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  Sally McKenzie's
 Weekly Management e-Motivator
  7.11.03 Issue #72

The ‘N’ Word - "No ... Not Right Now"

Sally Mckenzie, CMC
McKenzie Management

     Rejection. Humiliation. You know the feeling, the blood drains from your cranium, your vision blurs, as the patient sets you straight. “Dr. Jones, I’m really impressed with what you’ve shown me today. But, no, I’m just not ready to pursue that type of treatment at this time.” In just two short sentences, your hopes for a major treatment plan are deminished. Forty percent treatment acceptance rate – hey, I can live with that.”

No, Dr. Jones really can’t live with that, nor does

he have to. At 40%, his treatment acceptance numbers aren’t just low. They are abysmal. But in fairness to Dr. Jones, his presentation skills are very good. He is well prepared, patients listen attentively, and often indicate that they will pursue his recommendations only to cancel or not show for subsequent appointments. In this case, he was fortunate because the patient told him up front that she just wasn’t ready.

So what’s going wrong? Keep in mind there are three primary barriers to overcome in securing treatment acceptance – time, fear, and money – and they don’t necessarily fall in that order. Money is an issue for the majority of patients, regardless of what late-model car they pulled into the lot driving today. However, as that new Mercedes illustrates, patients are still making major purchases every day. They are choosing to do so because they are emotionally involved in the decision, all of their objections have been addressed, and they can logically justify the expenditure, whatever it may be. The patient will not proceed with treatment if they do not have an emotional attachment to the benefits.

Dentists frequently find themselves wasting precious time presenting treatment plans that are either dismissed or half-heartedly pursued by patients. While there are many factors in securing treatment acceptance, rethinking some basic patient communication strategies can yield significant improvements. One of the most important communication steps a dentist can take is involving a treatment coordinator in the presentation process.

Patients often have objections or even questions that they are not comfortable raising with you, the doctor. In reality, patients are far more comfortable discussing treatment plans with an auxiliary. Next week, proven strategies for getting patients to say “YES”!

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Building On The Theory

How An Ailing Business Foundation Can Cause
“Digital Chaos” Part #15

Mark Dilatush
VP Professional Relations
McKenzie Management

Technology Tool Box

Professional Referral Management

Last week I discussed tracking your new patient sources other than professional referrals. [see article]. No matter what type of dentist you are (general or specialist), co-managing patient care with other professionals can get tricky. It can be time consuming, confusing, and sometimes downright inefficient. However, it

doesn’t have to be. This week I will focus on managing all of those professional relationships with your computer system.

If you are a general dentist ...

  1. Add all of the specialists you refer to into your referring doctor database. Be sure to create complete contact records, including cell phones, pagers, email addresses, web site addresses, hours of operation, etc.
  2. When you refer out to a specialist, be sure to enter the date you referred the patient out, why you referred them, and the patient’s expected date of return.
  3. Periodically run a report to find your overdue returning patients. Delegate the task of contacting each office with overdue patients. Enter pertinent notes as to why the patient is overdue, in the patient note area of your practice management system. Follow up directly with patient as necessary.
  4. Always store pertinent clinical contact notes from conversations with the referring doctor into you practice management system. Some practice management systems give you contact notes in the referring doctor area. If you have those, use them. If you do not, use the contact note area within the specific patient.
  5. Consider opening and establishing an email communication process between you and the specialist(s). Your normal everyday email address may not be the right one to use. You may want to establish a sub account email address and use that one just for communication with your specialists.
  6. Always synchronize your personal digital assistant (PDA, Palm, etc) with your practice management system. If you ever have an emergency call during off hours, you can provide instant and complete service to the patient on the phone.

If you are a specialist ....

  1. As we discussed last week, a specialist wants to keep their referring doctor database clean and clear of other new patient sources. Enter all other new patient sources (besides referring doctors) into your database as patient records. The only exception would be if your practice management system offers multiple referral fields and multiple referral tracking systems.
  2. You rely heavily on professional referrals for new business. Your practice management system “should” be able to provide production reports by referral source. You should be able to select any date range you wish. Look for total number of patients referred, total production value of patients referred, and average production value of patients referred.
  3. Establish an email communication strategy with your referring doctors. Specialists should embrace technology and leverage its power to add value to the generalist/specialist relationship. We have specialists as clients who have established internet service providers, secure web site access (to share digital x-rays and intra-oral photographs), and email accounts for all of their best referring dentists. This makes it ridiculously simple for the referring dentists’ team to communicate with the specialist's office. Who do you think the general dentist thinks of first when it’s time to refer a patient out?
  4. Always synchronize your personal digital assistant (PDA, Palm, etc) with your practice management system. Keep a complete accurate database of all of your referring dentists. You can even synchronize the information from patient records attached to specific referring dentists, just in case they call while you’re not in the office.
  5. Always use the referring dentists contact note area when summarizing telephone conversations. This allows the specialist to quickly review prior pertinent discussions before calling the referring doctor or preparing to take a call from a referring doctor.
  6. Use your computer system to generate monthly update reports of procedures performed on each referring doctors’ patients. A monthly recap report is perfect for a general dentist. You can still send the individual reports but that monthly recap gives them all the information they need quickly without having to remember or go pull charts. Some specialists put the monthly recap report in professionally done folders with business card or Rolodex card replacements each month. You can really make the monthly recap report useful and very effective if you use your imagination.

Most specialists have yet to exploit the relationship management aspects of technology. Sure, most specialists have practice management systems and use them to run their practice but as you can see, there are a lot of ways to use your computer system for more. I know a periodontist who established an on-line local dental e-community with an emphasis on implants. The referring dentists can share in discussions on specific cases and learn from one another. Guess who gets all the referrals?

I want next week’s topic to come from our readers. So, email me some specific questions regarding computer issues or technology concerns and I will do my best to include them in next week’s issue.

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

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Getting The Cold Shoulder


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

From the Coach:

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.

Several weeks ago I answered a question sent in by Dr. Desperate [see response] who was a victim to the female forces of human nature. I then received an email from "his brother" who found the mere presence of these problems to be such an inconvenience that he capitulated and limited the size of his business in order to keep control.

Dr. Desperate and his older brother perpetuate their family tradition of “the glass will always be half-full” perspective not by choice but by family mandate. Here is another perspective to consider which incorporates some universal truths about human nature.

We are discussing men and women. It is an anatomical and cognitive science fact that the brains of men and women reason differently within the same environment. I didn’t say ”better or worse, good or bad”. I said differently.

Humans are at the top of the food chain in part because of our adaptability and the overlap of male and female solutions to the challenges of survival. This is a testimonial to the power of any male-female collaborative effort.

For the purposes of this article, I will offer a reasonable perspective from which individual perspectives might diverge. In order to grasp the complex interactions of the sexes, we have to understand the intra-dynamics of each sex.

By nature, women will socialize freely and frequently. This is one of the ways that women feel safe in the world. They establish groups and networks. Their association provides them with the emotional strength to feel secure in the world.

Whereas women will collect in groups in order to feel safe, men will isolate themselves and simply work harder in order to achieve mastery of their technical skill and create a sense of safety by creating their indispensability.

Whenever a new person appears within the environment, the sexes deal with it differently. Acceptance into any group of females is always conditional, and the criteria for acceptance into the group is usually reasonable; Truth #1 Every group is entitled to the criteria they value.

Acceptance by the group of men is often simply to evaluate the contribution in the form of skills and talents that will be provided by the newcomer. Truth #2 Skills and talents are essential to survival of the group.

In Dr. Desperate’s practice, belief that a newcomer woman has a questionable morality has created a tension in the office. In response to this tension, the inner circle has found a reason to close ranks, get stronger, and solidify their sense of security as any group might when their morality is challenged.

Dr. Desperate thinks that the issue is about the facts of her tainted history, but it is not. The women in the office, as women everywhere, created criteria for their group and network. Anyone of questionable moral character is not acceptable to them. This is very universal.

Dr. Desperate, being a man and therefore thinking “rational thoughts” says that a dental practice is not about moral character but about doing a job correctly. Since the woman in question has excellent technical ability, his rational perspective makes sense to his masculine mind.

Both positions have merit but only one position will relieve the tension. The rational solution is to take a stand but that stand when faced with the cultural and evolutionary realities may look very foolish in the long run.

In summary, the women value moral character while their employer values technical proficiency. The problems in this office will continue forever because they are not speaking about the same problem. Truth #3 Morality trumps proficiency.

The Coach

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Sally's MailBag

Dear Sally,
I would like to drop a PPO plan. I feel I need to inform the patients who have those plans the reasons why and how it will affect them. How do you suggest I word the letter?

Dear Patient,
I am writing to notify you of an important change in your dental insurance. On January 1, 2003, (Insurance Company) made a very significant change to their policy, which, without warning, became part of the agreement of every dentist who participates with (Insurance Company). This was done without consulting or discussing the issues involved with the dentists themselves.
Because this change would make it impossible to practice high quality, exceptional dentistry for my (Insurance Company) patients according to this new agreement, I have reached the decision that I must become a non-participating dentist. As all of you know, my first priority has always been to deliver the most superior, state of the art dentistry that is available in a caring and warm environment. As a non-participating dentist, I can still do so!
As a non-participating office, you are still free to come to our office for your dental care or can choose to go to another office that (Insurance Company) may "assign" you to. We will treat (Insurance Company) in the same way that we treat the many other dental plans that we see. This means that we will submit all of your claims electronically on the same day as your visit so that (Insurance Company) can reimburse you as soon as possible. We would expect that patients, who choose to pay for their visits on a credit card, would receive their (Insurance Company) check before their credit card statement.
This was a very difficult decision for me but I assure you that it was made only with my patients in mind, so that I can continue to deliver the excellent dental care that you deserve and have a right to expect from me.
If you have ANY questions at all, please call us and we will be more than happy to help. This change will become effective on (date).

Dr. Dentist

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