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  Sally McKenzie's
 Management e-Motivator
  7.04.03 Issue #71
The Big Issue ... Features
Annoucements - McKenzie Management's Annual Team Retreat
Sally's Management Tip - Whiners Welcome
                                              When Reliable Patients Clue You In

Mark's Technology Tip - Referral Management - Marketing Sources
The "Coach" - Reprimand = Fear of Losing Employee
Spotlight - Antibiotics in the Dental Office
McKenzie Management's Annual Team Retreat

Together We Can Make It Happen … for You! The McKenzie Management Team is meeting this week for our annual team retreat. From July 1-5, we’ll take time to recognize both individual and team achievements. We’ll also focus on steps we will take over the next several months to continuously improve how McKenzie Management helps dental practices reach their goals.

The long retreat getaway at the Las Rocas Resort in Mexico will focus on the theme “Together We Can Make It Happen.” We’ll hear directly from industry leaders on some of the major issues that impact the dental practice, including OSHA, HIPAA and Periodontal Therapy updates. And we’ll be learning about the latest advances in dental practice technology from Dentrix, Eaglesoft, Easy Dental, Softdent and PracticeWorks as well as patient financing from Care Credit.

McKenzie Management is the leading practice management firm in the industry because we recognize that as a staff we must ensure that we too are working effectively as a team. We will be looking closely at our own approaches to providing the best customer service, conflict resolution, and team building – just as we ask you to do. When we return to the office next week, you will find that not only are we renewed and revitalized as a team, but we also are ready with the most up-to-date information and strategies to best help you and your dental team.

Whiners Welcome ... When Reliable Patients Clue You In

Sally Mckenzie, CMC
McKenzie Management

     Standing there and just taking it from an unhappy patient doesn’t exactly make for a good day. Even Dr. Brass Britches squirms when cornered by CON-FRON-TATION. Human nature being what it is your first response typically is to become defensive. But a little pain in the practice can end up as more profit in your pocket – if you are willing to listen and learn.
When reliable patients clue you in to a problem, you can bet you are getting some pretty dependable information. It’s one of your best barometers for measuring patient satisfaction and discovering what’s working - or not.

Take the example of Mrs. Jackson. She’s a 20-year patient of Dr. Anthony’s. The entire Jackson family sees Dr. Anthony on a regular basis. They pay in full at every visit. They keep their appointments and they refer new patients. Last week Joey was scheduled for sealants. Unfortunately, Mrs. Jackson was running about 10 minutes late. She called on her cell phone to let the office know she was on her way but it took longer than expected to get Joey from school. Rather than just saying, “No problem, Mrs. Jackson, thank you for calling.” The receptionist told her that she would have to check with the assistant to see if this was going to be OK. Excuse me! This is a courtesy call the patient is making to the practice. The receptionist then attempted to reschedule the appointment while Mrs. Jackson was on her way. Needless to say, Mrs. Jackson went ballistic, she’d already waited six weeks for this appointment. Unbelievably, the receptionist tried to tell her it would be another six weeks before she could get Joey in. Mrs. Jackson hung up.

She showed up in the office furious. Fortunately, according to Dr. Anthony, Mrs. Jackson did not wrap the computer around the receptionist’s head, although he almost did when he learned what had transpired. Mrs. Jackson told Dr. Anthony that she valued him as a doctor and felt he needed to know about how this “standard office procedure” worked for her. He was lucky. Most of your patients will simply walk away mad; they have neither the time nor the inclination to give you patient relations 101.

Listen to your patients and learn from their experiences.

  • Take complaints seriously. DO NOT blow them off with the attitude of “Oh, that’s just Mrs. Jackson.” Or this is just an isolated incident – it’s not.
  • Handle complaints in a professional and timely manner.
  • Inform the patient as to how the issue is being handled and let them know about the outcome.
  • Ask for patient feedback regularly through simple surveys and suggestion forms.
  • Place 3 x 5 cards in each operatory, front desk, lab, etc as a reminder to document patient comments. Gather and discuss at your monthly meeting.
  • Ask yourself if the practice is truly patient friendly.
  • Are staff welcoming and helpful?
  • Are patients treated the way you would want to be?

Welcome the whiners and everyone else. You will receive insights into any number of minor adjustments your practice can make to be responsive to your patients.

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 14

Mark Dilatush
VP Professional Relations
McKenzie Management

Technology Tool Box

#14 Referral Management - Marketing Sources

Last week I finished my discussion of your insurance management system as an integral part of your overall business foundation and ways to leverage your technology investment [see article]. This week I will focus on your referral management system and various ways to leverage your technology platform.

Below is the foundation of your referral management system.

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 designated employee assigned to your referral system should report on the items listed below at each of your team meetings. Reports generated to provide the information should be comparison reports, in other words, the previous time frame (usually a 30 day report for two months ago) to the current reporting period (the last 30 days).

  1. Total number of new patients referred into the practice
  2. Total number of patients referred, sorted and identified by referral source. These are reported in order, from the best (most referrals) to least referrals.
  3. Total new production generated into the practice through referrals.

If the above business foundation exists in your office, here are some ways to use your computer system to leverage growth, efficiency, and customer service.

If you are a general dentist .....

  1. Add your known outbound marketing campaigns into your referring doctor database. Avoid adding your marketing campaigns into the patient database. For instance, yellow pages, 1-800 DENTIST, Welcome Wagon, coupon mailer, etc. Make a list of the marketing you invest in (spend dollars on) and add them to the referring doctor database.
  2. Add your passive marketing efforts. Examples of passive marketing efforts would be your church, a club you belong to, or perhaps the schools your hygienist visits once per month to teach the pupils about the importance of their oral health.
  3. Be diligent in collecting the referral source of new patients during the initial patient interview.
  4. Be equally diligent in your selecting the referral source accurately when you update the patient record in your practice management software. The importance of creating a complete list (task#1) will determine the accuracy and efficiency by which your team enters information to provide accurate reporting results.
  5. When reviewing your referral reports (above), keep them in a three ring binder from month to month. Look through past month reports to establish trends. Eliminate costly marketing efforts with a poor return on investment. Reallocate that expense to new or established successful marketing efforts with good return on investment results.

If you are a specialist ....

  1. Most specialists rely heavily on referrals from general dentists and other medical professionals. We will discuss how to leverage your referring doctor database in a future article. Many specialists also advertise and market their practices outside of the general dental community. A specialist should add their known outbound marketing campaigns into the patient database of their practice management system unless your system has a separate database for marketing source. You do not want to “muddy” up your referring doctor database. For instance, yellow pages, 1-800 DENTIST, Welcome Wagon, coupon mailer, etc. Make a list of the marketing you invest in (spend dollars on) and add them to the patient database.
  2. Add your passive marketing efforts. Examples of passive marketing efforts would be your church, an article you wrote in a local newspaper, a club you belong to, or perhaps the schools your hygienist visits once per month to teach the pupils about the importance of their oral health.
  3. Be diligent in collecting the referral source of new patients during the initial patient interview.
  4. Be equally diligent in your selecting the referral source accurately when you update the patient record in your practice management software. The importance of creating a complete list (task #1 and 2) will determine the accuracy and efficiency by which your team enters information to provide accurate reporting results.

As a specialist, you now have the ability to isolate your doctor referrals and communication from your marketing results.

Next week we will move on to Professional Referral Management.

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

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


Reprimand = Fear of Losing Employee


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

Dear Coach,

My name is “B”, and I am the office administrator at a multi-disciplined group practice. I have been in this position for five years, and I love it.

I have a great staff. Everybody has been here long term and gets along well. Every once in a while, something will happen that requires the reprimand of a staff member.

It's so hard to find good employees; I don't want to lose anyone because their positions are hard to fill. My question is: How do you reprimand someone without always having the fear of them going somewhere else?

Sarah Fearful

Dear Sarah,

First, your question did not specify whether “every once in awhile and something will happen” occurs with the same person or with different individuals. If it is the same person, then you are failing to see the handwriting on the wall, and if it is a different person, then perhaps there is some underlying tension that is affecting the team.

Second, the concept of discipline can be awkward in business. To healthy adults, the consequences of making mistakes are evident. I believe that most of us do not make mistakes, because we enjoy the feeling of doing a job correctly. However, it is unreasonable to expect all adults to share the same feeling, and it is unreasonable to expect human beings to be perfect every day.

I have encountered office administrators who love their staff and have hired people that do not genuinely want to feel good about their daily routine, but they love their staff. Therefore, it is not surprising to conclude that these office administrators, by being in denial about the quality of the people they hire, really create the disciplinary conflict they encounter from time to time.

Thirdly, reading in-between the lines, I want to propose two scenarios.

Scenario #1, I will assume that you are reasonable in your assessment and honest in your evaluation of your team. If so, then I would look at the word reprimand and ask, exactly why you use that term? Reprimand is what adults do to children. Do you see yourself as the authority and your team as the children?

Furthermore, there are different kinds of mistakes that occur in any adult work environment. Mistake #1 are mistakes in judgment which come about from insufficient information or making assumptions too quickly, often called “honest mistakes”. Then there is mistake #2 which are mistakes that have nothing to do with the work environment but manifest themselves as the product of personal issues from outside the office and have nothing to do with the team.

When office administrators, themselves, have personal issues outside the office, mistake #2 is often considered to be a mistake #1, when it is not. They will unknowingly defend mistake #2 because they do not want to acknowledge their own personal difficulties.

For those administrators who unknowingly entertain mistake #2, all the reprimanding and discipline in the world will not eliminate the problem nor will it provoke such an employee to leave.

Scenario #2 is more personal. The nature of your question addresses the fact that you are suffering here from a fear of the consequence of your actions. If your reaction to a mistake is reasonable, then no reasonable adult would leave the team. On the other hand, if your reaction is inappropriate, then a reasonable adult might leave the team.

What strikes me is that your perception of the problem and the ensuing fear manifests in all situations and this makes me think that it is a personal issue.

When healthy people make mistakes, they know it and usually attempt to correct it themselves without the need of “reprimand”. When people make mistakes and are unaware of it, they are usually grateful for having the error pointed out and do not make the same mistake again. In both circumstances, there is no need to feel that leaving the team is a solution to anything.

If I assume that the members of your team are reasonable adults hired for the right reason and who enjoy their work, then it is my belief that the fears are your creation and thus a personal problem. In addition, I will offer you that if it is a personal problem, it is likely that the team has been aware of it for some time. It would be in your interest to get to the heart of your own issue without upsetting the daily routine of your office.

The origin of your problem lies outside of the office and it is in everyone's interest that you address it outside the office. I’m sure your dentist would appreciate your attention to this matter and support your efforts.

The Coach

Want your issues answered? Ask the


C.E. Magic! Releases First of Its Kind,
Interactive DVD Learning Kit for Dentistry

C.E. Magic! announces the release of their Interactive Learning Kit entitled, “Antibiotics in the Dental Office.” The Kit includes a comprehensive interactive DVD, which can be accessed on a computer with a DVD player or any DVD player hooked to a television to watch movies. The Kit also contains a comprehensive written summary with hundreds of printed information slides. Two additional audiotape programs are included on the subjects of prophylaxis in the dental office and intraosseous anesthesia. Each component of The Kit has a corresponding post-test, which can be sent to C.E. Magic! for grading. A dentist who successfully completes all the components of The Kit, and passes the tests, will earn a total of 10 CE credit hours recognized by the Academy of General Dentistry.

Leslie Fang, M.D., PhD and Robert C. Fazio, D.M.D. are the featured clinicians on C.E. Magic’s first installment of their Interactive DVD Kit Series. Dr. Fang and Dr. Fazio are co-authors of Principles and Practice of Oral Medicine and Oral Medicine Secrets, two popular dental textbooks. Their relaxing style and back-and-forth interaction make for interesting learning. The accessibility of information only allowed through the interactive DVD format, makes this a unique and particularly useful tool for every practicing Dentist.

Dr. Kit Weathers, a recognized leader in dental continuing education, and one of the principals of C.E. Magic!, introduces the program and teaches several entertaining and easy-to-learn magic tricks on the DVD. “This is the only truly interactive educational DVD on this complex subject of antibiotics in dentistry that I’m aware of,” Dr. Weathers stated. “Besides being the most comprehensive and entertaining coverage of the subject matter, at $15 per CE credit hour, the Learning Kit is a great value in continuing education.”

Interactive DVD: Antibiotics in Dentistry
Audiotape: Antibiotic Prophylaxis in the Dental Practice and The Use of Intraosseous Anesthesia
Comprehensive Companion Summary/Workbook
Test for 10 CE Credit Hours

Price: $149


Do You Feel Your Practice Could Become More ... But You're Not Sure Where To Start?

Are YOU a Perfect 10?
According to an opinion survey of 5,000 workers, employees look for the following characteristics in an effective leader:
Has the ability to give clear direction.
Practices candid, honest, and open communication; encourages two-way communication and creates a climate of trust.
Is willing to coach and support people.
Relates rewards to performance.
Gives feedback on important actions.
Selects the right people for the organization.
Understands the financial implications of decisions.
Encourages new ideas.
Gives employees a voice in decisions.
Displays consistent high integrity.
Remember, employees want to work for leaders they can respect.

9 Faces of Leadership
According to FEDEX, its best leaders share nine personal attributes--which the company defines with remarkable specificity. FEDEX also has a system for rating aspiring leaders on whether they possess these attributes. How do you rate? Judge yourself against these edited descriptions of the nine faces of leadership at FEDEX.
Instills faith, respect and trust. Has a special gift for seeing what others need to consider. Conveys a strong sense of mission.
Individual Consideration
Coaches, advises, and teaches people who need it. Actively listens and gives indication of listening. Gives newcomers a lot of help.
Intellectual stimulation
Gets others to use reason and evidence, rather than unsupported opinion. Enables others to think about old problems in new ways. Communicates in a way that forces others to rethink ideas that they had never questioned before.
Willing to stand up for ideas even if they are unpopular. Does not give into others' opinions in order to avoid confrontation. Will do what's right for the company and for employees even if it causes personal hardship.
Follows through and keeps promises. Takes responsibility for actions and accepts responsibility for mistakes. Works well independently of the boss.
Functions effectively in changing environments. When a lot of issues hit at once, handles more than one problem at a time. Changes course when the situation warrants it.
Does what is morally and ethically right. Does not abuse management privileges. Is a consistent role model.
Reaches sound and objective evaluations of alternative courses of action through logic, analysis and comparison. Puts facts together rationally and realistically. Uses past experience and information to bring perspective to present decisions.
Respect for others
Honors and does not belittle the opinions and work of other people, regardless of their status or position.


What do I say when a patient wants to cancel their appointment?

“The doctor will be sorry to hear that. May I tell him the reason?”

Something Came Up
“(Patient’s Name), I can understand how schedules can change unexpectedly. However, the treatment that you are scheduled for is so very important that it should not be delayed or put off. Is there any way that you can rearrange your schedule to enable you to keep your appointment with the doctor?”
Canceling or Changing Appointment
“Would you like to reschedule that appointment this week or next? Would the early part of the week or the latter part be better?”
Canceling at the Last Minute
“I’m sorry to hear that. Is there a problem? (Pause.) (Patient’s Name), I know that the doctor will be concerned about your treatment. He was looking forward to taking care of you. Is there anything I can do to help you keep this appointment?”
Frequent or Excessive Cancellations
“(Patient’s Name). I am so sorry to hear that you cannot make your appointment. This is the ( _) time you have changed the scheduled visit. It seems that we cannot find a time that works for your schedule. The doctor does not schedule his appointments more than two weeks in advance. I will make a special note to call you if an appointment time becomes available sooner.”
Patient Wants to Check his or Her Schedule
“Fine, (Patient’s Name). If I do not hear from you, I will call you back in a couple of days. We are very interested in your health. Are mornings or afternoons better to call you?
Contacting No Show Patients
“(Patient’s Name), this is (Your Name) from Doctor (Doctor’s Name)’s office. Is everything all right? I am glad that things are okay, (Patient’s Name). We were worried that something might have happened to you because you missed your appointment yesterday."

"Hopefully we can come back to the center and visit soon! I also wanted to brag on our office! Yesterday, my hygiene department produced $2,025 in one day! We were so excited! Just thought I would let you know and thank you for all your advice! Our hygiene department rocks!!*

Alexis, Patient Coordinator
Graduate of The Center for Dental Career Development

*Note: Results are four months after receiving training from The Center

Advanced Business Training For:
· Office Managers
· Financial Coordinators
· Patient Coordinators
· Scheduling Coordinators
· Treatment Coordinators
· Hygiene Coordinators

Test Your Skills NOW!

For a FREE Educational Video

The Center for Dental Career Development
Advanced Business Education for Dental Professionals
737 Pearl St. Ste. 201
La Jolla, CA 92037

Want to know more about McKenzie Management?
For a Free Video by
Sally McKenzie, President

Sally's MailBag

Dear Sally,
I have been having a problem with being scheduled too tightly and too far out (3-4 weeks solidly). I have been hearing a lot about scheduling blocks of appointments to insure a high daily production. How do you do this when there are so many routine operatives, etc that seem to fill my schedule.? I'm having trouble fitting patients in with emergency situations. Any help would be welcome.
Dr. Busy

Dear Dr. Busy,
If you are going to block the schedule, for example crown preparations, then how much time you reserve MUST be based on your historical performance. Go to your computer and generate a report on treatment you performed last year by ADA code and count the number of units of crown and bridge and divide that total by the # of days you worked last year and that's the # of units you performed in order to have a realistic basis on how to block the schedule. This same historical performance and reserving of time should be done for how many emergency patients you treat on an average per day or week. Analyze first, why you have so many emergency patients rather than just accepting the fact that you have them and how do you deal with it.

There are many other parameters to consider such as your ability to delegate to a chairside assistant or do you have to make the temporaries, for example. Whether or not you are working from 1 operatory or 2 or 3? Do you use one bur to do a crown prep or five? Clinical efficiency MAY be something that can also open up your schedule. We have doctors who take twenty minutes for a crown prep and others that take one and half hours and some that take ten minutes to insert a crown and others that take an hour.

We have also observed doctors that only treat one quadrant at a time or one tooth at a time and others that will do two in one appointment. So an observation of your diagnosis and treatment planning should be done in order to determine if there is a reason for "so many operatives". These are philosophical and technique decisions that you have to feel comfortable with.
Sally McKenzie, CMC

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