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4.18.08 Issue #319 Forward This Newsletter To A Colleague

Trust = Treatment Acceptance
by Sally McKenzie CEO
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Trust. Most of us believe that we are trustworthy individuals. It’s hard to imagine that someone wouldn’t trust us. After all, what’s not to trust? We’re hardworking, dedicated, committed people and others should trust our professional judgment. After all, we’re experts in our chosen fields, right?

For example, let’s say you have some concerns with your practice. You and I chat a bit, and I recommend that your practice undergo a McKenzie Management in-office consultation to ensure that you are getting the most out of your team and practice management systems. After all, McKenzie Management has been recognized many times for its expertise in this area. Would you immediately sign up for an in-office consultation

Realistically, you would probably want more information, and a more thorough understanding of what’s involved. You may trust what I have to say on one level, but you would want the opportunity to ask plenty of questions. You might want to check references and discuss what your return on this investment is going to be. And whether you proceed or not is going to be based on multiple factors that go well beyond the specific information you gather. You not only need to trust me, but you also need to trust that you are making the right decision.

So why would you think that your patients are any different? Certainly, patients trust you enough to come in for routine appointments. But what happens when they require or want care that goes beyond “routine” procedures? Will the patient have the confidence, the dental education and the trust in the practice overall to accept the treatment recommended? Consider the opinion of Mary, a patient in Dr. Smith’s office. 

“Dr. Smith’s office is great for cleanings and that, but he always seems so rushed. He takes a quick look at my teeth after the hygienist cleans them and sends me on my way. I want to ask about veneers, but I never feel like I should bother him with questions.” 

Dr. Smith, meanwhile, is befuddled when patients don’t accept recommended treatment. Yet he gives little thought to the manner in which he and his team build—or erode—patient trust. In Mary’s case, Dr. Smith doesn’t realize that he is undermining Mary’s trust in his care. Mary will be far less likely to proceed with recommended treatment because Dr. Smith is hurried, which makes patients feel uneasy and unimportant. Worse yet, Mary is interested in a certain procedure but doesn’t feel comfortable asking about it.

Through our Treatment Acceptance Training Program, we find that most dentists and teams understand the fundamentals of treatment presentation, but they forget that patients base their acceptance of those recommendations on multiple factors. In addition to always treating every patient as the most important and the only person in your practice and always taking the time to solicit questions from patients, consider a few other ways in which you can build trust during every visit:

Be candid. Most patients are aware of some general risks in treatment so they are waiting for you to be frank about what, if anything, they might be faced with as a result of the treatment. If they are given advantages and disadvantages, research shows that patients are more willing to trust you to deliver their care. Patients always feel better when they know the benefits and risks of proposed treatment.

Always speak at the patients’ level of understanding. Jargon and “ten-dollar words” can confuse patients and make them uncomfortable because they don’t understand, but they won’t ask you what you mean.

Exhibit clear confidence in your recommended course of treatment. A personal testimonial about recent treatment for another patient and the results obtained, for example, underscores that sense of security. It demonstrates that you have no doubt that you will get a good result for this patient.

Be aware of the perception of “fairness.” Many issues having to do with trust are linked to the patients’ perception of the value they are receiving. Studies show that patients avoid dental treatment because of cost more than pain. Yet if they feel that the costs measure up to the service received there is no complaint. Many patients will not question fees if the practice has demonstrated that they can deliver superior service. From the first phone call to dismissal, establish the “value” for services that a patient is receiving.

Next week, new patients mean new opportunities for your care to shine.

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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Nancy Caudill
Senior Consultant
McKenzie Management
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Work Less–Make More!

Dr. Bob Morley—Case Study #142

“I have been a dentist for over 20 years. My children are getting older and I want to spend more time with them. However, I am not ready to retire and I still need income.  How can I have both?” —Dr. Bob Morley

Practice Statistics:

  • practice sees patients 8 hours a day, 4 days a week, 50 weeks a year
  • office closed for vacation 2 weeks per year
  • office observes 7 holidays per year
  • 18 new patients a month
  • 1 Full-Time Hygienist working 8 hours, 4 days a week
  • 2 Full-Time Clinical Assistants
  • 1 Full-Time Business Coordinator
  Initial Monthly Analysis 6 Months after McKenzie Mgmt.
New D0150 Pts. 18 22
Patient Retention 62% 89%
Active Patients in Recall 1,250 1,941
Hygiene Days 16 18
Hygiene Production $16,000 $20,250
Doctor Production $40,000 $46,000
Days Worked 16 12
TOTAL after 6 Mos. $336,000 $397,500
% of Increase   18%

To summarize the information above, Dr. Morley experienced an increase in practice production of 18% (or $61,500) and he worked 25% less! How did he do it?

The following systems were put in place:

  • internal marketing to increase the number of new patients from existing emergency inactive patient lists
  • recall follow-up steps to increase patient retention of existing patient base
  • efficient scheduling and better use of assistants
  • morning meetings
  • monthly strategic meetings
  • statistical tracking

Internal Marketing
Dr. Morley was experiencing around 18 new comprehensive patients per month. The key word here is “comprehensive” patients. These are the patients that are seen by the dentist for a comprehensive exam, visit the hygienist and are placed into the recall system. These patients are considered “active” patients. New emergency patients do not contribute to the growth of the practice until they have a comprehensive examination and are treated by the hygienist. The goal is to increase hygiene days!

Handwritten “thank you” notes were sent by the doctor to the new patient. He also called the evening prior to the appointment to “welcome” the patient to the practice.  Getting this kind of attention before coming into the office made a great impression on the new patients.

As soon as new patients were seen by Dr. Morley, “thank you” gift cards were mailed to referring patients to encourage them to continue to refer more patients.

The hygienist calls the new patient the evening of the new patient’s visit to follow up on any questions they might have about their first visit and to learn if there was anything they could have done to make their visit more pleasant. Building trust comes from all members of the team.

The purpose of all these “warm and fuzzy” activities is to create a reason for this new patient to talk about the practice with their friends. Remember that patients have a choice…many choices…of where to seek their dental treatment and you want them to choose you.

Patient Retention
It doesn’t matter if you are seeing 100 new patients per month if you are losing 120 “out the back door.” You won’t know unless you track it. If you happen to be one of those dentists that still have 4 days of hygiene a week and you have been working 10 years or more, you are losing patients out the back door.

Tracking retention: Compare the number of patients expected at the first of the month that are on your recall list to the actual number of patients that are seen in hygiene. If you have anything under 90% and are averaging 20 new patients a month, your practice is not growing! That is why you only need 4 days of hygiene.
Increase the number of hygiene days.

With improved retention and proper hygiene scheduling, Dr. Morley was able to add an additional 2 days of hygiene per month. This does not seem like a lot but if the hygienist is averaging a minimum of $125 per patient, 9 appointments = $1,125 per day.

Yes…9 appointments per day. This may seem unusual because the Scheduling Coordinator thinks that the hygienist should see 8 patients per day…1 hour each. This is NOT correct. The hygiene patients should be scheduled according to the time that is needed for each patient. Some patients need 1 hour and some patients only need 30–40 minutes. The patients that need 30–40 minutes are generally children under the age of 14 and patients with few natural teeth and removable prosthetics.

Efficient Doctor Scheduling
By utilizing Dr. Morley’s assistants more effectively and keeping within the guidelines of his state, the patients were scheduled in 2 columns, staggering patients 10 minutes at the beginning and end of the allotted chair time. The crown and bridge appointments overlapped to allow the chairside assistant to fabricate the temporaries while the doctor started the next patient in another treatment room.

A time and motion study was conducted to have a better understanding of how much “chair time” is needed for the more common procedures. This information is noted on the Route Slip and given to the Scheduling Coordinator for each appointment so that scheduled appointments were based on an accurate assessment of the time necessary to do the procedure.

Dr. Morley was able to see as many patients in 3 days as he was in 4 days and customer service was improved because patients did not have to wait as long to be treated.

It is important to remember that when changes are made in the practice be sure that there is a system to track the results. Statistical reporting is vital to the practice so that you know where you are, where you are going and when you get there!

If you are ready to work less and earn more, contact McKenzie Management to invite a professional consultant to assist you in achieving your goals.

If you would like more information on how McKenzie's Practice Enrichment Programs can help you IMPLEMENT proven strategies, e-mail

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Belle DuCharme CDPMA
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Does the Value of Dentistry Sell Itself?

“We’re health care providers, not salesmen/saleswomen. Dentists shouldn’t have to ‘push’ patients into accepting treatment.”  —J.B. Jones, DDS (not real name)

Dentists are in a quandary when it comes to improving treatment acceptance. The clinical diagnosis and recommended treatment explanation appear to be accepted by the patient. The evidence was the nod and the “I see what you are saying,” but it resulted in the acceptance of the minimum treatment—the replacement of two cracked fillings on the left side. Forget that the patient is missing three molars (key chewing teeth) on the right side of his/her mouth, is losing supporting bone in those areas and is overcompensating by chewing on the left side instead—he/she doesn’t seem to think that it is important enough to do something about now.

Picture this same patient shopping for a new car. The car he/she has is still drivable but major repairs costing possibly thousands of dollars are looming in the near future. He/she hasn’t had a car payment in five years and the freedom from that financial responsibility has made it possible to buy other items, such as a new HD TV. Time is almost up for the car and for the teeth.

As healthcare providers, dentists are competing for the same discretionary consumer dollars as car dealerships. The difference is the “value” of an automobile is easier to judge than is the value of dental services. Dental providers’ advertising budgets pale in comparison to the advertising budgets of Ford, General Motors, etc. As small business owners, most dentists have to be frugal with their advertising and marketing expenses and careful with how it is targeted to get the best return. The Community Overview Report offered by McKenzie Management is a must-have before embarking on a marketing plan for any dental practice. Today’s patients look at price, quality and value and question if they are receiving their dollar’s worth from the dental office just as they would question the salesman at a car dealership.

Measuring dentistry for those buying factors is not only challenging for the patient, but also for the dental team. How does the dental practice communicate value to the patient and win by having the patient accept the treatment truly needed to improve overall health?

It is important to understand that promoting dental benefits is not “pushing” a patient to purchase services. Even a patient who is a sophisticated consumer is frustrated when trying to evaluate clinical expertise and skills that he/she knows little about. One of the most effective ways to communicate the value of the practice and the services of the practice is through a professionally trained Treatment Coordinator. There is a higher perception of value, a clearer understanding of the recommended treatment and both new and recall patients are educated when they experience a skilled, professionally trained Treatment Coordinator. This individual can help educate the patient as to the benefits of the practice, the clinical skills of the dental providers and the quality of the treatment delivered in the practice. The Treatment Coordinator is also seen as a “patient advocate” or an ally that the patient can contact with questions and concerns about treatment.

A patient who had just completed a three-phase treatment plan was asked about her experience and this is her response:

“Before working with Dr. Smith’s Treatment Coordinator, Alice, I always felt as though Dr. Smith was speaking to me in Greek. I couldn’t come to a decision about the treatment because I had questions that I was afraid to ask him. I know he is a busy doctor and I just felt that it could wait ’til another time. Now, Alice explains the treatment in language I can relate to; I feel more confident in my decisions and feel I am doing the right thing for myself.”

A knowledgeable Treatment Coordinator has strong interpersonal skills and in-depth knowledge of the practice, its providers and services. She/he is very instrumental in creating an environment that fosters trust and caring. As healthcare providers, we should understand what it takes to get our patients over the hills of fear and procrastination. Your patients should see the dentist and the team as experts in dentistry on whom they can rely for what they perceive as the best dental care in town.  Any member of the dental team would benefit from being professionally trained as a Treatment Coordinator because there isn’t any area, clinical or business, that cannot benefit from improved communication skills.

The value of dentistry does not sell itself without the help of skilled dental professionals.

For more information about McKenzie Management’s Advanced Training courses, email, call 1-877-777-6151 or visit our website at

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

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