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7.11.08 Issue #331 Forward This Newsletter To A Colleague
Practice Strategies
Case Study
Mission Statement

Seven Strategies For Success - Part Two
The "Little Things" Are Huge
by Sally McKenzie CEO
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Oftentimes it’s the little things that make all the difference. Our opinions of each other are shaped by them. Our perceptions of the products and services we purchase are influenced by them. And our views of the people who are selling or delivering them are directly affected by them. What are they? They are those seemingly intangible influences that give us a sense or feeling that this business or that office is a quality operation, that those people are truly a caring team or a trustworthy group. It’s the little things that are the “value added” bonus that reinforces what patients want to believe.

They are already convinced that you’re well trained and qualified to perform dentistry. What they don’t know and what you need to repeatedly show them is what separates you from every other dentist in your area and why you are worth their investment of time and money.

Patient opinions and perceptions are shaped by multiple variables, many of which tend to be subtle and vague. Often it’s the intangibles, the seemingly insignificant little details that have a powerful impact on your success.

Last week I shared with you four of the Seven Subtle Strategies for Success. This week, I’ll share three more “little things” that can make a big difference in every practice.

#5 Follow-Up
You’ve heard this before, but I’m going to say it again. Make follow-up phone calls to your patients the evening after more invasive procedures to demonstrate to them that you care about how they are doing. This is the single most important “little thing” that you can do and it will have a huge impact on how patients feel about you and your practice. I guarantee it.

#6 Conduct Regular Attitude Inventories
Evaluate your staff’s routine communication with patients. If necessary, train them to ensure that friendly people are prepared and ready to answer the phone with smiles on their faces and in their voices. Current and prospective patients want to feel that the entire staff cares, not just the doctor.

Pay attention to routine communications that can inadvertently send prospective patients down the street. For example, a new patient  who calls to schedule an appointment and is greeted with a conversation like, “Do you have insurance? No? Let me tell you about our financial policy,” immediately feels unwelcome and defensive. Educate patients first on the excellence of the doctor and team. Get into the rules and regulations later.

Acknowledge patients when they walk in the door. Under no circumstances should a patient ever be ignored. Greet them with a smile and a sincere “Welcome to Dr. Keith’s practice, Mrs. Jones. We appreciate that you chose this office,” or, “Good to see you again, Mr. Brown. How are the kids?”

#7 Stick with Straight Talk
…particularly when it affects patients’ busy schedules. The reality is that there are times when you are running behind, when things aren’t going as expected, etc. If the doctor or hygienist is significantly delayed—more than 20 minutes—make some effort to let patients know before they leave home or the office. They will appreciate your efforts and, if they have to wait a little longer one day, they will already know before they walk in your door. They will appreciate the fact that you cared enough to let them know.

Provide complete information. Patients expect to be able to ask questions and receive clear answers. They want to understand the treatment options that are available to them and why you are recommending a particular course of treatment. Education and information are keys to helping patients feel that they are making informed decisions. Make use of educational materials and websites when presenting your case, and train your entire team to answer basic questions about dental procedures. It will reinforce patient confidence in not only the doctor but also your whole staff.

Pay attention to the little things that influence how patients perceive your total practice. Step back and evaluate your office experience from a patient’s standpoint. What are the subtle differences that give patients reasons to return rather than going to the office across the street? Use my Seven Subtle Strategies for Success as a starting point for examining what you can do to distinguish your own practice from the others.

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
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Why Do Patients Leave Your Practice?

Dr. Carol Fontaine—Case Study #311
Dr. Fontaine’s Concerns:

Dr. Fontaine’s business team had noted that a number of patients had left the practice. Upon asking the team the reasons for the departures, the answer was always the same: “I don’t know—they didn’t say.”

Practice Facts:

  • Fee for service/no PPO
  • 18 new patients a month
  • 9 years in practice at same location
  • 4 days of hygiene
  • $45,000 a month in production

Dr. Fontaine is fortunate that she does not have to participate in managed dental care programs or “reduced fee” plans, but her monthly production is below the national average for a practice of her size. According to the reports generated, the practice has not experienced significant growth in the past 3 years.


  • No hygiene department systems or goals to improve retention and growth
  • No internal or external marketing programs
  • A/R is “within normal limits” of 1x monthly net production
  • Doctor is scheduled 1 week into the month
  • New patient appointments are not available for at least 3 weeks because of pre-scheduling solid for 6 months with no “blocking” of time for new patients
  • A new Hygiene Coordinator was employed 3.5 years ago
  • Scheduling Coordinator was employed at start-up

Observation of a patient requesting her family dental records:
Michelle: “Mrs. Melbrook, I need for you to sign a release form before I can give you a copy of your family records. Have a seat and give me a few minutes to make a copy for you.” Once the paperwork was completed, Michelle handed Mrs. Melbrook an envelope containing her family’s dental records. Michelle said, “Thank you and have a good day.” Michelle was very pleasant and professional but did not inquire as to why this patient was leaving the practice.

Here are two possible scenarios of how to obtain information from the patient regarding three very valuable pieces of information:

            1. Why is she leaving?
            2. Can we change her mind about leaving?
            3. What can the practice do to avoid the situation from happening in the future?

Scenario I
Standard in the industry is an attrition rate of 10% of the active patient base of a family practice; patients pass away or move away because of employment relocation other reasons. These scenarios cannot be avoided, but these reasons should be asked and tracked.

Example: “Mrs. Melbrook, I am so sorry to hear that you are transferring your dental records. I surely hope that it isn’t because we failed to meet or exceed your expectations of us.”

Wait for the response. If the patient is leaving because of relocation, she will quickly respond to the statement. “Oh no, Michelle! We have enjoyed our visits with you and the rest of the staff. Joe is being transferred.”

Michelle responds with, “Mrs. Melbrook, we will truly miss having you, Joe and the kids in our practice. Should you return to town, please don’t hesitate to give us a call. We would love to have you back any time.”

Scenario II
There are unfortunate occasions when a patient leaves because of something unpleasant that has happened. It is the responsibility of the Scheduling Coordinator or whoever is answering the phone or greeting the patient to determine why the records are being requested. The same statement is made: “Mrs. Smith, I am so sorry to hear that you are transferring your dental records. I surely hope that it isn’t because we failed to meet or exceed your expectations of us.”
If the response is, “I just need our records,” Michelle should inquire, “Mrs. Smith, is it something we said or did? If so, is there anything we can do to encourage you to stay?”

Many times the patient is upset about a miscommunication by either the doctor or someone on the clinical or business team. Michelle can assure the patient of confidentiality if necessary. The objective is to try to keep the patient in the practice as long as the patient has been compliant in keeping appointments, being cooperative and taking care of financial commitments.

Mrs. Smith responds with, “Michelle, I have noticed that I am waiting longer and longer to see the hygienist and the doctor. I am really busy and don’t appreciate what appears to be the lack of concern for my time.”

Michelle must address Mrs. Smith’s complaint with resolve. “Mrs. Smith, I am so sorry to hear that we let you down. I am sorry that you have had to wait beyond a reasonable time. We attempt to be sensitive to our patients’ schedules. It is obvious that we have failed you. Is there something that I can do to express our concern and convince you that we do care and don’t want to lose you as a valued patient? Can I offer you appointments first thing in the morning or right after lunch?”

From learning why a patient is leaving, the practice stands to gain information to prevent it from happening again with another patient and possibly salvage the relationship with the departing patient.

Be proactive. If a patient is kept waiting more than 10 minutes, inform the patient of the estimated time before being seen. Offer the telephone to contact family or employers. Keep an inventory of gift cards for local establishments and reward the patient for tolerating the inconvenience. Allow the patient to leave feeling good about having concerns addressed immediately.

Think of how annoying it is when you have to wait without anyone addressing you and apologizing for the inconvenience. How easy is it to say, “Mrs. Jones, I am so sorry that we have kept you waiting. We hope that the wait has not inconvenienced you in any way”?

Tracking the number of patients that are leaving the practice and their reasons why is one way that you will know where the practice can improve patient relations. Discussing the reasons patients leave at the monthly meeting will help the entire team to focus on ways to improve patient retention and further growth of the practice.

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

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Belle DuCharme CDPMA
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Does Your Function Serve The Big Picture?
Creating Mission Statements

“I am of the opinion that my life belongs to the whole community and as I live it is my privilege—my privilege to do for it whatever I can.” —George Bernard Shaw

In the dental office, each team member has strengths to build on to become better performers and to meet the objectives of the practice. Weaknesses can be defined as areas that need further training or additional skills to be proficient at getting the job done. People in every workplace talk about working as a team, building the team and being part of the team, but few truly understand how to create the experience of teamwork or how to develop an effective team. In the broadest sense, belonging to a team is feeling part of something larger than you and being responsible to that larger purpose.

What is the “larger purpose” in the dental office? The root is the dentist’s mission statement of what his/her practice represents to himself/herself and to the community. A team cannot be supportive of a purpose unless it has been defined. Even though the employees have specific job duties, such as answering the phone and scheduling patients, and are identified as either front office or back office workers, they are still unified with the other organization members to accomplish the overall objective. The bigger picture drives your actions; your function exists to serve the bigger picture.
Let’s say that the bigger picture has been defined by the dentist/employer as the practice mission statement. It reads:

My practice mission is to continually and tirelessly work to promote the total health of my patients, my staff, my family and the community as a whole and, furthermore, to provide education and understanding of the benefits of quality dental care in a professional and clinically superb environment that my patients and community can look to with confidence.

My vision is to create a supportive professional dental team that shares my mission and works with me side by side to promote patient education and implement and support the delivery of excellent dental care in our community, resulting in a satisfying and stable working environment for all.

The last part of the bigger picture equation is setting the goals to get the mission accomplished. An important goal for the team would be to bring out the mission and vision statement every six months and reconnect with this important practice philosophy. The first line of the mission statement resolves to “work to promote the total health of each other and the patients. Is the team supportive of each other in carrying out daily tasks? There are days when you just don’t feel well and it is good to know that co-workers will rally around you and help you get through the day.

Does the team recognize when a patient is not feeling well and take the extra time to make the patient comfortable during the appointment? Total health encompasses not only teeth, but also a patient’s emotional, physical and spiritual state.

The next line of text in the mission statement, “provide education and understanding of the benefits of quality dental care,” represents a goal of continuing education not only for the patients but also for the team. The team should embrace continuing education as a vehicle to perfect their performance of clinical and business duties and to improve communication with patients on how dental care can improve and enrich their lives.

Without education, the team quickly becomes stagnant and out of touch with what is happening to the clinical and business side of dentistry. In this world of ever-changing technology, what is new today quickly becomes old. If a patient asks you what you think of laser dentistry, dental implants, Vizilite or optical scanners, how are you and the team going to answer if you don’t have the education to back up your reply? Promoting the spirit of education creates energy that mobilizes the team toward improving the skills to motivate patients to accept recommended treatment.

When the practice is operating from its mission statement, it defines the big picture from which the team develops its larger purpose.

McKenzie Management Advanced Training programs are designed to help the doctor and his/her key team members define and mobilize their big picture for the success of their practice.

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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