Exceptional Dental Practice Management

The ADAA Creed - Cooperation

"To be a co-worker – creating a spirit of cooperation and friendliness rather than one of fault-finding and criticism."

Why does something that sounds so simple, straightforward, and positive, often seem so hard to do?  I think that we all have former experiences that have taught us that many times, people just don't do what they should do.  We've all been hurt when we've tried to be open and honest, so we go to the next situation a little more guarded and wary.  Get hurt again and the armor gets a little more heavily reinforced.  Why, then, do some people seem to remain open and trusting?  They've done the work it takes to understand the difference between what you have control over and what you have no control over.

For instance, you have no control over a co-worker who slacks off behind the scenes, but always appears busy whenever the doctor or manager is around.  Left unchecked our mind will spin quite a tale.  "Look at her, she's just trying to make it look like she's a hard worker.  She thinks she has him fooled.  And look at him, he has no clue.  He just walks around with blinders on."  Well, how do you feel after all that?  Not very cooperative or friendly, I imagine. And the kicker is, you can never really know if the story you're telling yourself is even true.  You're better off doing what you feel you should be doing and not worrying about fairness or the motives of others.  Approach co-workers with cooperation as a goal and don't let anyone dissuade you from that intention.  If a co-worker doesn't share that ideal, you can't change them, you can only choose to do the right thing yourself.

Always look for ways to serve.  By serving your patients and your co-workers you create goodwill for yourself and the practice.  This will lead to increased satisfaction for you in your career. When you see someone struggling, help them.  Don't worry about who gets the credit or who will know you helped.  You know you helped and so does the other person.  Remember the goal is patient service and satisfaction.  Helping someone else learn how to do something better, or giving them a hand when they are having difficulty will make them feel camaraderie with you and enhance the culture in the practice.

Fault-finding and criticizing is ugly and serves no one.  Don't criticize, advise.  Criticism takes something away, advise contributes.  People like to be around people who make them feel good.  I have a friend who works in our local oral surgeon's office.  I worked with her about 10 years ago and she brings a special light everywhere she goes.  When anyone sees her coming, they light up.  Everyone wants her attention to settle on them, even for a minute.  My boss is like that, too.  He enjoys everyone and they feel it.  He lifts spirits and causes smiles.  These two people enhance their workplaces.  You can be that person in your office.  To some people, like the two I mentioned, it seems to come naturally.  The rest of us may need to work on it, but it's worth the effort.

The ADAA Creed - Make the Most of Your Career

"To be prepared to visualize, take advantage of, and fulfill the opportunities of my calling."                 ~Juliette Southard~

This is a part of the ADAA Creed that can make the difference between developing a satisfying, rewarding career, or being stuck in a go-nowhere job.  In the end, it will also affect the future of professional dental assisting.

An assistant who visualizes the opportunities of assisting will pursue education for herself.  She will then bring that knowledge to her patients and co-workers.  She will visualize ways that she can use the knowledge she gains to improve service to the patients, thereby helping improve the practice.  She can see how things can be better and share her ideas with everyone else.  She will seek out opportunities to grow through on-line forums, publications and continuing education classes.  She can see that by bringing more to the practice she increases her value to the practice and will be given more responsibility.  She will not see that responsibility as an added burden, rather she will enjoy the variety that it adds to her day.  She will understand that being trusted with greater responsibility is an honor and an acknowledgment of her efforts.

As she grows in her career, she will realize that other opportunities will open up for her.  She can use her knowledge and experience to mentor new assistants.  She can reach out by writing journal articles herself, participating as a member or officer of the ADAA, or speaking and consulting, growing into a management position etc.  The opportunities multiply as the assistant develops herself within her profession.  Once an assistant and a dentist begin to visualize the possibilities of what she can offer the practice, fulfilling that promise is an easy goal to visualize and pursue. 

When assistants take advantage of the opportunities that assisting offers, and take pride in providing good service, they help not only themselves and their practice, they help the profession of dental assisting.

The ADAA Creed - Initiative

"To develop initiative– having the courage to assume responsibility and the imagination to create ideas and develop them."

Juliette Southard was right.  It is important for everyone in a dental practice to take initiative.  Taking initiative builds confidence, both in the dentist toward the assistant, and in the assistant herself.  Courage is needed because sometimes taking initiative means making mistakes.  This means that the assistant must be well trained and able to make decisions based on what she has learned about the dentist's preferences.  Good, clear, consistent communication will ensure that the assistant and dentist will develop the confidence needed to give good care to their patients and will keep the practice running smoothly.  When I work with a new staff member I remind them that mistakes are really learning opportunities.  Most mistakes can be fixed and they provide me with a chance to see how the employee reacts under stress and what kind of problem solving skills they have.  It also gives the staff member the ability to see that if they make a mistake, they can fix it and we won't disown them. 

We recently spent a lot of time discussing accountability, which is what Juliette is referring to when she talks about assuming responsibility.  It means making a decision or choice and standing behind it.  If it turns out to be a mistake, own it.  Don't make excuses, just state the facts and try to offer a solution.  Allow the issue to be discussed at a staff meeting so that everyone can learn from it and offer their own solutions.  Managers and dentists, don't make it a blame or shame issue.  Make it a learning process, respond with kindness, no one comes to work to do a bad job.  Let your employees see that you will support them, even when they make a mistake because you believe in them.  It will empower them to take initiative.

Encourage employees to offer their ideas.  Assistants, try to look at everything in the practice and figure out how it could be done better.  Could you find a way to greet patients more warmly, set the room up for more efficiency, develop protocols that make it possible for anyone to help if you're not there, etc.?  Don't be satisfied with just good enough to get by.  Knowing that perfection is elusive, strive for excellence.  Try to make your practice stand out from all the others.  Don't just come up with the ideas, be prepared to implement them.  Participate in staff meetings and help create interest and excitement in the working of the practice.  Don't just be an observer, get in there and make things happen.  That makes you an outstanding assistant.

The ADAA Creed - Loyalty

"To be loyal to my employer, my calling and myself."

This is the first line of Juliette Southard's creed for dental assistant's.  What does it mean to be loyal to your employer?  It means realizing that no one is perfect, and accepting your boss for his/her attributes as well as their failings.  When you accept employment, you must understand that there is trust being extended.  You will see your employer at their best and feel pride.  You will also see them when they are frustrated, anxious, grouchy, embarrassed, and scared.  Yes, dentists get frightened when a patient becomes accusatory, has a health crisis in the chair, or when they realize they have gotten in over their head and don't know what to do next.  I've seen it in dentists in all phases of their careers.  They are human, just like you and I.  The difference is that their profession puts them in a position to affect the health, quality of life, and even life itself of the patients they treat every day.  That underlying pressure and awareness is always there.

As humans, they hope for compassion and understanding.  They want their assistant to be their biggest fan and ally.  They hope that she will offer support, confidence in their ability, encouragement. When something does happen that is embarrassing or uncomfortable for the dentist, she should be counted on for her discretion and ability to move things past the awkwardness toward normalcy again.  When the dental assistant talks about her boss to others, within or out of the office, it should be with admiration for his abilities and attributes.  The way she talks about her boss should make others wish they worked for him, or want to become his patient.  When these hopes become a reality, hope turns into trust.

How can you be loyal to your calling?  First, how many dental assistants truly feel called to assisting?  Back when I began in 1977, I was out of high school for two years, had gone to college for medical lab tech and realized after one semester that it wasn't for me, and I began working in the account department of a bank in a job I disliked.  I would pass the Bryman School for Dental Assisting twice a day as I drove to and from work.  I don't know if I was called at that time, but it seemed like it would be interesting.  I loved it and knew that it was something I could get excited about.  After staying home, raising my children for 14 years, I thought about what I would like to do now that I was ready to go back to work.  I considered other careers, but then remembered how much I enjoyed assisting, so I entered an accredited program and went back to school at the age of 40.  After graduating I passed the DANB certification exam and began working.  Eleven years later I can truly say that dental assisting and practice management are my calling.  Being certified added credibility to me as a professional and gave my employer trust in my knowledge and ability so that he allowed me greater responsibility, which in turn gave me greater satisfaction in my career.

I would say that being loyal to myself has meant persevering through some very difficult times and believing in myself and what I was doing.  It has meant self-reflection; examining the reasons I do things, challenging my reactions and thoughts, and doing what is right for the practice and patient before being concerned for my own personal desires.  It means acting in a way that brings respect to me as an individual and to dental assisting as a profession.  It means having the maturity to mentor others who are beginning a career in assisting, teaching them how to be good assistants and holding them to standards, whether they like me for it or not.  Sooner or later, they will understand that being held responsible for themselves and their actions will make them professional dental assistants.  Finally, being loyal to myself and my profession means not looking at others in the practice and comparing myself to them.  I can only compare myself to myself every day to know if I am continuing to grow as a person and as a professional.

What Can I Do For Dental Assisting?

In 1911, Dr. Henry Fowler hired Juliette A. Southard as his dental assistant.  Articles refer to her as involved, intelligent, persuasive and a natural leader.  Ten years after beginning to work with Dr. Fowler, Juliette founded the New York Dental Assistant's Association.  Her vision was unification for all dental assistants.  Within a year she was named President of the American Dental Assistants Association.  By 1947 a certifying board was established which was responsible for testing and qualifying dental assistants for certification, thereby earning the right to use CDA after their names.  That means that for over 60 years, this certification and distinction has been available to dental assistants, yet still so many still do not pursue certification. 

I believe Juliette's purpose was to develop a profession that is looked upon with respect by all in the dental professions, as well as by the patients, and that the dental assistant would feel pride in the profession.  When I read and hear of dentists complaining that they can't find dental assistants with a good work ethic, and dental assistants complaining of lack of respect and a decent salary, I feel frustrated.  Here we had an assistant, so many years ago when assisting was a new profession,  who had the vision to see that dental assisting could become a profession in which an assistant could find a long a satisfying career, being more than just someone to sit and suction. Rather, she can be a valuable member of the clinical team and a critical asset in running a practice.  

So, why are dentists now frustrated by assistants who keep checking their text messages on their cell phone which is being kept in the pocket of their scrub jacket?  Why are assistants feeling like they need to leave assisting and go back to school in order to find a "real" job in which they feel they can be respected?  The fault lies with both the dentists and the assistants.  Dentists should demand better.  They should require certification or the willingness to pursue certification in the assistants they hire. Dentists should have a vision for their practice and share it with staff and the people they interview. When an employee performs in a way that supports that vision, the dentist should acknowledge it in a way that lets the employee know that they are proud to work with them.  They should not give up and just ignore the cell phone, the bad attitude, or lack of caring or work ethic.  They should not accept just ok because they are afraid that the next person may be even worse.  Do not settle for a bad fit because you are tired of it all and discouraged.  Yes, you may kiss a lot of frogs, but you'll end up with someone who understands what you want and who will knock themselves out trying to deliver it.

Dental assistants should take a serious look at the career they can have, and need to make an investment of themselves to uphold the work and vision that Juliette started with all those years ago.  If you want to work in a respected profession, you have to have enough respect for yourself and your profession to work for it.  Join the American Dental Assistant's Association for a start.  Get certified.  How?  Either attend an accredited program and take the DANB exam or work in a dental office for two consecutive years and take the DANB exam.  Work together with other dental assistants to gain respect for our profession.  If you are certified, encourage other assistants that you know to pursue certification and help them succeed.  When any assistant gains respect in the profession, we all gain respect, so act honorably. I've reprinted the Dental Assistant's Creed that Juliette Southard wrote all those years ago.  It still applies today.  I encourage you to reprint it and bring it to work.  Hang it in a place where you'll see it often.  Most important, try to live by it, you won't regret it.  For the next few days I'll be breaking it down and examining each section and discussing how bringing these ideas to work with us can make us better assistants and can improve and restore respect for our profession.

Her Words- The ADAA Creed

"To be loyal to my employer, my calling and myself.

To develop initiative– having the courage to assume responsibility and the imagination to create ideas and develop them.

To be prepared to visualize, take advantage of, and fulfill the opportunities of my calling.

To be a co-worker – creating a spirit of cooperation and friendliness rather than one of fault-finding and criticism.

To be enthusiastic– for therein lies the easiest way to accomplishment.

To be generous, not alone of my name but of my praise and my time.

To be tolerant with my associates, for at times I too make mistakes.

To be friendly, realizing that friendship bestows and receives happiness.

To be respectful of the other person’s viewpoint and condition.

To be systematic, believing that system makes for efficiency.

To know the value of time for both my employer and myself.

To safeguard my health, for good health is necessary for the achievement of a successful career.

To be tactful– always doing the right thing at the right time.

To be courteous– for this is the badge of good breeding.

To walk on the sunny side of the street, seeing the beautiful things in life rather than fearing the shadows.

To keep smiling always."

Juliette A. Southard- Founder of The American Dental Assistants Association.

More On Quitting

There are many ways to quit.  Dentists, how many times have you quit on your dream practice because you didn't feel your staff would commit to your vision?  Staff members, how many time have you quit trying to improve yourself, the practice you work in, or service to your patients because no one else seemed to care? 

I have seen the effects of a dentist who gave up and gave in to accepting mediocrity.  I've been a staff member who wondered whether it was worth it to care.  I persevered when it would have been easy to get by with good enough.  I know that if you find something you love to do, face challenges with strength, faith and determination, you can find success, happiness and satisfaction.  Quitting would have been easy for a minute, but a waste in the long run.  Everything has it's price.  Sometimes you pay for success by persevering through challenges.  Sometimes you pay for quitting by missing out on what might have been your dream job.  Sometimes quitting is just giving up.  At other times quitting is really finding the better path to your dream.

How many times have you as an office manager or supervisor been ready to just give up on an employee?  Maybe they don't seem to care, don't seem to have the capacity to perform the way you need them to, or the initiative to be accountable for their performance and growth.  You've had it, why should you care more than they do?   Maybe you're wrong, maybe they care, but they're lost and floundering.  You give it one more try, use a different approach and something clicks.  What feels better than finding that connection, figuring out the way to motivate, educate and inspire?  Watching them flourish and become a solid member of your team is the payoff.  What if you had given up on them?

It's only fair to be honest when someone is not performing as they should.  You know what you want from them.  Sure, it can be uncomfortable to tell someone they're not good enough right now.  But, focus on the potential if you believe it's there.  Make the conversation a little about what is wrong and a lot about what you believe they can do.  Insist on it.  If their job is on the line, tell them, it's only fair.  Sometimes they are just a little lost and you can help them find the right way to go next.  If you do all this and nothing changes, you have your answer. 

Sometimes quitting really is just accepting mediocrity.  We may think that mediocre is less harmful than outright bad, but it's just the same.  Mediocrity holds us in place and keeps the team from growing.  Pretty soon you have a whole lot of mediocrity because people will usually sink to the level of the lowest performer rather than fight to bring someone up to their level.  Accepting mediocrity might just be quitting on your practice, your team and your patients.  Suddenly mediocrity doesn't seem so benign. 

Here's how to tell when it's time to quit and when it's time to keep trying.  If someone responds to your demand for better performance and then keeps growing and improving, they're worth pushing and working with.  If someone improves for the short term, but then predictably slides back to the former level of performance they are telling you that mediocre is their comfort zone.  Letting that employee find someone who is content with that level of performance isn't quitting.  It's accepting the fact that you want more than mediocre and more than she can offer.

Watch How You Say It

    We're snowed in so I'm watching TV and an On-star commercial just came on.  That's the system that's in cars now so that if you have an accident, it's monitored and someone comes on through a speaker to see if your ok, and whether you need an ambulance.  The on-star person sounded so concerned and reassuring, and I found myself wondering if the real responders sound the same way.  Obviously, someone realized that concerned and reassuring is how someone should sound in that circumstance.  I bet they all don't really sound that way though.

    I was checking messages on the office answering machine and there was one from someone who wanted to ask my boss's opinion on something for their publication.  This person sounded like she hated what she was doing.  Her voice was monotone and almost as if she expected to be rejected.  I've noticed the same thing with a toothbrush manufacturer (who shall remain nameless) whose representatives sound anything but happy to sell you anything.  I've complained before and received an expensive toothbrush for my suffering, but nothing's changed.  They still sound unenthusiastic, and sometimes sarcastic when I call to place an order. 

    Think about how your phone is being answered in your office.  Do you just assume that your front desk assistant sounds warm and pleasant?   Don't take a chance, call your office and find out.  Have a friend call and ask some challenging questions and see how she responds.  How many times does the phone ring?  Does everyone feel comfortable answering, and are they doing it right?  I called two different offices last week and was put on hold immediately without the person who answered allowing one word to escape my lips.  Sorry, that's rude.  If your phone rings so much that your patients are put on hold upon answering, you may need a second person to help answer the phone.  The phone is your life-line to your patients.  Don't let anyone cut that line on you.

    At your next staff meeting, do some role-playing.  Staff usually hates role playing so have some Hersey's miniatures on hand to loosen everyone up a little.  Participation = candy.  Yay!  Now, pair up and have one person be a caller and one be an answerer.  Everyone else votes on whether the caller stumped the answerer, or whether the answerer kept her cool and outlasted the caller.  The winner gets extra candy.  Then, ask if anyone has ideas for how the call could have been handled better.  All idea offerers get candy, too.  The candy is just for fun and to make people less shy about role playing.  The role playing is important because it lets you see how things stand right now, and gives everyone a chance to take part in making a change. Decide how you want your phone answered and let everyone take a turn practicing.  I suggest, "Thank you for calling Dr. __________'s office, this is __________, how may I help you?" and say it with a smile.  Smiling while talking really does influence the tone of your voice.  No slouching or holding the chin in the hand either, somehow that lends a note of disinterest to the voice.  In addition, it looks unprofessional to patients in the office.   Never underestimate the power of the phone call.  Every call counts, so make sure you make the most of the opportunity the caller is giving you to impress them. 

Shake It To Pieces

"Think enthusiastically about everything; but especially about your job. If you do, you'll put a touch of glory in your life. If you love your job with enthusiasm, you'll shake it to pieces. You'll love it into greatness."

                                                    ~Norman Vincent Peale~

    We're having a snowy day here in North Carolina so I finally have time to sit down and write a post.  I've been pretty busy lately with trying to squeeze Christmas shopping and decorating in between working some pretty long hours as I'm sure the rest of you have.  I'm happy for this break in the craziness to sit down and "chat".

     At this point we have had our front desk person in place for six months and she's a keeper.  She is totally for our practice and team.  It shows in her attitude and actions.  She is honestly enthusiastic!  about our practice.  I say honestly because it's something she feels, not something she fakes.  When I say I want employees that have a heart for the practice, this is what I mean. 

    Cathy started out with the right attitude, she's wants to do whatever she does well.  She's also grateful to have a job, she was out of work for a while and knows that it's tough to get a good job now.  I have watched her enthusiasm and dedication make her fall in love with our practice, and in return, we're crazy about her.  Every day she becomes more and more vital to the well-being of the practice and of the team.  That is what enthusiasm can do for anyone.

    Enthusiasm brings positive energy to the practice.  Think about being at a morning huddle where one person just isn't them self.  They seem down and you know something is wrong, but they haven't said anything.  Notice that the mood of the rest of the team starts to sink down until everyone is sitting there somber and unlit.  Patients start to arrive and they sense it, too.  Something just isn't right.  Surely they're wondering what's going on and you can bet the mood will affect their responses to treatment or treatment suggestions.  Negativity is pervasive, but luckily, so is enthusiasm.  That's why it's so important, and can make the difference between mediocrity and greatness.  Yes, I said greatness, it's ok to want greatness for yourself, your team, and your practice, as long as the determining intention is to be great in order to gain the opportunity to provide great service to as many patients as you can.  The benefits that come to you all out of that will be well-deserved and honestly gained.

    Some people come with their enthusiasm fully lit, but others may need some help with ignition.  A lot of people get it wrong when they think about being enthusiastic.  There is a server that works at a restaurant where I really enjoy dining, unless she shows up at our table.  Her fake-iness drives me up the wall.  When she talks about the menu, it's as if she's reading it out of a child's book. It's intrusive and irritating and I pray that she will talk to us as little as possible.  On the other hand, in the same restaurant, there's a server that has a great natural enthusiasm for what he does.  When he talks about the specials, you get the feeling he's tried them and would tell you if there was something he didn't just love, but you can believe it when he says something's good.  He gives us that Cheers feeling, like we're regulars, which we are quickly becoming.

    If we want staff to be enthusiastic, we have to give them reason to be crazy about working with us.  I like new staff members to know that I will be honest with them about how they're doing, good or bad, and that I will demand great.  I will push them and teach them and talk as much as we need to.  I'll stay late, come in early, whatever it takes to light their fire, but they need to bring a few matches to the game.

    A lot of young people, and even many no so young people, have never worked in an environment in which enthusiasm was a job requirement.  Many employers have become jaded or disheartened and basically given up on getting their dream team.  I'm tenacious, I never give up.  I get tired and whine sometimes, but I claw my way back to enthusiasm and look for the great team member that's just waiting to find us or be found. 

    I can tell a lot by the way a team member responds to constructive criticism.  If I sit down with a team member and tell her that we need something different than what she's offering at the moment, but that I feel she has potential; that is usually a moment of truth.  If dead eyes stare back at me, the arms cross and the mouth says something like, "I think I'm doing a good job.", chances are that person's pilot light is out and she's not going to become a member of our team. 

        Note: employees do not become members of our team until we feel             them.  There is a defining moment when we feel their enthusiasm that         lets us know they are truly with us for the long term.  Until that they             are merely employed.

    On the other hand, if she says, "That is what I want to do.", and then I see the change I asked for; she's in to stay.  That is a sign of character, openness and maturity. 

    I think a lot of people see enthusiasm as dorkiness.  They hesitate to show true enthusiasm because when they have in the past, they been teased or considered a threat.  What I mean is this, lazy, uninspired employees don't like to see a co-worker with enthusiasm.  They want them to stop because they know it shows them up as lacking.  Rather than raise their own game, they'll try to squash the other person's attitude with ridicule.  Watch out for this in your practice because often, if no one intervenes, the enthusiastic person will move on to a practice with an atmosphere that embraces their natural enthusiastic nature.

    Norman Vincent Peale is one of my favorite authors and this quote embodies what I love about his writing.  Reading anything by him charges my enthusiasm and guides me in leading our staff.  I have been teased about my enthusiasm, but that's ok, I don't mind because I know a secret.  Here it is:  I love what I do and it's enthusiasm that drives that love, and the love, in turn, creates more enthusiasm.  I can't lose.  I've got it all figured out.  You can, too.

Check this out.

http://www.youtube.com/user/JPOL623#p/a

Communication - You Can't Get Anywhere Without It

I just read a really good article by Joshua Polansky in Dentistry IQ.  Joshua is a young dental lab technician who has been fortunate, and smart enough, to learn the value of communication very early in his career.  Fortunate, because it will add depth and pleasure to his work, as well as great satisfaction.  Smart, because many of us never learn that if it's not about the person or patient first, it's all just superficial, even success.  Read the article and you'll agree that Joshua is a very insightful guy.

As usual, I started thinking about how his ideas about communication could apply to my work as a manager and dental assistant.  So many times, I talk to our staff members and wonder if I made a difference or impact.  Reading Joshua's article made me realize that I often see these conversations as a way to get the information, correction, praise, etc. to the staff member, but does it really get in?  I wonder now if when I've walked away satisfied that I'd made my point, was it really just yadda, yadda, yadda to them.  I imagine that, in reality, my words may have just been skimming across their consciousness without ever penetrating.  And why not, if I'm not open to them, why should they be open to me? 

In my own defense, there are many times when we have a good exchange of ideas.  Joshua says that the technicians job shouldn't be thankless, and I have to admit that there are times that I feel that a manager's job is just that, thankless.  I sometimes wonder if anyone realizes the amount of thought and effort that go into managing the practice, or if anyone cares.  But, why should they?  I'm doing my job.   One thing that frustrates me is a staff member who tends to be dismissive of some of my ideas, even a little condescending.  My reaction is usually to feel annoyed and somewhat hurt.  After all, how would she like it if I belittled her work?  But, is that what she is really intending to do? And even if it is, isn't it my job to figure out how to resolve that?  Why should I expect her to think all my ideas are good?  Does she have a right to feel the way she seems to feel?  Does she have a right to be so obvious about it?  Does she even know how she's coming across to me?  Maybe a little communication could lead us to a better understanding.  Maybe even a better relationship.  At this point our relationship seems to be one of grudging tolerance.  It would sure be a lot more enjoyable to elevate it to the level of accepting tolerance.  We can work up from there.

Apply the thoughts in Joshua's article to every aspect of your work with your staff and patients and see how much more enjoyable your worklife can be.  Sometimes it's hard to remember that communication has two goals; to listen as well as to be heard, but if we want to succeed and enjoy our careers, I think we need to figure it out.