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  Sally McKenzie's
 Weekly Management e-Motivator

 4.25.03 Issue #61

The Minimalist Mindset

Sally Mckenzie, CMC
McKenzie Management

"Top Obstacles To Achieving The Ideal Practice"

     This week ... one of the barriers likely to be interfering in your ability to reach your goals. Next week I’ll discuss proven solutions.

Let me share with you a true story. “Sue” visited her dentist, Dr. Tom, recently for a regular, six-month oral hygiene appointment and check up. She had been having some sporadic trouble with a crown

and decided that if the doctor asked about any problems she’d mention it. Like many patients, Sue is a bit anxious about going to the dentist, and since the pain was only sporadic, she didn’t want to make a big deal out of it. In addition, she had been having some sensitivity with some other teeth, which the hygienist noticed during treatment.

Like most dentists, Dr. Tom is very busy. The day of Sue’s appointment was no exception. Dr. Tom came in, greeted Sue, politely asked about her family, looked in her mouth, checked a few old X-rays, and said, “Looks good, see you in six months.” Dr. Tom never asked Sue if she was having any problems. What’s more, although the hygienist noticed the sensitivity, she did not mention it to the doctor, nor did she recommend any special products or home care regimens to address it. During the appointment, Sue casually asked the hygienist a few questions about whitening. The hygienist didn’t bother to mention that to the doctor either – even though this practice is expanding its emphasis on cosmetic dentistry. Nor did the hygienist give the patient any literature about whitening options, sensitivity problems, etc.

Sue walks out with any number of negative impressions – “Well, doctor is too busy for me.” Or, “Obviously they’re not concerned about this sensitivity problem.” Or, “Maybe the practice is trying to reduce its patient base.” Or, “I wonder if I really need to bother with these expensive appointments twice a year.” The bottom line – the practice misses a golden opportunity every time a routine hygiene visit is treated like some sort of perfunctory exercise. The minimalist mindset takes over, reinforcing common misconceptions about the need for ongoing professional dental treatment and sending the wrong messages to your patients.

In many cases, the six-month visit is the only time the dentist is going to have the opportunity to sit down with the patient and assess not only their oral health condition but also their oral health concerns and interests. What do you do during every routine visit to WOW the patient, further educate them on the importance of oral healthcare, and inform them of the services that your practice provides? Anything? In about eight months, Dr. Tom’s practice is going to be wondering why Sue hasn’t returned. Can you figure it out?

Next week ... maximizing the routine patient visit.

Interested in having Sally speak to your dental society or study club? Click here

Building On The Theory

How An Ailing Business Foundation Can Cause “Digital Chaos” Part 4

Mark Dilatush
VP Professional Relations
McKenzie Management


Technology Tool Box

Scheduling - Foundation and System

Last week we discussed your team as an integral part of your business foundation and why it is so important to get them organized appropriately before automating their tasks [see article]. With more than 20 business systems

that make up the business foundation of your practice, each has its own foundation. In the coming weeks, each system will be broken down into Foundation and Automation. This week the focus will be on Scheduling.

Your scheduling system – its individual foundation

Job description – The written, discussed, and agreed reason for employment
Expectations – The performance you expect from this one “system”
Goals – Clearly attainable performance objectives in support of your vision
Responsibility – Who is ultimately responsible for this particular business system
Reporting mechanisms – Which reports they run to measure their performance
Accountability – Presenting the reporting results to the owner and the team
Statistical performance reviews – Compilation of reports for the business system(s) under the responsibility of a particular team member

The success and/or failure of your scheduling system has a profound effect on your bottom line. It also has a profound effect on “quality of life” for everyone in the practice – including your patients. How many times last week did the whole team get out on time? How many patients were seen later than their appointed time? Did you get a full lunch every day last week? Was your week productively scheduled or just filled in to “look busy”?

Your Scheduling System – Automation Techniques

Goals – Daily, weekly, and monthly production goals are entered into the computer system. Every team member who schedules should be aware of how to view and use these goals as a scheduling guideline.

Treatment plans – Every treatment plan (no matter how small) is entered into the computer system. If they schedule – fine. If they do not schedule, the next group of procedures is dropped directly into the “unscheduled treatment” or “tickler file” list for proper follow up.

Outbound sales calls – Someone is responsible for making at least 5 outbound sales calls per day. These calls are organized in and made from the unscheduled treatment or tickler file list. Pertinent notes from these conversations must be entered into the patient record in your practice management software.

Tickler file, Missed Appts. vs. Short calls – Cancellations made within 24 hours of the appointment time should be filled with entries in your electronic short call list. These are patients who are already scheduled in the future. These patients said they would be available to come in if you had a cancellation. Cancellations made outside of the 24 hour period should be filled with entries in the computer file. Important note: Using the short call list DOES NOT add production to the schedule. Using the “unscheduled treatment” or “tickler file” DOES add production to the schedule.

Pre-booking multiple appointments – If you entered the treatment plan into the computer system, there is absolutely NO need (zero, nada, zilch) to pre-book multiple appointments for the same patient. Pre-booking multiple appointments creates scheduling system breakdown, last minute cancellations, and elevates the chance for poor customer service.

Lab cases – If you don’t already, learn how to manage your lab cases with your practice management software. Attach the lab cases to the appointments when they are made. This will streamline the whole team. It will also eliminate those embarrassing situations where the patient shows up and you have no case to try in or seat.

Forecasting – If you schedule in your computer system correctly, your practice management software “should” be able to give you projected production into the future. Future production should be reported and measured against your stated and entered production goal. Slow times in your practice are FAR MORE avoidable than you may realize if your scheduling foundation and supporting systems are set up properly. Forecasting will also allow you to systematically plan expansion with far greater accuracy in timing.

Reporting on your scheduling business system

  1. Production to goal
  2. Unscheduled Treatment, Tickler, Missed Appointment report – total value, total value scheduled vs. unscheduled
  3. Openings per week/month for each provider
  4. Forecast (compare next 30 days with last months forecast)

Next week I'll focus on the recall and hygiene system.
If you have any questions, concerns, or stories related to this article series, please email me at

Interested in having Mark speak to your dental society or study club? Click here

Low Self-Esteem Plus Low Expectations Equals Disaster


Giving Dentists And Their Staff Different Perspectives On Day To Day Issues

Dear Coach,
I have an employee that has been trying to be my dental assistant for over a year. She went to school but has yet to take the registration test so she can't do many of the tasks I need her to do.

After a year of assisting me with composites she still can't always hand me the materials in the right order. I have been considering changing her job to that of patient coordinator but I'm not sure I could trust her not to screw it up especially if I can't give her direct supervision. My receptionist could supervise her but she may not have the necessary supervisory skills. She has been with the office for 4 years and has been fired once for not showing up to work and on probation twice for habitual tardiness. Getting rid of her is a hard decision because her husband is ill and she has a very gentle heart and is very compassionate to those around her. What are your thoughts?

The Coach replies:
The core issue in this question is your belief in a personal responsibility that does not exist. Personal just like professional liability only goes so far. You crossed the line after retaining her beyond the first year of her employment.

The want-to-be dental assistant in question provided many reasons for you not to continue her tenure with your business after the first year. Even though your question discusses a time period of four years later, I am confident that, if she is a poor performer today, she was even worse during the first year. She made a promise to become licensed and she breached that trust. Your inability to accept the reality and let go and move on to another qualified person is the issue here.

The answer to this question has nothing to do with the want-to-be dental assistant’s inability to do the job, the lack of trust that she inspires by not following personnel policy, nor her personal problems. The answer resides in your refusal to acknowledge that:

  1. many people have similar talents who want to be a dental assistant and work for you,
  2. many people have good self-esteem, good technical abilities, good memories, and are licensed.
  3. many people have a gentle heart,
  4. many people are very compassionate to their fellow employees, patients, and employers.

What concerns me is the limited perspective that you have taken. In the reality of business, is it not enough that you compassionately and fervently wanted to become a professional? Was it enough to be a wonderful human being. It is simply the truth. It is not enough to be a good person that entitles us to be carried by an employer.

You are more than free to care for this woman and to provide her with the support and compassion that she gives you and you require from her to feel good about yourself. However, consider the merits of your proposed solution of changing her job description. This will only help to exacerbate your frustration, because you will make matters worse by converting the job of receptionist into a manager position. Receptionists are important members of the team, and good receptionist make you money, and good receptionists are hard to find, and here is one more truth: receptionist do not want to be mangers.

Finally, your reasoning implies a belief that it is your job to support this employee because she is compassionate, gentle and has personal problems. And my question is, where did you develop this belief?

The Coach

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I haven't seen you in a while because I have been too busy making money to come to any of the big meetings. Since our last visit with your consultant in my office, our production has risen to over 20% per month. Last month I quit working Friday's, and come in one half an hour later. Thanks for the help. Hope to see you this year at some meeting.

David Black, DDS
Roanoke, VA


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Are you a Victim?

Unfortunately ... many dental practices still aren't tracking critical metrics and they've fallen victim to some common pitfalls:

9 out of 10 practices have staff turnover every 15 months.
92% of dental practices lose more patients per month than replace with new patients.
85% of dental practices grow less than 10% a year.
72% of dental practices have more than 20% of their revenues going to payroll.

Discover the performance metrics that you should be looking at on a regular basis. From scheduling to overhead   to staffing and hygiene. Our Comparative Baseline Analysis will give you the information you need to start improving your practice immediately. Get the information you need to make smarter decisions that have a real impact on your business.

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This issue is sponsored
in part by:
DENTRIX Dictation Simplifies Clinical Notes

DENTRIX Dictation enables doctors to record fully integrated clinical notes through voice recognition technology.

Dentrix Dental Systems, Inc., introduces DENTRIX Dictation, the hands-free alternative to the time-consuming, expensive, and inefficient process of transcribing clinical notes. Fully integrated with the DENTRIX clinical and practice management system, Dictation is a voice recognition program that allows doctors to record and save clinical notes directly to the patient’s file. Through Dictation, dentists will be able to increase their efficiency, productivity, and profitability by:

  • Eliminating the need for double-duty tasks such as transcribing notes
  • Reducing margins of error by eliminating transcription errors
  • Expanding a practice’s bottom line through increased efficiency
  • Utilizing full integration with the DENTRIX practice and clinical management system

DENTRIX Dictation was designed with dental practices in mind; it recognizes dental terminology with an added vocabulary of over 14,000 dental terms. As Dictation transcribes spoken notes, users can correct—or train—as they go. Additionally, doctors can edit vocabulary from the program’s menu. Whichever method chosen, DENTRIX Dictation offers a new level of accuracy, flexibility, and intelligent adaptability never before available in a dental-practice-specific transcription solution.

DENTRIX Dictation was made to integrate seamlessly with DENTRIX Voice, a state-of-the-art voice activation program that provides hands-free charting—a perfect solution for the hygienist. Together these sister products will provide all the voice activated tools necessary. With DENTRIX Dictation, transcription of clinical notes is a breeze, while DENTRIX Voice allows efficient clinical charting.

For more information on DENTRIX Dictation, contact your local independent representative to order Dictation or call 1-800-DENTRIX.

For more information, email
or call 1-877-777-6151

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