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  Sally McKenzie's
 Weekly Management e-Motivator

  6.6.03 Issue #67

Communication on the Fly Puts Stress into Overdrive

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.

      Driving to the office, you run through the coming day in your mind. “I wonder if Mrs. Jones has paid her bill.” Unfortunately, you won’t find out that little detail until she’s long gone. A familiar twinge of

anxiety starts to surface and you grip the wheel a little tighter. “I hope Mary has finally figured out where to put the emergency patients” Mary doesn’t have a clue where you want her to schedule them. She’s making her best guess. The sweat begins to bead on your forehead as you increase the pressure on the gas pedal. “Uh oh, I better remind the hygienist to encourage Mr. Johnson to pursue that unscheduled treatment.” Your heart rate and the RPMs of the car engine are now in perfect sync.

Before the day even begins, your stress level is in overdrive. You and your staff arrive at the office at about the same time, say good morning, begin seating patients immediately, and start ripping through another high anxiety day. Everyone is making decisions and handling situations based on what they think is best, and whatever guidance they might be lucky to get is happening on the fly somewhere between the fast lane and the no passing zone. Each one wishing they had a little more information about how to handle this situation or that patient. But, c’mon you don’t have time for a lot of chitchat – just move ‘em in and move ‘em out.

Every employee has a job to do; they come to the office and they get busy. So what’s the problem? You’re not operating as a team, you are not communicating as a team, and you don’t have a team focus. That’s the problem. Consequently, no one really has all the essential information to carry out his or her responsibilities confidently or effectively and things are about to spin out of control.

When staff operate as individuals just performing tasks, important details fall through the cracks, like Mrs. Jones’s outstanding balance, scheduling upsets, and important patient communications. Instead, take 10 minutes to steer clear of the crises. Next week, I’ll tell you how to get far more out of your team, your day, and your career in less time than it takes you to put gas in your car. It’s a lot cheaper too.

Interested in having Sally speak to your dental society or study club?
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Building On The Theory

How An Ailing Business Foundation Can Cause
“Digital Chaos” Part 10

Mark Dilatush
VP Professional Relations
McKenzie Management

Technology Tool Box

#10 Scheduling systems cont ...

Last week I discussed your scheduling system as an integral part of your overall business foundation. I discussed some ways to leverage your technology investment [see article] . This week I will again focus on your scheduling system with more ways to leverage your technology platform.

  1. Managing lab cases requires at least two people in the office. The person who opens the lab case and the person who marks it complete. What does this have to do with scheduling? Well, if you don’t look to see if the lab case is in before scheduling, what happens? Make sure the lab case function of your practice management system is followed precisely!
  2. Some offices like to monitor and control the volume of patients with capitation plans per day. Depending upon your software, you may be able to set a limit of capitation patients per day before the scheduling coordinator receives a visual and audio warning. For those offices that choose to use this feature, it will even out your daily production tremendously.
  3. Using color as a visual aid can be very effective. However, choose what you are going to use colors for BEFORE going “color crazy.” Some offices use color to guide the user to a particular provider column. This is the most common. Some offices assign color to specific ADA codes or groups of codes. Other offices assign color to a fee range. No matter what you want or why you want it, be sure not to overuse color. If you color providers and ADA codes for instance, the visual guiding becomes overwhelmingly confusing to the end user. The rule here is to keep it simple.
  4. Most dental practice management software allows you to set up different “views” of the schedule. These can be most useful to a scheduling coordinator that does nothing but book appointments all day. Some examples might be “Just Hygiene.” Clicking a button would only show you all of the available hygiene rooms for a given day, week, or month. Another example might be by day of the week. This is most useful if your office has multiple dentists and/or multiple hygienists that do not work every day of the week. If you have multiple dentists and/or multiple hygienists, you can eliminate half of the viewing “noise” simply by clicking on the provider’s book you need or on the day of the week the patient needs to schedule.
  5. Provider time allocation can be tightened up in 95% of the dental practices out there. Time allocation is usually found in the ADA code list. This is where you tell the computer how many units to reserve for the appointment and who has to be in the room for each individual unit. You can “allocate” the time to the doctor, the assistant, a hygienist, or a combination of all three. When your time allocation is “tight,” and, you use your schedule book correctly – it makes scheduling productively a LOT easier.
  6. Most of the dental software companies have built (or are building) HIPAA compliance “toggles” into their software. In particular, they are giving you the ability to see or not see patient identification information on the schedule. This is useful for offices with monitors in view of patient flow, especially in offices with computers in the treatment rooms. If your software vendor hasn’t delivered an update like this yet, be patient with them – they’re working on it.
  7. As you use your scheduler more, you will uncover the importance of detailed information. Many systems automatically tell you if the patient has to pre-medicate prior to being seated. Another example of detail might be “chief complaint.” A short simple note like “Pain UR” on the appointment itself makes a big customer service difference AND prepares the clinical team. Another example of good customer service might be “Must leave by 3pm!” How is this patient going to feel if you keep them there past 3pm? Some of the software actually warns you if you have yet to note that the patient has completed the new HIPAA compliance sheet. Details, details, details. The more you use your system, the more you will get out of it.

Think I am done talking about your scheduling system? NO WAY! I will continue this topic next week. If you have any questions or comments, please email me at

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Missed Past Issues of Our e-Motivator Newsletter?

Getting The Cold Shoulder


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

Dear Coach,
I have four ladies working for me - two front desk, one assistant and one hygienist. For the past 3 months, one of my front desk ladies (Lacy) has openly expressed, in my view, unjustified

animosity towards my assistant (Stacy). It's getting to the point now that Lacy is mad at Stacy almost every single day, for one reason or another. Luckily, Stacy may be sensing some of this animosity but does not express any return hatred or dislike towards Lacy, at least not to me personally. She may have discussed a few things with our hygienist that I don't know about. But don't get me wrong, they're still both very civil and friendly to each other ... Lacy just throws out a few verbal jabs now and then, especially behind Stacy's back. I love them both and desperately want all of us to get along. Furthermore, both receptionists have very negative perceptions of Stacy (they believe the rumors that she has slept with her ex-boss to get what she wants, that she's a thief, and that her husband uses and sells drugs). I do not believe any of that is true! In my eyes, Stacy is a very honest, compassionate, and skilled assistant. I am not going to fire her to make Lacy happy. On the contrary, I will not fire Lacy or Stacy either - they've been with me for 4 years - through many tough times. Please help me resolve this situation before it blows out of control.
Thank you! Dr. Desperate, DDS

The Coach Replies:
Key points that I would like you to look at more closely:

  1. What truth do you have to support “unjustified” animosity?
  2. Why doesn’t Stacy fight back?
  3. “I love them both” makes this personal and not about business.
  4. To be “desperate” is inappropriate since you are the leader of the team.
  5. If the accusations are true, what would you do?
  6. “In my eyes” makes it personal again. We see what we want to there another reason that is guiding your interpretation of the accusations?
  7. “Tough times” are part of business. Did they pull you through tough times and you feel loyal, or have they simply been with you through the times and you feel comfortable with the stability of the scenery?

First let us acknowledge that you are not necessarily privy to the truth, and thus your use of the term “unjustified” already creates trouble for you. You are free to believe what you choose, however, in that choice, there will be consequences.

Second, open animosity has an origin and an intent. The origin can be the creation of a person’s imagination, and sometimes it can be the truth about the past. You have no control over what people bring to their work.

The intent of open animosity is easier to deal with. How team members treat each other falls under your responsibility. Accepting or rejecting the behavior that upsets the tranquility and effectiveness of your team and your business is very much your responsibility. Regardless of the truth, how should team members treat each other?

There is a reason, truth or fiction, behind every behavior. Are you entitled to know the source of the irritating behavior...I believe you are, since this is your business.

You have a choice to ask Lacy why she expresses negative emotions in the office or to ignore the tension beneath the surface that she is creating.

To ignore it will send the message that either it is OK for the team to fight or that you are too afraid to end the issue by taking an action.

Lacy is taking the initiative to find a reason to attack and Stacy is taking the initiative to not react outwardly in front of you. In truth, I think it is reasonable to say that Stacy recognizes the attack and chooses to not involve you by complaining, but why?

Perhaps the accusations and judgments are true and she believes that she would rather ignore Lacy than have to face an inquisition. Perhaps they are false, and Stacy is not strong enough in character to put Lacy in her place and prefers to live with the consequences. Notice how Stacy must cope with this situation all alone.

Now, what do you want? While you say they are civil and friendly, you wouldn’t request help if this was accurate. Verbal jabs especially behind the back are cowardly. How do you feel about this type of interaction in your office?

While you may enjoy the company of these people, there is a whole other world of hypothetical sex, drugs, and rock 'n roll in the background. Will you permit the staff to judge someone on their private life or only on their performance on the team?

This is your call. What kind of behavior will you accept in your office? What if she is unfaithful, a thief, into drugs, and also compassionate, honest, and skilled in her job... what you choose to believe becomes the truth for the team, if you want to be the leader of your practice.

Firing Stacy means you believe the judgments and accusations. Firing Lacy means you do not believe the judgments and accusations and will not tolerate such behavior.

I think it is reasonable to ask for the truth for your own edification and then make it clear that certain behaviors upset the pleasant environment that you are trying to construct and maintain.

I want to remind you that the work environment is a piece of art in progress. It is never finished and always in a state of adjustment as personnel and business challenges rise and fall away.

Your responsibility is to be a leader and set the tone for what is acceptable and what is not. Remember, this is your business, your reality, and should reflect your wants and desires.

Being respectful of what you want will make the reactions and decision of the other people involved clearer and permit a resolution that is congruent with your immediate and long-term goal.

While knowing the truth makes decision-making more straight forward, it doesn’t always account for our decisions. You may choose to not need the truth and simply let it be known that verbal jabs based upon innuendo are not permitted.

I remind you that you are the leader of the team and set the tone and conditions for the environment. Should you abdicate this responsibility, your practice will become plagued with periodic but constant personnel explosions.

The Coach

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If You're Not Satisfied with Your Practice's Performance …
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72% of practices' payrolls are more than 20% of revenues.

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Prepare Before You Pick Up the Phone
You can handle it all -- objections, cancellations, and many other patient scheduling obstacles that arise during routine phone calls to patients if you take one step: Prepare.
Never speak off the top of your head.
Before you pick up the phone, gather the information. Have it in hand in the form of a prepared telephone script.
Know the prepared presentation so well that it comes across completely naturally.
Spell out the facts for the patient clearly and concisely.
Keep the scripts readily available so that others handling phone communications can convey a consistent message in each phone interaction with patients.
Follow this example to develop scripts on everything from collections to confirmations.
What is the current situation?
The patient is due for their oral health exam and professional teeth cleaning.
My focused objective is what?
To contact the patient and schedule an appointment
My general objective is what?
To reach a responsible party, to leave a message, or to call back at a specific time to schedule the appointment.
What are the benefits for the patient?
Healthier mouth, maintain existing dental restoration, and overall better health and wellness.
What new services/practice features do you want to tell the patient about?
Whitening techniques, intra-oral camera, and new convenient hours, doctor / staff recent continuing education.

What specific information do you have about this patient?
 - Prefers a specific hygienist
 - Prefers a specific time of day
 - Prefers to be addressed by their first name, Mr., Ms., Mrs.
 - The patient is a child or adult.

What do I know about them personally? The greater personal connection you can establish with the patient on both professional and personal levels, the more committed that patient will be to your practice .
Telephone scheduling requires skill, professionalism, confidence, and finesse – qualities that are achieved only through careful and thorough preparation.


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