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  Sally McKenzie's
 Weekly Management e-Motivator
  11.21.03 Issue #91

Overcoming the ‘They Don’t Get It’ Barrier

Sally Mckenzie, CMC
McKenzie Management

   If you find yourself shaking your head and lamenting that members of your team will “never get it,” maybe it’s time to consider the very real possibility that they don’t “get it” because you haven’t given “it” to them. Make sense? Let me explain. Often in the busyness of today’s dental practices doctors are so consumed with addressing the urgency of treating the patients they don’t take the time and energy or have the experience to maximize their teams.

If the doctor does have a practice vision, often it’s not shared with the team. Staff members frequently do not see any relationship between their roles and practice goals. What’s more, team members in these practices are typically found fumbling along, trying to guess what their job responsibilities are and what the doctor’s expectations might be. Meanwhile the doctor “just wants to do the dentistry.”

In reality, dentists want far more than to just “do the dentistry.” You want a comfortable and reliable income. You want your patients to keep returning. You want to pay your bills in a timely fashion. You want patients to invest in your quality care. And you don’t want any more stress chipping away at your days...and nights. To achieve that you need team members who, at a minimum, are playing in the same ball park you’re in. How do you get them there? Start with the job descriptions for each employee.

Although the dentist has the final say in each employee’s responsibilities, input from the team members is particularly beneficial in encouraging individual ownership and responsibility. Ask each member of the team to list the tasks currently within their job. Provide an example description such as the following:

  1. Define the job. Treatment Coordinator. Informs patients what treatment is required, the benefits of completing treatment, financial obligations and options available, schedules first appointment. Welcomes new patients to the practice and builds rapport with new and existing patients.
  2. Spell out specifically what skills are necessary for the position. Articulate, well organized, good listener, sensitive to patient concerns and objectives, ability to understand and clearly explain dental procedures. Ability to work with computer systems and dental software. Enjoys working with and helping others. Can handle rejection.
  3. Outline the specific duties and responsibilities of the job. Discuss treatment plans with doctor prior to meeting with patients. Prepare predeterminations. Conduct case presentations. Measure results using an established system and report regularly on results to the team. Monitor case acceptance. Enter patient treatment into computer system. Serve as a liaison with insurance companies regarding patient financial arrangements. Serve as communication liaison to the team and regularly report on concerns raised by patients to enable staff and doctor to address those issues. Provide other assistance as needed, including appointment confirmation, patient processing, and front desk and clinical assistance.

Job descriptions are the cornerstone for virtually every system in the practice. I guarantee that putting employee duties/responsibilities in writing will have an immediate positive impact on your productivity, your stress level, and the overall quality of your team. So what are you waiting for?

For a listing of “business” job descriptions go to the September-December 2002 issues of the Monthly e-motivator newsletter on our web-site. Go Here

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 12
More Patient WOW

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

A patient of ours will appreciate and UNDERSTAND a 15” digital image of an xray vs. the doctor holding a 1 x 1 xray up to a light box 6 feet away.

If you read these each week, you are sensing a theme by now. How and what you do with our treatment room computers can have a profound impact on the patient understanding and “owning” their problem. Having a patient “own” their problem is the first successful step to improved acceptance. One of the more obvious benefits to digital x-rays is the ability to present a radiograph much, much larger than life. If you have ever pinned traditional film to the light box and drawn the patient’s attention to it, wait until you can show them on a 15”, 17”, or 19” flat panel monitor! The software you use with your digital x-rays will also be able to focus in on a particular area of the radiograph. Some software calls this feature “zooming in” and others have made it look like a “flashlight”. Basically, it’s like pointing at a tiny spot on a 1”x1” film with your finger. With digital radiography though, the patient can actually see what you are referring to! When they actually see it rather than just taking your word for it, they will be more prone to “own” their problem and seek your solution.

A patient of ours should expect us to be able to email (or print) their treatment plan for their spouse (significant other).

You have heard me say before that 80% of the healthcare decisions in this country are made by females. Our culture over the last generation has shifted to two breadwinner families as the norm. The females and males in these two breadwinner families are busy – very busy. Their lives are packed with other “stuff”. They want to quickly and accurately assess the need, the want, and be able to visualize the outcome. They also want to know the cost in time and money. They do not want to dwell on this decision. Let’s assume most of your patients cannot make a $5,000 purchase decision without first consulting their spouse or significant other. Now ask yourself, what additional service do you provide your patients that will help them to “sell” their spouse (assuming the spouse wasn’t present at the treatment plan consult)?

If your answer is “very little”, or, “nothing at all”, you just put the burden of selling your treatment on the back of your poor patient. It is now out of your control. You are at the mercy of your patient’s ability to communicate the value of your dentistry. Not exactly the best case scenario.

What you “could” do is prepare (either printed or electronically transferable) a Word document or PowerPoint presentation and get it in your patient’s (or their spouse) hands. Make sure to include radiographs. Draw a circle around an area to draw their attention. You should definitely include a digital “before and after” as well. If the clinical team is using your digital camera on a routine basis, creating an impressive before and after is a snap.

Some practice management systems automatically create Word or PowerPoint presentations. Ask your software representative to show you how your system can prepare a transportable treatment plan.

With everything, you look for a return on investment. If you already have digital radiographs and digital camera pictures in the patient record, creating a professionally done transportable treatment plan presentation should take no more than two to three minutes. Taking the pressure and burden off your patient’s shoulders is exceptional customer service. Having both spouses involved in the decision will increase case acceptance and cut down on those case start “no show appointments” that leave your team wondering.

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 column is dedicated to the Dental Team.

Working with doctors, dentist, lawyers, and business executives around the country, I am

very familiar with the types of behaviors that manifest in the office workplace. Many of the recent columns have been addressing the issue of the executive, the dentist, the doctor, and the business owners who find themselves a little short on reasoning when it comes to solving problems of their own lives as well as those of the interactions with the staff and coping with the interactions within the team.

I consider the business owner to have certain inalienable rights which very often he or she does not see for themselves. It is often a surprise to a business owner when they learned that you can tell people the truth and tell people what they want and such an act will not be perceived as the coming of the next great world-hating dictator.

However, it must also be said that these shy nearsighted executives will also hire staff within their own model of perceived inadequacy and perceived negativity. They do this to recreate the same abusive environment in the workplace that they recognize in other aspects of their lives. There is no choice here.

Thus, it can be said that the business owner contributes their own brand of pain and disappointment by handpicking a staff for their negativity and personal sense of inadequacy. Such a pattern leads to a chronic office culture of chaos, emotional abuse, financial catastrophe, and the absence and impossibility of achieving work place harmony and tranquility.

These seedling decisions and behaviors contribute to the blooming of uncontrolled office specific politics. Once office politics begin, then the competition for power and influence over the wounded business owner falls into a structure that defeats the business owner’s intent which is to make money and feel independent.

Today's column is addressed to those staffers who do not want to be part of the negativity or participate in drama of office politics but would rather find the harmony and tranquility of the moral and ethical high road of the daily work routine.

Over the next several weeks, I will discuss questions and principles which you can ask yourself and answer honestly in order to discover if you are truly on the right side of the political line.

Every day when you come to work, are you absolutely sure that your presence matters to the owner of the business, as well as the people with whom you work. Are you absolutely sure that your presence is recognized and acknowledged. One of the ways you can tell if you matter is whether people smile when they first see you. Another way you can tell if you matter is if the owner of the company periodically takes a moment to find out how you are feeling and how your family is doing.

The owner of the business, in order to be an effective leader, must recognize that every individual has a life outside of the office, and he or she must acknowledge that life if they are to gain and maintain the respect of the staff. In addition, every staff member is obliged to recognize the importance of every other staff member, because they are working together in the trenches to make sure that everything is in place for the office product to be delivered to the customer.

It is not enough to say you matter, and it is not enough to feel like you matter. You can feel a feeling and it feels right, but that does not mean the feeling is correct for the circumstances, although it may still be correct from your personal history. For example, if you are accustomed to being funny to break up the tension in your family, then you will tend to be funny in the office when you sense the tension. When people laugh, you feel safe again, but the truth is that you distracted everyone from the issue at hand to suit your own need for security and this is simply inappropriate. Thus, when people laugh at you, you feel like your presence matters, because your family relied on you to break the tension at home...but this is business!!!

I am very very specific on this point. Do people smile at you when they see you? Does the owner of the company take a moment periodically to find out how your life is going outside the office? It is only when these types of behaviors, and there are others, occur that you can be certain that you matter.

At any point during the day, are your words, thoughts, and actions taken seriously? At meetings, do the other staffers listen to you? At these meetings, does the business owner not only listen to you but demonstrates the importance of your contribution by asking questions about what you have just offered to the group. Can you recall a time where you said “no” and everything stopped?

It is essential that you understand that everyone's job description is very specific for a reason. Your job description creates the boundaries around which your domain of control is an inalienable right within the office. By this, I mean that your job description is exactly the same as the boundary on your house or the desire not to have anyone dent your car by accident. Your job description is a very sacred label or identifier of your purpose and importance. Therefore, when you are within the domain of your job description and you attempt to express yourself about a necessary observation or caution, are you taken seriously.

You can actually feel when you are being taken seriously, because people tend to not smile at you and your eyes tend to hold their visual gaze as they listen intently to every word. When people listen, your brain can feel the presence of commanding power. Many people are afraid of this power that they possess, because it was not permitted or encouraged in their family; however, I am trying to tell you that this power is inherent in your job description and you are expected to feel powerful within the role that you play within the office, and therefore, you are entitled to be taken seriously.

Next week, I will continue with this political self-assessment.

Regards, 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

If You're Not Satisfied with Your Practice's Performance …
Why Not?
9 out of 10 practices have staff turnover every 15 months.
76% of dental practices have hygiene departments producing less than 33% of practice production.
85% of dental practices grow less than 10% a year.
72% of practices' employee costs are more than 25% of revenues.
Only 23 Performing Days Left to
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Your Performance Measurements kit includes an extensive workbook with copy-ready appraisal forms and measurement graphs to use for each employee. In addition, you will learn how to determine the number of employees needed for a successful practice, how to design results-oriented job descriptions for all business and clinical staff, use performance charting to objectively measure your employees, and make sound hiring and firing decisions.

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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



Sally's Mail Bag

Dear Sally,
My BIG problem is new patients and broken or cancelled appointments even after they have been confirmed the day before.

My “new” staff has been informing patients during the confirmation call one day prior to appointment whether on voice mail or speaking to the person, that there will be a charge if 24 hours notice is not given.

So far not one patient has paid the BA fee, however I have noticed they are not returning for treatment and do not return calls.

This is a losing battle. Any advice ?
Dr. Hammerstein

Dear Dr. Hammerstein,
The symptoms you have stated, i.e., patients not returning for treatment and not returning phone calls indicates that your approach is not working and should be stopped. I can’t help but focus on your comment of "new staff". Not knowing the socio-economics of your patient base, I would give an educated guess that the new staff is not trained to protocol of establishing the importance of keeping their appointment at the time the appointment is made. Something that is happening internally is causing these patients not to return. It could be a myriad of things from fees, to parking, to hours, to feeling you are over recommending treatment. While you also mention above that the symptoms are coming from New Patients, this is more than likely caused by what is being said to them when they initially call. For example, they are asking to get their teeth cleaned and an untrained New Staff person is saying, “no”, you have to come in for exam and consultation and it's going to cost $195 and you have to pay cash when you come in. Something is turning them off. An analysis of your systems would uncover what is actually causing the symptoms you are having. The bottom line is that if you allow these symptoms to continue, the growth of your business will stagnate or decline.

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
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  Treatment Coordinators
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For a FREE Educational Video
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Advanced Business Education for Dental Professionals
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Missed Past Issues of Our e-Motivator Newsletter?

This issue is sponsored
in part by:
The Center for Dental Career Development
San Diego Workshop Series
Fall/Winter Schedule
 Date Seminar Instructor(s)  
 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
 1 - 4pm
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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