Exceptional Dental Practice Management

The Dignity Of Discretion

A reader commented on a post I wrote recently.  She said that she just went to work in a dental office at the front desk.  She was surprised, and I think dismayed, at the amount of personal information her office manager discussed throughout the day.  She said she is 50.  I'll turn 52 next week and I've noticed the same thing and I wondered if it's a generational thing.  I don't remember co-workers being quite as open about their personal lives when I first started working 34 years ago.  I do think that people share much more than they used to at work

Here's the problem: when you tell too much at work, you are inviting people to judge you.  I remember working with a very pretty young woman a few years ago, who seemed compelled to report on her personal life every morning.  It got to the point that staff members were waiting at the front desk for her to arrive so they could hear all the details of whatever she had done the night before.  Now, these details were extremely personal, always racy, and often demeaning, even though she didn't seem to realize that.  It started to bother me to see what it was doing to our staff.  These nice, very down to earth ladies were becoming voyeurs.  A voyeur is defined as  an obsessive observer of sordid or sensational subjects.  Not what I wanted to see our staff dissolve into.  My first step was to talk to our staff members and help them see how they were contributing to her degradation by encouraging her to talk about these things.  Once they realized what was happening, they agreed to stop their part in it.  I then talked to her and told her that they weren't asking because they admired what she was doing.  They were titillated by it.  She was becoming a living, breathing soap opera.  She seemed to get the picture and said she'd stop.  Within a week she was talking again.  I realized that it made her feel important.  She didn't have anything to replace it with that would enable her to reproduce the feeling of popularity and importance she got when she opened the door into her personal life. 

I've noticed that people get competitive with this kind of talk.  They seem to have a need to top each other with something more bizarre or shocking.  It escalates because no one objects, no one says, "Enough."  Even when we know it's wrong to encourage someone to talk in a way that demeans them, we want to know more, we want to be shocked, maybe we want to feel superior.  When we urge someone to tell more, we need to stop and ask ourselves why we are doing that.  We need to learn to tactfully guide the conversation to a more dignified subject.  I know I sound like an old fart, but that's ok, as long as you believe me and do the right thing. 

It's a bad feeling to go home and know that you've revealed too much about your personal life.  Once it's out, it's out.  What you put out about yourself, is the information that will shape people's opinion of you.  If you want to be respected, use discretion.  If you want to be interesting in the long term, use discretion, leave them wanting more, rather than giving them something to talk about. 

Where Are All The Normal People Hiding?

If you've ever interviewed for an opening in your practice, I'm sure this thought has entered your mind.  I am currently interviewing for a roving office assistant and I am disheartened by the attitudes of the applicants I've been interviewing. 

To begin with, I can remember interviewing for positions when I wanted a job.  I tried to present my skills, abilities and willingness to be an integral part of a team.  I never asked what the position benefits were until we were clearly negotiating my employment.  Once I was hired, I understood that if I wanted my salary to increase, my skills and value to the practice would have to increase first.  I didn't expect to be paid more for being nice, or funny, or for just existing.  I knew that I'd have to take on more responsibility, find ways to improve what we were doing, and be an overall asset in terms of my physical, personal and psychological presence in the practice.

Let's break it down.  When I say my physical presence, I mean I have to work.  If a patient cancels and I'm an assistant, I have to find other things to do, even if it's just wiping down shelves or straightening the supply closet.  I have to offer my help to others in the office.  It doesn't mean sitting in the break-room with a cup of coffee and the newspaper.  The dentist is already losing money because of the cancellation, I'm not going to rub in the fact that he's paying me to read Ann Landers.  This holds true for any position in the office. 

When I talk about personal presence, I'm referring to the mood you create around you.  I try to be upbeat and optimistic, try to help my co-workers and look for ways to help them stay on time and relieve stress for them.  I don't wait to be asked, I don't act like a request is an imposition and I don't feel like they owe me something if I help them.  It's all work, it all needs to be done, and I'm getting paid to work; seems like a no-brainer.  Everyone knows they can come to me for help and I like that. 

Finally, having a healthy psychological presence in the practice is so important.  We've all worked with people who bring their baggage to work with them.  They seem to define themselves by their quirks and expect others to find it endearing.  It's not, it's usually annoying.  They seem to think that it's their God-given, legally protected right to be weird, and if we are unlucky enough not to catch it in the interview, we're stuck with them. If we really can't take it and we let them go, we're going to end up paying unemployment while they sit home watching The Price Is Right.  They may even manage to seem fantastic during the interview process, only to unleash their poor work ethic, entitlement attitude and generally unacceptable personality flaws soon after beginning to work. All of which would have been huge red warning flags slapping you in the head if they hadn't so carefully hidden them while they were sitting in your office convincing you that if you just gave them the chance they'd be a dynamic part of your hard-working team.

What I am finding, despite the poor economy, are people who want to spend the interview time telling me what I'll need to do to make them feel cherished and happy.  They are applying for an entry level position, but want to tell me what responsibilities they will assume, rather than show a willingness to progress by learning what we want to teach them in the time-line we have developed.  I'm sitting there listening to what they apparently consider the thoughts of a genius, and thinking, "Where are all the normal people hiding?"  Sometimes I even wonder if my boss has set up a hidden camera somewhere in my office, but I think Candid Camera has gone off the air.  I have developed an interview system that usually saves us from making hiring mistakes, but it's arduous and time consuming. 

I've heard that this is a great time to be hiring because there are a lot of talented people available due to cut-backs and lay-offs.  What I'm really seeing are people who are willing to take a job outside their area of interest until something they really want becomes available.  During the interview, if you ask them why they want to work in a dental office after attending nursing school, they'll tell you that they realized they don't like working in a hospital, but really love the dental environment.  Two months later, they may tearfully hand you their resignation when a nursing job is offered.  I understand that people need to do what is best for them, but it's made me harder to convince when the next person comes along.

I want to interview someone who will show an interest in becoming a hard-working member of a fantastic team.  I want someone who will not damage the culture of our practice with bizarre behavior and unreasonable attitudes.  In other words, someone with a great work ethic, a desire to serve our patients, and a pleasant and caring personality.  Anyone like that out there?  If so, click on comment, I'd like to interview you.

A Culture of Nobility

"So long as we live among men, let us cherish humanity."  ~Andre Gide~

How often do we look at other and notice their flaws?  It's so easy to see the sour look on a grouchy patient, the obnoxiousness of someone who always has something sarcastic to say, and to hear the whine of a complainer.  Often we can spend so much time thinking about how annoying those traits are, that we forget that there might be something positive about them.  Their name shows up on the schedule and the groans begin.

For the last 18 months I've been lucky enough to work with someone who sees and responds to the good in others.  My boss is not blind to the less pleasant personality traits in others, he just manages to look beyond them and play to their strengths.  At first I thought his magnanimity was the result of new practice ownership.  Surely time would deter that optimism and what a sad thing that would be.  Instead, not only has his accepting nature remained intact, it's contagious.  Things that used to bother me, don't seem that important anymore.  I don't find myself liking people despite their flaws, I like them because of their attributes which I seem to find myself noticing more often.

Dr. Morgan has a noble mind.  He has a generous character that assumes that the benefit of doubt is a God-given, human right.  He doesn't dwell on hurts and wrongs, but looks for the next good thing that he is certain is going to happen.  His high-minded, unspiteful attitude makes life good for everyone.  He's a happy guy and we are happier just by osmosis. 

I think people tend to assimilate the attitudes that they are most often surrounded by.  It would make sense to surround yourself with happy people if you want to be happy.  Our practice is a happy place to be.  Laughter is a common sound and the mood is vibrant.  One of the best things about being around someone with a noble mind it that he elicits the nobility that lies within each person.  He creates a culture of nobility.  The good news, it only takes one person to get nobility started.  It can be you.

Talk Is Useless

Everyone can talk, people do it all the time.  Everyone's talking, but who's communicating?  Think about it, dentists hire consultants and pay them a lot of money to talk at them and their staff.  Dentists talk at their patients and tell them what they need to do if they want to keep their teeth.  Hygienists talk at patients and tell them they need to brush and floss every day.  Staff talk at each other about who isn't doing what they should, who said something they shouldn't have, and the cluelessness of the doctor about the fore-mentioned.

When you talk about problems without looking for a solution, you are complaining.  When you talk about others to anyone but the person involved, you are gossiping.  When you talk at patients about treatment without educating them about their conditions, you are wasting your time and their's.

Talkers talk because they like to hear their own voice, like to hold center stage, like to get reactions, or just don't know the difference between talking and communicating.  Talkers aren't bad people, they better not be, since a majority of us spend a great deal of time talking without really communicating. 

Communicators listen, wanting to hear.  They've learned a better way.  That's right, communication is a learned skill, that's good, it means you can learn it, too.  They ask others what they think and feel about what they are doing together.(1)  They want to improve the work they do together and increase the quality of their relationships.  They strive for honesty and openness and are not afraid to give or receive either.  They speak with an intention to build-up, not break down.  They understand that the growth of the people around them allows for their own growth as well.  They realize that they are all on a journey toward the same destination.When people talk about problems without striving for a solution, they intensify the problem.  Since a solution was not achieved, the problem seems bigger because now two of you recognize it's existence.  As that recognition expands through further talking, it keeps expanding until it seems insurmountable.  More people talking = more convolution = more stress.  Communicating would have put the problem on the table, asked for ideas and more information, leading to different takes on the situation and facilitating brainstorming and finally a solution.  No wringing of hands, no victims, no negativity needed.

When people talk about others to others, they cause pain.  Even if the subject of their gossip never finds out, they cause some amount of pain for themself, because we all know what's right and what's wrong.  Gossipers know they shouldn't have gossiped deep down, and they lose some, even small, measure of self-respect.  The person who hears the gossip feels a loss of respect for the gossiper, even if they enjoyed hearing it.  The victim may notice a difference, but may not be able to put their finger on what it is or the reason for it.  I remember hearing a story as a child about a person who gossips and then goes to confession (I went to Catholic school) and asks for forgiveness.  The priest tells the confessor to tear open a feather pillow and let all the feathers get blown away by the wind.  Then they are told to collect back all the feathers.  "But, that would be impossible, I could never get every single feather back."  The priest replies, "That is how it is with gossip, try as you may, you can never wipe the gossip out of the mind of every single person it will be passed on to."  Something to think about.  Better to go to the person you are concerned with and tell them what you're thinking.  Let them know that you want to understand what they did or said and want to work toward a better relationship.  Don't be embarrassed.  It's less embarrassing than being faced with the discovery of gossip.

When health care professionals talk at their patients about treatment without educating them about their conditions they cheat the patient out of making an informed decision about their oral health care. They cheat the practice out of the opportunity of serving their patient and receiving referrals from a completely satisfied patient.  No one benefits from being talked at.

Think about the phrase, "I'm going to give him a good talking to."  It might as well be "talking at."  We've all been on either end of that talk.  When we're are being talked at about a mistake or bad decision, we feel beaten down, reprimanded, or scolded.  We don't feel much hope and our self-esteem usually takes a hit in the talk.  If you've ever given someone a "good talking to" you know that there is a moment when you think, "Is any of this getting in?"  No, it's not, because you are usually throwing criticism at someone who now feels like a victim and has likely shut down in an effort to protect themselves and salvage some measure of self-esteem.  If you have someone on your team who refuses to be open to communication, maybe you need to communicate the importance of their ability to learn to communicate.  If they can't or won't, they may be wrong for what you are trying to build in your practice.  Give them one final opportunity to succeed by communicating the seriousness of the situation.

When consultants, staff, managers and dentists sit down and start communicating, amazing things will happen.  Areas that need improvement will be correctly and accurately identified, stressors will be revealed and relationships will be examined.  Communication will enable and encourage the development of focus and purpose and align everyone on a journey that will lead to the same destination.  Fractured, damaged or undeveloped relationship will be discussed with an intention toward repair, re-building and strengthening and this will result in cooperation, support and a much higher degree of friendship and satisfaction. 

Talk is useless.  Communication is priceless.  How would great communication improve your practice and make your life more enjoyable ?

(1) If Aristotle Ran General Motors, by Tom Morris

Leading Through Disappointment

I think the biggest challenge in managing a dental practice is hiring, training and keeping good staff.  It's as precarious a task as building a house of cards.  Pull one card out and the whole thing comes tumbling down.  Losing a staff member that I thought would be with us for a long time is a big disappointment for me.I thought we were there with a really strong staff that was on it's way toward being long term.  This morning, our roving assistant e-mailed me to tell me that she'd accepted a job as a scrub tech because she'd get better medical benefits.  I'd like to say my first thought was that I was happy for her to have that opportunity, but I'd be lying.  I was annoyed because I'd put time into her, believed her at her interview when she told me she didn't want to work in a hospital and could see herself with us for years, and know my effort was in vain because I'd have to start all over with someone new.  I'm disappointed because she was the best person we've had in that position and she didn't even give us a chance to counter with an offer of higher salary. 

I called and talked to my boss about it and his pragmatism helped me to see that although this is a huge inconvenience and disappointment, it's just the way it goes.  People will, and probably should do what is best for them.I know our staff will be disappointed and even a little annoyed, just like I was.  This always affects everyone.  We all have to chip in more, help guide a new employee and get used to whatever their new personality will bring to us as a team.  As a leader, I'll have to keep them focused on positive aspects of this situation.  Who knows who we'll find to take this position and what special benefits and side effects they'll bring with them.  I was reading this article about interviewing on Dave Rendalls Freak Factor blog and liked what he had to say about the side effects that people have  on a workplace.  He also says that we all have weaknesses in addition to our strengths and I'll admit, my initial despairing gut reaction to an employee quitting is probably my Achille's heel.  I immediately get flooded with negative thoughts in response to reading, "I'm sorry to say I'll be leaving."  Luckily, I have Dr. Morgan to counter that with his eternal optimism.  That's not to say he wasn't disappointed, as well, he just seems to have a resevoir of "pull your socks up and keep moving-ness" to draw from.  Knowing he'll back me up and support me in the challenges to come will help keep my socks up, too.

This employee was thoughtful enough to give us two weeks notice.  Now, I have often heard dentists say they won't accept the offer and want the employee out immediately.  I once had an employer try to force me to refuse the notice, but I talked him into letting her stay.  If an employee bears no ill will to the practice, they can be a major asset in helping train someone new, or at least keep things moving for two more weeks.  It will be odd to go in next week and tell the team that she is leaving while she's still there, but I hope that I will have the wisdom wo find a way to make it comfortable for everyone. 

It's always stressful to work with an incomplete staff, so I'll be working hard to find someone to take her place.  In the meanwhile, I'll be trying to find ways to keep our staff optimistic, knowing that while they may have to work a little harder for a while, it won't be forever.  We all have to realize that some employees will come and stay a long time and become a part of who we are as a practice.  Others will drop in, add a little flavor and move on.  It's not about who we are, it's about what they need and we'll wish them well.  We'll all keep our socks pulled up and if we have to, we're not above bending over and pulling up someone else's when they just can't do it themself at the moment.  And it's good to know we're stronger than a house of cards.  Pull one out and we may lean a little, but we keep standing.  Disappointment happens, and that's all it really is.

Are You Holding Back?

Disclaimer: This is a totally gratuitous, possibly a little boastful post.  I have it made, as do my co-workers.  We have an amazingly kind, fun, optimistic, totally wonderful boss. 
In these worrisome days of a dismal economic outlook, it seems that most people are focused on how bad things are.  Sometimes we have to take time to look around at the people we are with every day and realize we have a lot to feel good about.  For the past two days I kept getting the overwhelming feeling that I just needed to tell my boss how great it is to work with him.  I didn't want to come off as a kiss up, but when I thought about it I realized that we often have no qualms about criticizing or complaining, but we can feel squeamish giving a heartfelt compliment.  Maybe we just need more practice with it.  Why do we feel so awkward telling someone else how much we value them?  Why do we brush off the urge to say something nice?  We worry more that someone will think we're odd when we give a compliment than we worry about what they'll think when we say something negative.
I'm sure I looked completely goofy when I told Dr. Morgan that we have it made, but I'm glad I did it.  He looked so pleased and he immediately responded that he has it made, as well.  That sure feels better than complaining or blaming.  So, maybe it would be a good idea to make a habit out of giving truly felt compliments.  I say truly felt, because I don't want you to go around giving smarmy, insincere comments.  People see through insincerity and it makes them feel weird about you, so make sure you mean it.

Think about it, are you holding back?  Why?  Do you worry about how the other person will receive your compliment?  Do it anyway.  Even if they act uncomfortable, inside they love it.  Keep it up, you might get everyone else started.  Our staff really likes and supports each other and we don't mind letting each other know that.  We probably don't do it often enough though, so I'll need to expand it out to them.  We should never take having it good for granted.  If we don't have it so great, we should try to find ways to change that.  It has to start somewhere.  Why not with you?

What Are You Going To Do Tomorrow?

Are you going to do the same old thing, or are you going to dare to do one thing differently?  I say dare, because making any change comes with baggage.  First, you have to be brave enough to actually let the words come out of your mouth.  Then you have to let them sink in and wait for a reaction.  Most of the time, any mention of change brings an initial, knee-jerk resistance.  Eyes roll, moans escape lips, and sometimes the most assertive staff members will actually string a sentence or two together to let you know why things are fine just the way they are.

So, how brave are you?  Once you get past the initial reaction, if you really want change to happen, you'll probably have to go first.  Then you have to keep encouragement coming and momentum moving forward.  When the results come in you have to share the victory or take the blame if it's not so good.  Still want to do it?  Yes?  Then it's a good idea, go for it!

I once had a boss who told me that life is full of peaks and valleys, but he preferred to live in the ruts.  I drove him nuts.  Truth be told, he drove me a little nuts, too.  I like to rest in a plateau now and then, but that next peak is just waiting to be reached and you only get there by taking the first step.  It may be easy to just keep on doing what you've always done, but it's boring.  Change keeps people on their toes.  I'm not suggesting you have a constantly morphing practice, just one that is always looking for tweaks.  Never say never.  New technology can be exciting or it can be frivolous, you have to check it out to see what will work for you.  New ways of doing things can make work more fun, or just complicate things.  You'll never know if you never investigate. 

Going to work tomorrow and making just one change you've been wishing would happen, could lead to more good changes.  Before you know it, you might start feeling excited about going to work.  In this economy, many are so focused on worrying and watching their practices decline.  What one change could become an action that answers some of those concerns? 

What are you going to do tomorrow?  Let us know.

Joy Rising

How cool is that? I can't watch this video without smiling and wishing I had been there. I'm probably the world's worst, yet most persistent dancer. I would have loved it. I was watching Oprah (love her or hate her, she's pretty impressive) and some of the people who danced in the video were talking about how great it felt. These were all amateurs who were strangers to each other. One person said it was like joy rising. Another talked about how amazing and unifying it was. They were talking about how fantastic it felt for so many people to work together like that, at one point each person had their hand on another person's back, and how much fun it was. They said it was shared joy for the Black Eyed Peas and the crowd. It was something neither group could have done without the other. Now, if a huge crowd can make something that takes so much cooperation happen, and have a great time doing it, it should be easy for us to create synergy and shared enthusiasm in our practices. Believe me, when a dental team works happily together, the patients feel it, and love it. Our staff went out to dinner together the other night after attending an OSHA meeting and had a wonderful time. Our waitress commented on what a happy group we were. That's joy rising. It came right off of us and floated onto her. She felt it and appreciated it. It happens in our office, too. Our patients comment on it all the time. My son worked with us this summer and I asked him what he thought the feeling in the office was. He said, "Happiness. Everyone always seems to enjoy what they're doing, they like each other, and you can always hear someone laughing." That's joy rising and floating up and down the hall and in and out of the rooms. You may be thinking I'm exaggerating or that it's a fluke, nobody's that happy all the time, right? So, what's our secret? It's simple, anyone can do it. We decided to make it happen. we made a conscious decision to make the atmosphere in the office happy. We decided to like each other despite the things we may not like 'about' each other. It's a minute to minute choice that we make daily. Oh, sometimes we get off track, but then we want the joy to rise again. Joy rising. It's addictive. Is joy rising in your office?

I'm So Happy To See You!

Do you make your staff feel like that when they arrive in the morning?  Chances are you don't.  I don't think I really do, consistently.  This is what usually happens:  I'm usually the first to arrive by at least 30 minutes and I'm usually deep into something by the time they get there.  Cathy usually gets the best greeting because she comes in the front door and we say hello and often have something to discuss from the day before.  Julie and Annette come in about 20 minutes after her and shout up the hall.  I don't know if they even hear me grunt my reply, which is usually something like, "Uh, huh" or just "Huh" if I'm really into something.  Harris flies by with barely a nod and passes by so fast that I could easily miss her. My boss yells hello down the hall and heads straight to his office. I often feel a little miffed at the abruptness of it all.  Why don't they walk the extra few steps down the hall to make visual contact with me? Why doesn't she slow down and say "Hello?" Well, why don't I go to them?    When we all finally get into the breakroom for morning huddle, we give each other a more considerate greeting.
I started wondering today, what would it be like if I broke away from whatever "important" thing I'm working on and was waiting to give them a really great greeting.  What if they felt that I was really happy to see them.  Because honestly, I am.  The day is always better when everyone shows up.  When I start to realize that it's 10 minutes past the time anyone would normally get there, I start to worry like the mother hen that I am.  So, how can I start the day by letting them know how happy I am that they've arrived?  I already have the coffee brewing when they get there, and to be honest, they take it for granted.  If I forgot, they'd just make it themselves, so that's not such a big deal.  I think I'll try just getting up from my desk and going to them and asking how they are today and really listening to the answer.  What if I made greeting them the important thing.  Now, they might think I've finally cracked, but they might also realize just how appreciated they are.  People like to be noticed.  Often, they'll do whatever it takes to be noticed, even if it means they have to cause some trouble before anyone pays attention to them.  They love it though, when you notice them for who they are.  Don't group them into "the hygienists", "the assistants", or the "front office".  See them as individuals who each add something valuable and unique to the practice.  Ask them how they feel and what they think about what you're doing together.  Really listen to understand.  When people see that you notice their contributions, they tend to contribute more.  When they see that you acknowledge change that you've requested, they are more willing to comply with your requests in the future.  Best of all, when you show them that you're happy to see them, they tend to be happy to see you, too.

Do You Really Know How To Lead? Really??

Leadership is an interesting concept.  I call it a concept because there are really no set rules about how to lead.  There are no real leadership schools, because it's something you learn along the path of life.  I think that very few of us are ever finished, we've never learned all we can about leading others. 
I remember when I started managing our practice.  I felt like someone threw me into the middle of the ocean and said "Swim" without also teaching me how to tread water, or at least tossing a life preserver in after me.  So I did what anyone who wants to survive would do, I desperately paddled and waded, went under a few times, (felt like staying under a few times) and finally started making some productive progress.  It wasn't too long before I thought I knew all there was to know about swimming leading.  I'd soon find out that all I really knew was just enough to keep me from drowning. 
I have found that just when I think I'm really a good leader, reality smacks me in the face and I realize that I have a lot to learn.  Here's a little of what I now know:

1. Leadership lends you no power.  If you are accepting a leadership position, don't do it for the power you think you'll have.  If you try to lead by might, you'll find out how weak you can be.  You will realize that you are dependant on those you lead, not vice versa.  If they don't like you, don't agree with you, don't like your methods of leading, you will be as effective in getting things done as a bird with no beak or wings.  The power is in the relationships you build with your team.  It is in the example you set.  The power is in the character you unfailingly display.  It is in your consistency.  The power is in the trust you build.
2. Speaking of trust, in case you didn't know, you build it with every word, every response, every facial expression, every nuance and every action you take, every conversation you have, the way you handle good times and the way you react in harder times.  When you are doing it right, your staff will look to you for reassurance, they will base their response on the way you seem to feel about a situation, and they will mirror your attitude toward others. If you want to test this, walk into a meeting and just be quiet and don't display your usual upbeat personality.  You will see the mood deflate and become flat.  They trust you to set the tone for the day.  If you think it's a downer, it must be.  So if you want to have people who are working together in harmony for a common goal, you better make sure you do it first.  Make sure you're happy doing it, too if you want to work with happy people.
   
3. You don't get a bye when you are in a leadership position.  It doesn't matter if the boss is grumpy, the patients are nuts or the staff seems like they just hopped off a party boat, you have to be consistent.  You get to have a bad day now and then, hey, you're only human, you just really shouldn't show that you're having a bad day.  I guarantee you, if you do, and if you do it too often, you'll lose credibility.  I'm speaking from experience, so believe that I know what I'm talking about.  And if you think it was hard to establish credibility to begin with, it's much harder to regain it.   Control yourself in the short term to make your own life easier in the long run.  It's a choice and you know you're making it when you decide to give in to a bad mood or other negative attitude, so dig in really deep and pull out that strength of character and save the meltdown for the car ride home.  Or, instead of melting down in the Honda, congratulate yourself keeping it together instead.  Don't worry that no one would have known that you were upset about something.  It's not wasted, be proud of yourself for dealing with it and not letting anyone see you sweat.  Let it be over and move on.  (Note to self, let it be over and move on).
   
4. Leadership is all about impact.  What do you teach the others around you?  Do you model patience, or are you often exasperated?  Do you persevere, or are you always on the verge of throwing your hands up and the towel in?  Do you have faith, because in this economy you really need to be positively realistic and realistically positive.  You have to find ways to keep your practice afloat and even thriving, but you should not promise the impossible and then fail to deliver.  You inspire faith when you set achievable goals and have a plan for reaching them.  Then you lead the way.  You inspire faith when you do what you say you will do.  Do you really believe in your boss and his/her skills and character or do you roll your eyes and complain behind their back?  The staff will do what you do, so I hope you have faith in the person who trusts you to lead their practice.  If you have faith, the staff will have faith.  If you all have faith, the patients will, too and that's the impact you want.  If you have a hard time with this, better to leave your work then to work in  bitterness.  (Someone else said that first, I can't remember who it was). Remember always, it's an honor to be asked to run someone else's practice.  It really is, so respect that and leave it if you cannot fully support the dentist.
   
5. Leadership is about dedication.  Do you dedicate yourself to the staff?  That means caring more about them looking good, then looking good yourself.  It means giving them wings and teaching them what they need to know to succeed.  It means helping them before you help yourself.  Stopping to show them how to do something, rather than attending to your own work.  Then later, you don't suffer because you have to stay a little late to finish the task you postponed to help, you just do what needs to be done.  Do you dedicate yourself to your patients?  Do you spend time helping them understand why they need treatment, and what their condition means?  Do you maintain your composure with them, even when they seemed determined to make you lose it?  Do you continue to be respectful to them despite the fact that they may be  behaving rudely to you?  Do you dedicate yourself to your boss?  Do you know what his vision for the practice is?  Do you listen to him and give him suggestions when he needs them?  Do you partner with him in making the practice and staff successful?  Do you dedicate yourself to yourself?  Do you have balance in your life or is your job your life?  Make time for the things you enjoy away from work.  Save attention for the people you love and the things you like to do.  Don't be boring and if you are only interested in work, guess what?  You're boring.  Dedication doesn't end as you lock the door behind you. You're always watching what others do in their business that makes you feel good, and then incorporating that into the practice.  It's talking up the practice, dentist and staff whenever the opportunity arises (without being annoying, use common sense here).  It's not about doing it all yourself because it's easier, it's about sharing what you know and being confident that you'll still be needed.
6. Leadership is about perseverance.  "Never, ever, give up."  Winston Churchill said it succinctly.  So did Thomas Edison, "Most of life's failures are people who didn't realize how close they were to success when they gave up."  Don't give up on your doctor, your team or your patients.  Don't write people off.  Invest in them.  Spend time trying to understand who they are, how they are, what interests them, what motivates them, and what their talents are.  Then take that and use it to help them get where they need to be.  Realize that not everyone will be ready to be where you think they need to be when you think they need to be there.  Also realize that even if they aren't, and it doesn't work out that you'll continue a relationship with them, you still never have to give up on them.  You can accept that it is what it is, and separate with goodwill.  It will always serve you well.  Persevere when things seem hard, it won't kill you.  Be aware of your emotions during difficulty and try to call on an emotion or attitude that will aid you in difficulty rather than pull you down.  When you feel frustrated try to figure out what is frustrating you.  Maybe it's a team member who has a bad attitude.  Will frustration on your part make a dent in her attitude?  It may actually increase it and take away from your credibility.  You can't control her attitude, you can only address the problem, discuss the change you expect to see, and let her know the consequences of staying the same.  No need for frustration when honest, open communication is available, and it always is, you just have to be brave enough to use it.
7. And the last one for today.  Leadership is about courage.  It's not easy to tell someone else they have to change.  It's not easy to keep going back over mistakes or bad attitudes.  It's hard to be the one who has to give feedback and face the fury of a staff member who doesn't want to hear it.  You get tired, you get hurt, and sometimes you wonder, "Who cares about me, who worries about me, who tells me I'm doing ok?"  The honest answer?  You do.  You are your own mentor, you are your own cheerleader.  You supervise yourself.  And you have the courage to believe in what you are doing.  You know that you want the best for everyone and for the practice.  You have the courage to put yourself in front of everyone and make mistakes.  You have the courage to put yourself behind everyone and push them to success, even though there may be mistakes along the way.  And when success happens, you place yourself beside everyone else and share the victory equally, knowing that it really is equal, because without them allowing themselves to be led, you wouldn't get anywhere.  Knowing that you did what it took, gave what you had to give, to develop the influence that made them choose to follow you is enough satisfaction for you.  You lead.
   

Everything's Amazing and Nobody's Happy

Something to think about?

Valuocity

I just finished reading Valuocity by Dr's. Marc Cooper and Mark Silberg.  I will be published soon and I'll include ordering info at the end of this review because I think you'll want a copy.

Valuocity

Marc Cooper

Mark Silberg

Let’s start with the acknowledgements.  We get a real sense of where the authors are coming from and who they are as people.  I like to know I’m about to read something written by someone with healthy priorities and values. The story opens with a recognizable figure.  Carl is a dentist who wants to keep moving forward, but who feels the unrelenting suction of a bleak economy trying to pull him into decline along with many of his peers.  His thoughts, feelings and responses will be familiar to anyone connected with a dental practice. 

His fears, concerns and worries are palpable and really drive home the reality of what many dentists are carrying in their hearts and minds these days.  He wants what we all want…to be ok and to keep what he’s got.

As I read, I got a real sense of the overwhelming nature of his concerns.  He can think of nothing but his present problems and the possibility of a dismal future for himself and his family, to the extent that all pleasant and positive stimuli are blocked by these worrisome and dismaying thoughts.  Seem familiar? 

Carl had been pulled into a tornado of negative thinking that made even attempts at positive solutions seem like formerly valuable possessions that were now reduced to rubble because of the force and ferocity of the destructive nature of the power of the wind.  In his despair, he’d allowed his thinking to spiral into a pit of negativity where one desperate thought feed another, and even the arrival of a stranger who wants to cast some hope into the situation, seems like just another burden to cast into the wind tunnel.  Even though he initially snubs his offer of help, he can’t get him off his mind.  The man, Sidney, is a fellow dentist, who has a consulting business and he assures Carl that he’s helped other dentists in his position.  Carl just can’t see how he can ask a stranger to help save his practice.  After all, he built this practice; shouldn’t he be the one to save it?

We then see that Carl has another problem.  His wife has no idea of the trouble the practice is in.  She helped him build the practice, but once they were certain of success, her involvement had dwindled and she fell out of the daily loop concerning the health of the practice.  They’d begun to take success for granted and now Carl didn’t know how to let her know the truth.  He was loathe to pull her into his misery and out of her safe, secure, happy life.  How would this situation affect them and their marriage?   Rather than find out, he’d been avoiding the discussion altogether and now he had another problem.  His unwillingness to be open with her in the beginning was making it seem impossible to tell her the real truth now that it had gotten bigger and harder, and their relationship was suffering the same decline as his practice.  One problem was causing and adding to another until everywhere he turns, there’s another thing he’s too overwhelmed to face.  Finally, Carl realizes that the problems are just building on each other and nothing is getting better.  He is ready to reach out for help, even to a stranger, even though it feels odd and discomforting.

  As he talks he starts to feel his burden lifting as he shares his worries and burdens with Sidney. As we listen to Carl struggle to decide whether to share the entire truth about the severity of the problem’s with his practice, we realize that Carl’s feeling about himself as a dentist, husband, father and man are defined by the success or failure of his practice.  If he’s honest about his practice, what will Sidney think of him as a man?  What will anyone think?  What does he think of himself?  Is he really ready to face that?

At this point let me say, I found it hard to miss the undeniable coincidence that the author is a dentist who is a consultant, and so is Sidney.  I started to fear that this whole fable would begin to seem like a glorified marketing technique, and then I started to understand that just as I’ve always found with Dr. Cooper, the focus is on helping dentists learn how to help themselves.  This isn’t a cookie cutter program designed to fit one and all. It isn't even something for which success is dependent on hiring Dr. Cooper.  He's giving you the information you need so that you can depend on yourself. This becomes a probing foray into what makes you tick; a co-discovery that will allow you to help yourself and help your practice.  Dr. Cooper or Sidney facilitates that means to a successful end.  The one being served is the reader, who will then go on to put these lessons into play, thereby improving the lives of everyone involved with their practice.

How do you see your situation?  That’s the question that defines the problem and helps point you toward the solution.  It’s easy to fall into patterns of thinking.  You have to become aware of them before you can start to create new patterns.  Carl starts to understand the negative momentum he’s creating by living in dread and denial.  He starts to see that his perceptions were determining his actions.  He also began to see that his perceptions were inaccurate.  He realizes that he underestimated his wife’s ability to handle bad news and her willingness to partner with him for a solution.  He begins to see everyone and everything as they really are.  He sees the possibilities.  A new way of thinking is opening up for him.

As Carl agrees to let Sidney help him, the first step is to spend a weekend at Sidney’s ranch.  The first advice he gets is to surrender to the journey.  Think about it, don’t we all have to surrender what we think is the only reality in order to find possibilities?  Aren’t we so sure we’re right, even when we’re sure things are hopeless?  How can you go anywhere better, without first surrendering your despair?  As Carl finds out, you have to transform yourself before you can transform your practice.  You have to see yourself and your abilities differently before you can make positive changes in your practice.  Only when you question the reality that you think exists, can you see the possibilities that are all around you in your environment and the people you share it with.

First Carl must give up his habit of making others and himself wrong.  He is told that most people make others wrong so that they can be right.  As I read along I realized that I had stopped seeing the story as just a fable, I was beginning to look for my own answers, too.  Revelations were taking place that hit close to home and I found myself cringing at the recognition of my own tendencies to make assumptions, but at the same time, I was excited by the anticipation of changing that pattern.  I found myself thinking, “ Hey, I read this to give my opinion, not to find my own story in the pages!”  I don’t have a failing practice and I work in a pretty successful one, but I still saw myself in the tale.  I didn’t hate what I saw; I just recognized the need for more awareness and a different way of seeing things. 

Dr. Cooper makes Carl a very identifiable figure; one in whom any of us can see something of ourselves. Carl finds that he has to figure out who he is.  How does he view the world around him?  What is at the center of his practice?  What are his assumptions?  What does he stand for?  What does his practice stand on?  Does it have a foundation at all?  Think your practice is based on excellence?  You may need to redefine excellence and you may find that you have a bit of work to do if you want excellence in your practice to become a reality. What are your core values for your practice?  It’s what you base your decisions and actions on. 

Carl learns how to determine what his core values are, and how to apply them daily.  He has to define the way he and his staff would demonstrate their core values in their behavior.  He begins to visualize how that would look in practice.  As Carl finds out, defining values, describing behavior that would express those values, and measuring behavior to see if the values are being lived in the practice is a process that requires an initial contribution of time and consideration and an ongoing investment of attention and monitoring.

Carl will also find that he needs to put more effort into his staff if he wants his staff to choose to uphold the core values in the practice.  Do you have job descriptions in your practice?  Get ready to put them on the shelf.  Valuocity will teach you how to lead your staff to responsibility.  They will begin doing what should be done because they are part of the process and choose to work for success, rather than just working for a paycheck.   They will become accountable for their actions.  Carl will learn how to develop performance reviews that are individual to his practice, based on his values for his practice.  He will use those reviews to steer staff in the right direction.  He’ll learn that performance reviews set the stage for salary reviews. .  Carl learns how to create a meaningful salary review and how to assign points for performance. When the practice does better, the staff does better. 

Carl vacillates between optimism and anxiety about how much work it will take to make changes and how the staff will resist his efforts.  We’ve all been to CE that had us excited and enthusiastic, only to experience that slow deflation as the work week goes by.  Soon enough, that CE that had us hopeful and excited is just a vague memory, like all the others.  Why would this be any different?  It’s different because it involves a process that has values at its core.  It’s not the same for everyone; it’s based on individual values and commitments and depends on accountability   The dawning of a new way of leading and managing give Carl the promise of a better way of living his life and managing his practice, and he sees that he can still have the practice of his dreams.  He understands that he’ll need a coach to hold him accountable for doing the things that are uncomfortable for the good of the practice.    He goes from the person who is lost in despair at the beginning of the story to a man who has a vision for the future and a renewed sense of optimism and purpose. 

Valuocity 2 will take off where Valuocity leaves off.  It will follow Carl as he returns to his practice and finds the hard work is putting these lessons into practical use.  The feeling I had after reading Valuocity was this: Someone had reminded me that I had the power all along.  I had to stop wishing for the changes I’d like to see in the practice I manage.  My boss and I need to sit down and design his dream practice and then we need to pull our staff into in with us and build it from the core.  Even though our practice is already very good, we still can, and should, continue to grow and evolve.  So can you.

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Disclaimer:  I will not receive any gratuity or any form of reimbursement for this review.  These are my personal opinions and thoughts on this book, provided purely as a guide for the readers of this weblog.  I am involved in Dr. Cooper's Mastery of Office Management program, but that in no way influenced my review.  My participation is not contingent on any reviews or testimonials for Dr. Cooper's work.

Mom, Dad, and the Kids

Do you ever feel like that in your practice?  Mom and Dad are the dentist and office manager and everyone else waits for them to tell them where they're going next.  The problem is, the staff aren't kids and pulling them along isn't as productive or enjoyable as driving your kids to a day at the beach. 

It's easy to fall into that type of pattern though, because it often seems more efficient to just "do it yourself."  If you do that, you may save time in the short term, but you'll lose growth in the long run.  It takes time to train staff and  monitor them, and it takes a certain amount of trust and generosity to set them loose, but it's the right thing to do.

Why generosity?  Because we managers like to be the go-to person.  We often like to be depended upon.  Sometimes we may feel powerful, in charge, all-knowing, whatever, we have to realize that the real power and impact is in giving knowledge away and letting go of responsibilities.  First of all giving knowledge away, doesn't lessen your own knowledge.  I like to tell the staff that knowledge shared is knowledge squared.  It not only helps another team member, it increases their appreciation of you as a person. 

When we let go of responsibility, I don't mean we shirk our responsibility or throw it to the wind.  I mean that we take the opportuntiy to pass on the task to someone that we have given knowledge to and can now trust with the responsibility.  Then we allow growth for ourselves as well, by freeing us up to learn something new and tackle new challenges.  When was the last time you asked your staff what they thought about how the practice is doing, what they think works and what could be better?  In tough economic times, the thoughts that may be languishing inside your teams brains may be the thing to pull you out of a slump. 

Many times staff have ideas, but nobody bothered to ask.  Ask away!  Set aside time for a brainstorming staff meeting and give them at least a weeks notice.  Ask them to come prepared with ideas and issues to talk over.  Have small, fun prized for things like best idea, most ideas, most unusual, but useful idea, etc.  Ask them what they are willing to do to be a part of the success of the practice.  Ask what motivates them and what keeps them excited and interested in their job. Then remind them that they don't have to wait for the next meeting to share their ideas, encourage them to come to you regularly with their thoughts.  Let them know that you see their ideas as a gift and not a burden.

Most of the time, the kids don't have much say about which direction the family car is going to be pointed in.  Does your staff?  Remember the Flintstones foot powered cars?  Well, wouldn't they go faster and be more efficient if everyone's feet were moving?  Think of your practice like that and you'll get where you want to be a lot faster and you'll share the work, too.

Hygiene Anxiety

   It seems like the economy is really starting to have an impact on hygienists in some practices.  More and more resumes come in for hygienists and I see more posts on DentalTown by hygienists looking for work.  It seems that patients are looking to cut expenses wherever they can, and sometimes they see their hygiene visit as a luxury along the lines of having their nails or hair done.  We can do something about that.  Dentists also sometimes look at the hygiene department as their loss leader and feel that they can cut their hygienist's hours and do some prophy's themselves and save money.  We can do something about that as well.  There are probably other reasons for hygiene anxiety, but let's concentrate on those two because I think they're the main problems.

    Ok, so your patients are looking at their hygiene visit in the same category as their more optional grooming appointments.  That may be a sign that you need to educate your patients more about the importance of regular hygiene visits.  If you can make them understand that oral health is directly related to overall health and well-being, you will take yourself out of the manicure, waxing, hair coloring loop, and put yourself back into the necessity category.  I think it's great for hygienists to develop a good rapport with their patients, but you have to remember to guide the appointment and include patient education in the conversation.  If you go through the entire hour and the patient has learned nothing more than your dog's name and the adorable thing your six year old said, they may think you're just wonderful, but not necessarily the vital part of their health care team that you truly are. 
    Make every visit a co-discovery of their oral health.  Talk as you examine their soft tissues so that they know what you're doing.  Discuss your probing results and when you do find deeper pockets, describe the reason it's important to disrupt the bacteria that is colonizing under their gums.  Help them understand so that they can help themselves.  Treat each tooth as an individual and discuss it's health or disease with the patient.  Talk about the overall condition of the tooth - does it have a large fracture line, an old amalgam with breaking down margins, etc.?  Let them know that acting preventively can help avoid more costly treatment that postponing or ignoring the problem could cause them to need.  When you're done, sit them up and review your findings before the doctor comes in.  Then go and brief him/her on what you discussed with the patient.  Your patient and your doctor will see you in a new light.    When a dentist thinks that he can save money by cutting hygiene hours, I often wonder if he is seeing the whole picture.  When anyone sees hygienists as loss leaders, I know they are only looking at part of the equation.  It tells me that they are saying, "My hygienist charge for the appt is $75 and she gets an hour to do her work.  I pay her $xx per hour.  I have to pay for her supplies, the front desk person to schedule her appointment, the room..., hey, I'm barely breaking even on her!"  And then they stop thinking.  If they continued to think realistically, and they have a hygienist that does what I've described above, they'd realize that a hygienist who educates her patients plays a big part in treatment acceptance and that keeps both the patient and the practice healthy.  A dentist doing his own prophies should be a last gasp effort. 

    "But my hygienist is sitting around with hours of open time on her schedule!", you might say.  First, you have to see if you really have hired her for more hours than you need.  Multiply the number of patients in the practice times two and that's how many hours of hygiene time you need to have available.  For instance, a practice with 2,000 patients will usually see those patients twice a year for recall, so they will need to have 4,000 hours of hygiene appointments available for the year.  If that all adds up, then maybe patients are falling through the cracks.  This is what the hygienist should be working on during her open appointment time.  Don't call it downtime because it sounds like time when she is shutting down.  This is time that can be as vital to the health of the patients and practice because she can get on the phone and get patients motivated to come in and continue their good oral health regimine.   

Many people think that hygiene is boring because they just do the same thing patient after patient, day after day.  Not so, if the hygienist is truly up to date with current practice modes.  The hygienist should be classifying patients by periodontal type from health to severe periodontitis.  If she isn't, your patients might not get the treatment they need and your practice could be falling short in that part of patient care.  Patients don't like to hear that they have periodontal disease, but let's face it, many of them do.  By educating them about their condition and helping them accept the fact that their disease literally lives in their mouth, the hygienist can help them attack the problem and, if not completely conquer it, at least improve and control it.  So many patients come in with problems that 1. they don't know they have, 2. they don't realize there's help for, and 3. they don't understand the consequences of.  Let's take a patient with xerostomia (dry mouth).  A dry mouth can wreak havoc with oral health.  Bad breath aside, it can cause food to stick to both hard and soft tissues leading to periodontal disease and rampant decay.  How often do we really have time to invest in discussing the causes, effects and treatments for xerostomia in the course of a routine hygiene visit?  Set up a protocol for a xerostomia visit and give the patient 30 minutes of the hygienists time to go over products and treatments that can help.  This patient may even benefit from a three month mini recall visit during which the hygienist can evaluate home care, plaque score, give a fluoride treatment and polish.  Keep the fee reasonable and keep in mind the preventive value and benefit of this appointment. Look at how you are using your hygienist's skill and knowledge and you may find that you are underutilizing talents that have been right there all along.  Hygienists, take a part in finding ways to put your talents to use for the good of the patients and practice.

    These are just a few thoughts about reducing hygiene anxiety.  Hygienists can look at what they can offer in a new way and help themselves while they help their patients and practices.  Hard times don't always mean we have to fall apart.  We are always so much stronger when we pull together and use adversity to gain strength.  Look for ways to build up, rather than ways to shut down and you may get what you're looking for.

Listening

    I'm involved in Marc Cooper's Mastery of Office Management Program and our homework for the last two weeks has been listening.  I am amazed at how hard it is for me to turn off my own thoughts so I can manage to actually really listen to others.  I'm not happy with this realization, but better to know it so I can try to do something about it.

    If I had a dime for every time someone told me I'm a great idea person, I'd have  a lot of dimes.  Ideas just come to me.  Sometimes I even wake up in the middle of the night with 2 or 3 ideas for something that would be just great to do in the practice.  People like to hear my ideas and think that I always know the right thing to say.  So, why should I listen more?  Maybe I meant to be talking more than listening.  After all, I'm so good at it, right? 
    Well, I got a lesson in the value of being listened to the other day.  There was a situation one morning that left me feeling hurt and upset.  At the moment, I didn't really know where to go with what I was feeling, my boss didn't know a lot of the background behind the reason for my distress and so he couldn't really appreciate or understand how I felt.  It was very real to me and all the more frustrating because it threatened to put us at odds with each other, which would have made the situation all the more dismaying for both of us. 
    We got through the day, talked a little, but I still felt like a solution was not reached.  The next day I got up and felt like I'd love to just turn off the alarm and sink back into the pillow and forget about that thing called work.  I pushed myself to get moving and made it through the day with less than my usual enthusiasm, but satisfactorily as far as I was concerned.  At the end of the day I was talking to my boss in his office and he told me that he didn't like seeing me feeling the way I was, and that seeing me frazzled would affect the way the staff looked at me as a leader.  He told me he wanted to help me find a way to breeze through stress like this without  letting them see me sweat.  Then he listened to what I was dealing with, how I felt about and we talked about how to handle the next situation like this.  As I talked I could see him listening to me.  He was really considering what I was saying looking at it from my point of view.  Finally, he said, "You sound like what happened makes you feel separate from everyone."  Exactly!  He put into words exactly what I was feeling.  I didn't even know the word for it myself until he said it.  I could see him replaying it all in his mind and seeing it how I saw it.  I don't know if he agreed with my point of view, but he saw it and accepted it for what it was.  And suddenly, the weight lifted and I felt better. 

    If he had sat there and talked and told me how I should have felt and how I should have handled the problem, I would still have felt isolated.  Instead, by really hearing me and considering my view of things, he stood with me as a mentor.  He showed me that listening is a performance art of wisdom and grace.  It is not passive, but a dynamic form of interaction.  Listening validates, it says, "You're worth the time it takes to hear you out."  Listening inspires.  It builds loyalty and gives you influence with others.  Listening is mature.  It means you can control yourself and your own impulses long enough to give someone else a chance to give you the information you may need to really know what is driving their reaction.  It allows you to be wise.  With all it has to offer, listening seems like a worthwhile endeavor.  I know I can talk, in the future I'll listen more.  I want to make someone else feel the way my boss made me feel.  That is something to aspire to.

Don't Mommy Me

    As I've said, I'm taking Dr. Marc Cooper's Mastery of Management course, and we had our second phone session on Wednesday evening.  These phone calls last one hour and they go by so fast, it's amazing.  Dr. Cooper said something that really hit me just a few minutes into the call:  "We have to move people to a place of responsibility."  When he then asked what we hoped to get from the course, I knew that was my answer.  I want to move the people I manage to a place of responsibility.  When I think about it, I want to free them from whatever fear, anxiety, insecurity or demotivating factor holds them back from making a decision and acting on it.

    So often, we as managers or leaders tend to fall into a pattern of parenting, rather than leading.  I think it's one of those chicken and egg situations, did we need to parent someone, or did they want to be parented?  Which came first?  It doesn't really matter because the result is the same, diminished power on both sides.  The manager has no power to lead because she's too busy carrying everyone, and the staff has no power to act because they haven't developed any confidence in their ability to think and make good decisions. 
    We have a great staff, but I realize that they like to depend on me a little too much, sometimes.  Since I like to be dependable it's hard for me to make them struggle when I can just as easily do it myself.  There's also that desire that we all have to keep peace and harmony in our practices and to keep the staff intact.  So, how do we know whether we're applying a healthy amount of tension that motivates, or if we are crossing over into pushing someone so hard that they give up.  We don't really, until it happens.  I think we have to pay attention to reactions, be open to talking and hearing how the staff member is handling your expectations, and find ways to help them develop confidence.    Sure, you can pull your staff along for a long time.  Sometimes you might even feel great about how much everyone admires your ability to do it all.  The flip side is that you'll end up resenting them for not taking responsibility.  They will miss out on the pride that accompanies accomplishment.  I remember that when my kids were getting to be old enough to drive, a lot of their friends were being given very nice, or even new cars.  My son was going to be driving my old Ford Escort.  It was in great condition and a very safe car.  He mentioned that his friend's grandfather was giving him an SUV.  I told him that someday he'd be happy that we didn't do that.  I explained that he'd understand when he experienced the joy of buying a car with money he earned himself.  When people are given to much, nothing is ever enough after a while. Well, he didn't look like he believed me, but he went and bought a monster stereo system that occupied the entire trunk and boomed his way up the street every evening.  He made lemonade with what he initially considered a lemon. Thank goodness our neighbors were tolerant.  I was happy when he told me a few years later that he understood what I meant.  He was happy with very little while he was in college, while his friends who had been given so much, never seemed satisfied or content. Now that he's graduated and earning a paycheck, he has a healthy respect for saving money, and enjoys the things he buys for himself.  It's the same way with leading staff.   You can rob them of satisfaction, by doing things they could learn to accomplish themselves.  Trust them, know when to push and when to pull, and be there to guide them.  Set expectations and hold them accountable.  They may squirm at first and you may itch to "just do it", but there will be great pride when they succeed, for all of you.
    Next, I'll write about our homework for the next month.  Listening.  How will I ever shut up long enough to do that?  

The Way You Make Me Feel

    I've been writing about my favorite restaurants, and what makes them so great, quite a bit lately.  Now I want to write about one of my favorite shops.  Rabbit & Company!  It makes me smile just to think about it.  That's what it's all about, creating pleasant anticipation in your customers, clients or patients.    Why do I love Rabbit & Company so much?  It's a wonderful specialty cooking shop owned by the delightful Katy Kistler.  Let's start with Katy.  She's a little southern mensch.  When you walk in you feel like she's just been waiting for you to arrive.  When she sees you her face lights up and her whole body just says she's thrilled to see you.  If she's talking to someone else, she'll very naturally work you into that conversation.  She remembers everything you tell her and will ask about it the next time she sees you.  But, the thing that makes it all very genuine is her interest in you.  She asks about you, she listens and she responds with warmth, delight, laughter or commiseration.  She basically draws you in to the warmth of her shop and her own personality and makes you a part of it all.    Now, how in the world does she create all that warmth in a building that, if empty, would resemble a warehouse?  Well, of course, there's Katy, greeting you as you walk in.  Then there are the thoughtful displays that grab your attention and make you want to investigate.  Everything is wonderful, I'm not exaggerating.  She uses her space wisely and pays attention to detail.  Nothing is ever out of place, yet you feel invited to pick things up and examine them.  Everywhere you turn, there's something you haven't seen before.   Katy knows her stuff, too.  She can tell you about everything she sells and usually has some funny or interesting experience to go along with it.  I recently bought a mandolin and she strongly warned me about being careful, lest I lose a fingertip.  She then went on to tell me about a customer that I know that did just that.  I left with the promise to always use the pusher thing and then saw the fingertipless individual in the grocery store.  I smiled and said, "I just bought a mandolin."  He laughed and said, "Katy told you, didn't she?"  She creates community from her little corner of town.  That creates goodwill and good feeling toward her business.  It makes me feel a little smug about being known in Rabbit & Company. 
    Ok, so what does this have to do with dental practices, you may wonder?  Everything.  Let's look at the reasons that Rabbit & Company makes me feel so great.  First, there's Katy herself.  Imagine if a patient walks into your practice anticipating the great feeling she knows is waiting for her inside.  Each and every team member is responsible for creating that feeling.  It can't just be the front desk person, everyone has to carry it through or it will die with the first grumpy face or careless greeting.  It has to be consistent or it will feel phony.  Every time, every person.  Once you get past the greeting, there has to be interest in the patient.  Talk about yourself a little, but talk and ask about them a lot.  Give advice, it shows you really care.  Follow up later if warranted.  Draw them in with warmth, concern and your personality.    Develop your skill.  Develop your personality.  Check your and your team's attitude and appearance.  Nothing makes me feel worse than a healthcare provider that doesn't seem to care.  Sometimes it seems that people in health care think that seeming indifferent makes them come across as competent.  It just really makes them seem uncaring.  Have you ever had someone prepare to take blood from you who acted nonchalant and flat?  You're sitting there anxious and dreading it and for them it's business as usual.  That may well be the case, but if they just acted like they cared about your experience it would change everything.  Next time your preparing a patient for extraction, try to think about what they may be feeling and thinking.  I guarantee, from personal experience, it's anything but business as usual.  They are feeling loss, fear and anticipation of pain.  Let them know you understand and support them.  That's how you create the magic that Katy creates in her shop.  That's wrapping your arms around them and bringing them into a warm, comfortable place where they feel like someone cares and is for them.  Know your stuff, just like Katy does.  If you bring a new service or product into the practice, learn everything about it.  Don't wait for instructions, do your own homework.  When you recommend something for a patient, be prepared to answer questions intelligently.

    How about the physical surroundings?  Make things cheerful and welcoming.  That adds to the anticipation.  Katy is always changing her central display and that adds to the fun.  Find some area of your office that you can create a seasonal display and keep it interesting.  I just decorated our office for fall and it adds so much warmth when patients walk in the front door.  There's nothing worse than a dental office that is just dental.  Add some interest to the decor to relax patients and make them feel that someone is trying to delight their senses as well as care for their teeth.  Light scented candles to detract from the smell of eugenol, have some items that ease the anticipation of the drill, have a good supply of up to date, interesting magazines available and offer some kind of refreshment while they are waiting.  Look around as if you are a patient entering your office and see where you could make things more cheerful and welcoming.  You'll be surprised when you look at it from their point of view.    How do you want to make your patients feel when they are coming to see you?  Do you want them to smile, the way I do when I think about going to Rabbit & Company, or do you want them to have that sinking feeling of dread that so many associate with a dental visit?  I want the Katy factor in our practice.  I want patients to smile when they think of us, just like I've smiled through this whole post thinking about Katy.  You can do it, you just have to want to do it.

Here's Rabbit & Company's info.  If you are in Hendersonville, check them out.  You'll see what I mean about Katy and find something you didn't know you needed at the same time.

124 Fourth Ave. East, Hendersonville, NC, 28792,  828-692-6100

Thoughtfulness

This is a picture that was taken of my daughter, Kim, and me last night. You may notice my beloved son-in-law, Adam, giving me devil horns. It was my husband's birthday and we'd just finished dinner.  My son, who lives in Florida, had sent a box of presents, not only for my husband, but there was something for everyone.  It was thoughtful of him, and it made us happy.  I could picture him going to the Ron Jon shop, determined to find something that each of us would enjoy.  He was doing it purely to make us happy.  He probably felt good doing it as well, and that's a side benefit of making others happy. I know he put a lot of thought into what everyone would like because he told me about his decision process and he really considered each person's likes and dislikes. 

     Funny enough, I had been thinking this post out last night after seeing this picture and this morning found Dr. Marc Cooper's newsletter on Selflessness waiting for me. Register to receive his newsletter here, it's a good one.  I realized that selflessness allows thoughtfulness, and in the end, makes room for everyone to feel good.

    My husband took this picture and sent it to Erik so he could see how happy he made us.  You guessed it, I'm sure it made Erik happy to see it.  Enough about me and my family, but can you see how this attitude of selflessness and thoughtfulness can make life in a dental practice a pleasure?  It's funny, often people tell me that my boss is lucky to have me.  I wonder why they don't realize that it's a circle.  He may be lucky to have me, but I'm lucky to work for someone as pleasant, kind and fun as him.  We are both lucky to have a team that is willing to keep improving, happy in what they do, and great to work with.  They think we are fair and generous.  We all make each others lives better at work and that benefits our patients.  It never seems to end, thankfully.  And if you think we aren't better friends, wives, husbands, mothers, etc. for spending our days that way, you're fooling yourself.  It has a direct impact on our lives and our day to day happiness.

    Think about the alternate reality that many offices are immersed in.  So many times you hear of offices where backstabbing, jealousy and childish games seem to be the norm.  It makes me wonder how anything ever gets done.  I'm sure that no dentist ever thinks that will be his/her reality when they are leaving dental school.  Unfortunately, for many, even as associates, that is the first, and longest hurdle they have to handle.  Sadly, sometimes they spend their entire career re-approaching that same roadblock to success and happiness.  The key is to insist on something different, and to be the one to start.

    You spent a lot of your waking hours at work.  You can choose to make them happy.  You don't need everyone else behind you at the start.  Just get going and see what happens.  What will your impact be?  The ripple effect may surprise you.  When you see a normally grumpy co-worker come in with a funny story, when your boss thanks you for a great day, when a patient says she actually looked forward to her dental appointment, you'll know it's working.  Once you've started a cycle of thoughtfulness in your own office, branch out, treat the other practices you deal with thoughtfully, too.  I realized recently how a bad encounter with another practice can cause stress, and I'm kind of thinking that's the good that came out of that experience.  I now go out of my way to be sure to ask how the person who answers the phone is doing today.  I also really feel thankful for practices who are easy to work with and who respond to requests quickly, so I tell them how great they are.  They love hearing it.  That's a thoughtful act that costs nothing and takes only seconds to perform. 

    If you want to be happier, start being thoughtful and see where that gets you.  I think you'll like where you end up.

Service Joy

“I slept and dreamed that life was joy. I awoke and saw that life was service. I acted and, behold, service was joy.” R. Tagore

I just read this quote on Twitter and it was tweeted by none other than someone I have the utmost respect for, Tom Morris.  The word service is one of those words that make people feel something.  Some feel inspired to act, but others feel almost victimized when they think of serving.  I think it helps to think about where you're coming from when you are considering serving another.

If we think of serving as something we are forced to do or have no choice about, we may feel somehow less than the person we are serving.  But, if we look at serving as something that we offer, something which is accepted from us by another, we may see the honor in that.  We are taking an ability that we have, offering it to another, and being accepted.  In the process we make their life or experience better and find meaning in our ability. 

When we serve our patients we not only affect their oral health, which in turn affects their physical health, we have the opportunity to enhance their psychological health.  In turn, when someone accepts our service, they allow us to be of use to them.  That makes us feel pride, accomplishment, and yes, joy.

Whenever a patient feels compelled to hug a staff member before leaving, you can be sure that both the staff member and the patient experience a symbiosis and pleasure in what has happened between them during the interaction.

The best thing is that this joy is available at most any time of the day, any day of the week.  It's right on the tip of your tongue, just open your mouth and say a kind word, offer good advice, thank someone else and you will inspire joy.  The power is in you.  Every moment you have the chance to give someone else what they need whether it is supporting a team member, holding a hand, or just listening.  Yes, even listening is service if it is what someone needs from you.  Allowing others to serve you is also a form of service in itself.  Sometimes people want to do something for you to gain your trust or admiration.  Having the self-discipline to accept their service, even though you could do a thing for yourself, is generous. 

If you want to experience true joy, give.  If you want to share true joy, accept what others want to give.

I've Been Enlightened

"Treat people as if they were what they ought to be and you help them to become what they are capable of being."         ~Johann Wolfgang von Goethe~

I read this the other day in Dr. Marc Cooper's Enlightened Dentist newsletter and I can't get it out of my head.  I keep asking myself, "How many times have you done just the opposite?"  In other words, how many times have I thought about a staff members shortfall in performance rather than their potential.  More than a few times, my boss and I have resigned ourselves to accepting less than we'd like from an employee and decided that changing would be too difficult for that person.Reading Goethe's quote makes me realize that if we approach a team member as if they are already capable, they may just prove us right.  Let's think about a hygienist who is giving adequate care, but who isn't keeping up with change in the profession.  We can fall back on the often cited possibility that she's burned out and not interested in what's new out there.  Or we can subscribe to a few hygiene publications, bookmark a link to www.perio.org on a computer that she has access to, and sign her up for a hands-on perio course.  Then, we can approach her as a professional who will be just the right person to research, document and present the dentist and office manager with a plan to update the office hygiene and perio program. 

Which is going to benefit the practice, patients and employee more?  I think that a lot of times we are detoured by resentment.  Let's face it, if you're bothering to find and read this weblog, you care about your practice.  I am always amazed at the emails and comments I get from professionals who read this weblog.  They obviously care, not only about their practice, but about the teams they are building.  Often, it is hard for people like us to accept that others don't share our enthusiasm.  We are looking at things from our experience and point of view when we do that, not theirs. 
We may be making a fundamental attribution error, as stated in Overcoming the Five Dysfunctions of a Team by Patrick Lencioni.  That is when we assume that others do negative things because of their character, while we explain our own negative behaviors as being caused by something environmental.  We may assume that an employee was late to work because they're lazy or uncaring, but only a natural disaster could make us late.  Getting back to my point about restentment.  Every now and then I catch myself wondering why I should care, run myself ragged trying to help an employee, etc., when they don't seem to be making an effort.  If I assume that they don't care, and approach them from that mental attitude, I'll probably get just what I'm assuming I'll get.  But, if I approach them as a capable, caring team member; one who I'm counting on and have confidence in, I just might get that instead.

Let's face it, we really don't know what other people are capable of becoming.  We'll never find out if we assume they don't care, assume they won't, or can't change, or if we give up on them.  Sometimes, by considering the growth that others are capable of and leading them to it, we find our own path for growth as well.  After all, isn't the former thinking stagnating for us as managers, too?  Got Enlightenment?

*Sorry about the differences in font sizes.  Typepad seems to be having technical difficulties today.

You Don't Have To Sell Dentistry...

    ...when you enlighten your patients.  I've always hated the way the suggestion of selling dentistry sounds.  Dentistry is not a commodity, rather it is a healing art.  Healing your mouth heals your body as well.  If you have ever watched a skilled dentist hold a handpiece as he works, you get the impression that he is holding a paintbrush.  An excellent dentist doesn't just fill a tooth, he restores it to health.  He doesn't just place a composite, he sculpts it until it disappears into the rest of the tooth.  Just like an understanding of art leads to an appreciation of it, and a desire for it, understanding the benefits of dental care and recognizing that there is a difference between filling a tooth and restoring that same tooth will lead patients to a desire for good oral health.

    There are lots of psychological techniques designed to make anyone want anything.  So many times we think if we could just own a certain item, we'd be happy. The problem is, that kind of happiness isn't very long-lasting.  You don't need techniques, when you teach your patients about how good oral health enhances their feeling about themself and improves their overall health.   I can tell you that there is a relief in having good health.  If you can talk to your patients in a way that leads them to an understanding of their conditions, their thoughts or circumstances that block them from accepting or attaining good oral health, and show them solutions that can help them, you will enlighten them to possibilities that can change their lives.    The way to do that is to listen first.  Ask questions that create opportunities for them to tell you about their fears, their limitations in budget, time or courage, and their misconceptions about their own oral health and what dentistry can offer them.  Make them think about what they accept as normal.  Gobs of denture adhesive, drinking warm soda so their teeth don't hurt, smiling with their lips closed because they're embarrassed of their smile?  It doesn't have to be that way, but so many people have just resigned themselves to living like that. 
    It's a great feeling to know you've opened a patient's mind to thinking about their oral health in a new way.  I don't think it would feel as good to sell someone on treatment because you've made them feel pressured or ashamed.  We recently saw a senior patient whose 5 unit bridge had failed.  No matter how you look at it, that's a disaster and an expensive disaster to fix.  We explained his options which included a removable appliance or an implant supported bridge along with some splinted crowns on teeth that were salvagable.  He went home to consider his decision and called me the next day.  I was delighted to hear his response.  He said, "You once told me it wasn't how many years I have left to live, but how I want to live those years.  I don't want to live the rest of my life taking my teeth out at night.  I want to go for the implant bridge."  I was happy to hear that something I'd said gave our patient a new, more open way to consider his choice. 

    When you ask your patient questions that help them understand their choices and preferences you'll never have to "sell" dentistry.  They'll never walk away wondering who made their choice, them or you.  They will be grateful, feel a part of the process and in the end, feel great satisfaction with the results of their decision.

That Explains It!

"The rule is perfect: in all matters of opinion our adversaries are insane."

                                                    ~Mark Twain~

    That explains the nonsense we've been dealing with from the specialist's office I wrote about last week.  It's as good an excuse as any since it seems like they would like to keep it current, and that seems insane to me.  I got a call from their office manager today and she started out sounding like nothing ever happened.  "Works for me" I thought to myself.  The pleasantries didn't last long, however, before the end of the short conversation she managed to work in at least 3 contentious comments.  

    I'll be honest, my knee-jerk reaction was to give as bad as I got.  I'm happy to report that something wise fought it's way to the surface and overrode that initial temptation.  Something inside me just whispered, "Nah, don't do it, let her be a jerk all by herself."  Let me tell you, I grew up in Brooklyn, NY with 2 brothers.  Smackdowns come easily and I could have left her wondering what ever possessed  her to mess with a city kid.  It was infinitely more satisfying to behave like a grown-up.  Maybe I'm getting old or something, but it was.  That brings me full circle around to one of my favorite ideas from The Success Principles:  E  (event) + R (reaction) = O (outcome).  In this situation the aggressive event was met with a neutral reaction, resulting in a neutral outcome.  Do you see how the neutral reaction always gives you control of an outcome?  Same with a positive reaction, except a positive reaction has the bonus possibility of bringing about a positive outcome.  Only negative begets more negative.  Do you see the freedom that offers you?  It's like a get out of jail free card.  You always have it at your disposal.

    So, is this other office our adversary?  Only if we choose to allow them to be.  Isn't that something?  They can't be our adversaries without our permission.  If we choose to continue to be positive or neutral, we drive the relationship.  They can try to grab the wheel and steer us down a dead end, but we can determine to stay the course.  No helplessness, no victimhood, no poor us.  Yeah, I like the way that explains it.

Well Seasoned Service

    I really want to continue to focus on service for a while.  After all, in this time of economic unhappiness, it may be the only thing that sets us apart.  Good service will surely be a bright spot in a stressful day and an often unexpected but very welcome pleasure in the midst of a growing tendency toward casual inattentiveness on the part of service providers.

    It seems that some people don't even realize they are supposed to be providing service.  Fortunately there are others out there who knock themselves out providing fabulous service.  In my enthusiasm for praising 131 Main, I almost took the excellent care I receive at Rezaz  in Asheville, for granted.  I say care because the kindness with which our last server attended to us goes beyond the duty of service.  Let me tell you why.  I had just sat down to dinner with my husband and was happy to be in one of my very favortie restaurants.  I was wearing a new necklace and caught it on the table and broke it.  Since I felt that the necklace made my outfit I was pretty unhappy.  As my sweetie-pie husband struggled to fix it with no luck, our server came to take our order.  Well, I was too wrapped up in the necklace disaster to think about the menu and he patiently waited until I was past the disaster.  Now I'm sure he wanted to move on because undoubtedly that table was booked all through the night, but he acted like he had all the time in the world.    When I finally got over my obsession with the darn necklace, which breaks every time I wear it by the way, he came back to take our drink order.  Since I'm am somewhat on a diet, I asked if the bartender could make me a Skinny Girl Margarita.  He was sure the bartender would be happy to try.  I was delighted to look up from my first sip to see the bartender watching.  He gave me a questioning look and a tentative thumbs up which I happily returned.  I've been in other places where they won't even try, but this guy not only made it, he really cared about whether I liked it.  So, they've got it all figured out.  Great food, fantastic funky atmosphere, personable, caring service, what more could I want?  Well, I could want to get in to their Argentinian Wine Tasting but we were too late, not surprisingly they are sold out already.  I'll just have to react faster next time.

    So you're probably thinking, what's this got to do with dentistry?  Nothing, it has to do with service and service is important in all areas of life.  Money doesn't have to change hands to make service important.  Think about the difference that could be made in a life when someone shows genuine human caring.  Whether it's in a soup kitchen, a homeless shelter, Buckingham Palace, the White House, or your own home, doing something with care for another makes an impact and affects how they will treat the next person.  Service is good.  Adding care to that same service in the seasoning that makes it memorable and important.  I'm going to continue talking about great and not so great service I receive around town because I'd love to see Hendersonville become known as the little town with great, caring service. 

Let's Get Engaged

    How many times have you wondered why your team or employees just don't seem as excited about work as you do?  Yeesh, even reading that sentence makes me realize I may be a bit of a dork.  I really do get excited about what I do.  Most people seem to be resigned to work as a rat race, though.  A lot of times we think that if we can just hire someone with the "right work ethic", the right character traits, or even (sure, blame it on the mother), the right upbringing, we'll have the committed, selfless, engaged star that we're looking for.  And we'll all live happily ever after. 

    So, enough fairy tales, engagement takes effort.  The effort initially must come from the leader, be it a manager, owner, or both.  We have to get people interested, excited and motivated.  We have to show them the value in the work we are asking them to do, the value in presenting themselves the way we want them to, and the value in serving our patients the way we are asking them to.   We hire people because we feel they have what we are looking for in a certain position.  Often, when we are interviewing people we notice their appearance first.  We notice that they took care in dressing for the interview, or that they appear messy or unkempt.  Realize, that in our mind we have a tally sheet with a plus column and a minus column and we've just put a check mark on one side or the other.  The next thing is the expression on their face.  Are they pleasant and approachable, or are they unfriendly looking?  Check.  As we go through the interview the check marks keep adding up and we make our decision based on that.  But, have we really been able to get to the heart of things?  Have we found out what makes them feel passionate about their work?  What engages them?  Probably not, because most people are saying what they think you want to hear so that you will hire them.  You usually don't get into the reality of how they will work until you're actually there working with them.    Ok, so I said I get excited about what I do.  That's true, but then again, not always.  I don't love everything I do, but I love a lot of it.  I hate cleaning the plaster trap, but I do it once every six months and only start remembering how much I hate it when I realize it's time to do it again.  I hate when someone forgets to put an appointment on the schedule and a patient shows up with their appointment card that says they're supposed to be there.  That's not fun at all, but it's an important time for me to be able to engage and use whatever strengths I possess to make that situation turn out positively.  Now, that's what I love.  I consider it a save.  So, I have to deal with something I hate, to do something I love. 

    How about our team members?  Can we see that happening for them, too.  I'm sure our hygienist doesn't love plowing through a lot of tartar, plaque, and still identifiable food in some cases, to clean a patient's teeth.  She may feel some satisfaciton in educating the patient on oral hygiene techniques and home care (at least the first time or two), but I bet she gets her passion from seeing that patient come in six months later with a cleaner mouth.  Hearing the patient say that they took her concern to heart and are happy they did because they feel so much better would make her see the value in her effort and feel passionate about her work.  So, how do we keep that end in mind when she is feeling discouraged or unmotivated because she seems to be cleaning the same junk off everyone's teeth over and over again?  Engage her in tracking her and her patient's progress.  Set up measurable criteria for her to look for in her patient's home care progress, in what treatment she is able to educate them about and help them accept, and in the value she adds to the practice as a whole when patients are understanding how the health of their teeth affects their overall health.  Keep reminding her of the patients who have benefitted from her care.  In other words, engage her in the practice completely, not just as a part of the hygiene department.

    It's the same for other team members.  Find out what they really love about their job and help them see how the parts they don't love may be a necessary evil to deal with so that they can get to the good stuff.  In other words, engage with your team so that you know what gets them excited.  Find out what would make them feel like you do about your job.  Let them know that you are just as interested in what they don't like as in what they do like.  Make it safe to say, "I hate this part of my job."  You may find that they don't really need to be the person doing that part of the job.  Someone else may just love the challenge.  Remember how I said I like to fix the situation with the patient whose appointment was placed on the schedule?  The rest of the staff turns to me with an endearing look of hope and expectation on their faces when this happens (which, thankfully, is rarely), and I feel like a hero.  Now, come on, who wouldn't love that feeling?  What they are really feeling is trust in me, and knowing that they and my boss trust me to make things go right makes me really passionate about what I do.  For me,that trust from them and our patients is one of the things that keeps me engaged and excited about what I do. 

    Think about sitting down with one of your team members this week and finding out what she loves, what she doesn't like so much and what she thinks she can bring to the practice that she's not getting a chance to use much right now.  You might just find that you have a lot more in that employee than you realized and you will have a new level of engagement with that staff member between she and you and she and the practice. Next week do it with another staff member and keep doing it until you've talked to everyone.  Then keep doing it every now and then.  So, what are you waiting for, doesn't everyone want to get engaged?

Mastery of Office Management

    I've been lucky enough to have been asked to participate in Dr. Marc Cooper's Mastery of Office Management program.  We had our introductory call tonight and I'm excited to see that there is an energetic, interesting group of managers that seem to deal with the same issues I face.  That made me realize that many of the experiences of an office manager are universal. 

    It sounds like the program is going to help us learn how to manage up (or gain influence with the doctor), manage down (gain influence with the staff) and manage ourselves. 
    I find that often, managers tend to be very progressive, always wanting to keep moving forward.  Just as often, we can be stymied by the people around us who are probably thinking, "Can't we just take a break for a while?  Aren't we good enough already?"  I have a feeling that the answer will be forthcoming. 

    This course feels like a support system, a place to get another point of view, support and even some empathy.  I hope that's what this blog provides for all of you, too.  I know how important that can be because as I listened to the other participants talk about what they hoped to get out of the program, I found myself breathing a sigh of relief.  I'm excited about it and I'll report back here on our monthly conference calls.

I Don't Blame You

    Have you ever noticed how hard it can be to get your message across when you are trying to tell a staff member that something needs to be done better or differently?  Basically, people almost automatically assume that if something is wrong, it only stands to reason that someone is going to get blamed.  It's a knee jerk reaction that stands in the way of getting to a solution. 

    I recently decided to talk about blame at a staff meeting.  As I was saying that just because I may need to tell someone that there is a problem with something, it doesn't mean that I am placing blame on them, so they don't need to feel defensive, one person started defending herself for being defensive earlier that day.  When I told her that she was proving my point, she defended herself about that.  No matter what I responded, she defended.  After about 10 minutes of that, with the staff quietly observing, I asked her what solution she felt we had reached.  She thought for a moment and then began defending herself for not getting to a solution.  I stopped her and asked her if she could even identify the problem at that point.  You got it, she couldn't. 
    I reminded everyone that the original issue was about the futility of blame.  The staff member said, "Well, I guess I proved your point, didn't I?"  I couldn't have paid her to have proved it more thoroughly.  Blame is useless.  When a problem arises, I immediately want to find a solution, especially if it involves a patient.  That doesn't mean I don't want to understand why the problem occured, of course I do.  Understanding is not blaming.  If people know they are not going to be blamed, they will be much more likely to admit to mistakes so that you can help find a solution or teach them how to do the thing right. 

    Blame misplaces focus.  The focus should be on solutions when problems arise.  As managers, we have to be careful not to automatically fall into blame mode when something goes wrong.  Examine your feelings the next time a problem arises at work.  Do you feel like you need to find someone to blame so that no one thinks you messed up?  Are you reacting in anger and placing the blame on someone in an effort to get the spotlight off of you?  Blaming and shaming have long-lasting effects.  So do supporting and teaching.  Which makes more sense to you?

What Makes You Unique?

    I was walking my dog Lucy and an airplane flew overhead.  Whenever that happens Lucy stops, looks up and watches until the plane is out of sight.  I think that makes her unique.  I've never seen a dog do that before.  She has a lot of things that make her unique.   She is the shyest dog I've ever owned, she's the only dog I've had that must bury her bones, every one of them.  She is also the sweetest, most gentle dog I've ever had.  She also passes the most wicked gas of any dog I've ever known.  That is something that sets her apart in a way I don't admire very much.  But, all of her good unique qualities make putting up with the gas, worth it.

    That got me thinking about what makes employees unique.  I decided to start with myself and I realized that some of the things that I think make me unique have been admired by some employers and co-workers and disliked by others.  For instance, I really have a need to understand why things happen and why people do what they do and feel how they feel.  That used to drive a former boss up the wall.   He hated it so much that it often made for some tense and hurtful conversations.  My present boss thinks it's an asset.  I tend to be a very hard worker who rarely misses work.  Former co-workers didn't love that about me, but my present co-workers count on it.  I talk a lot and have a wide-ranging sense of humor which causes my boss and I to really have a lot of fun most days.  Other bosses thought I was too much some days.  Frankly, I know I am, but sometimes it seems to just burst forth.  Hopefully, like Lucy's gas, my good assets make that worth putting up with.
    When I look at my co-workers I see the same thing.  They all have a lot of positive unique characteristics and a few that are not so enjoyable.  I also notice that some of the things that irk me, don't bother anyone else and vice versa.  What this tells me is that we have to make our uniqueness work for all concerned.  We have to find the place that our good unique qualities override our "gas." 
    A hygienist sent me an email today about some things she is struggling with in her job.  To be honest, her workplace is dysfunctional for her because her uniquely good qualities aren't appreciated and the uniquely dysfunctional qualities of the office she's in are making her miserable.  She needs to find an office in which her unique goodness works.  Days and weeks turn into years quicker than we realize.  Staying in a situation that never changes for the better will never be good for anyone.  Once those years pass, it is painful to realize that you could have found your uniquely good fit. 

    I feel fortunate to be in a uniquely perfect work position.  It really couldn't be better.  I work with a happy boss, nice co-workers, and for the most part, take care of wonderful patients.  I then go home to a uniquely great family life.  Yes, my kids are grown, but they're wonderful and I know how lucky we are.  Take a look at yourself and your life.  What makes you and your life uniquely wonderful?  Can you improve it?  What would it take?  What would you gain by doing that?  What would you lose by not trying?  Does the good make up for the gas?

Oh, Trust Me

Really listening and suspending one's own judgment is necessary in order to understand other people on their own terms... This is a process that requires trust and builds trust.                    ~Mary Field Belenky~

    How many times have you been in a relationship in which you felt like you'd developed a firm feeling of trust in the other person, only to find yourself feeling betrayed by them?  So many relationships in life seem to be based on a high degree of trust.  Your relationship with your spouse, your parents, your children, your friends, your co-workers, your boss...the list goes on and on.  You feel so sure you know the other person and that they understand what's important to you. 

    The problem is, a lot of what builds trust for you may seem perfectly reasonable and obvious, but the other person may not have a clue of how strongly you feel about it.  A lot of times when we are doing something, we just aren't clearly thinking about how someone else may be affected by it or feel about it.  We are full of expectations and beliefs that are as different from person to person as one snowflake from another.  What seems crucial to you, might seem inconsequential to the next person.  Can we really say which person is more right or rational?

    Trouble begins when we react immediately to what we perceive to be a callous disregard of our feelings, when it may really truly be a lack of awareness of the magnitude of importance a matter has for you.  More time is wasted, and problems instigated, by a rush to judgment, rather than a desire to understand.  When we immediately react with anger or hurt feelings we wipe out an opportunity to gain greater understanding, or to resolve a difference of style.  Rather we can rapidly escalate what may be a poor decision into an evil act of betrayal or careless inconsideration.

    What's the solution?  Wait a minute.  Really, 60 seconds can give you the chance to slow your heart rate and allow a few generous thoughts to germinate.  Wait 60 seconds more and those thoughts may take root and allow you to approach the situation from a more positive place.  You usually get what you're looking for in a conflict.  If you want to have a fight, you'll probably find one.  If you want peace, you will approach the other person amiably and usually find a peaceful solution.  You can let someone know where you're coming from, allow them to understand why would have liked to see a situation handled differently, without making them wrong or bad.  When you do that, it's likely that when that situation arises again, the other person will go out of their way to make it turn out right. 

    When you listen, rather than accuse you also save yourself from making yourself look silly.  How many times have you been absolutely certain someone deliberately disregarded your feelings, only to find out they really meant no harm at all.  If you had just asked, really wanting to hear what they were thinking, you could have saved both of you so much stress and hurt feelings.  Someone has to trust first, and by trusting, they increase trust for everyone involved.  When trust is consistently developed in a dental team, the culture of the practice becomes peaceful, supportive and caring.  Each aspect grows from the initial trust and the benefit is felt by the team and the patients.  How much trust do you have in your practice?  Can you begin to increase the level of trust between the members of your team?  What would you do to make that happen?

                                   

The Gratitude Campaign

I was talking to my friend Diane the other evening and my heart hurts for her. Her 20 year old son, Gavin, has just been deployed. She's not sure if he'll end up in Iraq or Afghanistan. She's holding it together like she always does, and she's had plenty of practice. She's had many challenges in her life, but in the last few years she's really had to be strong. When I think of the many times I see a military person in the airport or anywhere and I've wanted to say, "Thank you for sacrificing your time and your safety to help keep the rest of us safe." and I didn't, I wonder why. It's awkward, I guess. You don't know how they'll react, maybe. Well, after watching the following video from YouTube, I think I'll be doing something. I may not use the gesture they are showing, but I will find the nerve to speak up. In the meantime, thank you Gavin for risking it all, and thank you Don and Diane for raising that brave young man.

You Don't Say

    Ok, so I'm over the weird episode with the specialist's office last week, sort of.  No really, it'll be a gnat at the back of my brain whenever I deal with them, but hey, that's life.  What have I learned from that episode?  Good communication is the responsibility of the participant who most wants to go forth productively.  In other words, if you want to break free of the trap of immaturity, insidious nastiness, and useless blaming and defaming, if you want to move forward positively, you must make the decision to cut the crap and say, "Enough."

    There are many ways to verbally express yourself and just as many reasons.  Some folks just love the sound of their own voice.  They love to sing their own praises, or pontificate on some subject on which they feel they have some unique and amazing viewpoints.  (I know I've been guilty of pontificating.  I know it for sure because the truth is, you can hear yourself when you're doing it, you know you can, and honestly, you think you sound amazing at the time.)  Ok, enough of my confessions.  Some people love banter, my boss and I are full of banter, hopefully our patients enjoy it as much as we do.  Some people just love the give and take.  But, for some, putting someone else down, makes them feel better about themself. 

    Knowing this, there are choices to make.  Sometimes there is strength in the spoken word.  Sometimes, the ability to remain quiet is where real strength of character can be found.  And sometimes, the only way to end an out of control, spinning in circles argument is to simply and gracefully, step away.  It's so effective, because once you stop participating, there's no where left to go with it.  Now, if you can find it in yourself to agree to just move on in cooperation, you'll have the satisfaction of having done the right thing.  Even though it may seem like there would be a lot of satisfaction in shooting off the perfect come-back or having the last word, sometimes what you don't say is infinitely more powerful than a stunning rebuttal.