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5.30.08 Issue #325 Forward This Newsletter To A Colleague
Converting Emergency Patients
Winning Patient's Confidence
Team Accountability

The 60 Second Conversion:
Emergencies to Comprehensive Exams
by Sally McKenzie CEO
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In stressful situations, people don’t necessarily remember what you did but often rather how you made them feel. When managing an emergency patient, that point couldn’t be truer. Take steps to ensure that your emergency patients feel good about your staff, your care, and their decision to choose your practice and you’ll find you’re well within striking distance of that much-desired 80% conversion rate.

Start with a little sensitivity training for staff on the front lines. Business staff, who tend to be more task-oriented and are much more comfortable when the day runs according to a specific plan, occasionally need to be reminded that emergency patients are likely to require more empathy and concern than they may typically convey in their day-to-day patient communication. The emergency patient should feel that your practice is one that is understanding and helpful—not punitive.

Oftentimes, emergency appointments are viewed as negative and potentially problematic by the patient and the staff. Consequently, practices commonly send the wrong message to those patients that they must interact with under emergency pressure. The person is squeezed into an already full schedule. Although it’s probably not intentional, this patient is frequently viewed as an annoyance, an interruption to the day rather than an opportunity. And that message comes through loud and clear to the patient.

Listen to how the emergency patient calls are handled. Are these conversations warm and welcoming? What is the staff member’s reaction? Irritation? Frustration? Does it depend on the time and the day? How would you feel if you were an emergency patient calling your office? Would you be glad you chose this practice or would you feel that the practice’s primary concern is the payment rather than the patient?

Here’s what happens in many offices: The scheduling coordinator takes the call and scans the already full schedule. With a labored sigh, she/he tells the patient it’s going to be very difficult for the practice to work them in, but they will. Oh, and doctor expects payment up front. Within the first 60 seconds of contact with that emergency patient, your practice is laying the groundwork for conversion to comprehensive exam …or not, as the case may be.

I recommend dental teams develop phone scripts to help them effectively communicate with emergency patients from the very first word. A script provides a general guide to assist all staff in gathering necessary information, conveying essential details, and continuously expressing a helpful and caring tone and attitude throughout the exchange, no matter who picks up the phone,

Whatever the circumstances—full schedule, stressful situations, etc.—emergency patients must be treated with compassion and understanding. Believe me, I know this can be tough for your highly task-oriented and incredibly efficient office manager who is lightning fast on the computer and spits out numbers…production, collections, accounts receivables…with a pinpoint accuracy a sharpshooter would envy. But this is when she/he and the rest of your highly efficient business staff need to step back, take a deep breath, and put forth a caring and considerate tone that would make Florence Nightingale beam with pride.

When patients arrive at the office for an appointment, the business staff welcomes them and greets them with a smile. They assure patients that the clinical team is excellent and that they will take very good care of them. In addition, they give patients a general idea of how long their wait will be. They ask if patients would like assistance completing their paperwork. If patients are in considerable discomfort, they take them into a consultation room or other quiet area where a staff member can help them complete practice medical forms and other documents. The focus should be on making the process as easy and comfortable as possible for patients.

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Belle DuCharme CDPMA
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The First Ten Seconds—Winning Patients’ Confidence

“Exclusive attention to the person who is speaking to you is very important. Nothing else is as flattering as that.” —Charles W. Eliot

The team is on target with a new patient. The initial phone contact was great and the patient was able to get an appointment to be seen within a week. Mary, the Scheduling Coordinator, made the patient feel at home with her pleasing personality and offer of coffee while the patient waited to see the doctor. The Treatment Coordinator connected with the patient and built rapport by asking open-ended questions about what the patient wanted and expected from her/his dental visit and future care. It is now time to meet Dr. Goodtooth.

Tom Hopkins, the bestselling author of How to Master the Art of Selling, states that you have ten seconds to make a stellar first impression. The goal is to be a person whom other people like, trust, and want to listen to. A dental office can be a challenging environment in which to create a lasting positive impression unless attention is given to the experience from the patient’s point of view. Having a bad past experience generates fear in the hearts of potential patients. The Treatment Coordinator can relay the patient’s frame of mind in relation to past experiences that were discovered during the new patient interview; with that information the doctor can meet the patient with a feeling of “I know how this patient wants to be treated.”

When the doctor makes his/her entrance into the treatment room, it is often from behind the patient, who is sitting upright in the treatment chair. It is recommended that the doctor meet the patient in the consultation room or other neutral location and be prepared to:

  • smile, deep and wide and natural and at the same time…
  • make steady, friendly eye contact
  • offer a greeting and a welcome to the practice
  • introduce himself/herself and any other team members present in the room

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.

In many dental offices, a patient’s typical first encounter with the dentist goes something like this: The dentist enters the treatment room from behind the patient seated in the treatment chair, picks up the health history chart or looks at the computer screen, and says, “Hi, Pam. I’m Dr. Goodtooth. So nice to meet you.” The dentist then comes around and stands to the side of the chair looking down at the patient. There is no question of who is the authority, if you consider the positions of the patient and the doctor. The patient/doctor relationship has been established and the doctor is in control.

It is better to make the person-to-person connection on neutral ground first because this patient is in a decision-making frame of mind and wants an equal say in treatment choices. Being introduced to the doctor in a business environment, like a consultation room or doctor’s private office, will give the patient more of a feeling of control over choices he/she will make. Those choices include whether they will return for dental services in your practice.

From the notes taken by the Treatment Coordinator, the dentist can build a connection and try to find common ground with the patient. Discussing a past negative dental experience with a patient will show concern that the patient’s feelings and comfort are important to you and that you certainly don’t want the patient to relive a bad experience in your office. Perhaps the patient was referred by an existing patient of record. It is important that the dentist know who that patient is before being introduced to the new patient. This information is often a great ice-breaker. Hopefully, there are personal notes about the referring patient in the computer so you can say, “I will thank Jim for referring you to my practice. He is a great golf enthusiast; do you play golf with him?”

Once the introduction and the patient interview has taken place, the dentist can now direct the clinical team member to escort the patient to the treatment room to begin taking radiographs and photos. After gathering clinical data to do a diagnosis, it is much easier to sit down with that patient and deliver the treatment presentation because the dentist has created a personal connection and has established a comfort level with the patient, who sees the dentist as a “partner” in his/her care rather than a dictator.

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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Accountability for My Performance? Who Has Time?

Dr. Jason Wright—Case Study #279

Dr. Wright was distressed over what appeared to be tasks not being completed by team members in the office, both clinical and business. He wanted to put new systems in place to measure performance and to give each team member an area where each was accountable for the results of his/her department. In order to move the practice in this direction, the following information needed to be gathered and addressed:

Practice Statistics

  • 800 active patients
  • 2 clinical assistants
  • 6 hygiene days
  • 2 business assistants
  • 1 doctor working 32 hours a week
  • Average daily gross production: $7,500 per day


  • The assistants were unclear about their job descriptions. One assistant was more adept at chairside assisting with the doctor and anticipating his chairside needs. At the same time, sterilization tasks were not getting accomplished in a timely manner by either assistant because they each thought “the other assistant” was completing the task. Both assistants were working into their lunch hour or working overtime. There wasn’t a policy in place pertaining to “who stays and who goes” when Dr. Wright ran late. In most cases, there was only one patient in the treatment room but two assistants, one of them working with the patient and the other “standing around” trying to look busy.


  • Both business assistants enjoyed working together and sharing the same tasks. They commented that they both “do what needs to be done.” When asked about follow-up on collections and unscheduled recall they admitted that neither of them worked those areas consistently.
  • Job descriptions were not in place so many duties were duplicated or not accomplished at all. Without defined duties and accountability, they choose what they would or would not do on a given day. Neither business assistant had a clear understanding of the dental business systems that are key to practice success. (Advanced Business Training through McKenzie Management was recommended.)
  • When questioned about incomplete tasks, the response from both business assistants was, “I don’t know when I would have time for that.”

The business team was only following the directions that had been given to them by the doctor upon their hire. In their eyes, the job was getting done to the best of their ability.


  • Assign the more skilled assistant to remain with the doctor as he moves from treatment room to treatment room. Her/his responsibilities are to maintain rapport with the patients, write clinical notes for the doctor’s review, assist with all the chairside duties, answer any questions regarding treatment and/or recommended treatment, and dismiss the patients to the Scheduling Coordinator. She/he is also responsible for clinical supply inventory.
  • The less skilled assistant will be in charge of seating patients and verifying the treatment scheduled, the setting up and breaking down of the doctor’s treatment rooms, sterilization of all instruments, keeping the lab and sterilization areas clean, stocking of all the treatment rooms, unpacking supply boxes, checking off invoices and assisting the hygienists when available for perio-charting or other support.

Assigning specific duties to each assistant gives clarity to job duties. Should there be a need for overlapping duties, these issues should be discussed at the morning meeting when preparing for the day. The morning meeting is the time to discuss who will stay through lunch and who will stay at the end of the day.


  • Specific job descriptions must be given to each business team member. The Scheduling Coordinator is responsible for keeping the doctor scheduled to the daily goal, checking all the patients in and sometimes out. She is also responsible for all unscheduled treatment plan follow-ups by phone and by mail. Treatment plan acceptance rates should be monitored and reported on at the monthly meeting. She is also responsible for preparing the charts with routing slips and confirming all the appointments for the doctor.
  • The other business team member is the Financial/Insurance Coordinator. Her/his job duties would include follow-up on outstanding insurance claims, financial arrangements with patients and follow-up on past due accounts, sending weekly statements and posting payments from the mail. This position is often the Hygiene Coordinator, responsible for the maintenance of the recall and patient retention systems, including the follow-up on all past-due hygiene patients and reporting this information at the monthly meeting.

Having specific tasks and accountability for the outcome of these tasks is the only way to measure the success or failure of office systems. Accountability for completion of daily tasks is paramount to the efficiency and productivity of the practice.

Dr. Wright came to the understand that he needed to be accountable for the success of his dental team by seeing that systems were in place to measure performance based on job duties and accountability to the practice vision and goals.

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

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