7.27.12 Issue #542 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Who's Responsible for Treatment Acceptance? You... and Everyone Else
By Sally McKenzie, CEO

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Doctor, did it ever occur to you that the manner in which your Scheduling Coordinator talks to patients affects treatment acceptance? Probably not. Many dental teams view treatment presentation/acceptance as a one-time event involving the doctor and/or another member of the clinical team. In actuality, staff lay the foundation for treatment acceptance or rejection in virtually every patient interaction.

Have you and your team instilled in the patient trust, knowledge, and respect for the team’s skills that will enable them to pursue recommended treatment without reservation? Or have you subtly and unwittingly undermined their confidence? Consider the following:

If there is a sense that the right hand and the left hand don’t know what the other is doing, this erodes trust and confidence. For example, the patient schedules an appointment and the business employee accidentally books it on the wrong day. If this happens more than occasionally, it’s wearing away the trust patients have in your practice. If procedures are regularly interrupted because necessary products and instruments are not at hand, it becomes disconcerting to patients, and they begin to question the competency of the team.

Most patients today base major decisions, such as extensive dental treatment, on multiple factors - including full comprehension of the need for treatment; the importance of the procedure to them in terms of quality of life, aesthetics, or health; possible ramifications if they choose to procrastinate or elect an alternative procedure; payment options, and how they feel about the practice as a whole. They will judge your practice on virtually every system that they encounter - from how staff talk to them on the phone, the use of modern technology, payment and insurance procedures, and many more.

If the ancillary systems are functioning well, the treatment presentation procedures will likely need little more than some additional burnishing, such as:

1. A relaxed, non-rushed environment where treatment is explained. Patients need to feel that you have the time for their questions.

2. A clear understanding of the procedures, not “dental-ese.” Explain the procedures using language that fits the patient’s educational level of understanding.

3. A plan. Clarify the steps required for the procedures, number of appointments necessary, and how long each appointment will take.

4. A level of comfort. Explain to the patient how you will make her/him comfortable during treatment and what options are available, such as anesthetic.

5. A chance to share “what they’ve heard” about this or that procedure. Ask the patient questions to determine if they have any misperceptions about treatment. Many patients still think that root canal therapy involves removing the roots.

6. The opportunity to actually see what will be done. Use educational tools, such as video or other educational aids, to summarize what the patient has viewed and ask if there are any areas that need further explanation. Do not leave them in a room alone with a video presentation. The patient is not buying the procedure. They are investing in the dental team.

7. A non-judgmental environment. Be empathetic to the patients’ concerns about the condition of the teeth. Patients who have postponed dental care are often embarrassed and don’t want to be perceived as neglectful or hopeless. Encouragement coupled with kind words can build trust and respect.

8. An understanding of options available. Explain alternatives to the treatment. Make sure the benefits and the possible risks to the procedures are understood. Informed consent in writing is necessary when there are risks and when the outcome could be less than favorable.

9. A candid conversation. Most patients are aware of some general risks in treatment so they are waiting for you to be frank about what, if anything, they might be faced with as a result of the treatment. If they are given advantages and disadvantages, research shows that patients are more willing to trust you to deliver their care. Patients always feel better when they know the benefits and risks of proposed treatment.

10. Realistic and reasonable payment options. Studies show that patients avoid dental treatment due to cost more than pain. Yet if they feel that the costs measure up to the service received there is no complaint. Many patients will not question fees if the practice has demonstrated that they can deliver superior service. From the first phone call to dismissal, consistently demonstrate the “value” for services that the patient is receiving.

Give your patients every reason to proceed with recommended treatment.

For more information on this topic, visit my blog: The Lighter Side.

Interested in speaking to me about your practice concerns? Email sallymck@mckenziemgmt.com
Interested in having Sally McKenzie Seminars speak to your dental society or study club? Click here.
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Carol Tekavec, RDH
Hygiene Consultant
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A Really Good Day!
Carol Tekavec RDH

As most of you who read my articles know, in addition to working as a consultant with McKenzie Management, I am a practicing dental hygienist and have been taking care of patients for twenty plus years. My day-to-day work consists of new patients, prophys, radiographs, perio treatment, and lots and lots of education. Sometimes I feel frustrated when patients don’t seem to “buy in” to what I am telling them about their perio condition. I try everything from illustrations of perio disease, copies of their probing depths, videos, and their own photos to show them what I am telling them. Even so, some patients just don’t seem to get it. But how great it is when someone does!

Three months ago I had a young man as a patient who presented with serious problems. Heavy calculus, bleeding pockets, and swollen tissues revealed a mouth full of disease. Our first appointment together consisted of an exam with our wonderful general dentist, full mouth radiographs, full mouth periodontal charting, many photos, and a diagnosis of generalized moderate to severe periodontitis. Restorative issues were also revealed, but were secondary to the serious nature of his perio condition. He understood his situation, received an estimate for treatment from our treatment coordinator, and scheduled his first hour and a half appointment to complete scaling and root planing on one side of his mouth, to be followed by another appointment to complete the opposite side about a week later. He understood that he would be receiving periodontal maintenance four times a year thereafter.

Our first scaling and root planing appointment went well. He was happy to be completely numb for the procedure as his tissues were very sensitive. Prior to beginning treatment, I went over the home care routine I wanted him to follow. I concentrated on brushing and the use of a floss aide for interproximal areas. I did not want to overwhelm him with “too much to do each day” for his own maintenance. Our second appointment also went well. He could already see and feel the difference between the treated side of his mouth and the untreated section. Bleeding had lessened and tissues were shrinking.

Fast forward to three months later and here comes my really good day. My patient presented with tighter tissues, much less swelling, a relatively plaque free mouth, and when compared with his previous periodontal charting; the reduction of pockets in all four quadrants! His periodontal maintenance appointment consisted of charting, scaling and root planing of isolated areas, placement of sulcular meds where needed, and reinforcement of home care to include the addition of another “cleaning” aide; a rubber tip stimulator. He and I were both so happy with what had happened to his oral condition. He told me that he felt like a new person. We both agreed that neither one of us ever wanted to see him in his previous condition again. I set up his three month periodontal maintenance appointment and we parted as more than patient and hygienist, but as enthusiastic friends.

This patient personifies the personal rewards I gain from my profession. It is wonderful to see a person regaining his oral health and seeing how much better he looks and feels. It is fabulous to view the positive changes that the application of my services can bring. 

When I thought the day could not get any better, it did. My next patient was a person who previously had a tooth extracted due to a failed endo. Retreatment had not resulted in healing, and extraction had unfortunately been the only choice. This patient had opted for an implant and crown and had received excellent care from our general dentist. Her implant was perfect and she was so happy! She could not believe that for all intents and purposes, a new tooth had been miraculously placed in her mouth. Her home care is immaculate and she likely faces a long, happy life with her new replacement. We went over her daily home routine and I gave her some specialized brushes to use around the implant.  She was delighted that they came in their own little carrying cases, making them easy to take in her purse. We had a great appointment, and she told me that her sister had also set up a time to come to our office based on her recommendation.

A day like this makes up for all of the days that I feel no one is paying attention to what I am doing to help them with their oral conditions. It helps to think about this day when I have a patient who cannot seem to open his mouth more than four millimeters, or who is so jumpy that I have to keep reassuring them and announcing when I am going to be placing the mouth mirror into their mouths. It helps to think about a day like this day when I am faced with a five-year-old whose father tells him as we walk toward the treatment room: “She won’t hurt you” - thereby raising the question in the little one’s mind - “Why would Dad mention that if being hurt wasn’t a possibility?”

I love my profession and I love my patients - even the ones who are sometimes hard to take. I keep trying to reach the ones that don’t “get it” and I try to never give up on anyone. It is satisfying work that means something. At the end of a hard day I have not just been sitting at a computer or moving papers, I have had the opportunity to help someone become healthier, better looking, and happier. It can make for a really good day!

Carol Tekavec RDH is the Director of Hygiene for McKenzie Management. Carol can improve your hygiene department in just one day of training “in your office.” Interested in knowing more about how to improve your hygiene department? Email hygiene@mckenziemgmt.com.

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Nancy Haller, Ph.D.
Leadership Coach
McKenzie Management
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Strategies for Introverted Dental Leaders
Nancy Haller, Ph.D.

Leadership is a process by which a person influences others to accomplish specific goals and objectives. As such, the basic nature of leadership is interaction between people. This can be difficult for introverted dentists. Introverts are not necessarily shy (although shy people are introverted). The difference is that shyness is about feeling anxious in social situations. Most introverts are not necessarily apprehensive. In fact, introverts can have great people-skills.


  • Have you been told you're too serious?
  • Do you hate small talk?
  • Do you prefer working alone in your office rather than with your staff?
  • Ever been accused of being aloof or hard to read?
  • Is leading your team a draining experience?

If you answered “yes” to these questions, chances are you’re an introvert. No, you don’t need psychoanalysis or medication. There’s absolutely nothing wrong with you. However, it you want your practice to be more productive and profitable, you will need to “stretch” outside your interpersonal comfort zone.

Science has learned a good deal in recent years about the habits and requirements of introverts. Through brain scans, we know that introverts tolerance for external stimulation is lower than extraverts. Introverts process information better when they can think and reflect. As such, introverts do best when they have time to mull things over, and they can be quite interactive if they balance “people-time” with time for solitude.

Introverts can be outstanding leaders. They generally listen better. Typically they think through issues in more depth than their extraverted counterparts. They are more focused. When they speak they are more concise. In my coaching and leadership training with dentists I have found that introverted dental leaders can be wonderfully warm and witty…with their patients. But when it comes to employees, they’re just worn out. Low on interpersonal fuel, many introverted leaders rely on hibernation - they retreat to their office and close the door. Employees are left on their own with little to no guidance, direction or support.

If you’re an introvert, I am not suggesting that you change your private nature. But I am recommending that you shift your behaviors to engage more with your team. These are skills you can develop and practice.

1. Engage with and affirm your employees. Give positive feedback. Ask staff about their families or the purchase of a new car. Conversely, tell them about something fun you did on the weekend.

2. Express thoughts rather than rehearsing ad nauseum. This is especially true when something displeases you. For introverts, problems in the office are internalized. Introverts can spend so much time on inner dialogue that the issues don’t get discussed openly. This can snowball into serious conflict.

3. Seek out opportunities to convey your message to your team. Plan to let your staff know more about your practice vision at staff meetings. Remind them during morning huddles - great ideas can be expressed in short segments of time. Script it. Come up with a few talking points on important practice issues.

4. Add a little enthusiasm to your words. This is a skill you can practice with the help of a tape recorder or with a trusted ally. By putting more “punch” to your communication you will ignite more believability and credibility in your message.

5. Be the first to speak rather than the last. By going first, you’ll be more relaxed as you listen to others. In turn you may actually speak up more.

6. Reduce the amount of time you spend in your office. Walk around. Have lunch with employees at least once a week.

7. Say “good morning” when you come in each day. Never leave without saying goodbye or letting your staff know you’re stepping out of the office for a while.

8. Smile. Misunderstandings are often based on small nuances…like an overly somber facial expression or a frown. When you smile, it shows others that you are approachable and confident. Employees will want to follow.

If you are an introvert, celebrate your strengths. Remember that your natural gifts are essential for team harmony. Your style can be calming and reassuring during stressful situations. Now it’s time to expand your skills. The key is to remind yourself, and as Nike says, just do it.

To learn more about your communication preferences and the impact on your practice, contact Dr. Haller at coach@mckenziemgmt.com

Dr. Haller provides training for leadership effectiveness, interpersonal communication, conflict management, and team building. If you would like to learn more contact her at coach@mckenziemgmt.com

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

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