11.24.06 - Issue # 246 Forward This Newsletter To A Colleague
Broken Appts.
Staff’s Perception
Hiring Office Managers

Catch the Number One Profit Thief in the Act
by Sally McKenzie CEO
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Would you knowingly allow someone to steal $40,000 from you? The logical response is, well, of course not. Okay, so explain why you’re allowing no-show and last minute cancellations to take at least that from your practice every year.

Broken appointments are the bane of virtually every practice, and one of the most expensive profit pinchers. Admittedly, you may not be able to completely eliminate broken appointments and no shows, but you can take steps that will go a long way in reducing the impact of this income slayer. The easiest and most efficient means is to confirm all appointments. It is also the most cost-effective method of ensuring that patients are in the chair when they are supposed to be. Here’s how: 

First, make sure everyone is on the same page. Establish guidelines for broken appointments. Once you define the practice’s expectations, be sure to communicate them clearly and regularly to both new and existing patients.

Next, designate and train the Scheduling Coordinator to handle confirmation calls. This should be viewed as an essential personal phone call from the practice, not a routine chore that some poor employee is stuck with. The importance of dental care is the focus of this phone call. Emphasis is on the value the practice places in the patient, as well as the value of the appointment to the patient.

Pay attention to your choice of words. Terms such as “routine,” “regular,” even “cleaning,” can minimize the patient’s perception of the need and importance of the appointment. In addition, be careful not to “invite” cancellations. For example, “Mrs. Jones, this is Mary from Dr. Wheeler’s office. I just was checking to see if you planned to keep your appointment tomorrow.”  That approach gives patients a clear opportunity to back out at the last minute. Instead, use the confirmation call to emphasize the significance of this appointment and that the doctor is expecting the patient at the designated time.

Make personal contact with the patient 48 hours in advance of the appointment and resist the temptation to leave a message. If a message is left, the appointment cannot be considered confirmed until the practice makes contact personally with the patient. To avoid telephone tag, request a daytime phone number and/or cell phone number from patients. In addition, schedule time for the coordinator to contact patients after hours at home for those who are difficult to reach during the day.

When making appointments, state the day, date, time, and length of the appointment. For example, “Mrs. Smith, your 45-minute appointment is on April 28 at 9:50 a.m. If you are unable to keep this appointment, please call us at least 48 hours in advance to allow another patient the opportunity to see the doctor at that time.”

Be prepared to take steps to fill gaps in the schedule when they occur. Ask patients if they would consider changing their appointment if one becomes available sooner. Keep a list of those patients willing to move their appointments to fill unexpected voids in the schedule. Additionally, keep a list of patients who cancel, don’t show, or don’t reschedule appointments and follow-up with those patients. Contact “no shows” within 10 minutes of their appointment time.  Indicate concern for their absence. “Mr. Smith this is Jane from Dr. Carol’s  office. We were expecting you for a 3 p.m. appointment today and were concerned when we had not heard from you. Is everything okay?”

But don’t let the last minute cancellers dictate your schedule. After two “no shows” consider the patient unreliable. Tell the patient you will contact them when an opening is available, and they can determine if that time will be convenient.

Don’t let “no-show” patients and last minute cancellations rob your practice profits. Implement a few key steps to ensure that your number one line of income – the patients – are in the chair and paying for your quality dentistry.

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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Dr. Joe Garrison - Case Study #123

When a doctor and his/her staff begin working with McKenzie Management, a confidential “staff” survey is conducted.  This survey is used to gather information about the staff’s PERCEPTION of the doctor in his/her role of dentist and employer.

Dr. Garrison’s office was no exception. It was obvious from the survey review that there was stress in the office between the doctor and the team, as perceived by the staff.  This information was going to be difficult to share with the doctor, because he perceived himself differently.

Here was the compilation of the staff’s answers about Dr. Garrison

  • Doctor is not consistent with office policies and procedures – NEVER
  • Doctor changes policies and procedures that affect me without asking for my opinion – ALWAYS
  • The doctor listens and tries to use ideas raised by others in the group – NEVER
  • The doctor tells me in a constructive manner when I make mistakes – SOMETIMES
  • The doctor is sensitive to the feelings of his employees – SOMETIMES
  • The doctor takes it out on others when things don’t go his/her way – ALWAYS
  • The doctor is warm and friendly with the staff – SOMETIMES
  • The doctor treats patients kindly – SOMETIMES
  • The doctor tries to provide the highest quality of care possible – ALWAYS

This was not an office full of happy campers!  Above all else, he was an excellent dentist and clinician.  Patients don’t really understand the difference between good dentistry and poor dentistry.  However, they do know if they like the dentist or not.  The staff’s perception of Dr. Garrison was that many of his patients did not like him.  Patients don’t like change, and as a result of this, they will continue to visit their dentist even if they don’t like their personality.

In Dr. Garrison’s case, his patient retention was very low and he was not seeing new patients as a result of referrals from other patients, but rather from his insurance affiliations.

When I visited with Dr. Garrison’s staff, I asked the obvious question.  “Why do you stay if you are so miserable and you didn’t give him flying colors?”  Their response was, “We stay because we like one another – we just don’t like him!”  This was not the first time that I have heard this.

The team indicated that they liked their jobs and they enjoyed their patients of long standing.  Many of these team members had been with Dr. Garrison for over 20 years.  It is amazing to me that staff members can be so unhappy for such a long time.  Now, upon my arrival, they THINK that I can fix him!  I don’t think that they sell that magic wand in the stores where I shop!

Dr. Garrison’s temperament type makes decisions based on how he “thinks” about things.  He is “introverted” – meaning that he does not do a good job of communicating with patients or staff in many cases, thinking that everyone can “read his mind”.

On the other hand, the majority of his team members are the complete opposite, talkative and sensitive. Teaching Dr. Garrison how to communicate with “feeling” staff would be difficult because he doesn’t “feel” their sensitivity. When he read the compilation of the survey results, he was totally surprised and thought that we had the surveys mixed up with another office!  I tried to remind him that PERCEPTION IS REALITY.  It doesn’t mean that it is the truth, but it is how his staff perceives him.

McKenzie Management’s objective was to put protocols in place that would help improve the communication between the introverted dentist and the extroverted staff so they felt that he was “sharing” and he didn’t really have to put forth any effort, since that was not his nature.


A beginning of the day meeting to review the schedule, discuss patient’s special needs and treatment, recognize birthdays, celebrate the previous day’s production and concentrate on today’s production.

A monthly strategy meeting to review monthly statistics regarding production and collections, doctor and hygiene production, scheduling goals, overhead goals, accounts receivables and a “To Do” List with agenda items that are either completed or in progress assigned to an accountable staff member.


By conducting daily and monthly meetings, it helped Dr. Garrison to relate to his staff under specific guidelines.  He is making a concerted effort to thank his staff from time to time, but this is not his nature, so it may not continue.  His behavior is not intended to be uncaring, but can be viewed as such by others who are not of the same temperament make-up.

On the other hand, his team was encouraged to praise Dr. Garrison as well.  It is the old adage of, “reap what you sow”. 

I encourage all team members to “be happy or be gone”.  As adults, we all have choices.  If you are truly not happy in your practice, seek fulfillment elsewhere.  Doctors and other staff members will not change – we are who we are. 

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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Belle DuCharme CDPMA
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Desperate Dentist Desires Diligent Dental Dynamo
The Search for the Perfect Dental Business Manager

As a Business Manager/Office Manager for over twenty-five years in many types of practices, my biggest challenge has been (and still is) finding qualified and dedicated people to fill the important positions in dental practices. 

In the last fifteen years, I have observed the quality of applicants in general to be lacking in promptness, work ethics, personal appearance, training and desire to set personal or professional goals. For instance, I placed an ad in the local paper for an experienced Scheduling Coordinator/Receptionist.  After going through the resumes and setting up interviews, half of the people did not show up or call to say they weren’t coming.  One woman showed up in jeans and a low cut sweater.  One applicant did not know the name of the computer software system used at her previous office and confided in me that she “didn’t like” computers.  Another woman who had three years “experience” said that no one took the time to train her beyond filing and confirming appointments.  None of the applicants interviewed had any definitive short term or long-term goals for their own future.  Just securing the next job was the only goal.

I have nurtured many a frustrated dentist through this challenging arena to find good and sometimes great people for their offices.  What’s going on?  Why is there a shortage of experienced people for all dental positions?  Experience is not standardized in the business end of dentistry, as it was when appointment books were “books” and a pegboard ledger system was the norm. You can be experienced with customer service, but if you have poor computer skills you are doomed to working at the car wash.  You may have excellent knowledge of how insurance companies reimburse but can you get the patient to buy dentistry beyond what the insurance company will participate in paying? The need for marketing skills is steadily on the rise and will continue to be a desired ability as dentists compete for the same demographic patient base.

There are several dental software programs to choose from and each has a different language of the tasks that it performs.  If you have a working knowledge of Dentrix at one office, you will have to go through a training period at your next office if they have Eaglesoft  or another program. Knowing how to create and read the reports generated by these programs is a must to insure the success of today’s dental practice.  Now with the click of your mouse, you can create reports with much more detail about the practice than the dentists’ accounting firms can create. Business Managers in today’s world must have a good-to- excellent experience level in the use of the Internet for sending and receiving attachments from other offices, or to and from insurance companies. Confirming by e-mail will soon be standard. Being able to create a document in Word or to create a spreadsheet in Excel is a skill that wasn’t necessary in most offices ten years ago.

Training your Business Manager to “hire” the right people is one of the most important factors in creating a successful dental practice.  Hiring wrong can cost thousands of dollars in scheduling, posting and insurance billing errors.  Lack of marketing skills can bring the practice to a crawl in a short period of time and will take much time and energy to recreate. 

The investment in The Office Manager Advanced Training Program offered at McKenzie Management is sound insurance against the waste of revenues in hiring wrong.  How to create job descriptions with areas of accountability, testing of applicants, and discovering the best personalities for the job are part of the learning program.  Learning how to read the reports generated by the dental software and applying the data to a workable marketing strategy is critical to success and is customized to your office needs.

It is important to remember that today’s new dental office, no matter what the “experience level” of new hires, you will have to provide additional training beyond the educational experience already achieved.  This may be accomplished in the office by bringing in trainers specializing in the software program and sending your employees to a professional organization (McKenzie Management) for formal training.

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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