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  Sally McKenzie's
 Weekly Management e-Motivator
  1.23.04 Issue #98

Role Playing, it’s no Game

Sally Mckenzie, CMC
McKenzie Management

   Now that you are kicking off your New Year with a fresh commitment to hold regular staff meetings – as I know you are – and to look carefully at all your systems over the next several months – as I know you will – I want you to take some time to engage in a little exercise too. I promise you won’t break a sweat, but it just might get your heart rate up. Before the next staff meeting, ask your financial coordinator and another employee to be prepared to show the rest of the team how the practice handles a

situation with a patient, we’ll call her Mrs. Jones, who has just seen the hygienist, and, before she leaves the office, she needs to schedule multiple appointments for a crown or other higher dollar procedure.

The purpose of this is not to see how effectively appointments are scheduled. Rather, the objective of this exercise is to enable everyone, including the doctor, to observe how and if the practice’s financial policy is implemented on a regular basis. And, most importantly, it gives the team the opportunity to objectively consider what improvements can be made in that system.

For some doctors and team members this exercise is going to be a real eye opener. If you’ve been wondering why you closed 2003 well below where you expected to be this just might clue into what was behind last year’s slip. It is not uncommon in dental practices for the business staff to virtually ignore the payment issue entirely when the appointments are scheduled for crowns and other major procedures. Many practices don’t even discuss payment until the procedure is complete. Consequently, the patient has no real investment in keeping the appointment, increasing the likelihood that she may cancel or not show. What’s more, the patient is silently dictating when and on what terms she will pay for the dental care.

For some practices, failure to make payment arrangements with a patient in advance of more involved procedures indicates that no financial policy is on the books and no clear processes are in place for handling this type of situation. For others, the employee simply does not know what to say or how to say it. Often, the typical exchange goes something like this, Lori, at front desk, says to Mrs. Jones who is on her way out the door, “Would you like to make a payment today?” Mrs. Jones, of course, says “No. Just bill me,” and shuts the door behind her. Meanwhile, the good doctor wants collections to increase and tells Lori to do exactly that. Dutiful Lori says “Sure doctor, no problem.” Turns around, rolls her eyes, and wonders how the heck she is going to get patients to part with their hard-earned cash.

Next Week, the collections drama ... make sure your leading lady is following a script.

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

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DON'T PANIC ... WE CAN HELP! >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

Last week, [see article], I finished discussing the financial coordinator position. This week, I’ll start exploring the scheduling coordinator’s job/technology responsibilities. Each dental office is different. You should consider the following data responsibilities as “bare minimum” for the position.

Scheduling Coordinator

Your scheduling coordinator should be responsible for the following...

1. The collection of accurate patient/account data before patient is seen

This would normally be the welcoming person at the front desk. This responsibility may be ultimately shared with the financial coordinator [see January 16 issue] but the scheduling coordinator can drastically improve their own performance and enjoyment on the job by having complete information. Imagine knowing individual recall intervals, individual recall time units needed, patient’s preferred day and time to schedule, as well as pre-med requirements. Imagine having every patient’s family scheduling needs at your fingertips every time you go to make an appointment. The completeness and accuracy of patient database information is a must for every scheduling coordinator.

2. Scheduling to office production goal

Your scheduling coordinator is responsible for keeping your office at maximum production. One way of doing that is setting a production goal and scheduling toward that goal. Your scheduling coordinator is also responsible for printing and reviewing the provider allocation of time units for each ADA code at least every 6 months. The dentist(s) and dental assistants have to have the time to review the provider allocation for accuracy. They in turn, hand any changes to the scheduling coordinator. The scheduling coordinator updates the ADA codes and provider allocation accordingly. It is the provider allocation of time within each ADA code that allows the scheduling coordinator the ability to keep the book as productive as possible without under booking or overbooking.

3. Managing unscheduled treatment

Unscheduled treatment could be outstanding treatment plans or overdue recare patients. Either way, it is unscheduled treatment. The key tool at your scheduling coordinator’s disposal is the “unscheduled treatment” or “tickler file” list inside your practice management system. Your scheduling coordinator is responsible for making a minimum of 5 outbound telephone calls each day and entering the notes of these conversations into your practice management system. The basic premise behind this list is as follows. If someone needs treatment but doesn’t schedule – they go onto this list. If a patient cancels or breaks an appointment – they go onto this list. Period! Your scheduling coordinator calls from the list (on screen), schedules from the list (to keep the list clean), and enters pertinent notes onto the list (to keep the list current and the whole team informed).

Next week we will cover more scheduling coordinator responsibilities! You didn’t think I was done did you?

Remember, we are here to help. Email me your questions or comments!

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

The Concepts of Leadership and Management

A Continuing Discussion

To reiterate last week’s discussion [See January 16th issue] ... there is a great deal of talk these days about leadership. It is a big concept that is thrown around in national and international politics and corporate America.

Today, the concept of leadership from politics and economics has been rationalized down to the level of the small business. This process has led to ambiguity, distortion, and confusion over how it should or should not apply. These detriments not only confuse the office staff who pines for a great leader on horseback, but also is distorted by the business owners who perceive themselves to be more responsible than they really are or need to be.

This week's column is a continuing discussion of the difference between leadership and management. For the sake of clarity, I believe that all business owners must be managers first and leaders second. The reason for this definition is that the goal of the office practice is simply to carry out the product and services as promised, effectively and efficiently. The typical office practice is not challenged with the responsibility of guiding millions of people and billions of dollars. Ours is a very simple challenge: make money and enjoy the day.


For our purposes, the concept of focus is about what the brain pays attention to. Different people in different positions of responsibility will pay attention to different aspects of the business. The administrator is focused on tasks and responsibilities that are different from the specific focused concerns of the clinical assistant. A similar distinction can be attributed to the business owner. There are times where he/she must focus on the particular procedure of the moment, and there are other times where he/she must focus on the overall direction of the business.

The greatest return for the effort will occur when good management pays attention to the daily purpose of the business. The purpose of the business is to make money, and therefore, managing the personnel and making sure that transactions are completed thoroughly is the responsibility of good management. When there is good management, every transaction is initiated and completed within the quality constraints of the personnel and the structure of the business. Good management maintains a firm grasp of what is producing profit and what is not.

The concept of leadership as it applies to the necessity of good focus is a perspective that does not enhance the day-to-day requirement for precision and accuracy. One will often say that leadership must maintain a vision into the future, picking a star to follow somewhere over the horizon. This is a very reasonable definition when you apply it to something as large and complex as a corporation or a government; however, such grandiose definitions tend to lose their meaning when applied to a small business environment.

Business owners need to be focused and to be actively engaged in the transaction process. Hypothesizing the horizon is a component of leadership that does not instill the kind of loyalty and commitment from the staff that one might presume, because the nature of the small business environment and the typical office staff simply does not require such grandiose vision to be happy.

The office staff in any office will be far more loyal and committed, if the business owner focuses on good quality, punctual service, and attentive patient care. The management perspective is more relevant, because the actual direction of the typical small business environment is really very simple. Focusing on rendering quality, service and care will produce an expanding market and the accompanying increase in the number of financial transactions. The typical office is not diversifying into multiple markets nor coping with technological advances; therefore, the applicability of broad-based leadership definitions does not apply.


All brains love the novelty of creativity, because creativity is a form of stimulation requiring the processing of new information in new patterns. New information is actually a form of entertainment for the brain. With this principle in mind, it is reasonable that taking initiative to be creative is a natural impulse and will surface from time to time in every office. However, how is it handled?

Within the small business environment, good management wants to pay attention and encourage the initiative of its employees to improve the structure or operation of the business, because this improves profitability from within the organization. Nothing new must be added. Therefore, individual employees who take the initiative to either create structure in the office or initiate new procedures help to manage the overall management process. Management always looks favorably on improved efficiency. Thus, the basic task of good management is to encourage staff to improve the business as a whole by maintaining levels of productivity and continuing to repeat or imitate the guiding principles of the business as established by the owner everyday.

The concept of leadership embraces the principle of initiative by being proactive and moving into areas of profit before the competition or before such areas of opportunity are even discovered by anyone else. Taking such initiative creates market opportunities that can produce substantial changes in business structure and profitability. These leadership principles have their place, however, I think it is more reasonable to recognize that proactive initiatives in the small business environment are limited.

It is my belief that initiatives that are too broad or discussions that are too frequent will undermine the regularities that office staffers actually prefer and enjoy. Talking too much about changing direction, trend, or market increases the office team’s sense of insecurity due to visions of new procedures and responsibilities and contributes to a breakdown of team and individual focus. Therefore, talking about taking the initiative in marketing opportunities possess the capacity to expand the external business vision and undermine the internal business structure, because the staff and the business owner do not share the same return on the effort.

I would like to request your stories of Dentists and Staff members who have experienced the difference between management and leadership. Send them to No incriminating information will be published.

Regards, Coach

Want your issues answered? Ask the

Missed Past Issues of Our e-Motivator Newsletter?

Increase Production by 25%?
Set job descriptions for staff with performance measurements?
Reduce the accounts receivable by 15%?
Get a full one hour for lunch?
Bring on an associate dentist in the first quarter?
Increase perio treatment in the
hygiene department by 28%?
Equip another operatory first quarter?
Increase fees 3% the first of March and October?
Teach dental assistants how to make temporary crowns?
Have 2 hour monthly meetings with system measurements?


What Every Office Manager Needs To Stay On Top!

Sally's Top Selling Books
Cash Flow, Hiring, Hygiene, Performance Measurements, Recall

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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 perform at their very best.


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

Sally's Mail Bag

Hi Sally,
My office has a different situation than that addressed in last week's newsletter. My perceived problem is lack of patients. We have an excellent hygienist, front desk person and assistant. I am a solo practitioner.
We have a base of 500 patients and have been unable to grow this base. The hygienist is in 3 days per week and it has been difficult to get 7 hygiene patients per day or 21 patients per week. How do I remedy this lack of patients?
Dr. Nopayshuns

Dear Dr. Nopayshuns,
The first thing you need to do is to determine how many days of hygiene you need. If the hygienist has the capacity to see 21 patients a week and let's say she works 49 weeks a year, 2 weeks vacation and a week of holidays that is 1029 patients. If they come in 2 times a year (which not all should if you have perio therapy being performed) that would be 515 active patients and you say you have 500 patients. What are you using to determine 500 patients? If it's charts in the file, that is the wrong criteria. Go to your computer system and print out a report of patients due for recall between today and one year from today, with and without appointments. That is your true active patient base. If that number is less than the 500, then you have lost patients due to a patient retention problem somewhere in the "system". The system could be made up of: recall system, customer service, how patients are handled, patient complaints from fees, to parking, to your statements, to your financial policy can be some of the reasons why patients will leave the practice. While getting in new patients is important to growth, the most cost effective way to get in new patients is to keep the ones you have and get them to refer. I hate to see you paying out hygiene wages when it is a possibility that you have lost patients and don't have enough to support three days a week. You may have to downsize hygiene work days or continue to financially subsidize the department while closing the back door and marketing for new patients. This is not an easy task without a game plan. You have a definitive problem and while I know I have a service to sell here, the only way you can solve it is to have the practice "analyzed" so a definitive plan of treatment can be prescribed. Give us a call so we can discuss some solutions, 1-877-777-6151.
Best regards,

IN 2004?
Dr. Allan Monack,
Hygiene Clinical Consultant for
McKenzie Management,
develop a profitable
Hygiene Department

To find out more about the
Hygiene Clinical
Enrichment Program
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Office Managers
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This issue is sponsored
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San Diego Workshop Series
Fall/Winter Schedule
 Date Seminar Instructor(s)  
 Jan. 30
 9:00 - 4:00
How to Become an EXCEPTIONAL Front Office Dental Employee Sally McKenzie, CMC.  
Feb. 6
 9:00 - 4:00
How to Become an EXCEPTIONAL Front Office Dental Employee Sally McKenzie, CMC.  
Mar. 5
 9:00 - 4:00
How to Become an EXCEPTIONAL Front Office Dental Employee Sally McKenzie, CMC.  

The Center for Dental Career Development has been approved under the Academy of General Dentistry Program Approval for Continuing Education (PACE) program. Starting 10/19/03 through 10/18/07 members of the Academy of General Dentistry can receive AGD credits for all seminars and workshops sponsored by the Center for Dental Career Development.

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