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  Sally McKenzie's
 Weekly Management e-Motivator
  10.31.03 Issue #88

Out of Sight, Out of Mind, Out of Pocket

Sally Mckenzie, CMC
McKenzie Management

   What if I told you you’ve most likely misplaced several thousand dollars - $50,000, $100,000, $250,000. “Overlooked thousands of dollars?” I can just hear the near total disbelief in your voice. It’s difficult to conceive, I know. After all, how could you not miss tens of thousands of dollars? It happens all the time though. In fact, recently I had a conversation with a doctor who misplaced over $300,000.

He didn’t even realize he had lost it until by

chance he happened to take a closer look at a couple of charts. Right there along with “Mrs. Madigan’s” X-rays was about $3,000. Then he discovered that another $1,500 was spilling out of “Mr. Jacob’s” file.

Before long this good doctor uncovered tens of thousands of dollars in recommendations for treatment made over the last several months that had been lost somewhere between the folds of the patient files. Although dentists look at patient charts every day, few give thought to the wealth of unscheduled treatment that is wasting away unnoticed, and, worse yet, unpaid for!

We see it repeatedly, case after case recommended to patients but never pursued. You could call it the toe-tag treatment strategy – treatment recommended but never followed up on. Case after case, just left to waste away, eventually relegated to the “treatment morgue” because the office doesn’t have a treatment presentation/follow-up procedure. The dollar figures will take your breath away. In one dental practice alone, literally $400,000 in unscheduled treatment was sitting in the patient charts because there was no standard protocol for treatment presentation.

It’s time to resuscitate these cases, and breathe some life into your treatment acceptance. First, designate and train a member of the team to serve as treatment coordinator, and train other staff so they can step in when necessary. A treatment coordinator is a liaison with the patient who is both a “treatment advocate” and a “patient advocate.” This person speaks privately with the patient and presents the doctor’s recommendations in lay terms. They help the patient feel at ease and comfortable asking questions.

Next week, a step-by-step strategy to get treatment out of the files and on to the schedule.

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

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 9
More Patient WOW

Last week [see article], I shared a reader email and his experience with two of the finer benefits of clinical notes and document imaging. This week, I want to go back to our clinical computing commitments and expand the thoughts behind each.

“A patient of ours will have immediate access to information (visually or printed) specific to the treatment we recommend and/or they require.”

This is pure patient education. There are many patient education systems on the market today. In my opinion, the best uses are continuing loops in the reception area and specific presentation within a consult room setting.

“A patient of ours will always be able to see a sample “before and after” picture of themselves BEFORE they commit to treatment.”

Quality digital photography is the fastest growing technology component in dentistry today. The power of visualizing the work is immeasurable. The increase in acceptance IS measurable. We see the difference in the field every day. A good quality camera and training for the clinical team will run you $3,000 to $6,000. Invest in having quality training for the WHOLE clinical team. Once they get the hang of taking quality pictures, you are only a short training session away from being able to do pre-treatment before and after presentations to your patients. If you don’t already use a digital camera in your dental office, put this one on your list for 2004. You’ll be glad you did.

A patient of ours will always be able to take home specific information about the treatment we recommend (or they require) so as to discuss this treatment with their spouse, family, significant other.

80% of healthcare decisions are made by females in this country yet most of you send adult males home with little more than a brochure and a printed treatment plan with fees on it. All his significant other has to go on is your fees. Not good. Many practice management software vendors now incorporate treatment presentations into their software. You can print, email, or burn them to a CD so the patient can take them home to consider the treatment plan with their spouse. Same holds true of the female partner. Very few spouses (on either side) can make a $10,000 purchase decision without consulting their significant other. Take the heat off your patients! Send them home fully prepared to make the right choice!

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

This week’s question from an employee describes two different levels of office politics…. the management of the practice as a business and the handling of staff matters, i.e.,

her inability to recognize appropriate boundaries of behavior.

This week, I will address the practice management issues of communication with staff, attention to successes and the resolution of staffing problems. Next week I will discuss why she is suffering unnecessarily and necessarily for good reason.

Dear Coach,

I believe our office needs some help. My employer stated he would consider some outside information. Here are some of the issues.
I have been a Certified Dental Assistant and Certified Orthodontic Assistant since 1988. I have worked in Pedodontics, General, and am presently in Orthodontics. I have been here for 5 years.
Our boss is a great Orthodontist and his patients love him, he knows everything about them, their families, pets, sports: you name it but he couldn't tell you how many employees he has working for him. He couldn't even tell you how many children they have let alone their names. I love what I do (being an assistant) and have excellent skills. In each office that I have worked, I have been complemented about my ability to perform well above average.
Right now, I am so unhappy where I am. I have tried to quit at least 3 times, but my employer either refuses to accept my resignation or talks me into staying. He will give me raises or guilt me into staying by reminding how much he needs me or that I can have specific patients for whom I would be the only assistant to work on them.
Specifically, most of the reason that I am unhappy is because there is no communication between us until I hand him my resignation. He and our office manager are very quick to tell you when you've dropped the ball but, rarely tell you that you did a great job until they think there is a problem.
I am usually very stressed and exhausted, and I don't have the energy to resolve conflicts or hurt feelings with my boss or other employees until I am ready to quit.
Whenever I have tried to open up the communication or clarify something hateful that was said, I get the brush off with, “That is your perception".
In addition, we have a very high turn over rate, I feel. Just since I've been there, we have had 20 employee changes. My boss and office manager are very quick to tell you what you do wrong and many assistants go home in tears on a weekly basis. They will make you sign an incident report if you bring up any concerns you have. What should be the first thing to do to find out how to make things better before we lose any more good assistants?

Coach Replies:

It is nice that your doctor is open to outside help, but I really think that he is placating you rather than being serious. The reason why I say this is because nobody accepts outside help when all the operatories are full and there are no holes in the schedule. He is making plenty of money and there is no reason why he should change anything and upset the stability of his world. He is safe the way things are.

Your employer communicates effectively with patients and ineffectively with staff, because it suits his agenda. He maintains a wonderful memory for his customers, because they provide him with something that he wants, something that is important to him. As long as the business is making money, your employer will remain open to the source of that important motivation.

It is reasonable to conclude that people who take the risk of going to school and starting their own business are interested in making money, but you cannot assume that they are interested in making friends. In this situation, his priorities are clearly demonstrated: the desire to make clients happy in order to make money.

Understandably, it is not surprising that his zeal for patients does not necessarily carry over to a love for the staff. This is because the staff is perceived as, not only expendable and replaceable, but as a source of possible discomfort.

Patients provide money and so he can let them approach as far as the distance to reach out and take their money and perform his service. Staff on the other hand involve day in and day out problem solving. This interaction tends to make people feel closer and more intimate because they have struggled together against a common adversary. This is simple human nature.

When one human being is insensitive to the sufferings of another human being, there is something in the agenda that is being hidden.

Avoiding the details of your staff without whom you could not accomplish your goals seems to me to reflect a quiet secret: the employer becomes fearful when the staff becomes too intimate with the true nature of his self-image. Even though you like him and his clients like him.... he may have a secret which is that “he does not like him” and so he pushes everyone away except the money. This is a very common dynamic in all business.

The same could be said for the office manager. She feels very good about running the office with a minimum of necessary friendly contact and interaction with the staff. In order to keep her job and too also feel safe, she too endorses this distance and avoidant connection environment with staff so that she too can remain safe and secure in her position.

So, you can see that the reasons for avoiding telling staff of their success and their quickness to let them know of their failures helps to maintain a distance which creates a comfort zone from which management can feel safe and protected

Successful entrepreneurs will tell you that the time, energy, and money spent on unnecessary hiring, firing, and training is financially excessive and wasteful.

Every good businessperson will tell you that in every business it pays to keep good employees. In this situation, the bottom line for this business is that the amount of money wasted on firing, hiring, and training, although an enormous waste of time, energy, and especially money, is well worth the risk of being safe and secure with one’s secret.

Review the following assessment:

  1. Your boss is a wonderful technician and an artist but he does relate to his customers because they are a source of money.
  2. Your boss is a wonderful technician and an artist, but he does not relate to the staff because they are an expense and a danger.
  3. Your office manager follows the dictates of her boss, because she also prefers to avoid connecting and getting too close to staff; the patients are a source of her money.
  4. They are very happy wasting time, energy, and money in return for feeling safe and secure by avoiding contact with the staff.
  5. All of the technicians and assistants that have left the practice are wonderful technicians and artists who enjoy connecting with people and derive a great satisfaction from smiling and interacting with other human beings. They left to find those satisfying feelings, because the money or the lack of friendly working environment just was not worth the office tension.

The Coach

Next week I will continue with this staffers’ dilemma of suffering unnecessarily and necessarily for good reason.

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

Can You See
for the TREES?

McKenzie Management has been helping Dentists see a CLEAR PATH to their desired future for over 23 years.

“Plain and simple...
we listen, we understand
and we’ll get you there.”

- Sally McKenzie
President & CEO



GOALS IN 2003?

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Sally's Mail Bag

Dear Sally,
If we use a daily production scheduling goal and the next day's schedule is nowhere close to the goal (with patients scattered all over the schedule and with gaps,)... is it unreasonable to cancel/reschedule those few next day patients and tell the employees to stay home?? There is no reason for employees to come in and make money when I (the doctor) cannot produce because of no patients/production on the schedule.

The flip side to this situation which one of my employees asked me today was... since our collections bonus is on a monthly basis, then why should we worry about the schedule on a daily basis.. as long as the end of month's numbers are good? ... Well I told my employee it's because the last three months we have not met those monthly goals and something has to change. These employees are good overall, compared to the first bunch of staff I had when I bought the practice, but I'm not working just so they can receive a paycheck. Am I wrong??
Courtesy of DentalTown Message Boards

Dear Townie,
I am going to recommend that you and your scheduling coordinator and assistant start reviewing over the daily schedule 48 work hours ahead every day. This way the scheduling coordinator has 2 days to get the schedule to meet the production objective. If the schedule is not meeting production objectives because no one came from the hygiene operatory that needed another appointment or from your treatment room, then her responsibility is to make calls from the unscheduled treatment report. Run this report for the past 6 months or year and I am sure you will find thousands of dollars in undone dentistry. She should also make calls from past due recall reports and the missed appointment report.

Having a collections bonus is obviously not working for you and sending the wrong message to the employees, i.e.,"as long as we collect $x we are successful and should be rewarded". In the meantime you are coming up on days with no production and important practice measurements such as patient retention are not being taken into the "success" equation. This also represents that the collections goal is not high enough. The employees are not educated/trained on what is needed to manage the business side of a dental practice. I think a practice assessment with team training is in order. Call me 1-877-777-6151.

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
The Center for Dental Career Development
Advanced Business Education for Dental Professionals
737 Pearl Street, Suite 201
La Jolla, CA 92037

This issue is sponsored
in part by:

C.E. Magic!
Releases First of Its Kind, Interactive DVD Learning Kit for Dentistry
by Leslie Fang, M.D., PhD and Robert C. Fazio, D.M.D.

C.E. Magic! announces the release of their Interactive Learning Kit entitled, “Antibiotics in the Dental Office.” The Kit includes a comprehensive interactive DVD, which can be accessed on a computer with a DVD player or any DVD player hooked to a television to watch movies. The Kit also contains a comprehensive written summary with hundreds of printed information slides. Two additional audiotape programs are included on the subjects of prophylaxis in the dental office and intraosseous anesthesia. Each component of The Kit has a corresponding post-test, which can be sent to C.E. Magic! for grading. A dentist who successfully completes all the components of The Kit, and passes the tests, will earn a total of 10 CE credit hours recognized by the Academy of General Dentistry.

e-Newsletter special: $149


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