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10.24.08 Issue #346 Forward This Newsletter To A Colleague
Building Patient Relations
Dentist Coach Case Study
Hygienist Or Not?

Build Patient Relations - Who Has Time?
by Sally McKenzie CEO
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Ten minutes twice a year—or less. That’s the time that most dentists have to plead their case, if you will, to patients. They have five minutes to greet them and come across as caring, attentive and interested in patients as people. They have another five minutes to examine the patients, wow them with their diagnostic acumen and encourage them to pursue whatever recommendations the doctor might have. Yes, 10 minutes to sell yourself, your care, your team and your services. Is it any wonder that many dental teams perform poorly under such conditions? Is it any wonder that many patients leave practices feeling shortchanged and not very important?

You and your team struggle to balance the patient experience with the constant race against the clock, and are frustrated by knowing that the practice should be doing so much more. “We need to educate patients on our services.” “We need to tell patients about how good we are.” “We need to get patients in and out on time.” “We need to communicate with patients in between their appointments.” “We need to build better relationships with our patients.” “We need patients to keep their appointments.” “We need to have a greater presence in our patients’ daily lives.” And the list goes on and on and on.

What if you could address virtually all of those needs in about five minutes or less? And what if you could do so without spending a dime? Read on.

Over the past year, I’ve had the opportunity to learn more about Dental Senders. This company specializes in patient communication packages that close the patient/practice communication gap that occurs between dental appointments.

The packages, which are completely HIPAA compliant, offer dentists the opportunity to reach their patients in between visits by sending birthday and holiday greetings via email or text message as well as periodic newsletters on current dental topics. In addition, the program will automatically identify patients who have not been in for an appointment in the last 12 months, contact them via email or text message and encourage them to call the practice to schedule.

But probably one of my favorite features is the Automated Appointment Confirmation feature. This is an email/text messaging system that allows practices to confirm patient appointments by notifying them through email or text messaging. The completely customizable message is sent with the dental office’s email address and contact information, so patients recognize that it’s from their dentist immediately.

This feature ensures that communication is made with the patient, yet there is absolutely no burden on the dental team. The program synchronizes with the practice management software to identify upcoming appointments and sends the messages automatically according to the practice’s preferred timeline. The dental office is given a daily report as to which appointments have been confirmed and which will require additional follow-up. It’s fast, easy and efficient.

Hesitant to use email or text messaging? Don’t be. The fact is that most patients today use these communication tools routinely, and they would prefer that dental offices confirm appointments using these methods. It’s fast, efficient and allows them to quickly indicate if they will be able to keep their scheduled appointments. However, patients can opt out of the messages if they choose not to receive them at any time.

It’s compatible with most dental practice management systems. Moreover, it does not require dental practices to purchase any hardware or software, and there are no costly support contracts to deal with either. All you need is a high-speed Internet connection, such as broadband or DSL.

Best of all, signing up takes about five minutes and it is completely free. Yes, FREE. What’s the catch? The messages contain a small ad from dental industry leaders, such as an ad from Philips Sonicare or some other highly regarded company.

My recommendation is to stop trying to build practice-patient relations in 10 minutes or less and instead educate patients about your services, tell them how good you are, ensure they are in the chair at the scheduled appointment time and build a positive relationship with them throughout the year. Visit and check it out for yourself. I believe you will be as impressed as I am.

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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I Didn't Say "Good Morning"
What's The Big Deal?

Sounds like a trite thing, right? After all, if people get offended because you didn’t say“good morning they must have some super thin skin. Get over it, you might be thinking.

Well think again.

Employees need to feel that they matter. It’s a human need, really. We all have a basic and natural desire to be acknowledged as significant. When we greet others we convey respect for this need to be recognized.

Now, you may not put much thought into how and when you say hello to someone, but I encourage you to think about it more seriously. It’s been written that when you greet people with a “good morning,” you are actually giving them a blessing. You are telling them that you hope they will have a good morning. You aren’t defining the morning as “good.” You are actually offering a blessing that it should be a good morning.

I got to thinking about this whole exchange of “good mornings” myself, and my thoughts turned to a consultation I recently had with a dentist whose entire office staff threatened to quit. Personality clashes among the employees had intensified to the point that Dr. Smith (not his real name) worried about a mass exodus. He called in McKenzie Management to help stabilize the team and get the practice back on a productive track. You might be wondering how this is related to saying “good morning.” Keep reading.

When I met with Dr. Smith, we decided that I would interview each of his eight employees individually. Here’s a summary of what they told me.

The Good News:

All employees reported positive regard for Dr. Smith. They described him as calm, easygoing and sincere. They respected his dental skills. Employees saw one another as technically competent and ethical, with a focus on delivering quality dental care to patients. Well-networked in the community, referrals from other dental specialists were strong. Patients were seen as the priority of the practice and employees all believed they did a good job in their respective roles. They adhered to the schedule. Patients were seen on time and they were treated cordially.

The Bad News:

Employees noted that interpersonal conflicts have been present for years. Turnover was high. Despite what previous staff had reported to Dr. Smith, the incumbents were convinced that tension and disharmony were significant factors in resignations. There were split allegiances in the office, like Front Office vs. Back Office. The conflicts were rampant. There was an enormous amount of indirect and negative communication. In truth, many of the surface issues were trivial. For example, employees argued over who did or did not go to lunch together. However, these symbolized much larger themes about trust and respect. A lack of team unity was evident in examples of blaming vs. helping when problems arose and/or mistakes occurred. Because no action had been taken, the problems escalated to the point of my consultation.

The conclusion:

On a positive note, no one left the practice. Through a series of team meetings, employees learned to engage in constructive dialogue. Misunderstandings were clarified, resulting in greater trust and commitment.

So how does this relate to saying “good morning”?

The dental team reported that Dr. Smith was disengaged from employees. When he came into the office each morning, he went directly to the desk in his office without greeting employees. Similarly, when he left the office at the end of the day, he didn’t check out with staff. Inadvertently he had created a perception that he “doesn’t want to be bothered.” Though he was “friendly” in the operatory, his introverted and task-oriented demeanor had handicapped his leadership effectiveness.

Social niceties are important. They are the bare minimum of courtesies we can afford to give those with whom we work. Even if you are a strong introvert (as is Dr. Smith), you can learn to mobilize the energy to greet the people who spend 8–10 hours a day running your practice. And if you are like Dr. Smith, imagine the impact of your quiet nature on the people in your office. As one of his employees said, “I don’t feel like he even considers me. He seems really, really locked in his world and isn’t interested in anything other than coming to work to earn a living to get on with his own life.”

The choice about whether to say “good morning” is ultimately yours. Just keep in mind that words can carry a tremendous amount of energy. After all, don’t you wish for every one of your employees to have a “good” morning? It’s in your best interest.

Who did you greet today and why? Talk it over with Dr. Haller. She’s coached hundreds of dental leaders to high levels of engagement with their teams. 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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No Hygienist? No Way!

Why is it that some dentists make a conscious decision to work without a dental hygienist and perform hygiene services themselves? Is it because they don’t want to pay a hygienist to take care of patients in a fashion only a hygienist is trained to do? Is it because they love doing prophys and making about a third of what they could be making providing the kind of dentistry they have been trained to do? Whatever the reason, it is a poor decision on many levels.

First and most important, let’s consider the effect this decision has on the health of the patient. It is imperative that the periodontal health of each and every patient is assessed and addressed if warranted. This is what the dental hygienist has spent at least two years in school learning about. Hygienists are the preventive/non-surgical periodontal treatment specialists. This is what they have been specifically trained to do. Dental schools spend time discussing and performing hygiene-related tasks, but they do not dedicate the amount of time to these topics that hygiene schools do. From a periodontal standpoint, in most situations, patients are better off treated by a licensed dental hygienist than a general dentist simply because hygienists have spent two full years, if not more, perfecting their hygiene skills and passing rigorous examinations to prove their competency. A hygienist is very adept at assessing for conditions and providing appropriate treatment of these diseases. They have been trained how to discuss periodontal conditions with a patient, and gain treatment acceptance and compliance. The patient looks to the dental hygienist as the expert in professional teeth cleaning.

Dentists have been trained to do restorative dentistry but one would never consider having the hygienist prep a tooth for a restoration or take an impression on a tooth prepped for a crown. Hygienists have briefly learned about these applications, but this by no means makes them the experts. Dentistry is a very specialized application, as is dental hygiene.

Dentists are not providing hygiene services because of their love of these procedures or because they think they can provide better services than the hygienist. The motivation stems from the anticipated cost of hiring a dental hygienist and not understanding that the hygiene department should be profitable to the practice.

For example, an office utilizing the consulting services of McKenzie Management set an hourly goal for the hygienist at $150, and the hourly goal of the dentist at $440. If the hygienist worked 8 hours in a day, and met the goal, hygiene would produce $1,200 daily; the doctor would produce $3,520 for a total of $4,720 daily office production. Now, if the dentist did not have the hygienist in place, production would be reduced instantly by $1,200. Not only would he/she lose the hygiene production, his/her production would suffer because of the need to be providing hygiene services. If 4 hours of the dentist’s time was spent completing prophys at $150 per hour, this would reduce the office daily production to $2,360. This means the office loses 50% of the production it could be bringing in daily. If the office is open 4 days per week and 50 weeks a year, the office misses $472,000 in production annually.

Consider that the hygienist gets compensated 33% of production. This is the highest amount the hygienist should be compensated and includes wages and benefits. If the hygienist produces $1,200 daily, this means the most the wages and benefits should be is $400 daily. At 4 days per week and 50 weeks per year, compensation would be $80,000 annually. With the hygienist in place, the office would bring in the extra $472,000. Once the hygienist wages and benefits are paid out, the office would be ahead $392,000 for the year. After doing this math exercise, it is difficult to make a case for not having a hygienist to provide hygiene services.

When the hygienist is working effectively, the dentist can achieve the true production potential of providing restorative services. Hygienists can practice in their area of expertise and the patient and the practice benefit from a successful hygiene department.

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? Contact her here.

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