7.20.07 - Issue # 280 Forward This Newsletter To A Colleague
McKenzie Case Study

Delegation – It’s Not a Dirty Word
by Sally McKenzie CEO
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For those dentists who are accustomed to doing it all themselves, handing over responsibility for certain tasks can be the ultimate struggle, the impossible dream. They’re trapped in the “no one does it better than me” mindset, or the “if I don’t do it, I’ll lose control” shackles. Consequently, these dentists are stressed out, working and working, yet never able to actually get ahead because they simply can’t relinquish management of the smallest details. They can’t bring themselves to even utter the word, delegation.

Forget quality of life, forget balance, these docs hit mid-career and are living their jobs. The staff, meanwhile, has settled into the “why make the effort” mentality. They’ve learned that the doctor won’t be happy unless he/she does it his/her way. Don’t do anything unless you’re told. Don’t make a decision on your own. Don’t take the initiative to address an issue yourself. And, if at all possible, don’t think unless directed to do so.

Take the case of Dr. Anderson. She insists on taking down the medical histories of her patients. While the staff has offered repeatedly to take care of this, she contends that it is time well spent with the patients. No, it is not. It’s time wasted on a task that should be delegated so that Dr. Anderson can focus on what she does best, the dentistry.

Then there’s Dr. Roberts who wants things to be “just so.” His practice has needed a New Patient packet for months, but he insists on handling this responsibility himself rather than assigning it to a capable member of the team. He wants the documents that cover certain policies to be “carefully worded.” He wants to introduce his staff a “certain way,” answer key questions “carefully,” convey a “certain feeling about the practice” – and he’s convinced no one can do that as well as he can. But Dr. Roberts, understandably, does not have time to take care of it.

Even though something would be better than nothing, he simply cannot hand over control. New patients, meanwhile, cause unnecessary bottlenecks because information that could have been covered in detail in the packet must be explained on the phone or in person. Forms must be completed, routine questions must be asked and answered, and what should be an efficient, seamless system is fraught with inefficiencies.

The reasons for a doctor’s aversion to delegation may be rooted in the need to control or simply a fear of asking for help. In some cases, the dentist may assert that he/she has tried to delegate, but it wasn’t a good experience. Or, she/he doesn’t feel the team is trained well enough to take over certain tasks. Maybe the doctor just doesn’t know how or what to delegate. In fairness, oftentimes the doctor feels a strong sense of responsibility. She/he may well have built the practice from the ground up and may feel that she/he must control all aspects of it. The problem, however, is that for the practice to grow and truly succeed, the doctor simply cannot do it all. But how do you bring yourself to relinquish a few of those tightly held responsibilities?

It starts with identifying what duties to give away and what responsibilities to keep. I suggest you conduct your own time-motion study. Carry a notepad with you for three to five days and write down everything you do relating to your practice, including reviewing patient records, talking to patients, directing staff, calling in prescriptions, completing forms, evaluating prices on supplies, diagnosing and treating patients, cleaning out the refrigerator, etc.

After you’ve gathered your data, assess how you are spending your time. Is your day primarily consumed with activities that are focused on growing your practice – specifically diagnosing and treating patients? Or are you engaged in activities that repeatedly interrupt your primary mission of delivering care? Is your list full of items that only the doctor can do? Or do you have a multitude of duties that the staff, whether it’s the assistant, hygienist, scheduling coordinator, business manager, etc could and should do. Lastly, are there items on that list that no one should be doing because they should be outsourced or are they the result of lack of technology, inefficient space, or broken systems.

There are only so many hours in a day. Ensure that yours are spent primarily on diagnosing and delivering care. 

Next week, a step-by-step guide to effective delegating.

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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Take the ‘I’ Out of Micromanager

If you want a job done right you have to do it yourself.

You know the phrase. To some degree it’s true. It does take longer to train employees to do something than it is to simply do it yourself. In fact, if you’ve hired employees,you know that a certain amount of directing is essential. After all you need to know the respective strengths and weaknesses of your staff. Furthermore you need to have a commitment to them so you’re constantly helping them to improve and grow. 

Certainly employees need to know that you care about getting things done on time and in the right way. But when exactly does the positive leadership trait of attending to the details become problematic micromanaging?

  1. You spend too much time handholding employees.

Sometimes you need to let go of things and allow people to find their own way. Yes, mistakes might happen but these also are great opportunities for employees to learn and develop new skills. These can be times for finding new and better ways of doing things too.

If you are doing too much handholding, is it because that employee is not capable? What kind of training do they need to gain the job know-how to do the work you’ve given them to do? Or, if you’ve been coaching that team member enough, is it time to think about termination?

  1. You spend too much time overseeing particular projects.

Letting go of projects can be a fearful experience. As a leader you may fear losing control, losing face, and ultimately losing your business. It’s likely that you are dealing with these fears by using strategies that have worked in the past…like self-reliance. Not knowing any better you may be overly controlling. Or trying so hard to avoid being controlling that you don't communicate clearly what's expected.

Pay attention to which projects you spend the most time checking. Then ask yourself whether you have given the employee(s) responsible for these aspects of the practice a chance to prove their capabilities.

  1. You spend time telling people exactly what to do and how to do it.

Call me naïve, but my experience in business is that most employees really want to do a good job. In most cases, if a team member isn't doing a good job it’s often because they don't know how. 

Think about what kind of instruction is necessary. Is there a way to give less information about ‘how’ you want it done and more clarity about the outcome you expect? In this way, you empower employees to find solutions to issues themselves. Then give positive feedback. Successful leaders notice what employees do right, and give them immediate recognition for doing a good job.

  1. You find yourself irritated when employees don’t operate the way you do.

Not everyone works the same way. Your hygienist may be someone who is creative and spontaneous but not a morning person. She’s terrific with patients and generates a lot of revenue for the practice. It could be mutually beneficial to adjust her hours.

It’s important to pick your battles. You can’t go to war on every issue. Focus on the things that are most crucial for your success. Adapting to someone else's needs goes against the grain of most of us but it's easier if you focus on the goal you want to achieve.

That said, keep in mind that some employees want more direction while others need to be left alone. The key is to know what each member of your team needs to perform at his/her best.

Micromanagement is not the sign of a healthy leader. It does take time in the short term to train the employees, but it is so worth the time commitment in the long run. You’ll end up with more time in your day to devote to dentistry, and your employees will be more productive when freed from your hovering. The improvement in team morale yields big pay-offs…for your staff and your bottom line!

If you want to make the transition from micromanager to successful leader, 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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Old Dogs Can Learn New Tricks!

A McKenzie Management Case Study

Dr. Susan Walker Case Study #110

How many are “out there” reading this article that have been in the dental industry for more than 15 years…whether you are a dentist, hygienist or work in the business aspect of dentistry? In that period of time, think about the changes we’ve gone through.  Insurance, OSHA, HIPAA were major changes for us but then we have computers and digital x-rays and cad-cam and on and on. Change is often necessary to grow. Change can also be difficult without education and guidance.  But with those two factors in place…change is good.

This case study involves Dr. Walker’s office (name has been changed, of course, to protect the innocent) and is dedicated to all of us “old people” still working in the wonderful field of dentistry.

Dr. Walker’s practice facts:

  • 17-year old practice in the same location with the same hygienist and business coordinator.
  • The practice is slowly starting to plateau from a production/collection standpoint.
  • The number of new patients is declining steadily over the past 3 years.
  • The office has not gone “high tech” due to the fear factor of learning something new.


  • There was no internal marketing to encourage new patients into the practice.
  • The practice was located in a well-established area but the office décor was still from the 80’s.
  • June, the business coordinator, was excellent at what she did.  She knew all the patients and greeted them with a smile.  She knew how to make appointments and post payments in the computer.
  • Sherry, the hygienist, also knew all the patients by name and was comfortable sharing her weekend plans with them.
  • Kathy, the dental assistant, had worked with Dr. Walker for 2 years and was also a high-energy, friendly person who enjoyed what she did.
  • Debra worked only part time and was Dr. Walker’s niece.

As I shared the information that I was gathering through my analysis with Dr. Walker, it was very apparent that she was “comfortable” in her routine, as were June and Sherry.  They had all worked together for 17 years and enjoyed their working relationship.

However, something needed to happen to “jump start” this practice. 

Dr. Walker was under the assumption that her two long-time employees knew all they needed to know about working in a dental office.  After all, they had been doing the same thing for over 17 years.  What could they possibly need to know?

It was important for Dr. Walker to understand how necessary it was for her team members to continue to learn and grow as employees in the field just as she continues to learn new procedures and improved techniques to advance her performance.


  1. Bring in the software trainer and teach the staff how to more fully utilize their system, including chairside charting and treatment planning.
  2. Redecorate the office to something more current and incorporate some “dental art” on the walls.
  3. Start implementing the following:
    1. New Recall System
    2. Chart audit for additional income
    3. Offering CareCredit™ to their patients to decrease A/R and increase case acceptance
    4. Introduce educational programs chairside for patient education
    5. Improve the new patient experience by taking blood pressures, doing oral cancer screening and other “state of the art” evaluations to improve the patient’s perceived value of their appointment
    6. Implement internal marketing concepts and the doctor calling patients after lengthy appointments, etc.
    7. Morning meetings to better prepare for the day.
    8. Monthly meetings to review their performance for the month

In reality, this is only part of the list of recommendations that were presented to Dr. Walker for improvement.

When I returned to Dr. Walker’s office six months later, many of the 75 items that were on her “To Do List” were completed.  The staff was enthusiastic and proud of their daily and monthly achievements.  They discovered, along with the doctor, that they COULD learn new ways of doing things to be more efficient and productive.  Systems that used to work 15 years ago aren’t as effective today because of all the computer technology that is available now.

Marketing has become essential in order to grow their practice.  The entire team has developed marketing concepts that they are excited about and monitor the results for effectiveness.  The practice statistics have improved 20% and everyone is happy.

Yes,..change is hard.  The good news is that, with proper training and feeding, all of us “old dogs” can become “young pups” again.

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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