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9.26.08 Issue #342 Forward This Newsletter To A Colleague
Consulting Myth Debunked
Dentist Coach
Hygiene Case Study

Do You Have the “Local” Advantage or Disadvantage?
by Sally McKenzie CEO
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I like to buy locally. Many of us are partial to the local farmers’ market, the local restaurants and the local sports teams. Your area news media are always looking for the local angle in reporting the day’s events. After all, “local” is where you live and earn your livelihood.

When it comes to hiring a practice management consultant, dentists sometimes want to “buy local.” Occasionally we hear dentists lament, “I need a practice management consultant in here once a month, and so I want to find someone local.” And that would be the 5th most common practice management myth. It’s actually a two-part myth: first is the idea about what constitutes “local” and second the idea that you need a consultant in your practice once a month.

Certainly with some purchases, it does pay to buy local. But we discourage practice owners from hiring a consultant based primarily on proximity. You need experience and expertise, particularly if you are looking at making an investment that should have a profound and positive impact on your practice and your profitability over the long term.

Without question, there are some very committed local consultants available; however, too often we find that dentists who go this route end up paying for consulting services twice. Those practices that lean toward hiring someone locally usually end up later seeking out a company such as McKenzie Management because, although the local individual did help in some areas, he/she simply did not have the experience, expertise or resources readily available to address the many different scenarios that come up in practices.

Why are cancellations and no-shows up? Why are collections down? Why is production lagging when the schedule is jam-packed? Why are new patient numbers dwindling? Why doesn’t the staff get along? Why do I keep hiring the wrong people? Why can’t I figure out how to get the right reports off my computer system? Why can’t I get the insurance company to pay? Why don’t patients accept treatment? And so on. A local consultant may have some answers to some of those critical practice questions and concerns, but the chances that he/she will have hard data to back up assessments and system-specific knowledge to address shortcomings in each system is sometimes lacking..

This individual may live in the area but not necessarily know or understand particulars of the local economy without the economic data on hand. Perhaps he/she may have some concept of the local mindset regarding dentistry, but most likely has no access to reports on the psychographics that are behind those mindsets.

Moreover, oftentimes the locals have worked in just a few similar practices and are quick to apply their limited experience to every practice they walk into. After nearly 30 years and thousands of practices, we at McKenzie Management are well aware that your practice and the one across the street may have some similarities, but that they also have some major differences.

In addition, what many dentists don’t realize is that McKenzie Management consultants are often more “local” than they think. Yes, our headquarters are in La Jolla, California, but our consultants live in every area of the country, from rural to suburban to major metropolitan regions in the North, South, East, West, Midwest and Great Plains, and Canada. Not only are they likely to already be in your neck of the woods, they also have the experience, knowledge and resources to back up every single finding and recommendation that they deliver to you and your team.

Finally, regarding the idea that you need someone in your practice every week, consider this: The benefit of working with a company like McKenzie Management is that once the arrangement concludes, your practice should have the tools, training and expertise to excel on its own. Ultimately, you and your team will have the confidence and the ability to make critical decisions, track your systems, address shortcomings and celebrate success over the long term, even as the staff and the practice change.

Rest assured that once you are a McKenzie client you are always a McKenzie client and additional assistance or the answer to your question is just a phone call or email away—24/7 and 365 days a year.

Now are you ready to try a new twist on a local favorite (namely, your practice)? If so, give me a call.

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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Team Building Event of the Year!

Dr. Nancy Haller
Dentist Coach
McKenzie Management
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Want To Be A Better Leader? Itís Time To Do A 360

As the Dental Leader, you are a significant key to the success or failure of your practice. You possess essential technical know-how. You control critical resources. You are accountable for business outcomes. But you don’t do it alone. You have to manage relationships with employees, patients, even vendors. How these individuals see you has a huge impact on your bottom line.

Want to be a better leader? It’s time to do a 360. As the term implies, it means going full circle. Also known as multi-rater feedback, 360 surveys allow participants to receive job-performance feedback from all levels of the organization. This strategy can yield results that will be returned exponentially.

In dentistry, as in businesses elsewhere, leaders rarely receive accurate feedback. The old adage, it’s lonely at the top, rings true. Direct, open feedback is in short supply in many organizations. Most employees are reluctant to give feedback to their boss, especially if it’s not positive. For this reason, the 360 survey provides developmental feedback to leaders from the people who surround them. It is a tool used by the vast majority of Fortune 500 companies today.

Why is it called “360”?

Imagine standing on a mountain top, seeing everything within three hundred and sixty degrees. The view would be circular. So too with a 360 survey—feedback is obtained in a circle. Leaders receive confidential, anonymous feedback from the people who work around them. In a traditional organizational hierarchy, feedback comes from a person’s subordinates, peers and boss. In some cases, external sources such as customers and suppliers or other interested stakeholders are invited to give feedback.

360 feedback enables leaders to learn about their workplace behavior from several sources within the organization. It is collected electronically and with confidentiality. For feedback raters to be candid, they must have anonymity. The survey questions in a 360 cover a broad range of leadership competencies. The person receiving feedback also fills out a self-rating survey that includes the same questions that others receive.

The purpose of the 360 feedback is to identify your strengths and weaknesses in order to increase personal or team effectiveness. The most effective 360 feedback processes focus on observed behaviors that can be modified. The aggregate summary report provides information about whether intentions are matching impact. That is, do others see you as you see yourself? Do others see you the way you want to be seen?

The outcome of a 360 is invaluable behavioral insight—knowledge that all leaders need to have about the way people perceive them. By having increased awareness of their competencies, leaders can identify crucial actions they should continue to demonstrate and behaviors that they should stop. By inviting employees to give feedback, there is a greater climate of trust within the leader’s “circle.” They realize that she/he is striving for continuous improvement. In turn this can incentivize employees to focus on their own development.

There are standardized surveys as well as customized methods for 360 feedback. The advantage of standardized surveys is that they have been well researched and are known to assess leadership characteristics. In addition, standardized surveys may have normative data that have been collected from multiple sources, which allows for comparisons. Customized 360s are just that—they are developed specifically for one organization. A customized 360 feedback questionnaire can be useful if designed to fit the exact needs and organizational development objectives. However, given the cost and time involved to customize a 360 feedback questionnaire, psychometrically sound (reliable and valid); off-the-shelf questionnaires are well worth the trade-off.

360 feedback is usually conducted with the support of a facilitator. That person is trained in the interpretation and use of 360 data. She/he helps to create an individual action plan to build on identified strengths and to develop new leadership competencies. The goal is to make your leadership more effective and your practice more successful.

Dr. Haller is available to coach you to higher levels of performance in your practice. Contact her at

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

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Angie Stone RDH, BS
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Hygiene Practice Enrichment Program

McKenzie Management received a call from an office manager, Suzie, who was aware the hygiene department in her practice needed improvement.

Because she had read many McKenzie Management E-Newsletters she was aware of what the hygiene production numbers should be. She also knew their numbers were not on target. In fact, their numbers had been declining for several months and she was concerned. Though she was able to make a basic assessment, she did not possess the knowledge required to make the numbers go the other direction.

She recognized she was going to need all the solid information that she could get because the doctor she worked for was not in favor of consulting services. He thought things were going along just fine, but Suzie knew the facts did not support his thoughts.

Another concern was the manner in which one of the hygienists, Heidi, was practicing. She did not attend any continuing education courses unless she absolutely had to and was not abreast of current methodology. She was a friendly, “chat and polish” hygienist concerned with how the families of the patients were doing and where Johnny was going to college and if Sara was getting married. This type of information exchange certainly can develop patient relations, but the conversation cannot stop there. Dentistry needs to be brought into the conversation. After all, isn’t this why patients have their teeth professionally cleaned and examined? If dental situations, particularly periodontal conditions, are not evaluated and discussed it is irresponsible and not in the patient’s best interest.

Bridge The Gap

On top of this the doctor had fallen into the same pattern as Heidi the hygienist. He too had more of a social focus and less of a dental focus during the examination. He was relying upon the hygienist to let him know what she found. Oh, she did fill him in on the patient’s latest personal news, but when the doctor did not hear any dental concerns from the patient or the hygienist, he dismissed the patient with a casual, “See you next time!” There was never any talk regarding periodontal disease, pocket depths, etc. Heidi did not feel comfortable enough to bring up the issue of periodontal disease. She had been seeing these folks for years and had not discussed anything other than personal issues while cleaning their teeth. How was she supposed to tell the patients they have periodontal disease?

Luckily for Suzie and the entire dental team, her concerns were addressed. She received information and support from the McKenzie Management team, so she was able to convince the doctor to participate with  McKenzie Management utilizing their Hygiene Enrichment Program . The following is the practice analysis data.

There were 2,004 patient charts in file cabinet, but only 1,154 active recall patients. 850 patients had not been retained over two years.

  • The practice was operating on a net loss of 24.5 patients per month because of an ineffective recall system.
  • There were approximately 1.5 hygiene hours a day not scheduled, which resulted in $47,232 lost annually from openings in the hygiene schedule. This loss did not include the additional treatment that would have been diagnosed from the hygiene department.
  • Hygiene production to office production was 13.04%. Industry standard is 33%.
  • Periodontal production to hygiene production was 5.3%. Industry standard is 33%.
  • Daily average hygiene production for the year previous to consulting services was $1,151.
  • Daily average hygiene production needed to be increased to $1,488 per day to cover hygiene salaries and benefits, which were running at 39.16%. Industry standard is 33%.
  • Average monthly hygiene production = $32,320
  • Hygiene production for 4 months pre Hygiene Enrichment Program = $129,280

Post-consulting data (for the 4 months following consulting program):

  • Daily average hygiene production = $1,262 (an average increase of $112 per day per hygienist)
  • Average monthly perio production = 22% (an increase of 17%)
  • Hygiene to practice production = 18% (an increase of 5%)
  • Average monthly production = $44,781 (an increase of $12,461 per month)
  • Hygiene production for 4 months  = $179,089 (an increase of $49,809 over 4 months)

The numbers tell the story of success but the most important improvement came from the patients. Because the doctor, hygienists and the rest of the team learned how to change the systems affecting patient care, a measurable difference in patient acceptance and compliance took place.

Need help with implementing new systems in your Hygiene Department to ensure patient acceptance and compliance? Email
Interested in having Angie speak to your study group or at your next seminar? click here.

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