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5.23.08 Issue #324 Forward This Newsletter To A Colleague
Dentist Coach - Leadership
Patient Surveys - Marketing

Make the Most of Effective Cross-Training
by Sally McKenzie CEO
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Many dentists like to talk about how their teams are “cross-trained.” One of their favorite lines is, “Everyone just steps in and does what needs to be done.” They are convinced that employees who have been around for a while are cross-trained because with a little longevity in the practice (say a few months) they’ve surely learned by osmosis how to step in and take care of things, like collections, scheduling, patient phone calls, etc. You know—those little things that are at the heart of your management systems.

Unfortunately, although the dentist’s concept of cross-training sounds really great, it’s the stuff fairy tales are made of and it simply doesn’t work effectively in the real world. Why? Because when everyone is expected to do everything no one is truly accountable for anything. And how could they be?

Don’t get me wrong; certainly cross-training, when implemented correctly, can be tremendously effective. There are fundamental benefits to preparing staff to step in when an employee is sick or on vacation, or when a vacancy occurs. It also helps employees gain a clearer understanding of the practice big picture, and enables them to understand how their duties influence the practice as a whole. Not to mention the fact that it’s very easy to criticize co-workers until you’ve walked a mile in their shoes.

However, you cannot begin to even expect staff to step in and just “help out” when necessary until you’ve established a clear delineation of duties, until you’ve designated a specific person to be responsible for specific systems and until you’ve trained them first!

For example, let’s say your business employee Emily’s newly crafted job description (we talked about those last week) dictates that she is responsible for cash flow management, including processing insurance, collecting from patients, treatment financing, financial presentations, etc. She’s also responsible for developing a telephone protocol, new patient protocol, measuring hygiene production/hygiene days needed, etc.

But just because the responsibilities have been spelled out in a job description doesn’t mean that Emily is prepared to effectively carry them out. In fact, without the proper training and tools, this employee—as bright, energetic and talented as she might be—is no match for inadequate training. As I’ve said multiple times before, the single biggest contributor to practice inefficiency and mismanagement is a poorly trained team. In particular, the lack of instruction provided to business staff costs dentists thousands upon thousands of dollars. And given the current state of the economy, you really don’t want to be throwing money away.

In today’s dental marketplace, there’s simply no excuse for lack of training. A wide variety of affordable educational options are available. At a minimum, invest in job-specific instruction to ensure that staff is prepared to carry out their duties efficiently and effectively. Not only is this essential to the success of your practice, it is an investment in long-term team loyalty.

Once key staff is professionally trained, then you are prepared to make ongoing internal training a part of your practice culture. Set aside time during your monthly two-hour staff meeting to provide instruction and educate each other on specific systems.

For example, once your business employee has been trained to establish telephone protocols, put her on the staff meeting agenda to teach the entire staff proper telephone techniques. Have your business manager provide a lesson in scheduling to meet production goals and your hygienist discuss the finer points of building lasting patient relationships. Finally, the doctor and assistant can train the staff on how to answer common questions about a new procedure being offered.

Cross-training can be used effectively in the dental practice but to ensure it is successful, insist that a foundation of thorough and professional training take place first.

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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Are You the Captain of Your Ship, or Chicken of the Sea?

I was directed to a book about leadership recently. Truth be told, it had been sitting on my shelf for a few years, but when the title came up in conversation I decided it was finally time to read it.

Having served as a commissioned officer in the United States Navy, I was intrigued by the military context. The book? It’s Your Ship: Management Techniques from the Best Damn Ship in the Navy.

When Captain D. Michael Abrashoff took over the USS Benfold, the high-tech fighting ship was anything but ready. Morale was low and performance was poor. Abrashoff had to make changes quickly. In his book, he tells how he transformed the USS Benfold into an award-winning model of efficiency and success. Here are some of Abrashoff’s core principles.

  • "It's your ship, so take responsibility for it. Don't ask permission; do it."

If you’re going to be the LEADER of your SHIP, you’ve got to see yourself as the one who’s accountable for the state of your practice. Be honest with yourself. What’s working, and what’s driving you crazy? Be careful to avoid the islands of ‘woulda,’ ‘coulda,’ and ‘shoulda,’ because you’ll get marooned there. Although you may not see solutions at this very moment, the first step to making improvements is recognizing where you are.

As Abrashoff wrote, “Whenever I didn't get the results I was looking for on the Benfold, I tried to look inward before flying off the handle. Eighty percent of the time, I found that I was part of the problem and that, through my actions alone, I could have altered the outcome significantly.”

  • “Never forget your effect on people.”

You have a tremendous influence on those around you, even when you don’t see an explicit reaction or hear comments. One of the keys to becoming a more effective leader is realizing that your patients and your staff notice everything you do—or don’t do. Perhaps you overlook the significance of your words and gestures but I assure you that it is your energy level that determines the enthusiasm in your office. This doesn’t mean you need to be effusive or disingenuous. It does mean that you need to think of how you act and decide to be a positive role model. We all have bad days. When it’s a “dark day,” minimize the damage you impose.

  • "See the ship through the crew’s eyes.”

It is a challenge to attract, retain and motivate employees. One Gallup study found that 65 percent of employees who leave their companies are actually leaving their boss. Research confirms that the top five reasons for this are:

  1. Not being treated with respect or dignity
  2. Being prevented from making an impact on the organization
  3. Not being listened to
  4. Not being rewarded with more responsibility
  5. Receiving low pay or salary

To be successful, a leader needs to know how to lead and how to follow. Be open to suggestions from your staff and be ready to listen to new ideas. Furthermore, make the effort to get to know the people around you. This creates a positive atmosphere that motivates, encourages and gives confidence.

  • Did I clearly articulate the goals I was trying to achieve?
  • Did I give people the time and resources they needed to succeed?
  • Did I give them enough training to get the job done properly?
Taking command of your ship doesn’t mean shouting out orders. Effective leaders encourage employees to find better ways to do their jobs and also to enjoy their work. This is the only way to get salutes and results!

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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Scott McDonald
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The Case for Market Research

We have all had the experience of believing that we have a large amount of money in the bank but then finding out that funds are missing. It is usually the result of a forgotten withdrawal or miscalculation in making a deposit. It is a horrible feeling of panic and anger. “What could have happened?” we ask ourselves as we stare at the numbers again and again. “Who did this?”

This dose of reality is chilling to say the least. But it is also invaluable because it provides us with a sense of “the real world” as opposed to a set of vague assumptions. Although there is definite comfort in not knowing what is going on, it is a poor way to do business. Knowing your exact balance makes sense.

So, what should you know about the “real world” of your practice to help you make better decisions (even if it is not great news)? The attitudes and opinions of your patients will be helpful. So will an understanding of the world outside your office door.

McKenzie Management can offer some insightful tools to help determine what your patient relations account looks like and the current environment of your practice.

Patient Surveys

Knowing what is going on in the heads of your patients is certainly a good start to understanding the state of your practice. In our experience, doing an annual patient survey of 100 or more patients will give the doctor and staff real-world information, or market research that can either reinforce good expectations or provide a wake-up call about factors in the practice that may be a concern. Are patients finding it harder to find a parking space? Does it seem more difficult for them to get an appointment? How is the change of staff working out? Are you falling into some bad habits?

It does not take very long to find out what you are doing right and what you are doing wrong. Unfortunately, most patients like you so much that they may consider offering such candid advice or making such frank observations that they could be taken as insults. Getting a third party to carry out and analyze patient comments may be the best way to learn the truth.

We use a survey that takes into account specifics such as the reception area, parking and billing. We want to know about the patient’s attitudes regarding each member of the dental team as well as the doctor. Knowing their thoughts about fees, hours of operation and location can be an extremely useful exercise that helps the practice stay ahead of potential problems as well as continue doing the things that are working out well.

Demographic Reports

Knowing about the people inside the practice is valuable, but what about the people outside? For example, no practice should assume that the same patient pools it has always drawn upon will remain the same. People grow older. Households shrink. Families move away. New offices open nearby. Big employers may be hiring or firing your patients. The housing and credit crisis may be sneaking into your practice area (or not).

We have noticed that during the space of ten years, the entire population of many American cities nearly completely turns over (at least for the population under 40 years of age). Communities may gain new socioeconomic strata, cultural values and even languages. If a practice is still making its basic assumptions of practice promotions on information that was gleaned a decade earlier, is there any wonder that the practice might have some trouble growing?

Many people turn to their local chamber of commerce or some other “free” demographic site from the Internet for information. The trouble with free demographic information is that it comes with no analysis. Data is cheap. The real value in this kind of information is having it interpreted by an expert. Wouldn’t you feel better about someone who has looked at several thousand X-rays before trusting your case to a surgeon? For that same reason, having an expert examine the recent demographic data surrounding your practice makes sense.

McKenzie Management has a series of demographic tools that will help you identify what is going on outside of your office doors. In addition to evaluating your current location, they can help you identify the best sites for a second office, alternate locations and satellites. The only complaint we ever hear is, “Why didn’t I do this a long time ago? It would have saved me tens of thousands of dollars!”

The Bottom Line

In a world that changes as quickly as ours, it only makes sense for a wise professional to check vital signs not just inside the practice but outside the office as well.

If you are interested in a Community Overview Report that will help explain what your practice area is like NOW and what it is becoming IN THE FUTURE, go here: Community Overview Report

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