Exceptional Dental Practice Management

The Reward

    People in all walks of life, in any profession, tend to wonder from time to time if what they do makes a difference.  Dentistry is no different.  Patients come in with varied dental IQ's, their own desires and expectations, and their own ability to appreciate what the dental team can do for them.  It's frustrating at times to suggest treatment that you know the patient needs, only to have them decline and opt for treatment that you know will not give them the best long-term prognosis.  I know that hygienists get very discouraged by the feeling that they are cleaning the same debris off of a patient's teeth every time they come for a recall visit.  As an office manager, presenting treatment plans can feel like pick-pocketing.  I am aware that many times the patient comes in with the mindset that I want to "sell" them the most expensive treatment that I can.  I'm not sure if they think that I receive a commission or that I'm going to be fired if I don't bring in the "sale".  Thankfully it's not always that way, but when it is I have to spend a good amount of time just earning the patients trust.
    So, what makes it all worthwhile?  Think about it, dentists spend so long going to college and dental school.  I know that dental school is grueling work with little time for the kind of activities most people in their 20's enjoy.  Starting a practice is tough and not very equitable for many years.  Hygiene school is stressful and intense.  Assistants who attend accredited programs cram two years of coursework and clinical experience into one year.  All must accumulate enough continuing education each year to stay current and maintain their credentials.  Where's the incentive, what's the reward?  It's very simple.  The reward is in helping patients live a comfortable and enjoyable life.  My boss, Jeff Price, subscribes to the Pankey Institutes Oral Health Report.  We give a copy to all new patients entering the practice so that they can get an idea of what has helped to form and guide our practice philosophy.  The latest issue had a very touching story titled, "May I Have Another Cookie?  Click on the link to read it in it's entirety.  It is about a dentist who goes to visit his grandmother in a nursing home knowing that she is near the end of her life.  As he sits with her, he is saddened to see how much ability she has lost and how little pleasure is left to her.  He started to think about how trivial many of the parts of his life were, even how unimportant teeth seemed at a time when a person has lost almost everything.  He had brought some cookies for her and as he was telling her about his life and family she was relaxing and enjoying eating the cookies.  He then started realizing how she had valued and taken care of her teeth all her life so that even at 89 she could still find some pleasure in the taste of those cookies.  Suddenly he understood just how important having healthy teeth for a lifetime really was.  The article states that many times a dentist's competence is judged on whether or not their patient's are pain free. The article goes on to say, "However, a dentist's true competence may be measured by whether patients still have the ability to eat at the end of their lives." 
    The dental team, with all it's combined knowledge and expertise can provide the long term, comprehensive care that is needed to help people stay comfortable and dentally functional until the end of their life.  They can help patients understand the need for and benefits of preventative and restorative care.  Incentives come in unexpected ways.  Maybe visiting an ailing grandmother and seeing her reach out her hand and whisper, "May I have another cookie, please?"  is all the reward any of us need.

The Cross Of Life - Worship

    Worship can take many different forms.  In it's most basic form it is simply stopping for a moment to just be and get a sense of peace.  When you are running from patient to patient, task to task, doing the laundry, cooking dinner, and finally falling into bed at the end of the day, do you ever stop to just reflect on what you're doing, who you're doing it with and how lucky you to be doing anything? 
    Our lives can become rat races if we just continue on the maze from one worry to another.  Stress sets in and ailments arise.  Meditation and reflection can remind us of who we are, what our purpose is and how we want to go about our lives.  When things get stressful and hectic, one of the best ways to gain control again is to take a moment to just think.  Evaluate what's happening and how you want to continue.  Mindlessness leads to uncertain results and less satisfaction.
    Everyone has their own manner of worship.  "Regardless of the words used, worship adds a dimension of purpose to our actions.  It reflects love, a broader view of self-interest, and an ability to believe in something greater than ourselves, which is the highest essence of being human."  When we adopt this type of worship we can live more harmoniously and realize more peace and satisfaction in our life.  That is when we are at our best.
    Worship does not necessarily require organized religion.  Some of the people who exhibit the most goodness and decency in my life, don't attend church.  Rather, they live their life in a thoughtful, respectful, loving way.  They believe in God or something bigger than themself, they just don't find it necessary to be part of a formally recognized group to practice their faith.  The people in my life who do go to church every week all have one thing in common, they don't look down on or judge the ones who take a different approach.  That is truly faith in action because it depends only on the individual.
    Having faith and taking time to pay attention to your spirituality can provide strength during life's challenges and disappointments, guidance in times of confusion, comfort when you are lonely or frightened, and peace when things are out of control.  It can help you appreciate the fact that all parts of life and all experiences work together to bring our appreciation of goodness, and our love for those who fail us.

The Cross of Life - Love

    In the Cross of Life, one definition of love is "accepting and caring for others unconditionally, without expectation of reward or reciprocation.  In the Greek culture it's called Agape love. 
    Freely and unconditionally loving others benefits both the giver and the receiver, usually resulting in fulfilling and happy relationships.  When someone feels loved and cared for, exactly as they are at that moment in time, they are also receiving the gift of peace with themselves and the other person.
    Loving your family and friends requires something from you.  It requires time, commitment and interest in others.  Just saying you love others doesn't make them feel loved.  Giving of yourself and your time does that.  That is why balance in life is so important.  You can begin to see why overdoing one aspect of life, cheats another aspect.
    "It has been said that love consists not of looking one another in the eyes, but of looking outward in the same direction.  Sometimes, love can be renewed and extended by sharing a similar vision.  Think about a couple who have raised their children and who have just dropped the last one off at college.  If they can share a dream and vision for a new future for themselves they can find the love they began the journey with renewed and re-energized.  If they look at each other and shrug, resigned to accepting that the best part of life just ended, they will grow old and wither quickly.
    Does love have it's place in the work arena?  Let's look at the 3 ways the Greeks define love.  As we said, Agape love is encompassing of the divinity of all people, so yes, that would be a valuable love to extend to our patients and workmates.  Eros love, which is romantic love, is probably best saved for outside the office.  The third type of love is phila or brotherly love.  Seeing everyone as a brother, worthy of love would certainly enhance any practice.  So, looking outward, together as team, would not only be acceptable, but highly desirable.
    Keep it all in balance, be sure to keep you family and home relationships strong and healthy and you'll find that love has it's place in all aspects of your Cross of Life.

The Cross Of Life - Play

    I love Dr. Pankey's thoughts on play.  "Play is not merely recreation, it is re-creation."  Think about the way children view their world.  Everything is new and noticeable.  It's all interesting and worth exploring.  Adults can become numb to the things that fill our lives.  Spend one day really noticing everything that happens, everyone you encounter, all the sights, smells, sounds and feelings.  My husband was sitting on our back deck, speaking to a work colleague on the phone.  The woman asked him where he was.  He told her and asked why she wanted to know.  She said, "It sounds like you're in a bird sanctuary."  He was oblivious to the birds singing all around him.  Now that we've become aware of it again, we really enjoy it.  You can't enjoy what you take for granted.
    Taking time to play makes you light-hearted and invigorates you.  It gives you a different perspective on other areas of your life.  Even being playful at work can make life so much better.  I can testify to that.  I spent at least the last two years exhausted due to undiagnosed sleep apnea.  Now that I've gotten some relief from using a CPAP machine, I feel like I've become my old self again.  I'm having fun effortlessly, just like I used to.  I was trying to keep things fun before, but the effort took something out of it.  Now that I feel alive again, the difference is amazing.  Not only am I happier, the staff at work is as well.  The fact that one person's mood or demeanor can have such an effect on everyone's makes it almost a duty to find time to play.
    Being playful at work can make the difference to patients in how they feel about the practice.  No matter how professional the appearance of the staff, how great the skill, how impeccable the office, if the atmosphere is grim, no one will want to be there.  Nobody really likes going to the dentist, we've all heard that a million times.  Having a sense of fun in the office can make that feeling recede while the patient is in the office.  One patient had such a great time that she said she never laughed so much at the dentist.  Once you establish that feeling, you've got to live up to it.  They'll count on you to recreate the fun every time.  We once had a patient who said we changed his mind about dentistry.  He actually looked forward to coming in because he had such a great time.  One day he came in and we were very busy and stressed and I guess it showed.  He emailed me that evening to ask if everything was ok and if we were upset with him.  Of course we weren't and I felt terrible that he had been let down.  So we know now that we must live up to our reputation.

     Taking time to play away from work reconnects you to your friends and family.  Many times I get so caught up in what I need to do for work, or in ideas that I have for work, that I forget that I'm home and supposed to be setting that aside to enjoy all I have here.  Even if you're home alone, put down the management book and pick up a novel.  Give your brain a different, less serious pathway to travel.  It's healthy and it makes you more rounded as a person.  If you don't pay attention to your friends and family because you're too busy with work issues, you could just be surprised someday to find that the space you once occupied in their lives has been filled with other things.  They have to do that to stay in balance themselves and to make the fact that they were not important enough to you less glaringly obvious.  It doesn't matter at that point if you protest and declare their importance, it's how you make them feel that counts.  So show it now, be there with them now, because the end of your career is a long time to wait for anybody.
    Finally, make sure you take all your opportunities to enjoy leisure and fun activities.  Notice the birds singing, the sun setting, the flowers waving in the wind. Hug your kids, a lot, and let them know that this is the best part of your day. Laugh your head off, dance like no one's watching and sing at the top of your lungs.  Wave at a stranger, smile at a sourpuss, goof off and take time to dream.  Play practical jokes, laugh at corny jokes and when you read a fortune cookie, no matter what it says, add "in bed" to the end.  For example; You will have a long and successful career, "in bed."  Got it?  My son thinks that's hysterical.  That's what I'm talking about.

The Cross Of Life - Work

    To have balance in the work area of the Cross of Life, the work must be enjoyable.  I have three children.  Two of them enjoy school very much and have been very motivated to study and get good grades.  One has her Master's degree and the other will start his Master's program in the fall.  The other is an amazing artist.  He is creative and gets lost in his art.  That is the path I hope he follows.  He does good enough in school, he could do a lot better if he had the drive the others had toward studying and grades, but that's not him.  He is in his element when the scent of paint is in the air.  I have told all my kids that whatever they choose to do in life, they should choose something that they will enjoy going to do every day.
    This is part of knowing yourself, and the first step toward enjoying your worklife.  Some people love predictability, others enjoy constant change.  Dr. Price is great to assist with because he is methodical.  He's perfected his skills, and working with him makes it easy to achieve that flow that feels so satisfying.  Working in tandem without fumbling and hesitating feels so accomplished and efficient.  I love that part of my job.  I also love autonomy, which I have a lot of in the management part of my position.  I love teaching others, and I get to do that with new staff members.  I'm very lucky to have all these different components in my position.
    Challenging work is also important.  If you can look at challenge as a way to expand your skill and keep things interesting you will be less likely to be stressed by the unexpected or difficult and more likely to enjoy what you do.
    Don't take on more than you know you can handle.  As I stated in my last post, lots of overtime and constant thoughts about work don't make you more interesting, it just makes you one dimensional, exhausted and dull.  It can also make you resentful, short-tempered and argumentative.  If this sounds like you, delegate what you can and reconsider what's realistic for you.
    Get feedback, good and bad.  Good so that you are inspired and satisfied, and bad so that you have direction.  When someone tells you about the good results of your efforts you can appreciate what your work has allowed you to achieve.  Hearing about what doesn't work or needs to change can give you new direction and re-energize you to set off on a new and interesting path.  Critical feedback doesn't have to mean negative feedback.  Critical feedback says, "I believe in you, so I'm telling you what you need to change because I know you will succeed."  Negative feedback is, "I don't think you will ever be able to do this, you're fired."  See the difference?
    One of the feelings I enjoy while I'm working is what I call "getting in the zone."  Getting so absorbed in what I'm doing that an hour passes in what feels like 5 minutes.   When that happens, work is truly satisfying and enjoyable.
    Finally, your worklife must be a step toward other meaningful things in your life.  Does your work allow you to spend time doing things you enjoy with people you love?  Do you receive and feel a sense of gratitude because of what you do?  One of the best realizations that I have had in my work is that I'm lucky to work for a person of Dr. Price's character, with a staff made up of brave, inspired, strong and wonderful women, in an environment of trust, understanding and love.  It is the recognition and understanding of all that which lends grace to what we do.

The Cross Of Life

    As I said in my post on Wednesday, my boss, Dr. Jeff Price has shared many of his life philosophies with me.  He learned much of this during his time at the Pankey Institute.  Dr. Pankey believed in a philosophy called The Cross of Life.  The Cross of Life contains the elements of a balanced life: work, play, love and worship.  We need to be productive, to enjoy daily life, to have people in our life we care about, and to be interested in something other than ourselves.  If you are out of balance on any of these things, your life will become out of balance as well.  This can damage self-esteem, lessen our enjoyment of life, and even alienate us from others.  If our life is in balance, we achieve happiness.  It seems so easy, and we all say we want to be happy, so why do we ignore or dismiss the need for balance?
    I have been guilty of becoming out of balance at times.  When it happens, I make excuses and defend the unevenness of my life, even as I realize that it's a problem.  This is one of the areas that Dr. Price will not let me off the hook about.  I couldn't understand why he would be disapproving of my working extra hours or coming in on the weekend to work on a project that I was enjoying.  Didn't he realize that this was beneficial to the practice?  I wasn't asking for overtime so why wouldn't this be a winning situation for him?  He would just look at me patiently and tell me that I needed to get away from work and enjoy other things in life.  Well, I thought, he doesn't understand, my husband travels a lot, my kids are pretty much grown, I love my work, why wouldn't he just leave me alone?  There are probably two reasons for that.  One, I know he cares about me as a person and wants me to be happy and sane.  Two, he knows that if I'm not happy and sane, it could affect the practice.  A happy, sane person stays that way because she has varied interests.  People don't realize that they are becoming obsessive or single-minded or they wouldn't do it.  I was becoming obsessive and single-minded about my work.  I love it and that was what I thought about most of the time.  That makes a person become pretty boring to other people.  None of my friends is really fascinated about dentistry, my family isn't either, and I was becoming a bore.  So I finally realized that I needed to branch out and rediscover the other arms on my Cross of Life.
    I'm going to the beach this week to enjoy the play part of my life so I've written some articles before I left that are set to publish during the week.  Most of them will be about the Cross of Life.  My week at the beach is the one time I truly relax and get lazy.  I've had a busy year with planning my daughter's wedding (October 20) and dealing with health issues (finally better) so I plan to do whatever I please while I'm on vacation.  I'm going to put as many miles on my bike as possible, read books that I've been saving up, sit on the beach till I can't stand it anymore and anything else that I want to do.  Most of all, I'll enjoy being with my family and knowing that I've got it really good.  What more could anyone ask for?

The Power Of Thought

     My boss, Dr. Jeff Price, has completed the Pankey Continuum.  By working with him, I have learned so much about dentistry and also the life philosophies he lives by.  Many of these philosophies were learned at the Pankey Institute.  I have read A Philosophy of the Practice of Dentistry by Dr's L.D.Pankey and William J. Davis and I keep a well thumbed copy in my office for inspiration.  The following is a short excerpt from the book As A Man Thinketh by James Allen which was given to Dr. Pankey by Dr. Daniel Hally-Smith.

"As you think, you travel; and as you love, you attract.  You are today where your thoughts take you.  You can not escape the results of your thoughts, but you can endure and learn; can accept and be glad."

     "You will realize the vision (not the idle wish) of your heart, be it base or beautiful, or a mixture of both for you will always gravitate toward that which you secretly most love."

     "Into your hands will be placed the exact results of your thoughts; you will receive that which you earn-no more, no less."

     "Whatever your present environment may be, you will fall, remain, or rise with your thoughts, your vision, your ideal.

     "You will become as small as your controlling desire; as great as your dominant aspiration."

     This is a powerful statement.  It is a testament to the power that we really do have over our destiny.  If you really think about everything good and everything bad that comes into your life, in most cases it either resulted from your thoughts or the actions that you took because of your thoughts.  I know that it is true for me.  I am grateful that Dr. Price shared what he learned with me.  It has helped me many times in my life since I learned it.  As human beings we often need to be reminded of things that help us succeed, but it is never too late to adopt new ideas or to return to them.  It is by sharing the things we learn that we can change things for the better in our lives and the lives of those around us.