10.27.06 - Issue # 242 Forward This Newsletter To A Colleague
Rate of Hourly Production
Recruiting Employees
Patient Demographic

Turn Chaos into Cash
by Sally McKenzie CEO
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Are your patients getting lost in the commotion of your practice? The constant whir, the frantic pace, the perpetual crisis, the culture of conflict.  All of these affect not only doctor and team but also the patients. In fact, in today’s non-stop busy world, patients visiting a practice that is constantly running at the pace of panic are less likely to keep their appointments. They are less open to pursuing recommended treatment and they are more likely to find another practice.

In fact, depending on the level of perceived stress in the practice, some patients may actually feel that they are in the way; they are a bother. They are hesitant to ask questions or to raise concerns because there is already so much perceived stress they don’t want to add to it. They hear the phones ringing. They see the patients lined up in the waiting area. They note the tension in the voices of the team members. They can feel the pressure, and this is not where they want to spend a lot of time or money, for that matter.

And if that’s how the patients view the practice environment on their periodic visits, how is it for those working there day-after-day? Do you feel you are in a race to beat the clock from the moment you slip into that white lab coat until you pat the last patient on the back and tell them, “Everything looks good. See you in six months.” But just exactly how do you impose order on the chaos swirling in your office?

Shift your focus from reactive to proactive. Beginning with practice goals that you identify and share with the entire team, better yet, involve them in the process of establishing attainable objectives for both the practice and themselves. When each person can equate what they do on a daily basis to the practice’s ability to achieve specific objectives, they are motivated to achieve their individual goals.

Next, the fundamental step in turning chaos into cash and goals into reality, manage the schedule. As every dentist knows all too well, the schedule can be the foundation of an excellent day or the ultimate source of frustration and stress that will have you racing one hour and crawling the next. A productive, manageable schedule is possible when the Scheduling Coordinator understands the concept of scheduling to achieve specific daily production goals. It is then that the distinction between keeping the doctor productive and keeping the doctor busy becomes clear.

For example, perhaps one of the doctor’s goals is to produce $1,000,000 annually.  Taking 33% out for hygiene leaves doctor with $670K. This calculates to about $13,958 per week (taking four weeks out for vacation). Working 32 hours per week, means the doctor will need to produce about $436 per hour.

A crown charged out at $950, which takes two appointments for a total of two hours, (hopefully yours is less time) exceeds the per hour production goal by $39. This excess could be applied to any shortfall caused by smaller ticket procedures. Unfortunately, you are probably not doing crowns every hour on the hour.

The formula below will help you determine the rate of hourly production and whether your practice is meeting production objectives.

  1. The assistant logs the amount of time it takes to perform specific procedures. If the procedure takes the doctor three appointments, she/he should record the time needed for all three appointments.
  1. Record the total fee for the procedure.
  1. Determine the procedure value per hourly goal. Take the cost of the procedure, for example $215; divide it by the total time to perform the procedure 50 minutes. Production per minute value - $4.30. Multiply that by 60 minutes - $258/hour.
  1. The amount must equal or exceed the identified goal.

When the team is focused on achieving specific production goals and practice objectives, the entire atmosphere of the office shifts from pressured to productive. Subsequently, doctor and staff are able to focus on diagnosing and delivering the best dentistry for patients.

Next week, steer clear of the top three scheduling mistakes.

Interested in speaking to Sally about your practice concerns? Email her at sallymck@mckenziemgmt.com.

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Nancy Caudill
Senior Consultant
McKenzie Management
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One Good Employee At The End Of The Rainbow
A McKenzie Management Case Study

Dr. Frank Peters  Case Study #99

Finding good staff is difficult and, at the same time, essential for the practice to run smoothly.

Dr. Peters lost his Business Coordinator when she elected to return to school.  He has a small staff with only two assistants and himself.

To make matters worse, one of his dental assistants failed to show up for work ONE more time in a run of many times so he dismissed her.  Rightfully so!  So now he is short two employees!  As a dentist, don’t you just wish that you could work alone and not have the headaches of employees? Hopefully, the good news is “it’s just once in a while” we have a headache!

Considerations at this point:

  • Where does he go to get a good employee?
  • What does he look for on the resume?
  • How much does he pay for this employee?

Where to get a good employee?  My first recommendation was for him to read “How To Hire The Best Dental Employee”.   This book contains all the necessary elements for recruiting new employees.  Here are some suggestions:

  • Friends of existing employees – if you like your employee you will probably like their friends.  “Birds of a feather flock together”.
  • Ask your dental supply representatives – they are a wealth of information and know everything that is going on in every office that they service.  Tell them you are looking for a staff person.
  • Place a notice in your local church bulletin, if an option.
  • Run an ad in a local community paper – on Craig’s List – on Monster.com – on Dentalworkers.com – on DentalTown.com.  The headline of your ad should give a YEARLY salary range – it looks better than $10/hr!  Tell them what YOU have to offer, not what you expect from them.
  • Check with your local dental assisting/hygiene school.  They can post your ad on their bulletin board.
  • Check with your local county dental association or auxiliary association.  Often they will run a list of dentists looking for positions as a courtesy to their members.

What does he look for on the resume?

  • Longevity at the previous places of employment.  You do not want a “job hopper” looking for an additional nickel an hour increase.
  • Is there a cover page expressing why the applicant feels they are a good candidate for the position?  Or did they simply mass e-mail their resume to everyone running an ad?
  • Misspelled words in the resume!  There is absolutely no excuse for this with “spell check”!  This shows a lack of detail on the part of the applicant.
  • Employment reference list. Call their previous employers. Don’t accept “references on request”.
  • Is the resume handwritten or typed?  Please – this is the 21st century.

How much does he pay for this employee?

He has to mathematically determine how much of a salary his practice can afford while keeping his total salary overhead in line with the industry of 19-22%.   Instead of making an emotional decision, he needs to make an informed decision of how much the practice has to collect in order to be able to pay a new employee.  We recommend McKenzie’s Employee Salary Review form.


  • Start your new employee out at a rate lower than what you anticipate their final salary to be until they prove themselves.  By monitoring the office statistics as mentioned in previous articles, you can “see” how well they are performing their duties.  Explain to them in detail what you expect from them and how you are going to track their success.  Review the “job description” with them so they know what you expect.
  • Always hire with the understanding that the first 90 days are on a “trial basis” only.  They are free to leave at any time and you are free to let them leave at any time.  This makes it easier for you IF you need to dismiss them due to poor performance.
  • Pay a new candidate to come into the office for a “working interview”. See how they perform and interact with the existing staff.  Let your staff take them to lunch.  Your staff can learn more than you can in one lunch period.
  • Most importantly….cut your losses early!  It is just like a bad relationship…it doesn’t get better.  You are seeing them at their BEST.  Imagine how bad it will get later on.  Listen to your instincts and don’t try to analytically think of reasons to keep them because you can.

The good news is that after many months of working short-handed, Dr. Peters held out until he found the right person.  It has made a tremendous difference in the atmosphere of the office.  He found a team player that doesn’t whine and works hard.  The patients love her and she enjoys her job.  Maybe there really is a pot of gold at the end of the rainbow….we just don’t wait long enough for the rain to stop!

If you would like more information on how McKenzie's Practice Enrichment Programs can help you IMPLEMENT proven strategies….. email info@mckenziemgmt.com.

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Scott McDonald
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Are All Patients Equal?
By Scott McDonald

If we ask this question from the political or human rights point of view, the answer is a resounding, “YES!” Indeed, every patient deserves to be treated with respect, professional courtesy, and clinical excellence.  But from a more pragmatic perspective, not all POTENTIAL patients have the same value to a practice.

While it goes unsaid, some patients cost the practice much more to treat than others. These people may be a problem in collections. We have to run them down, follow-up with emotional phone calls, and even legal claims. Others may be emotionally abusive, causing stress and time to be wasted by doctor and staff. Therefore, we can easily see how some patients may cost us more to treat. But what about POTENTIAL patients?

What if you knew there was a patient out there who was easy to treat, grateful for your service, willing to pay, and anxious to refer their friends and neighbors?  Well, of course we would want them in our practices!  Ironically, we often and unknowingly send out signals that we don’t want THIS kind of patient. The message goes out through our staffs, our advertisements, and out of our own actions. We call it, “Fighting for the Bottom”.

Our most successful strategies for attracting the wrong patient:

  1. Discount indiscriminately
  2. Avoid asking for referrals
  3. Target renters versus home-owners
  4. Favor the young and beautiful
  5. Eliminate rewards of any kind

As a demographic research company, we help dentists learn more about their locations and how to promote practices. So what do we know about patients?  We don’t know dentistry but we do understand internal and external marketing.

Discount Indiscriminately
There are households where people wait for the mail to arrive with scissors in hand waiting for the discounts. These bargain hunters have no loyalty to their grocery store, dry cleaner, or dentist. As long as there is an offer, they will take it. If we consider that less than 1% of recipients of the average dental mailer respond, you can be sure that the majority of the respondents will be shoppers IF the primary motivation is a discount.

Should discounts NEVER be used? Of course not! But we know far too many dentists who use them indiscriminately.

Avoid Asking for Referrals
Not only are referrals the most effective way of getting new patients, it is the most effective way to get GOOD patients. Ironically, some dentists and their staffs get the idea that if they don’t have to TALK to people throughout the course of treatment, it was a good day. The opposite is true.

Most people don’t know you WANT them to refer unless you ask. Don’t let a sign ask for you. Don’t depend upon a form, letter, or e-mail. Ask for referrals yourself. Referred patients are better referrers themselves, have a better “pay” rate, and tend to appreciate your treatment much more. Those that don’t come through referral TEND to be more difficult to motivate and more difficult to collect.

Target Renters versus Home Owners
The dirty little secret about New Resident Mailing Lists is that they are going to have four times as many renters as owners. The reason is simple. Renters move more often than owners. This is not to say that people who rent are inherently flakey. Rather, they TEND to have poorer credit worthiness and to be less permanent. That is why all mailings, whether focusing upon new residents or not, should depend mostly upon single-family homes (SFDUs) that are owner-occupied rather than renters. True, the list may cost more but the return on the investment will be superior.

Favor the Young and the Beautiful
Everyone would rather look at pretty people who are young and healthy. However, if you stop to think about it, these are not your best patients. Because they are young, they may have little dental need and may also lack money. So, who REALLY needs dental care and can afford it?  Well, they look a little more like you and me.  So why do we feature “perfect people” in our ads?  There is a thin line between creating an atmosphere in which these models stop becoming aspiration figures and start becoming unattainable perfection.

Suggestion: When using models in your advertisements, consider differing ages, genders, races, and “types” of models. Glamour can be good but it can also put people off who are nervous about being judged.

Eliminate Rewards of Any Kind
We know that this can sound petty but it is true. Some of your best patients seek care from YOU because they get something back. Most often it is a personal recognition of some kind. It is remembering the name of their dog or cat. It is mentioning their husband’s or their wife’s hobby. It is talking about their kids for a moment. These are little perks that seem to be fading in many dental practices and may seem to be inefficient. They can even make you a little late for the next patient. Although, when eliminating the little personal “rewards” of coming in to your practice, you run the risk of attracting ONLY those patients who don’t care about investing in a relationship with you.

While our Country accepts the premise that “all men are created equal”, we have to confess that all dental patients are not created equal. In order to attract the best patients, we must do those things that they will notice. At the same time, we must be selective on  who we choose and concentrate our time and our efforts on those patients.

Scott McDonald is the largest provider of dental marketing research to dental practices.  For more information demographics@mckenziemgmt.com.

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A Division of The McKenzie Company, Inc.
3252 Holiday Court, Suite 110
La Jolla, CA 92037
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