Exceptional Dental Practice Management

Longevity Doesn't Just Happen

If you want to have lasting power, you have to work for it.  Whether it's a long, healthy life, a long happy marriage, a long satisfying career, or long, enjoyable friendships, they don't just happen, you did something to make it what it is.

So often, people find it easier to move on rather then persevere.  The longer something lasts, the more you have to work and strive to keep it going.  It's easy to get bored with people or fed up with the way things are, and it may seem easy to just walk.  The reality is, if you can try to work through problems and look at the positive aspects of a situation, you build depth, trust and respect.  Walking away may solve immediate problems, but it also results in shallow experiences. 

Barring illness or accident, people who live consciously, who exercise and eat right, tend to live longer, healthier, more productive, enjoyable lives.  Friends who work through arguments, come out stronger and more dedicated to the friendship because they put effort into it.  Employees who remain objective about their co-workers and who maintain a positive attitude tend to become highly regarded valuable employees.  Spouses who work through the hard times, and who realize that there will be ups and downs build dedication and faith into their marriage. 

Perseverance keeps you moving toward a better life.  It leads to accomplishment and fulfillment.  It builds confidence and self-esteem.  It's not always easy, but you have it in you.  Look at the situations that you want to walk away from.  Can they get better?  Can you start working toward that?  What would it take to make the effort?  What will the rewards be?  What is keeping you from taking the first step?  Are you ready?  Then get going, you can start building longevity right now.

Good Intentions - Who Paved the Road to Hell?

"No matter how full a reservoir of maxims one may possess, and no matter how good one's sentiments may be, if one has not taken advantage of every concrete opportunity to act, one's character may retain entirely unaffected for the better. With mere good intentions, hell is proverbially paved."

                                                        ~William James~

I was talking to a friend the other day who is an office manager in another practice in town.  When I asked her how things were going, she was clearly frustrated.  Everything is running smoothly in the practice, the staff is nice, the patients are satisfied, everyone gets along, and she's about to go crazy.  Well, of course my next questions was, "Why?", but I thought I knew the answer.  It's all a balancing act, and it's a tower of stuff that feels like it's perched on a tea cup on top of her head.  If she lets her shoulders relax for a minute it will all come tumbling down. ( I knew the answer because we office managers tend to take on all the responsibility in our practice.  It happens gradually because we may have tried to delegate something and it didn't work out so we decide it's easier to do it ourself.  The problem is that if it grows out of control, we soon find that we think we're the only ones that will do anything right and we build our own tower of stuff.)

She likes her staff and thinks they're all great people, but they don't think for themselves.  She is constantly running interference and jumping in to rescue everyone.  They don't accept accountability for anything out of the norm.  If something comes up that is unusual in any way, they immediately run to her rather than trying to come up with a good response.  On the other hand, when they have made decisions on their own, they haven't always been so great.  She always ends up having to step in and rescue the situation.  The doctor sees that everyone seems happy and they all get along, production is good, and that makes him feel satisfied with the way things are.  He doesn't seem to understand why she's so stressed.  At this point, not only can I see her stress, I can feel it, it's palpable.  She said that when she tried to explain her frustration to him his reply was, "I think that they are all coming from a place of good intention."  He doesn't understand why, with everything that's going well, she feels so on edge.

I do understand what she's worried about.  Sooner or later, she's going to need to let her shoulders relax and all the stuff will come tumbling down.  The problem is with the foundation, it's like an inverted pyramid, there's too much empty space on either side of the tip for it to be stable.  Starting out with good intentions is fine, but good intentions have to be fortified by determination.  That would build a solid base.  Think about a hygienist who sells her patients lot's of high fluoride toothpaste, but forgets to charge for it over and over again.  When she comes to you about it she says, "I always forget to charge for the toothpaste, I wish I could remember."  Well, her intention is good, she wants her patients to have less decay, and she would like to remember to charge, but those good intentions are not solving the problem.  The problem is she is giving away toothpaste and costing the practice money.  Her intention is not solving the problem because she has not taken every opportunity available to act differently.  She could make herself a little reminder note that she'd see before she lets the patient go, "Did you remember to charge for toothpaste?"  Or she could make a rule for herself that she cannot let go of the box until she enters the fee into the ledger.  It's not hard, it just takes determination.  It's the same with any other performance issue in the practice, if the staff member is determined to improve, she will find a way.  If she hopes to survive on good intentions, sooner or later it won't be enough.

Now, let's get back to my friend.  How much of her problem is of her own making?  Her good intention is to make the practice and team successful, I know that about her.  You can even say she's determined to make it happen, even if she has to do it herself.  Aha, maybe that's where her good intention has led her down the nicely paved path to hell?  Maybe her intention needs a few building blocks along the way.  If we return to the idea of a pyramid, a proper pyramid sits on a broad base that eventually reaches it's pinnacle.  Maybe she needs to build her base a little more by holding her team accountable for what they do and helping them find ways to improve.  She was slightly annoyed by that suggestion, after all, she is constantly trying to get them to do things the way she wants them done.  Well, what if we try to bring them into the process of solution rather then just prescribing the reactions and actions we want to see?  Maybe that's the reason they can't think for themselves, they've become accustomed to her having all the right answers.  If she asks them what they think when it comes to finding solutions, they may feel more accountable, rather than just feeling that they are carrying out orders. 

This is the way I see it.  There are positives and negatives that come along with every staff member.  If the negatives are outweighing the positives, and you've addressed it and nothing changes, the staff member won't work out.  If you have a staff that are nice, treat your patients well, are caring and get along with each other, you're way ahead of the game already.  That's the foundation you build on, that's your concrete.  Now you decide if you are going to put in the determination to take that cement and build up to a pinnacle of success, or if you are going to let good intentions build a long and winding road straight to...well, you know where that's going to end up by now, don't you?

Dumbing Down Dental Assisting

I began dental assisting in 1977.  Back then I remember that I learned something new just about every day.  Thirty-three years later, I'm still learning.  My job is vastly different than it was back then, but I've always been thinking and trying to keep a step ahead of what was going to happen next.  I was lucky, I've had some great dentists as mentors clinically, and a great philosopher in Tom Morris to keep me thinking about how to act with integrity.  Did these people just happen to come along for me, or did I seek what they had to offer?  I promise you, it's the latter.  I recognized the gifts they were willing to share and opened myself up to learning.  I read and still read, anything that will help me grow in my profession.

So, how do I see the dumbing down of dental assisting?  When I hear dentists saying they prefer their Isolite to an assistant because it doesn't talk.  When I hear dentists saying they'd just as soon hire someone from McDonald's than deal with a dental assistant with experience because he won't have to get her to do it his way.  These are signs of lax leadership, giving up, and settling.  It is keeping dental assisting at a basic level, just a superficial position in which one sucks up spit and cleans up rooms.  Thinking and anticipating become a long lost item on a wish list that the dentist comes to think of as too much to ask for.  That dentist has decided to accept mediocrity, but in doing so, he's made mediocrity a commodity.  Acceptance of mediocrity begets and attracts more mediocrity.  Mediocrity plays no part is success, so that dentist has limited himself, as well as condoning mediocrity in his employees.

What role do assistants play in the dumbing down of dental assisting?  A major role.  Dental assisting should be as much a profession as dental hygiene.  We should want to understand dentistry and work in partnership with the dentist and the team to give our patients outstanding care.  Dental assistants can develop themselves constantly and see themselves as healthcare providers.  Instead, many see dental assisting as a job.  They don't bring curiosity, don't learn why everything happens, don't engage and don't became an active and essential contributor to the success of the practice.  As long as they are doing good enough to keep from being fired, that's good enough for them.  Then they complain about salary and respect as if it is something owed, rather than something earned.

Do I feel like it's this way most of the time?  I don't know, but I think it's this way enough of the time to cause dental assistants to be looked at as less serious and less intelligent than they can be, and like many are.  I am willing to bet that other career assistants cringe when they hear assistants complain about how they are treated, but who don't do anything to make themselves deserving of better pay and greater respect.  Just saying you deserve something doesn't make it so.  If more assistants joined their local associations, joined the ADAA, became DANB certified and asked their dentists, "What do you need from me?"  "How can I improve?"  "What can I do to help the practice?", you would see the growing up of dental assisting.  Dental assisting seems to be stuck in the teenage years.  Time to grow up and develop the skill and wisdom that earn respect. 

There are many dental assistants that have seen the potential that exists for them in this profession.  People like Shannon Pace, Tina Calloway, Theresa Duncan, Gina Hegarty and many more.  People like Kevin Henry, Jen Blake and others promote assisting as a profession and work hard to give assistants pathways for growth and learning.  Dentists themselves are often very willing to teach and enjoy the mutually rewarding working relationship that can develop between a dentist and a skilled, knowledgeable assistant.

You, the assistant have to make it happen.  The scene is set, you have to take your place and apply yourself to learning and growing.  You can develop yourself personally and professionally and hold the door open for others to follow.  If reading this has made you mad, I'm sorry, it was not my intention.  On the other hand, if reading this has made you think about doing things a little differently, you've got it.  That's what I meant to do.  Go into work with renewed interest and greater vision of how you can contribute.  Talk to your boss about what you want to do and how you want to grow.  And then just do it. Begin to grow and see what happens.  Take your profession seriously.  There is a satisfying, rewarding career waiting for you in the profession of dental assisting.

Do You Know If They Know What Their Job Is?

I know it's an awkward title, but it's an awkward situation, too.  Many times, employees don't really know exactly what is expected of them.  We may think they do, we may feel we were clear when we trained them, they've got a job description, so why does Cindy seemed so surprised when you ask her why she isn't doing something that you consider a routine part of her job?  Well, just because you're clear on it, doesn't mean she is.  Don't get frustrated, figure out what she doesn't get.  Then, don't try to make her get it the way you would get it, figure out what she needs from you so she can master it.  You may think that sounds like a lot of effort for something that seems easy to you, but you're not her.  Put in the right kind of effort now, and she'll have it faster in the long run.

I took my dog, Lucy, to a new vet yesterday.  It was the first time she didn't balk about going in.  I usually have to call for reinforcements from the staff because she weighs 70 lbs. and can be pretty stubborn when she's terrified.  This time she walked in, no problem.  I think it's because it didn't smell doggy.  It was a very clean facility.  We were greeted pleasantly and brought right back for a weigh in, and then brought to a room.  They had already obtained her records and gave me a very brief form to fill out as I waited.  The vet's assistant was extremely kind to Lucy, took her time with her and earned her trust.  Lucy happily went with her for whatever testing she was going to do.  The vet himself was pleasant and took his time, as well.  He explained everything he was doing and talked about his findings.  Her ears are a mess, but he offered to work together to get them better.  Before we left, the assistant came back in and hugged Lucy and gave her a treat.  I was thrilled with everything.  Here's what stood out, the facility was immaculate, the staff and doctor were warm and friendly, they took their time with us, they were on time, they cared, and everyone knew their job and did it without prompting. 

I had taken my dogs to my former vet for about 15 years.  Why did I change?  The place had gotten run down and dirty.  No one seemed like they cared, and everyone was rushed and almost militaristic.  No warmth, no pleasantness, and Lucy was terrified every time.

Now, I know Lucy's a dog, but she's a patient, too.  The difference in this new office made a big difference in that hour of our lives.  I felt that my money was well spent, and the experience wasn't exhausting and stressful.  I'll not only go back, I'll send my friends, too.  Would the appointment have taken less time if they hadn't approached it in a soothing, relaxed manner?  Maybe a little, but not enough to make a difference in their production.  Did the fact that everyone knew their jobs so well buy them the time to spend on treating their patient with care.  I think so.  It also bought them a better atmosphere in the office which tends to allow staff to be more relaxed and happy.  It wasn't that no one wanted to help anyone else, no one needed to.  They all did what they were supposed to do and it worked.

Look around your office.  Is it clean and up to date or is it starting to look run down?  Is the atmosphere relaxing and reassuring, or is everyone in a big rush?  Do patients seem to genuinely like you and your staff as people, or are they just suffering through the hour?  Pay attention to your staff next week.  Try to notice where they get stuck in their work.  Keep notes, you won't remember, and then talk to them and ask them if they notice it, too.  They may be a little defensive at first, but reassure them that you're intention is to build up, not tear down.  You'll probably find they are grateful to finally acknowledge the issue and begin to find ways to work better.  If you ignore it, it stays the same.