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  Sally McKenzie's
 Weekly Management e-Motivator
  8.22.03 Issue #78

Surveyyy Said!! ...

Sally Mckenzie, CMC
McKenzie Management

   ... McKenzie Management e-Motivator readers are ahead of the curve in their use of technology. (Note to all those techno-gurus that have labeled dentists as technophobes, you’ve got the wrong group.) In the last few issues of our weekly email newsletter, I asked you to take 60 seconds and tell us a little about how you use technology to communicate. If you haven’t taken this quick and easy eight question survey click here and please do so.

Here’s what you told us: More than 93% of those responding to date have Internet access, 41% via dial up modem, 32% use DSL, 15% have a Cable Modem through a cable television company, and 5.1% use a T1 line. Ok, I’m impressed. In order to prepare yourself for future services, you will want to have high speed internet access.

Not only do you have Internet access, many of you tell us that you have multiple computers in the practice. Nearly 30% have between 6-10 workstations and nearly 13% have between 10 and 15 computers in the office. The trend of clinical computing is clearly upon us. That is very good news, but it does bring with it a few caveats. Remember, you now have every human in your practice with their hands in the “cookie jar.” You want those hands to be clean. In other words, take steps to systematize security, consistent data entry, and data maintenance.

In addition, the numbers tell us that not only do you have multiple computers you are using them. A full 97% of you are using your practice management software for patient billing and 92.2% are using it to bill the insurance companies. Just over 90% are using the software for recalls. What’s more, an impressive percentage of offices are using dental practice software for clinical purposes: 78.1% for treatment planning, 35.3% for restorative charting, 31.4% for periodontal charting, 31.1% for digital imaging, and 29% for digital X-rays. Yes! You are good!

Good, yes, but could be better. Unless accounts receivables are up or, worse yet, staff are killing time with rounds of “Go Fish,” nearly 60% of our e-Motivator readers do not pay close attention to their practice numbers. Many of you (28%) take a closer look when you are entering a slow period. But we know you may not know how to see a slow period until it hurts – really hurts! If at this moment you’re smiling that smug grin and telling yourself that you’re one of those docs in the forty-something percentile who does pay close attention to their numbers, make sure your financial parachute is ready to open when you need it. Learn how a practice management consultant would analyze your numbers.

If production looks like July rainfall in Death Valley, you need to tune into the problem now, not when bills can’t be paid or your retirement isn’t funded for yet another month. Don’t lull yourself into thinking it’s just this economy thing. On the flip side, if the receptionist is joking with patients that it’s easier to get tickets to see Barbra Streisand in concert than it is to get an appointment at this practice, sorry to say it may not be just a testament to your fantastic dentistry. You, my friend, are not taking advantage of a wonderful opportunity. Stick around and see what happens in this situation and the results are predictable. Your practice will plateau prematurely; I guarantee it. More likely, recall and scheduling are on autopilot. Hygiene is booked – you guessed it – six months out and no one is considering that whole scheduling to meet production goals concept. It’s your practice. It’s your profit or it’s your loss. If you’re not monitoring the numbers correctly, your team will most likely stop monitoring the systems for which they are accountable.

Overall, however, congratulations clearly are in order. Many of you are pointing and clicking your way to million dollar practices, and several others are using technology to continuously improve systems. Look for more survey results and comments on those findings in upcoming editions of e-Motivator.

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

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

Building On The Theory

A series of short weekly chores designed to keep the return on investment in technology at its highest level

Mark Dilatush
VP Professional Relations
McKenzie Management

Technology Tool Box

Clarifying Common Myths Regarding Software Support

Last week I discussed a productive project for the week [see article]. I received a few emails asking me “how” to run the reports I specified in the article.

I speak to literally thousands of dental offices

each year. The requests to have me help them run the reports struck me as rather odd. Our e-Motivator survey [take survey now] shows that 98.6% of you own practice management software. My previous professional experience tells me the majority of you subscribe to software support from your software supplier. This means you are paying for them to be there when you need help. It would be reasonable then to ask the question, “why don’t you call your software support center when you don’t know how to run a report?”

I will share with you some inside tips on how to get quality software support from your practice management software vendor. First, I want to address some common misconceptions regarding technical support.

Common misconceptions/beliefs regarding technical support

  1. I need my answer now. It will take forever to get an answer.
  2. They won’t know the answer when I call anyway.
  3. They will try to tell me I need training if I ask a question.
  4. Their whole goal is to take my money each month and not have me call.
  5. Their job is to solve my problem.
  6. One time I called and they didn’t help, therefore they can’t help with anything.

Reality from your software company’s viewpoint

  1. No you don’t, and no it won’t!. Our records indicate that only 8% of our calls are truly “emergency” calls (help!, my whole network is down). All others are triaged in priority order based on volume.
  2. We have three levels of technical expertise. You can assume the level one technicians are new and learning. If they can’t handle and resolve your question, it will go to a level two technician. If a level two technician cannot find a solution, your problem will be elevated to a level three technician (most experienced). Our level three technicians openly communicate with the software development/testing department on the hardest of questions.
  3. It is certainly plausible that you do need training! You should know that when you call, we have a record of the last professional software training you received. If you are asking questions covered in training, it is best for you to receive training. Training is NOT a high profit center for our company. As a matter of fact, it is one of the lowest profit centers. We are not recommending training to make more money. We are recommending training so you use and are happy with our product. We want you to be a customer for life.
  4. Quite to the contrary! Every time you call, we get the opportunity to introduce our newest products and services. The last time you spoke to the phone company about your bill, did they speak to you about call waiting, call forwarding, messages on hold, your cellular plan, high speed internet access, etc? We want you to call!
    From a pure business standpoint, support is not a large profit center. Even the largest company in the practice management software business has a hard time making the support department profitable. Client relationship management software alone can cost the big companies upwards of $250,000 to manage thousands of users efficiently.
  5. No, our job is to help you diagnose your problem over the phone. Our “hope” is to determine if our software is the cause of your problem. If it is our software that has created the problem, we will make it right. If it is something else in your network, we are there to assist in the diagnosis but we cannot be responsible for the end solution.
  6. If you called and do not think we helped resolve your situation, please call and re-open the issue! Remember, we want you to call. Our technicians must mark items as “open” or “closed”. Their managers are tasked with making sure items are not “closed” if they do not deserve to be closed. The managers are responsible for customer satisfaction.

Things to do when you call your software support department

  1. Be clear if it is an emergency or if you can indeed have the question answered within a reasonable amount of time
  2. Know your network, operating system, printers, etc. Have an equipment list ready to fax to the tech department if they ask for one.
  3. Be courteous! They are there to help you. When was the last time you yelled at someone and received help? Better yet, when was the last time someone yelled at you? Did you feel like helping them after that? If the level one tech doesn’t know the answer, expect them to elevate the problem. If they do not, ask them to. One inexperienced tech does not mean they’re all inexperienced. It just means they are new to the work position.
  4. Understand that your practice management software is 1/1000th of the components that make up your whole system. There are all kinds of other things like hardware, wiring, electricity, operating system, and other software, that could be causing the problem.
  5. Adhere to a planned training policy. If your software vendor publishes one major update each year, schedule update training once a year. If you don’t like calling support, the fastest way to avoid it is to become more thoroughly trained on the product.
  6. Print Screen! If you get an odd error on your screen, hit the Prt Sc key on your keyboard. Bring up your word processor and right click onto an open new document. Click Paste. Voila’, there you have the error code.
  7. Try to remember (even document) what you were doing (in the software) at the time of the occurrence. You can’t expect a technician to be able to help you quickly without credible and complete information.

Make friends with your support technician. Send their manager a complimentary email every once in a while when they do help you out of a jam. Your software technical department is a valuable resource. You pay for technical support. Now you have some guidelines to make its use more efficient and effective.

What’s stopping you now???

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

See Mark's Technology Workshop titled Using Your Practice Management Software to Drive Revenues on Dec. 10th in La Jolla. For more information email or call 1-877-900-5775

Getting The Cold Shoulder


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

Dear Coach,

I am the wife of one of the dentists of a two dentist practice. I am a registered dental assistant and have been working part-time in

the office for six years. Due to a family emergency, the office manager was forced to leave suddenly and my husband asked me to become the office manager and takeover full responsibilities temporarily. Temporarily has become permanently. At the time, I agreed in order to help out my husband and his partner, but I soon realized that being an office manager included a great deal of paperwork and managing of the finances. I find myself spending long hours on the computer and deeply miss the client contact that I enjoyed as a registered dental assistant. I want my husband and his partner to hire a new office manager but they say I am doing such a good job and they feel uncomfortable bringing in a new person . They say this new person would disrupt the harmony and friendly team environment. I am not happy, do you have any advice?

Sad in Sarasota

Coach Replies:

There are four issues that come to mind. Being a registered dental assistant, you are well aware of the dynamics, responsibilities, and obligations that go with conducting business in a dental practice. This level of awareness makes you a wonderful partner in a marriage and it makes you a tremendous asset in the business, because not only do you have a personal investment, but you also have a business perspective that includes technical ability and expertise. You are a very valuable person to your husband, his partner, and the business. This level of influence should feel good.

On the opposing side, we have a sense of obligation that comes from your relationship in marriage as well as your direct benefit from a successful business. From this standpoint, your sense of obligation makes perfect sense. In response to your sense of obligation, agreement to fill in for the office manager makes perfect sense, as it was offered as a temporary solution. The second issue concerns a trivial lack of honesty. Your husband and his partner obviously recognized your talents and recruited you to help them through a difficult period. It is not surprising that, when you demonstrate effective management talent, they, recognizing how hard it is to find good talent, would attempt to keep you on full-time. Their sense of security in having someone that they know and trust in the position of financial management is a great relief to the owners of any business; however, encouraging you to take a position by saying that it is temporary and then resisting your calls for them to fulfill their promise of finding another manager begins to cloud their honesty and taint the level of trust. This does not feel good.

From this perspective, the doctors are abusing their power. Your agreement was based on trust and a sense of responsibility and their lack of follow-through demonstrates a certain discounting of your personal self-interest in favor of their own businesses interest. While some may make the case that you are the direct beneficiary of this added responsibility, I will offer you that if your temperament is one that enjoys and takes pleasure in relating to people, then the stress and strain of these new duties will hurt you. It is for certain that the stress and strain will appear in your marriage overtly or covertly. It is not worth the price of passively complying with your husband's wishes. His vision is very shortsighted as the consequences to your marriage might be substantial and you may not realize it until it is too late.

The next issue concerns your personality. You are the only person in the world that has an obligation to protect your own self-interest. It is my belief that everyone is born with a brain that has a unique set of natural talents. When we interact with our world and utilize those abilities that come natural, we consume the least amount of energy, enjoy the time spent expressing ourselves through these talents, and maintain a disposition that is positive and constructive for others to see and enjoy. Any attempt to diverge from your natural talents will begin to stress your personality. You do not need me to tell you that stress is a destructive force and will eventually, I repeat, eventually eat away at your overall happiness in life.

When we are young, it is easy to live life and tell ourselves that we are doing something for a greater good; however, as we age, maintaining the energy to maintain the lie becomes prohibitively expensive. Your awareness that you enjoy client contact is another way of saying that your natural talents require such a connection to feel good about yourself and it is your obligation to find and create the avenues that provide such connection. It is enough to say that it simply feels good. Sacrificing your natural temperament in the name of making money will have long-term consequences for you, the team, the business, and ultimately your marriage.

Finally, the last issue concerns the interest of the business practice verses your own personal self-interest. We are all in business to make money and making money feels good. There are those people who live to make money because they believe that making money is an end point. However, happy people know that money is only a means to end. Regardless whether one of the partners is a husband or just a longtime friend, the interest of the partners is to make money in order that they can use money to enjoy the things in life that feel good. Their obligation is to themselves and to the extended family that benefits from their hard work.

However, there is your self-interest which must also be maintained and respected. Your self-interest, at least in this situation, is not about making money but rather about being helpful, effective, efficient, responsible, and finally being loving and supportive. By nature, you have the right to maintain your dignity, the respect of others, and an entitlement to privacy. I will advise you that you are the only one that can defend these entitlements, and for that reason the responsibility falls on your shoulders to solve this problem. Despite what you might feel, if you make an announcement that you will be leaving as office manager in 3, 6, 12 months, it will be received with confusion, dismay, or congratulations. None of this is important. Their reaction does not matter and nor is it real.

You are perfectly entitled to take back your life and everyone, I repeat, everyone will understand what you are doing and why. You may feel that it is necessary to explain to your colleagues and husband in great detail why you want to go back to being a staff member, but I am telling you, as your coach, that you do not have to explain because everyone understands.

Everyone has recognized that the change in position has changed your demeanor. You are not the same person that you were before and everybody knows it. It is for this reason that when you make your announcement, regardless of the reaction on their faces, everyone understands including your husband. Remember, that they felt the same way when the office manger suddenly left. I would encourage you to simply make the announcement and give the problem of managing the practice back where it belongs: on the shoulders of your husband and his partner.

The Coach

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The Best of Sally McKenzie

Featuring 20 years of Sally McKenzie’s best articles as published in Dentistry Today, Dental Economics, Dental Practice Report and many others.

Articles include: Seal Up the Recall Cracks, How to Retain Key Members, Building a Continuous Improvement Plan,
I need to Talk to You About a Raise, How Does Your Hygiene Department Measure Up, Checking Your Practices Vital Signs, Organizing Clinical Teamwork Boosts Team Productivity, and much more.

Sally McKenzie has been writing articles for years to help show you the path to success. Now, you can have them all in this collaborative book created especially for you, by the person most qualified to give you all of the information you will need to be one of the most successful practices in the industry.

For more information on this and Sally’s other products, call McKenzie Management & Associates at (877) 777-6151 or visit their web site at

Special Price: $25


Sally's Mail Bag

Dear Sally,

I have a question that I believe will be of interest to a lot of practices. When do you consider a patient as "inactive"? Every patient in our office, whether emergency or comprehensive, is placed in our recall system so they are kept "in the fold". When two years have gone by and the patient has not had a recall appointment or is overdue for one they are sent a letter notifying them that they are still in our practice but will no longer be contacted via phone, letter or e-mail to get their teeth cleaned etc.(please realize that this is after multiple contacts and office newsletters to their home in an attempt to get them in). We do this so as to no longer waste anymore time or postage attempting to get them in. In your opinion is this too strict of a system and are we shooting ourselves in the foot? Also, should we continue to send them a newsletter (which costs approx.$1.30 each)?

Dr. Black

Dear Dr. Black,

Technically an active patient is a patient who is due to come in for recall from today to one year from today. They are “actively” engaged in a treatment process in your practice. A patient who was due yesterday who did not keep their recall appointment is now in an "inactive" state. Your chances of retaining this patient "back in the system" is of course, very likely. However, a patient who was due last week, or last month, or 3 months ago, etc. who is also inactive, stand a slimmer chance of being retained. It is very common, however, to keep patient records "active" of patients who have not been in for two years...HOWEVER, if you honestly believe they are an "active" patient which constitutes the patients you have "actively" returning every six months, you're kidding yourself, aren't you? A patient who was due July 2001, on 6 month recall has missed 5 visits to your practice. Your chances of retaining them are slim to zero. The only reason for keeping 2 years worth of paper charts is the convenience of not having to go to the basement should one call back but don't kid yourself… they are not an active patient.

Regarding emergency patients, develop a plan to sell the comprehensive exam to the emergency patient at the first visit. I would delegate this to the chairside assistant and she would report at your monthly meeting her % of conversion. Those emergency patients not converted would not be given an "active" patient chart or status in the computer. A survey letter could be sent to the patient after 3 months of them not scheduling for the comprehensive exam. I would not send them a newsletter as they have not shown their commitment to the practice.

I would recommend that the letter you send out after two years be a survey type asking the ptient to respond and you must enclose a self addressed envelope with a "stamp". Your letter is probably passive in nature, simply stating a fact "you won't be contacted" when it needs to have a call to action. This letter can be found in my How To Have A Successful Recall System book that you can order on my web-site

It does cost 5x as much money to get one new patient as does just to keep the ones you had who will tell other people. Therefore in regards to the newsletter, my advice would be to send it to your active patient base, active as being described above, and one year past due patients.

Good Luck!

Are you wondering if your hygiene department is producing what it could be?

Dr. Allan Monack's hygienist produces $1231 a day seeing
1 patient an hour with a
prophy fee of $70.

What's your hygienist producing?

Dr. Monack is the Hygiene Clinical Consultant for McKenzie Management. He can help you produce the same results.
To find out more about the Hygiene Clinical Enrichment Program [go here], contact us at or call: 877-777-6151

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This issue is sponsored
in part by:
The Center for Dental Career Development
San Diego Workshop Series
Fall/Winter Schedule
 Date Seminar Instructor(s)  
 Oct. 3
 9:00 - 4:30
How to Become an EXCEPTIONAL Front Office Dental Employee Sally McKenzie, CMC.
Belle DuCharme, RDA CDPMA
 Oct. 8
 9:00 - 4:30
Office Politics ... The Enemy Within    
 Oct. 31
 9:00 - 4:30
How to Recover the Lost $$$$ in Your Practice Sally McKenzie, CMC.
Belle DuCharme, RDA CDPMA
 Nov. 7
 9:00 - 4:30
How to Become an EXCEPTIONAL Front Office Dental Employee Sally McKenzie, CMC.
Belle DuCharme, RDA CDPMA
 Nov. 8
 9:00 - 4:30
Taking Your Practice Back - Leadership Development for Dentistry    
 Nov. 14
 9:00 - 4:30
Unleashing Your Team's Potential & Optimizing Clinical Efficiency Risa Simon, CMC.  
 Nov. 19
 9:30 - 4:30
How to Recover the Lost $$$$ in Your Practice Sally McKenzie, CMC.
Belle DuCharme, RDA CDPMA
 Dec. 5
 9:00 - 4:30
How to Become an EXCEPTIONAL Front Office Dental Employee Sally McKenzie, CMC.
Belle DuCharme, RDA CDPMA
 Dec. 6
 9:00 - 4:30
Office Politics ... The Enemy Within    
 Dec. 10
 9 - 12pm
Boosting Your Hygiene Department Allan Monack, DDS FAGD
Hygiene Clinical Director
McKenzie Management
 Dec. 10
 1 - 4pm
Using Your Practice Management Software to Drive Revenues Mark Dilatush
VP McKenzie Management
 Dec. 17
 9:00 - 4:30
How to Recover the Lost $$$$ in Your Practice Sally McKenzie, CMC.
Belle DuCharme, RDA CDPMA
To Register 877-900-5775 or

For more information, email
or call 1-877-777-6151

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