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5.2.08 Issue #321 Forward This Newsletter To A Colleague

Losing Patients? Solve the Mystery
by Sally McKenzie CEO
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Oh, if only you knew … You’re busy working, working, working every day providing the best care you can for patients. From all outward appearances things seem to be just fine. Patients are in the chair, you provide care for them, you like them – well, most of them, anyway. They like you. They come back. Okay, maybe not all of them return but a lot of them do.

Actually, if you look closely, chances are very good you’ll find that not as many come back as you would like to think. In fact, your existing patient base is shrinking. But not to worry, right, because you have a steady supply of new patients coming in, or so you believe until you take a closer look. New patient numbers are dwindling as well. But why? What is happening? Where’s the disconnect?

Oftentimes, patients are lost at precisely the point where the patient experience begins – the telephone. If you were a prospective new patient calling your practice, would you schedule an appointment? Would you feel the staff is welcoming and accommodating?  Would you find your telephone experience pleasant or something you just had to endure on your way to getting in to see the doctor or hygienist? Would everyone who answers the phone be able to answer basic questions about treatment, procedures, insurance? All of those questions are critical to sustaining and building your practice, but few dentists are concerned enough to ask them.

In fact, only 12% of dentists believe the telephone has a major impact on their practice even though it is the only point of entry for new patients. And only 5% of practice staff are trained to properly handle patient phone calls. The vast majority simply wing it. Worse yet, most view the telephone as a necessary nuisance. The truth is that there are days in which if they could cut the line on your practice they would happily do so. After all, it presents a steady string of interruptions and a fair number of routine annoyances.

Yet, if poor telephone protocol causes you to lose just 20 new patients a month and each would have spent an average of $1,000 on dental care a year, that’s 240 patients and nearly a quarter of a million dollars lost.

The telephone is the only entry into the office. For new patients in particular this is precisely where they begin to assess the competency of doctor and team, the quality of the dentistry provided, and whether this practice deserves their business and that of their families. In today’s consumer-driven dental marketplace, the old cliché that you only get one chance to make a first impression couldn’t be truer.

Yet many of you have convinced yourselves that the telephone isn’t all that important, and once patients get in the door they see how really great you and your team are. From your viewpoint, the phone is just, well, the phone. Then there are those of you who simply assume that because Ann is supremely competent surely she comes across well on the phone, or because Spencer is just the nicest person you’re just certain he can handle calls beautifully. Oh, if only you knew... 

How well does your team really manage phone calls from current and prospective patients? The truth is you don’t know until you hear both sides of the conversation. McKenzie Management recently developed a 28-point telephone assessment protocol in which a professionally trained and certified “mystery shopper” calls your practice and assesses the effectiveness of your team’s telephone skills on multiple occasions. You receive a written report as well as a recording of the conversations. 

In the medical community, “mystery shoppers” have been around for several years. Dentistry is embracing the concept more and more as practices have come to realize that they are profoundly dependent upon a satisfied patient base.

The program allows you to be the fly on the wall (so to speak) and hear exactly what transpires between the caller and your employee. But most importantly, the assessment enables you to identify exactly where you and your team can make immediate improvements and see immediate positive results.

Next week, what to do when your “best” is costing you big. 

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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Belle DuCharme CDPMA
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Team Morale and Personality Types

“It’s a fact that it is much more comfortable to be in the position of the person who has been offended than to be the unfortunate cause of it.” -Barbara Walters

Staffing the dental office with an effective team is the most challenging aspect of managing a dental practice. The Dentist Start-Up Program, offered by McKenzie Management, is designed to ease the new dentist (or the clinically experienced dentist going solo for the first time), into this challenge by providing the tools and the training to avoid the problems that arise in practices that have not had the benefit of this education. Understanding personality types and how they directly affect the success of the practice is a cornerstone to hiring people that will be motivated to do the job duties and be accountable for the results.

A much larger issue is the personality of the Dentist CEO of the practice. The role of leader is not a comfortable place for some personality types. Often, after finding out his/her personality type, the dentist attending the training will pause for reflection. Dentistry is a people profession; research shows that the best personality type to work in dental practices is extroverted. Extroverted types love to be around people and are energized by the give and take associated with relating to people. Introverted types enjoy people also but are tired by constant interaction and prefer to work alone.

McKenzie Management has tested dentists and their teams for many years and has discovered that many dentists are introverted in relating to patients and team. Research proves that many introverted people prefer to work privately at times throughout the day and often choose a career path in “behind the scenes” type of work. You may find many introverted computer programmers, software designers, engineers, architects, accountants, researchers and writers, to name a few.

 An introverted dentist has a difficult time giving bad news, such as telling a patient he/she will need periodontal surgery in order to save his/her teeth. Studies have shown that introverted dentists avoid team meetings and performance reviews unless duty driven. Introverted dentists typically don’t spend enough time connecting to patients and the team because it is uncomfortable and confrontational. The introvert needs time alone to recharge his/her battery but this is difficult in a busy dental office. Personality traits have nothing to do with the dentist’s clinical and technical ability but can influence the amount of treatment diagnosed.

 Extroversion and introversion are only part of the personality profile, but they are the only traits that will be addressed in this article. To get the bigger picture of personalities and their influence on practice successes, purchase the book, How Personality Types Affect Practice Success. Included is the book Please Understand Me, based on the Myers Briggs Temperament Type and written by David Keirsey and Marilyn Bates.)

What does an introverted dentist often do when he/she observes a breakdown in team morale? For instance, he/she overhears an argument between the hygienist and the assistant about who is supposed to set up a room and sterilize the instruments. The dentist retreats to his/her office only to be confronted by a “red-faced” assistant who has “had it” with Becky, the hygienist. Hoping that it will just go away the dentist says “the two of you need to work it out together.” This suggestion may or may not work, but the introverted dentist is hoping it will so that there won’t be a “meeting” to discuss the problem. Oftentimes, the conflict is not resolved and one of the employees eventually terminates with a bad feeling toward the doctor.

Once you know your personality type, you can learn to adjust yourself to meet the demands of the situation. Getting professional coaching to overcome personality traits that have become obstacles to communication has helped many dentists become more effective leaders. As a professional business owner, a dentist cannot afford to have low team morale caused by a continual revolving door of disgruntled employees. In the situation with the two team members in conflict, a mediator who is detached enough from the emotionally charged situation to identify the problem and offer solutions is necessary. In dental practices, this person is almost always the dentist and few dentists have had the training necessary to referee employee conflicts with success.

McKenzie Management’s research has shown us that extroverts and introverts typically have problems relating to each other until it is revealed that it is a personality issue and not that introverted types are “cold, impersonal and quiet” and extroverted types are “noisy, pushy and bold.”  Understanding each other’s differences in personality and temperament will open the door to better communication, not only for the team, but for the patients that come into the office for treatment.

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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Nancy Caudill
Senior Consultant
McKenzie Management
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New Patients…Are They Impressed or Depressed?

Dr. Stu Carter – Case Study #98

In many dental offices, obtaining and retaining patients is a challenge. Dr. Carter's office was no exception. Over the past five years, the number of new patients (those patients that were seen for a comprehensive exam and professional cleaning) had declined from 28 patients to less than 20 a month. Dr. Carter wondered what was happening. At least he was aware of the decline. Without proper monitoring of basic practice statistics on a monthly basis, this fact would not have been known but possibly “felt” as the scheduled production dwindled. As part of the practice analysis, the "New Patient Exam" was evaluated. 

New Patient Exam Observations:

  • The patient was greeted with a "Hello….and you are?" question! The receptionist was nice enough but not "warm and fuzzy.”
  • The clipboard with the paperwork was given to the patient with instructions to "complete and give back to me as quickly as you can so we can get you back.”
  • The clinical assistant herded the new patient from the reception area, down the hall and around the corner. The patient was observed trying to keep up with her, as if it was a race to the operatory.
  • The patient was seated and the first statement from the assistant to the new patient was, "OK, Mrs. Brown, I am going to take quite a few x-rays so Dr. Carter can see what is going on in your mouth."  The office does not have digital radiography.
  • While the assistant was developing the full series of radiographs, Mrs. Brown was left to "twiddle her thumbs"-- no educational video, music or magazine.
  • Finally, about 15 minutes later, the assistant returns, along with Dr. Carter. Dr. Carter enters the operatory, introduces himself and the first thing he says to the new patient is, "Mrs. Brown, I am going to lay you back here and I will take a look at what is going on in your mouth."
  • He calls out numbers and letters foreign to Mrs. Brown, evaluates her radiographs, and says to her, "Mrs. Brown, I see some areas of concern. Tooth #3 has an old MOD amalgam that will need a PFM, Tooth #11 will need a DI composite and #31 might need endodontic therapy followed with a Post and Core and gold PFM. Do you have any questions?

 Was Mrs. Brown impressed by her initial visit with Dr. Carter?  No. She did not make a follow-up appointment for treatment.

"I have not changed anything about the way I present treatment to my new patients.  Why do I need to change now?"  Dr. Carter asked. His internal referral base had dwindled and the statistics show that his new patients are not accepting his treatment recommendations. It was time to make necessary changes to a failing system.

Recommendations to Dr. Carter to WOW his new patients

  1. The initial telephone call is vital to set the tone of the office. The Scheduling Coordinator must be able to "smile" on the phone. The very first statement she/he makes is, "Thank you so much for calling our office!"  The last statement she/he makes is, "Thank you again for calling our office.  We look forward to seeing you."
  2. The arrival of the new patient should be anticipated with a greeting by name from the Scheduling Coordinator. A simple and friendly introduction such as, “Good morning Mrs. Jones.  I am Suzie and I spoke with you on the phone a few days ago.  It is so nice to meet you", will make the patient feel welcome.
  1. When the clinical assistant comes to escort the patient to the treatment facility, she/he also introduces herself to Mrs. Jones and welcomes her to the practice as does any other member of the team who happens to be within a few feet of the patient.
  2. The clinical assistant seats Mrs. Jones and asks her a few "get to know you" questions before she places the bib, puts on gloves and puts the treatment chair in a semi-prone position. The assistant sits at eye level with Mrs. Jones to facilitate establishing rapport.
  3. As the radiographs are being developed, Mrs. Jones should be offered something to drink and asked if she would like to view an educational video about the practice and its services.
  4. Take blood pressure readings on all new adult patients. You may save a life and it is definitely a "valued added" service. Even though dental offices should do these screenings they are often overlooked. It is important to explain to the patient that he/she will be receiving an "oral cancer screening" and tell the patient how it is done and what you are looking for. Patient’s value both of these services and can see the relationship of dental health and overall body health if it is explained.
  5. Use the intra-oral camera on all new patients. Pictures are worth a 1,000 words.  Allow the patient to "co-diagnose" their conditions right along with you.
  6. When the doctor enters the treatment room, the patient should be sitting up so that he/she can introduce himself/herself, ask a few "get to know you" questions and review her medical history. Then he/she can recline the patient and begin the examination.
  7. Talk to your assistant in language the patient can understand. "Suzie, Mrs. Jones has a large, old, silver filling on her upper right first molar with a broken edge that will need a nice porcelain crown so she can chew again on that side."
  8. When presenting the treatment plan, involve the patient in the discussion. Ask her how she feels about what you have shared with her. Encourage her to ask questions so you can answer them now instead of her asking the Financial Coordinator later. Use visual aids to demonstrate. A closing statement might be, “Mrs. Jones, I know that you are concerned about that tooth with the large crack in it. I recommend we start there. I have available time this week.”

The most important part of the New Patient Exam is the time that is spent with the patient. In most cases, 30 minutes should be ample time to conduct your exam and make recommendations. If it is a complex treatment plan, express this to the patient and invite the patient to return for a review of your findings and a discussion of the options. Invite the patient to bring along a spouse or another person who may be involved in the decision making process.

It is not acceptable to "breeze in and breeze out" of a comprehensive new patient exam.  It is necessary for the Scheduling Coordinator to schedule enough time so that the dentist does not appear to be “hurried” through the information.

Your goal is to impress your new patient with valued added services, friendliness and an experienced eye for detail pertaining to the patient's health and well-being. You want your patient to leave impressed, not depressed!

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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