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  Sally McKenzie's
 Weekly Management e-Motivator
  8.29.03 Issue #79

Two Week’s ‘till Doomsday

Sally Mckenzie, CMC
McKenzie Management

   You suspect something is wrong just by looking at the person’s face. There’s an uncomfortable tension and then it starts. “Doctor, I have something to tell you.” Oh, you can just feel it. This is a Mylanta moment waiting to happen. “I’m giving you my two week’s notice.” The words hit you smack between the eyes. A thundering stampede is now pounding its way across your temples.

There it is. In one sentence, five year’s of

experience is going to trot out the door in two weeks. How could she?! In those first few moments after impact, irrational thinking typically sets in, and you are probably taking this all too personally. “What’s wrong with me, my practice? How, after all this time, could she just up and find anotherrrr job!”

Chill, doctor, that employee may be walking out, but opportunity could be walking in, provided you hold the door. When an employee leaves your practice, you’ve just been given the invitation to fine tune and, if necessary, overhaul systems. No more status quo, it’s time to shake things up. Chances are pretty good that certain systems haven’t been running as well as you believe they could. Collections, scheduling, hygiene, recall, perhaps one or more of those has been quietly nagging at you, but you just looked the other way, waiting for the right moment. Well, tah-daahh! It’s here.

When an employee leaves the practice, the opportunity to make change comes charging in. Take advantage of it. Resist your own powerful urge and pressure from staff to just get a warm body in that position as soon as possible. That warm body needs to do more than fill a spot on the flow chart. He or she is going to affect you, your team, your patients, and your profit quite possibly for a very long time. Easy answers and fast fixes now can metamorphous into complicated problems and staff issues down the road. Treat the hiring process as you would dentistry – with careful and deliberate planning and preparation.

Next week 10 steps to the perfect hire.

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

How An Ailing Business Foundation Can Cause
“Digital Chaos”

Mark Dilatush
VP Professional Relations
McKenzie Management

Technology Tool Box

Technology and Front Desk Staff Turnover

Last week, I clarified some common myths regarding technical support from your software vendor [see article]. Part of that article involved training. As Sally’s article above talks about the dreaded “two weeks notice”, some of you may not even get that much warning hence having

a software training budget is definitely in order. Let’s focus on receiving quality, professional training from your software vendor in your time of need – turnover time!

Staff Turnover – the beginning of the erosion process

Mary has worked at your front desk for 14 years. She comes into work one day and tells you she is moving to another state. Her last day is the last day of this month. How do you handle the situation?

What many offices do:

  1. Panic
  2. Place an ad in the local paper. Many of you list your practice management system right in the ad as a “plus”, or a reason you might hire them.
  3. Take a team member who is happy in their current role and throw them at the front desk – just temporarily of course.
  4. Use the leaving employee as the pseudo software trainer for the new employee coming to take their place.

What you should consider doing:

  1. Every healthy/growing business has employee turnover. Dentistry is not immune and it never will be immune. Do not panic. There is no fear of the unknown if you have a plan and a system in place to handle this inevitable situation. The key word here is “plan”.
  2. Place a professionally written ad in the newspaper. NEVER mention your practice management software in the ad. By doing so, you alienate many (possibly more than qualified) candidates that may have used a different system. There’s another reason. If an embezzler has figured out how to take money and hide it on a particular practice management system – guess which ads they are going to respond to? Keep their knowledge of your practice management software as a “mental plus” during the interview process. The question is a valid question. Just don’t advertise it!
  3. Taking a perfectly happy, performing employee and making them responsible for running your business operations could be an exit route for the transformed team member. They may do it out of loyalty. They may perceive this as being a team player. Heck, they may even be good at it. But, if they don’t come to you as the owner of the business and ask you for the opportunity because they believe THEY would be happier there – I wouldn’t recommend it.
  4. The employee who is leaving can work side by side with your new employee. Certainly watching, listening, and doing the routine will help the new employee learn how you want your practice to function. This is NOT practice management software training!

The next step is to get the new employee fully trained on your software as it pertains to their job description AND get the rest of the team trained on any new updates OR features of the system that you currently do not use.

Cookie Cutter or Customized Training?

You could call your software vendor and simply ask for a trainer on a certain date and leave it at that. What you will receive is “cookie cutter” training. Actually, you will probably be disappointed and blame the trainer or the new employee. Neither of these outcomes will make you feel good.

What you should do
is call your software vendor and ask to speak to your trainer. Have a list ready. In the example above, your list may look as follows ...

Train new business coordinator

  1. Process patients (check in – check out)
  2. Post insurance payments
  3. Post mail
  4. Scheduling
  5. Minor reporting

Update/Feature training

  1. Show us how to start charting
  2. Show us how to scan documents and save them
  3. Show us how to create PowerPoint treatment plan presentations
  4. Show us how to email our patients
  5. Show us how to track our lab cases

Your trainer will be able to estimate the number of hours needed to teach everything on your list. You should plan on being closed or at the very least, the trainer and trainees should be away from the hustle and bustle of patient care.

With a list, your trainer will be able to budget their time wisely. You will only pay for the training you need. You will have your expectations met.

Believe it or not, some or most of this training is available without having a trainer travel to your office. Many software vendors offer internet based remote training via collaboration software. Collaboration software allows both the trainer and the trainee to see each other’s screens and control the mouse. Add a telephone headset (which your office should have anyway) and you can receive this training an hour or two at a time.

The bottom line? Too many dentists blame staff turnover as the reason NOT to invest in software training. In my experience, under-trained or legacy trained (trained by outgoing employee) new employees are starting off in your practice with two strikes against them. In my experience, the more training commitment you show to an employee, the better the employee retention and performance. Your software company’s trainers are wonderfully gifted specialized educators. Use 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

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,

It has been my practice over the years to leave the financial management to my office manager. I do not like to pay attention to those

details even though I know that I should. My office manager seemed to enjoy the work and our practice continued to grow. About a year ago, her husband took a job in another state and had to leave. One of my staff in the front office volunteered to manage the financial issues of payments at time of service, down payment on all crown and bridge cases, and collections. In the beginning she seemed happy and cash flow seemed identical to that of when my long time office manager was handling these responsibilities. I was delighted to let her run the show. For some reason, I recently decided to review our receivable reports only to discover that receivables and collections were excessive and non existent, respectively. My financial operations staff member hadn’t said a word nor indicated any type of problem. When I brought this to her attention, she had a long list of circumstances to explain everything. I am not sure what to believe and what to do. This situation is financially untenable, but she is very adamant that she has everything under control. What am I missing?

Coach Replies:

The first issue concerns your leadership responsibility. Despite the fact that this is your business, your lack of desire to manage your own financial future is no different than your staff member who apparently has taken on a job greater than their abilities. Both of these behaviors contradict certain emotional truths.

A healthy perspective on money might be that money is a means to an end and that is all. It is neither a danger nor a friend. People who do not like to look at money are manifesting some very basic fears that now interfere with the efficient management of the business. This cannot continue without severe catastrophic consequences. You were fortunate to have discovered this problem before it became a critical business survival issue.

I will offer you the following observation. Everyone of your staff is dependent upon your ability to make money. Your leadership capacity is severely diminished in the eyes of your staff when you do not take responsibility for the management of cash flow and the solvency of the business.

The second issue is that your front office staff person saw an opportunity to enhance their value to the practice by volunteering to do a job that they were incapable of doing. You have to respect a person who takes on more responsibility, but you cannot continue to respect a person that continues to do a job knowing they are in over their head and that everyone’s survival is hanging in the balance. Again, you are obliged to monitor your staff for their attitude and productivity and to make the appropriate decisions so that the right person is doing the right job.

In response, I advise you to have a meeting over lunch. At this time you will clearly state that down payments must be collected, that receivables cannot extend beyond any certain time, and that collections is a necessary part of her job and must be kept to a specific limit. Give them the opportunity to discuss the situation from their perspective over lunch and then give them the necessary parameters and offer them a time frame to achieve these goals with the understanding that if these targets are not met, she will have to go back to her old position.

The third issue is a lesson for you. Even though people may volunteer to take on more responsibility than they can handle, you as the owner of the business cannot simply ignore the feelings and attitudes and performance of your staff by assuming that everything is good. I am very certain that her attitude over the last nine months has changed as the financial affairs continued to become progressively worse and worse. I am sure that her anxiety level over not performing the job correctly was manifesting in her relationships with you and with the other staff members. You’re responsible to be aware of the emotional atmosphere in the office and of this person cannot be delegated nor ignored.

Perhaps you are a person that wants to believe that your dental practice is a family. I would advise you to rethink that vision. It is more effective to see your dental practice and your staff as a team trying to win the game or a machine functioning smoothly. The family metaphor is inappropriate if you do not want to have cash flow problems.

On a strong team, everyone has to be healthy and everyone has to be 100 percent there everyday. If anyone has a problem, then it is a team problem and everyone will help solve it. This person was left alone long enough to not only get herself into trouble but created the potential to drive the practice into financial ruin had you not suddenly become curious.

Your next issue concerns finding a person who has the right experience and attitude to do financial management and add to the positive atmosphere of the team. It should be someone who shares values and interests with the other team members, as well as someone that you personally would enjoy taking to lunch on a regular basis.

The final issue concerns your responsibility to manage your financial obligation through the delegation to this new person. This person must have your confidence and the only way that they can generate your confidence is to be someone that you can talk to. Therefore, when you find someone to manage your financial matters, be sure that it is someone that you will look forward to going to lunch with at least once a month. You must find someone that you like to talk to because the issues of money are far too serious to give to someone you consider an acquaintance.

Your lack of attentive management to the financial details permitted your staff member to get themselves into trouble. I do understand that issues of money can be very distressing, especially to those dentists who fashion themselves to be technical artists. I am in complete support of their art and their technical ability, but just as their art is a personal reality, there is another reality which is that dentistry is a business; and therefore, only when it is run like a business does everybody, artist and staff, feel good about the business, themselves, and the future.

The Coach

Want your issues answered? Ask the

Don’t miss The Coach’s workshops on Oct. 8th, Office Politics …The Enemy Within, on November 8th, Taking Your Practice Back – Leaderhip Development for Dentistry. For more information email or call 1-877-900-5775

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A Dentist's Guide to Effective Interviewing

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Sally's Mail Bag

Dear Sally,

I don’t know what to do when a patient needs immediate treatment, i.e., root canal or crown due to serious decay and or pain and they desire to wait. How can I tell them they must have the work started now…today. I have said, “My secretary informs me we have the time to treat you Mr. Jones and we can begin the treatment at this time.” Telling the patient “I feel you should have it now” was meant for “I do not want you to be in pain over the weekend.” Yet ,they still put it off and then they call me on the weekend and say “you were right the tooth is killing me and I can not wait until next Tuesday.” Do you have any suggestions?
Emergency Frustrated

Dear Frustrated,

My guess is the emergency patient is not convinced they need it and/or the cost is prohibiting them from having it done. My recommendation is to have a relationship with a patient financing company such as Care Credit so the patient understands they will have to pay a very low monthly fee. Perhaps you could do just emergency treatment, i.e., and open and drain on the root canal tooth, medicate, put them on antibiotics, and charge a lesser fee, (I know I’m not a dentist but you get the idea.) Explain it's a temporary measure and reschedule them. I think it’s very likely they are in sticker shock and that has overcome their pain threshold.

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

Missed Past Issues of Our e-Motivator Newsletter?

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· Hygiene Coordinators

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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 $$$$ in Your Practice Sally McKenzie, CMC.
Belle DuCharme, RDA CDPMA
 Nov. 7
 9:00 - 4:30
How to Become an EXCEPTIONAL Front Office Dental Employee Sally McKenzie, CMC.
Belle DuCharme, RDA CDPMA
 Nov. 8
 9:00 - 4:30
Taking Your Practice Back - Leadership Development for Dentistry    
 Nov. 14
 9:00 - 4:30
Unleashing Your Team's Potential & Optimizing Clinical Efficiency Risa Simon, CMC.  
 Nov. 19
 9:30 - 4:30
How to Recover the Lost $$$$ in Your Practice Sally McKenzie, CMC.
Belle DuCharme, RDA CDPMA
 Dec. 5
 9:00 - 4:30
How to Become an EXCEPTIONAL Front Office Dental Employee Sally McKenzie, CMC.
Belle DuCharme, RDA CDPMA
 Dec. 6
 9:00 - 4:30
Office Politics ... The Enemy Within    
 Dec. 10
 9 - 12pm
Boosting Your Hygiene Department Allan Monack, DDS FAGD
Hygiene Clinical Director
McKenzie Management
 Dec. 10
 1 - 4
Using Your Practice Management Software to Drive Revenues Mark Dilatush
VP McKenzie Management
 Dec. 17
 9:00 - 4:30
How to Recover the Lost $$$$ 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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