Exceptional Dental Practice Management

Back To Aristotle - Beauty

Well, I was wrong, I took a long time to get back with this post.  But here we go, let's talk about Beauty - the Aesthetic dimension.

"Business should be viewed as a performance art.  We all have a deep need to feel that we are performance artists - to experience active as well as passive beauty in our work."       ~Tom Morris~

Tom defines the passive mode as: what we see, what we hear and what we smell, touch and taste.  The active mode is described as: what we plan, what we create, what we do.  

When I first mentioned beauty, I'll bet you immediately thought of cosmetic dentistry, didn't you.  That is a part of beauty in our practices, but it is more of a part of the whole instead being the whole purpose of what we do.  Can you see that when you read Tom's definitions of passive and active beauty?

Let's start with what we, and our patients see.  Have you ever walked into the front door of your practice and paid attention with a critical eye to what it looks like?  I did that one day and was dismayed to see that the foyer looked barren and unwelcoming, the waiting room was just ok, and the front desk, and particularly my office, looked messy and disorganized.  As I went into the operatories I noticed that the hygienists had too much stuff on the back counters, wipes and spray on the side counter and their carpet looked worn.  It was basically the same throughout the office.  I told my boss at the time about what I was seeing and he was not interested in spending any money to improve it.  I did what I could for free, such as asking everyone to straighten up, spent a small amount of my own money for bins to neaten up my own office and tried to put out seasonal decorations from my stash at home.  Little did I know that my boss was planning to sell the practice so he wasn't about to re-decorate.  My new boss is very open to making everything look warm and inviting and little by little we've made improvements.  Our foyer is now beautiful with a console table, a lamp with a low watt bulb to add a warm, welcoming glow, a pretty carpet and some photos and scented candles that make it feel homey and nice.  Patients notice and mention how nice it is.  People care about how they feel when they enter a place.  Making it pleasant, shows you care at least that much and that's a good start.

What do patients hear when they enter your practice?  In our office, patients often remark that they've never been to a dentist's office where it sounds like everyone's having such a good time, even the patients.  They rarely mention the sound of the handpiece unless that's been a phobia of theirs.  If they do we are quick to offer headphones with music to drown out the whine of the drill.  Most often they turn us down because they don't want to miss out on what we'll talk about.  My boss and I have a great rapport and we tend to tease each other or tell stories about whatever is going on in our lives, what shows we watched, or what crazy thing we saw someone do.  We set up a good-natured banter that often develops into pure silliness and the patients love it.  They say it takes their mind off what we're doing.  Now, to be sure, we don't just go on with our lightheartedness if someone appears to be experiencing pain or emotional distress.  We are just as in tune to comforting our patients as we are to entertaining them and they notice and appreciate that.  Our hygienists are warm and caring and they also display a sincere interest in and enjoyment of their patients.  The other sound our patients hear is the sound of a team who truly cares about each other and who love working together.  They feel it and it makes they feel secure.

We also pay attention to what patients smell when they are with us.  Of course we have the usual "dentist office smells" when we are using things like Eugenol, but we do not allow it to permeate the office.  We do regular smell checks and I have some really nice scented oils that I can refresh our potpourri with.  Subtle is the key here,  you shouldn't overwhelm, just give the suggestion of a wonderful scent.  We have luxurious, soft blankets and pillows to offer our patients and they often ask where we buy them so they can get one for their own home (Target).  It's a pleasure to see our patients all cuddled up in the chair and reluctant to leave when their treatment is over.  There are times, when we have time, that we just turn off the light and let them relax there for a few minutes until they're ready to return to their regular routine.  If you think about it, any other service or activity such as massage, or yoga, that cause you to be prone for any period of time, allows you a few minutes to "come back to reality".  Why should we expect our patients to just abruptly jump out of what we've tried to make a pleasant experience?  Schedule five more minutes into the procedure for the luxury of letting them take their time.  As far as taste goes, we all know that most impression material and cements don't taste so great, but we don't have to let patients leave with a bitter taste in their mouth.  Be conscientious about rinsing their mouth well and cleaning their face.  Offer a gentle tasting mouthrinse as they are leaving and help them fluff up their hair, or at least let them know they need to.  Help them on with their coat and walk beside them as you escort them to the front desk.  Tell them how much you enjoyed your time with them and wish them well.  

If you haven't realized it yet,  passive beauty is the result of active planning.  It doesn't just happen, it must be created, but to create it, it must first be imagined.

"The proper use of the imagination is to give beauty to the world...to cast over the commonplace workaday world a veil of beauty and make it throb with our aesthetic enjoyment."    ~Lin Yutang~

I really hope that what I've written so far is igniting even the tiniest spark in your imagination about what you want to change or introduce in your office.  Maybe you're even a little excited just thinking about it.  Most things don't cost a lot.  I would start with planning, don't just jump in and buy a bunch of potpourri or cute pictures.  Think of what will be meaningful to you, your team, and your patients.  People naturally like to nest a little in any place that they spend a significant amount of time.  It's true for you, as well as for your staff, so I'd start there.  In our office I didn't just want to give the go-ahead for a decorating free-for-all, knowing that we'd immediately have "theme" rooms.  One would likely be filled with angels and puppies, another would be full of a collection of framed family photos whose frames wouldn't match, and yet another would display "boyfriend" pictures.  So, I started out with a staff meeting talking about what we wanted our office to feel like; what signature stamp would we be putting on this space,  what would we be telling our patients what we care about and how we would care about them?  Of course, we wanted to start with the basic, that we really do care for their comfort.  That's where the blankets, pillows and nice smells come in, but it's also where our determination to be responsive to their fears and emotions came from as well.  Next came relationship.  We want to build a warm, honest relationship with our patients.  I remember a day when a retired military male patient came in and asked me if he could feel free to be honest with me, question me about treatment, and tell me if he had any complaints, disagreements or qualms about any treatment we recommended or completed.  I said, "I'd be disappointed if you didn't.  There's nothing we recommend that we aren't open to discussing as long as you need us to.  We don't take any of that personally because it's not about us, it's about you and we want you to feel good about what we do all the way from the beginning to end."  He smiled and visibly relaxed and proceeded to grill me about the implant supported bridge we'd just suggested to him.  He then asked if my boss would be just as open to discussion, or disagreement as I was.  Of course, I was able to say he would be.  Finally, we realized that the culture in our practice began with the relationship that the team has with each other.  We need to trust each other not to backbite, gossip or take offense where none is intended.  Actually, we had to learn to trust that none of us ever intend any harm toward one another.  We had to learn to share not only in any glory that might show up, but also in anything that didn't go well.  No finger pointing or blame here, just an opportunity to learn a better way.  In some instances where a pattern of aggravation, or inconsideration had developed, we came up with ways to signal the beginning of annoyance and responses to those signals.  What was once a fairly significant problem, has now become a non-issue as patience and understanding have led to trust and affection.

After we decided what was important for us to create in our practice, we set about achieving it.  As I said above we set up some guidelines about how we will treat each other.  The great thing about agreeing on a way to behave is that when someone deviates from the path, you have a map to guide them back to the way you've all agreed to go.  Anyone can do it if they do it with care and kindness.  We also talked about what would make patients feel that we care and we all felt that "being known" was the key.  As new staff members came into the practice, we noticed that they would call patients from the waiting room and then look around to see who belonged to the name.  Now we make sure that they know before they greet the patient.  We also ask that they go to the patient in the waiting room and greet them as they would a guest in their home.  That means a big smile, a handshake or pat on the shoulder, and an offer to help them with their things.  They then walk alongside them and talk as they go, rather than walking ahead and expecting them to follow.  We are not trying to give the feeling that we are leading anyone to the gallows.  Once in the room we ask about whatever they told us last time we saw them.  We use our software to make notes about any upcoming vacations, or events that are important to the patient and they appreciate our interest.    If we've just met them for the first time, we show interest without being pushy, about who they are and what's important to them.  

The real work is in putting all this into action, and keeping it going.  That means revisiting and revising on a regular basis.  Staff meetings are a great way to keep up with all this.  Give up the idea that staff meetings need to be boring, dead-serious hours filled with numbers and grim statistics.  Fill the hour with discussions about how to please your patients, how to improve your service and how to build a healthy, happy culture and those numbers will take off.  No one will be bored and if they are, that tells you something else and gives you something to think about.  Some people may need to get with you on your new vision and some others may need to find a place that won't expect them to commit to beauty in their lives and workplace, because when you work in beauty, you tend to live in beauty in other areas of your life.  It's like a circle that keeps expanding, keeps giving and keeps getting better and better.  Think about concepts like grace, excellence, appreciation and integrity and try to find ways to apply them to what you are doing with and for each other and your patients.  I'll leave you with a quote from Tom Morris that sums this all up.

"...there is a beauty to be experienced in solving a problem elegantly, in creating a business structure, however great or small, however permanent or ephemeral; and there is beauty in providing acknowledged excellence of quality in a service or product.  This is performance beauty in the workplace.  It is important to corporate spirit and may be inversely related to the attention it has received.  I believe Socrates was right when he said that the least important things, we think about and talk about the most, and the most important things, we think about and talk about the least.  It's time we turn that around."

 

Back To Aristotle - Truth

"All men seek happiness.  This is without exception.  Whatever different means they employ, they all tend to this end.  The cause of some going to war, and of others avoiding it, is the same desire in both, attended with different views.  The will never takes the least step but to this object.  This is the motive of every action of every man, even of those who hang themselves."        ~Blaise Pascal~

 

Pretty grim, but true.  And if it's true that we are motivated for a desire for happiness, then we must define what happiness means for us personally, and strive to understand what it means to our patients and staff.  Obviously, it can be very different for every person, but in order to attain fulfillment, everything we do must respect and nurture the 4 basic dimensions of human experience.  They are:

1. Truth > The Intellectual Dimension
2. Beauty > The Aesthetic Dimension
3. Goodness " The Moral Dimension
4. Unity > The Spiritual Dimension

We'll begin with truth.  Truth and respect go hand in hand.  Truth and trust walk together, as well.  

"One of the most ennobling gestures any of us can make toward another human being is to ask her sincerely, what she thinks about what we are doing together.  What is her take on the truth?  When we ask, wanting to hear, we treat the other person with a fundamental respect, and this behavior is then much more likely to be mirrored back to us. ~Tom Morris~

It is important for leaders in the workplace to understand the we must develop a culture in the workplace in which people are not afraid to tell us the truth.  That means that we must develop the ability to wait.  We have to learn to listen and ask questions that will bring out more information.  Then we must set personal preferences and prejudices aside and consider what will work best for everyone and get us the most positive result.  We must be able to handle the truth and learn how to use it as we proceed in a situation for the best good.  To be able to encourage others to tell us the truth, they must know that we respect them and value them, just as they are.  In order for truth to be respected, people have to know they are respected first.  It is the same with patients and staff alike.  Show them you respect and want to understand them and you will develop a sound moral relationship with them in which the truth is easy to speak.

Truth also comes into play regarding the knowledge we share with each other.  If we respect and trust another person, we feel free to share the knowledge that we possess,  and which they need to succeed in their job.  We don't worry that they'll look better than us or that we'll lose our "specialness".  Competitiveness  becomes something that works for both.  It's like running a race, you both run faster because you have someone to compete with and you both do your personal best.  You encourage each other to do the best you can.  Sharing what we know doesn't diminish us, it adds to both.  Knowledge shared is knowledge squared.

How can you develop a culture of truth in your practice?  Start by being honest with yourself.  How are you about the truth?  Do you tell it to others?  Do you respect them when they trust you with the truth?  Or, do you frighten others into deception and self-protection by blaming, accusing and shaming?  Do the consequences fit the offense when mistakes are made?  Are you open to others when what they say doesn't fit your belief about the way things should be?  

Ask your staff what the truth means to them.  Ask them to examine the reasons why they might avoid telling the truth.  Are they frightened?  Are they worried that they'll hurt someone's feelings?  What would make it easy for them to tell the truth all the time?  Are they afraid to answer that question because they're afraid of how you'll react?

Now ask them how being dishonest can hurt the practice, the patients, the team and themselves as individuals.  

One thing everyone needs to realize is that the way you tell the truth is just as important as telling it at all.

"Thanks to words, we have been able to rise above the brutes; and thanks to words, we have often sunk to the level of demons."  ~Aldous Huxley~

It is necessary to tell some hard, even unpleasant truths at times.  It is wise to learn to speak even difficult truths with love and compassion so that the message doesn't get lost in the emotions.  We must learn to hear what the other person will hear, before we ever let the words out of our mouths.  Ask your staff to talk about how they can speak the truth in love.

Finally, tell them about why and when it is hard for you to be truthful.  Maybe it's during a performance evaluation.  How can they help you be more honest with them?  How will it help you both in the long run?  How would life change in the practice if everyone treated each other with respect, dignity and honesty?  Is there any reason not to do it?

Next, I'll discuss the aspect of Beauty.  I promise not to take so long to get back to it, too.

Well, What Did You Expect?

People don't always do what we expect them to do.  Sometimes we think things are pretty clear and then we get surprised.  Often, another person has no idea of what we were expecting and was just acting in a way that made sense to them.  

Let's think of a situation in which a patient is being unreasonable, or even somewhat abusive to a staff member.  The dentist walks in and tries to placate the patient while the staff member is fuming because he didn't put that patient in his place and let him know that he can't talk to her in a demeaning manner.  For his part, the dentist is irritated that the staff member is taking the patient's behavior personally.  He expects her to just shrug it off, but she's standing there pouting.  When the patient leaves, the dentist and staff member are less than cordial to each other.  Each one thinks the other is wrong and no one even thinks to look at the situation from the other point of view.

The staff member sees it as a matter of loyalty, perhaps.  She gives her best to her patients every day.  Doesn't he realize that she'd do anything to help the practice?  Why didn't he return her loyalty by sticking up for her?  She may start making a list of all she does for the practice and all the times that she was taken for granted.  Pretty soon she has a long list of all she does, and of all the ways her boss has proved he doesn't care.  Now, the situation with the patient lasted for about 2 minutes, but she's spent the better part of the morning obsessing about it and getting more and more agitated.  This can't be good.

On the other hand, the dentist is baffled.  The staff member has a role to play, and part of that role is dealing with patients and making all interactions with them turn out well.  Sure, that patient earlier this morning was pretty gruff, rude even, but so what?  He expects her to just deal with it and move on.  She's a good employee and he appreciates her, but sometimes he doesn't understand her.  The thing he doesn't get is why she seems to be mad at him.  He didn't say anything mean to her.  Why is she taking it out on him?  As the morning goes on and her attitude gets worse, he's starting to become angry.  Nope, this won't be good.

Finally, the morning is over and the staff member comes into the dentist's office and closes the door.  Amid tears and accusations she tells him she's disappointed that he let that patient treat her so badly.  He's astonished.  So that's why she was so mad?  What did she expect him to do?  Argue with a patient over something that was no big deal?  He cuts her off and tells her to grow up and suck it up.  It's her job to deal with all kinds of people and situations and he's not going to argue with his patients.  After all, they're the ones who pay her salary.  She storms out and tells herself he just doesn't care.

Neither one stopped to think about the other person's point of view and so the argument rages.  Neither one considers that they just don't have the information they need about the other's reasons for their behavior, so they get nowhere.  Nothing gets resolved and they both walk away nursing hurt feelings and thinking that the other just doesn't get it.  Well, that's true, they can't get what they don't know.  

Sometimes the behavior that seems completely reasonable to us, is completely unacceptable to someone else.  Telling off the patient would have been something that the staff member would have seen as a sign of loyalty and respect on the dentist's part.  Does the fact that he didn't do it mean that he doesn't respect her or feel loyal to her?  Not necessarily, it may just be something that he is not willing or comfortable doing.  Does the fact that the staff members feelings were hurt by the patient and then by the dentist make her a bad employee?  Of course not, she just wants something that never occurred to him.

Next time they could avoid a miserable morning by putting themselves in the other person's shoes.  We have to be willing to see it the way they see it, without our own expectations clouding the picture.  That doesn't mean we have to do it there way, just respect their opinion.  In other words, don't get mad, get curious.  It's a lot more pleasant than arguing and you'll build stronger relationships while you're at.