6.8.07 - Issue # 274 Forward This Newsletter To A Colleague
Keep Patients Returning
McKenzie Case Study
Do Employees Trust You

I Want More ... but
by Sally McKenzie CEO
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I want more patients. I want better patients. I want increased production. I want to make more money...  Sound familiar? I hear from dentists on a daily basis who want all of the above and more. Virtually every one of them could have it all were it not for one small obstacle.

In hopes of attracting new patients, for example, dentists will invest in beautiful direct mail pieces, promotional brochures, catchy commercials, etc. The results can be great, at least at first. New patients are calling. They’re taking full advantage of the special offer the practice is providing. The office is a flurry of activity. Diagnosed treatment is being scheduled. Visions of production records are dancing through the doctor’s head. Yes siree, the office is reeling them in. 

Then the cancellations begin. The patients don’t pursue the recommended treatment. They took advantage of the special offer, but never returned. A few months down the road, few lasting results have come of the marketing campaign.

What went wrong? It goes back to that one small obstacle that often interferes with dentists’ ability to turn their wants into realities. The fact is that it’s easy to want, but it takes willingness and an investment of time, energy, and money to turn wants from wishful musings into results yielding realities.

The dentist isn’t willing to take the necessary steps internally to keep patients returning. He/she is not interested in looking at what is happening with the patient experience once they’re in the office. “I want more patients, but I can’t afford to train my staff on customer service. I want more production, but I’m the only one who can deliver treatment presentations. I want better patients, but I don’t have time to think about ‘the patient experience’ and I don’t want to take valuable staff time to develop a New Patient Packet.” And so on.

If your campaigns are bringing patients in only to see them slip away, you may not be delivering on what the patient is expecting. It’s time to look beyond the catchy jingle or the fancy “special offer” postcards.

Starting with the first phone call. In the business of dentistry, the voice on the phone is the voice of the practice. If that voice comes across as unprepared, rude, or unprofessional, that is exactly how the entire office is perceived to prospective patients. The positive, enthusiastic welcome from a smiling face rings loud and clear to the caller, so too does the tension-filled tone through gritted teeth. 

Patients can be alienated in 20 seconds or less depending how that “typical” phone transaction is handled. The person calling your practice should feel as if you’ve been expecting them, and they should feel welcome and appreciated. The business employee should convey enthusiasm and a positive demeanor even when the phone rings at inopportune times. In addition, your practice should use a standard greeting such as, "Good morning, Dr. Gary Mack’s office, Julie speaking. How may I help you?" No one should ever have to ask if they've reached the right office.

Next, consider your schedule. The ad says that you’re taking new patients, but callers are told they’ll have to wait at least four weeks to get an appointment. If you claim to take new patients, make sure they don’t have to wait any more than a couple of weeks for an appointment. Reserve popular appointment times for those responding to your promotion.

Reinforce their good decision. Send all new patients a New Patient Packet. This assures them that there’s substance beyond that slick campaign. It tells the patients that they will be valued and the office will make a sincere effort to communicate effectively with them.

The packet should be sent within 24 hours after the appointment is made. It should welcome and educate the new patient about the office. It should include a brief letter from the doctor indicating his/her commitment to providing the best possible care for patients. The letter also should emphasize specific qualities about your practice that set it apart from others, such as, the extremely high infection control standards, dentistry for the entire family, sedation techniques, cosmetic procedures, a commitment to never making the patient wait more than 5-10 minutes, etc.

Next week, managing patient expectations.

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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Nancy Caudill
Senior Consultant
McKenzie Management
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Catch and Release Your Employees

A McKenzie Management Case Study

Dr. Deborah Kassell Case Study #54

This practice is a general family practice that may be just like yours.  Dr. Kassell’s concerns are also applicable to any dental practice, whether a specialty or general practice. When I initially spoke with Dr. Kassell on the phone prior to my arrival, she shared with me her financial concerns and struggles with meeting payroll and paying her practice bills in a timely manner.

 “Nancy, for the first 3 years of my practice, it grew steadily with new patients, an acceptable cash flow that allowed me to pay my staff, myself and my bills.  I was pleased with my growth.  For the past 2 years, I continue to see more new patients and I have added another day of hygiene.  However, I am struggling with meeting my financial obligations and have not purchased any new equipment or added more staff other than the additional day of hygiene. What is happening?”

Dr. Kassell’s practice facts:

  • 5-year old start-up practice that is barely surviving with 20 new comprehensive exams a month and 4 days of hygiene.  The practice thrived for the initial 3 years.
  • Practice Coordinator has been with the practice for 2 years; chairside assistant has been employed 4 years and the hygienist since the practice opened.
  • Practice participated with 3 PPOs and did accept the assignment of benefits for all other insurance plans with the exception of HMO plans.
  • Monthly net production:  $62,500
  • Total accounts receivables (not including credit balances) $174,300
  • “Over-the-counter” payment percentage of net production was not being tracked


  • No job descriptions or system protocols.  No statistical monthly tracking of staff performance.
  • Treatment plans were entered into the computer but not formally presented to the patient.
  • Statements were sent monthly or whenever there was time.
  • The patient portion was not being calculated for the appointments being scheduled so the patient was not asked to pay at the time of service.

There were also many observations about her practice that were very positive.

  • Patients enjoyed visiting with the staff and Dr. Kassell.  It was a friendly and professional atmosphere.
  • The dentist was excellent at presenting a concise and understandable treatment plan to each patient.  Her assistant was well-trained and was very effective in answering the patients’ questions about procedures and treatment.
  • Her hygienist was comfortable with “pre-heating” her patients to possible treatment that may be recommended by Dr. Kassell.  She used the intraoral camera extensively.
  • The “New Patient Experience” was well accepted by all the new patients and I heard many compliments from the patients as they were leaving.

OK…so what is wrong with this picture?  With so many positive points, what is happening here?  Do you know?  Is this happening in your office? 


  1. Jamie, the Practice Coordinator, MUST learn to perform the following tasks:
    1. Present the treatment plan as sequenced by the doctor and assistant, along with the patient’s investment.  Offer financial options, such as Care Credit and schedule the patient for the first appointment, informing them of their “portion” to be paid at that time.  Give the patient a signed copy of the treatment plan.  Write the patient’s portion on the back of the appointment card “as a courtesy”.
    2. Statements MUST be sent out weekly or when an insurance payment is posted and the patient still has a balance.
    3. Insurance claims MUST be followed up on within 15 days
    4. Past due account follow-up phone calls MUST be made monthly and handled accordingly
    5. She MUST collect the patient’s portion at the time of their visit and not wait to send the statement after the insurance company has paid.
  2. A monthly monitor must be completed and reviewed that illustrates Jamie’s performance in order to hold her accountable for her tasks.
  3. A review of her performance must be conducted with Dr. Kassell to discuss training issues, challenges and positive reinforcement.
  4. Within a reasonable amount of time (3-6 months) a decision must be made regarding whether or not Jamie is the right employee for this position.


WOW!  Item #4 is aggressive and confrontational, isn’t it?  No, it isn’t.  Dr. Kassell owns a business and she must make business decisions in order to keep her business profitable.  If she is not profitable, she can’t keep her doors open and continue to do what she enjoys, which is practicing dentistry.

Dr. Kassell’s practice thrived for the first 3 years because she had a Practice Coordinator that understood the necessity for patients to pay for the services that they received.  When she left and Jamie was hired, Jamie was an exceptionally friendly face at the front desk and all the patients liked her immediately.  However, managing the financial aspect of the patient accounts was not her strong suit.  Over the past 2 years, less and less money was being cash-flowed.  Since there were no monitors completed to illustrate these facts, Dr. Kassell didn’t know what was happening. 

Doctors….PLEASE get training for your business employees in order for them to perform at their maximum potential.  As hard as it is, DO NOT KEEP an employee that is not suited for the position that they were hired for.  It will eventually break your bank and you could be the one looking for another job!

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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Dr. Nancy Haller
Dentist Coach
McKenzie Management
coach@ mckenziemgmt.com
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QUESTION ONE: Does it matter if your employees trust you?
QUESTION TWO: How do you find out?


In my last article I talked about trust as the foundation for teamwork. Building trust takes time. Like a good relationship, trust on a team is never complete; it must be maintained and nurtured. And the degree to which your employees trust you, the dental leader, impacts the overall level of success of your practice.

I guarantee you that you will not get top performance out of any employee who does not trust you. If they don't trust you to make the best decisions AND trust you to look out for their best interests, your staff will feel that they have to do it themselves. The time they spend looking out for #1 erodes team cohesion, decreases productivity, and reduces the quality of patient care.

Let's face it. As the dental leader, your ability to influence your staff is measured by the trust they place in you. After all, leadership is the ability to get things done through others, and that is directly correlated with your performance. Employees watch you. You are the role model who sets the standard for office behavior.

Trust is not a right; it's a privilege that must be earned every day. Unfortunately trust earned over a period of years can be lost in a few seconds. A poor choice of words or a thoughtless act is all that it takes to lose trust.

The good news is that your staff doesn’t expect you to be perfect. In fact, most employees are very forgiving…if you show a sincere interest in their success. To earn your employees' trust:

  • Recognize the things they do and voice appreciation publicly.
  • Give feedback about mistakes privately.
  • Show respect by practicing the golden rule – treat others as you would like to be treated.
  • Match your actions to your words.
  • When you are wrong, admit it. Say ‘I’m sorry’.


Be courageous and ask for feedback
Granted, it's not easy to solicit opinions about improving your performance. At the very least it’s uncomfortable because most of us are afraid or just don't want to hear what anyone else has to say. But that’s exactly what you need to do to find out if your employees trust you.

How you ask for feedback is just as important. What do you think your employees will feel if you say, “Do you trust me as a boss?”If they want to keep their job they probably will answer, “Of course” regardless if that’s the truth.

Rather than focusing on what you have done in the past, get ideas from your staff on what they want you to do to from this point forward. Specifically you could ask an employee, "What could I do to become a better boss?" (If you aren’t the dental leader, you could say to a co-worker, “What could I do to become a better team player?”). Research indicates that requesting feedback in this way still elicits 80 to 90 percent of what they would have said but instead it comes out in a positive way.

When you ask for feedback, really listen. Listen to the words and read between the lines. Pretend you're watching a movie with the sound off and be aware of facial expressions and physical gestures.

Say thank you…nothing more
Even if you disagree with what your employees tell you, the only response you should give is, “Thank you.” Don’t argue. Don’t explain. Just thank them and take notes.

Trust is the foundation for practice success. It is built and maintained by many small actions over time. As the dental leader, what you do is the cornerstone of that foundation. Lay the groundwork carefully for what you want your practice to be, now and in the future.

If you want to strengthen leadership and teamwork in your office, contact Dr. Haller at coach@mckenziemgmt.com

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

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