The numbers dont lie

June 1, 2000
Case Profile: This Omaha general practice is located halfway between the home of billionaire Warren Buffett and the city`s stockyards. Aptly positioned, the practice has a patient base that cuts across every socio-economic sector.

Sally McKenzie, CMC

Case Profile: This Omaha general practice is located halfway between the home of billionaire Warren Buffett and the city`s stockyards. Aptly positioned, the practice has a patient base that cuts across every socio-economic sector.

Symptoms: In this case, I wasn`t called in to "fix" anything. After attending my all-day lecture, "Breakdown: The Hidden Signals in Practice Systems," the doctor brought me in to coach him and develop a 10-year business plan, which will guide him until his retirement.

Observations: This practice suffered from the same neglect I find in many operations. The computer system wasn`t used to capacity, accounts receivable were out of line, and patient retention and scheduling were in dire need of attention. One problem, however, stood out from the rest: the fat 8.9 percent of monthly production spent on dental supplies.

On the positive side are two staff members who clearly demonstrate an ownership attitude. Claudia, the ace dental assistant of 20 years, not only assists the doctor, but also actively supports his treatment plans and sells his dentistry. This motivated lady went to the office on her day off in order to address the issue of surplus supplies. She meticulously reviewed catalogs, checked prices, and prepared for some tough negotiating with her dental sales representative. I`m impressed!

Janie, the business administrator, has been with the practice for five years. From the beginning, she`s been the prime "go-to" person for the doctor and staff, pitching in wherever and whenever she`s needed. Two such employees in one practice - what a find!

Discussion: Employees like these should equal excellent practice numbers. However, I discovered the doctor was taking advantage of Janie`s commitment to help out and please him by having her pay his personal bills too.

The doctor inadvertently does a disservice to the practice by requiring this of Janie, because it takes up 25 percent of her time. During the remaining hours of the day, this young lady has her hands full checking patients in and out. Unfortunately, the doctor hasn`t considered how much time Janie could possibly have left for making delinquent account calls, implementing patient retention, or scheduling production goals?

Treatment: First and foremost, the doctor should recognize and reward the work ethic and ownership attitude shown by Claudia and Janie. Never should such effort or commitment go unrecognized. Rewards, by the way, should be based on what will please that particular employee, thus reinforcing good behavior. For one employee, that might mean tickets to the ballet, while extra time off might be the preferred choice for another.

Claudia`s efforts at comparison shopping and price negotiation for supplies are valiant. She should be given a budget for dental supplies based on 5 percent of monthly production (last quarter`s revenues). Furthermore, a history kept on each product - quantity ordered, date of order, how quickly it was used, or how long it sat on the shelf - would be very helpful in projecting future supply needs.

Finally, by taking his personal "accounts payable" out of Janie`s hands, the doctor will free up 10 hours a week that she can spend on increasing production and collection. That`s a simple change that should yield a sizeable difference.

Sally Says: A great employee is a gift and if you`re smart enough to recognize, reward, and reinforce such gifts, you could very well end up quoting the legendary Buffett, who said: "There is no job in the world that is more fun ... and I count myself lucky to be where I am." Imagine that.

Sally McKenzie, a proponent of advanced education for dental professionals, has recently launched The Center for Dental Career Development in La Jolla, Calif. A Certified Management Consultant, nationally known lecturer, and author with more than three decades in the dental profession, Sally is a consultant to the Council on Dental Practice of the ADA. McKenzie Management and Associates, Inc., provides in-office analysis of the business, clinical, and hygiene departments; conducts on-site staff training; and offers a full line of educational management books, audiotapes, and videos. Call Sally toll-free at (877) 777-6151; send e-mail to: [email protected], or visit her Web site at: For information on The Center for Dental Career Development, call toll-free at (877) 900-5775 or visit

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