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  Sally McKenzie's
 Weekly Management e-Motivator
  11.07.03 Issue #89

Overcoming the Out of Sight, Out of Mind, Out of Pocket Barrier

Sally Mckenzie, CMC
McKenzie Management

   Many doctors never notice it although you examine them every day, dozens of times a day. Your patient charts are likely holding tens of thousands of dollars in unscheduled treatment. Case after case that was recommended to patients but never pursued, relegated to the dark recesses of the filing cabinet because the office doesn’t have a procedure for treatment presentation. It’s costing some practices close to half-a-million dollars!

Get treatment out of the files and send your

practice profit off the charts. First, designate a member of the team to serve as treatment coordinator. The coordinator is trained to skillfully uncover and address issues such as finances, fear, and any general reticence that may interfere with patient treatment acceptance. The coordinator also is fully prepared to discuss available payment options.

Next, as charts are pulled for hygiene and other upcoming appointments, conduct chart “audits” to determine which patients have outstanding treatment and schedule case presentations in conjunction with those appointments.

I recommend that the treatment coordinator follow a presentation format similar to the one below. It’s logical and enables the patient to make an informed decision about treatment.

  • Review the plan and treatment options before the presentation. This will involve reviewing the chart and it may involve sitting down with the doctor.
  • Clarify any aspects of the plan with the doctor or other provider.
  • Review the case presentation mentally.
  • Prepare pre-determination or pre-estimate if that is part of the office routine.
  • Calculate the patient’s portion of payment using the insurance information received or estimate to the best of your ability.
  • Insert a financial arrangement form in the patient’s chart for discussion during the presentation.
  • Use necessary X-rays during the presentation.
  • Use visual aids and educational handouts to underscore the case presented.
  • Have paper and pen on hand for the patient to take notes.

Provide sensible financing options that benefit both the practice and the patient, such as those offered by CareCredit. Patients are far more likely to accept treatment when they can make necessary financial arrangements easily and quickly.

Provide a private space where financial details can be discussed in private. Do not send the patient to the front desk to hammer out the financial plan in front of the waiting room audience.

Start auditing your charts today and begin following-up on recommended treatment with your patients. As a medical professional, patients expect you to encourage them to pursue the best possible care. In many cases, they are just waiting for a cue from you to begin that treatment. And, ultimately, the greatest profit you realize is the excellent care you insist on providing for your patients.

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

Clinical Computing - Part 10
More Patient WOW

Last week [see article], I discussed three more of our commitments to our patients when you implement computer systems into the treatment rooms. This week, we are going to continue examining three more patient commitments in greater detail.

A patient of ours will always SEE the problem before we present a solution.

I know we discussed digital cameras last week but I wanted to expand on what patients SEE and what you use that allows them to see their problem. A patient can see THEIR problem with an intra-oral camera, a digital camera, an electronic perio probe, a microscope (yes you can integrate these into your computer system), a digital x-ray, the graphic historical trend of their perio condition, their tartar and calculus, the measurement of sulfides in the mouth, how their “bite” contacts (where and how hard), and they can even see the results of an electronic tool that detects even the smallest amount of caries. The important part of this is to take the time to let the patient see the problem. Once they see it, they will “own” it. Once they “own” it, they will seek a solution. The old saying “I believe half of what I hear and everything I see” has specific merit.

A patient of ours will NEVER be told that we cannot locate their chart.

Now, I know you don’t make a habit of actually admitting that you lost a patient chart. Some of the excuses you make up though are classics!

How could a chart be misplaced? There aren’t any! No more fumbling around the front desk, the doctor’s personal desk, the doctor’s car, the office manager’s car, the sterilization area, the break room, yuck!

As long as you have a verified backup and restore plan in place, you will never ever have to apologize for misplacing a chart – ever again.

A patient of ours that we refer to a specialist will NEVER get lost through the cracks.

This one is a little more involved. If you tell your practice management system that you referred a patient to a specialist, why they were referred, and a date you expect them back – nobody can fall through the cracks as long as someone has the responsibility of running the overdue referral reports and following up. For those general dentists that refer their ortho, endo, perio, or oral surgery patients, you are sitting on (this is a guess) about 10% of your annual revenues for seemingly no apparent reason. For every patient you do not track and follow up, the patient grows more and more concerned that YOU don’t care as much as you really do.

Proactive dental teams NEVER leave patient care management to a specialist’s office. Proactive dental teams ALWAYS have that overdue referral list somewhere near the front desk or on their screen. Someone on the team should review the status of this list at team review meetings at least once per month. All notes from communication with the specialist’s office are entered into the patient’s record in the “patient notes” area. Some systems call this area the “contact” notes. Bottom line? If you ignore your patients, they’ll ignore you right back!

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

Last week’s article was a question from a dental employee that described two different levels of office politics. I addressed the practice management issues of communication with staff, attention to successes and the

resolution of staffing problems. This week, I will discuss this individual staffer and why she is suffering unnecessarily and necessarily for good reason.

Coach Replies:

It is clear to me is that since you have been told by your past as well as current employer and office manager that you do good work; you have the power of your fate in your hands.

You may stay where you are or you may leave and quickly find new employment in an environment that suits your personal needs.

Of course, your current employer will be happy if you stay, because of your technical skills, your people skills, and devotion to your work; and yet you chose to make their happiness more important than your own.

You have the power to find happiness, and yet you remain working for people who do not provide you with an essential human connection that naturally feels good to everyone.

Your desire to gain some control and influence over this one particular hurtful and staff insensitive environment makes this problem of the office a personal problem and that is unhealthy.

While I see that you possess all this power, and while I believe that you have the wonderful option to stay or leave, you do not seem to possess a reasonable explanation for remaining in a place where it does not feel good to connect with the people you work with: your employer and office manger.

It is important to keep in mind that there are personality types that enjoy connecting with people, and there are types that prefer to avoid such contact. One group needs this connection in order to feel grounded and safe, while the other group needs the exact opposite experience to accomplish the same feeling. Why not go and find the type of people just like yourself?

While I believe that I understand why you do not leave, I also believe that you do not understand why you stay.

Review the following facts:

  1. Your boss does not relate to you.
  2. Your boss only relates to his money.
  3. Your office manager does not relate to you.
  4. You are very good at your job, but the environment is painful
  5. You enjoy connecting with staff but they are leaving you.
  6. While other technicians and assistants have left the practice to find a satisfying work environment that feels good, you refuse to make a move on your own behalf.

While your question asks for help to avoid losing more assistants, I have to tell you that if it is not a problem for the owner of the business, then it is not your problem. If you insist on making it your problem, then we have to ask you, WHY?

You are free to stay and you are free to go. Why not look at yourself and ask yourself why do you choose to remain with the pain? Therein lies the essence of your question.

You continue to maintain a belief system or a value system in which your expectations of pain and disappointment are familiar to you and it is for this reason that you remain in this particular practice.

While you say that you are unhappy and that you tried to quit, the reality is that you do not have enough of an incentive to move toward pleasure. I will offer you that pleasure is not a familiar feeling. Thus, when your employer comes back to you and gives attention to your desire to leave, you immediately receive that momentary connection and thus you stay.

On a very personal level, you believe that his promises and his gestures are the best that you can hold for, but this is simply not true.

I am quite certain that the people who have left the practice have recognized the same in sensitivities, but they believe that they were entitled to work in an environment that was supportive, nurturing, and appreciative, whereas such an environment does not enter into your repertoire of behavioral options.

Of course he refuses your resignation, and of course, you can be talked into staying by his promises, because this is a dialogue of interaction that is familiar to you. However, for most healthy adults, they recognize that they are entitled to work and feel anything they choose. It is for this reason that they leave because this environment does not feel good.

In addition, recognizing that there are only criticisms and no compliments is in all probability a familiar environment for you, while it is probably not as familiar to your colleagues who have left.

The fact that you allow yourself to get stressed and exhausted also demonstrates that you are very familiar with feeling pain and frustration, and you are also very familiar with feeling disconnected and alone. It is because these feelings are familiar that you remain with this doctor and this office manager.

People do not change their behavior unless they must and as long as you continue to function in a familiar painful environment, you will stay.

Another example which supports my contention is that you continue to stay and accept the brush-off when someone says something hateful. This is ridiculous. When someone says something hateful, you either attack them back, or you leave the situation. Under no circumstances do you remain where there is hate.

You do not come to this basic adult conclusion naturally. I understand that you would not, but it is still the truth and deserves your consideration. In such an environment, it makes sense that the turnover rate would be high, because there are more healthy people in the world than you want to acknowledge.

I am sure that you consider yourself a healthy individual and that is perfectly acceptable, but try to recognize that you are pleading in this question to avoid more turnovers of other people and completely eliminating your own suffering predicament from the question.

It is clear to me that all the assistants left this business for a good reason and are healthier people than those who stay and suffer the abuse, the shame, the embarrassment, and insensitivity. These people have deeper problems than even your boss and office manager. Consider that your boss and your office manager have figured out a way to feel safe and secure. Can you make the same testimonial?

The Coach

Want your issues answered? Ask the

Don’t miss The Coach’s workshops on Dec 6th, Office Politics ... The Enemy Within. For more information email or call 1-877-900-5775

Missed Past Issues of Our e-Motivator Newsletter?


If You're Not Satisfied with Your Practice's Performance …
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9 out of 10 practices have staff turnover every 15 months.
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72% of practices' employee costs are more than 25% of revenues.

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GOALS IN 2003?

Let us help you and your team establish an overall business plan for the upcoming year. Achieve your goals with our two day Team Building Retreat!

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Sally's Mail Bag

Dear Sally,
Last year about this time you gave us a letter that could be used to send out to our insurance patients that had not completed their treatment plan. Can you make that available again?
Dr. Lucas

Dear __________,
Did you know that each year insurance companies make millions of dollars off patients who forego necessary and preventive dental care? Many individuals who are paying for dental insurance do not realize that their plans provide coverage up to a certain dollar amount annually. Consequently, some patients are not scheduling the dental treatment they need, deserve, and have insurance to cover. Thus, the insurance revenues allocated to pay dental claims on many patients are never used, and, unfortunately, those dollars cannot be carried over year-to-year. The bottom line: What the patient does not use they lose.

Clearly, it pays in many ways to schedule the preventive care or other dental treatment that you need. We are here to help you secure the insurance coverage available to you on every dental procedure you schedule. Our computer estimates that you still have $ xxxxx in unused dental benefits. Give us a call today, and together let's make sure you are in excellent dental health. As a special incentive for you to take charge of your dental care, we are offering a ____% reduction on dental treatment completed by January 1, 2004. Give (name of appointment scheduler) a call at 555-5555. I look forward to seeing you again and sharing some of the many innovative means we now have available to provide you with superior dental healthcare.

Dr. Best Dentist in USA

P.S. Find out about additional interest free financing options for dental care. Check with Peggy in my office for all the details.

Dr. Allan Monack,
Hygiene Clinical Consultant for
McKenzie Management,
develop a profitable
Hygiene Department

To find out more about the
Hygiene Clinical
Enrichment Program
[go here]
or contact us at:
or call:

  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:
The Center for Dental Career Development
San Diego Workshop Series
Fall/Winter Schedule
 Date Seminar Instructor(s)  
 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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