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  Sally McKenzie's
 Weekly Management e-Motivator

  6.13.03 Issue #68

Breaking Down the ‘Drive By’ Communication Barrier

Sally Mckenzie, CMC
McKenzie Management

     Invest 10 minutes in your practice and watch your day do a 180. In less time than it takes you to gas up your car, you can supercharge your team and head off the potential collisions of the coming day long before things start to spin out of control. I guarantee that this simple strategy, carried out regularly, will significantly improve the flow of your business day, help to build a more effective team, and better serve your patients. Before you begin seeing patients, start every day with a 10-minute planning meeting, this is where you map out your strategy for the next eight hours. Follow these steps

to chart a course for a productive, stress-free day.

  1. Distribute copies of the daily schedule to each staff member. Discuss the amount of scheduled production for the day and exactly where emergency patients should be placed. Distribute the next two work day's schedule in order to be proactive to achieve an ideal day.
  2. Note patients’ personal milestones that should be acknowledged during the appointments – births, deaths, marriages, graduations, etc.
  3. The hygienist reviews individual patient charts and schedules for the day. Treatment that is to be provided should be discussed as well as any periodontal therapy and unscheduled treatment plans that the hygienist can reinforce.
  4. The clinical assistant discusses potential traffic flow problems that could occur and how to ensure that treatment procedures flow smoothly.
  5. The business assistant summarizes concerns, both personal and financial, that need to be addressed regarding specific patients.
  6. The doctor closes the meeting by offering a personal view of the day, taking time to reinforce each staff member’s value and contribution to making the day both productive and enjoyable.

With just 10 minutes, you are more organized. You increase productivity because you have information that will enable you to more effectively communicate with patients and fellow staff. You and your team have reduced the collective stress level because everyone has the direction and guidance they need to handle situations and problems most effectively – no more communication on the fly. What’s more, every member of the team understands the objectives and how their individual roles impact in the total team effort.

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Building On The Theory

How An Ailing Business Foundation Can Cause
“Digital Chaos” Part 11

Mark Dilatush
VP Professional Relations
McKenzie Management

Technology Tool Box

#11 Scheduling Systems cont ...

Last week I discussed your scheduling system as an integral part of your overall business foundation. Different 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. As you may already know, a very important part of what a McKenzie Management consultant performs when they go into a dental practice is to analyze the results of the practice's current business operations. Booking multiple appointments according to some pre-determined timing of a treatment plan is usually a statistical no-no. If you are a Scheduling Coordinator reading this article, you may be shaking your head up and down. Here’s what happens. Dr. Jones likes to work on a quadrant of the mouth at a time. Dr. Jones also likes to have the whole plan scheduled in the appointment book once the patient accepts treatment. Dr. Jones believes this helps treatment from falling through the cracks. Little does Dr. Jones know that it actually creates cracks – big ones too! Mary, the Scheduling Coordinator, books six appointments for our patient – Mrs. Smith. The appointments are booked two weeks apart over a two and a half month time frame. Let’s look at the realities of this example.
    • Everyone reading this knows that unforeseen things happen to us that affect our schedule over a two and a half month time frame. Statistically, perfect compliance to this type of scheduling is very low..
    • The resulting changes in schedule usually happen late in the game. That is, when Mrs, Smith does call to change – it’s likely to be a last minute phone call. After all, the appointments were made so long ago! Last minute cancellations of operative treatment can cause major production loss.
    • c. The resulting rescheduling chaos creates a poor customer service experience. Now our scheduling coordinator Mary has to not only reschedule one appointment, but she must remember and reschedule the other one’s as well.
    • The chance that all operative and lab work will be completed exactly as planned is also a statistical anomaly. What if one of the cases has to be sent back to the lab? What does that do to the remaining appointments? You're right, it puts every one of them in jeopardy and creates a poor customer service experience.
    • One of Mary’s responsibilities is to report future scheduled production. Pre-booking multiple operative appointments creates a “false echo” in your future scheduled production.

    So, what is Mary to do?

    Dr. Jones should organize the treatment plan into “groups” of appointments. As Mrs. Smith completes her “groups”, the next group is scheduled. The remaining treatment plan items stay on Mrs. Smith’s record and on the treatment plan report until scheduled. Remember Mary’s reporting responsibilities? She has to report scheduled and unscheduled treatment plans each month. Grouping your treatment plans closes every crack, allows for better customer service, and keeps the reporting mechanism perfect.

  2. Ever want to find out what team member made an appointment? Or perhaps you wanted to see who cancelled and rescheduled an appointment. How about looking to see who cancelled but didn’t reschedule an appointment? Most practice management systems have wonderful audit trails. Audit trails can be sorted by team member, patient, or date. A quick look at your scheduler audit trail will really help you bring a new Scheduling Coordinator up to speed on your scheduling policies. A routine look at your scheduling audit trail can also pinpoint embezzlement.
  3. Remember when you were just building your practice? Did you call patients at the end of the day that had certain procedures done, just to see how they were doing? Your Scheduling Coordinator can use your software’s callback list. Just go into the ADA code list in your software. Look for a “toggle” on each procedure code window. Extraction is a good place to start. Then, instruct your Scheduling Coordinator to print the list for you before you go home each evening. You can make the calls on the commute home.
  4. Better yet, buy yourself a PDA (personal digital assistant). Some people refer to these as “Palm Pilots”. Your schedule, daily register, call backs, referring doctors, prescriptions, pharmacies, and more information can be “synchronized” with a PDA. Have your Scheduling Coordinator sync your PDA as the last thing before the lights go out and you lock up.
  5. Preparing for tomorrow’s patient flow could be part of a Scheduling Coordinator’s job description. Use your software to note which patients have or have not completed their HIPAA compliance forms. Some practice management systems do this automatically. Use the new forms to your advantage. If your patients have to fill in a new form anyway, make sure you get their email addresses. I give you my personal guarantee that your use of your computer system will expand if you capture your patients’ email addresses!

Do you think we’re done with scheduling? There is more but, I want you to start with the last three weeks of information I've given you.

Next week we will discuss insurance systems.

If you have any questions or comments, please email Mark Dilatush at

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

From The Coach,

In response to last week's column [go here], I received a very well written and timely email. The doctor’s comments and question reflected the same sentiment behind my efforts to provide

solutions to the typical problems of the average dental practice, knowing there is another level to the solution. I will present the essence of his letter and then explain the cure.

His letter goes:

I have imagined many scenarios of dealing with the ladies, but no matter what I say, how I say it, to whom I say it or in what setting I say it, it does not feel right, and does not possibly help the situation.”

My efforts come across as stilted and pathetic, or massively authoritarian, and no match for the machinations of scheming females in a cat fight."

The only scenario I can see is to tell Lacy and Stacy how the behavior is affecting the practice, tell them it is unacceptable, tell them the behavior I expect, and not give them any chance to respond.

If this works, great, but if it doesn't work, my scenario proceeds to temporary compliance and then the inevitable recurrences of the behavior, then I have to repeat myself, this time with a threat of job termination.

The threat of termination may bring about sullen compliance; the sullen part upsets me. Now, I have to deal with that, or just live with that.

The threat of termination may result in someone quitting, or I may have to actually terminate someone. I prefer not to have to deal with that.

I concluded that the imagined outcomes, based on my attitude and interpersonal skills, are no improvement over the status quo ....

What you said does not get me closer to my goal of resolving this situation. I still can't see a clear path of specific behaviors to take that are likely to be effective.

I would like to be able to say effectively what needs to be said, but I don't know what that looks and sounds like. Every scenario I imagine is no improvement to the current situation, and possibly worse than the current situation.

Until I can see an effective approach (I'm motivated but feel incapable), I will choose the status quo.

I have been in practice 24 years. I’ve had as many as 6 employees at one time. Never again. What works for me is to have a staff of 2 ladies. I have chosen smaller dollars in exchange for fewer hassles.

I doubt that any of the conflict-phobic, introverted technicians out there who can identify with Dr. Desperate's request for help would actually find help in your reply.

I do not say this with malice, just to let you know that we're somewhat deaf to this material, and, if you erroneously think that we hear you, then you can't possibly change your approach to help us actually hear what you have to say.

Maybe conflict-phobic, introverted technicians should not be running dental practices.

I wish you well and admire your skills and insights and wish they were easily transferable.

Sincerely, Dr. Desperate’s Older Brother

In response:

This gentleman’s assessment of his circumstances and possible solution describe the plight of other dental professionals.

The imagined scenarios and the anticipated consequences dramatically ooze with the negativity of inevitable and certain loss.

He will lose this encounter and every encounter when asked to express what he wants.

By no means is this gentleman weak or a non-achiever. He works hard and he is attentive to the feelings and needs of others. These are both proof of his great strength.

However, the world of coaching offers solutions which are not obvious to the causal eye, because these solutions concern the principles of human nature, and human nature is a force that we must learn to convert to our own purposes.

Dr. Desperate is a victim to these forces, just as his older brother finds the mere presence of these problems to be an inconvenience and thus victimizing.

Next week, I will discuss the answer to Dr. Desperate and demonstrate where his older brother continues his family tradition of “the glass is half full” perspective not by choice but by mandate.

The Coach

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The 5 Dysfunctions of A Team- Part IV
Absence of Trust
Team members must be confident that their respective vulnerabilities will not be used against them such as weaknesses, skill deficiencies, interpersonal shortcomings, mistakes and requests for help.
Fear of Conflict
The general attempt at avoiding to hurt team members feelings ends up with an undisclosed tension.
Lack of Commitment
Consensus is not necessary; in the end it is not necessary nor possible because the leader of the team will make the call.
Avoidance of Accountability
Members of great teams improve their relationships by holding one another accountable thus demonstrating that they respect each other and have high expectations to one another's performance.
Inattention to Results
There must be an unrelenting focus on specific objectives and clearly defined outcomes.


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