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  Sally McKenzie's
 Weekly Management e-Motivator
  12.12.03 Issue #94

Practice Resolutions to Boost Production

Sally Mckenzie, CMC
McKenzie Management

   Should auld acquaintance be forgot … Well, here we are again on the edge of the New Year. Champaign toasts, fireworks displays, and the familiar melody of Auld Lang Syne will herald the start of 2004. The New Year brings the sense of hope and opportunity and, yes, the familiar urge to make resolutions.

Lose weight. Exercise. Reduce stress. Increase collections. Reduce accounts receivables. Eat a more balanced diet. Give feedback regularly to staff. Exercise. Provide necessary computer

training to the team. Reduce stress. Increase production. And the list goes on. As the dust settles on the holiday season, it is an excellent time to take a close look at your practice – actually this should have been done regularly over the last year, but so too should the exercise regimen! How did your practice perform in 2003? Did you meet your goals – did you have goals? Where do you want to take your practice in the coming year?

Many dentists discover in December that production has leveled off and the practice has been stuck in neutral for months. Like the ghost of Christmas future, this is enough to send chills down your spine and ice through your bank account. It’s a bellwether of things to come unless you look closely at why production is on a downhill slide and take steps to turn it around.

Have you introduced new services in your practice – and actually told patients about those services? Or have you spent the last year doing the same thing, the same way, on the same days, and so on? Perhaps you did start offering whitening or other expanded cosmetic services but didn’t actually inform your patients that the services are now available. Remember, patients don’t know what they don’t know. In the coming year, resolve to educate your patients on the many benefits of your expanded services.

How are the diagnostic practices? Do patients need more dental care than you are diagnosing? In your effort to be sensitive to the patients’ financial means – which frankly you have no way of really knowing what those means are – you’ve been diagnosing what you thought they could afford. This is a disservice to both the patients and the practice. In the New Year resolve to diagnose what the patient needs, what will benefit their total oral health, not what you think they can afford.

Is the treatment coordinator tracking patients who need treatment but are not scheduled? Resolve in the New Year to follow-up on all unscheduled treatment. If a patient cancels an appointment and says they will call back to reschedule, give them a reasonable amount of time to do so. If they do not reschedule within a few days they should be contacted. Your concern is the patient’s welfare. Following through on treatment ensures excellent oral health and is in the patient’s best interest. Review patient charts daily and follow-up in person with those that have not pursued recommended treatment. Remember, it is the dental team’s job to educate the patient on the importance and need for the recommended dental treatment.

Next week, kick off the New Year with 15 practical steps to boost production.

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

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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 15
More Patient WOW

Last week [see article], I expanded on the last of your patient commitments. This week, I promised to review the procedural steps (team member by team member) during an example patient visit. This week I will start with the front

desk coordinator position. I will be covering all of the coordinator positions as well as each clinical team position in future weeks. I do realize many of you may have just one person at the front desk. If you do, you can roll all of these procedural steps into one position.

The average patient visit as implemented by your front desk coordinator.

Patient walks in 10 minutes before their appointed time.
Front desk coordinator data responsibilities.

  1. Greet patient with a warm welcome and by first name. You would know who they are because their picture is attached to their record on your appointment book screen in your database.
  2. Review (visually) HIPPA release, last medical history, last insurance information, pre-med, and update if necessary. Every one of these should be one mouse click away from the patient’s appointment. It should only take you 10 seconds to make sure the information is complete and accurate. Some office’s print what they have on file and have the patient review the information for accuracy. This is a good practice until you get the speed and flow you need to do it verbally.
  3. Review (visually) the procedures for today, any existing balance (insurance or patient), and any balance expected to be paid at the end of today’s appointment. The absolute best time to address these is before today’s appointment. The patient hasn’t received what they want and/or need from you yet (today’s visit). They will be much more inclined to be in a positive negotiating mood.
  4. Review any family members who are overdue for recall or treatment. Again, one or two mouse clicks from this patient. If the patient is just sitting there waiting, ask them to come over and discuss. Book any necessary appointments for their family members. Print appointment reminders for their calendar at home. Offer to email appointment reminders. Circle the appointments at the bottom of their walkout statement when they leave the office today.
  5. Alert clinical team only after you have updated all the information necessary to carry out a complete checkout process under 2 minutes. Your software probably has some notification feature built into the appointment schedule module. Your assistants should get used to hitting the “refresh” button in the treatment rooms to see who has arrived, who is ready to be seated, and who is already past their appointment time. The front desk personnel should try to avoid releasing a patient to the back before the appropriate data entry has been made. Take the extra two minutes at the check in procedure to save 10 minutes at the check out procedure.

Next week I will break out the business coordination duties into general job descriptions and database responsibilities. If you have any questions, concerns, or comments – please send me an email.

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

Getting The Cold Shoulder


Giving Dentists And Their Staff Different Perspectives On Day To Day Issues

Continuing with last week’s article focused to the staff, this week I want to comment on being perceived as valuable and being perceived as helpful. They are not the same.

To those staffers who do not want to be part of the negativity or participate in the drama of office politics but would rather find the harmony and tranquility of the moral and ethical high road of the daily work routine, I offer you the following observations.

Everyone would like to consider that they belong. This desire reflects the natural desire to be acknowledged for their presence. It is a much greater feeling to know that you are an asset to the situation. By your presence, you add value to the business, to the team, and to your own sense of personal satisfaction of a job well done.

When you were first hired, there was an assumption that you would not only fill the job description, but that your personality would add to the human experience of working together day after day. Being perceived as valuable demands that you do more than your job description and behave more than just as an individual member of a group. Being valuable implies that your absence creates a void, which is not easily filled. Being valuable implies that your presence improves the probabilities for everyone’s success.

The leader of the team can be valued for their leadership, just as easily as the receptionist can be valued for her ability to communicate as a liaison between customer and staff. It is the ability to go beyond the job description of leader or receptionist that creates a sense of value.

When you are not in the office and you return, do people express the fact that they missed you? When you are not in the office, does anyone make an effort to call you to find out how you are feeling or to ask you a question regarding procedure? When you are in the office is your advice sought or are people interested in sharing their feelings and experiences with you?

Most reflective of your value is present when you return to the office. Are there big smiles when someone sees you? The ability to be valuable is not incorporated in what you say. Rather, your value is reflected in how you answer and when you choose to comment. It is the ability to respect the feelings and the boundaries of other people that allows others to value your presence. Is your ability to remain quiet or your ability to spontaneously make changes and adapt that creates value.

This is a very subtle virtue and it is unreasonable to expect that all people will be or can be perceived as valuable; however, it is essential that you understand and recognize that to be perceived as valuable is an honor, and to recognize the value of others is a natural gift. This honor and gift is returned to you in the form of sincere acknowledgments such as, “I'm happy you are back.”

Being perceived as a helpful individual is reward for some, but not for all. Being helpful could be described as being interested in putting in the extra effort when it is necessary or when it is unnecessary. For some people, putting in the extra effort make sense, because it takes them closer to getting the job done; however, there are also people who put in the extra effort in order to be liked by other people. This motivation stems from a neediness that is easily camouflaged by self-denial and grandiose visions of oneself.

It is fair to say that occasionally everyone in the office may need someone's help; however, it is also fair to say that not everyone likes to ask for help, and if they ask for help, there are only certain people that they would ask. I believe it is reasonable to decide what kind of person you are. Are you someone who wants to be asked for help because of the positive feelings that come with sharing that particular experience, or are you someone that would rather not be helpful because this experience aligns you with someone who you perceive as weaker than yourself.

If you see yourself at the bottom of the continuum of power, then everyone is perceived as potentially helpful. If you see yourself at the top of the range of power, then only certain people will be perceived as having the ability to aid you in a particular situation. It is important to dissect this issue in order to recognize that being perceived as helpful and asking for help are not necessarily the clear-cut behaviors that you would wish they were.

Some people ask for help in order to reinforce their inadequate self-image and some people ask for help because they are manipulative and lazy. Some people are graciously available to help anyone, because they harbor feelings of inadequacy, and some people are graciously available to help only certain people who are worthy of their time.

For our purposes, let me offer you the following guidelines. A person called into the next room having two healthy legs should be allowed to walk unassisted. A person faced with the same challenge but who has a broken leg that has not been put in a cast might ask for help and would consider you helpful if you aided them. However, consider the person who has a broken leg that is in a cast and has crutches. Should you help them go to the next room?

If you make an attempt to help them without being asked, then you may remind them of their inadequacy and they will not consider you helpful. If you let them hobble to the next room on their own, they may be reminded that they can still pull their weight, if only slowly, and consider you helpful for letting them make the effort. By allowing people their dignity and not offering to be helpful inappropriately, you actually are more helpful than if you insist on paving the way for them. It is the inability to recognize the boundaries of dignity and respect that are really the topic in this question.

Being helpful feels good, it naturally feels good to help someone; however, this natural feeling comes with a consideration. You must consider whether you are helping yourself or helping the other person. When you cross someone's boundaries and do something that they can do for themselves, you are not being helpful. When someone invites you to cross their boundaries to help them do something they cannot do for themselves, then this is perceived as being helpful. Notice the key term is invited

Thus, what I want to emphasize is that although it feels good to be helpful, you have to be invited to be helpful, to offer aid, to perform in place of that person. It is the concept of invitation that allows you the privilege of being helpful. If you can wait for the invitation, then you will be perceived as helpful and appreciated. You know that you have truly been perceived as helpful when you receive a bold “Thank You”

Next week, I will conclude this list of politically correct behaviors

Regards, Coach

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McKenzie Management, Inc. has been named the WINNER in the DentalTown Magazine and 2003 Townie Choice Awards™ for Practice Management Consultants.

“It is an overwhelming honor to be singled out by literally thousands of dental practices across the country as the number one dental practice management firm,” said Sally McKenzie, President, McKenzie Management.

“We know that dentists take great care in selecting only the very best products and services, and to be among this elite group is truly a testament to the commitment the McKenzie Management team has demonstrated over the past 23 years to provide consistently superior consulting products and services,” added Ms. McKenzie.

The McKenzie Management Team looks forward to continuing to provide the very best consulting services so that dental practices in turn can become the very best dental teams.


McKenzie Management, Inc.
737 Pearl Street
Suite 201
La Jolla, CA 92037

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 8 Performing Days Left to
Reach Your
Year End Goal
What are you waiting for?
Take a Closer Look Here

THE CLOCK IS TICKING and time is running out on 2003. You’ve seen your practice’s preliminary year-end numbers and are kicking yourself because you knew you should have done something, anything MONTHS AGO.

What’s worse, your accountant is telling you the TAX MAN will be at your door expecting a sizeable chunk of YOUR INCOME unless you take action before the bell tolls Midnight on December 31.

RELAX! Within just a few days McKenzie Management will turn your PANIC to PROFIT. But don’t put this off another second! December is filling up quickly with practices just like yours that have waited until the bitter end to TAKE ACTION.

McKenzie Management, Inc.
737 Pearl Street
Suite 201
La Jolla, CA 92037

Sally's Mail Bag

Dear Sally
Currently I pay my entire staff on a 9 hour day even though we are open only 8 hours in the day. I did this to help compensate staff for coming in 15 minutes before work (although they rarely do come in that early), possibly having to work into lunch, and possibly having to stay late after the last patient.

However, my hygienists are paid per day, not hourly. How should I handle days when I have a working lunch office meeting? Do you pay the hygienists extra for giving up their lunch? Usually I take 2 hours for these meetings and we do not spend the entire time "working". And are these considered 9 hour days?
Dr. Howtopay

Dear Dr. Howtopay,
Something to ponder is that hygienists are paid a higher dollar amount than assistants or business staff because they are "producers". So...does it seem fair to pay them a producing salary when they are not producing, i.e., staff meetings? My recommendation is to pay 50% of their producing salary when they are not producing. However, it may be a little "sticky" to pull this off if they are used to being paid the full amount. It is sometimes easier to present during the hiring process.
Thoughts for consideration.

Best regards,

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
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