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  Sally McKenzie's
 Weekly Management e-Motivator
  8.01.03 Issue #75

Breaking Down the More Money or Else Barrier

Sally Mckenzie, CMC
McKenzie Management

     Rather than giving a raise, raise the bar. Set guidelines for raises when you hire an employee and inform current staff of the new policy. Explain when raises can be discussed and under what conditions they are given. Staff will respect you as a leader, and you won’t be working just to meet payroll.

Use performance measurements to determine raises. Performance reviews are one of the most effective tools in creating a total climate of success in your practice. They

provide an objective and neutral means of leveling the playing field for the entire staff. While resistance is common initially, employees rated against objective measures will place more trust and confidence in the process. They also see the direct relationship between their performance, the success of the practice, and ultimately their potential for individual achievement, which comes in the form of a pay raise.

With input from the employee, establish individual performance goals that compliment practice goals, such as increasing collection ratio, improving accounts receivables, expanding production, reducing time to prepare treatment rooms, and increasing clinical skills. Provide job expectations in writing, and rate the employees on those expectations. For example, if you expect collections to be at 98%, tell your front desk staff, help them to develop a strategy to achieve that rate, including collections training if necessary, and hold them accountable.

Follow these guidelines for establishing performance measurements.

  • Develop results-oriented job descriptions/expectations for all staff
  • Give performance appraisals twice a year
  • At a minimum, appraise the employee’s performance in the following areas:
    • Following instructions, cooperation, quality of work, initiative, innovation, time management, communication, and flexibility
    • Work ethics
    • Attitude
    • General characteristics, such as professional appearance, verbal skills, ability to work under pressure, organization skills, ability to prioritize
    • Attendance
  • Track productivity and measure performance
  • Provide constructive feedback regularly

Raise the standards before you raise wages.

If you have any questions or comments, please email Sally McKenzie at

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Building On The Theory

How An Ailing Business Foundation Can Cause
“Digital Chaos”

Mark Dilatush
VP Professional Relations
McKenzie Management

Technology Tool Box

Technology Budget

Last week I discussed setting up a workstation as an emergency server “just in case” your server ever needed repair [see article]. This temporary “contingency plan” costs very little (if anything) to implement and will provide one of those “WHEW” moments if you ever have the need to run your dental practice while your main server is down.

Last week’s article prompted two responses from our readers which begs the question – “When does this all end (spending $’s on technology)?

My response to the question is to first offer some spending guideline’s and benchmarks.

Business Technology
A dental practice investing in technology to augment the operational (business) side of their practice should expect to invest (budget) 1.5% of their annual gross revenues. What does that 1.5% include, you might ask?

  1. Practice management software, updates, unlimited telephone support
  2. New computer hardware every 36 to 48 months
  3. On-site professional technical (hardware/network) installation/maintenance
  4. At least 16 hours of on-site software training each year

Example: Practice gross = $500,000/year. Technology budget = $7,500/year
Example: Practice gross = $750,000/year. Technology budget = $11,250/year
Example: Practice gross = $1m/year. Technology budget = $15,000/year

Clinical Technology
A dental practice investing in technology for both operations and clinical information management should expect to spend (budget) 3.0 to 3.5% of their annual gross revenues. Your investment should cover the following:

  1. Practice management software, updates, unlimited telephone support
  2. All clinical software upgrades to their practice management software
  3. Digital xrays, digital imaging (camera), periodontal probing, etc.
  4. New computer hardware every 36 to 48 months
  5. On-site professional technical (hardware/network) installation/maintenance
  6. At least 32 hours of on-site software training each year

Example: Practice gross = $500,000/year. Technology budget = $15,000/year
Example: Practice gross = $750,000/year. Technology budget = $22,500/year
Example: Practice gross = $1m/year. Technology budget = $30,000/year

“Mark, I don’t think I spend that much each year?”

It is certainly possible that you do not spend that much money. Back in 1998 and 1999, all of you scrambled to buy Pentium computers so the little clock would recognize the year 2000 – remember Y2k? Well, it’s Y2k+3 right now!

It is now August, 2003! Guess what, you may not have spent your budget amount during ’00, ’01, or ’02 but you may need to start thinking about it! As we all get older, these upgrades and updates will become less of a surprise and more of a standard of doing business.

Technology + Training = Productivity Increase = Return on Investment. For those of you who have heard me speak before, you know how passionate I am about the need for your team to receive professional training. Many practice owners have no problem investing (or re-investing) in digital cameras, intra-oral cameras, digital xrays, etc., but at the same time, many of you “skimp” on providing professional training for your team. Your practice management software is the center operational “core” of your business. Your software company updates your “core” every year. Your team needs professional training in order to generate the return on investment for you!

Getting back to the question, “When does this all end?” The answer is ...

You’d better hope it NEVER ends – at least until you retire!

Keep sending in your questions and responses! We love getting them.

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

Getting The Cold Shoulder


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

Dear Coach,

I have two employees, each were dental assistants who moved to front positions. They become very unreasonable when asked to

assist me when the true dental assistant is gone.

I have resorted to giving a bonus for the times when they have to do the dreaded deed. However, I feel this is really not needed, since true team members would fill in for a fellow employee whether receiving a bonus or not.

In the last week, my main assistant has broken her ankle and will be off for a period of time. I increased the flat bonus but they thought they were to receive it for each time rather than a lump.

I am already overstaffed and ready to throw these two employees to the wolves for being so reluctant to do a job that is within their job description.

Am I being unreasonable and do you have any other suggestions?

Regards, Dr. Reasonable

From The Coach:

As with all offices, there is history, and this history influences what is reasonable and what is not; however, notice that I said influences and not “determines”. The reasonable approach to making money and handling staff is based upon universal principles of behavior. The environment of work is about an exchange of services. I pay you and you do what I ask you to do. I do not have to hire you and you do not have to stay and work for me.

Now Dr. Reasonable, are you willing to begin to examine this situation by employing this premise. If you will not accept the principles of “fair exchange, money for services”, then you will never understand nor resolve your situation.

You are a man and the assistants are women. Women enjoy talking to each other. This is not a newsflash; however, it deserves to be factored into the assessment. They do not like being separated and this makes sense.

To pay them a bonus to do their job is the equivalent to paying a ransom; however, do they really have something you cannot replace? You are right that the bonus is unnecessary but for the wrong reason. You do not have a team but rather a group of individuals enjoying themselves at your expense.

In response to your assistant being out for an extended period, you offered to pay even more, and then they became even greedier. Doesn’t this sound like they only want to stay together and only reluctantly want to help you make money? Does this sound right to you? Are their priorities correct? What about yours?

Now I am well aware that your behaviors in the past have created the dynamics for this scenario. They are behaving as they should “I am being inconvenienced and should be compensated, and he will back down like always”. The question becomes do you want to do the right thing or continue to feel bad about your team?

When you use the term “team”, you are implying the presence of a “leader”. A leader is a certain kind of person with specific behaviors that make followers want to follow. Anyone can be a leader in a business situation, because you are paying them. Social movements require born leaders, because they must make people follow without payment. Do you want to lead your team?

The answer to your question “am I unreasonable?” is no, you are not unreasonable to ask someone to do their job; however, are you ready for the solution?

The inability to say “no” goes back many years. The inability to tell people what we want goes back even farther. What is currently clear is that your inability to say “no” has the staff blackmailing you for more money and your inability to tell people what you want has you over staffed.

Can you see that while the answer to your question is “no, you are not unreasonable”, the real answer concerns taking action. You can tell people what you want in a nice gentle voice. They do not have to listen to you...right? So now what? Will you go and find someone who will listen to you or must you remain trapped fiscally, physically and psychologically?

Executive coaching teaches people how to take command of their life: career, family, and interpersonal relationships.

The Coach

Want your issues answered? Ask the

Is Your Overhead Rising and
Your Revenues Staggering?

Payroll – 19-22%
Dental Supplies – 5%
Miscellaneous – 10%
Dental Laboratory-10%
Payroll Taxes and Benefits
3% - 5%
Facility – 5%

Wondering How To Tip The Scales Back In Your Favor?

Have You Increased Your Hygiene Days Per Week In The Past Year? If not ... this book is a must!!!

How To Have A Successful Recall System
by Sally McKenzie, CMC

Unfortunately, patient retention is not guaranteed by preappointing, sending postcards, letters, or even phone calls. But an effective use of an integrated retention system can significantly improve your ability to keep patients returning. This step-by-step guide to the systems used by today's most progressive practices includes: letters that get responses, telephone monitoring techniques to ensure patient retention, tools to monitor your success, and scheduling tips for a productive hygiene department.

Special Rate for this week's newsletter subscribers - $37.00


Sally's Mail Bag

Dear Sally,
Do you have any letter ideas for dismissing a patient from your care? I know we need to let her know that we will treat her for emergencies only for thirty days, but how would you word a letter like that to keep the peace as much as possible?


Dear Susan,
Here is a letter that you may find helpful

Dear (Patient Name):

Providing excellent dental care for my patients is of utmost importance to my staff and me. It is also necessary that I be on the “same page” with my patients regarding their goals for their dental health. Personalities play a big role in our success together as a team. It is apparent that we are not a good fit for a long-term professional relationship.

I truly believe that it is in your best interest in seek professional dental care with another dentist that you feel comfortable with. I will be available to you for emergency dental treatment only for the next 30 days from the date of this letter.

If you would like for us to provide you with a copy of your dental records, please visit us to sign your release form. It would be helpful to call ahead of time to give us time to duplicate your records.

We wish you the best and feel certain that you will find the right dentist for you.

Dr. Name


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What's your hygienist producing?

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To find out more about the Hygiene Clinical Enrichment Program [go here], contact us at or call: 877-777-6151

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