Exceptional Dental Practice Management

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.