Associate Issues

Welcome back to Coaches Corner! We are happy to share our years of experience working with dental offices all across North America.

Here is today’s question:

Dear Coaches Corner,

We just hired a new associate dentist to work two days a week. He graduated dental school in 2015 and finished his residency in 2016.

He is a very skilled, capable, and ethical dentist and patients like him.  However, like all of us just out of school, he doesn’t understand how the practice of dentistry works. He hovers over the staff annoyingly watching every move they make and repeatedly questions them as to the billing, supplies, paperwork, etc. He just doesn’t understand that if he lets the front desk do its job and assistants do their job, everything will be done properly.

Our staff has been together for more than 10 years. We are trying to guide him but he can be stubborn. He also changes his gloves at least 8 times while doing a single procedure on a single patient. Do you have any tips on how to work a new associate into the practice?

Name and location withheld

Dear NALW,

Thanks so much for your question. You are experiencing something we have seen many times – an associate who is clinically quite capable but just does not get the “big picture” of the dental practice.

But first we need to pose this question. (Disclaimer: We are NOT psychiatrists, although many days we feel like it!)

Is it possible your associate has Obsessive-Compulsive Disorder? He changes gloves constantly. He hovers over everyone and everything. He constantly repeats this annoying behavior. Does he have any strange rituals? Will he not see a patient unless all the rubber dam clamps are aligned in a perfect circle? Does he only do things in sets of three? (That could be good for production.) Does he store dental supplies in alphabetical order?

This could actually be a serious issue. But again, we are dental coaches, not shrinks. In any case, all of this needs to start with a very frank discussion. The good news is that your associate is skilled, capable, and ethical. So he could be a keeper. But remember, he may know absolutely nothing about how a dental practice functions in the real world. Teaching him these things is crucial at this point.

He needs to be told in no uncertain terms that in order for the dental practice to operate at its peak, we need to truly be a team. That means when we have capable staff, we need to let them do their jobs without interference. No one likes to have everything they do scrutinized, and it can lead to major conflicts. So ask him – can he recognize and understand this?

Many times the best thing a dentist can say to a patient is something like:

“Mary – that’s a great question about your insurance and payment options. My job around here is to keep you comfortable and do the best dentistry possible. Carole will be glad to discuss the other stuff with you – she is the best!”

And you can’t just say it – you gotta believe it.

So use these things as teachable moments. Explain. Demonstrate. Lead by doing. But the eight pair of glove thing is a little worrisome. You may be dealing with a more difficult issue here. The only way to find out is to ask.

Please keep us posted.

Coach Rich
Coach Dave

Dr. David Madow and Dr. Richard Madow are actual dentists who have been helping dental offices become more successful for over 28 years. They are down to earth, real people who personally connect with their clients and are proud to call them friends. If you have a question for this column, please write to them at We are now offering a complimentary 30-minute coaching session! Please CLICK HERE to schedule yours. Doctors only please.

A Question From A Down Under Dentist

Welcome back to Coaches Corner! We are happy to share our years of experience working with dental offices all across North America. Here is today’s question:

Q: What are the three most common things that once implemented have the greatest effect on the bottom line? What is the one simple thing you see missing most often that would make the greatest impact for a practice?

Dr. David O’Malley
Bendigo, Australia

A: Great question Dr. O’Malley, and so nice to hear from one of our Australian followers. Of course we did a little research and learned that Bendigo is in Victoria, Australia, not all that far from Melbourne. It was once a gold rush town and is now a bit of a financial centre. Sounds like a great place to live! It’s also home to Frank McEncroe, inventor of the Chiko Roll, whatever the heck that is.

Okay – on to your question. It’s a tough one because there are so many things that impact the bottom line, and of course, every practice is different. However, these are three things that we see in just about every practice we visit. Of course, they are simple, obvious, and rarely mastered.

1) Answering the phone every single time it rings (dental practice phones go unanswered over 40% of the time during normal business hours!) with a well-trained front desk team that knows how to get the patient off the phone and into the appointment book.

2) Analyzing and understanding dental practice overhead and taking the proper steps to reduce it.

3) Effectively mining the “Million Dollar File Cabinet” and getting those patients signed up for treatment. (The “Million Dollar File Cabinet” is our term for patients with recommended treatment that has not been appointed.)

Of course this is just the start – there are so many more things that can be improved in just about every practice!

Part two of your question is: What is the one simple thing you see missing most often that would make the greatest impact for a practice?

This may sound self-serving, but it is honest. The one simple missing thing that would have the greatest impact on dental practices is professional and effective coaching. Most dental practices are too busy cranking out dentistry and putting out fires (especially putting out fires, sometimes with gasoline!) to really see what is going on inside their own walls.

Coaching is an investment in the practice that pays off big time, but too many people are afraid to make that investment. Or, they are afraid of having an outsider come in to “shake things up.” But remember the old adage…

If you keep doing what you’ve always been doing,
you’ll keep getting what you’ve already got!! 

Thanks for writing in. We hope to meet you one day!
Coach Rich
Coach Dave

Dr. David Madow and Dr. Richard Madow are actual dentists who have been helping dental offices become more successful for over 28 years. They are down to earth, real people who personally connect with their clients and are proud to call them friends. If you have a question for this column, please write to them at We are now offering a complimentary 30-minute coaching session! Please CLICK HERE to schedule yours. Doctors only please. 

What do we do With THESE Patients?

Welcome back to Coaches Corner! We are happy to share our years of experience working with dental offices all across North America.

Today’s question comes from the beautiful Midwest!

Q: What do we do when someone wants to get treatment but doesn’t have the funds and doesn’t qualify for CareCredit? We are losing a lot of production because of this.

Thanks for your advice.

Jenna Feldski, Office Manager
Overland Park, KS

A: Hello Jenna, and thanks for your great question. There are two important things you need to consider here.

  1. Outside financing companies like CareCredit, while pretty liberal in their qualification process, are doing the work for you. They are the professionals and the experts. If they don’t approve someone, they are telling you this:


So beware. Any kind of “payment plan” you make with this patient is likely to wind up as an unpaid collection headache and eventually a writeoff.

2. While we always recommend being ethical, law-abiding, etc.. remember that you are not obligated to treat every person who steps into your office. Pain, bleeding, swelling, infection  – those are different stories altogether. But someone who needs routine dental treatment, (and that could include crowns to repair rotting amalgams, perio disease that is smelly and gross, missing teeth, poor function, etc…) are not under our ethical obligation.Sure – it is great to treat everyone we can. But they gotta pay! And if an outside financing company is telling you don’t treat them – don’t do it!!

Now does that mean we should stop doing “in-house payment plans” for old Mrs. Goldfinch who has been coming here since Eisenhower was president and has never missed a fifty dollar monthly payment? Of course not. But those are rare exceptions.

Does that make you feel like you are not being generous and charitable? It shouldn’t. Remember, doing charity dentistry is YOUR choice! Don’t let a patient screw you over and then tell yourself it is charity. That is not the way it works!

Charity dentistry is a beautiful thing, but it needs to be decided upon ahead of time!

Coach Rich
Coach Dave

Dr. David Madow and Dr. Richard Madow are actual dentists who have been helping dental offices become more successful for over 28 years. They are down to earth, real people who personally connect with their clients and are proud to call them friends. If you have a question for this column, please write to them at We are now offering a complimentary 30-minute coaching session! Please CLICK HERE to schedule yours. Doctors only please.





Okay – time for another restaurant story. It’s a quick one that can have some serious implications for your practice!

At checkout in a local Baltimore lunch spot:

“Would you like anything to drink?”

“Yes – coffee please.”

“We don’t serve coffee here – but a lot of people ask for that.”

Okay – just for effect let’s repeat that line again.

“We don’t serve coffee here – but a lot of people ask for that.”

If there ever was a “duh” moment – this is it! Buy a commercial coffee maker for a few hundred bucks, or even easier, call a coffee service and tell them to set it up today!!

When our practices were young we both had a “policy” – no cleanings on the first visit. Yes – we knew that clinically that was the best decision. After all, how can you properly appoint a patient with the hygienist without an examination?

But after losing hundreds of new patients due to this policy, we both loosened up a bit and realized the number one customer service lesson in history –

Give the people what they want!

What do you hear yourself saying on a regular basis?

We don’t have Saturday hours.
We don’t take that insurance.
We don’t do cleanings on the first visit.
We don’t have a financial solution for you (so you can’t afford treatment).
We can’t get you in today or tomorrow.
We don’t do even simple orthodontics here.
We don’t do cleanings on the first visit.
We don’t.
We can’t.
We won’t.

Want your practice to grow?

Do. Can. Will.

A simple lesson. Yes.

The answer is “NO!” Now what is the question?

A short time ago we were at lunch with a coaching client at a Chinese restaurant near their office. (Some of the best ideas are generated during lunch meetings!) They were excited to take us there because they were a “regular” and knew we would get great treatment.

“The lunch special comes with an egg roll. Is it possible to get a spring roll instead?”


“Can the Szechuan green beans be made with no sauce?”


“Can brown rice be substituted for white rice?”

(Care to guess the answer?)

“NO!” (At least they could have said the classic “One dollar extra!!”)

No exaggeration here – this really did take place. And then it got worse.

Someone came in and asked, “Do you sell gift cards here?”


What if that customer bought five $50 gift cards for his co-workers? That would have meant a $250 sale. Then what if one of the recipients had never been there before, and loved it so much they became a regular customer, bringing in their family ten times a year for an $80 dinner? And then what if….you get the picture!

So, every time someone in your practice says “no” – you could be missing a similar opportunity.

Even if the answer is technically no, at least try to turn it into an opportunity. Here’s an example:

“Does Dr. Garvey have appointments on Wednesday evening?”

And he doesn’t. But instead of saying “NO!” – how about something like this.

“Oh – sounds like daytime appointments are tough for you, is that right? Well we start at 7:00 AM on Mondays and Thursdays, and our new doctor, Dr. Grant, sees patients on Saturdays. Which works best for you?”

A little creativity and positivity go a long way!!

One of the most typical examples is “Do you take my insurance?  It’s a PPO and I don’t see you on the list.” The typical response to this is “NO.” Then the conversation ends.

How about trying this instead?

“While we are not a member of that plan, we are an unrestricted provider with all insurance plans. That means you can still come see us, and we will give you the best dental care possible. You can pay us directly and we will help you maximize your insurance benefits with that company.

Would you like to come in for a no-charge consultation? That way you can meet the doctor, she can answer any questions you have, and we can explain exactly how we can make financial arrangements comfortable for you! Is tomorrow at 11:30 AM convenient?”

Granted – most people on a ‘list’ will say no to this, but nothing is lost. And sometimes someone will say yes, become a great patient, refer lots of others, and well – you can figure out the rest!

Sometimes it’s the simple, easy things that can help your practice grow. And to that we say “YES!!!”

How to Effectively Answer the Dental Office Telephone

Hey guys, I have been very frustrated with my front desk team member. She thinks she is great on the phone but my appointment book does not share her opinion. Ideas?
Dr. Sei Nguyen, Orange County, CA

Dear Dr. Nguyen,

This problem is one that we see all over and it does not seem to be going away. Even with the expensive “institutes” that are popping up. Sometimes it’s best to get back to basics. We would love to share some ideas from our lead coach, Betty Hayden:

Do we really need to keep talking about how to answer the telephone? Absolutely!  This is one key to your success. All of your marketing efforts lead people to the phone first. Don’t waste your money by losing the potential patient or aggravating current patients due to poor telephone skills and habits. Your entire team (clinical & admin) should be trained on how to properly answer the phone and handle the call. Answering the phone is a privilege and a great opportunity!

Here are a few tips:

  • Smile before you pick up the phone.
  • Answer the phone within the first couple of rings.
  • Answer the phone with a thank you for calling, identify the office and give your name. (ex: Thank you for calling Dr. Smiles, this is Betty. I can help you)
  • Do NOT let the caller go to voice mail (or a busy signal!) during business hours (including lunch hours). People hate leaving messages. Oftentimes, they’ll hang up and call the next office on their list.
  • Never, ever answer the phone with “hold please” or “can you hold?” Take a quick second, find out who they are and what they need. People hate to be put on hold. If you are habitually needing to put callers on hold, you need more people answering the phones.
  • For the few times when you do need to put a caller on hold – please, consider having a great message on hold service.
  • Get the caller’s name and use it often. Find out how they heard about your office (document the referral source!). “What type of insurance do you have?” shouldn’t be the first thing you ask. In fact, let the caller bring that part up. Your goal is to build a relationship with the caller, to get to know them and their expectations.
  • Offer an appointment. Sounds obvious right? You might be surprised to know how many office’s I have called as a “shopper” and was never offered an appointment.
  • There are words/phrases that should never be used on a call. Make a list of the words/phrases you want to eliminate from the office vocabulary.

Set aside some time to meet together as a team – everyone in the office should be trained on how to not only answer the phones but they should know how to handle the calls. At the very least, professionally & courteously direct the caller to someone who can help. Role playing will help all to feel more comfortable handling different types of calls.

Worried about your team members sounding like robots on the phone? Don’t be. This is what you do – create as a team your Telephone Principles (your goals & expectations for each call.)

Be Firm In Principle – Flexible in Procedure

The procedure may vary but the principles remain the same. This will allow the team member’s to customize their words to the individual caller’s. However, professionalism is always a must!

A few more things to consider during your meeting and training with your team:

What times are your phones being answered? Examine whether or not the times you’re actually available to answer the office phone is when your patients and potential patients are actually available to call the office.

What happens after hours? Ringing? Voice Mail? Answering Service? Here’s your chance to exceed expectations by answering the office phone after hours! (Forward calls to a cell phone.)

The Greeting – First impressions matter!!

Shopper Callers – Great opportunity! Typically, the shopper caller has a need and is ready to “buy”, that’s why they are “shopping”.  Don’t blow it by refusing to quote fees over the phone. By all means, offer them to come in for a complimentary consultation.

Insurance Questions – (Have a great response to: “Do you take —-ins?)

Wrong Numbers – offer an appointment anyway.

Sales Calls – Be kind, they’re just doing their job. Maybe they need an appointment. Plus, you don’t know who they know. It’s simple – always be kind.

Moms calling for donations or any organization that asks for donations – Empower your team to fulfill their request. At the very least, offer them an appointment.

Certainly, handling the phones is a big responsibility but it’s an even bigger privilege. Don’t miss out on any opportunities to set your office apart from the others by always exceeding the caller’s expectations.

If you have questions about how to successfully handle telephone calls or need help training your team, don’t wait, ask for help. I’m ready to help you.

Yours for Greater Success,

Betty Hayden is the lead coach at The Madow Center For Dental Practice Excellence. She has over 25 years of experience in the dental profession. Her expertise is in effective telephone answering techniques, profitable scheduling, marketing campaigns, communication, social media, new patient acquisition, practice growth, and much more. She has been labeled “The Idea Woman” by many of her clients!

If you have a question for this column, please write to them at If you would like to ask a confidential question, please CLICK HERE to schedule a free call.



His Fly Was Down

Recently our friend Sally got to meet a Nobel Prize nominated physicist.

She said that he was incredibly intelligent, articulate, funny, charming, and if that’s not enough, really good looking! But what was the main takeaway – the think she mentioned first and couldn’t stop talking about?

His fly was down.

There is a thing called “Negativity Bias” – a psychological phenomenon by which we have greater recall of unpleasant things than positive ones. It was first proposed and published by psychologists Paul Rozin and Edward Royzman in 2001 and has been confirmed by many follow-up studies. It’s why, for example, five minutes of turbulence and a screaming baby are what someone would remember from a five hour flight that arrived on time and landed safely.

It’s also why a cranky, unhappy patient is more likely to write a review online. And it’s why we have to do so many little things right, or the patient will remember mostly the bad.

Run late, cause pain, estimate insurance incorrectly, etc…. and there is a great chance negativity bias will undermine your otherwise excellent treatment.

What are you doing in your practice to cause negativity bias, and how can you correct it?

A simple thing to remember…

As dental people, we see all kinds of folks in our practices. And many (possibly most?) are extremely kind and appreciative.

But then there are others who are almost impossible to please. They can be combative, grumpy, or downright nasty. And that is why we always need to remember something.

Many of our patients would rather be anywhere other than the dental office – but that doesn’t mean they are bad people. And quite frequently we are seeing people at their worst.

So you can walk around all day calling people names, and asking things like “Why can’t every patient be like Mrs. Jones?”

But the thing is – the worst patients need the most loving – and when you give it to them you can transform their lives AND your practice.


Is there trouble brewing at your office in the form of patients not accepting their treatment? This may be the reason.

One hundred years ago, Schlitz Beer (remember Schlitz??) became the number one selling beer in the country by running a radical marketing campaign. Their ad detailed how Schlitz beer was actually made. Since no one reading the ad previously knew how beer was made, they assumed this was some kind of proprietary process – and Schlitz’s sales quickly rose to the top! It became known as “The beer that made Milwaukee famous!” (Or was it “the beer that made Mel Famey walk us?”)

Fast forward to 2017. Do beer ads describe the brewing process in detail? No way. They show attractive twenty-somethings at the beach. They show beautiful crispy-clear snow-covered mountains. They show majestic horses. The goal is to get a feeling attached to their brand, so when you pick up a six-pack of Budweiser you are transported from your dull, ordinary life to a place you would rather be. We all know it isn’t true, but with annual US beer sales topping $100 billion, it seems to be working!

So what’s the point? Your patient doesn’t want to hear about how the crown is made, how the implant surgery is done, and what their composite resin is made of. They want to know how it will look, how it will function, and how it will make them feel!

Get excited about how your dentistry will transform your patient! And if you can get them equally excited, go pop open a beer!

Say this, not that…


“We would love to see you as a patient in our practice! Would tomorrow at 3:00 PM or Tuesday at 11:00 AM be better for you?”


“Would you like to make an appointment?”


“I know what the problem is and I can help you.”


“This tooth needs a crown.”


“Would you mind if I place you on a brief hold? I’ll be right back and able to give you my full attention.”


“Dental office – hold please….”


“We have some fantastic financial options to help make the cost of treatment more comfortable.”


“Sorry – it’s not covered by insurance.”


“Hello Mrs. Costello, I’m Dr. Luther. What may I help you with today?


“Open wide please…..”


“Thank you for calling Hill Valley Family Dentistry, this is Lorraine – I can help you!”


(Voice mail answers) “If you’re hearing this message during normal practice hours, we are busy treating other patients…”


“When you return for your next cleaning and examination in three months, we want to pay close attention to that area on the lower right to make sure the inflammation is under control.”


“You’re due for a check-up in six months.”


“If you were a member of my own family, that is the treatment I would recommend.”


“If you can’t afford a crown we can always do a large filling.”