6.22.07 - Issue # 276 Forward This Newsletter To A Colleague
Hiring and Firing
Leadership Trust
McKenzie Case Study

Taking the Dread Out of Hiring and Firing
A 4-part E-Management Series
by Sally McKenzie CEO
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The problem is not new and the headaches associated with it are many. The scenario usually begins something like this. You hire a new employee and you expect that she/he will be able to handle the demands of the job. Admittedly, you were under pressure to fill the position quickly. So you took a bit of a gamble on the new recruit but you rationalized your decision by noting that the applicant had some previous dental office experience, or maybe the person had a nice smile, or a good personality, or seemed to be a real “go-getter,” etc. Whatever the reason, you assured yourself and your team that everything was going to work out just fine. No problem!  

Six months later you’re shaking your head and wondering how you could have been so wrong about someone who seemed so right. The new employee is a whirling dervish of disaster. One of you needs to go and chances are pretty good it’s not going to be you, doctor.

Hiring and firing are two of the most stressful of the administrative challenges doctors and dental teams face regularly. This is the first in a four-part series on the issue to help you steer clear of disaster. Today and over the next three weeks I’ll cover specific do’s and don’ts to help you ensure that the next employee you hire will be a winner as well as what to do when you’re faced with that most unpleasant chore – firing a team member.

Hiring Rule #1
Do NOT hire under pressure. Yes, I know, when that two weeks’ notice lands on your desk, panic sets in as the blood drains from your head, and the one thing you want now is a warm body to fill the void. Resist that powerful urge. This person needs to do more than fill a spot on the flow chart. She/he is going to affect you, your team, your patients, and your profit for, quite possibly, a very long time. Easy answers and fast fixes now can metamorphous into complicated problems and staff issues down the road. Treat the hiring process as you would dentistry – with careful and deliberate planning and preparation.

Hiring Rule #2 Seize the Opportunity
As the cliché goes, take this lemon and make lemonade. When an employee quits your team this as an opportunity to make positive changes in your practice. Follow these steps and take advantage of it.

  1. Assess the systems before you bring in a new employee. If you’re hiring a new office manager take a look at business operations first. Have the systems been breaking down? This is your chance to fix them.
  2. Plan to provide training. Success or failure of both the employee and the systems they are accountable for hinge on this. You want your new employee to succeed and this employment arrangement to work out. Give the new hire the tools and the training to achieve their best and you’ll both benefit significantly.
  3. Take 15 minutes and think about what you want the person in this position to do. Do you want someone to warm the chair and collect a paycheck?  Or do you want an accountable, ambitious, individual willing to learn new things?
  4. Once you’ve given some thought to the position, update or write a job description for the job tailored to attract the employee you need. Include the job title, job summary, and specific duties. This is a simple yet critical tool in the hiring process. It clarifies what skills the applicant must possess and explains what duties they would perform.
  5. Cast a wide net. Develop an ad and place it on multiple websites and in multiple publications, such as newspapers as well as business and dental journals. The goal is to reel in as many applicants as possible. Promote those aspects of the job that will have the greatest appeal, including money. Ads that do not include salary are ignored by 50% of job prospects. Sell the position. Tell the reader what’s in it for them. Keep the copy simple but answer the reader’s questions – job title, job scope, duties, responsibilities, benefits, application procedures, financial incentives, and location. If you have a website, direct prospects to your website to learn more about your practice and the position. This is not the time to dwell on negatives such as long hours and difficult patients.

Next week who and how to interview.

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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Dr. Nancy Haller
Dentist Coach
McKenzie Management
coach@ mckenziemgmt.com
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Leadership Trust:
Strive for excellence, not perfection

As you get ready for work in the morning is your mind relentlessly going over and over your never ending "To Do" list? Do you find that there is never enough time in the day to get everything done the way you would like to have it all done? Do you double or even triple-check your employees’ work?

If so, you need to take a good hard look at whether you’re taking on too much and not delegating to your staff.

You say you can’t trust them? Read on.

Trust is a relational concept. It is a measure of the quality of a relationship between two people. In essence, trust is about how comfortable you are relying on someone.

In dental school your success depended on trusting one person – you. Now you are in a position of leadership and you must trust others if you are going to succeed. In fact, the most difficult challenges you face in your office have little to nothing to do with your technical skills as a dentist. The problems are more likely due to your behaviors. And nothing erodes practice success like micromanagement – the need to control everything that goes on in your office.

It’s good to have a high personal drive to achieve. You wouldn’t have made it this far without ambition. But if you are suspicious of everything your employees do, if you continuously correct them, the message you give is that they are not trustworthy, or valuable. As a result, there will be little to no accountability. Your team will think/say, “Why bother? No matter what I do it isn’t good enough”.

Pushing for continuous improvement, so your team performs at their best, is good. Finding fault and constantly telling employees how they could have/should have done it better is bad. When employees sense that you don’t trust them they develop a self-protective vigilance that inhibits communication and effective performance. Their focus shifts from doing a good job to making sure they don’t upset you. Nothing inhibits peak performance like fear of making mistakes. Ask any athlete. 

There’s no such thing as perfect. When you strive for such an unrealistic standard you aren’t aiming for success as much as you are trying to avoid failing. Perfect is unattainable. It also has undesirable side effects that inhibit leadership behaviors, and it will hold you back. Stop operating under the myth that ultimate control is possible. Life is filled with uncertainty and risk. Channel your energy to do well by paying attention to your strengths. Play to win rather than play not to lose. Here are some suggested solutions.

  1. Do a personal inventory
    Be objective. Really look at yourself and leave your ego behind. You might consider keeping a daily reflection log, tracking your actions so you develop more self-awareness. As the dental leader, the more you become self aware, the better you can read the signs of discontentment or unhappiness within your team. 
  1. Strengthen work relationships
    If you have difficulty reading the signs of low morale within your team you can try another tactic. If you have employees who are willing to be open with you, solicit feedback about your leadership. However, if your employees have not seen you as approachable, they aren’t likely to be very honest with you. If this is the case, hire a coach who can collect feedback for you anonymously.
  1. Honor the diversity of your team.
    If you are a perfectionist, it’s likely that you are very tough on your team. You see their weaknesses very clearly and overlook their achievements. As a conscious leader, aim to respect the differences by taking pro-active steps to align assignments with employees' strengths.
  1. Leadership training
    One of the most difficult challenges you face is shifting from an individual contributor to an influential leader. You went to school to be a dentist, and it is unusual if you had even one management class. Human behavior is complex. Fortunately the skills to be a more effective leader can be learned. By integrating your existing strengths with new behaviors you will have a positive impact on your team.  Leadership training also will help you to develop strategies that lead to heightened levels of trust and openness among team members, improved practice results.

Train yourself to interpret the anxiety of not knowing every detail as a sign of progress towards becoming an empowering leader. Think and act as if outcomes are not life and death affairs. Stop fear and failure statements from your internal self-talk. Learn to lead, not control.

If you want to gain greater trust with your team, 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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Nancy Caudill
Senior Consultant
McKenzie Management
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Sherlock Holmes vs Blissful Ingnorance

A McKenzie Management Case Study

Dr. Dan Goforth – Case Study #57

I know this Case Study sounds like a broken record (for those of you who know what “records” are!) but doctors tend to call us about similar concerns; such as, production and collections, not busy enough, need more new patients, too many cancelled and broken appointments, staffing issues, etc.  Dr. Goforth was no exception – not enough money to pay my bills”.

Practice facts:

  • Steady practice growth over the past 5 years
  • Overhead almost 80% (not including his salary)
  • Staff gross salaries at 30%
  • Paying staff bonuses based on production and collection goals without considering salary and overall overhead expenses
  • Too many hygiene days for the number of active patients
  • Too much overtime for employees
  • New employees added to existing staff over the past six months

McKenzie Consultant’s job is similar to that of Sherlock Holmes, i.e., get out the magnifying glass and determine why “things” are the way they are.  Here is a list of reports that needed to be generated in order to uncover the cash flow crunch.

  • Adjustment Report – look for adjustments that “don’t make sense” such as high PPO adjustments when posted adjusted fees have already been done.
  • Credit Balance Report – This can reflect courtesy and other adjustments posted without being offset by charges, hindering the proper billing of the account.
  • Profit and Loss Statement – Identify the 7 major expense categories and compare them to collections for the same time period.  These are “within normal limits” ranges in the dental industry for these categories. These ranges can reveal concerns such as not enough lab procedures being produced, too much money spent on staff salaries AND BONUSES or benefits paid are too high.
  • Past Due Recall Report –The practice may be seeing 50 new patients a month but if you are losing 60 “out the back door” through your recall program, your practice is declining!
  • Outstanding Insurance Claims Report – Looking for lost revenue?  It might be here!  There should be no claims outstanding over 60 days.  What does your report look like?
  • Daily day-sheets can identify what type of charges and payments are being posted.  If there is more than one provider in the practice, are the procedures being posted to the correct provider?  Are the patients paying at the time of service….which means – is your business coordinator asking for money?

Doctors, it is important to be knowledgeable on the reports from your computer that will help you to oversee the performance of your business staff.  I am not saying that you need to “micro-manage”.  I am saying that you need to be informed of what is taking place in your practice from a business standpoint.

New employees need training.  I don’t care how many years of dental experience they have.  Every office is different and follows different protocols.  It is YOUR job as their employer to make sure that they get proper training and their work is reviewed for accuracy.  Don’t assume that the previous employee trained them!  Trust me, you don’t want a disgruntled employee who is working her two-week notice to train your new employee.


  • Dr. Goforth learned how to generate and analyze reports
  • He provided training for his business coordinators and learned how to hold them accountable
  • He reviews his P&L and makes “informed” business decisions accordingly
  • Once a week he scans his day-sheet for anything that “doesn’t make sense” and questions his business staff for explanations
  • Monthly staff meetings are conducted to keep the team involved in the practice

Don’t stick your head in the autoclave and assume that “what you don’t know won’t hurt you”.  Ignorance is NOT bliss in your dental practice.  Learn how to use your magnifying glass and become Dr. Sherlock Holmes for a profitable and happy practice.

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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