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  Sally McKenzie's
 Weekly Management e-Motivator
  10.10.03 Issue #85

Time on the Run

Sally Mckenzie, CMC
McKenzie Management

   “I am a slave to my day.” “I feel totally out of control.” “I am running virtually non-stop from
7 a.m. to 4 p.m.” “By 5 o’clock I can barely concentrate long enough to turn the key in the ignition.”
Any of these sound familiar?

Certainly, one of the most critical systems, if not the most critical, is the schedule. It will either burn you out or fire you up. Save you or slave you. It’s your ticket to freedom or your ball and chain. For many doctors, the schedule often lapses into a hodge-podge of space and

time strung together with little direction other than – “We know the doctor wants to be busy.” Busy yes, brain dead no. Controlling the schedule requires constant vigilance, commitment, and, yes, training. But every well-managed schedule has a few key elements. Read on.

First, consider the bottom-line. How much does the practice need to produce to meet your financial needs and wants – i.e. goals? How many hours per day and days per week do you want to work? How much vacation time do you want to take? How much do you need to pay your staff and yourself, the mortgage, utility bill, etc. Identifying your practice’s financial demands and objectives enables doctor and team to understand the importance of scheduling to meet daily production goals. It provides the scheduling coordinator with clear scheduling objectives, and it allows the doctor to focus on diagnosing the best dentistry for patients.

Scheduling time should be clear and consistent. It also MUST be communicated by the doctor/assistant. Clearly communicating the specific time needed for treatment ensures that the scheduling coordinator isn’t rolling the dice on your day – it’s not up to chance whether she gets it right. She knows exactly how much time to allocate. Complicated stuff – eh?

For example, the doctor examines a hygiene patient and determines they need three fillings. The doctor tells the hygienist specifically how much time is necessary. She, in turn, can specifically tell the scheduling coordinator exactly how much doctor time and assistant time to book. The doctor’s time should be scheduled in one color on the computer and the assistant’s in another. This simple strategy ensures that the doctor is not double-booked.

Avoid the tendency to over schedule. No doubt there is a temptation when presenting higher dollar, multi-appointment treatment plans to nail down all those visits at once with the patient, like some sort of patient insurance policy. In reality, booking the entire treatment plan does nothing to guarantee that the patient won’t change or cancel appointments. On the flip side, it does everything to make your schedule appear clogged and overwhelming. What’s more, practices that overbook typically force loyal patients to wait several weeks for routine procedures – seriously bad customer service. The doctor should never be scheduled out more than three weeks from a customer service point of view.

Delegate procedures to the assistant. Many states have expanded functions for dental assistants. Maximize your time, your talent, and your staff and give your team the opportunity to achieve their full potential. Provide necessary training to prepare your staff to perform procedures that they are legally allowed to carry out in your practice. If you do not have the confidence that your assistant can handle the additional responsibility even with proper training then she should be replaced – plain and simple.

Review the schedule as a team first thing during the a.m. huddle. The clinical staff can then advise the scheduling coordinator where to place any emergency patients. The dental assistant also can review specifically what procedures are scheduled and set up the treatment rooms accordingly.

Reserve time for crown and bridge appointments based upon actual patient activity. Avoid the tendency to engage in “wishful scheduling” in which more time is reserved for the doctor’s “ideal” treatments than the practice has a history of delivering. Rather, calculate the number of crown and bridge units over the last six months, divide by the number of days worked. Reserve time in the schedule based on the number of units actually performed.

Allocate necessary time for new patients. Look at new patient activity over the last six months. If you saw 60 new patients (comprehensive exams), that would be 10 per month and 2.5 per week. Reserve at least that much time in your schedule to handle immediate new patient demand. Remember, new patient slots should always be reserved during prime time and attempt to make them diversified during the day/week.

The schedule is your servant not your master. Take charge of it and reclaim control of your day, your work, and your life.

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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Missed Past Issues of Our e-Motivator Newsletter?

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 6
Patient WOW

Last week, I discussed your clinical computing commitments to your patients. [see article]. We discovered many benefits to your existing patients. As we work through these individually, I would like you to keep in mind all of the end

benefits to you and the dental team. Any time your service level is increased, your patient value perception is increased. When a dental practice earns a high patient value perception, more treatment will be accepted, higher fees will be justified, collections will go up, referrals (organic growth) will increase, and your whole team will feel better about coming to work every day.

Today’s Patient WOW’s

“A patient of ours will never show up for an appointment with a missing or incomplete lab case.”

How embarrassing is that when it happens?

Until now, if you tracked your lab cases with the computer system, it was generally a business team function. Now that you have computers in the treatment rooms, this will become 90% clinical team and 10% business team. The process “should” work like this. The dentist tells the assistant (verbally) that we have completed a crown prep today (with appropriate tooth number). Your practice management system will most likely prompt you to open a lab case. The dentist tells the assistant which lab, it is entered, and saved.

Once each morning a dental assistant should have the responsibility of printing an outstanding lab case report (or review it on screen if it’s near the lab trays). The assistant tells the computer which cases have arrived in good shape and are ready for the patient. This tells the front desk everything is ready when they appoint and/or confirm an appointment with a patient. That’s it! When the crown seat is posted in the treatment room, the lab case will be officially closed. It’s that simple!

“A patient of ours will always have a completed HIPAA consent form.”

You are undoubtedly going through this right now. It is up to the business team to present, receive (scan if you want to), and tell the computer system that they are in receipt of a completed HIPAA form. It is up to the clinical team to “see” that every patient has the HIPAA form completed before beginning work. Your practice management software may alert you of a missing HIPAA form as you enter the patient’s chart. Your software may actually allow you to set up an alarm if the HIPAA form isn’t complete. Look closely at your software for these “alarms”.

“A patient of ours will always have a recently completed or updated medical history form.”

Just like the HIPAA form, the medical history form is presented, received (perhaps scanned), and entered into the computer system by the business team. It is obviously the responsibility of the clinical team to review the medical history information prior to treatment. Some practice management software incorporates the medical history into the examination “flow” (there’s that word again). Look in your software to see how easy it is to quickly review the patient’s medical history as one of the first steps within your clinical information review flow.

Next week, more patient WOW. Email me some ways you use your computer system to WOW your patients. I would love to hear your stories.

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

I have received many e-mails and have had long conversations with practitioners over their ability to be a “leader” and what is going wrong with this process. Last week, we talked about

the ability to love the people that you work with. If you cannot feel a closeness or intimacy with these people, who are helping you to make money, then you cannot ask them to follow you into the depths of the unknown. It is simply unreasonable to expect that.

However, there is another truth which is often overlooked. You are running a business; this is not the military nor politics. Simply by being the owner of the business, the people to whom you pay money to in an exchange of services are already predisposed to follow your instructions which are consistent with their job description.

Many people have heard the expression “lead by example”. Some of these people have internalized this definition to say that if I will not do it then how can I ask someone else to do it. It is this reasoning that permits a type of mild anarchy to run rampant in offices that are poorly managed.

Offices that are poorly managed require two things: systems which provide structure, and coaching which redefines the interpersonal relationship between owner and staff. Practice management consulting is the most efficient way to improve a business culture of confusion due to a lack of guidelines. The second most important step is that the owner of the business must learn that, as the owner of the business, they are the automatic leader of the business and therefore do not have any leadership problems. The problems appear when they harbor a different definition of leadership or are unwilling to accept this simple business definition.

Many practitioners see themselves as would-be politicians or military geniuses charged with the impossible task of saving the day through insight, cunning, and reallocating resources as needed. I hope you can see this as gross exaggeration and intentional hyperbole.

For those that I have worked with in coaching, what I have discovered about these practitioners, who want to be better leaders, is that being a leader is a terrifying experience. They believe that they are suppose to have the necessary skills, but are dismayed to find themselves ill prepared. In response to believing that they are ill-prepared, the first thing they want to do is go back to school. They buy a book or go to a seminar expecting to learn for themselves how to be "a leader".

The solution to their particular problem has nothing to do with leadership skills or being unable to follow the dictates of a book or seminar. Rather, their difficulty is really the reappearance of a very old and familiar problem. A problem they have lived with for decades. The problem I am speaking of dates back to childhood when they learned that there was no point in telling others what to do because no one would listen. In other words, those practitioners that believe in their need for leadership skills believe that leadership is somehow some magical concept that will allow them to have people listen to them and in turn do what they want them to do.

Next week a continuation of the “social business contract” between employer and employee.

Want your issues answered? Ask the

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

Wish Your Chairside Assistant Were More Efficient?

Optimizing Team Performance!

How long have you been practicing inefficiently? Are all those compromises you've been making worth the price of lost production and the physical wear and tear on your body? Wish you could choreograph your chariside team for optimal performance? If so, then this DVD "Optimizing Team Performance" was designed for you! This training resource was produced by Risa Simon, a certified management consultant, published author and one of dentistry's top clinical management speakers. Don't waist time watching videotapes when you can dial up topics of interest from the DVD's scene selection menu. Scenes include: Posture & Positioning, Magnification & Illumination, Assistant Access & Visibility, Ergonomic Work Zones, Chairside Efficiency Techniques, including Instrument & HP Transfers for efficient 4 handed & 6 handed dentistry - a must for every office!

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Sally's Mail Bag

Dear Sally.
My question is about % collections. To get this number, do you take into account all money coming in for that particular month? For example, looking at September collection % do I only look at collections from September procedures or do I add all money coming in, even though it was produced in August? Considering a month to month basis, collecting 95%+ from that month’s production seems rather difficult. If it takes into account collection from the production of the previous month, I could see where it would be misleading to look at that %. In other words, slow current month in production and a stellar previous month would lead to over a 100% collection rate.
Can you help clarify?
Dr. Periwinkle

Dear Dr. Periwinkle,
The collection percentage is calculated by taking the collection divided by the adjusted production. It is adjusted production because you can't collect what you adjusted off.
This percentage can be figured for the month, the past two months, the past three months, year to date, etc. It has nothing to do with what was produced the previous month and collected two months later. However, this is why it is best to look at the collection percentage for the month and also year to date. You can have a "roller coaster" effect in the percentage from month to month. The year to date should show close to the 98% which is industry standard. However, if looking at your aged accounts receivable report you see the % of monies owed by patients and insurance is more than 12% over 90 days, then immediate effort needs to be applied to get in that old money plus 98% of the monies produced currently which means that your collection ratio would be over 100% for a period of time until the "old" money was collected or reduced to an acceptable %.
Hope this helps.

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

  Office Managers
  Financial Coordinators
  Scheduling Coordinators
  Treatment Coordinators
  Hygiene Coordinators
For a FREE Educational Video
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737 Pearl Street, Suite 201
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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. 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

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

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