11.10.06 - Issue # 244 Forward This Newsletter To A Colleague
Intraoral Camera Scripting
Job Descriptions
Team Building

Intraoral Camera…
The Positive Take For Patients
by Sally McKenzie CEO
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Dear Sally,

Recently, my office added state of the art intraoral camera technology with monitors in each operatory. We can now see things magnified that we couldn't see before, and so can the patient. The downside is we have also started hearing patients say they "feel bad" about what they are seeing. For example, fractures that were not visible at their recall appointment six months ago are now glaring at them on the screen. In our enthusiasm to apply this new technology, we have unwittingly caused patients to feel defeated. That is not what we want to do at all. We want to motivate, not discourage patients. Can you help?

Dr. Fred

Dear Dr. Fred,
Thank you for your question. Yes, sometimes the view from the intraoral camera can be a bit more “reality TV” than patients are ready for. But as you and I both know, the benefits to the patient and the practice are enormous. Although the patient may not like the looks of what is “glaring” at them on the screen, it is the condition of their mouth.

And it is in seeing the fractures and the true state of their oral health that gives the patient the knowledge and the power to make educated oral health decisions – decisions they may not have been open to before now.

Consider the oncologist who must show the patient the results of a bone scan that reveals areas of cancer. The patient doesn’t want to know this information. They do not want to see the areas where cancer appears to be, but now they are empowered to discuss the best means of treatment. In your patients’ situations, they are looking at opportunities to ensure the long-term health of their mouths.

I recommend a bit more front-end education. Below is a suggested script that you can modify and tailor for your practice and your team. The key is to help patients understand what they are going to see before you place the camera in their mouth as well as how this information will benefit them…

Doctor: The intraoral camera is sort of like your opportunity to be the dentist. You get to see essentially what I see with my magnification glasses. If a tooth is causing you problems, you may be able to actually see what is causing the trouble, rather than just relying on my explanation. It helps you understand why I am making the recommendations that I am. In effect, we’re both examining, asking questions, and diagnosing what we see.

Also, the intraoral camera is like a lens into the future. Because our oral health is affected by many things, it is changing all the time. This helps us to identify together any problem areas that may have come up since your last visit and spot situations that could cause problems for you down the road. Consider it your early detection system. In the past, it was hard for patients to understand why a problem would need to be addressed until the tooth became painful or broke or other problems arose. But with the intraoral camera, we are much better equipped to identify those areas before they become major problems. And when we both have a much clearer picture of the condition of your teeth and gum tissue, we can work together to effectively address any areas of concern.  

Now, when I put the camera in your mouth, you might be surprised. Anytime something is magnified, it can be a bit of a shock at first. But in clearly seeing the condition of your oral health, you can make educated decisions on how you can improve or maintain it. As I explain what we are looking at, feel free to stop me and ask any questions about what you see or any concerns that you have.

As you go through the mouth, you would phrase your observations in such a way that patients understand that this information helps them to be better prepared to make wise choices about their oral healthcare. It’s a bit like that fancy sports car. It looks great on the outside all shiny and pretty, but look a little closer and you find that there are things that will need to be addressed if you want to get many years enjoyment out of it.

I hope that is helpful, Dr. Fred. Please don’t hesitate to call me if McKenzie Management can be of further assistance.   Sally

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

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

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Belle DuCharme CDPMA
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The Importance of a Job Description with Accountability When Hiring Front Office Personnel—
A Tale of Two Business Managers

Dear Belle,

After receiving my Advanced Front Office Training, I have begun modernizing filing systems, purging the paper files and making necessary additions to the computer software systems to better manage data.  I am tightening up the AR and it has improved significantly.  My problem is Marsha, the receptionist, who was here when I started.  She was told that I am the manager and that she is to follow my direction. However, she has a negative attitude about learning any of the new systems that I have learned during my training with you and wants to keep doing things “her way”.  The doctors say I have free choice in this matter and it is up to me.  What do you think?


Dear Sharon,

Perhaps Marsha feels “left out” since she did not attend the training.  Coming from you it may not have the same influence as coming from me.  I would be happy to have a conference with her on the phone and explain the systems and the goals of productivity and eliminating stress.  It is important that you have a firm understanding of each other’s job duties and have separate areas of accountability.  Marsha will feel like she plays an important role in the practice and that she is not your “assistant.”  Marsha needs to understand there is a better way and in order to take the practice to a higher level, she needs to cooperate.  Write out the new systems and train Marsha to do them as instructed.  If she continues to undermine your efforts, you may give her a written warning with a timeline to show improvement.  If she still continues the negative behavior, you may put her on probation with a timeline to improve.  If it continues, then termination is the unfortunate answer. Please check with your state employment separation rules before establishing a disciplinary process.


The Outcome:

Marsha did feel left out when not included in the training.  She admitted to having a “chip” on her shoulder and to being resistant to change. After being told that she could have one-on-one time with me, her attitude changed and she wanted to be a part of the new goals.  A definitive job description with areas that were Marsha’s responsibility gave her direction and a feeling of “ownership.” 

Dear Belle,

As you know, Dr. Toths hired me because I have a Business Degree and have worked as an account manager in an upscale financial institution for five years.  I am accustomed to acquiring financing for people and am used to dealing with larger accounts than we have here in our office.  Dr. Toths wants to do more high-end cosmetic cases and thought that I would be an asset.  So why am I not doing what I was hired to do?  I have no desk area or a definite designated space.  I carry my briefcase from place to place in the office like a nomad.  I was supposed to replace a woman that is retiring but she is still here and she is not being “phased out” of the practice like I was told she would be.  She has made a mess of the AR.  I get it when it is 90 days old and she has given up.  I have a written job description but I am not accountable for it because she is still in charge.  I like this job and I have added some great systems, thanks to your help, but I can’t operate without a desk.  Help!!!!!!


Dear Katarina,

During the training with you, I recall that you have excellent verbal skills and when we did some role-playing you were very smooth with your presentation.  You are “chomping at the bit” and nowhere to run at this point.  Your CEO doctor knows that you are an asset, however, he is suffering from a common fear of change.  He feels loyalty to the woman who is supposed to be retiring, Minga, but he knows that she does not have the formal training to take the practice where he wants it to go.  He is also aware that Minga, is “friendly” with the patients to the point of letting their account balances get beyond their ability to pay back.  I will be happy to assist you in having a meeting to establish your role in the office and to further cement this role by insisting that you have a designated work area.  If Minga is to remain, she needs a written job description with areas of accountability clearly defined.  You will be in charge of Financial Arrangements for all patients and follow-up on AR.  Minga’s position will be that of Scheduling Coordinator.  This will eliminate Minga from making “emotional” financial arrangements.

The Outcome:

Katarina, Minga and I had a meeting with her employer and he liked the idea of the new job description for Minga and taking her out of the treatment financing.  At first Minga was put off by the change but actually liked not having to deal with the finances anymore and agreed to take direction in this area from Katarina.  Katarina was given a special corner of the business office and was able to unpack her briefcase.

Is your office an “emotional” battleground?  Successful systems and professionally trained Front Office Employees are the answer.

For more information on McKenzie's Advanced Training for Front Office and Office Managers, email training@mckenziemgmt.com, call `1-877-777-6151 or visit our web-site at http://www.mckenziemgmt.com/.

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Nancy Caudill
Senior Consultant
McKenzie Management
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“Show and Tell Your Team!”
A McKenzie Management Case Study

Dr. Brian Carter - Case Study #225

Why do some offices excel and others continue to struggle?

With Dr. Carter’s permission, we share his experience after McKenzie because we feel that it is applicable to all doctors and their team members.

Let me set the stage for his comments:

Dr. Carter, his team and McKenzie Management worked together in 2004.  He had purchased his practice from his father where he had been working as an Associate.  He was in need of assistance implementing business systems and developing a strong and successful team to work with.

Dr. Carter sent the following e-mail in September of this year after inquiring on his progress.  He was so positive and proud that he took a minute to reflect on what he felt was the most important factor in his achievements.  Here is his response:

I think regarding my involvement with the employees, that the biggest thing we did was not having "secrets".  Exposing the practice numbers helped them to see that I wasn't hoarding. 

I really began to empower them by giving them the freedom to do their job but expecting 35% etc, and Expecting goals met. We have only missed our collection goal 4 months since McKenzie in September of 2004. Wow…that is two years. I think that is amazing!

Fortunately, I have been able to trust employees to just do their job, and have accountability.  Having reviews really builds a rapport with the staff, and lets them know how I feel.  I think we made some staff changes right before McKenzie and after that people were worried about their job and that creates employee stress wondering if they are next.  Holding the reviews takes some of that worry away and allows them to focus on what I want them to focus on. 

I try not to micromanage them, and they appreciate that.  I have also tried to show appreciation for them by little things, but have never done so in a lavish way, mostly small ways. 

I try to be really accommodating for family situations and emergencies.  They  know that I feel that their jobs are not as important as their family.  But when they are here, I expect their best. 

My relationship I have today with the team wasn't something that I said and BAM! there was trust. It was a process, and we had bumps along the way. But being open and trying to solve their concerns as if they had ownership in the practice has really helped.

I truly believe that the employees now have a feeling that this is partially their practice as well.


  • Establish job descriptions for your team.  It empowers them to perform their tasks based on what you expect from them.  Help them to be accountable by statistical reporting at the monthly meeting.
  • Establish daily production goals for effective scheduling for each provider.  These goals can be established by reviewing your overhead percentages and determining what is healthy for your practice.
  • Conduct morning meetings to discuss daily goals, scheduling issues, concerns about patients, etc.
  • Conduct monthly meetings to review a To Do List of actions that need to be implemented.
  • Thank your team for jobs well done.  Most team members are “feelers” and like to be appreciated.  Tell them.

You don’t know when you have arrived until you know where you are going.  Otherwise, you are just making good time going nowhere!  Contact us so we can help you determine where you need to go and how to get there.

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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McKenzie Management
A Division of The McKenzie Company, Inc.
3252 Holiday Court, Suite 110
La Jolla, CA 92037
Email info@mckenziemgmt.com
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