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11.30.07 Issue #299 Forward This Newsletter To A Colleague
Personnel Policies
McKenzie Case Study
Employee Management

Before You Fire any ‘Warning’ Shots, Target your Personnel Policies Instead
by Sally McKenzie CEO
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You’ve reached the end of your rope. The problem employee isn’t just a problem anymore; she/he’s a full-blown, raging disaster who’s draining the life out of your team and your practice. You can’t ignore it any longer; it’s time to Google “progressive discipline plan” and start firing off those warning notices.

And that would be about the time that your problem employee hires an equally problematic attorney and starts laying the groundwork for one very long and expensive nightmare for you and your practice. Think it can’t happen to you? Talk to attorney Mike Moore, McKenzie Management’s new Human Resources Director and the author of the Employment Policy and Handbook. He knows all about suing employers. Prior to joining my team, he spent the better part of 18 years representing employees who felt they had been wrongfully terminated. Today he’s putting that experience to work for dentists, who tend to be ill prepared on human resources policies and procedures.

Mike notes that for the few practices that actually have employment policies, in most cases, they have been pulled from some other business’ manual and are typically very punitive in nature. Essentially, they put the employee on the defensive before an issue even arises. Equally troublesome is the fact that oftentimes employees don’t receive a complete policy handbook. They might get a list of do’s and don’ts but the actual policy book is kept under lock and key in the doctor’s private office. “Every employee needs to have every policy in hand. The policy handbook the employee is given needs to be identical to the one the doctor has.”

In addition, those policies should be affirmative rather than punitive. For example, most progressive discipline policies typically are a series of “warnings” that do far more to derail the employment relationship than foster improvement in the employee’s behavior. “Everything says warning, warning, warning and we are going to impose this on you if you don’t change. All these warnings do is make the employee angry and create hostility toward the employer. It never accomplishes any good.”

An affirmative approach, notes Mike, treats employees as human beings and gives them the opportunity to take responsibility for their behavior. And what warnings don’t accomplish, oftentimes a conversation will. “It can be as simple as comments made in the office to the employee about their behavior. It can be time you schedule with the employee to go over a concern, but you don’t raise it in terms of ‘We’re giving you a verbal warning.’ The primary goal of these ‘counseling sessions’ is to exchange information.”

He notes the communication aspect is particularly important in situations in which a good employee begins to slip. Virtually every employer has seen an outstanding team member start to lose their effectiveness. This is the time for dialogue not progressive discipline. “You’ve invested tens of thousands of dollars in this long-term employee. You want to know what’s going on and you need to approach it in a manner that will put them at ease. Take them out for coffee and have a conversation with them about what you’ve observed. But make it as non-threatening as you can.” While the conversation is noted in the employee’s file nothing is given to them in writing.

However, if the employee’s behavior is disruptive to the practice, Mike urges dentists to have a more formal meeting with the employee. “You will probably want something in writing at this point in which you are outlining the behaviors that need to be corrected and what needs to be done. Specifically state the behaviors and the actions the employee needs to take, but don’t refer to it as a warning.”  

The key is preparation. Waiting until employee behaviors are so problematic that they are damaging the practice or dealing with issues such as tardiness, family leave, unprofessional conduct, dress code, etc. inconsistently make the dentist and practice highly vulnerable to litigation.

I recommend that instead of waiting until you reach the end of your rope, reach for The Employment Policy and Handbook instead. It’s customized for each practice and comes with step-by step forms for every policy. It’s like having a human resources expert with 30 plus years experience on staff round the clock.

Interested in having Mike Moore write your customized Employment Policy and Handbook?  Go here. Interested in having  Mike speak to your dental society or study club? Click Here.

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Nancy Caudill
Senior Consultant
McKenzie Management
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Team Members…Is Your Dentist Dr. ‘Nice Guy’?

Dr. Bob Baker – Case Study #101

Dr. Baker’s concerns: “Nancy, I love dentistry but I am not a business person and I really don’t understand what makes a practice successful monetarily.  I want all my patients to be happy and like me.”

Dr. Baker wasn’t saying anything different than the majority of dentists that McKenzie works with.  This is just one reason why it is so important for any dentist to have a business-thinking coordinator in the front office.  SOMEONE must understand that concept of “making money” and in many cases, it is not the dentist!

Dr. Baker’s practice facts:

  • 5-year old practice in the same location with the same team members
  • The practice production has never “taken off” like it should.  He is averaging $45,000 a month
  • Approximately 22 new patients a month
  • The recall system is effective  and the hygienist is producing 3x her salary

Dr. Baker’s team members were frustrated with his generosity.  On one hand he was always complaining about not making enough money and how he wasn’t busy, etc.  Then, they would observe him “giving away” dentistry, even when the patient was informed of the cost and had made financial arrangements to pay for the procedure(s).

The team wanted Dr. Baker to be successful.  He was a very likeable dentist and was easy to work for…but not easy to work with.  His team was putting forth the effort to encourage their patients to accept recommended treatment and he was talking the patient out of the very treatment that he had recommended six months ago.  They were very discouraged because they knew that the practice could be very productive, as they had wonderful patients that trusted them and were willing to have their work done.


  • Dr. Baker thought that if he said, “I think that I can fix that with a filling.” his patients would like him more.
  • He didn’t LISTEN!  I observed Dr. Baker’s #1 assistant inform him in the hall that Mrs. Jones elected to have her new partial done and was scheduled for the next month.  When the doctor walked in, his comment to her was, “Mrs. Jones, everything looks good.  I will see you in six months!”  This is enough to drive any dedicated assistant out the front door.
  • Dr. Baker also had difficulty making a diagnosis and following it.  I hope that he read my previous article about “say what you mean and do what you say”.  It is confusing to the patient when the treatment plan changes repeatedly and it is very difficult for the team to stay on the same page as the doctor.
  • Doom and Gloom…I think that Dr. Baker enjoyed being unhappy and feeling like a failure.  I recommended that he consider Dentist Coaching.  He was surrounded with excellent employees and wonderful patients but all he saw was the negative aspects of his practice.

During my 4 days in the office, over $3,000 worth of dentistry was either “given away” or negated after it was sold to the patient.  This is $12,000/month and $144,000/year!  This is enough to decrease his overhead to 55% and give his team members a well-deserved bonus or salary increase.

Doctors…it is very costly to be Dr. Nice Guy and it gets you nowhere except a non-productive practice where patients don’t know the difference and unhappy employees.  Patients respect you for telling them what their dental problems are and how you can help them.  It is NOT your fault that they have the needs that they have but it IS your fault if you don’t address their needs and make your best recommendation to solve them.  Be Dr. Great Dentist instead!

If you would like more information on how McKenzie's Practice Enrichment Programs can help you IMPLEMENT proven strategies….. email

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Belle DuCharme CDPMA
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Take the “worry” out of employee management.

Craft fairs this time of year are fun and a way to obtain one of a kind item from local artists.  I could not resist and bought a small plaque with the quote “Worry is a useless emotion.”  It reminded me of the many times I have worried over important and silly things at the same time.  Without action or resolve, worry is a waste of time and can be costly in time, money and relationships.

Employee management is the biggest challenge most dentists will face in their careers yet this area is where most dentists are ill equipped.  Addressing the employment laws from state to state to put together a template for an acceptable employment policy is a huge undertaking and the cost too prohibitive to pursue.  As senior trainer for the Dentist Start-up Program and the Advanced Business Training I could give an outline and suggestions on the contents but not the legal side.  The ADA has a “fill in the blanks” employee policy manual advising legal counsel for some areas.  Many dentists still did not take the time to “fill in the blanks” because they needed more guidance as to what to write.  For those reasons and more McKenzie Management is pleased with the new Employee Policy Manual written by attorney, Michael Moore.  It is easy to understand and covers most areas of potential conflict and miscommunication encountered in dental practices.  With Mr. Moore’s professional expertise and “hands-on” help, this policy can be customized easily for each dentist’s unique practice.  With the “worry” taken out of whether you have fair and equitable policies for all employees, you can concentrate on building positive relationships that enhance the practice.

The following are issues taken from actual case files of McKenzie Management relating to the absence of an Employment Policy Manual.

Dear Belle,
I started my practice six years ago with one person and myself.  I did not see the need to create any kind of “policy” at the time.  I now have four employees and need to hire another hygienist.  I still don’t have an office policy.  The new hygienist I am thinking of hiring wants more benefits and I want to give them to her, however I am not offering this to my other hygienist.  I worry that my first hygienist will find out and leave or demand the same.  What should I do?  Dr. Dave in SF

Dear Dr. Dave in SF,
Now is the time to draw up that policy.  It is never too late.  Right now you have “crisis driven” policies.  This means that policies are created when an employee makes a demand.  I suspect that each of your employees has asked for benefits at hire and there is an absence of uniformity.  It is getting more complex and impossible to control spending. Your total employee costs (salaries and benefits) should not be more than 22 to 27% of collections. A dental hygienist salary and benefits should be no more that 33% of her/his production. This does not include doctor exam fees.

Dear Belle,
Our office has updated to new computers in every operatory and three at the front desk.  There is a mad dash at lunch hour to check e-mail and some employees are at the computer surfing the net all lunch hour.  I don’t want the staff to get mad at me but I am annoyed with this behavior and as harmless as it seems… is unprofessional.  I don’t have anything in writing to state how the Internet is to be used.  Should I?  Dr. Sharon B

Dear Dr. Sharon B,
It is time to update your Employee Policy Manual to include the use of the Internet.  Due to HIPAA regulations, access on a “need to know” basis of patient records needs to be protected.  Password protected entry to certain levels should be mandatory.  In the policy manual it needs to be stated that the Internet is intended for the dental practice business only.  The office computers should be off limits to all staff for surfing the net or checking e-mail.  Lunchtime is their time but the computers and other business machines belong to the practice. 

Want to take the “worry” out of your practice, call McKenzie Management today for information about The Advanced Business Course, Dentist Start-up Program and our practice enhancement products.

For more information about the Advanced Business Training and Dentist Start-up Programs for your educational benefit,  email, call 1-877-777-6151 or visit our web-site at

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

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