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  Sally McKenzie's
 Weekly Management e-Motivator
  9.19.03 Issue #82

Breaking Down the Under-Performing Staff Barrier

Sally Mckenzie, CMC
McKenzie Management

   Start by building up. If you’re frustrated by what you perceive as average or below average team performance, first determine if you’ve given them the foundation to achieve your standard of success. How well have you covered every employee’s five basic questions? Work with your staff to discover the answers and create the basic infrastructure to build the high performance team. You will clearly see if that mediocre/ poor performing employee just needs direction or is a legitimate staff problem.

How Do I Fit In? Assess the personality of each team member. Personality directly affects how well employees perform in key positions. Case in point, some are perfectly at ease asking for payment, while others feel as if they were making some extraordinarily difficult demand of the patient. Obviously, the second person should not be in charge of collections. I highly recommend personality testing to place current and prospective employees in positions for which they are best suited.

What Am I Supposed to Do? Have you ever actually told your employees what their job duties are? With input from your team, develop job descriptions for each team member. Define each employee’s job. Specify the skills the person in the position should have. Outline the specific duties and responsibilities. Include the job title, summary of the position and its responsibilities, and a list of duties. This is an ideal tool to explain to employees exactly what is expected of them. (For an example of job descriptions refer to my past e-Newsletters, Scheduling Coordinator, Financial Coordinator, Patient Coordinator, Treatment Coordinator)

How Am I Supposed to Do THAT? Train your team- all of them. I’ve watched this jaw-dropping scene a thousand times - dentists allowing untrained team members to handle hundreds of thousands of dollars in practice revenues. Would you hand them the instrument tray, a couple of handpieces, and say, “Have at it, let’s see what you can do.” Of Course Not. Your practice lives and breathes on collections and patients. The person responsible for this and scheduling must be given the tools and training to succeed and be expected to meet certain performance measurements.

So, Doctor, How Am I Doing? Monitor and measure employee performance. Performance reviews are an objective and neutral means of making sure everyone is on the right track to achieving practice and individual performance goals. While it is not uncommon for employees to express concern initially over performance measurements, a credible system for employee review not only yields a more effective and higher performing team member, it also increases that person’s personal job satisfaction. Let’s face it, when we understand the game and how we can win, life and work are a lot more fun and rewarding.

Can You Say “Thank You”? Reward your team. Celebrate success and encourage each member of the team to not just perform a task but to excel. Inspire the team with a practice vision and goals and recognize the progress you make together in achieving those goals.

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

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

Clinical Computing - Part 3

Last week, I discussed your expectations of training and the setup time required to successfully implement computers in your treatment rooms [see article]. This week, I promised to discuss planning for what we affectionately call “Live Day”.

Certainly at different levels, your whole team will experience excitement, fear, angst, worry, dread, and cautious optimism regarding your “live day”. It’s funny, after they fully process the first patient, the only feelings your team will experience is I WANT TO DO MORE! Isn’t it funny how our implementation of technology follows the same path every time we try something new? Think back to the day before you threw away your paper appointment book. Now think back to how you felt after it was gone. It’ll be the same in this situation.

Here is a list of things to do before “Live Day” that will make the experience much more enjoyable and productive for everyone on the staff. I have also included an expectation list so nobody is disappointed.

Live Day - To Do List

  1. Add one time unit to every appointment in each doctor schedule excluding one unit appointments like re-cements, post op checks, etc.
  2. Add one time unit to the first four appointments in each hygiene schedule.
  3. Assign a clinical computing officer (usually a chair-side assistant). I know it sounds silly, keep reading.
  4. Keep a list (MicroSoft Word) of incomplete setup procedures or clinical notes that need to be added, edited, or changed. Remember the importance of taking the time setting everything up right?
  5. Schedule some time (one hour/week) to review everything on your “change list” and make the changes until nothing appears on the list.
  6. Your clinical computing officer meets with the business administrator at least once per week (usually a working lunch) to review the negative AND positive impacts on the administrative team.
  7. When you confirm, ask your patients to arrive 5 minutes early if they can.
  8. Prepare your patients verbally at the business desk upon arrival so they know what to expect and can become an interested part of the process. I recommend you do this verbal preparation of the patients who have yet to experience your new digital treatment rooms for at least the next 6 months.

Expectations of how your “Live Day” will unfold.

  1. It “should” be fun! “How” fun it is will be a direct reflection on how well you have prepared prior to "Live Day"!
  2. You “will” have bumps in the road – make notes and fix them as a team. Get the notes to the clinical computing officer.
  3. Once they have mastered the basics, your clinical team will start to get real curious about some of the fancier things they can use to WOW your patients. Write them down. Wowing your patients is GOOD!
  4. Leverage their curiosity by providing them the time they need to include these WOW tools into your clinical charting routine. If necessary, prepare a mini "live day" for the implementation of the WOW tools. Once you’ve done your first "live day", these little live day’s will be a piece of cake.
  5. You should also expect your business administrator to be in a bad mood at the end of the day. Your clinical team is going to make mistakes! Your business administrator will “catch” them. NEVER allow your business administrator to fix the mistakes. The clinical team member who made the mistake should learn from it and fix the entry or procedural error. Don’t worry. Your business administrator will be fine after a couple of days. In the long run, the clinical team is probably going to do some of their work for them. This will undoubtedly put a smile on their face!

Next week I will start combining your clinical exam sequence with the patient’s WOW factor.

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

The Artist verses the Businessman

I have been receiving e-mail's from dentists trying to understand what it is that their staff wants. I also received e-mail's from staff

wanting to understand the dentist better in order that they can better enjoy their work. Both of these types of questions cover-up a deeper issue. Despite the fact that human beings are a social species, and despite the fact that we need each other to survive, another truth is that we would all like to be recognized as individuals and believe that we are strong enough alone and do not need the safety of the group. Although paradoxical, it is more accurate to acknowledge that we must belong to the group and at the same time be recognized as an individual with unique talents and the ability to make a singular contribution.
I would like to use this week’s column to help dentists and staff understand each other by explaining the components that we all bring to work everyday.

There are four components of our personality that we bring to work. They are natural talent, family values, expressed interests and activities, and our wants and desires for ourselves.

Natural talents: everyone is born with certain skills that their body and their brain perform with a high degree of accuracy and pleasure. The experience of accuracy comes from the ability for the brain and muscles to focus in on the very small details. The ability to focus in on small details is a tremendous asset because the ability to focus and concentrate brings with it a desire to feel good about achievement.

Everyone is born with a natural talent. Some have mental skills and some have physical skills that provide them an advantage in the game of life. Recognizing your personal talents will allow you to use it to your advantage in order to get what you want in life. The physical talents of an athlete are the best example of a natural talent that pays off exceptionally well in this country. Money brings great pleasure to some; however, there are many more examples of mental skills that afford us the great pleasure of being confident and competent. Patience is a type of mental skill. A steady mood is a type of mental skill. Doing a job correctly is a type of mental skill, and following the directions of a manager is a mental skill.

Everyone has natural talent and it is the ability to use that natural talent every day that determines who is happy and who is miserable in their work. It is important to recognize that you are born with natural talents, however it remains your responsibility to identify your natural talent and to use it appropriately in your own interest. When you use your natural talent in your own interest, then the interests of your environment will also be served. Your natural talents are your tools to negotiate through life. You should first recognize what your talents are and then take pride in those talents. Finally, continue to exercise those talents so that you become more talented and acquire greater satisfaction in your life.

Personal Values: we are not born with a personal value system. Your value system is something that you learn and acquire while growing up in your family. Whatever behavior and outcome was expected in your family either became a value that you move toward or a value that you move away from. The point to be made here is that what we value is learned and it is not necessarily 100% a matter of choice. We can learn that people who are quiet are dangerous, and we can act accordingly. On the other hand, we can learn that people who are quiet are weak, and we can act accordingly. What you value in life is really a product of what you have come to expect from your efforts and the actions of others around you. These expectations were designed and accumulated from your early experiences with other people in childhood.

For this reason, what you value in life becomes your measure of the world as you are comfortable knowing it. It is for this reason that we naturally seek out people who share our values. People who share our values help us to feel comfortable and safe. When we are at work, we bring our individual values into the office and create defensive judgments and establish friendly alliances based on a need to feel safe. On the other hand, the truth is that when we come to work, our safety has already been spoken for by the owner of the business and therefore the only value that we really should be focused on is making money and enjoying the day.

There are those who bring their value system to work, the same system they learned in their family, and impose it on others with the expectation of creating safety when there is no need. This is an example of where values helped to undermine the harmony that is possible when we recognize that most people in the office share common values which is to make money and enjoy the day.

Activities of interest: when we begin to combine our natural skills with the outcomes that we learned from our family values, we find ourselves moving in a direction. This direction is about what we do with our lives: the actions and activities we pursue. The important part to recognize about our interests is that by just being observed no one will know what your natural talents are and no one could possibly know what you value in life. As soon as you begin to take action and make choices, then suddenly people begin to know something about you.

It is essential that you understand that everyone else is observing us by our decisions, actions, activities. Our activities reflect those things in our lives that interest us. Thus, what is interesting to us, not only reflects our skills and our values, but also permits others to recognize just how much in common they may share with us. It is no great leap of intellectual capacity to recognize that people who share similar interests may have similar skills and values. It is for this reason that people who share similar interests generally get along.
In the office, it is very valuable to build teams of people who share similar or overlapping interests, because their skills and values are likely to permit them to understand and communicate better.

Wants and desires: what do we want from ourselves, what do we want from others, what do we want from life. The best way to understand your wants is to perceive it as a quantity: a measure of effort. Visualize that you have talent combined with values that lead toward interest in certain activities. Your wants and desires reflect exactly how much effort (energy) you are more willing to put into the attainment of success.

It is not difficult to see that if your interest is to make money, then the question becomes how hard will you work, how much effort will you put in that direction? Although business is all about making money, the experience at work every day is not necessarily the same for everyone. Some people want to make money while some people want to make friends. Others may want to make power alliances to feel safe while others want to be left alone. The capacity to win is a measure of the ultimate effort that you will expend in order to achieve satisfaction in any direction of interest you are inclined to choose.

How much you want is measured in units of energy or effort; however, what you want is a reflection of interest, and those interests reflect your values and your personal skills. It is the subject of wants and specifically what people want from their day at work which brings us to office politics. Office politics is about similar different people with different wants sharing the same office space.
More about office politics next week

THE ART OF COACHING is about helping clients to discover and analyze there talents, values, interests and guiding them through the process of expressing their wants and desires to themselves and then to others. Coaching is about finding these natural attributes and raising them to a level of awareness that allows the practitioner to feel good about their decisions, their accomplishments, and their goals to date and beyond.
There are people who do not appreciate or recognize their natural talents, the origin of their values, and the freedom to express their interests. These people require the services of coaching because they cannot see their own talent and value and the contribution to the larger picture of their life, their family, their staff, and their patients.

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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How to Prevent Under Performing Staff

  • Performance Measurements
    An Easy and Effective Method to Measure Dental Employee Performance
  • How To Hire The Best Employee
    A Dentists Guide to Effective Recruiting and Interviewing
  • How To Reward Your Dental Team
    Learn How to Develop The Best Formula for Your Staff
  • Maximize Practice Performance
    Understanding How Personality Types Affect Practice Success

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Sally's Mail Bag

How do I hold my staff more accountable?????

Dear Sally,
How do I hold my staff more accountable? I have delegated responsibility to them and feel they are failing. Let me site some examples: I had to cancel a two hour crown seating for today because the case was not back from the lab. I have told them to check all cases at the beginning of the week and be sure all cases are in. The patient was going to pay the balance today. Then when I ask to get the time filled, they move my afternoon so they can leave early. I was busy yesterday afternoon so didn't notice today’s schedule change until half the staff had left for the evening. Should I have made whoever was there stay until it was filled?????

I also found out they let a patient out the door with a very large balance. She was going to send in the check but we have failed to receive it. How do I make them more accountable. I delegate to them so I can do the dentistry - I pay them good money to be responsible. HELP!!!!!!!
Help Me Now

Dear Help Me Now,
It appears that the employee's do not understand what is expected of them in their jobs, and/or they haven't been trained, and/or they have unclear job descriptions and therefore no one person is accountable for specific systems/tasks, and/or they do not respect you as a leader.

I would suggest that you have beginning of the day meetings and one person is the designated Scheduling Coordinator. She is responsible for bringing to the meeting today, tomorrow and the next day's schedule. As a result, planning for items such as delivery of lab work is discussed by her and your chairside assistant who should also share in that responsibility. In addition, collection of money can also be discussed 48 hours ahead so you are being pro-active rather than reactive. If you just talk about today, it’s too late to react to last minute situations.

You should also have delegated a specific person who handles the collection of money. Depending on the size of your practice, that may be the same person as the Scheduling Coordinator above. This employee knows that her performance is being measured for the % of money that she collects over the counter from treatment that was rendered that day. She knows what that % goal is from the training she's received from you regarding her job description. She is also accountable for reporting to you and her team members her % every day, week or month. If she doesn't achieve it, then she knows she has failed in her position and has let her other team members down. She also knows that this affects her performance review for receiving raises and she also knows that her failing to perform based on the practice's expectations will be documented in her employee file as a basis for possible dismissal.

You make your employees accountable by training, giving them performance measurements of the systems/tasks they perform and then putting into place a reporting structure to you and the entire team. No one wants to look bad in front of the other team members. Peer pressure does work.

I would also recommend that you have set office hours. If working 8-5 on Friday is what they agreed to when they were hired, then leaving at 1:00 is another reprimand to write up for their employee file. A definitive employee policy manual would state office hours and approved time off.

I sure hope this helps. Feel free to contact me. We do provide training of employees as well as helping you to structure and implement job descriptions and accountability.

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

Want to know more about McKenzie Management?
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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 $$$$ in Your Practice Sally McKenzie, CMC.
Belle DuCharme, RDA CDPMA
 Nov. 7
 9:00 - 4:30
How to Become an EXCEPTIONAL Front Office Dental Employee Sally McKenzie, CMC.
Belle DuCharme, RDA CDPMA
 Nov. 8
 9:00 - 4:30
Taking Your Practice Back - Leadership Development for Dentistry    
 Nov. 14
 9:00 - 4:30
Unleashing Your Team's Potential & Optimizing Clinical Efficiency Risa Simon, CMC.  
 Nov. 19
 9:30 - 4:30
How to Recover the Lost $$$$ in Your Practice Sally McKenzie, CMC.
Belle DuCharme, RDA CDPMA
 Dec. 5
 9:00 - 4:30
How to Become an EXCEPTIONAL Front Office Dental Employee Sally McKenzie, CMC.
Belle DuCharme, RDA CDPMA
 Dec. 6
 9:00 - 4:30
Office Politics ... The Enemy Within    
 Dec. 10
 9 - 12pm
Boosting Your Hygiene Department Allan Monack, DDS FAGD
Hygiene Clinical Director
McKenzie Management
 Dec. 10
 1 - 4
Using Your Practice Management Software to Drive Revenues Mark Dilatush
VP Professional Relations
McKenzie Management
 Dec. 17
 9:00 - 4:30
How to Recover the Lost $$$$ in Your Practice Sally McKenzie, CMC.
Belle DuCharme, RDA CDPMA
To Register 877-900-5775 or

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or call 1-877-777-6151

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