Exceptional Dental Practice Management

The Most Common Reason For Failure

The most common reason for failure is quitting.  In their new book, Three Feet From Gold, Sharon L. Lechter and Greg S. Gold explore ways to turn obstacles into opportunities so that you won't quit just when you were about to succeed.  I was sent a review copy of this book and have to admit, I took a while to get around to reading it.  I'm glad I finally got started, the book is a quick and interesting read based on the ideas of Napoleon Hill in Think and Grow Rich. 

The book begins with the story of R. U. Darby and his uncle who were would-be gold prospectors during the Great Depression.  They didn't know much about gold prospecting and didn't do much research, they did know that they wanted to strike it rich.  You see, gold prospecting wasn't their purpose in life, the thing they felt driven to do.  They were successful at first and quite excited at the thought of fulfilling their dream to get rich.  Soon, however, the gold seemed to run out and they became discouraged and gave up.  They sold their claim and gear to someone who had always wanted to be a gold prospector.  Having his purpose in view, the new owner of the claim called in an expert for advice and then started digging as instructed.  He struck gold three feet from where the Darby's had quit.  Why did he succeed where the Darby's had failed?  He was pursuing his life's purpose and he was willing to ask for advice from someone who knew more than he did.  On hearing of their misfortune in quitting, Mr. Darby took the lesson about quitting and applied it to his work in his new business.  In addition, he shared his story with others so that others could learn from his mistake. 

So, now that we know that quitting is the number one reason for failure, and people quit because they're not committed to the cause, it stands to reason that in order to succeed, you must determine what it is that you can commit to as your life's purpose.  Then, persevere through obstacles to reach success.  Commit to the outcome.  Develop "Stickability."

More to come later.

A New Earth

    You hear so much about staff member's needs for recognition and appreciation.  I've written about it myself.  It encourages people to hear that they do a good job and to be thanked.  Why?  It fills a need within them.  That need is in their ego.  The dentist and manager have the same desire for praise and recognition.  After a while, it can become somewhat of an addiction.  The more you get the more you need and if you don't get any, the lack becomes your main focus.
    Wouldn't it be good to be free of this dependency on someone else to give you what you need?  You can do it if you can recognize that it's coming from your ego.  You must then ignore what the ego is thinking and listen to what you know about yourself.  I didn't come up with all this myself, I'm as needy as anybody when it comes to praise and recognition, but it doesn't make me happy.  I'm reading a book titled A New Earth by Eckhart Tolle.  It's Oprah's Book Club pick, and I'm not always crazy about her picks, but she's doing better lately.  My daughter has already made fun of me for reading it, but I really think he's got some good thoughts.  Anyway, that's where these ideas about neediness and ego will be coming from.

    Our ego is the part that is thinking all day long and telling you stories about what's happening, what it means and how you feel about it.  You know what I mean, "I just did all this extra special work and my boss didn't even notice.  It doesn't matter what I do, he doesn't appreciate it."  That's your ego talking.  If you can think without your ego it might go something like this, "I don't know if my boss noticed what I did or if he appreciates it.  It doesn't matter because I'm pleased in the knowledge that I did a good job."  Do you see why it's not good to let your happiness or self-esteem depend on someone else's opinion of you?  You are laying your happiness in their hands and letting them control how you feel.  The stoic philosophers through the ages have cautioned not to put too much value on what others think of you, either good or bad, or risk having your happiness depend on the fickle emotions and opinions of someone else.  It's ok to be pleased or happy when someone pays us a compliment, it's needing it that causes problems.

    Another thing to remember.  Your need speaks to a need in their ego,  the need for power and control.  If you've ever desired praise from someone you look up to and not received it, you may know what I mean.  You keep trying to impress, all the while trying to draw their attention to your actions.  They recognize this, see your efforts and exert their power over you by continuing to withhold praise.  This exemplifies neediness in both parties, just in different forms.

    Mr. Tolle reminds us that we aren't our thoughts.  We must learn to recognize that our ego exists and has a mind of it's own, but we must also think beyond your ego with your real mind.  Ask yourself if what your ego is telling you is true or helpful.  Many times it isn't.  Try it for a day.  You may find that not only is life easier on you when you don't listen to your ego, but you may be easier on those around you as well.  The ego is often judgmental and harsh.  The more you can think around it, the more you may find that there's just no need for basing your life on what others are doing or living and dying by what they're thinking of you.  Wouldn't that be peace and freedom?

Mastering Success

    Finally, a dental practice management book that addresses the real-life, everyday issues that a dentist or manager faces.  Mastering Success. Mastering the Business of Practice, written by Marc B. Cooper, DDS, MSD is a book that looks at the business of practice and talks about "who" you need to be to succeed. 
    Many books, articles, newsletters and consultants will give you cookie-cutter programs telling you what to do.  A lot dentists really don't have a good handle on managing people and they basically react to situations as they arise.  Their decisions are often influenced by the fear of yet another employee leaving, and the dread of having to begin the hiring and training process anew, only to have it happen all over again.  Dr. Cooper's advice can help dentist's define their role as a manager and give them tools for handling the often predictable situations that arise in a dental office. 
    One of the things that I like is the real-life situations and the down to earth answers that Dr. Cooper uses.  Here is an example:

    A dentist complains about a high rate of turnover and the fact that the staff he currently has is not good, with the exception of his office manager who has been with him for seven years.  He asks: "What do I need to do to have a great staff?"
    Now I know a lot of you are nodding and thinking "Welcome to the club, that's what we all want."  Well, prepare yourself, Dr. Cooper's answer may not be the soothing pat on the back that you're expecting.  He challenges you to action.

    "First, and I don't mean to be harsh, but if you are like most dentists, you must realize that you don't really care about having a great staff.  You want a staff that doesn't cause you any trouble, that is problem free.  What you're really looking for is a "robo staff", not a great staff.  If you really want a great staff, you need to think and act differently.  The first change required to have a great staff is you changing as an owner.  You need to begin looking at building your practice as a great business, not a small business where you continually take all the money out of the top drawer."

    I love Dr. Cooper's list of 8 tasks a highly successful practice owner must be committed to mastering.  His list of the conversations of a good employee vs. a bad employee, in itself, may be worth the cost of the entire book. 
    If you can read this book without stopping after just about every chapter or example and comparing yourself to the topic he is addressing, than you didn't really need the book, but you can pat yourself on the back for having achieved the practice you want.  Dr. Cooper does do practice management consulting, but I can't remember the last time I've seen a consultant put out so much information, just for the price of a book.  There are no teasers or come-ons here, just valuable information in a concise readable format.

To buy the book:

Fax orders - 603-720-0369

Phone orders - 425-806-8830

Mail orders - Sahalie Press, PO Box 1806, Woodinville WA, 98072

Online orders - http://themasterycompany.com (catalogue)

Price - $19.95

I, Linda Zdanowicz, in no way benefit from any sale of this book.  My opinions in this review were given freely with no intent or promise of financial gain.  It is important to me that this site exist solely to give information and help to dentists, managers and team members who want to build better practices, and to serve their patients and each other in a caring, team oriented atmosphere.  I accept no advertising and never have or will, profit monetarily from writing this weblog.  My purpose is to give back after receiving so much from my boss and mentor Dr. Jeff Price.  The pleasure and satisfaction I get from managing his practice is something that I want to help others discover.

The No A$$#@le Rule

    Well, I've just started a book titled, The No A$$#@le Rule.  I am not as brave as the author of the book, so I couldn't just write it right out like he did, but I'm sure you can figure out what comes before rule.  Like I said, I've only just started it, but it got me thinking.  Let's substitute the word jerk for a$$#@le.  A$$#@le is just too descriptive and graphic for me.  The author states that there are a lot of jerks in a lot of workplaces.  First of all, being the self-improvement junkie with a guilt complex that I am, I wondered, "Am I an a$$#@le?"  Oh yeah, I was going to use jerk, wasn't I?  So, am I a jerk?  Honesty is so painful.  Yes, I admit it sometimes I am.  But, not a complete jerk, thank goodness.  Sometimes I tend to get quiet when I'm upset and I know that my mood affects everyone else's, so I know I shouldn't do that. I also have a hard time dropping an argument until I understand everything about it, which drives some people nuts.   But, that doesn't make me a complete jerk, just an occasional jerk.
    There are two criteria for complete jerkhood.  1.  Does a conversation with you leave the other person feeling put down, degraded, less valuable or worse than before they talked to you?  2.  Do you tend to be abusive to people in lower positions to yourself and never to people in higher positions than yourself?  If you do both these things you're a complete jerk.
    The problem with being a jerk is that you hurt others as well as yourself.  It's terrible to be the victim of a bully and that's what most jerks are.  When someone in a higher or more powerful position bullies an employee he or she makes that person feel hopeless and helpless.  That eventually turns into anger and resentment and a desire to get even.  Sometimes people get even by sabotaging, stealing or just not trying.  It takes a toll on the employee's personal life as well when they bring their problems home to their family or take out their anger and frustration on those who love them.  Eventually, bullying costs the business in sick days and employee turnover.  Eventually it costs the bully when someone higher than him catches on and fires him. 
    When I was having my sleep study, the technician told me that his sister manages a doctor's office.  He said that before she was diagnosed with sleep apnea she had terrible mood swings and would scream at the staff.  I can't imagine doing that.  I would think the mood in that practice had to be horrendous.  Now that she is sleeping she's stopped screaming, but I doubt the staff has lost that mental image of her.  As managers, we have a duty not to be jerks.  The snowball effect of being a jerk just creates other jerks as your staff members get fed up and take on your attitude.  I peeked ahead in the book and they're going to tell us what to do if you are a jerk or if you work with a jerk.  I'll keep you posted.

Still Discovering

    I'll update you on the book I'm reading, Now, Discover Your Strengths.  I know it probably seems like it's slow going, I can usually read a book in 2-3 days, but I'm taking my time and stopping to consider what I am discovering.  I took the strengths test and I will tell you this, it was worth buying the book to get the code.  The test is spot on.  If I was just given the list of 34 strengths and told to pick the top 5 that I thought described me, I would have been wrong.  After taking the test and reviewing the results I could see it was right.  Not only that, I could see where I have blocked my strengths and where they have been blocked by others.  Now I can work on focusing on building them and applying them to my work and life.  Knowing the strengths of our staff could help me find new ways to help them succeed and grow.  It could also let me know when I'm on a dead-end and expecting someone to grow in a direction that isn't right for them.  I have made the mistake, at times, of assuming that everyone can learn everything if they really want to.  Now I know that is probably not right and that trying to instill a talent doesn't work.  A talent is something you are born with.  You can develop a certain amount of skill or ability, but a talent is something you excel at.
    One really interesting new insight I've gained that will help me as a manager and a parent is that when we spend more time focusing on weaknesses than strengths, we waste time we could spend building on strengths.  The example given in the book is of a child who brings home a report card with an A in English, A in Social Studies, C in Math and an F in Chemistry.  Most parents will spend a lot of time discussing the F in Chemistry and very little time focused on the A's in English and Social Studies.  While the child does need to do better in Chemistry to be able to achieve graduation and acceptance into college, he doesn't have to make it an A.  It discourages the child because it seems that the A had less significance than the F.  If an employee has a great, welcoming manner, but is not a good 'on her feet' thinker, you will not make her better at critical thinking by trying to force her to think like you do.  You will just frustrate her and, worse yet, risk demoralizing her. She may even give up and go away.  Maybe that is what needs to happen if her talents don't match the job, but you may force the issue before you know what her actual talents are. Focus on what her strength can bring to the practice and devise coping methods for the critical thinking part.  Decisions trees and scripts can help here.  Call on your strengths to help develop those of others.  This book is definitely worth buying and would make a great staff meeting activity if your staff feels comfortable discussing their strengths in the group.

Uh Oh!

    Bad news.  I might as well not bother giving you the URL for the strengths test.  You have to buy the book if you want to do it.  There is a code you must have that lets you into the test and only one person can use the code.  Since I have the book from the library, I'll have to wait till the one I ordered gets here to take the test.  So, if you want to take the test, you'll have to buy the book.  I'll add it to my book list so you can find it easily.  I don't even get a commission for this.  You have to admit it, they're pretty smart to do it that way. 
    By the way, I ran across an article on the Leadership Blog that you might find interesting relating to what I've been writing about lately.  It's called Stop Trying To Help People Who Don't Want To Change.  Someone commented on yesterday's post that they had taken a writing course that forced them to look at the positive.  That is the best place to look.  But, there comes a time for realism.  If you are seeing positive that is not there, you have to face it.  Am I starting to confuse you with my ping-ponging?  Then join the club.  I find it very confusing.  I don't understand why positive responses don't beget positive results.  I wonder if sometimes the most positive thing to do is to face a situation and evaluate it honestly.  If the evaluation leads you to the realization that you must instigate change then maybe doing that in a positive way is the answer.  It isn't productive to allow an unworkable situation to persist indefinitely.  It not only hurts the team as a whole, it affects each team member individually because it's so painful to watch a slow death.  It affects the poor performer because it keeps them in a situation in which it has become obvious they are not equipped to handle and it will begin to damage their self-esteem.  It may be more merciful to free them to find something they are better suited for.  How do you know when the time has come to take steps to end the situation?  When hope turns to dread.  When you look in the person's eyes you are trying to help and see only shell shock.  When you look in your own eyes and see exhaustion and sadness.  This is not fun, it's not easy, and no one ever feels good about it.  It is someone's failure to thrive and someone else's failure to find the key to unlock someone's potential.  Just as you should not spend an inordinate amount of time trying to fix weaknesses rather than increase strengths, there comes a time when spending too much time trying to fix a weak team member decreases the strength of the team.  If they don't want to change, nothing you can do or say will make them change.  I guess it's that simple.

Now, Go Find Your Strengths

    As managers and business owners do you find yourself concentrating on people's weaknesses and wondering why you can't get them to shape up?  You may be beating a dead horse.  What if concentrating on their weaknesses only makes their weaknesses more apparent to you and discourages them?  That's a new concept isn't it?  It is for me.  I try to fix things.  I like to make them better.  I'm reading a new book titled Now, Go Find Your Strengths .  The authors tell us to find peoples' strengths and build on them.  The rationale is that people don't change much and spending time focusing on weaknesses will not garner as much improvement as focusing on building on strengths. 
    This would put the onus on the manager to discover the individual strengths in staff members and be sure that they are in a position that makes the most of their talents.  First, the manager needs to identify their own strengths and make sure they are working with them correctly.  That could be a little scary as you might find that managing is not your thing.  If you are a dentist and find that managing is something you don't do well, this may be enough to make you take the plunge and hire an office manager.  You can use the strength finder on line to discover your strengths. I'll post that URL tomorrow.  I'm tired now and the book is upstairs.  You can also use the strength finder to help you in your hiring.  I intend to do this with our staff and talk about what we discover at a staff meeting.  I'm lucky, I have a very willing staff that are open to self-discovery.  They weren't always, we've done enough exercises over the last 2 years that have shown them that what we talk about will be treated with respect and discretion. 
    If you think about it, dentistry is one of the few professions in which the person with the most critical skill also functions in an administrative role.  I been told in no uncertain terms by dentists that they won't hide behind a staff member when it comes to firing an employee or dealing with unhappy patients.  Why would allowing someone who is willing to do that, and possibly more capable, be shirking responsibility or being a coward.  That's what managers do.  They do it as part of their job responsibilities and they move on to the next task.  We don't love that part of it, but every job has it's tough aspects.  L.D. Pankey promised his mother that he would never extract another tooth after she relayed her dismay at loosing hers so he sent his patients to another dentist when they needed an extraction.  He wasn't being a coward, he was just playing to his strengths and his commitment to his mother was one of them. 
    One interesting thing I just read was that we have very good, accurate words that define negative traits in people, but not very good ones to define their talents.  If you say someone is depressed, you will likely be very accurate and even a trained psychologist would probably agree with your assessment.  If you say they have good people skills that could have a variety of meanings.  Yet, this is often how we describe our staff members talents.  We need to be more specific in order to put those talents to their best use.  Many times we even see talents as negative traits.  When a person likes to take action we might say she is impulsive rather than decisive.  A person who is not afraid to say what she thinks might be described as aggressive rather than assertive.  Maybe the talents that we don't possess are threatening to us when we see them in others and don't understand them or know how to direct them.  Clearly defining talents may be the answer.
    I will continue posting as I continue reading.  I have taken this book out of my local library but I'm planning to jump over to Amazon next and order it so I can use it with our staff.  I'll be back tomorrow with that URL for the skill finder. 

Something New

    There's a new magazine coming from Penwell, the publishers of Dental Economics.  It's called Dental Office.  I'm excited to have been asked to be a contributer to this new publication.  My first article will be published in the March edition.  It will be the first in a series based on the "Other Side Of The Chair" series that I wrote for this weblog.  I also have an article pending publication in the March edition of Dental Economics.  I'm honored to be asked and am letting you know about it here, not to brag, but to show you that if you set goals for yourself, you can achieve them.  Back in the summer, our staff was reading "The Success Principles" by Jack Canfield.  One of the exercises in the leader's manual for the book was to set some goals and share them with the group.  One of my goals was to try to write for publications such as these.  Four months later, it's a reality.  So, choose some goals that mean something to you and go for it.  You can do whatever you set your mind to, but you have to get started.

Start Small For Big Results

    I'm reading "Leadership" by Rudolph Giuliani right now.  I like the way he writes, you can almost hear him speaking.  In the book he talks about something he did when he first became mayor of NYC.  New York really was a mess then and he wanted to do something right away to make a noticeable improvement.  He decided to start small.  He would pick one small thing that was attainable, that would make an impact quickly and would get people's attention.
    He decided to get rid of the squeegee men.  If you ever visited NYC prior to Giuiliani becoming mayor you know what I'm talking about.  These guys would come over to your car when you were stopped at a light,  spray your window and swirl the resulting mess around with a filthy rag. Your window was definately better off before they "cleaned" it.  Then they expected you to pay them.  If you didn't they were likely to spit on your window or kick your car.  Kinda scary for a wimp like me.
    At first the police said they couldn't do anything because they weren't breaking any laws.  So Giuiliani decided to ticket them for jay-walking.  Then they could do a background check and many had outstanding warrants.  He got it done.  Why did he pick the squeegee men to focus on first?  They hung out around the bridges and tunnels and they were the first and last impression made on visitors to the city.  He didn't want squeegee men to be the lasting impression that people left NYC with.
    What small change could you make in your practice that would delight patients upon entering and make them leave with a satisfied sigh of appreciation?  Even a more enthusiastic greeting at the front desk can make a big difference.  Offer something to drink if they are going to have a few minutes to wait.  Before they leave the operatory make sure they are put back together.  You know what I mean, ...no alginate on the face, give them a mirror to reapply lipstick and fluff up their headrest flattened hair.  Give them good home care instructions orally and written.  Call patients who've had surgical procedures at the end of the day to see how they are doing. What can you think of that would make a noticeable improvement in your practice?  Figure it out and do it. Your patients will love it.  Little things really do mean a lot.

I Love Integrity

    You may have noticed I posted a new book on my list of favorite management books.  It is Integrity by Dr. Henry Cloud.  I love it.  I've only just started it but I had to let you know how much I'm enjoying it.   Dr. Cloud discusses how facing the realities of situations demands integrity.  In other words, you have to have the courage to face people and situations as they really are, not as you wish or think they should be.  That requires you to be honest with yourself and others and that can be daunting. 
    I will come back to this discussion as I continue reading.  I already have a half dozen of those post-it page markers sticking out of my copy.  I love those things. I wish I had thought of that.  I was close, I was ripping post-its into strips and sticking them in the pages.  I should have thought a little further outside of that box.  Oh well, someone beat me to it.  I'll be back.