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3.28.08 Issue #316 Forward This Newsletter To A Colleague
Economic Downturn
Team Feedback
Periodontal Therapy

Ease the Blow of Economic Woes
by Sally McKenzie CEO
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For those who rode the wave of prosperity the last few years, weathering this latest economic storm may require both a philosophical and practical change in course. You probably won’t be able to dodge the downturn entirely, but you can minimize its impact by following what I call the Four Tenets for Tough Times. Last week I discussed #1: Be Flexible and #2: Get Real & Get Paid. This week: Tenets #3 and #4.

Tenet #3—Marketing Is a Must
The number one mistake dentists make during difficult financial times is to shut down their marketing efforts. Don’t. You may change your strategy somewhat, but you still need to get your name out there. The key is smart, cost-effective marketing. Keep the website up and running and current. This is just as important as your telephone. Continue to regularly reach out to patients with a practice newsletter or periodic letters from the doctor. Perhaps you want to reconsider that great billboard deal or the expensive radio campaign, but this is definitely not the time to disappear from the landscape. Take the opportunity, however, to make the most of internal marketing in every interaction.

Remember, everyone on staff is responsible for marketing. If your front line on the phones is Debbie, and she’s cold, rude or simply indifferent when she’s talking to patients, you’re dancing with disaster. Many patients don’t want to spend the money on dental care at this point anyway (and going to the dentist isn’t something they’re clamoring to do even in the best of times), so you don’t need staff giving them any excuses to take a pass on your practice.

Debbie needs to be a rock star. It needs to come across clearly that she enjoys people, from chatting it up with the grandmas to expertly handling the more challenging patients.  Don’t fool yourself into thinking that patients see past a not-so-friendly front line. They don’t.  

Your practice must scream superior service. It is the most cost-effective marketing strategy you can implement at any time, and especially during tough times. Involve the entire team in developing service-minded strategies.

Examine the total patient experience from the first phone call to the doctor’s after- treatment follow-up call. And if you’re not making those after-care calls, there’s no better time to start than now. The reception room should be clean, uncluttered and comfortable. The bathrooms must be spotless. The patient should feel she/he is the only person in your practice today because, after all, tomorrow she/he might be.

Reach out to your community. If the schedule no longer has you running from dawn til dusk, use the opportunity to become involved in a local school oral health education program, join the Rotary Club or offer to be the team dentists for a couple of local soccer or baseball teams. Encourage your staff to be involved as well and get the name of your practice out there on a regular basis.

Tenet #4—Make the Most of Your Team
During thriving economic times, dentists argue they are too busy to train staff. Take advantage of slower periods to invest in staff education. It will pay dividends down the road. Send a couple of staff to area dental meetings and ask them to present what they’ve learned during staff meetings. Ask each employee to give a mini-workshop to the rest of the team on his/her specific responsibilities. Educate the business team about dental procedures performed so they can better answer patient questions.  

Build on excellence. Take extra care in your hiring decisions. With a slower economy and layoffs, you’ll likely have higher quality applicants to choose from. Carefully evaluate what you want in your next employee. And make the most of applicant testing tools available through McKenzie Management to ensure that your next team member will be a perfect fit for your practice long after this current economic situation is a vague and distant memory.

Finally, along with your team, use this slower period to examine practice systems and carefully look at what could be improved. Now’s the perfect time to implement necessary changes and shore up strategies on everything from patient recall to treatment presentations, scheduling, collections, pursuing unscheduled treatment plans, telephone communication, etc. Bring in outside experts to help guide you through the improvements in management systems so that you are prepared for rapid growth when the downturn is over.

Interested in speaking to Sally about your practice concerns? Email her at
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
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Giving Feedback that Works

Feedback is information. The term “feedback” was originally borrowed from electrical engineering. In the field of rocket science, for example, each rocket has a built-in apparatus that sends messages to a steering mechanism on the ground. When the rocket is off target, these messages come back to the steering mechanism that in turn makes adjustments and puts the rocket back on target again.  

You don’t need to be a rocket scientist to see the parallels between launching missiles and leading employees. Your mission is to keep your team on track with your practice vision. Feedback is the best way to ensure that your team is soaring toward practice goals. It is communication regarding the effect that a person’s behavior has on another individual and/or group.

Feedback tells people whether they are on coursekeep doing what you’re doing because it’s working—or it redirects them back on course. The problem is most people associate the term “feedback” with criticism rather than information. As such, it is met with reluctance or anxiety, or simply avoided. Yet, the process of giving and receiving feedback is one of the most important communication tools you have to keep your office efficient and profitable.  

In my last article I emphasized that annual appraisals are insufficient for employee development. I strongly urge you to conduct monthly reviews with each member of your team. Even “star employees” need to meet with you at least once per quarter so they know that you value and appreciate them. Whether you are praising stellar performance or monitoring a problem employee, good feedback is behaviorally specific.

 An excellent model for giving feedback is called SBI, an acronym for Situation-Behavior-Impact. When you use this model, you provide information so that the recipient knows whether they are on track or need to modify their behavior because it is not effective.

There are three components of the SBI model. The first is to describe the situation in which the action occurred. Be specific with date, time and location. You want to capture the details so the person recalls the situation.

The next step is to articulate the exact behavior(s). This is essential and it requires a bit more thought than it might seem. Our tendency is to abbreviate and categorize what other people do. That leads to judgmental and critical messages. Describing Carol as “lazy” does not provide clear, tangible direction over which you have influence. “Carol is lazy” should be translated into “Carol needs to be more punctual with the weekly report.” In this way, you and Carol have a starting point andsomething that can be measured. No generalities; only specific, observable behavior.

The final step in the SBI model is to convey the effect that the other person’s behavior had on you. It might be feelings you had and/or outcomes that happened as a result of the person’s action.

Practice giving positive SBI feedback first so you will become more skilled and familiar with the model. Be specific. Drive-by praise without behavioral examples is ineffective. Strengthen “Great job!” with concrete details such as, “Thank you for taking quick action and filling the schedule when we had a cancellation this morning. It really made a difference in our daily production rate.

Here’s an example of a developmental SBI to your chronically tardy employee:
“Sara, you were late to the morning huddle twice this week. We had already reviewed the daily schedules by the time you arrived, but we had to go over it again for you. This was frustrating for me and your co-workers, and it delayed the team from starting the day.”

Delivering quality developmental feedback will take preparation on your part. Plan your words and your delivery. The more you build effective feedback on specific actions, the more your employees will benefit from your improved leadership in this area.

You can learn to give feedback well. You must practice to improve your skill until the complex process of putting together all of this material becomes second nature. Build a climate of feedback in your office. Help your employees achieve the overriding mission—to be successful in their careers and in your office!

Dr. Haller is available for team building and dental leadership coaching. She can be reached at

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

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Angie Stone RDH, BS
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Not Just Tooth Loss Anymore

The patient’s need for periodontal therapy has been identified. The patient has been informed that, without the recommended periodontal therapy, he/she may lose his/her teeth. The patient‘s reply to this information is, “Well, I feel pretty lucky I haven’t lost my teeth yet. My Mom lost her teeth when she was 50. She does just fine with her dentures. I will lose my teeth eventually too.”

What can the hygienist say that will convince the patient he/she needs to keep his/her teeth? It is apparent the tooth loss scenario is not going to work with this patient. He/she has already conceded to a life without teeth at some point. The patient is right: people do live without teeth and people with teeth do not perceive the edentulous person’s life to be any different than theirs.

The issue here is that periodontal disease is not only about losing teeth. The conversation with this (and every) patient should have been directed down a different path to arrive at the periodontal therapy destination.

The news is not new to dental professionals that correlations exist between mouth health and heart health, lung health, adult onset diabetes, etc. The mainstream population is not fully aware of the overall health implications of periodontal disease. The job of the dental team, particularly the hygienist, is to educate patients about these connections. Patients are not aware that elevated C-reactive protein (CRP) levels are a better indicator for heart attack and stroke than cholesterol levels and that, untreated, uncontrolled periodontal disease leads an increase in CRP. With periodontal therapy, CRP levels can be reduced, causing an improvement in overall health. If the aforementioned conversation had incorporated a discussion that included words such as heart attack, stroke, cardiopulmonary obstructive disease and/or diabetes, the patient would have more than likely been compelled to listen. Patients are more apt to move forward with recommended periodontal therapy when there is more at stake than “losing a few teeth.”  

When periodontal therapy recommendations are accepted, the patient wins by way of improved health. The dental practice is also a winner because periodontal therapy brings in more revenue. Not only are periodontal fees higher than prophy fees but periodontal patients require more than the typical two visits a year. Production increases with the need for more appointments and higher associated fees. Though production is important, treating more periodontal disease raises the feeling of achievement for the hygienist.  

When a clinician sees a patient who is in an unhealthy state and, through education and clinical services, helps the patient obtain a state of health, the hygienist begins to see that his/her services are definitely valuable. The more the hygienist is able to assist in this process, the more he/she gets comfortable with and confident in his/her skills. The attitude of being a “prophy mill” vanishes.

Routine prophies become mundane to a hygienist, much like placing occlusal restorations would be for a dentist if done day after day. Performing prophies all day becomes automatic so conversations can easily turn to subjects other than dentistry. This is when the doctor begins to notice a lot of idle chit chat about family life, weekend events, etc.

An interceptive periodontal therapy program requires a constant thought process. Each patient needs to be evaluated on several different levels. Health histories become more important when the shift has been made from strictly mouth health to whole body health. Blood pressure screenings are of utmost importance. A patient’s general state of health can be an aid when deciding on an oral care protocol. Gathering the information allows the clinician to assess the oral cavity more effectively and allows her/him to make evidenced- based decisions for periodontal care. With this type of assessment and subsequent treatment, there is hardly an opportunity to become complacent with hygiene services.

McKenzie Managements Hygiene Practice Enrichment program can assist the hygiene department with the implementation and management of an effective periodontal therapy program.  

Interested in knowing more about how to improve your hygiene department?
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