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  Sally McKenzie's
 Weekly Management e-Motivator

 5.2.03 Issue #62

Overcoming the 'Minimalist Mindset'

Sally Mckenzie, CMC
McKenzie Management

      Eighty percent of practices are losing more patients than they are gaining new patients. It's easy to assume that patients you've had for years will continue to return and it's also easy to fall into the trap of thinking that those patients will raise questions and inquire about treatment options without your prompting. What happens far too often is teams fall into the "Minimalist Mindset." The patient is coming in for a routine oral hygiene appointment and exam. Everybody goes into auto pilot and nobody is recognizing that this is one of only two contacts your office will have with that

patient in the next 12 months. Make the most of it.

Take advantage of this opportunity to find out about what's on the mind of your patient from an oral health standpoint. Do they have questions about new treatments they've seen in the news media? Or perhaps you and your team have recently participated in continuing education programs that will benefit your patient. Tell them! Educate them about new services. WOW them with your information, your time, your consideration, your care, and your questions. You and your team are involved in a constant cycle of patient education. You share information with them and you gather information from them.

Take the following steps and get out of the ‘Minimalist Mindset.’

  1. Engage the patient in conversation about their oral health goals. If you’ve been seeing a patient for three years and haven’t asked them lately about how they feel about the condition of their mouth, you’re missing more than the boat. You’re losing a fortune in treatment opportunities.
  2. Ask several broad questions and listen to what your patient is and is not telling you. For example, “How do you feel about your smile?” “How would you like it if your lower teeth were straight?” “Have you ever thought you would like to have a brighter smile?”
  3. Use the questions to better understand the value your patient places on oral healthcare and how they perceive their individual oral health condition.
  4. Encourage the patient to talk.
  5. Educate the patient about new treatments that are offered in the practice. Provide patients with professionally written and designed materials that educate them about new services and procedures. How are they supposed to know what you can do if you don’t tell them?
  6. Inform them about changes in policy in writing and clearly explain those changes.
  7. Thank your patients. When was the last time you looked your patient in the eye and said “Thank you for choosing this practice.” Or on their way out, hand them a letter from the doctor and staff thanking the patient for their ongoing confidence in the practice and their commitment to pursuing excellent oral health. I guarantee your patient will be stunned and impressed.

Break the Minimalist Mindset and take the routine approach out of the routine checkup.

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 5 - Hygiene/Recall System

Mark Dilatush
VP Professional Relations
McKenzie Management


Technology Tool Box

      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]. This week, we are going to focus on another individual business system – recall/hygiene.


Hygiene/Recall System – Foundation
Job Description – The written, discussed, and agreed human resource responsible for this business system
Expectations – The performance you expect from this “system”
Goals – Clearly attainable performance objectives in support of your vision
Responsibility – Who is ultimately responsible for this particular business system. This should be one team member – not everyone!
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

Your hygiene/recall system requires cooperative responsibility. Your hygienist and the business administrator, responsible for the recall system, need to work in tandem. If not organized properly, this causes a disconnect in accountability. Some times it causes “friction” between the front and the back. It doesn’t have to be that way. This week, I'll the discuss the recall coordinator and in next week’s column the hygienist(s) role.

Recall System/Recall Coordinator
The person responsible for the recall system in your office should be accountable for ........

  1. Measuring and comparing the number of new vs. lost patients each month.
  2. Calculating and reporting patient retention percentage.
  3. Calculating the necessary number of hygiene hours per week.
  4. Keeping the number of openings per day in the hygiene schedule to a bare minimum. This should be maintained at no more than .5 openings per day.
  5. Converting unscheduled time units to dollars of lost production


  1. Family recall/scheduling is a powerful way to raise patient service levels AND pack your hygiene schedule. Your computer system organizes and connects family members. Most computer systems bring this information to the forefront when running reports, scheduling, and/or simply looking up a patient record. Ask your computer software vendor for training on family scheduling.
  2. Don’t run a recall report to paper. Run the list of patients and keep them on your screen like a task list. Enter pertinent notes like “left message answering machine”, "no answer 2:15 PM", or, “asked to be called next week when they get back from vacation”. Keeping the task list in front of you will keep you focused. Keeping notes will personalize the next phone call or contact. Storing notes allows the whole team to know what’s going on with every patient. It definitely keeps the hygienists aware of what the business team is doing.
  3. Some computer systems actually automate the whole list and present it to the appropriate team member according to their login name and password. This is a wonderful new feature found on some practice management programs.

Next week the hygienist's role in building your business foundation.

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

Missed Past Issues of Our e-Motivator Newsletter?

Taking Advantage Of The Time Clock


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

Dear Coach,
“I have a hygienist who went crazy when I bought our first time clock. She took offense to being on the clock. Now with the time clock, she has more hours than ever. The problem is, after she is

done with patient care, she hangs around reading charts, slowly cleaning up, etc. I am getting aggravated because I feel she is taking advantage of the time clock to be paid more. Am I overreacting? Should I just keep quiet or tell her how I feel? I do not want her to feel like I am "nickel-dime-ing" her.
Harried by the Hygienist

Your institution of a time clock demonstrates your desire to keep a very close account of the dollars that you spend on your staff. It may also reflect your desire to send a message to the staff regarding a problem that you are ashamed to express openly. You are communicating to the staff that there is a problem and this is the solution….but is it really a good solution to the problem?

Your staff wants to believe that you appreciate their efforts and attention to detail and are willing to pay them for it. Since you cannot measure an employee's efforts on a time clock, you may be insulting them by this solution. From this perspective, there is no win-win, because effort and value is not the issue.

Every doctor has expectations of himself and levels of performance that are comfortable and professional. The same can be said for the staff. They have expectations of their own performance and levels of comfort where they feel balanced by the amount of money they receive and the effort that they give to the business.

When a staff member feels that they are not compensated adequately for the value that they provide, there is often a covert event, attitude or behavior which manifests the disgruntled employees’ true feelings. The time clock is really incidental to this issue.

The fact that the employee would take offense at your desire to monitor their time and your money betrays their true sense of worth. Staff members who are measured by their performance and paid adequately and fairly have nothing to hide or fear and therefore take no offense in your counting the dollars. The same cannot be said for staff members who are not as honest and accurate about their efforts and abilities. People who do not give a dollars worth of effort for every dollar they paid are well aware of their deceit. It is the discovery of this deceit to which they take offense.

Just as the doctor can ask if he is overreacting, so can we ask if the staff member is overreacting and why? As the leader, you are reacting, because you sense that there is something that is not right. I will offer you that you had concerns about this employee long before this precipitating event. It has simply raised your awareness of your discomfort with their performance.

Suggesting that a leader should keep quiet and be afraid of upsetting the troops is not the behavior of a person in command of their destiny. Leaders believe that they have the best interests of their staff, and therefore they propose policies with great boldness in an effort to demonstrate how good they feel about their principles and the intended outcome.

The doctor models the values and principles that are guiding the practice, and from this perspective, the staff is free to either jump on the crusade or figure out a reason to be dismissed. The truth of this matter is that when you watch her take advantage of your time clock, does this observation evoke your desire to give her more responsibility or less responsibility? The answer is obvious when examined from this perspective.

The concept of quibbling over money with the staff completely misses the point. Your desire not to spend needless money makes perfect sense, however, when that desire is confronted by a person who has no intentions of giving you fair value, why should you be concerned about quibbling over pennies with them when they are not quibbling over dollars they’ve taken from you ever since the day they started work.

In summary, any staff member that takes offense is a staff member who has not been honest with you. It is the discovery of their dishonesty that they take offense to and not the time clock. There was a problem with this staff member long before the time clock appeared.

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 30 minutes later. Thanks for the help. Hope to see you this year at some meeting.

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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.

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Leaders never share with their staff how they feel about anything. Leaders might share how they feel with someone with whom they share intimate details, but they never share feelings with their staff. The staff wants to know what the leader wants from them and not why they want it.

The Coach

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