Issue # 228 - 07.21.06

Is Your Practice Thriving or Threatened?
Check the Telltale Signs
by Sally McKenzie CEO
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Are you resting comfortably knowing that your practice is thriving? Or do you suspect that your practice may be threatened?  Most importantly, do you know how to tell the difference?

It’s an interesting irony, the telltale signs of a troubled practice often go unnoticed because dentists interpret them to be indictors of a healthy, thriving practice. For example, the office is so busy you feel like you could add a second shift, or a third for that matter. New hygiene patients are scheduled out six months or more. Existing patients had better not cancel because who knows when they’ll get another spot.  The doctor’s services are so much in demand that even routine procedures can’t be booked for a good four weeks.

The focus is squarely on reacting to the demands of today, and doctor and team can’t begin to think about taking time out to plan for the future or evaluate what’s really happening with the systems. The staff is strained; conflict is taking its toll. The way everyone sees it the team just can’t keep up, and you’re thinking it may be time to hire more help. The only problem, even though you seem to be busy as ever, you have yet to experience the financial payoff. 

Sound familiar? If so, it’s likely your practice is in the throes of uncontrolled growth, and you and your team are struggling under the weight of this so-called “success.” Making matters worse, the too busy practice is a threatened practice because typically in spite of all the activity, it’s cash-strapped. Even though everyone is frantically racing from one patient to the next day after day, production is, well, pathetic. How can this be? It’s not that difficult to determine, but first you have to step off this wild ride long enough to look at what’s going on around you rather than just what’s coming straight at you.

Check the primary indicators first:
The schedule - In addition to making patients wait weeks for even the most routine treatment, there is little if any consistency in the time booked for procedures – 30, 60, 90, minutes. The chief objective is merely to keep the schedule full; consequently, the scheduling coordinator is sticking patients anywhere and everywhere. There’s no time to catch your breath. Lunch hour?  Ha! You must be kidding. Everyone just grabs something when he or she can. But you keep telling yourself this is good. It’s organized chaos and it will pay off…eventually… or not. 

The patients - Patient retention is weak, but you probably haven’t taken the time to assess it. You just figure all those patients behind all those patient records keep coming back. In reality, yours is probably a revolving door practice.

The money - Last and certainly not least, but definitely worst of all, revenues are flat. You might have suspected this having felt the pinch now and again. But you kept convincing yourself that the big bucks would be in the bank in a matter of weeks. It’s not happening.

So how do you transition from threatened to thriving? First, the vision. Without a clear vision of where you want to be and how you want to get there, you and your team are constantly in a reactionary state, responding to the many external pressures that are driving your practice. In identifying your vision you retake control of your practice.

What would define your successful practice – money, time, technology, early retirement, continuing education for you and the team, all of the above and more? Now what will it take to achieve your definition of success. How much does the practice need to produce to meet your financial goals?  How many hours per day and days per week do you want to work? How much vacation time do you want to take? How much will go to overhead costs? What about bonuses, retirement, continuing education etc.?

Next week, taking your practice from threatened to thriving begins with looking closely at two key areas you’re probably taking for granted.

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

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Who is Steering Your Ship?
A McKenzie Management Case Study

Nancy Caudill
Senior Consultant
McKenzie Management
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Dr. James Laramy’s Story:

Dr. Laramy had invited me to work with his practice to help him establish business systems in order to hold his business staff accountable.  We were talking over dinner on the first evening of my 4-day visit to his office.

“I have hired a really bright woman to take the most important position at my front desk!” he proudly announced.

“Excellent” I responded.  “And what position is that?”

“Managing the collections and billing, of course.” he answeredAt this point he is glaring at me as if to ask….”You don’t know that?  What planet are you from?”

Office Facts:

  1. 18-year old practice
  2. Turnover in the business area during the past few years
  3. 2 positions – “billing person” and the “receptionist”
  4. No job descriptions for either position

The next morning I arrive at the “scene of the crime” and meet the staff.  As usual, everyone is on their best behavior, including the doctor.  I always find it fascinating to hear the staff tell me at lunch (without the doctor) that they wish that I were always in the office because the doctor is so nice today!

Anyway, as I sit in the business area to start my analysis I am observing the activities of these two wonderful employees.  This is what I see:

The “billing person” is obviously extroverted and very comfortable communicating with me – a stranger.  She is smiling a lot and I immediately like her.

The “receptionist” is reserved but very efficient.  She knows the patients by name when they arrive and manages the telephones very professionally but somewhat “robotic”.

Now – before any of my readers take issues with what I just said, allow me to present you with some concepts to consider:

  • Dentistry is no different than any other place of business.  We sell a product and service!  Oh my gosh…I said it….the “S” word!  The products that we sell are fillings, crowns, root canals, whitening, and so on.  Patients do have a choice NOT to purchase our products.  They can purchase these same products in another dental “store”.
  • Who “sells” your services?  You may say that you do, your well-trained chairside assistant, your highly experienced hygienist or your “financial coordinator.”
  • Who answers your telephone?  Is everyone cross-trained to “grab the phone” to keep it from ringing?

There is a saying that goes something like this: 

Nothing Happens Until Something is Sold!

Think about this for a moment.  According to Dr. Laramy, the most important position in his office is his “billing person”.  She is the one that sends statements, posts the checks that come in the mail, calls insurance companies about the claims that are unpaid, yada yada yada.  I propose to you that she doesn’t have a job until something is sold!

Do you realize that when you arrive at work every morning, you work according to whatever is on your schedule.  You didn’t create that schedule – your hygienist didn’t create her schedule.  The person(s) at the front desk created your schedule and directly influenced the amount of money that you made that day.  You dance to her tune!

Guess what?  The person scheduling the appointments for your patients can’t schedule appointments until you have a patient to schedule!!!  Isn’t that a concept?


The #1 most important employee in your office is the person that answers your telephone!  You can call her a “receptionist”, a “schedule coordinator” or “the front desk person”.  The title is not important.  What IS important is for you to understand this:

The team member that answers your phone must be capable of projecting her smile and warmth over the telephone to the potential “buyer”.  She literally invites them into your “store” to buy your products by her mannerisms on the telephone.  The caller wants to visit your store.  They have already bought what she is selling before they even make an appointment. 

This person is directly responsible for each and every new patient that walks into your practice.

So I ask you now…

  • Who drives your car?
  • Who pays your bills?
  • Who steers your ship?
  • Who controls your purse strings?

NOTHING happens until something is sold…and the person in your office that is responsible for answering your telephone…your “receptionist” is in the #1 most important position in your office.  Do you have the right person controlling your financial future?

If you would like more information on how McKenzie’s Practice Enrichment Programs can help steer your ship in the right direction….. email

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Think Before Starting Up Your New Dental Practice

Belle M. DuCharme
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New dental imagery software, new computers, new monitors, new cabinetry, new digital x-ray machines, new office location, old management concepts???  Whoa, wait a minute!!

Over the years I have observed many start-up practices.  It is common for new dentists to begin their career in an existing practice as an associate prior to purchasing their own office. This practice is a “learning laboratory” for new dentists.  What they learn there may determine whether the new dentist remains an associate, establishes a mediocre practice or creates a successful rewarding practice. Having the established dentist as a mentor can be a positive experience but as I have heard frequently, “I don’t want a practice like the one I have worked in for the last five years.” Often, the management systems in place are outdated and inefficient for today’s sophisticated market place.  Unfortunately, this is what the new dentist has learned and now has to “unlearn” in order to get off to a “good start”.

Recently, I visited a dentist who had started up his new practice two years ago.  He had worked in a managed care practice for ten years.  His new practice is 90% PPO Network.  He doesn’t do any internal or external marketing and does not know how to attract fee for service patients. He would love to do more dentistry but not in a PPO environment where reimbursement keeps him at break even each month. His training as a managed care dentist has taught him to diagnose very conservatively.  I introduced the idea of treatment phasing instead of “watching” or ignoring dental situations that would need treatment in the future.  The patient that has come to the practice because you are listed as a Preferred Provider needs to be groomed as a fee for service patient.  When the employer changes plans and you are not on the plan the patient has a choice to stay with you or move on to another practice.  The way you have marketed this patient will make or break that decision.  While treating the PPO network patients you must begin a marketing strategy geared to attract and keep fee for service patients.  

People in the business of dentistry who have the successful practices have learned by trial and error and spent countless days attending seminars and courses on practice management and staff motivation.  Their advice to the new dentist may suit their own practice but may be entirely wrong for the new dentist.

  • Much depends on the type of practice you want and how you are going to develop it, your personality, your location and your budget as basics.  At McKenzie Management we have developed the Dentist Start-up Program to address all issues involved in getting your new practice up and going.  It is not a “cookie cutter” program with general information, as you would find in a seminar.  Instead, it is a custom program designed to answer the questions relating to your new practice only.  The Community Overview report looks at the Demographics and the Psychographics of your neighborhood.  The Fee Analysis report studies the fee schedules of dentists in your new neighborhood and gives you suggestions as to how to set your fees.  We analyze how much you need to produce and collect to meet your overhead demands. 

Staffing, the most challenging issue facing today’s dentist is divided into segments to guide you to:

  • Recruit staff members
  • Develop job descriptions and areas of accountability
  • Choose the right personalities for the job
  • What salaries and benefits to offer
  • Develop Office Policies to set standards for staff management
  • Coordinate and facilitate successful staff meetings

By thinking before you start-up and getting customized information will save years of trial and error and give you the tools to succeed where others have failed to thrive.

Dental software programs are constantly being improved to manage more data and produce reports rivaling expensive accounting firms, however most dentists use only about 20 to 30% of their programs due to lack of understanding of the software.  Showing the new dentist how to use these reports and what reports will be necessary to run a progressive and profitable practice is a must in a technologically fast paced society.

Remember: don’t adopt the management systems of your “mentor” dentist friend or partner without fully understanding the dynamics of your practice.  Put the right building blocks together with McKenzie Managements Dentist Start-up Program and reward yourself with the tools to succeed.

For more information on McKenzie’s Start-Up Program email

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