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6.9.06 Issue #222

Burned by a Bad Hire? Strategies to Steer Clear

Sally McKenzie, CEO
The McKenzie Company

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No matter how superior your clinical skills, how technologically advanced your practice, how stress-free your schedule, it only takes one bad employee to undermine it all.  That’s a frightening reality particularly when you consider that about every 18 months most dentists are staring at yet another “two weeks notice.” And as virtually every dentist has come to realize, a seemingly rock-solid resume and practical skills offer no assurance that the person you hire will prove to be the excellent candidate you interview.

Worse yet, bad hires are a big drain on practice finances. Estimates range between 1.5 to 5 times their annual salary, and that doesn’t begin to measure the cost of strained patient relations and crumbling staff morale.

While there’s little question that the hiring process causes dental teams, particularly doctors, stress and consternation, it’s not all doom, gloom, and woe. Hiring or replacing an employee offers an excellent opportunity. It’s an ideal time to fine tune and, if necessary, overhaul systems. Charge into this occasion for change as you would a comprehensive treatment plan – with a deliberate strategy and a total commitment to achieving the best possible outcome.

First, look for quality candidates even when you’re not hiring. If you experience exceptional service, whether you’re at the gym, a restaurant, or other business, give the person delivering that service your business card and invite them to send a resume, which you will keep on file. Create a “Join Our Team” section on your website that tells prospective employees about what sets your practice apart and enables them to submit resumes for future consideration.

Network. Connect with friends, colleagues, patients, local dental societies, vendors, and others whose opinion you respect and ask them for employee referrals. Contact area business schools, hygiene programs, and assisting programs and ask faculty to refer those candidates that would best represent their programs.

Update or write a job description for the position and tailor it to attract the employee you need. This is a simple yet critical tool in the hiring process. It clarifies what skills the applicant must possess, explains what duties they will perform, and it assures that you will have a clear objective when considering each candidate’s credentials. If you know exactly what you are looking for, you will be much less likely to just settle for the first living, breathing being to walk through the door.

Sell the position through effective ads. Focus on the potential applicant’s wants; tell the reader what’s in it for them. In writing the ad, remember: money motivates. Use salary to get the reader’s attention. Your headline should give the position title and the salary range, “Administrative Assistant $20,000-$25,000.”

Think about what your ideal candidates are looking for and use wording that will appeal to your “audience.” Dental auxiliaries, for example, typically have five primary objectives when searching for a position: 1) Salary, 2) Benefits, 3) Location,  4) Hours, 5) Status of the position. Highlight all of those in your advertising. Clinical Assistants are looking for more responsibility than just passing instruments. Hygienists are likely to be attracted to treatments and advanced equipment advertised such as, “Become our interceptive periodontal therapist. Voice activated perio charting and intraoral camera.”

Keep the text of the ad simple, but answer the reader’s questions – position title, job scope, duties, responsibilities, benefits, application procedures, financial incentives, and location. Use active verbs and clear descriptions, for example, “Self starter with organizational and communication skills to manage patient and business activities in a progressive eastside dental practice. No prior dental experience required. Professional training provided. 36-hour week. Excellent benefit package. Fax confidential resume to 341-8458 or email to”

Offer the option of faxing, mailing, or emailing a resume and calling to inquire further about the position. The phone number enables the applicant to ensure they aren’t applying to their current employer. Direct prospects to your website to learn more about your practice and the position.

Next week, finding the best applicant from all those resumes.

Interested in speaking to Sally about your practice concerns? Email her at

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Grrrrrowing or Groooaning?
A McKenzie Management Case Study

Nancy Caudill
Senior Consultant
McKenzie Management

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This case study is an illustration of a family dental practice maybe similar to yours. The names have been change to protect the guilty!

Dr. Steve Martin’s Story:

The phone call went like this:
“My production has leveled off and the practice just doesn’t seem to be growing.  Obviously, something is wrong but I just don’t know what it is!  Can you help me?”

If “misery loves company” is true, many dentists out there have lots of company.  This scenario is heard at our office daily – lack of growth.  I would like to propose that it isn’t a matter of stunted growth but rather a matter of patient retention.

What is your definition of practice growth?

  • Increasing the number of New Patients
  • Increasing production or collections
  • Increasing the number of days you are working or the hours you work

How about this definition:  “Practice growth is when you are adding more hygiene days in order to serve your patient base.” what does this mean to you?  Let’s look at this from a purely statistical aspect.

Office Facts:

  • 20-year old practice
  • Dr. Martin works 4 days a week
  • 1 hygienist working 3 days a week
  • 20 Comprehensive Exam New Patients per month average

Grab your calculator and let’s do some simple math.  Let’s assume the following:

20 pts/month x 12 months x 20 years = 4,800 patients
Each of the 4,800 patients are seen 2x/yr = 9,600 appts
His hygienist sees 9 patients/day x 3 days/wk x 48 wks/yr = 1,296 appts per year at 2 visits per year = 648 patients
This means that 4,152 patients are NOT being seen!!!

OK…now you see that in a 20-year old practice, it is impossible for 1 hygienist working 3 days a week to see the entire patient base of 4,800 patients.  Who is seeing the other 4,152 patients?…another hygienist in another dental office…NOT Dr. Martin!  His practice has lost 4,152 patients over the past 20 years and is currently only maintaining an active patient base of about 600 patients or less.

In other words, Dr. Martin’s practice stopped growing after the first two years and simply has been exchanging the 240 new patients/yr with the previous 240 patients, keeping some and losing some.

“So what?”, you say.  I only want 3 days of hygiene.”  50% of your production comes from your new patients and 50% comes from treatment diagnosed during the hygiene exam.  Imagine how much more productive Dr. Martin would be if he looked in 4800 mouths instead of 600.  I would also venture to say that he would need an associate or partner to share the success with as well.

And what about the increased production from the hygiene department?  Let’s make up a number and say that the average hygiene appointment (not including periodontal therapy) is $130 x 9,600 appointments = $1,248,000! I know…reality sets in.  No office can keep 100% of their patients and I understand that but this was just for illustrative purposes.  However, with a strong recall system, Dr. Martin and you can retain 80-90% of your hygiene patients.


Stop spending thousands of dollars a year in mining for new patients and start buying fertilizer!  GRRROW your business with the patients that are currently in your practice by  having your systems analyzed and improving your patient retention. 

If you would like more information on how McKenzie’s Practice Enrichment Programs can help you….. email

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Is Your Hygiene Department Producing At Industry Standards?

Jean Gallienne RDH BS
Hygiene Consultant McKenzie Management

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Most doctors have a yearly, monthly and daily production goal. As a Hygienist do you know your yearly, monthly, and daily production goals? Do you know how these goals are set? Do you know what your raises are based on? Doctors, have you determined what your Hygienists goals are? Have you made your Hygienists aware of these goals and how you determined what they should be?

Every well-run business sets goals. Dental practices should do the same. These goals help to establish proper fees, salaries, budget, and capital expenditures. Hygiene salaries should be no more than 33% of their adjusted production not including the doctor’s exam fee. 

Many of you are already working and have an established income level set and are thinking, “Well, I am not taking a cut in pay.” Well, you do not have to.  Most the time it is not the compensation that is too high, but that the production is to low. Let us take a look at how we may determine what the daily production for an individual Hygienist may be based on the following example.

  1. Hygienist is paid $40,000.00 a year.
  2. The Hygienist’s benefits and related expenses include
    1. Holiday pay
    2. Vacation pay
    3. Medical
    4. Payroll taxes
    5. Employer pension contribution, etc.
  3. These benefits can or cannot be added to the salaries for a total compensation. This is at the discretion of the doctor.
  4. If the practice pays $3000.00 a year for the above benefits that is added to their gross salary for a total compensation of $43000.00 for the year.
  5. The Hygienist production for that same year is $100000.00
  6. Hours worked per week are 32 for 48 weeks a year

The Hygienist’s daily pay ends up being $223.96 for an eight-hour day. Unfortunately the current Hygienist is being paid 43% of what she produces, when the industry standard is 33% or less. Therefore, if you take the daily pay and divide it by the industry standard you will come up with how much the Hygienist should be producing per day in order to have the compensation be at 33%. This particular Hygienist will need to produce $678.66 a day or no less than $84.83 an hour.

Now, we have goals… but how is the Hygienist going to track these goals on a daily basis? One way is to have a daily monitor that she keeps in the operatory while working.  The Hygienist will mark what procedures were done for each individual patient, how many hours were worked that day, how many cancellations, no shows, and open units. At the end of the day, add the total amount up based on actual fee schedules and divide by the hours worked. This will tell the Hygienist what was produced hourly. Is this meeting the daily goal? If not, what do you do to increase the production in the hygiene department?

One place to look is the interceptive periodontal therapy program. Is 33% of the hygiene production coming from periodontal procedures and ancillary products? An ancillary product does not include x-rays.
 Is the recall system being implemented in your office successful? Are you pre-appointing? Do you have more than 0.5 appointments open per day per Hygienist? As a Hygienist, if you are paid a guaranteed hourly rate and there is one hour of open time, not only does the office lose the hourly production that could have been produced, but the office also loses the income that you were paid during that hour. Do you have an x-ray protocol that is providing the quality of care you want for your patients?

These are the systems that tend to break down in the hygiene department. Having any of these systems not functioning at 100% can make a difference of a hygiene department that is profitable and one that is creating a loss for that office.

Our goals with the Advanced Hygiene Performance Enrichment Program are to help prevent open time, no shows, or cancellations from occurring in the first place and to have the hygiene department meet or exceed the industry standards.
So, if you have determined that your hygiene department is not producing enough…what are you waiting for? Consider having me come in to your practice. I can help prevent further breakdown with your hygiene department.

For more informarion on how to turn your hygiene department around email

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  June 8-9 Santa Barbara, CA - The Art of Endodontics Sally McKenzie  
  July 20 Del Mar, CA - Ortho Symposium * Sally McKenzie  
  July 26 San Diego, CA - San Diego Womens Dental Society Nancy Haller  
  Aug. 2-6 Denver, CO - Academy of General Dentistry * Sally McKenzie  
  Aug 10-11 Santa Barbara, CA - The Art of Endodontics Sally McKenzie  
  Sept. 15-17 San Francisco, CA - California Dental Association * Sally McKenzie  
  Sept. 21-22 Santa Barbara, CA - The Art of Endodontics Sally McKenzie  
  Sept. 29-30 Oviedo, Spain - Clinica Sicilia Sally McKenzie  
  Oct. 7-8 Krakow, Poland - UNO Dental Sally McKenzie  
  Nov. 8 San Diego, CA - San Diego Womens Dental Society Sally McKenzie  
  Nov. 17 Concord, NH - New Hampshire Dental Society Sally McKenzie  
  Dec. 7-8 Santa Barbara, CA - The Art of Endodontics Sally McKenzie  
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