Exceptional Dental Practice Management

Listening

    I'm involved in Marc Cooper's Mastery of Office Management Program and our homework for the last two weeks has been listening.  I am amazed at how hard it is for me to turn off my own thoughts so I can manage to actually really listen to others.  I'm not happy with this realization, but better to know it so I can try to do something about it.

    If I had a dime for every time someone told me I'm a great idea person, I'd have  a lot of dimes.  Ideas just come to me.  Sometimes I even wake up in the middle of the night with 2 or 3 ideas for something that would be just great to do in the practice.  People like to hear my ideas and think that I always know the right thing to say.  So, why should I listen more?  Maybe I meant to be talking more than listening.  After all, I'm so good at it, right? 
    Well, I got a lesson in the value of being listened to the other day.  There was a situation one morning that left me feeling hurt and upset.  At the moment, I didn't really know where to go with what I was feeling, my boss didn't know a lot of the background behind the reason for my distress and so he couldn't really appreciate or understand how I felt.  It was very real to me and all the more frustrating because it threatened to put us at odds with each other, which would have made the situation all the more dismaying for both of us. 
    We got through the day, talked a little, but I still felt like a solution was not reached.  The next day I got up and felt like I'd love to just turn off the alarm and sink back into the pillow and forget about that thing called work.  I pushed myself to get moving and made it through the day with less than my usual enthusiasm, but satisfactorily as far as I was concerned.  At the end of the day I was talking to my boss in his office and he told me that he didn't like seeing me feeling the way I was, and that seeing me frazzled would affect the way the staff looked at me as a leader.  He told me he wanted to help me find a way to breeze through stress like this without  letting them see me sweat.  Then he listened to what I was dealing with, how I felt about and we talked about how to handle the next situation like this.  As I talked I could see him listening to me.  He was really considering what I was saying looking at it from my point of view.  Finally, he said, "You sound like what happened makes you feel separate from everyone."  Exactly!  He put into words exactly what I was feeling.  I didn't even know the word for it myself until he said it.  I could see him replaying it all in his mind and seeing it how I saw it.  I don't know if he agreed with my point of view, but he saw it and accepted it for what it was.  And suddenly, the weight lifted and I felt better. 

    If he had sat there and talked and told me how I should have felt and how I should have handled the problem, I would still have felt isolated.  Instead, by really hearing me and considering my view of things, he stood with me as a mentor.  He showed me that listening is a performance art of wisdom and grace.  It is not passive, but a dynamic form of interaction.  Listening validates, it says, "You're worth the time it takes to hear you out."  Listening inspires.  It builds loyalty and gives you influence with others.  Listening is mature.  It means you can control yourself and your own impulses long enough to give someone else a chance to give you the information you may need to really know what is driving their reaction.  It allows you to be wise.  With all it has to offer, listening seems like a worthwhile endeavor.  I know I can talk, in the future I'll listen more.  I want to make someone else feel the way my boss made me feel.  That is something to aspire to.

That Explains It!

"The rule is perfect: in all matters of opinion our adversaries are insane."

                                                    ~Mark Twain~

    That explains the nonsense we've been dealing with from the specialist's office I wrote about last week.  It's as good an excuse as any since it seems like they would like to keep it current, and that seems insane to me.  I got a call from their office manager today and she started out sounding like nothing ever happened.  "Works for me" I thought to myself.  The pleasantries didn't last long, however, before the end of the short conversation she managed to work in at least 3 contentious comments.  

    I'll be honest, my knee-jerk reaction was to give as bad as I got.  I'm happy to report that something wise fought it's way to the surface and overrode that initial temptation.  Something inside me just whispered, "Nah, don't do it, let her be a jerk all by herself."  Let me tell you, I grew up in Brooklyn, NY with 2 brothers.  Smackdowns come easily and I could have left her wondering what ever possessed  her to mess with a city kid.  It was infinitely more satisfying to behave like a grown-up.  Maybe I'm getting old or something, but it was.  That brings me full circle around to one of my favorite ideas from The Success Principles:  E  (event) + R (reaction) = O (outcome).  In this situation the aggressive event was met with a neutral reaction, resulting in a neutral outcome.  Do you see how the neutral reaction always gives you control of an outcome?  Same with a positive reaction, except a positive reaction has the bonus possibility of bringing about a positive outcome.  Only negative begets more negative.  Do you see the freedom that offers you?  It's like a get out of jail free card.  You always have it at your disposal.

    So, is this other office our adversary?  Only if we choose to allow them to be.  Isn't that something?  They can't be our adversaries without our permission.  If we choose to continue to be positive or neutral, we drive the relationship.  They can try to grab the wheel and steer us down a dead end, but we can determine to stay the course.  No helplessness, no victimhood, no poor us.  Yeah, I like the way that explains it.

I Don't Blame You

    Have you ever noticed how hard it can be to get your message across when you are trying to tell a staff member that something needs to be done better or differently?  Basically, people almost automatically assume that if something is wrong, it only stands to reason that someone is going to get blamed.  It's a knee jerk reaction that stands in the way of getting to a solution. 

    I recently decided to talk about blame at a staff meeting.  As I was saying that just because I may need to tell someone that there is a problem with something, it doesn't mean that I am placing blame on them, so they don't need to feel defensive, one person started defending herself for being defensive earlier that day.  When I told her that she was proving my point, she defended herself about that.  No matter what I responded, she defended.  After about 10 minutes of that, with the staff quietly observing, I asked her what solution she felt we had reached.  She thought for a moment and then began defending herself for not getting to a solution.  I stopped her and asked her if she could even identify the problem at that point.  You got it, she couldn't. 
    I reminded everyone that the original issue was about the futility of blame.  The staff member said, "Well, I guess I proved your point, didn't I?"  I couldn't have paid her to have proved it more thoroughly.  Blame is useless.  When a problem arises, I immediately want to find a solution, especially if it involves a patient.  That doesn't mean I don't want to understand why the problem occured, of course I do.  Understanding is not blaming.  If people know they are not going to be blamed, they will be much more likely to admit to mistakes so that you can help find a solution or teach them how to do the thing right. 

    Blame misplaces focus.  The focus should be on solutions when problems arise.  As managers, we have to be careful not to automatically fall into blame mode when something goes wrong.  Examine your feelings the next time a problem arises at work.  Do you feel like you need to find someone to blame so that no one thinks you messed up?  Are you reacting in anger and placing the blame on someone in an effort to get the spotlight off of you?  Blaming and shaming have long-lasting effects.  So do supporting and teaching.  Which makes more sense to you?

You Don't Say

    Ok, so I'm over the weird episode with the specialist's office last week, sort of.  No really, it'll be a gnat at the back of my brain whenever I deal with them, but hey, that's life.  What have I learned from that episode?  Good communication is the responsibility of the participant who most wants to go forth productively.  In other words, if you want to break free of the trap of immaturity, insidious nastiness, and useless blaming and defaming, if you want to move forward positively, you must make the decision to cut the crap and say, "Enough."

    There are many ways to verbally express yourself and just as many reasons.  Some folks just love the sound of their own voice.  They love to sing their own praises, or pontificate on some subject on which they feel they have some unique and amazing viewpoints.  (I know I've been guilty of pontificating.  I know it for sure because the truth is, you can hear yourself when you're doing it, you know you can, and honestly, you think you sound amazing at the time.)  Ok, enough of my confessions.  Some people love banter, my boss and I are full of banter, hopefully our patients enjoy it as much as we do.  Some people just love the give and take.  But, for some, putting someone else down, makes them feel better about themself. 

    Knowing this, there are choices to make.  Sometimes there is strength in the spoken word.  Sometimes, the ability to remain quiet is where real strength of character can be found.  And sometimes, the only way to end an out of control, spinning in circles argument is to simply and gracefully, step away.  It's so effective, because once you stop participating, there's no where left to go with it.  Now, if you can find it in yourself to agree to just move on in cooperation, you'll have the satisfaction of having done the right thing.  Even though it may seem like there would be a lot of satisfaction in shooting off the perfect come-back or having the last word, sometimes what you don't say is infinitely more powerful than a stunning rebuttal.

Critical Feedback

    There is no harder conversation to have than one in which you will be passing on critical comments.  Let's face it criticism is hard to hear.  It's also hard to give, especially if you feel that the person or people you're giving it to won't take it as you intend it. 
    I had to pass on some information to a staff member at a practice that we refer to the other day.  I asked for the staff member who was concerned in the issue, told her what the problem was and felt we'd had an amicable talk.  I wasn't annoyed with her, I didn't even know for sure if she was at fault.  I just wanted to give her the information that I'd been given about a situation and let her take it from there.  I went on and felt we were done with it.  Well, hold on a minute.  Her office manager called me back and asked me if I was having a bad day.  I was mystified at why she'd ask that and she told me she felt it might explain why I'd attacked their staff member.  Since attacking is not my style, and I'd felt we'd had a good conversation I was shocked.  I told her that I hadn't attacked anyone, but that was not to be the end of it.  She insisted that I had and what should have been an acknowledgment of a misunderstanding became a mess. 
    Now, I'm incredibly stressed because I don't understand why it would benefit either practice to continue this.  I suggested agreeing to disagree and move on, but that's not going to happen, it seems.  So, how to fix it?  I was thinking about it and I've decided that I can do one more thing.  I can take my own interest out of the situation and look at it from the other staff member's view of what happened.  Obviously, she felt criticized, whether that was my intent or not.  The other om felt she needed to defend her staff member.  Maybe she feels that will build loyalty, maybe she truly feels I offended her.          There's one thing I can do if I really want to move forward.  I can acknowledge her view of the situation and tell her that although it was not my intent to hurt her, I obviously did and I'm sorry she experienced that.  Then I'm done with it.  Now, they have to deal with the fact that I'll never be able to give them critical feedback.  It may mean that eventually we won't be able to continue a professional relationship, because if our patients won't be served well because of it, we'll have to make a change.  I for one, welcome critical feedback as much as I welcome praise.  I like praise better, who doesn't?  But, I know that giving critical feedback means that the other person cares enough to risk doing it.  Most people will just walk away when they don't like something and find something else.  I'd rather be given the opportunity to rectify a problem. 
    We have to have the ability to hear criticism without letting it crush us, or taking it personally.  If we feel it is given unfairly, then just acknowledge it and move on.  It's a sign of maturity to be able to hear that we need to make changes or corrections and accept it in a spirit of goodwill.  It's a sign of humanity to be able to give another person the benefit of the doubt if they say no harm was intended and accept that. 
    For myself, I look at this unpleasant situation as a learning experience.  I will never casually pass on a critical comment again.  I will think through my words and look for any way in which I might make anyone feel defensive.  If nothing else it will be worth it to save myself days of stress and replaying the conversation. I also value my relationship with staff in other practices.  We all work better when we work together.  In the end, stress is felt by the patients and the rest of the staff and that's not what we're about.

Criticize This

"Asking a working writer what he thinks about critics is like asking a lamppost how it feels about dogs."      ~Christopher Hampton~

"People ask for criticism, but they only want praise."
                                             ~W. Somerset Maugham~

    As a manager or owner, when you see a staff member doing something wrong that you've corrected them on a few times already, what is the first thing you think?   Maybe it's, "I showed her how to do that 10 times, what's the problem?"  Maybe it's, "Oh no, how many times do I have to show her the same thing, over and over and over...?"  It gets frustrating, doesn't it?
    I'd like to suggest that when you find yourself thinking something like that, you use it as a reminder to stop and review.  What's going on here?  Is the task very complicated?  Are you confident in your ability to explain it in a way that someone who has no experience can understand?  Have you looked at it from the employees experience?  Have you asked her why she's struggling?  That question alone could open a floodgate of insecurity and pent up frustration.
    I believe that most people want to do well.  I'm also aware that there are people out there that feel entitled to come to work, do a lousy job, and have that job protected just because we made the mistake of hiring them in the first place.  But, for this, let's pretend we've already weeded them out and are dealing with someone who wants to do it right. So, let's say you just watched your employee do something wrong for the umpteenth time.  You've shown her how to do it correctly just as many times.  You've typed it out step by step and made a nice book of guidelines for her that is sitting right there next to her.  Ok, be honest now, what are you feeling?  Frustration, disbelief, impatience, aggravation, helplessness, hopelessness?  Yeah, well, to be honest, that's your problem.  Your job is to help her "get it."  When her job gets hard for her, your job gets hard for you.  The only way to make it get better for both of you is to find a way to help her "get it."  Sorry, and it's hard for me to do this, too, but you have to put how you feel about it aside and think about them.  I imagine that the person is feeling awkward, embarrassed, frustrated, aggravated, helpless and even a little disbelieving herself.  So, you already have a few things in common. 
    What if someone was going to critique your handling of this situation?  What would you want to show them?  A patient, understanding manager who worked kindly with the employee to discover a way to help them understand the correct execution of the task?  Of course you do.  So, everytime you face this situation in the future, imagine you are being critiqued on your critique.  Treat the person as you would if you knew your handling of the situation would be on the front page of the newspaper tomorrow.  If you wanted to impress him, how would you behave? 
    Now, get down to the nitty gritty.  Really see the person and work with them to get them where they need to be.  This is what you want to have happen.  You want to help them learn to do the task correctly.  In the process, you have the opportunity to create a mutually respectful relationship and to develop influence with them.  They will have an additional reason to learn.  They want to make you proud of them.  They want to show you that they have the ability that you've shown them you believe they have.  In the process, their confidence is increased, you've accomplished what you set out to do and everyone feels good about the outcome.  So, remember, no one really needs to be criticized.  They need to be lead and taught. 

Show Me

    Patients are becoming discerning "consumers" when it comes to dentistry.  Especially when it comes to anything that involves aesthetics or cosmetics.  People want whiter, straighter, more perfect looking teeth more than ever.  Or they want very natural looking teeth.  They want to know what they are going to look like when it's done.  Most important, they want to see what you can, and have done.
    What can you show them?  This is not usually an area that most dentists have a lot of experience with, but it can drive case acceptance.  People have to be able to see something in order to want it, and patients will only agree to treatment they want.  The first step in helping patients want treatment is to explain the benefits they will receive in terms of health, better quality of life and appearance.  Beauty being in the eye of the beholder, the next step is in showing them what you can and have done.  One helpful tool is a lab wax up of their study models.  Using an actual study model in comparison to a wax up will enable the patient to not only see what's wrong, but also to envision the improvement that restorative dentistry can provide.  Many photo software programs allow you to enhance and manipulate the patient's photo to give them a better idea of how they will look after restoration.
     Perhaps the most influential aide though, is a gallery of the results of the dentistry that you have provided for others.  They want to see proof of what you can do.  Time and time again, I've seen patients say, "I want to improve my smile, but have you ever done this before?"  Why just say yes, when you can show them instead.  Take the time to document the dentistry that you're proud of.  It can be as important as the degree that hangs on your wall to your patients.  Get some quality training for yourself, or for any staff members that will be taking photos.  Consider using a professional to develop some marketing media from your photos.  Check out this website for some ideas.  Even if you're just starting out, invest the time in documenting your dentistry, even if you just buy an inexpensive photo album to start with.  Don't be caught empty handed when patients say "Show me."  It may be the last step along the path to treatment acceptance.

You ARE The Boss

    I repeat, you are the boss.  Really, it's your name on the door, your years of work that earned the DDS, your reputation, your risk, your investment, your's to succeed or fail.  So why do you often find yourself worrying about how your staff will react?  How will they react to feedback?  How will they react if you change your mind?  How will they react to changes, requests, ideas or just about anything else you want to talk to them about?  What if you want to change hours?  What if you want to change the way your hygienists treat patients?  What if you want your assistant to walk the patient to the desk?  Will they get mad, roll their eyes, or heave a big sigh and look at each other as if to say, "Poor man, he thinks he can tell us what to do.  Let's just let him talk.  We all know who's in control here." 
    So, what's that about?  Have you resigned yourself to having your requests and expectations met with lukewarm, barely noticeable reactions?  Is indifference the common attitude?  Do you walk away wishing it were different?  Do you find yourself becoming passive/agressive and slipping in little sarcastic digs as you skulk off to your cave office?  Do you tell yourself you're just no good at managing your staff and wish someone would come along and do it for you?  Ahh, but who's going to manage that person? 
    I have witnessed this first hand and it's sorrowful.  I've heard the piteous, wondering queries from good-hearted, but non-assertive dentists who wonder if this is as good as it gets.  Here's the answer, it only gets better if you wake up one day and really believe, "I'm the boss.  I have the right to make requests and expect them to be fulfilled.  I have the right to change my mind and expect my staff to go with the flow.  I have the right to expect my ideas to be met with enthusiasm and my staff to step up to any challenge I may present.  I have the right to tell a staff member the truth about what we are doing together and to expect them to join me in finding solutions to problems.  I don't have to fear resentment or ridicule when I turn my back to go back to what we all come here for every day...the care of our patients.  That's not presumptuous or pompous.  That's how it should be, but somehow, for many dentists, it seems as far-fetched as owning your own island or standing on the Olympic medal podium. 
    What happened?  When did you give control of your practice, the way you work and the way your patients are treated, over to your staff?  You've probably had some great staff members along the way and wondered why they never seem to stay.  Be honest with yourself, do the rest of your staff make life miserable for any hard workers that come along?  Are their suggestions met with disinterest or ridicule?  Do you even know?  Because what you don't know will hurt you.  What are you doing about it?  If any of this hits close to home, it's time to start.  With yourself.  Be honest, what have you ignored long enough?  What drives you crazy?  What are you hoping will change?  Ok, when are you going to step up and take control of your practice and your life?  It all comes back to you.  You are the boss.

So, What's The Solution???

   

Have you ever noticed that when employees come to inform you about a problem, sometimes they almost seem smug about it?  They, very importantly and eloquently, give you the nitty gritty in all it's glorious detail, then stand back to wait to see what you're going to do about it.  You, the proverbial deer in the headlights, are in the unenviable position of absorbing bad news in front of someone who seems to be waiting to see what brilliant solution you're going to come up with.  Inside you may be screaming, "Oh come on! Why me?? What the heck is going on, why can't a day go by without something like this?!"  On the outside, you may be thanking the staff member for bringing the problem to your attention, even though you can still hear what's clamoring on the inside.  As they walk away, and this is the best part, you glare at their back in resentment and think about how nice it must be to be the person who dumps all the problems on someone else, rather than being you, the dumpee.  Oh, if you could only see your face at moments like this.  It's not a pretty sight.  I know, I've caught a glimpse of myself in a mirror as I've turned away in disgust.  It made me want todecree that black cloths be placed over all the mirrors.

    It's your own damn fault!  Nope, sorry, I don't feel sorry for you.  Wanna know why?  Because I've been you.  There were days I hated my staff for being such big babies and never solving a problem.  Then I realized something.  I grew this staff.  I was reaping the result of the seeds I'd sown.  Now, I didn't intentionally do that, but I do think that sometimes, those of us in leadership positions tend to believe that we have the best answers to everything.  I used to be quite amazed and satisfied with myself when I first started leading our team.  I would sit back and think about all the wonderful decisions I'd made, ideas I'd come up with and solutions I'd designed and think about how lucky my boss was to have me.  Gag!  Sorry, I just made myself a little bit sick just typing that.  Anyway, I realized something was wrong with my thinking the first time a staff member came up with a great idea and I felt a twinge of resentment toward her. " Hey, I'm the idea person, aren't I?  That's my job, you just get back in there and clean teeth!"  Mind you, none of this was ever uttered, it was all mindtalk, but wow!, even I was appalled at myself so I'm glad the words didn't burst past my lips.  So, being me, it was time for introspection and change.

    The next time someone came to me with a problem, I resisted the urge to give the solution and asked her what she thought we could do to make it better.  Her answer, "I don't know, that's your job", confirmed that I had a problem.  So, another staff meeting was born.  We talked about considering possible solutions whenever we saw actual or potential problems.  I asked them to take the time to be quiet with the problem and just let ideas come.  That's where the best solutions are usually born anyway, in solitude.  Knee-jerk reactions have a 50/50 chance of working in most cases.  The reason I say that is because most often they deal with the immediate problem, but not the future ramifications of the solution.  Giving yourself even 5 minutes to consider what will happen next, and next, and next again, can add clarity to a solution. 

    The next challange is to recognize a staff members great solution without worrying that you are making your own job obsolete in the process.  Once you do that, the result will make you want to do it again.  When you see the pleasure dawning on a staff member's face that their idea was not only approved, but applauded, it makes you want to encourage them to keep it up so you can see that look again and again.  It's an "I'm ok, you're ok" moment that really feels great to everyone.  The thing to remember is that leadership isn't about getting your own way, it's about leading to the right way.  It's about making everyone think and share what they think,  so that you have more choices, more input and more good ideas.  Coming to a solution together, choosing a path together, makes everyone more committed to success because they each own a piece of it.  Wouldn't you rather be a part of the process of a solution or success, rather than a bystander?
    So, what's the solution to problems?  Share the pain and share the glory.  Get out of the "me" of it, and get into the "we" of it.  Stop talking about the team as "them" and start recognizing the team as "us". Stop resenting the bearer of bad news and start helping them be a part of the solution.   If you can even entertain the idea that you may be one of the problems, that's when you'll get to the best solutions.  You just have to be brave enough to look at yourself honestly (ouch), that's the solution. 

The Truth, And Nothing But The Truth

    Telling the truth sounds simple, but it rarely is.  Ask anyone in a leadership position what it's like to be completely honest with any employee when giving feedback in a review.  It's hard to look another person in the eye and tell them there's something lacking in their performance or attitude.  There they are, hoping that you have called them in to tell them something wonderful, and you have a bomb to drop.  Set a precedent early on and let new employees know that they can count on you to be honest with them and the butterflies will eventually subside, for both you and them.  Let them know that even though something they are doing may need to change, it doesn't mean that you don't like them or that it's a reflection on them as a person.  In other words, get them to see they can accept it as information without taking it personally.
    The truth doesn't have to hurt.  You still have to tell it, but you can immediately back it up with an offer to work together toward improvement.  Have ideas ready.  Have examples of instances when this employee has risen to the occasion.  Give examples of times when you've been faced with the need to improve.  Listen to their reaction.  Are they accepting what you are telling them, or are they focused on convincing you that you're wrong.  Keep coming back with the truth.  Include good truths, too.  Tell them about how traits you admire in them make you feel confident that they can overcome the issue at hand.
    If you've ever had to fire an employee, you know that it's a lot less traumatic if you've been brave enough to be honest with the employee about how they were doing all along.  Firing a staff member is one of the most stressful responsibilities an office manager has to carry out.  It has to be that much harder if you haven't been honest with the employee about their performance.  If you haven't told them the truth, you've cheated that person out of the chance to save their job.  If you have approached them with the truth numerous times leading up to their dismissal, they usually know that it's about to happen and are much less emotional and angry about it. 
    Telling staff members the truth about what they are doing is a matter of trust and respect.  It says that you respect them enough to handle the truth and that they can trust you to be honest with them.  If they are able to make the necessary changes in their performance, they will likely become your most loyal team members and will give you honest feedback whenever you ask their opinion.  The truth is nothing to be afraid of.  After all, it's nothing but the truth.

The First Five Minutes

My boss made a comment today that got me thinking. We were talking about a very charismatic colleague who works in another office. He was saying how great she is for their office because her first five minutes are so good. He's talking about the first five minutes of her interactions with patients, co-workers, and even staff from other offices. Everyone loves her because she makes them feel important. She's charismatic and extremely upbeat without being too much or seeming phony. That's her particular gift; we all have something that we can use to make our first five minutes great. Maybe, like my friend Julie, you're bubbly and outgoing. You leave your own problems outside the office and focus your attention on the people around you., You're a beam of sunshine and everyone basks in the warmth of your glow. Maybe you're more laid back. You're one of those people who are easy to talk to. You remember things that people talk to you about and ask for an update when you see them again. It's that little thing that impresses people and adds sincerity to your care. Whatever you've got, it's what makes you special. Share it. Use it everyday. It gets people talking and it draws success to you and your practice. Make your first five minutes great and you'll enjoy your work and enrich your patients lives.

Talking Yourself Silly

    Have you ever felt like your well thought out words of wisdom are falling on deaf ears?  Every word sounds so great coming out of your mouth, but what happens to it on the way to the staff's ears?  Obviously, some horrible change takes place as they float through the air before being intercepted and deciphered.  That's the only possible explanation for the blank stares you're receiving rather than the standing ovation you deserve.  Sometimes, you might even catch a glimpse of outright hostility.
    So what's going on?  Let's face it, we have have a certain style of doing things.  Communication is no different.  The way you are giving the staff information may sound reasonable and clear to you, but to them you may sound no more interesting than Charlie Brown's teacher, "Mwha, Mwha, Mwha."  The exciting new ideas that you think you're relaying may just sound like pipe dreams to them. 
    So, how do you get them into it?  Get into their heads and hearts.  Find out what motivates them.  What's important to them?  Listen to them.  Give them the floor and let them take the problem and come up with a solution.  Don't get in the way.  Put it to them and see what they come up with.  Lead them to the answer, but don't always spoon feed it to them.
    One thing I've found is that people are more likely to follow through on ideas that they come up with.  Make it safe for them to speak up at meetings.  Let them know that there are no dumb ideas, just some that aren't ready for primetime just yet.  Keep prompting them to go deeper into conversations and brainstorming sessions.
    No matter how tempting it is to talk through silences in staff meetings, resist.  Put an issue on the table and wait.  If no one speaks up, be ready to ask specific staff members for their thoughts and then encourage them to keep putting ideas out there.  Before you know it you may have trouble getting a word in edgewise.  There's nothing silly about that.

You Didn't Just Say That

    Have you ever sat their with your jaw hanging open because you can't believe what someone just said to you or someone else?  It sometimes seems like evolution has mistakenly eliminated the filter in people's brains that edits out foolish, inconsiderate and hurtful comments.  It's a shame, I miss good manners and kindness in communication.  I don't think everyone has to go around flashing peace signs and having honey drip from their lips, but that old admonishment that you'd be better off staying quiet if you don't have anything good to say could be brought into play a little more often.
    Sometimes we have to give others feedback that is less than easy to hear.  Do you ease the blow or do you just spit it out in it's most basic form?  If you've ever had a patient come in who looks like he needs to be introduced to a toothbrush, you know there's something a little affronting about the fact that he didn't care enough about your sensibilities to scrape some of the gunk off his teeth before you had to set your sights on that slimy scene.  Does that give you the right to be blunt about how gross it is?  Nah, you're a professional and you have to communicate professionally.  As my boss says, "You have to meet them where they are right now."  If you can talk to them in a way that leaves their dignity intact, you may just help them change their thoughts about caring for their mouth.  And that's what your goal is, right?
    How about your staff?  Do you think you have the right to just flip out some off the cuff, insulting responses?  Dismissive replies?  Hurtful criticisms?  Well, you don't have that right and you just make yourself look small if you act that way.  It really is true, people might not remember what you say, but you can bet they'll remember how you made them feel.  And if you have any sensitivity, you'll  remember too, and wonder if you'll ever erase it from their memory.  People don't come to work hoping to do a bad job.  If you have people working for you that don't care about what they're doing, it's your responsibility to let them go, but it doesn't give you the right to be rude. 
    If you're a patient do you think that you can treat the staff however you want as long as you're sweet to the dentist?  What possesses you to act that way?  Let me tell you something.  When a patient talks rudely to a staff member it is like a kick in the shins.  It's senseless, infuriating and belittling.  These people are there to take care of you.  You are not better than them.  You don't have the right to abuse them just because you think they have to put up with you.  You cause discord in the office and the dentist does not appreciate your behavior.  And you can bet he'll hear about it.  If you're a dentist and you have a patient who does this, don't let them away with it.  There's nothing that will inspire more loyalty in a staff member than hearing your boss tell a patient that he will not allow them to treat his staff members shabbily.
    Staff, listen up.  How do you talk to each other and about each other?  How do you talk to your boss?  Are you respectful?  When you treat each other with reverence, you make life wonderful.  When you respond to unpleasant patients pleasantly, you rise above the chaff.  You have one chance at every day.  Life happens and there are days when it's more challenging to be nice, but you can do it.  Just remember that at some point you'll have to look back over your actions and it feels better to look back with pride and satisfaction than to cringe with embarrassment at the way you treated someone.

Why Should I?

Dentist: "Why should I give you a salary increase?"
Team member: "Why should I work late to finish that root canal with you?"
Patient: "Why should I spend that much money on the implant you suggest?"

Why, indeed?  What makes anyone do what you think they should do?  How do you make them say "Yes, indeed" rather than "Why should I?"  The answer is to be sure that what you want is doable, supportable, deserved, or will serve a greater good. 

We've all seen team members who feel that a salary increase should be just as predictable as the rising and setting of the sun.  They don't really do anything to make it happen; it just does.  As the dentist or manager, asking them to justify their request serves two purposes.  You don't have to list all the reasons they shouldn't get a raise and they may just realize that they have done nothing to deserve one if they can't come up with anything.  It also opens the discussion for goal-setting and improvement.  When the improvements are made, a new salary discussion can take place.

So, you're working a little late and your assistant keeps making exaggerated glances at the clock.  You've gone 30 minutes past the end of the working day and she's wondering if you're going to compensate her.  Hopefully, your office manual states that on occasion you will need to work a little late to finish patient care.  I also hope that the culture in your practice is such that the team members don't look at situations this way.  If you've been talking about service to the patients and working as a team, your assistant is focused on what she is doing.  Tomorrow evening, when you are done 30 minutes early for the day, she knows you'll tell her to go on home and enjoy an early evening with her family.  If you have the right conversations and team meetings all along, these situations won't result in demands and aggravation.

You are sitting with your patient and discussing the options for replacing their missing tooth.  How will you make him want an implant which you feel is his best replacement option?  He sits down and says, "How much is this gonna hurt my wallet, doc?"  Do you start to tell yourself to just offer him a bridge or do you present the plan you know is best?" 
I usually smile and acknowledge the fact that anyone would rather spend their money on a nice vacation than on dental care.  Then I get to work educating the patient on his options.  I understand that it is my job to give him all the information he needs to make the best choice for him.  If you go into the discussion determined that you will fail if you haven't scheduled an implant before he leaves, you are serving your own interest, not your patient's.  Most of the time, if you communicate well, and the patient feels that you want the best for them, they will be more likely to choose the treatment you suggest.  You have to find out what is stopping them and then find a way to make it possible.  If you come to the conclusion that the treatment is not possible for the patient, for whatever reason, then you have to  do your best to serve him where you can.  That means meeting the patient where he is.  Sometimes you can bring the patient further along, sometimes you have to respect that they are going to stay right where they are a little longer.  If you can remember that "no" today doesn't mean no forever, you will have a dedicated patient who trusts you.  Trust is the foundation for getting patients to believe in the treatment you suggest.

When someone asks, "Why should I?" give them every reason to believe they should.

What's Up With That

If you've tried to email me lately and haven't gotten a reply, it's not for lack of trying on my part.  The emails from the address on my site keep getting returned to me.  I've tried to change the email address but it's not happening.  So, if you're one of the people who are wondering why I don't return emails, try this address:
lindaz@mchsi.com
Now we'll hope for the best.

Are We Clear On That?

    If I had a nickel for every time I've heard a dentist say, "What can I do, I'm a lousy communicator?", I'd have a whole lot of nickels.  Just admitting you have a problem, does not eliminate the problem. 
    In defense of male dentists I'll say this, the poor guys are surrounded by women.  They probably feel like they are tiptoeing through a minefield some days.  It's not the same as having a discussion with his wife.  The dentist and staff member don't have the same background, they don't have the same future and they don't have the same emotion.  The dentist is not half as wrapped up in the feelings of his employee as she may wish he was.
    Our society tends to be a little narcissistic these days.  We tell others more than we should about ourselves and expect them to be as interested in us as we are in ourselves.  That tendency also makes us less interested in others.  Thus, the communication problem.  We don't look at problems or issues from the other person's point of view.  We don't want to have to change our opinion or deviate from the path we have decided is correct.
    When we do this, we cheat both ourselves and the other person.  We don't get insights and ideas that might benefit us.  We don't let them see us for who we are, which might make them even more eager to follow our vision.  If we sit and nurse our dissatisfaction without letting the other person know about the problem, we become a major part of the problem.  We are then an obstacle to any solution to the problem.
    It is also destructive to withhold positive comments.  Employees shouldn't expect constant compliments, but everyone is inspired by hearing that they are doing a good job. As a dentist or manager, we have to make an effort to come out of ourselves once in a while to notice what the staff is doing right.  That's how you get more of it.
     Communication can be a chore.  Having to face a difficult discussion is never fun, but procrastinating only builds more tension and allows the situation to become even worse.  Don't wait until you're ready to explode, that's always ugly.  Develop clear guidelines, state expectations, give feedback regularly and you'll find your communications are easier and much more pleasant. 

Don't Assume

    By now you know that I love Gretchen Rubin's Happiness Project weblog.  Here's a tip for you.  Read this article.  Gretchen talks about seeing Gilda Radner and Gene Wilder in a drugstore in NYC.  She was surprised to see that they were talking in very serious tones.  It was right about the time that Gilda was dealing with her cancer diagnosis.  Gretchen gives a convincing argument for not judging people by the way they are acting at the moment.  You never know what they are dealing with.  Take a minute and read her article.  Share it with your team, too.  It may help you give the next grumpy patient you encounter the benefit of the doubt.

We Are What We Say We Are

    Watch your words, you may become just like them.  I love the English language.  My husband calls me the Commander, as in the Commander of the English Language.  I just really like words and I love to talk, hence, the title.  Did you ever notice that most people have a few signature words or phrases?  One that my kids tease me about is my tendency to say, "What's that about?"  I say it a lot.  I think it's because I'm inquisitive.  That's the nice word for nosy.
     I work with someone who is extremely dramatic.  (Notice that I used "extremely" rather than plain old "very".  I needed the extra emphasis.)  Her key words are devastated and horrified.  She can be devastated by anything ranging from a spot on her clothing to someone dying.  It's all devastating.  She can be horrified by a murder or a mosquito.  When she says the words, you believe she truly feels that way.  It's all super-sized and it's all very dramatic.
    I have another friend who loves everything and everyone.  Ask her how she feels and she'll tell you she's terrific.  Her kids are doing fantastic in school and her last vacation was heavenly.  She also means it.  You can see it in her face. It's all super-sized and it's all wonderful.
      Do you see where I'm going with this?  I think that you can set your mood with the words you use and you can also affect the reaction that others have to you.  Think about a time when you said, "I'm so stressed."  Saying it didn't make you feel less stressed, just the opposite.  You sink right into the feeling of the word.  Ranting and raving doesn't dissipate anger, it justifies it.  Laughing doesn't make problems go away, but it sure takes some of the impact out of them. 
    Want to make your work environment feel lighter and easier?  Watch your words.  Use encouraging, upbeat words.  Don't be phony, just be more conscious of what you say and how you want to feel.  I used to feel very pressured when the schedule was crazy.  Verbalizing that made it feel even worse.  Now I look at the schedule and try to plan out ways to make it all run smoothly.  The more I assure myself that we can handle it, the calmer I feel.  So if you want to feel upbeat, speak that way.  Before you know it, you'll feel fantastic.
   

Encouragement

    A friend of mine read my post titled, "Burned Up" and said that it reminded her of how she felt.  She works in a medical office, but for a demanding and hard to please boss.  She wants to understand what would make him happy and she'd love to go home feeling like she satisfied him.  I don't think it will happen.  He doesn't have it in him to encourage her.  He's more likely to notice what's wrong than celebrate what's right.  He is crushing her spirit and she is losing hope. She works hard and really wants to help.  I think there are a lot of others like her, trying to succeed and being crushed by the oppressive weight of someone else's inability to encourage. When a person who wants to excel is never encouraged and never given feedback that makes them feel that they are achieving their goals, sooner or later they will lose enthusiasm. What her boss doesn't realize is that as she loses enthusiasm she may also lose her desire to give it her all. 

 
Each person has an ideal, a hope, a dream which represents the soul. We must give to it the warmth of love, the light of understanding and the essence of encouragement.

Colby Dorr Dam

If bosses and managers could just look at others and realize that they affect the soul of the other, I think they would temper their words and consider the result of their actions. When we tell a hard-worker that their best wasn't good enough, it hurts.  You may have to tell them that something isn't working, but you can choose your words carefully so that you are encouraging rather than demeaning. 

 

There are high spots in all of our lives and most of them have come about through encouragement from someone else. I don't care how great, how famous or successful a man or woman may be, each hungers for applause.

George Matthew Adams

Consider this.  The gift you give another when you let them know you believe in them and applaud them, is a gift you receive as well.  Think of every acceptance speech you've ever heard for any achievement.  The recipient invariably thanks the people who helped them make it.  Very few people feel that they reached a great height alone.  They want to thank the people who believed in them.  Just about every book has an acknowledgment in the beginning.  I'm always amazed at how many people the author feels a need to thank.  None of us exist in a vacuum and none of us achieve alone.  If you've reached a position of any importance, someone helped you.  Think about someone who encouraged you.  How do you feel when you think about them?  Don't you want someone to feel that way  about you?

 

Sticky Situation

Sometimes we can find ourselves in some pretty awkward situations.  Your reaction can make things get better or make them even more uncomfortable.  If you really think about it, most situations involving personalities fall into a few categories.  I was in a treatment plan consultation today with some pretty unusual people.  There was a mother, father and adult daughter.  The father sat in the middle of the women and was a major curmudgeon.  He was very combative and I understood that he wanted to make me squirm.  I recognized that immediately and whenever he made a goofy comment I just asked him to repeat himself.  He would wave his hand at me and say, "Oh, never mind."  I just smiled and said, "Oh, I never mind answering questions."  By the time he left he thought I was just great.  I recognized someone who would respect me for not being intimidated.  He had two intimidated females on either side of him.  He was bored and I was a challenge. 
    Then there are the bullies.  They are rude, they interrupt and they dismiss.  They demand that the dentist come talk to them and expect me to slink off down the hall in surrender.  I explain that the dentist will be happy to talk to them, but since he wasn't planning on it today and has other patients, we'll have to reschedule.  No problem, my ego can take it.  Most of the time my boss will invite me to sit in on his consult so that the patient doesn't get the idea that he can call the shots.  You see, in the end, my boss holds all the cards, he's the one who's got what the patient wants.  We have a good thing going with our working relationship and it can outlast anything a patient throws at it.
    One of the most difficult is the patient who doesn't ever want the meeting to end.  Once everything has been explained and all questions have been answered they begin again with the same questions.  It's a dental twilight zone.  At this point I find it best to voluntarily offer a brief synopsis of everything that was discussed and point it all out on the treatment plan that they will take home with them. I'll suggest that they go home and digest what we've talked about and call or come back in if they still have questions after that. I then thank them for asking such educated questions and most importantly, I stand.  Body language can speak volumes and if you ever want to see the light of day again, with a patient like this, by all means use your best moves. 
    The most uncomfortable situation may be with the patient who receives unexpected bad news and becomes extremely emotional.  Be supportive and empathetic.  Point out whatever positives you can, even if it's just the good decision they made to seek treatment.  Promise to help them through and work with them to gain their trust and keep them comfortable.  In the end, you may make a huge difference in their health and their life. 
    If you think before you speak and act, sticky situations don't have to become really uncomfortable.  Stay calm and think with reason.  Take your time and gauge your responses to get the best outcome in any sticky situation.

Shame Hurts

                             Communication is an amazing thing. In equal measures, it can be a blessing or a curse.  Words can be used to elate or devastate.  That's power.  We all wake up in the morning with the possibility of the coming day before us.  How brave we are to take the chance of facing devastation.  How trusting to hope for elation.  We owe it to the people we encounter to use care in our communication.  If we are honored to be in a position of leadership or influence, the obligation to use words responsibly is even greater.  We have the potential to lift up or pound down the spirit of those around us with the words we choose. 

    I had the unhappy experience of being on the receiving end of some unkind communication today.  I had submitted an article that I was excited about, to the editor of a publication that I admired.  I had been published there before and thought I had a good relationship with the editor and his assistant.  The article had been submitted two months ago and I'd had no response.  A previous article had been rejected harshly, but I was willing to look at it as a learning experience and ignore the childishly emotional e-mail response I received.  This time it was a phone call from his assistant.  The person was absolutely condescending and superior.  There was no reason to be.  I was perfectly willing to accept that my article wasn't right for them and move on to another publication.  You see, I like the article.  I know other's will, too.  What I didn't like was the fact that both people wanted me to feel ashamed.

    What people don't realize, or maybe just don't care about when they try to shame someone, is that people set out to do the best they can.  Nobody wants to make a mistake, break something, or even write an article that someone doesn't like.  People who put themselves in the public arena in any form, expose something private about themselves.  It's ok to say, "No, thanks."  It's not ok to demean.  It's fine to correct or instruct.  It's wrong to belittle. 

    People who feel a need to shame others are really telling us something about themselves.  In this case the editor was being a bully and his assistant was trying to impress a bully.  They both needed a scapegoat.  Enter your's truly.  I am lucky enough to have a great support system.  Sure, it hurts to hear comments that are designed to shame, but I had the safety net of reassuring people who care about me to bounce me right back onto my feet again.  What if I didn't?  Many people go home to more of the same; or they may even go home to nothing at all.  What do you think happens to those shameful words?  They swirl around and take on more importance.  They seep in and become a part of that person.  They erode.  The only good they do is to act as a reminder not to treat others that way.

    On the other hand, positive communication builds up.  It plants seeds of pride and self-esteem.  It creates bonds of love and friendship.  It gives the people who face shame in other areas of their lives a coat of armor. It gives lonely people hope.  We all have the power to choose how we will communicate.  Be assured that whether you choose to tear down or build up, you will make a difference. 

That's A Good Question

  There is a post on the Dentaltown website that is talking about giving concise answers to the questions most frequently asked by patients.  It's important for all team members to be willing and able to answer patients questions consistently.  It occurred to me that it would be a good idea for practices to decide on how they want these questions answered and for all team members to understand and use the same explanations.  To get you started, I've pulled some of the questions off the Dentaltown thread and applied the answers that we generally use to them.  One thing I always tell patients when I give them information is that I want them to understand their condition and the possible treatments for it.  I also want them to understand the benefits of each treatment and the consequences of waiting or doing nothing.  Then the patient can make an informed decision and take responsibility for their dental health.

1.  Why do I need a crown ?
    Your tooth has suffered trauma or decay that has weakened it.  It is at a point where filling it again will undermine it even further, rather than strengthen it.  A crown will not only protect the remaining tooth structure, but also the health of the nerve as well. 
    Or...The root canal treatment removed the diseased tissue from your tooth, but it also removed the tooth's blood supply.  This causes your tooth to become brittle and more likely to crack.  Sometimes when this happens the tooth must be extracted.  Placing a crown will protect your tooth and the investment you've already made in it.

2.  What is a crown?
    A crown is a protective covering for your tooth, much like a thimble.  It holds the tooth together so that you can chew your food just like you did with your real tooth.

3.  What if I don't get the crown ?
    There is no way to predict how long your tooth will be ok.  You may be fine for years or you may fracture it tomorrow.  Placing a crown before a catastrophic event happens prevents your tooth breaking at a time when you can't get immediate help or during a vacation or other time when you want to enjoy yourself and not worry about pain or an ugly cracked tooth in the front of your mouth.  Sometimes, when a tooth breaks, it fractures below the gumline resulting in the need for gum surgery before a crown can be placed.  Other times it fractures in the root system and the tooth must be removed.  By acting proactively, before a bigger problem occurs you can function well and not have added expenses in response to bigger problems.

4.  Can't you just pull it instead ?
    We could, but then you'd have the bigger problem of a missing tooth.  When you lose a tooth and don't place an implant, you begin to lose bone.  Over time your remaining teeth will shift and that can also result in periodontal problems.  Saving this one tooth now can prevent multiple problems in the future.

5.  What is a bridge?
    A bridge consists of multiple crowns that are splinted together to span the empty area where a tooth or teeth were lost.  Two or more of the teeth on either side of the missing teeth must be prepared by taking away some of the tooth surface so that abutment crowns can fit over them.  The teeth that take the place of the missing teeth are called pontics.  Bridges are acceptable appliances to replace missing teeth, but they do not stop bone loss in the areas where teeth have been lost.

6.  What is an implant?
    Implants are artificial roots.  They are made of titanium and look like a screw that is placed into the bone where a tooth was lost.  The bone then grows into the threads of the implant and preserves bone.  Implants surgery is no more uncomfortable than having a tooth filled and patients report very little discomfort once their numbness wears off.  Healing takes 3-6 months and at that time impressions can be made for a crown that will be cemented to the implant.  Implants functions just like real teeth and can't decay or have toothaches.  Implants are the most natural tooth replacement available.

7.  Why do I need so many fillings ?
    Brushing and flossing are important in preventing decay.  If you brush your teeth, but never floss it is like washing your hands and never opening your fingers to clean between them.  Bacteria builds up and starts attacking your tooth.  Diet plays an important role, too.  If you eat a lot of carbohydrates and don't brush and floss properly, you are feeding the bacteria that feeds off your teeth.  Proper home care, good nutrition and regular dental visits can help you avoid fillings in the future.

8.  What is a root canal?
    A root canal is a procedure that removes the dead and dying nerve tissue from the inside of your tooth.  Once the diseased tissue is removed, the nerve space is disinfected and filled with a medication that seals the end of the root and occupies the empty space in the canal.

9.  What is a night guard and why do I need one?
    A night guard is a plastic device that is made in the laboratory and worn by the patient while they are sleeping.  It fits over the upper or lower teeth.  Night guards are recommended for patients who are causing damage to their teeth because they are clenching or grinding.  They are literally wearing their teeth away while they sleep.  A night guard covers and protects the teeth from further wear or protects teeth that have been restored with crowns.

10.What is periodontal disease and why should I be treated for it?
    Periodontal disease occurs when teeth develop gum pockets.  Those pockets are too deep for your toothbrush to get to the bottom of and clean out.  Bacteria set up camp in those pockets and grow colonies that cause infection which causes deeper pockets and bone loss.  Without treatment the condition worsens and can cause you to lose your teeth.  Once periodontal disease is present, your hygienist must do a deeper cleaning and sometimes will feel it is necessary to use medications under the gums to help kill the bacteria.  Bacteria are live organisms that are living in your mouth and causing damage.  Periodontal disease can affect your overall health as well, so it is important to take action.  Think of it as having termites eating away at the foundation of your home.  One termite probably wouldn't do too much damage on it's own, but we all know that termites don't go it alone.  Just like bacteria, they colonize and destroy.  You wouldn't sit by and allow termites to destroy your home, so you won't want to do nothing while bacteria destroy your gums and bone which are the foundation for your teeth.

11. I'm too old to spend money on my teeth.  How much longer am I going to need them?
    No one knows how long they're going to live, no matter how old they are.  But...as long as we're alive we need our teeth to eat well, stay healthy and look good.  No matter how old you are, you're too young to lose your teeth.  While none of us knows how long we're going to live, we do have a choice about how we're going to live.  Living with healthy natural teeth or optimally restored teeth is more comfortable and healthier.  It will allow you to enjoy a better quality of life.

12.  Why do I need x-rays?

     Bite-wing x-rays show if there is decay between your teeth.  Panorex and periapical x-rays allow the dentist to see the health of your roots and bone.  He can not tell if you have infection, cysts or tumors in these areas without x-rays.  The sooner decay and other conditions are diagnosed and treated, the better the chance for a successful treatment result.

Who Are Your Giants?

"If I have seen farther than others, it is because I was standing on the shoulder of giants."           
     ~Issac Newton~

    Who are your giants?  They are the people that you learned from along the way.  The ones that cared enough to be tough on you and took the time to be patient with you.  They are your teachers, your coaches, your mentors, your co-workers...anyone that you've had an impact on or that has had an impact on you.  Many times we reach a certain level of success or satisfaction with ourselves and begin to think of all we've achieved.  We can forget that there were people who showed us the way and allowed us to find our own unique path to success. 
    Your first giants were probably your parents, siblings and extended family.  My grandfather was one of my giants.  No matter what I did, right or wrong, he let me know that I was still ok with him.  My mother was a giant to me in her example of how to treat others.  No one was unworthy of her esteem and goodwill.  She was one of the givers of this world.  My husband and children are giants in their unconditional love for me.  They are the feather bed that I fall on when life's events hurt or tire me.  They are the bubbles in the celebratory glass of champagne when things go well.  They are the warm embrace that gets me through anything. My husband is the person who loves me when I'm unlovable and tells me that I'm the best. He is my constant giant. Tom Morris and Ed Brenegar were giants to me when I was at a crossroads in my working life.  They kept me aware of the fact that the world was open to me and that I could choose the path I wanted and do what it takes to enjoy my journey.  My boss, Jeff Price is one of my giants.  He keeps me grounded without pinning me to the ground.  He has given me opportunities to grow and achieve, advice that made sense rather than placating, and guidance when my path had too many rocks in the road.
    I can try to pay them all back by being the giant someone else will think of someday when they are taking stock of their life and the people in it.  When I do that, I not only help someone else, I realize how much of themselves my giants put into helping me.

Courage In Action

 "A leader must have the courage to act against an expert's advice."

            ~James Callahan~

    Wait a minute.  Aren't leaders supposed to seek out the wisdom of experts?  After all, the experts spend all their time figuring out the best way to do things and what to do when things go wrong.  Many times experts do have good advice, but many times they are just thinking generically.  People aren't generic.  There are many different personalities that achieve success in many different ways.

    Human beings make mistakes.  Yes, the experts sometimes have great advice for dealing with those mistakes, but sometimes it won't work.  That's when a leader has to rely on herself.  You may have to follow your heart rather than your head sometimes even though the roar of the crowd is deafening in it's insistence that you follow expert advice. 

    I remember an expert telling me that I would have to fire a staff member if I was going to salvage my leadership.  This person didn't seem able to accept me in my position and surely didn't seem to like me very much.  I wanted to find out why because I believed that understanding would lead to solution.  I still don't understand completely, but my desire to wait and understand led to a better relationship.  The experts would have told me to give up and move on, but in the end I'm glad I didn't. 

    Sometimes it's a mistake to ignore the tried and true, but the lessons we learn from our mistakes are valuable too.  If your heart is true and your head is healthy and your purpose is sincere, you probably are somewhat of an expert in your own right.  You probably know what path to choose.

Treatment Plans Presented Wisely

    My boss frequently hands me something to read.  Sometimes it's a journal article, sometimes it's the entire journal, and sometimes it's a book that he enjoyed and thinks I'll find interesting.  He's always right and since he knows I'm an avid reader, he realizes that it's no imposition on me to be asked to read anything.  Since I only achieved one year of dental assisting school after high school, I consider myself to be earning my degree at the University of Linda Z.  All professors welcome, but the pay stinks. 

    The book I'm reading now is titled Words That Work - It's Not What You Say, It's What People Hear by Dr. Frank Luntz.  I am really enjoying this book, but I just read a sentence that made me sit up and think, "Hey, that's what anyone who is presenting treatment plans to patients needs to think about."  Here is the sentence: "Education must precede motivation, and even information."  Actually, I got so excited by that sentence (yes, I know I'm a geek, but geeks are generally pretty happy) I didn't read the rest of the paragraph which is equally relevant to us so here it is:  "This may be painfully obvious to read, and it is certainly painful to witness when it isn't practiced, but your audience needs to know the basic generalities before you can motivate them to respond to the specifics.  You can't short-circuit the communication process.  And to be a good teacher, you have to know from where the pupil is starting.  As my boss, Jeff Price says, "Meet them where they are."
    So, if you're wondering why you aren't getting anywhere with your treatment plan presentations, maybe you just aren't educating your patients first so that they can desire what you are offering.  Many times when I'm presenting a treatment plan a patient will drop into the chair and say, "Give me the bad news.  What's this going to cost me?"  When I first started doing this I would sheepishly slide the treatment plan to them and wait for the cry of anguish.  I would then, somewhat feebly try to start educating them.  I had it backwards and yes, it was painful.  Little by little I learned that I could control the pace of the presentation and the order of it.  After all, I had all the information.  I did this by putting together a folder with the patient's x-ray, review of findings, their dental chart and information sheets with pictures and diagrams of the treatment options I'd be presenting.  I would then respond to the above statement by saying, "Here, I've prepared some things that will show you what conditions are present in your mouth and what we can do to help you.  We will talk about the fees once we have looked at this information."  I then proceed to tell them what is in good condition in their mouth and what needs work.  Then I tell them what we can do to help and finally I present the fees.  If they say they can't afford something even though they desire the treatment, I try to find ways to phase their treatment or payment options for them.  Once they realize that I put some time and effort into the presentation, most patients are interested in seeing what I've come up with.  Once educated, they may still grumble about the fee, but they understand what they'll be getting and how much work goes into it.  Presenting a treatment plan wisely is worth the effort and is more likely to be accepted by the patient.

Things That Make You Go Hmm...

   Ed Horrell's weekly newsletter gives practice owners and managers something to think about this week:


    Have you ever wondered what your customers REALLY think of your service?  My guess is that it is pretty close to what your employees think of working for you.  Most of the best in customer service realize that the way they treat their employees is the way their employees will treat their customers.

    Want your employees to listen to your customers?  Listen to your employees.  Desire for your employees to treat your customers with kindness?  Treat your employees with kindness.

    This simple process works.  Try it,your employees will love it, your customers will notice it, and you'll own your customers (and your employees, as well).

Ed Horrell

    Makes you think doesn't it?  How do you treat your employees when you're in a bad mood?  Would it be ok for them to take their moods out on the patients?  How about when they've gone out of their way giving great service?  Do you comment or just act like it was nothing?  People tend to repeat behavior that gets noticed, whether it is good or bad behavior, negative or positive feedback.  Commenting on performance is a way of saying, "I know you exist, I see what you do."  So be sure to comment on good performance.
    I once worked for an orthodontist who had great rapport with the patients.  When the patients and parents were in the office he was Mr. Personality and really interacted with the staff.  At other times, he didn't seem to know we existed.  I remember feeling that if he passed me on the street, he wouldn't recognize me.  I did a good job for him, but I wasn't inspired to think about anything that would enhance the practice. 
    My boss, Jeff Price, not only noticed and commented on my performance, he paid me a great compliment.  He asked me to manage his practice.  You can bet I do all I can to make it great.  That's why I read newsletters like Ed's along with countless books and magazines, other weblogs and attend seminars.  I want to keep hearing positive feedback and I believe in him and his practice because he believes in me.  One hand really does wash the other.  Open up and let the positive feedback fly.
 

I'll Get Back To You On That

     Have you ever said that to a patient and then completely dropped the ball?  Here's Ed Horrell's weekly newsletter with his feelings about that:

I want to talk this week about the importance of getting back to your customer when they have a problem.  Nothing is more frustrating than to have a problem with a vendor or service provider, report that problem, and then have to wonder if anything is being done about it.

If you know something about your customer's status, make sure they do too.  Don't make the mistake of not getting back to them. Leave that to your competition.  Also, try to never have a situation where your customer calls you to learn something that they should already know.  Little is as frustrating as getting this from a service provider: I was going to call you to talk to you about this. If you were going to call me, why didn't you?

Call your customer when you know something.  They'll notice it and you'll own your customer.

Ed Horrell

     We've all been there, done that.  We've all let a patient leave wearing a provisional crown without reminding them to stay away from sticky stuff only to have them return the next day with their temp imbedded in a wad of gum.  It's all about going that extra step and showing that you really care.  It's about calling the patient who had an extraction or implant to see how they're doing.  You can hear it in their voice, they are impressed that you cared enough to call after work.  Also, don't forget about patients who are waiting to hear about insurance matters.  The temptation is to put those things off because who wants to sit on hold waiting for an insurance rep only to be put on hold again by them while they re-direct your call.  Heck, I actually drifted off once, I know it stinks.  Now I make sure I have that stack of reading that's always growing, right there with me so I'm not wasting the time on hold.

     Sometimes there are delays in getting an answer for a patient.  It's important to keep the patient informed of that.  When you do, it let's the patient relax and keeps them from developing inaccurate scenarios in their mind.  You are letting them know that you understand their need to know and the urgency they feel.  Just that alone is enough to lessen their anxiety and gain their trust.  They can relax because they know that you have it under control.

     I recently had to deal with a situation where the patient had an estimate from his insurance company and once the treatment began, his coverage was changed to a different carrier and they were denying the claim.  He had his implant placed, but was not willing to proceed with the crown because of this.  I got on the phone with the insurance and got the usual delays, but I let him know of every call I made on his behalf.  This not only let him know that something was being done, it also let him know that a lot of effort was being made on his behalf.  As a businessman, he apprectiated the service he was receiving.  His benefits were approved and he is scheduled to proceed with the crown.  The important thing to note here is that the crown is just one average procedure, but in the future this patient will remember that he was well-served and will speak highly of that to his friends and colleagues.  Don't you just love a win-win situation?

Explain That Again?

     If you present treatment plans to patients or even if you are just trying to answer questions that the patients ask you, it is important to explain everything.  By that I mean both the pros and cons of the treatment suggested as well as the possible consequences of doing nothing or choosing less than optimal treatment.  Patients will have more confidence in the dentist and you if you tell them the benefits and drawbacks of the treatment alternatives you are suggested.  Don't assume that they don't care or can't understand.  Explain the treatment that is being suggested without using dental jargon.  If you are suggesting implant supported crowns as a better choice than a fixed bridge, print out the fees for both and let them see that.  Then go on to balance the higher fee with the benefits of choosing implants.  Once patients see that you are not dodging the fee issue, your reason for suggesting implants will be more believable.

     Discussing what you are seeing in the patients mouth and the treatment for their condition helps to establish trust between the patient and the dental professional because the patient feels like they are participating in the decisions about their care.  Tell the patient what causes incomplete fractures, what can happen as a result and what treatment options you recommend.  If you are comfortable leaving it alone for now, explain that as well.  I like to tell the patient that I want to give them the information they need so that they can make an educated decision.  When patients understand what the perio probings numbers you are calling out means, they can feel either the satisfaction that their gums are in good condition of the need to address periodontal issues.  Give them a mirror, take digital photos or intra-oral pictures and show them what you see.  When patients can actually see what you see, they will understand why the dentist is recommending treatment.  Then they can actively participate in decisions about their oral health and own the outcome.

Huh?

 Sometimes we can be so happy with an employee that we forget to look at her with a critical eye.  Niceness can divert attention away from performance flaws and then suddenly you become accustomed to the personality and start realizing that there are some problems that need to be dealt with.  Here's Ed Horrell's newsletter for the week:

I do business with a company who has recently hired a new recpeptionist.  I call there often and she is a nice person.

The problem is that she is virtually unrecognizable when she speaks on the phone and I can barely understand the corporate name when I call.  I have actually wondered if I have called the correct number on more than one occasion. If I called for the first time and got this reception, I would be concerend.

Make sure that your first customer contact is one you can be proud of.  Take a minute and check each way a customer can contact you. 

Ed

     In this employee's case it may simply be a matter of not holding the phone correctly.  I often catch myself with the mouthpiece down by my chin.  Either way, it can cause the caller to feel awkward and leaves a bad impression.  One of my pet peeves is poor grammar.  There is no personality so pleasant that can make poor grammar sound pleasing to my ear.  As a manager, I found it very difficult to address this when I was faced with a receptionist who didn't quite speak the Queen's English.  I wrestled with the fact that she was using the local vernacular and that maybe it didn't bother the patients as much as it bothered me.  Every time she used certain phrases it was like nails on a blackboard for me.  I gave hints and she didn't pick up on them.  Once she actually came in my office and commented on a patient's grammar that was worse than hers.  She said it sounded ignorant.  I said that I'm sure we all have things we say that we're unaware of that aren't just right.  She said she sure hoped I'd tell her if she did.  So I did.  Nothing changed.  She couldn't or wouldn't break those ingrained patterns.  I do think that if I had addressed the problem immediately, I'd have had better compliance from her.  She has moved on and we now have a receptionist with impeccable phone manners and a melodious voice.  Patients are commenting on the difference.  It's funny, but patients generally will not pass on negative impressions about an employee until after they leave.  That's why it's important not to assume that everything is OK.  Call your office and see what you think.  Have someone who knows what to look for place a phantom phone call so that you know how your receptionist sounds to people who have nothing invested in her.  She is the front door to your practice and the last chance for a good impression as well.  Make sure everything she's doing is working well.

No NVIP's Around Here

 We've all had days at work when every phone call is a same day emergency and the schedule is packed to the brim.  It's almost inevitable, you're going to run behind.  Should patients just expect that as part of the status quo.  If your's do, you've got a problem.  Here's what Ed Horrell has to say about this in his weekly newsletter:

I want to talk this week about the importance of keeping your customer informed of open problems.  This is very important and also overlooked by many service providers.

I am currently frustrated at a construction company which is doing a TERRIBLE job of keeping informed of the status of a job they are doing. I am going to be a bad reference for them when they are done and will not be their best advertising (as you know, I like to talk about customer service!). 

Their problem is that their work may be good, but their service to their customer is not. 

Don't forget that these two issues go hand in hand. 

Do good work and provide good service and you'll own your customer.

     Sometimes you have to look at changes in the schedule the way a coach would look at unexpected changes in a sporting event.  His best player gets hurt, he'll do this instead.  In the dental office if Mr. Jones fractures his central incisor at the gumline, you can look at your schedule,identify the amount of time you need, find a patient that you can count on to be flexible and call them and explain the situation.  Let them know that if they will be willing to come in next week you'll be sure to give them the same consideration when they have a problem.  For smaller glitches that get you running behind ten or fifteen minutes or longer, be up front about it.  If you know ahead of time, call the patient and let them know that things are backed up so they can arrive a little later.  If they're already in the office, go sit down next to them and explain what's happening and how long they can expect to wait.  Offer to reschedule them if that would work better for them. 
    My sister-in-law called me the other day.  She said, "Why do dentists make patients wait so long?  Don't they know how long a procedure will take when they schedule it?"  She has a full time job and has to take vacation time to go to the dentist.  She arrived at her appointment on time and sat in the reception area for 45 minutes.  No one said a word to her.  She had a meeting to attend so she went to the desk and asked to be rescheduled.  They did this, but without explanation or apology for making her wait.  She thought it was just the way all dental practices operate. Thankfully, that's not the case.
    It's so easy to keep patients informed of what's happening.  It's the considerate thing to do.  Keeping them in the loop shows them that you value their time as much as you want them to value your's.  If you want to make someone feel like an NVIP (not very important patient)let them linger in your waiting room for a long time while you ignore the problem and them.  I promise you, before long they'll find someone who values them and treats them like a VIP.  And they'll tell their family and friends all about both of you.

The Practice of Compassion

    Most of us go through our days in pretty routine ways.  We know our jobs well and we do them by memory many times.  We barely have to think about what we are doing.  It may be time to pay more attention.  Many of the problems that occur between people are due to a lack of compassion.  Approaching our patients and co-workers compassionately could affect our relationships with them and with ourself.
    When people do things that hurt us, insult us, annoy us, or that we just don't understand, we tend to react with our gut instinct.  Now, sometimes following your gut instinct can save your life, but in relationships it can fail you.  Gut instincts were meant to get us out of trouble when danger is present and that's were you need to use them.  In relationships, being on the lookout for danger might get you what you hope to avoid, trouble.  When someone says something that seems unkind or unfair, try responding with compassion first in your thinking and then in what you say in response.  It may initially make them angry, but if you can stay calm and remain compassionate they will eventually understand that you care.  Responding compassionately is like peeling back the layers of an onion.  What's on the outside is unusable and must be thrown away.  The deeper you go the better it gets.  Most of the time, that's how angry people are, too.
    When you're being compassionate, remember to be that way with yourself, too.  So many times people put themselves down in front of others.  That not only makes them feel bad, it may make the other person believe them.  If you make a mistake and say, "I'm an idiot!", too many times, people will start subconsciously agreeing.  You will walk around fuming with yourself, unable to let go of your frustration.  If you make a mistake and admit it and then treat yourself as kindly as you'd treat others, the mistake will fade away a lot quicker for everyone.
    For managers, treating others with compassion sets the tone for the practice.  The team will feel better about themselves and each other and will treat the patients compassionately.  Whether they like you, are ambivalent about you or even somewhat dislike you, they watch you and reflect your attitude and behavior.  So be compassionate and see what it does for the rest of the team and the patients.  Think before you act or respond.  We don't know what prompts the behavior of others and many times when people are acting badly, there's a reason that we could never guess.  So, maybe it's best to assume that the person is troubled by something and to be compassionately thoughtful toward them.  Make your practice one that practices compassion.

Get A Grip!

    Have you ever had a patient in the chair who thought they were in a therapy session or at a cocktail party?  They want to sit there and talk and talk as if no one had anywhere else to go or nothing else to do.   It's interesting to see how different staff members react to a patient like this.  My boss tends to get the "how the heck am I going to get out of here" slightly panicked, half-sick smile, half-helpless expression on his face while subtly doing a mini side step toward the door.  Every now and then I'll take pity on him and step in and say "Excuse me, Dr. Price, you have a call on line 11."  Since we don't have a line 11 he knows I am trying to save him from the deep pit of patient small talk he has allowed himself to be pulled into. 
    Our hygienist had one of these patients today.  This lady is an infrequent visitor who loves to do 3 years worth of talking in one 50 minute appointment.  She talks about her favorite subject, herself.  She is quite fluent in the wonders of she.  The hapless hygienist was trying to be nice, but she was afraid to take her hand out of the woman's mouth for fear of having to wait out another episode of "let me tell you more about me."  The 50 minute appointment lasted 80 minutes.  Thankfully the hygienist had a cancellation following this patient so she had time to recover.  She very proudly told me that she charged the patient for a 60 minute appointment.  I asked her how she could have maintained control of the appointment.  She said she had no idea.  I told her that it would have been appropriate to tell the patient that she loved talking to her, but that she would have to get to work and finish her cleaning since she had a schedule to maintain and that if she didn't get busy she'd have to bring the patient back to finish her prophy.  Since this would incur a second charge she didn't want to run out of time.  When all that talking started costing her money, this patient would have stopped and the hygienist could have completed the prophy. 
    We have to respect our patients and treat them kindly.  All of our patients.  If we allow one patient to cause disruption in the schedule, we are inconveniencing the other patients.  A chronically late patient should be told their appointment is earlier than it actually is or reappointed for another time.  A talker must be gently reminded of the purpose of the visit if things get out of hand.  Not all patients who do these things are inconsiderate, most aren't.  Some are just lonely.  You can redirect the course of events kindly, but definitely.  You can find other ways to make these patients feel special if that's what they need.  Keep a supply of pretty cards in the office and write a short note saying you enjoyed their visit.  That way you can keep things moving and still let them know they are valued.  When you have someone who just loves the sound of their own voice, well, you just have to get a grip on the situation. In the end you will save everyone a lot of stress and aggravation.

You Talk Too Much

    Yesterday I focused on listening.  Today I want to concentrate on talking.  There is way too much of it.  First, let's separate talking from having a conversation.  When you have a conversation, the other person gets to talk, too.  There's some give and take and if they're good at it, both people also feel like they've been listened to and enjoy the exchange.  I'm talking about talking too much.  Telling more about yourself than you should.  TMI - Too Much Information.  Verbal Vomit.  Motor Mouth.  Besides just being tiring, what's wrong with talking too much?
    Sometimes there's nothing more than the fact that you might be inconsiderate of others that would like to get a word in edgewise.  What you have to watch out for is what you are talking about.  People seem to have few filters these days.  A thought enters their head and flies out their mouth without any thought given to whether it's appropriate to discuss it in any given venue.  At work, that can have serious repercussions.  For instance, if someone is talking about a wild weekend that involved some major lapses in judgment and good taste they may be setting themselves up to be looked down upon.  Everyone may be standing around listening, laughing in all the right places and acting like they approve, but it might be different when you walk away.  Or the more they think about it the lower their opinion of you sinks.  If you happen to spit it all out in front of your manager, even worse.  She may question the wisdom of your decisions and wonder if she should trust your ability to be discreet when speaking with patients.  It's fun to get your 15 minutes of fame, but make sure the price you'll pay for it isn't too high.
    Put yourself in the listener's place.  What would you think if they were telling you this story?  Would you think they were funny, but wonder about their good sense.  No matter how well you tell a story, you can't climb in their brain and filter it the way you want them to hear it.  They have their own filter and nobody's filter is as kind to anyone else as it is to themself.  So, while you may know all the little things that make what you're talking about acceptable or funny, they may have filtered those parts out and are left with something slightly humorous and highly distasteful.  I don't want to make your afraid to speak at all, just a little more thoughtful and discriminating about what you disclose.
    When I hear someone talking about something that I think others will lose respect for them over I want to walk over and clamp my hand over their mouth.  I know it's all a part of that hungry heart that I talked about yesterday.  They want to stand out, to be seen and heard and sometimes the fantastical is the only way they know to do that.  If you see yourself in this, try to remember that like a donut on the lips that ends up on the hips, the momentary satisfaction you experience may not be worth the longer lasting damage.  If you wonder if you talk too much, you probably do.  The next time you want to blurt out something personal, listen to your inner voice.  Is it saying, "Hey, hey, hey...maybe you better not do that?  Than wait 15 minutes and see if it still seems conversation worthy.  Just remember, nobody can watch out for you as good as you can watch out for yourself.

So You Had A Bad Day

OK, I lied.  I can't control myself with these videos...yet.  I'll get over it sooner or later.  In the meantime just don't click on it if you don't want to see it.  This one is so nice though.  I think you should click on it, it'll make you smile.  Anyway, it went so good with my title and Ed Horrell's weekly newsletter that I couldn't pass it up.

"Everyone has a bad day occasionally.  We are impacted by many things in our lives which overflow into our work lives.

Often, this impacts our attitudes when we are dealing with our customers.  The result is indifference when we have something which is more important to us than it is to our customer.

The difficult, but correct, thing to do when this happens is to leave our personal issues at home.  Our customer does not care about our problems; they care about THEIR problem.

The next time you feel that your personal problems are affecting your work, try to leave them at the door when you walk into your work.  They'll be there when you leave to go home and you can deal with them then.

At work, try to concentrate on what is important to your company, your customers. 

They'll notice the concern you have for them and you'll own them. 

eh

We've all had days like this.  It's so hard to leave it at the door, but look at it as giving yourself a break.  You're also sparing your co-workers and patients the drama.  I remember an employee came to work one morning on the verge of tears looking sorrowful.  All morning the other staff members kept asking her what was wrong.  She didn't want to talk about it, but she didn't want to give up the drama either.  Of course, everyone was coming up with their own ideas of what her problem was.  She was a new employee so we didn't know too much about her yet.  All that attention was diverted away from patient care toward something as useless as trying to guess what was happening in this person's life.  It went on all day.

She basically made herself the center of everyone's attention and her problem didn't get solved.  I don't even remember what she was upset about, but I do remember the drama.  Two things could have been done to put an end to it.  First, the staff could have taken her at her word and believed she didn't want to talk about it and then gone about their business.  Next, she could have matched her behavior to her words and dropped the "poor me, look at me" routine and just cared for her patients.

I have found that most bad days are as bad as we let them be.  I'm not talking about tragedies, just the general run of the mill bad day.  Maybe what seemed so bad in the morning, might not seem half as terrible in the afternoon if you give yourself a chance to focus on your work in the middle.  I know that if I go to work in a bad mood and indulge myself in that mood, not only do I stay down, I drag the rest of them down with me.  Remember that as a manager, you often set the tone for everyone else.  If I drop the mood and come in singing, the reaction I get from everyone else usually gets the seratonin pumping and off we go on another great day.  If I dance along with the singing, well, we're so happy we just can't stand it.  Maybe that's why I like the videos so much.

Pay Attention, Please

 Happy Easter!  Ed Horrell's column is a great one today.  This is something we do with our staff and I promise you, the benefits are worth it.  Read on:

I want to challenge you to do something this week. 

Take a look at the people you work with.  Single out the one that you think best represents the values of customer service that you think should be reflected in your company.

And then take a minute and tell them what you thinik. 

More companies should have a method for peers to "catch" their co-workers doing the right thing.  If your company doesn't have such a process, simply take it upon yourself to catch others doing well and simply give them a thumbs up.

You'll find that this is catching and contagious.  When it spreads in a company, it becomes a part of the culture of a company.  Your cusotmers then sense the difference in doing business with a company that constantly stirves for values in their customer service.

These companies own their customers.

    We did it a little differently but with the same idea.  We had a staff meeting at which everyone was encouraged to go around the table and say something positive about each person.  Everyone else got to hear the comments, as well, and the great thing was that you could see that people could hardly wait for their turn to give compliments.  The funny thing was watching how the receiver had to get over an initial discomfort with hearing all these great things about themself.  One of the guidelines was that the receiver's only response could be to say, "Thank you." 
    As a manager, I notice all the staff's strengths and weaknesses.  I have to so that I know what to expect from each and how to use their talents in the best ways.  You never know what they're thinking about each other though.  Or about you.  I was relieved to hear that they all were able to say some nice things about me.  You never know.  I was also interested in my own sense of anticipation as my turn came, and how thoughtful the comments were.  They weren't just rote sentiments, they were individualized for each person.  These were things that probably would never have been expressed if we hadn't set up a specific time to do that.  I loved seeing how much we all value each other and how meaningful this exercise was to everyone.  Our team is really very lucky to have such a wonderful place to work, a kind and honorable boss, and decent people of high integrity to work with as a team.  It was good to see how aware we all are of that.
    Ed's column has me considering setting up a part of each monthly meeting to have everyone write down one thing they saw another person doing that they admired.  We could then have a drawing for a small prize.  The person with the most entries would have the advantage and it would give an incentive to be positive as well as encourage staff to pay attention to the good things their co-workers are doing.  Sounds like a win-win situation to me and that's always the best kind.

Take It SLOW

 Here is Ed Horrel's weekly newsletter:

Try this next time you experience conflict with a customer.  I have used this many times and it works.

Begin by SUPPORTING the feeling of your customer.  This is done by simply indicating agreement with what they are feeling at the time.  The key is sincerely supporting their feelings with comment such as "I understand how you feel", "I sense your anger", etc.

Then LISTEN for any facts which are stated that you can agree with without arguing those which you disagree.  As the facts which you agree with are stated, simply respond with "That's correct", etc.  If no facts are agreeable, stay with understanding their feelings.

When appropriate, OFFER a solution to the problem (or ask what you can do to solve the problem).  Do this without dealing with why the problem exists or what caused it.

Once the solution is offered, either do it or offer a WORKABLE solution, always stating that you wish you could do what was requested, but countering with what you can do (i.e. "I wish that I could give you your money back, but what I can do is......").

This is called the SLOW process (support, listen, offer, and workable compromise).  Stay calm and slow...you'll own you customer.

eh

     I'm happy to see that this sounds a lot like the article I wrote yesterday.  Let's start with supporting the feelings of the patient.  Why is that important?  Because you are validating them.  You are letting them know you understand that they are upset.
    Listening for the facts gives you something to begin to work with.  They will begin to sense that you intend to help them.  Giving them the facts, at this point, does the opposite.  It puts the focus on you, rather than on the patient.  Look at yesterday's example of our receptionist clearing herself from blame rather than focusing on the patient.  It didn't help anything.
    Offering solutions is the first step out of the problem and into peace.  It gives the patient something positive to focus on.  If the solution the patient wants isn't going to happen, be respectful.  Let them feel that they are getting the best possible workable solution.  Most people can be reasonable once they see that you care.
    Finally, I like Ed's SLOW acronym.  It reminds us to slow down to listen and consider the situation and solutions.  People tend to seize up and want to hurry up and fix a problem.  That may give the impression that you don't really care.  Giving the patient time to express themselves is like slowly opening a pressure valve.  It makes things gradually better.  Opening it up too quickly can be explosive.  So SLOW down and everything will be just fine.

Mind The Gap

    Sometimes people really are their own worst enemies.  I want to look at the way our thinking can make us miserable.  Sometimes you can get into a situation in which you just can't come to an agreement with another person.  You may walk away feeling misunderstood and abused.  They may walk away feeling unheard and frustrated.  Either way, two people just became their own worst enemies.  Not to mention what they may have become to each other.  The next mistake they can make is becoming mired in the rightness of their position.  They don't take the time to give the other person's thoughts, feelings and ideas a chance.  They are so sure that they are right that they don't see the need to explore the other side; that would just take time and attention away from planning their next approach.  Heck, they may even begin to doubt their own rightness and they're just not ready to do that yet.  So, they stick to their guns, entrench themselves in their own opinion and create a tornado of feelings, accusations, anger, pain and misery.  And then they wonder why they feel so battered.
    Why would anyone do that?  Well, my first guess (and these are all guesses) is that it makes them feel smart.  You can come up with all sorts of brainy reasons for being right.  If they start to feel that they may be wrong, they might also start to experience other uncomfortable emotions like guilt, embarrassment and regret.  I think that this would be the best time to face those feelings and rethink and readdress the situation.  I doubt those feelings will get any less intense if you postpone.  But, of course, we do postpone and keep insisting on the validity of our argument.  Another reason we might hang onto our story is that we don't like to be wrong.  It's awkward to look at another person and admit that you've got it all wrong.  You don't know how they'll react. They may mock you, rub it in or go off on a tangent of what a worthless cretin you are.  I think most people worth knowing won't do that, so go ahead and try it, you may weed out some unsavory characters in the process.  I think the main reason is because we just don't know how to truly put ourselves in another person's place.  How to try on their thinking cap.  Because when we try to see it from their point of view, it doesn't work if we keep thinking the way we think.  To be successful in seeing their side, we have to try to think the way they might think.  Ahh...it looks different now, doesn't it? 
    Maybe the best way to look at it is like this: if someone cares enough to keep re-approaching the issue, they must care about what you think.  They want to be understood.  The answer lies in both parties really wanting to understand each other and in respecting each other enough to try to deal healthily with the gap between their thinking.  You have choices, you always do.  You can try to take the other person by surprise and push them into the gap.  Then you won't have to listen to them anymore.  You can look at the gap and see it as an empty space between you that will never be filled and can never come together.  Then you may as well give up.  Finally, you can both straddle the gap.  Sometimes you step over to their side, sometimes they come to yours.  Then you have something that can work and no one gets hurt and no one is eliminated.  You must mind the gap, but you must also keep in mind that the solid ground you both stand on is firmer than the empty space between you.  And there's no better way to close the gap than with an embrace.  Try embracing your differences and making them work for both of you. 

See Your Patients As They Are

    How do you decide what treatment is right for a patient?  You don't.  They do.  You've heard the phrase you can lead a horse to water, but you can't make them drink.  Well, you can present treatment to a patient, but you can't make them accept it.  You may be able to make them want it, but it may be more than they can afford.  Sometimes, no matter how you look at it, you can't make a removable partial budget stretch enough to afford implant supported crowns. 
    I presented just such a treatment plan today.  The patient was a 50ish woman who had just completed orthodontic treatment to correct her occlusion.  She expressed a desire for her smile to look better and to replace missing teeth.  If you judged her by her attire and appearance you would immediately start planning a removable partial.  But, that would be wrong because attire is just not important to some people.  So, my boss treatment planned an optimal series of procedures for her.  The fee was quite high.  I find patient's reactions to expensive treatment plans to be fascinating.  The patients that want the treatment and can afford it may start to try to find ways to get the fee down a little.  They're going to take the whole enchilada, they just want to see if they can save a little dinero first.  Some patients want to challenge the need for the treatment.  They fire off a rapid series of questions to see if they can find a loophole or trip me up.  That's why it's important to study the case and discuss it with the dentist before presenting it.  You must know and understand the treatment or they won't believe in it.  Then, there are patients like the lady today.  She just really can't afford it.  Her reaction was to become angry and defiant.  Now, this is a person who is generally very meek and quiet so I knew she wasn't really mad, she felt threatened.  She wanted some treatment, but not all of the treatment I was telling her about.  She may have thought it was all or nothing.  She may have worried that we wouldn't respect her.  Whatever it was, at that moment I knew I had to stop doing whatever was threatening her.  So I asked her to help me.  I explained that I can't judge patients and decide who gets an optimal treatment plan and who gets an acceptable plan.  They have to decide that themselves.  By her reaction, she was telling me that she needed to have an acceptable plan that would help her function well and allow her to smile without feeling self conscious.  We worked out a phased plan with a payment plan that would allow her to make progress at a reasonable rate.  The fee was something that she could afford and not feel resentful toward us about.  At one point, I sensed that she was ready to get up and walk out feeling discouraged and possibly ashamed.  In the end, she was able to leave with a treatment plan in her hand that suited her and she smiled and thanked me.  I didn't do anything special.  I did what anyone can do.  I looked at her and I saw her as she was.  I accepted where she is right now.  That helped me guide her to treatment that is right for her.  The person who showed me how to do that is my boss.  He sees patients as they are, where they are, and he meets them in that place.  If he can bring them further along, he does.  He never judges them or makes them feel inferior.  He needs to make money, everyone does, but he needs something else more.  He needs and wants to serve his patients.  He makes me and the rest of our staff want to follow his example.  That is one of the things that makes our practice special.  If making money is your bottom line, it will also be your downfall.  If serving your patients is your mission, it will also be your reward.

Is It Really a Man/Woman Thing?

    I'm stealing this topic directly from a discussion I'm involved in that's going on at Dentaltown right now.  It's about the man/woman thing at work.  What makes it so difficult for men and women to communicate.  This seems to affect the dentist and assistant or the dentist and manager more than any other combination.  I think the reason it affects those pairings is because they are together the most and work more dependently on each other.  They tend to develop a more substantial relationship and are more aware of each other's warts as a result. 
    I think that all people communicate in their own way regardless of whether they are male or female.  They also respond and react individually as well.  Different personality types seem to be drawn together because they appreciate some of the differences, but they are repelled by others, so that complicates things as well.  It's a perfect love/hate relationship.  The trick is to work it into a love/accept relationship.  Trying to change someone is useless.  It makes them resist.  You have to first accept that part of them that puts you off.  To do that, you have to realize that it's your problem, not their's.  It's who they are right now.  They may eventually change, but it's what you've got in front of you right now.  Can you deal with that?  If you can, that's great, find a way to accept with what you don't like.  If you can't, deal with that in a healthy, caring way.  By accepting the whole person, you may be surprised to find that the things that bothered you about them seem to fade away, either literally, or in their importance in your mind.
    There is a difference in how men and women use and interpret words, though.  Men see words as tools.  This word is used to describe this and this is how you use it.  Women see words as paint.  This word is used to paint this picture and once the paint is applied, it dries quickly and can't be erased.  The words paint a picture in their mind that they can keep turning at different angles and examining.  It's not so cut and dried for us.  So, when a man uses a word like ignorant or irrational, he means "your actions at that moment, in that event."  A woman hears, "You are irrational or ignorant."  There's no two ways about it, you've got a fight on your hands.  That guy is going to walk away satisfied that he made his point.  He may even be a little self-satisfied with his analogies, especially if he was able to think of a tool or car analogy.  Not so fast mister, you're in a big heap of trouble.  She's mad and you're going to hear about it.  A lot.  No, you can't rationalize this, don't even try, she can't hear you.  Not right now.  You've hurt her.  You've bruised her ego and offended her sensibilities.  Explaining yourself will just sound like blah, blah, blah.  So what can you do?  I don't know.  I've been there myself.  I don't know what my boss could have said at that moment to make me believe he didn't think I was irrational, but that my actions might have been.  So there, I've admitted it.
    I think that the best thing to do is to sit down at a time when every thing's great and have a strategy session.  Figure out how to handle bad times during good times, not in the heat of the moment.  I suspect that the reason that women react strongly to words like ignorant and irrational is because they are psychologically descriptive words.  Women come from a history of men looking at them as people who need to be cared for and protected.  Almost one step above children, but certainly not equal in intelligence or ability.  Women may react to those words because they feel like they are being "put in their place."  Now, this is just my theory, you could even say my guess, but I think that's how I felt about the word irrational.  To my boss, it was the perfect word to describe my actions in one instance.  To me, it was a condemnation of my character and intelligence and an example of what "he really thought of me."  Now, months later, I can see not only that my actions in that instance were irrational, but my reaction to the word was irrational as well.  On the other hand, he could have been more sensitive in his choice of words.  The real issue is to deal with behavior, not to attack the person.  If feedback hurts, at least consider it's validity, don't just bat it away.  It will just keep coming back to you.  Finally, understand that the man or woman giving you the difficult news must care about you.  One of the hardest things to do is to tell someone something that they aren't going to like.  The unpredictability of their response is not going to be risked by someone who could care less.  So men/women, put down your armor and just listen to each other.  Stay calm.  Ask questions if you need clarification.  Listen with your whole mind rather than preparing your rebuttal.  Forget the rebuttal altogether and just converse.  Maybe if we drop the right/wrong thing, we won't have so much problem with the man/woman thing.

Make A Connection

"The human heart will seek to be known, understood, and connected with above all else.  If you do not connect, the ones you care about will find someone who will."                  -Dr. Henry Cloud-

Do you connect with the people in your office; your boss, co-workers, employees and patients?  If you want them to stick around, you should.  When your patients come in, everything they do and say is telling you something that they need you to know.  Tightly crossed arms don't mean they're unfriendly, it means they're scared and they're protecting them self.  A gruff demeanor may mean that they need you to understand their anxiety.  A million questions that postpone the beginning of treatment may signal a need to slow down and explain what's going to happen.  Patients want to know a little about you and want you to know something about them.  The reasoning is that you'll be more careful and considerate of someone you have a relationship or connection with.
    Co-workers who form close connections can make a practice soar.  Tension between staff members is easily sensed by patients and that makes them wonder what's going on.  They want the staff to be focused on them, not fighting with each other.  Close team members back each other up, teach each other and support each other.  The mood of the office reflects the good feelings of the staff.
    The way the dentist or manager connects with the staff greatly affects the way they connect with each other.  If one person receives special treatment or more consideration, it is a recipe for trouble.  Other employees will first wonder what is so great about that person and then to make themselves feel better, will look for faults in her. Conversely, if one team member is singled out for harsher treatment, the rest of the staff may pity her, but then lose respect for her.  There was an interesting comment on Dentaltown by Mac Lee.  He said that many times dentists will be harder on the employee that they can count on the most and turn a blind eye to an employee who takes advantage.  Maybe the dentist feels so much faith in the connection with the dedicated employee that he feels that he can be uncensored in his comments to her, but is more careful with the employee whose dedication he is unsure of because he doesn't know how far he can push her.  In that case a weak connection protects the less dedicated employee.  In the end though, despite the strong connection, the dedicated employee may decide that the need to be understood outweighs the need to stay connected to that employer.  Likewise, if a boss basically ignores the staff it won't matter how nice the office is or how much they make, there's going to be problems. If people can't get attention and recognition by performing well, they may start slacking off or causing problems just so they know that someone knows they're alive.  I once worked for an orthodontist who was so unconnected to his staff that he could have walked passed me on the sidewalk without recognizing me.  When the patients were around he'd put on a show of laughing and joking with us.  When there were no patients present he'd go in his office and close the door.  He knew nothing about us.  It was weird and uncaring and people didn't last long there.
    Finally,staff, how do you connect with your manager or boss?  Do you find out what is expected of you and try your best to deliver?  Are you reliable and responsible?   Do you thank your supervisor for special considerations or for making your job a pleasure or do you take everything for granted and look for more?  Remember, the dentist and manager are people too, and being responsible for making everything work can be stressful.  Connect and find out how you can help.
    If you can make everyone feel understood and valued, everything will fall into place.  To do this you must have a genuine interest in others.  You must respect them and accept them as they are right now, at this moment in time. 
    

Oh the Places You'll Go!

    And now, the 12th element of great managing:  I have opportunities to learn and grow at work.  People in management roles have probably been learning and growing their way into their job.  Once there, it is important not only to keep learning and growing, but to bring the people you lead with you.  You have to be careful not to get everyone where you want them and then expect them to be satisfied to stay there.  Think of the Dr. Seuss book, Oh the Places You'll Go.  Dr. Seuss wanted that book to communicate a theme of "unlimited horizons and hope."  He wanted people to think beyond problems.  It is easy to get so focused on a problem that you forget to focus on a solution.  People need to remember to strive for something better and to accomplish new things all the time.  It is through achievement that people maintain healthy self images. People with poor self images tend to put off attempting new challenges.  People who have opportunities to learn and grow at work tend to stay in their company for the length on their career.  When you see dental practices that keep their employees for 10 or 20 years, that may be the reason.
    People tend to live up or down to the expectations you set for them, within reason.  Unrealistic expectations will discourage employees.  No expectation will encourage sloth and laziness for all but the most self-motivated.  Employees that do not have the desire to strive for achievement will probably leave and go somewhere that will not challenge them.  You are better off if they do.
    Employees who feel like they have the chance to learn and grow often tend to work harder.  Employees who have no opportunity to learn or advance tend to look at their job as drudgery.  Getting up and going to work is just a necessary evil.  There's nothing to get excited about.  Employees who are challenged and permitted to grow look forward to each day and what it will bring.  A sense of accomplishment allows employees to thrive and become more creative and efficient.
    Even managers need to have a chance to learn and grow.  Many managers were people who were conscientious about their work and showed initiative and pride in what they did.  Someone decided they would be great management material.  It's possible, however, that no one told them how to do it.  The only training they may have received may have been at the "seat of your pants" institute.  Trial and error university.  Maybe this will work college.  You get the idea.  An industrious, but untrained manager may educate them self by reading every management book they can get their hands on.  (Note the magnitude of management books in my side column). That's great but it can be hard to decide what will work and what is the fad of the minute.  Basically, I'm saying that it's your life, your career.  If you accept a management role, do what it takes to figure out how to do it.  If your company or boss won't send you for training, train yourself.  Then teach your employees whatever you can to help them achieve.  After all, their good performance review is your good performance review.  Conversely, their bad is your bad.  So, give them what they need to learn and grow.

Tell Me Something Good

    Tell me something good, or bad, but tell me something!  The 11th element of great managing: "In the last 6 months, someone at work has talked to me about my progress."  Most of the time we think of performance reviews as formal "sit down with a piece of paper and go over the year's performance."   Many times it's a pre-canned variation on a theme.  You have the typical categories listed and rated from 1-5.  The employee may even have filled out a self-evaluation prior to the performance review.  You, the manager, have looked at it and either thought, "Wow, she's really downplaying herself" or "Wow, she really thinks she's something."  Either way, you don't really expect too precise of an evaluation and you can almost see the humor in the fallacy of it all.
    All kidding aside, reviews are important.  They are important because they make the employee feel like they count.  It makes them feel like their supervisor took the time to consider what they do and how they do it.  But, are yearly reviews really productive or realistic?  How can you sit down and consider a whole year of performance?  You probably only remember the last few weeks in any detail unless something major happened during the year.  The best managers consistently give their employees feedback as they go.  Managing requires strong personal motivation.  Being a manager can be lonely and isolating.  It is important for managers to receive feedback from their superiors on a regular basis.  Most people who accept a management role are dedicated to pursuing excellence and they need to know how they are doing and where they stand.  It is so important to them to get it right.  That is because if they get it wrong, they are leading others down the wrong path as well.  Good managers know that it is important to let their team know how they are doing.  If the manager feels good about what they're doing and is assured they are doing it well, they can turn their attention to their team and give them the encouragement and guidance that they need. 
    The manner in which an employee receives feedback affects how they feel about what they do and who they do it for.  If feedback is delivered in a way that is considerate and makes the employee feel valued,  the employee is more likely to work in a way that will propel the practice forward.  If feedback is delivered harshly, in anger, then the employee is likely to give up.  Even if an apology or olive branch is offered later, the harsh words can not be erased from the employees heart and mind.  They are branded there.  So, it is important to give feedback on a continual basis.  Don't wait if criticism is warranted; point out the error and the correction or the correct way to proceed in the future.  Do it in a caring way so that the employee has enough self-esteem to move forward.  If something great happens, celebrate!  Make a big deal out of it.  People love to be celebrated.  Don't overlook your employees accomplishments out of work either.  It shows them that you see them as multi-dimensional. 
    Finally, don't make employees beg for feedback.  Take their desire to hear how they're doing as a sign of dedication to doing a good job.  No one wants to plunder in the woods indefinitely.  It's dismaying to go along thinking everything is good, only to be brought up short by an unexpected bad review.  Be sure to customize your review to the individual employee.  Don't give out cookie cutter review sheets.  Take the time to consider the employees strengths and base most of your review on that.  Bring up weaknesses only to brainstorm ways to somewhat improve on them or to figure out ways to circumvent them altogether.  It is important to understand that all human beings have their strong and weak characteristics and we must find ways to make the most of the good and neutralize the bad if we can.  See the potential in each employee, decide how their progress can be most meaningful to the practice and help them plan a way to go for it.  Then keep giving them feedback.  That's the way to get the most from your employees.

We Just Click!

    The 10th element of great managing: I have a best friend at work.  Let's face it, during the week you probably spend more time with your boss and co-workers than with anyone else.  Having a best friend at work makes it more enjoyable.  There can be a catch though.  In small dental practices it could be easy for someone to feel jealous or left out.  I don't think it is usually intentional on the part of the best friends.  Some people just click better than others.  There's really no choice, it just happens.  It's important to be considerate of other's who don't happen to click as easily.  If it isn't handled well the person who feels excluded may do things to undermine the friendship that she wishes she was a part of.  I think you have to recognize the problem and address it.  Invite her to be a part of the friendship.  This happened to someone I know recently and she asked my advice.  She was one of the clickers and realized that her co-worker was jealous and was trying to cause a rift.  We came up with this solution.  She sat down with the other two and asked what was going on.  Immediately the one who felt left out said, "Everybody knows you two are closer than everyone else."  That opened the door.  "Well, yes we do get along really great and have fun together, but we want you to be part of it as well.  We're all just different in what time we have to be together.  We have similar interests and more time to spend together, but we want you with us whenever you want to be.  Let's face it, we all have our great points and we all can drive each other nuts sometimes, too.  Let's just start over today."  It was that easy.  Sure, there'll be more tiffs and jealousies.  It's that thing called life.  You just keep messing up and finding better ways. 
    Managers can encourage friendship among team members.  Try to pair people up on projects that might not normally get together on their own.  Praise team efforts and let them know you are proud of the way they work together.  Don't ignore ongoing feuds. They don't get better when left alone, they fester. 
    People don't live near extended families as much as they used to.  There is more isolation than ever before.  With more mothers working, the friendships that used to form among Moms helping at school don't happen as frequently.  Connection with others is important to emotional well-being.  A person with no friends usually feels isolated and unhappy.  Watching other people in friendships and feeling like you are outside looking in is damaging to a person's self esteem.  Move staff members toward acceptance and inclusion.  Use staff meeting time to discuss the feeling in the team.  We did an exercise recently that was very powerful.  Everyone had to take turns telling each co-worker all the good things they felt about them.  At first it was a little awkward but after a few minutes people who had already taken their turn were asking to be able to add something they had forgotten to say.  The person receiving the positive feedback was not allowed to say anything but thank you.  It was a great way to find and focus on the positive about each team member and increased the already good bonds.  It cost nothing and was very effective.  Remember that this is a group of human beings who are striving to succeed and be happy.  We all basically want the same thing in life.  We all want to be loved and cared about.  We want to know that others see who we are and accept us.  This process can just click or it can take time, but the rewards are worth the effort.

Have You Ever Been Committed?

    The ninth element of great managing: My co-workers are committed to doing quality work.  Why is that important?  Because, one or two people get tired of carrying the load for the whole team.  Resentment builds when harder working, more committed people watch others get away with doing less.  They know that if the others would care more, try harder, give a little bit more, the whole team would prosper and thrive.  It's even worse if they talk the talk but then don't walk the walk.
    Think about the position this puts the harder workers in.  They can either suck it up or complain.  If they complain, all hell might break lose.  God forbid the slacker finds out she was complained about.  She'll make your life miserable.  The boss might even resent being forced to face and possibly confront something he might have been making believe he didn't see.  Why can't you just keep doing your job and keep your mouth shut? 
    If the boss doesn't appear to recognize the difference and treats everyone the same, one of two things is likely to happen.  First, the harder workers may get sick of it and sink to level of the low, but equally rewarded performer.  Worse yet perhaps, the harder worker may become bitter and resentful and give up.  Everyone knows what's going on.  When someone walks in a few minutes late everyday and says, "Gee, you guys are fanatics, there's never anything left for me to do",  the hard workers want to stick their fingers down their throats to bring up the garbage they're being fed every day.  When that same person floats out early, before everyone else leaves every evening, the hostility is palpable.  Feeling angry but wanting to be good team members the hard workers think, "But, we're a team, we have to support each other."  That is the sticking point for dedicated team members and that is what slackers count on. 
    Now, think about a team where everyone walks the walk that they talk.  Where everyone supports each other and does their part.  Members of the team celebrate each other's victories and help build each other up.  Taking advantage of the work ethic of others would never enter their mind.  You can feel it when you walk in, this place is dynamic and these people love what they're doing as well as each other.  They may even become emotional talking about it.  They're not embarrassed to be so into it.  This isn't high school.  It's OK to be a high achiever.  It's cool to be enthusiastic about what you do.  It also  is an important element that  is more likely to make a team successful.   

Your Love Is My Love

    The 8th element of great managing:  "The mission or purpose of my company makes me feel my job is important."
    "The degree to which a team agrees with this statement is predictive of it's performance on a wide array of measures."  Anyone managing or leading a dental team is probably nodding in agreement as they read this.  That is why most dental practices have mission statements.  How often does your team, or do you consider your mission statement?  A mission statement is a great thing, but maybe it is a little too all-encompassing to read on a day to day basis.  The Ritz-Carlton hotel chain has a credo.  It's more succinct that a mission statement, but just as powerful:

THE CREDO

The Ritz-Carlton Hotel is a place where the genuine care and comfort of our guests is our highest mission.

We pledge to provide the finest personal service and facilities for our guests who will always
enjoy a warm, relaxed, yet refined ambiance.

The Ritz-Carlton experience enlivens the senses, instills well-being, and fulfills even the unexpressed wishes and needs of our guests.

    You can read the Ritz Carlton's motto, credo and steps of service here.  The employees of the Ritz Carlton have a motto.  It is:

"We are ladies and gentlemen serving ladies and gentlemen." 

The employees practice the motto and credo because they believe in them.  They knock themselves out trying to wow their guests.  All of this creates a memorable experience for the hotel's guests and a satisfying work experience for the staff.  You may think of the staff as mere servants fulfilling every wish and whim of their pampered and expectant guests.  You'd get an argument from them if you expressed that. They see what they do as a mission.  They understand why they are there, what is expected of them and what they can expect for fulfilling the requirements of their position as well as what can be expected if they don't.  They agree to it and accept their mission.
    What if a dental practice changed the wording of the Ritz Carlton's credo a little?  It might sound like this:

Dr. Murphy's office is a place where the genuine care and comfort of our patients is our highest mission.

We pledge to provide the finest personal service and facilities for our patients who will always enjoy a warm, relaxed, yet refined ambiance.

Dr. Murphy's office calms the senses, instills well-being, and fulfills even the unexpressed wishes and needs of our patients.

 Would your staff look at that with a little more interest than they look at your mission statement?  Could they buy into it a little more?  It makes service sound and feel more noble, doesn't it?  If you made the pledge to your staff to reward and recognize this kind of service would they feel like their job was important, no matter what position they fill?  Recognition of and reward for great service begets great service and keeps it going.  Great workers do their best for their own personal satisfaction, that's true.  They also usually need to know that it is recognized and that they can expect to be rewarded in some way for it, or they may decide to do it somewhere else because they need that kind of satisfaction as well.  Look at it this way.  A person lost in the woods becomes hungry and thirsty after a few days.  Upon rescue if he is given a sandwich his hunger will be satisfied, but he'll still be thirsty.  If he keeps receiving food but no water, he'll eventually die of thirst.  It's the same with staff.  They can look inside themselves for validation of the good job they do, but without recognition from their leader they won't be truly satisfied in their job.  You can lose your best employees because of a lack of recognition and reward.  They will stop believing in the mission of your company because your mission will seem superficial to them.  They'll want to find a place where the beliefs come from inside the company, pass through and among the staff, and expand out to the customers.  That is how they will feel that their job is important.

Your love will only become their love if they feel it themselves first.

 

So, What Do You Think?

    The seventh element of great managing: My opinions seem to count.  Well, sure, opinions are cheap, everybody's got some, right?  Well, don't be too fast to discount the value of listening to the opinions of your employees, co-workers or patients.  If you only consider what you know, your knowledge base will shrink and become obsolete.  If you only listen to experts, you'll miss out on some good old common sense.  If you don't listen to your employees and patients they won't feel that you consider them intelligent enough to have thoughts which have validity or relevance to what you do.  Pretty soon they will feel disconnected from you and will desire something more, somewhere else.  If you find yourself continually looking for new employees or patients, think about what Tom Morris says here:

"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."

    Let's think about this quote.  "One of the most ennobling gestures..."  I agree, we make people feel noble when we make them see that we consider their thoughts and opinions important enough to seek out, listen to, and consider.  I think it's important to do all three.  False interest in someone is more insulting than no interest.  False interest makes a person feel used.  Think about someone you admire or consider to be wise.  Now think about how you feel if you express a thought that they find fascinating or insightful. You feel great, right? What would happen if you made the people around you feel that way?  Let's consider more of the quote, "When we ask, wanting to hear, we treat the other person with a fundamental respect..."  As you see, it is important to let the other person know you want to hear and are not just asking to placate them into a false sense of importance.  It's the wanting to know what the other person thinks that imparts the fundamental respect.  Respect is the meat and potatoes of any relationship.  Without respect there is no foundation, nothing to hold up all the words and actions, mistakes and victories, joys and sorrows that happen to all of us every day.  Caring about what someone else thinks lays the foundation for a respectful, functional, productive, and satisfying relationship with another human being.  Just remember, underneath our clothes we're all naked, we all come and leave with basically the same equipment.  It's what we do with each and to each other in the middle that makes the difference.  What do you think?

Encouragement-Give a Little to Get a Little

    Well, we're at the halfway mark.  The sixth element of great managing: Someone at work encourages my development.  That can make a big difference in an employee.  It can make the difference between a job and a vocation.  A worker and a professional.  A boss and a mentor.  I think great managers are great because they can be nothing else.  I believe that something drives them.  I have three mentors.  Before I started writing this I would have said that two encourage me and one teaches, but discourages me.  As I write I realize, that would be short-sighted and unimaginative of me to believe.
    Let's start with the easiest, the one who is pure encouragement, feel good support.  My cheerleader and proud patriarch.  He keeps me going when things get tough.  He makes me believe in something he sees in me, that I only take his word for.  I don't want to dissuade his belief in me so I keep working harder.  The second sees me pretty realistically, but drifts in and out of my picture so he's not a constant presence but he's only a mouse click away if I'm headed for problems or if I need to share an achievement.  The third is the hardest.  Yep, he's the discouraging teacher. He's the one I'm around the most. The one who won't let me fly too high before calling me back to earth.  He grounds me.  Sometimes it feels bad, but I think it's good for me in some ways.  If nothing else, it's ego control.  It's a reality check.  I don't have to believe everything he says, but I always consider it.  People with thin skins don't get very far in life and thanks to him I've got a coat of armor.  He makes me tough and he keeps it real.  I've had a lot of nice things happen lately and I could easily get obnoxious if I didn't have my anchor to keep me grounded.
    Maybe encouragement is in the eye and ear of the beholder.  It does no one any benefit to encourage mediocrity or excuse poor performance.  Sometimes the toughest critic can be the one who drives you to excellence.  He sees something in you that needs activation.  Or maybe something that needs taming to be of any use to anyone.  Listen carefully the next time you are given criticism.  Unless someone is an absolute curmudgeon, most people don't like telling another person something that might anger or hurt them.  I enjoy watching American Idol.  I actually like Simon Cowell.  He tells it like it is because he wants the contestants to know what they are doing wrong.  He could say it in a nicer way but they may miss the instruction and impact of what he is saying.  Now I don't think managers can be quite so caustic with their staff members, but well tempered honesty is a valuable tool.  The manager who allows poor performance to continue unchallenged not only encourages mediocrity, but in the end may cost someone a job.  I am probably seen as rather demanding of our staff, but I give them what they need to succeed and I will do whatever I can to teach and encourage them. When they do well I make sure they are rewarded and recognized.  It's a two-way street.  The staff member must be willing to accept criticism maturely and to make the requested changes. They have to be willing to try and to work harder. They must care about their own success as much as their manager wants them to succeed.  In that way the manager encourages the employee to grow and the employee encourages the managers continued belief and interest in them.  When it comes to encouragement, you may have to give some to get some.

Dental Teams - Life In the Tribe

    Tribes stick together.  They watch out for each other because they know the tribe is stronger with all it's members.  They care about each other.  The chief watches out for each tribe member and picks them up when they fall, strengthens them when they're weak and teaches them the way.  The fifth element of great managing is: Someone at work cares about me as a person.  That's how you know if you are a good manager.  You truly care about the people you lead.  You go the extra mile to make sure they know it.  You put them before yourself at work.  You try to form a personal connection with each staff member.
    What happens when employees don't feel that anyone cares about them as a person?  Commitment goes down, employees are more likely to cheat when they think they can get away with it and they don't stay with the company as long.  Gallup polls show that in high turn-over companies, where employees felt that no one cares about them, there is a 22% higher turn-over rate.  Dentistry is known for high turnover in positions.  Many dentists say that staff members are constantly looking for more money.  Statistics show that appreciation overrides salary.  Mother Theresa once said, "There is more hunger in this world for love and appreciation than there is for bread."  In the teachings of Buddha, "thousands of people may live in a community but it is not one of real fellowship until they know each other and have sympathy for one another."
    When people feel genuinely cared about at work they form a sort of tribe.  They work together for common goals, share information and help each other regardless of whose job it is or who gets the credit.  A good manager stops thinking about what's good for her and only thinks about what benefits the staff members individually and as a group.  That enhances their performance and ultimately benefits the patients, the practice and the dentist.  The manager then looks good because of all that.  The tribe stays together working and thriving better together because they are well cared for.

Recognition and Praise

    The fourth element of great managing: Have you given your staff recognition and praise for doing good work in the last seven days?  This should be an easy one; it costs nothing and takes very little time or energy. Then why, at any given company, would 1/5 to 1/3 of the employees say they haven't gotten praise or recognition?  Given that research indicates that production rises 10-20% in companies that routinely praise and recognize the efforts of their employees, it seems like more managers should start giving positive feedback.  The results also indicate the customer or patient satisfaction is proportionally higher in companies whose employees feel valued.
    When employees receive praise and recognition a brain chemical called dopamine is released.  Dopamine causes feelings of enjoyment and satisfaction.  People will change their behavior to get more dopamine.  So it stands to reason that if an employee does something good and their manager or boss praises them causing an infusion of dopamine, which makes them feel good, they will repeat that behavior to get more dopamine.  Dopamine is also important for memory and learning.  So, while teaching new skills it would make sense to give praise along the way for learning those skills to reinforce them in the employee's mind.
    If giving praise and recognition is inexpensive, easy and produces such positive results, why does there seem to be such a lack of it in most companies?  According to 12:The Elements of Great Managing there are two reasons.  "First, some of the deepest human emotions are basically selfish.  We are better wired to receive praise than to give it.  We feel our own hunger more than we empathize with others around us....Second, while the ventral striatum seems to be programmed to positive events, other parts of the brain are even more vigilant for negative news.  Biologists believe it is a survival instinct.  For our distant ancestors in the woods and ourselves on the highway, failing to see something good is disappointing; failing to see something bad could be fatal."
    Some managers feel that they give praise and can't understand why their employees feel undervalued.  Maybe they are praising things that the employee feels are commonplace.  Things they've done right already a million times.  It may feel false or insincere; as if the manager is grasping at straws.  Many managers of highly performing employees take their continued progress for granted and only point out their errors.  When handed a report they may only find the grammatical error or incorrect spacing, but fail to note that the report was produced on time and was thoroughly researched and well written.  The employee walks away wishing for a place where he could get a little dopamine jolt once in a while.  Sooner or later, he may decide to find that place, leaving a bewildered manager behind. 
    Praise and recognition may also go hand in hand with employees feeling satisfied with their salary.  Finally, if you have no other reason for doing things for others than self-interest, listen to this.  A person who gives praise can expect an "increase in happiness and decrease in depression that lasts for up to a month after the communication."
    How can you make recognition of employees most effective?  To quote Aretha Franklin "...find out what it means to me."  Find out how they like to be recognized.  One might like some public recognition, while another will value a heartfelt note that she can take out and read whenever she needs another dopamine fix.  Override the natural human impulse to point out what's wrong and find something the employee is doing right and use it to encourage them to keep trying. At times you have to point out errors so the employee can learn, just be sure to express confidence in the empoyee's ability to get it right. Grasp at those positive straws.  Seek to understand.  Many times there is something easy to remedy that is keeping an employee from progressing.  After 6 months of trying to find the right words to encourage an employee, in exasperation I said, "I keep pushing you because I know you can do this, I know you're smart."  That was the straw.  At 42 years old, it was the first time anyone had ever told her she was smart.  I gave her examples to show her I was right.  She has raised a wonderful daughter who is excelling in college.  She must believe me because she is back on track and growing in her position again.  It's not always easy and no one said it would be.  Managers and leaders hold something important in their hands.  The hearts and self-esteem of the people who have chosen to, or are required to follow them.  Don't fool yourself or try to excuse yourself by thinking or saying that you can't be responsible for validating someone else.  Especially if someone has chosen to follow you and that person respects you and has regard for your opinion.  We all validate each other in this life. The level of dissatisfaction and disillusionment regarding the way people feel about their jobs indicates that we're not getting high marks in this area.  It seems like a no-brainer.  The employee will feel good, perform better and satisfy the customer more, the manager will feel good about making that happen, the practice will prosper; what's holding you back?   Get out there and give the fourth element all you've got.  Get the infusion of dopamine flowing. You  may become a dopamine addict and that's good for everybody.

Do You Let Them Do What They Do Best?

    That's the third element of great managing.  Do you give staff members the opportunity to do what they do best?  You may be thinking, "Wait a minute, this is a dental practice.  The jobs are pretty well defined.  Assistants assist.  Hygienists clean teeth.  Receptionists answer the phone."  Well, it doesn't have to be that cut and dried.  There are ways to expand the definition of each role.  Maybe one of your hygienists loves to educate patients about their overall oral health.  She will be great to assign the patients to who always have a lot of conditions to discuss.  The other may love talking about nutrition.  Set up some time for her to do nutritional counseling with your patients.  Maybe your assistant does a fantastic job of explaining treatment to your patients.  Let her dual role be that of treatment coordinator.  Have her present your treatment plans and talk to patients about how the treatment you are suggesting will help them.  Maybe someone else feels very comfortable discussing fees and payment arrangements.  Make her your financial coordinator. 
    Dual roles serve many purposes.  They allow the practice to function better without adding additional staff.  They let staff members enjoy a variety of duties, preventing burn-out.  Maybe, most importantly, having staff members handle these duties allows the dentist to do what they do best.  Dentistry.  Doesn't that sound like a good thing?