence. Getting people to move together toward a common goal, sometimes so subtly that they are not aware that you are leading them. Strong leaders know that you can’t buy hearts, that formal authority does not yield follower loyalty and dedication.

So which are you – a manager or a leader? Only you can answer the question. And to do so requires honesty and objectivity.

I’ve been coaching dentists for several years and I’ve seen a common pattern. Frequently dentists find themselves in a leadership role because they have been good doers.

It’s unlikely that leadership was a part of your dental school curriculum. Most likely you studied hard, you completed tasks with proficiency, you learned how to do restorative procedures. Then you bought into a practice or you started one from scratch. And perhaps for the first time you had one or more employees. Voila – you’re a leader! But just because you are a good doer does not necessarily mean you are now a good leader.

Leadership requires different abilities, attitudes and skills. Understandably this is tough. It requires you to let go, to delegate, to give up power, to teach others to do. To be an effective leader requires four competencies.

  1. Know yourself.

You must have a keen awareness of what makes you tick and how you impact others. You may think you’re articulate but if your message isn’t being heard you’re not an effective communicator. You can say "They're wrong" and forget the issue. Or you can accept patients’ or staff’s perceptions as truths that count and take action to change your impact. Effective leaders know themselves and are confident enough to make adjustments in their own behavior. The key to knowing yourself is to embrace your strengths – the things you do easily and/or well – and to develop skills in the areas of leadership that need strengthening.

  1. Know your people.

You don’t need to be a psychologist, but you do need to observe human behavior - what makes your staff tick? What are their strengths? Weaknesses? What excites them?  Without such knowledge, you won't be able to inspire them with the right ideas, the right work, the right methods or techniques. Rather, you’re apt to lead by treating everyone the same. If you don't invest time in studying human behavior, the chances of your influencing others - in your practice or in your home - are pretty slim.

  1. Know your job.

There really are two sides to every job in a dental practice – the technical side and the people side. You need to be competent on both in order to have a successful business. Unfortunately while most dental offices spend enormous amounts of their budget on equipment and supplies (the technical side), less than 1 percent is devoted to training.  If you want to grow your practice, you need to invest in continuous learning on the people side, for yourself and your staff.

  1. Know the principles of leadership

To play the leadership game, you've got to know the rules. An understanding of leadership principles gives you insight, vision, and direction—even when you are bombarded with a multitude of demands. Read a book on leadership. Attend a seminar or workshop. Invest in your own leadership education. The knowledge you gain will make leading yourself and others easier. And your role as leader will become more productive and satisfying.

As you can tell, there are fundamental differences between the functions of leadership and the functions of management. To manage but not lead—or vice versa – will impede your effectiveness. Successful dentists need to do both.

If you want to move from being a manager to a leader, contact Dr. Haller at

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Last Minute Hygiene Openings

Jean Gallienne RDH BS
Hygiene Consultant McKenzie Management

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Successful retention of patients starts with educating them on how the recall system works. Whenever you have patients who do not perform in the manner you desire, for example, keeping their recall visits, the first place you should look to understand why this is happening is your recall protocol. This educational process begins immediately, and is the entire teams responsibility including the doctor.

When there is a cancellation in the hygiene or the doctor’s schedule, getting the time filled should become the top priority to the person in charge of scheduling. If the patient cancels last minute or no shows, and it is only a couple of minutes into the appointment, then it becomes the entire teams concern. The operator now has the time to seek out another patient. Since you had a morning meeting and have gone over which patients in the current schedule may be able to fill these appointments this will be a quick process.

There may be a patient in the doctor’s schedule that is going to be dismissed soon and is over due for hygiene, or if the doctor has a new patient in their chair that will be finished soon. If so, go over the financials for the hygiene portion only and ask the patient if they would be interested in starting their interceptive periodontal therapy program now. The financial portion for the restorative portion of the treatment plan may be gone over as soon as the Hygienist finishes. However, the Financial Coordinator will want to utilize good communication skills by informing the Hygienist that the patient still needs to have the restorative portion of their finances gone over, and to please make sure the patient returns to see them before leaving the office. This process can be moved in the opposite direction if…. there is a last minute cancel or no show in the doctor’s schedule, and there is an existing patient in the Hygienist’s chair that has treatment pending or… the doctor just diagnosed treatment during a periodic exam. Go over the financials for the restorative portion and move the patient into the doctor’s chair.

When communicating with the new or existing patient that time is available it is recommended that you not use the word, “cancel” or “No show”.  Remember you want to educate your patients from the first point of contact about office policy, and if you tell them you had a cancel or no show then you are teaching them that this behavior is accepted in your practice. A better approach would be to say: “Mr. Jones, We have an opening in our Hygienist’s schedule and we wanted to see if you would like to take advantage of this time to have your perio therapy started?”

Another place to check for patients to fill last minute cancellations is the reception room. Many times parents will bring their children with them or the children may have parents with them that are due for hygiene or even past due for hygiene and they are sitting out in the reception room.

What other resources are available to fill cancellations?   You have patients who cancel and don’t reschedule…you have patients who fail appointments or the patient who say’s “You know things are really busy right now and I’m going to have to call you back.” Tracking patients who cancel existing appointments are kept in your computer under a tickler file, or unscheduled appointment report.  Ideally, you should have no more than 0.5 openings per Hygienist per day in the appointment schedule. More than one opening per day on average is unacceptable.

Getting your patients to return for their periodic oral health examination is the most neglected system in dentistry. Devoting specific time to a recall system rarely occurs. Whose responsibility is the recall system? The time required to successfully operate this system can only be obtained by delegating the task to a person who is not involved in duties, which routinely contain interruptions as most front desk positions do. This very important system requires its own job description and title known as Patient Coordinator.

When consistent effort is applied in securing this “return business”, an increase in production and patient base will occur. Remember it is 5 times more expensive to obtain a new patient than it is to keep your current patients.

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