Exceptional Dental Practice Management

Heroes, Angels, Patriarchs and Heaven

Today's blog is about anything but dentistry.  You may have noticed that I've been pretty slack about writing this blog in the last year.  I haven't been lazy though, I've been bombarded.  So indulge me, this is a tribute to a very special man.

At this point I am in the end stages of laying a 31 year marriage to rest.  My husband was my hero in many ways, and as happens with many heros who imagine that being on a pedastal is a part of it all, he fell.  And he wouldn't get back up again.  So we go forward into a new type of relationship with each other that is being helped by the arrival of an angel.

My daughter gave birth to my adorable granddaughter, Sophia Emory on December 2.  Everything they tell you about grandchildren is true.  I was awestruck to see my beautiful daughter holding her beautiful daughter.  Not matter what problems are facing you, holding a brand new baby is healing.  Everything falls into place and you see things in a new way.  It balances you so that you see what is worth your attention.  Not to put too much pressure on a week old baby, but in some way she gave me the strength I needed to face losing yet another hero.

My beloved brother Charlie passed away on December 5 after a long and terrible battle with cancer.  I was able to be present for Sophia's birth and then leave the next day to spend the night in Hospice with Charlie.  It was a gift I will be forever grateful for.  Charlie was my true hero.  One who didn't expect admiration, but engendered it, nor did he look for worship.  He gave because he cared.  He didn't take a measure of what he was getting back, so he never felt cheated.  He accepted with gratitude and gave with abandon.  I didn't want him to know about my problems because he had enough of his own, but he found out and reprimanded me saying, "I am still the patriarch of this family."  Sounds like he was watching a little too much Real Housewives of NJ if you ask me.  He was in it till the end and he was the best brother anyone could ever have.  And I know he thinks he's still the patriarch all the way from heaven.  I'm counting on it.

Here's the thing; you never know when your heroes might leave or when your angels might arrive, so it makes sense to take care with everyone and appreciate what's right in front of you.  Heroes and angels beget other heroes and angels so the more you bring into your life, the happier you'll be.  Now consider this; how are you a hero or angel to someone else?  When I got back from my week of rollercoaster emotions, I found that my co-workers had left dinner in my fridge and a beautiful card on my kitchen table.  Yesterday, my boss took us all out to lunch to welcome me back.  Heroes and angels?  You better believe it. Did I think of them that way before?  Probably not.  The only thing you have to do to have more heroes and angels in your life is to learn to recognize what they look like.  I'll bet you already have many of them.  We go through our days so focused on tomorrow, that we miss so much today.  Slow down and appreciate your own heaven on earth. It's right in front of you, filled with heroes, angels, and every now and then, someone who is willing to be a patriarch.  What a shame it would be to miss it.  I knew what I had in Charlie all along and I was always amazed by him.

Thanks Charlie, patriarch, hero and sometimes really annoying big brother, and now official guardian angel to my angel on earth, Sophia.  I was so lucky to have you.  Other angels will take over now, you rest a little.  Thanks for showing me how to be brave.

Treatment Plan Presentation

I had posted an article a while ago about the patient care coordinator position.  A reader asked me to give some information about how I present the treatment plan.  

First things first, understand your patient.  What do they want? What do they care about?  Is it the perception others have of them, or their own comfort and health?  What is their understanding of oral health?  What can they afford, and what are they willing to spend?  How can you show them what they need in a way to make them want it, and how can you show them how to afford it?  This all starts in the pre-clinical interview, so don't cut corners here.  It's very tempting to rush the pre-clinical interview if you're running behind, or if the patient seems like an impatient person who wants to control the way the appointment is going to go.  But, don't do it, take your time and get in there with them.  Find a way to get past their defenses and get them to open up.  You go first, tell them why you do what you do in your office, before to try to tell them why they should buy it.

 Once you have a good idea of what is important to your patient and you've gathered all your clinical information with the dentist, sit down and discuss the patient's treatment plan with the dentist.  First listen as a dental professional and make sure you understand the rationale for the treatment.  Then put yourself in as close to your patient's frame of mind as you can and ask the questions you think they'd ask.  Finally, come up with 3 treatment plans; good, better and best.  (Sears used to do that years ago and who really wanted to go home with the good blouse if they could pay a little more and get the best quality one?)  Also, find out if there is any treatment the dentist absolutely won't suggest or provide.  Now you're ready to put your treatment plan presentation together.

Print out the following:  Review of findings, photos, x-rays, information about conditions or procedures (Click and Print is a great software package for this), and a copy of the treatment plan and fees.  Place it all in a presentation folder that has a slot for the doctor's business card.

When the patient arrives, be sure to have a small glass or bottle of water available for them.  I say small for a reason, you don't want them jumping up in the middle of your presentation to use the restroom, but you do want to show them you're considerate of them.  Next, start by reviewing what they've told you their goals are for their oral health.  Let them know that you want to help them achieve that and why you think your dentist has prescribed the best treatment plan for them.  In other words, go through your best treatment options and let them know exactly why it is the best choice.  For instance, if a patient is missing a tooth, you will likely have your good option as precision partial, your better option as fixed bridge and your best option as implant if they are a good candidate.  If they aren't a candidate for implant, everything moves down a notch and you start with clasp retained partial, then precision, then bridge.  Explain the pros and cons of each treatment honestly.  Don't fall into an annoying salesman technique of bashing the good option in favor of the best, just give them the facts and help them if they have questions or misconceptions.

As it becomes time to decide, you may realize that you've now led your patient to truly desire the best option, but they don't see how they can afford it.  This is where you must know what options your practice will offer in terms of financing.  For patients who you have very little experience with, who don't have a reliable reference behind them, or who just seem like a credit risk for you to take on, I'd suggest Care Credit or another lending program.  If you offer in house financing, work with them on that.  I love it when I can offer them a payment plan that takes them through a phased treatment plan.  In other words, we may be working with them to maximize their insurance so we may be phasing their treatment over 2-3 years.  If I can break up their payments to span that time period, everyone wins and the patient gets the best treatment available to them without undue financial hardship.  If you are creative and you have a reasonable patient, the finances can be worked out to the benefit of the dentist and the patient equally.

Once the treatment is accepted and the financial plan is achieved, it's time to schedule the treatment.  I don't like to schedule everything immediately, even though it feels great to get it on the books.  That is because life happens and if you have 10 appointments scheduled, chances are patient will get home and notice that they have a hair appointment that can never be moved. (funny how hair appointments trump dental appointments every time, but to be honest, mine do, too.).  Now you have to start moving all the subsequent appointments, too, and that's a pain.  I like to set up the first phase, or quadrant, and then midway through those appointments, set up the next.  

It's important if you are phasing treatment over the span of a few years, to make a note to call the patient to set up the next phase in the last quarter of the year preceding.  So, if a patient is going to start phase two in 2012, I'm going to have a note on the schedule in November, 2011 to call and set it up.  

Finally, as the patient care coordinator, you are the laison for the practice and patient and you need to be available to the patient to answer any questions they may have.  Make sure they know that.  Make sure they know that you are available to speak to their spouse, adult children, or whomever they release you to give information to  (make sure you have a signed information release waiver).

Presenting treatment is interesting, sometimes challenging, and almost always rewarding.  Helping people understand their oral health needs and then assisting them in making the possibilities and desires a reality is a fulfilling way to spend the day.

Circumferences and Centers?

Ok, so it's been a while, right?  Well, we're short-staffed right now, so that means I'm working harder.  Actually, we all are.  The last thing I wrote on here was the question, "Who steals your peace?"  Well, one of my answers would have been, "People who resign with little notice, especially after I've spent a year training them!"

You can relate, right?  It's so frustrating, you spend time training, you learn to work with their strengths and work around their weaknesses, and then, poof!, they're gone.  

This is all very annoying if you are spending a lot of time living on the circumference, or edge of your practice.  On the edge, things happen that affect the center for a short time, but fall away only to be replaced by similar things that might be a little better, or slightly worse.  Those areas continue to fall away and be replaced, and generally have limited, short-term effect on the whole, as long as the center is strong.  Unfortunately, that's where we often place our greatest attention because the effects seem to be so impactful, but we need to realize, the impact is short-lived.  We need to understand our center and trust that it will hold.

The edge is the beginning point - for a new employee, new product, new patient, new procedure, etc.  As they move closer to the center we can see if they fit in, enhance, grow, and work with the center.  The center is the heart of the practice - the dentist, the long-term employees, the patients, the basic, reliable products and procedures and policies.  

We begin on the edge and we can observe the employee deciding, "Is this something I can be, will be, part of?  Will I join in and work toward this center or will I stay out here on the edge?"  The questions are there and you can quickly see the natural inclination of the employee.  

Next, we can sense discipline, or lack of it.  Will the employee try to: learn to do what you need them to do, know what they need to know, understand where you're coming from and where you want them to join you?  If the answer is no, they will remain circumfrential, and eventually fall away.  If the answer is yes they will move closer to the center of your practice.  

Now, we will see thought come into play.  Are they thoughtful about what they are doing, or are they going through the motions.  That will make the difference between whether they will become engaged innovators who will be looking for ways to make things better, or if they will just do enough, which will eventually drag them back to the edge where you may allow them to hang out, or they will move on.  

Finally, you will see action in the center.  They will bring new ideas, research new products, think of new ways to serve the practice, the patients and each other better.  They become a part of the heart of the practice.

Figure this out.  Watch to see where your employees settle in.  Then you won't be so frustrated when someone drops off the edge.  Then you will know who is part of the heart of the practice and that's where your concern should rest.  When you know all this, you will sense an awakening within yourself and a resting.  You will care, and not care at all because you will know what actually is.  In the end, we do not find the center of our practice, it reveals itself to us.  We have to stop reacting to the distractions at the edges and keep our eye on the center so we can see it.

 

A little something to think about so we can discuss it later: What do you resent? What makes you seethe on a daily basis? Who steals your peace? How much pleasure does that take away from your day? I think we can change that, but first, really think about it. You can even email me about it so I'll use it in my post.

"God bless every soul that was lost. God bless everyone who has to endure that loss. And God guide us to our reunion in heaven. God bless America." ~Rudy Guiliani on the 10th Anniversary of the 9-11 tragedy.

Success

 

"What's money? A man is a success if he gets up in the morning and goes to bed at night and in between does what he wants to do."   ~Bob Dylan~

 

We've been talking about what we need to be ok, but what do we need to be a success?  Does having enough make us successful?  Ok, if that's it, when do we know we have enough?  Is it enough to be able to pay the bills on time and keep the staff employed, or is there more?  Do we have to be able to take as good a vacation as we had last year?  Keep shopping in the same stores?  Do we have to be able to keep up our memberships to the clubs that are important, go to the restaurants that everyone goes to, the events that we want to see and be seen at?  If we can do all that, will we feel successful? Will we be successful?  At what cost?

It seems that everyone is focused on scarcity these days.  Maybe you're worried that your patients will leave and find someone whose fees are lower, who takes their insurance, or even, who takes their insurance and writes off the balance.  Tough times can bring out the temptation to cheat and the propensity toward greed.  How do you respond?  Maybe you're noticing that patients aren't accepting the treatment you feel they need?  Do you panic and see it as the beginning of a downslide for you, or are you more concerned about the beginning of a downslide in their oral health?  What's your gut feeling?  What about your staff?  Do they care about your success?  Do you care about theirs?  Do they care about the success of the practice?  Do they feel that when the practice succeeds, they succeed and are an integral part in that success?  How about the guy across town?  How's his practice doing?  Do you care?  Can you help?  Would you care to help?

Success begins with sharing.   Even when it's seems like there's not enough to share.  In between getting up in the morning, and going to bed at night, are you getting to do what you want to do?  Are you enjoying it, or worrying your head off?  Then share.  Share first your joy in what you do.  Share it with your patients and your staff.  Tell them how much you love what you do.  That joy is infectious and that makes you a joyful success.  

Share your concerns with your staff, let them share your burdens.  You might be surprised by what they will do to help.  Listen to the concerns of your patients.  They're not being stubborn, they may have the same worries you do.  Share their burden.  Help them afford the treatment they need.  Offer payment plans with no interest.  Phase treatment where you can.  Work with them to maximize their insurance coverage.  Take the time to explain the reasons for doing some treatment immediately, and then why some can wait a little while.  Be patient with them.

Don't ever give in to pettiness.  Don't panic over small setbacks.  Don't see doom in every cancellation, or worry that it's the beginning of the end if someone leaves the practice.  Patients cancel appointments for many reasons, half the time they just forget.  People switch dentists on a whim, and you can't be everything to everyone.  If you try you might not enjoy what you do between waking up and going to bed anymore. 

Give.  Praise your staff for the good things they do.  Notice the little things and make a big deal out of it sometimes.  Bring in bagels now and then, or treat everyone to lunch just to say thanks.  They'll think you're a king.  Give to your community.  It's good advertising and it helps others succeed, too.  Find out if there's another dentist who's really just hanging on and try to help them succeed.  Share what you can, whether it's knowledge of how to improve their practice, or even a new patient now and then.  They will never forget you.

If you can do all this; when you get into bed at night, you might realize that you forgot to worry that day.  That's because you were focused on success.  And now you know that when you wake up in the morning, you get to succeed all over again.

Count The Ways

In my last post I asked you to think about what makes life good when things are going good, and what makes it good when things are hard.  I'll bet that when things are going good, the things that seem to make you happy are the things that are so easily lost and that are dependant on the whims of fortune.  Hey, I'm with you on a lot of that!  It's great to have extra money, easy success, and few worries.  As I remember it was also fun to ride on a seesaw...until the kid on the other end jumped off while you were up in the air.  Once you realized that might happen, wasn't there always a little anxiety associated with the seesaw, despite the promise of fun?  It didn't make you stay off the seesaw, but you tried to be ready for the big fall, didn't you?  

Depending on the economy to be predictable is like expecting every kid you ride a seesaw with to stay on and to tell you when he's getting off.  It's not realistic.  So, let's look at the things that keep you happy when things are tough.  I'll start:

I have three great kids who love me no matter what.  They're funny, kind, loving, devoted, dependable,and they have great character.  I even have a granddaughter on the way.  They love each other and they love me, and that makes me happy.

I have a deep faith in God that sustains me and inspires me.  I am part of a very supportive faith community.  

I have a wonderful extended family, especially my brother, Charlie.

I work for a great human being who is a gift to everyone he comes in contact with.  Our staff is filled with good people who are committed to what they do and who help and support each other and take great care of our patients.

I have enough of everything I need, and more than enough of some things.

I have just enough wisdom to know that anything bad that happens to me will make me stronger, and that if I wait long enough and have enough patience and faith, good things will happen again.

How about you?  Have you take the time to count the ways that you are fortunate, or are you too busy worrying about what's wrong?  Ok, so if you can't stop looking at what's wrong, can you step back just a little and see if you can use the good things to help you overcome the things that are wrong?  Start your good list and go from there.  You might be surprised.

 

Prosper

Yesterday I asked you to think about what you truly need, want, and what you could do without.  I also asked you if you could do with a little less, if you could help someone else survive.  What I'm talking about is this:  what does it mean to you to prosper?  The dictionary defines prosper as: to thrive or succeed, or to cause to thrive or succeed in a healthy way.  So, it can be something we do ourselves, or that we help others do. Sometimes we just decide that we want to prosper and we set about doing things that will make that happen in a way that our experience, to that point, tells us will make us happy and secure.  Other times, other people, or circumstances make us redefine what prosperity is for us.

I'm going to share something with you that I haven't discussed here before.  After 31 years of marriage, I am going through a divorce.  I never, in my wildest imaginings thought that I would ever be facing this, but here it is.  Sometimes life hits us from our blind side.  To say I was devastated is putting it mildly, but I have found that I am lucky.  I have family, friends and co-workers who love me and have rushed in to help me prosper again.  This is where redefining prosperity comes in, by the way.  When, after trying to find a way to make my marriage work, I was dealt a second blow late one evening, I emailed a friend who lived on the other side of the country.  She desperately want to help me make it through the night and sent me this Scripture passage to give me strength and hope:

"For I know well the plans I have for you says the Lord, plans for your prosper, not for your woe!  Plans to give you a future full of hope."  Jeremiah 29:11

I doesn't matter if you're Christian, or not, those words are full of hope in despair.  It made me think of what it meant to prosper in a new way. At first, to prosper meant to get through each day with my sanity intact.  Then it meant to get through each day with my dignity intact.  Now it means to know that each day is a new gift, full of opportunities to be happy and grateful.  

I realize that eventually I will probably need to move out of my house.  I looked around my living room at all the stuff I really wanted once upon a time.  Now, it's just stuff.  Nice stuff, but really pretty meaningless, and now, almost a burden.  The things I want are the things that have meaning: pictures of family, things that my kids made for me, things with memories.  That's what I'll take when I leave this house.

To me, prospering means having real meaning in my life.  Spending time in prayer, meditation, and reading relax me.  Spending time with family and friends fill me with love and satisfaction in a life being well-lived.  Helping others in any way I can makes me feel that I am giving back a fraction of what has been given to me.  

In the end, it is the way we live through both good times and bad times that give us a measure of who we are.   Trials and trouble bring us face to face with the reality of who we have become and let us know who and how we want to be.  This is the place in which we choose.  We can choose to fall apart and become pathetic, or we can choose to be strong and to be happy.  No matter what, happiness is something you decide to be.  Strong is inside all of us, we just have to drag it out; every day, as much as we can.

So, today I'll leave you with another thought.  What has it meant to you to prosper when things were good?  What can it mean when things are not so good?

Choose Your Own Way

Is the economy as bad as it sounds?  Maybe.  Actually, probably.  Well, really, yes it is.  But…it is what it is.  You can make it better for yourself, or worse.  Victor Frankl faced one of the worst trials in human history, the concentration camps, and he discovered something that enabled him to survive:

 

“We who lived in concentration camps can remember the men who walked through the huts comforting others, giving away their last piece of bread.  They may have been few in number, but they offer sufficient proof that everything can be taken from a man, but one thing: the last of the human freedoms – to choose one’s attitude in any given set of circumstances, to choose one’s own way.”

 

Maybe this sounds familiar:  The economy stinks!  Production is down!  New patients aren’t coming in!  No one is accepting treatment!  My staff doesn’t get it, and now they want raises!  How much longer can I make it?  These are the things we tell and ask ourselves, and others.  These are the things that keep us awake at night.  These are the things that make us feel hopeless and helpless.  They will keep having that effect if we don’t face them head on and deal with them.  That’s the hard news, but wait, there’s good news, too.  There are things you can do to ride out the economy, and even proper while doing it. 

 

When I say you can make it better, I don't necessarily mean you can make it easy.  I can't tell you how to go through this economy without any difficulty,  But, I think I can help give you a different perspective.  We have to learn to define what is important.  What do we absolutely need, what do we want, and what would it be nice to have, but could wait?  Is it more important to prosper alone, or more gratifying to have a little less, but know you’ve helped someone else hang on?  Can you look at difficulty as an opportunity to grow stronger and help others do the same?  If you can, this economy may just offer you a chance for so much more personal growth and satisfaction than you ever imagined. 

 

What I want you to do now is this:  think about the questions about what you need, want and could do without if you had to.  Think about how you feel about reaching out to help someone who’s struggling more than you are.  We’re going to talk about this some more, but first, you need to know where you stand right now.

 

What's Your Motivation?

Have you ever tried to talk to someone and thought it would be just an average, everyday conversation, and found yourself in the middle of an argument or drama?  You  walk away stunned, wondering what is wrong with the other person?  You really don't even consider wondering if it had anything to do with you, because you know you were just trying to pass on information, advice or constructive criticism, right?  Maybe you should wonder.

Often, we go into a conversation without checking ourself first.  Actually, we probably do that most of the time.  We get an idea or thought, we think it's valid, maybe even amazing, we approach another person with it, and we get a reaction that we never imagined.  

That's because we didn't stop to think about what was motivating us.  It is a rare event when we do or say anything doesn't have some self-interest involved.  Have you ever listened to someone talk about something they did for someone else?  Did you notice that somewhere in the telling, you'll hear something that gives the speaker a little pat on the back.  I do it all the time myself, so don't be afraid to admit it about yourself.  

I was at a meeting recently during which a new member of the group decided to give some "constructive criticism."  Just starting a statement with those words tends to put everyone on high alert.  It seemed that she felt we should format our discussions differently because she was used to a different format.  As she conveyed that idea, she managed to make remarks that made at least 3 people feel that she was criticizing them.  You could feel the tension spread across the room and the conversation basically became very stilted.  To top it off, she then monopolized the rest of the conversation.  So, what was her motivation?  She wanted things her way and her way meant she talked and everyone else listened.  What was the result?  A lot of resentment and hurt feelings that two of us had to spend a lot of energy reversing.  In many instances, there is no one who is willing to spend the energy recovering a situation like this and it snowballs into a mess.

Can you think of a time in your practice when this has happened?  What was the motivation?  It was probably that someone wanted to be in control, to feel important, or to put someone else "in their place."  It's amazing how quickly things can go downhill if no one steps in to call the person on it.  I think that the best thing to do is just to ask the person for clarification first.  If that doesn't make them see what they're doing, just go through a description of how their scenario or statement might pan out.  By doing this you'll get a good idea if their motivation was innocent, but misguided, or self-interested, and so might they.  I don't think that most people start out wanting to deliberately hurt others, but I do think that we often are driven by self-interest without consideration of others.  

I don't think that there are many people who set out trying to act like a jerk, but I do think that sometimes things start to go off in an unintended direction and before you know it, all hell breaks loose.  It's happened to me before and it's kind of stunning.  So, instead of just reacting, take a minute to try to figure out the motivation.  It doesn't matter whether you're the culprit, or on the receiving end, figuring out the motivation lends clarity to a situation and affects the outcome.  You may be able to just stop a situation that's going sour in it's tracks, before the real drama begins.  Since drama is highly overrated, you might want to give it a try.  That is, unless you enjoy drama, and that leads us right back to motivation again.

Good Gossip

"No one ever gossips about anyone's secret virtues.". -Bertrand Russell- Gossip is such a weird thing. On the one hand we feel uncomfortable with it because of how it makes us feel. If we listen to gossip we feel guilty, maybe a little trapped and we may even wonder if the person we're listening to will gossip about us to someone else. Hang on though, you're never a victim, you can change the subject or find a reason to leave, rather than provide a forum for gossip. We stay because we get something out of hearing it. We may feel preferred by the gossiper, interested in the information, or superior to the person being talked about. But, what about that person? How would they feel if they knew what was being said? How would you react if you turned around and discovered they'd been standing listening the whole time? Wouldn't you, as the listener, be just as guilty as the one talking? Moreover, how has the time you've just spent in that conversation impacted anyone's world? Has it made you a "better version of yourself?" If you ask me, nobody wins. Sure, some people may feel like they've accomplished something like letting everyone else know the "truth" about someone else. Just remember, that's the truth as they see it and it's impacted by their own personal agenda. The way we think and talk about others is often a mirror of our own interior life. The thoughts that we assign to others often only reflect the thoughts we assume they have, because that's the way we think. Gossip can be good, though. Just imagine walking up to two people talking and realizing it's you that they're talking about. Then imagine you hear that they are talking about how great they think you are! How do you feel? I know that I'd love it, and not only because I'd feel good about me, I'd feel even better about them. Let me ask you this: when you realize that someone is about to bad mouth someone else, doesn't a part of you feel some discomfort? When someone tells you something good about someone else, don't you feel uplifted? Then, really, how should you spend your time? Spread good gossip in your practice. Make a point of it by introducing the idea at a staff meeting. Give everyone small pocket sized notebooks with a page for each staff member and challenge them to write down every good thing they "catch" each person saying or doing for the next week, then start off Monday morning by having one person read out what they wrote all week. Continue each morning until everyone has gotten all their good gossip out. You'll be surprised at what happens to the atmosphere and attitudes in the office. People's outlooks are guided by what they think most about. Looking for the good in their co-workers will have an impact. Knowing that people are watching for the good in them will inspire goodness. Good gossip is good for everyone. It's free, it's easy and it's always available so spread some around your practice and see what happens.

This is hysterical. Take the time to read it, and don't be offended by some of the cuss words. The story demands them. http://thedentalwarrior.com/2011/07/15/vestigial-organs-by-i-p-freely-2/#more-1496

The Enemy of Excellence

"Minimalism breeds mediocrity.  It is the destroyer of passion.  Minimalism is one of the great character destroyers of our time.  It is the enemy of excellence and a cancer on society.  The problem is, culturally we encourage minimalism."        ~Matthew Kelly - The Rhythm of Life

It's hard to get people to do what you want them to do, isn't it?  Life seems to teach you that you're not going to be able to get others to work to the level of excellence that you'd like from your employees.  You start out with high ideals and then reality sets in and you begin to lower your expectations.  After all, not everyone is raised the way you were, not everyone is as passionate as you are, and let's face it, your employees don't benefit financially as much as you do, so how can you expect them to give so much?  If that's what you tell yourself, you've given up.

In The Rhythm of Life Matthew Kelly discusses the effects of minimalism on individuals and society in general.  He says that minimalism eats away at character, therefore impacting society negatively, and creates low self-esteem as the consequence not of failure, but of not even trying.  "A person gripped by the mind-set of minimalism becomes very self-seeking and contributes little to the common good..."

What is the mind-set of a minimalist?  "What is the least I can do?  What is the least I can do and still keep my job?"  We see this all the time among staff in a dental practice.  You have your A-players.  They are your best staff members.  They're the ones you know you can depend on to go the extra mile, give a little more, work a little later, keep at it until it's done and done well.  You don't even have to ask, they see what needs to be done and they do it.  

Anything else is minimalism.  I don't see any middle of the road between striving for excellence and anything less.  You can't strive for mediocre any more than you can strive for just enough.  Striving means working toward a goal.  The least I can do to get by is not a goal, it's merely survival.  It's clinging to someone else's best and hoping they'll carry you along, too.  The problem is, there's no satisfaction in it.  Sooner or later, resentment will creep in.  The person who has passion in her work will get sick and tired of the one who is dragging them, and the rest of the team down.  They will lose respect for the person who is supposed to uphold the standards and pretty soon they'll either lose their passion and forget about excellence, or they'll move on to another place where passion and excellence mean something.  The minimalist is also going to become resentful of the hard worker.  Come on, if she didn't work so hard, the minimalist wouldn't stick out like a sore thumb.  It's amazing how much effort the minimalist can put into discouraging someone else from striving for excellence in order to be able to keep giving so little to the job.

I remember someone once telling me, "The devil you know may be better than the devil you don't know."  In other words, "if you think this employee is bad, just wait, the next one may be worse!"   For a short time, that thought paralyzed me.  I found myself hanging on to employees that just could not meet the standards we expect in our practice.  I worried about patient perception concerning turnover, and I worried that the next person would be less capable than the one they were replacing.  I heard other managers voicing the same concern for their practices.  Then I realized that this fear was actually supporting minimalism.  If we allow fear to keep us from striving to build our practices with people who strive for excellence, aren't we guilty of minimalism ourselves?  We have to have the courage to do the unpopular thing.  Patients may lament about the sweet front desk person you replaced, because that's the extent of their experience with her.  You may dread training a new employee because it takes a lot of time and effort, but that's what excellence demands.

Strive for excellence in yourself when interviewing and hiring.  It's easy to be taken in by someone with a great personality, wonderful appearance and who says all the right things.  Let's face it, it's easy to say the right things.  The answers that an interviewer would want to hear are pretty obvious.  You have to verify everything.  Call references and call past employers.  Don't brush off intuition or a feeling that something isn't quite right.  Do the work at the beginning to give yourself a better chance of hiring well.

"What is the most I can do?"  Begin by asking this of yourself and then ask it of everyone else.  What is the most you can do?  Listen carefully for the answer and therein lies character and passion.

 

Joy

"Joy is the fruit of appreciation."  ~Matthew Kelly~

Sounds like a no-brainer, doesn't it.  If you are appreciated, you feel joyful.  It sounds simple, but it doesn't stop there.  You could also say, if you show appreciation for someone, their pleasure will make you feel joyful, as well.  It still doesn't stop there, either.  Ok, so now you have two joyful people in a practice full of other staff and patients, what do you think is going to happen now?  You've got it, it's going to spread.  

People pick up feeling vibes pretty quickly, bad or good, and it makes an impression on them.  It tells them how to feel and react to what is happening around them.  The dominant mood in an office spreads like wildfire.  The person with the strongest personality and the person with the most authority will set the tone for the rest most of the time.  Here's the tricky part, it's not always the same person.  You might have a stressed out, grumpy staff member who has a strong personality working with a happy-go-lucky dentist who just wants to enjoy the day.  Now you have a stressful day ahead of you.  The happiness of the dentist is going to drive the aggravated staff member crazy and she'll start writing her own story.  It might go something like this:  "Sure, he's happy, why not?  I'm doing all the grunt work and he's chatting up the patients.  While I'm sitting on hold with the insurance company, he's in his office surfing the internet.  I'm so sick of that smile of his, I want to wipe it off his face!"  Guess what, within a short time, she will.  Why?  Because she didn't feel appreciated enough to overcome her miserable mood.  Now, he's going to start getting sick of her attitude and he'll start to strike back.  From the way he sees it, not only is she a grouch, she's ruined his mood, too.  Before long, the temperature in the office is frigid and everyone else is feeling it and pretty much sick of all the drama.

Who's fault is it?  Is the staff member to blame?  Yes, in that she didn't reign in her temper and control her mood, but what got her started in the first place?  When people become embittered in the workplace, it's usually because they feel slighted in some way.  It may be a weakness in their personality that causes them to feel jealous about every nice thing that happens to anyone else and prevents them from realizing that they get their fair share of praise and thanks.  If that's the case, you can't cure them and shouldn't try unless you have a degree in psychology and lots of time to invest in that one staff member.  Sometimes the school of experience is the best impetus for someone like that.  When she sees her behavior won't be tolerated, she may get the help she needs.  On the other hand, maybe this is a very hard working staff member who has one of the less glamorous jobs in the office.  Everyone is so used to the fact that she sees a need and gets to work, that it's easy to take her for granted.  When a less hard-working staff member does something extra, the compliments and gratitude may flow because it's so unusual for her to work that hard.  You may just feel like you're trying to encourage that person to pick up more of the slack, but to the one who just does what needs to be done, it may seem like, "Why bother?"

Pay attention.  Is there anyone you take for granted?  If you realize that there's someone who works really hard, but has gone a long time without hearing how much you appreciate her, take her in your office and lay it on thick.  Even if she squirms, inside she's loving it.  When she leaves your office, her head will be a little higher, her smile more genuine, and her heart will sing.  She, in turn, will spread a little joy to someone else, and on it goes.  You throw the first pebble of appreciation and watch the ripple effect happen.  Staff members, do you appreciate each other and your boss?  Do you say thank you, pass on compliments from patients and look for ways to make those around you feel valued?  Do you ever thank your boss for a great day at work?  I know it sounds sappy, but do it and you'll enjoy the look of surprise on his face.  He'll go home happy and his wife and kids will love it. 

I happen to be lucky enough to work for an extremely happy boss who spreads his happiness all over the place.  He sees everyone with kind eyes and thanks us every evening as he walks out the door.  If he needs to give critical feedback, he does it in a way that let's the person know that he believes that they will go on to correct the mistake.  He leaves their dignity intact.  We all love and support him and each other and we know that we have it great.  We can't stop talking about how great our boss is when anyone asks and that's always good for a practice.  

Do you see what an impact you can make, good or bad?  Choose carefully, because whatever you decide, it will come back to you in the end.  So, plant appreciation and reap joy.  You'll be happy you did.

That's What It's About

When it all comes right down to it, dental practices are basically comprised of phone answerers and money handlers, spit suckers, tooth scrapers, and hole drillers.  Don't go crazy, I said basically.  If you don't go beyond the basics, that's pretty much true.  It's what you do beyond the basic description that makes you what you really are.

Let's start with the phone answerers and money handlers.  They have so much impact on how people feel about your practice.  You have to build on just picking up the phone and saying, "Dr. Jones office."  Believe me, I've heard phones answered this way at other offices when I call.  I usually sit there like a goof, waiting for more and then realize, "Oh, that's all she's going to give me."  And "give me" is what I mean.  Anything beyond the basics is what is given, what is chosen, what is offered from one person who understands that there is another person on the other end of the line, not just a patient.  A blunt office identification just never does cut it.  It's cold and barren and that's how the caller is left calling.  It also strips away any desire to call that office again.  On the other hand, I often have the pleasure of talking to an absolutely wonderful, upbeat, loving person in another office that I call frequently.  I love having a reason to call and I'm never disappointed.  She cares and she makes you feel it.  She is a treasure to her employer and to anyone who comes into contact with her.  She is not just a phone answerer, she's a blessing to all. 

Moving on, let's think about those spit suckers and tooth scrapers.  If they don't build on the basics, they can make you feel like a piece of meat.  Luckily, I don't run across too many of them, unless they are in the wrong profession.  Clincal dental professionals are a unique group of people. We go to work every day, and we just can't wait to get our fingers wet.  Now, I'm not saying anyone enjoys scaling a kernel of corn out of anyone's molar, that's just gross, but we like seeing someone leave a little better off than they were when they arrived.  We like seeing improvement in plaque scores, or knowing that we've been able to relieve someone's pain.  We know that no one really wants to be here, we get that, but we learn not to take it personally.  What if an assistant or hygienist is burned out, or is just not really into what they are doing?  You can feel it in the air just as clearly as you can feel it when she's caring.  A good assistant or hygienist has to have the ability to find the uniqueness of the person in the patient, and that's who she addresses herself to.  

The dentist creates the culture and makes it all come together.  Even if there is a manager in the office, the dentist decides what the culture will be, even if it's just by virtue of allowing the manager to work with the staff to develop a caring, loving atmosphere.  It's best when the dentist and manager present a united front and lead by example.  In my experience, you can fake it for a while and it will be ok, but the real thing is unforgettable.  And is that what you want to be to your patients?  Unforgettable.  You have to work for it.  That's what it's all about.

Be Gentle With Everyone

"Be gentle with all.  Try to see the heart I see, to know the pain and difficulty of the other life, that I know.  Try, before you speak to anyone, to ask me to act as the interpreter between you two."     ~God Calling~

 

This quote is from a devotional titled God Calling that a friend gave me recently.  When I read it today, I thought, "Ah, that's the best advice I could ever have as a manager.  Think about it, Be gentle with all.  How would just heeding that one sentence affect your staff and patients?  Hopefully no one would fall over in shock, but they may sit up and take notice.  Maybe it would be just a subtle difference,  but it would surely be a welcome one.

Now, how about trying to see the other person's heart, and their pain and difficulty.  We all have troubles and struggles that we keep hidden.  We pride ourselves on our ability to go on despite our pain, but we often then feel upset when others don't cut us any slack.  Don't they know our burden?  Can't they see that we're hanging on by a thread?  Probably not, if you're doing a great job hiding it.  I have found that if you take the time to look in someone's eyes, you can often see what is happening in their heart.  So, assume that there is pain under the surface in everyone you encounter and treat them gently.

Finally, isn't it wise to take a moment before speaking or reacting?  How many times have to assumed someone meant one thing and then reacted harshly only to find out you were wrong?  Didn't you wish you'd waited a minute before unleashing the words you now wish you could have back?  Taking a minute before speaking and thinking of being gently might prevent that.  

I will tell you this from my own experience.  People don't follow a harsh leader, they survive a harsh leader until they can escape.  People follow an inspiring leader.  Inspire trust, inspire confidence, inspire dedication and inspire love.  Do it with gentleness, determination, understanding and thoughtfulness.  When you are gentle with everyone, everyone wins.

The Good, The Bad, The Ugly, And The Annoying

We all want our staff to work together in harmony, to overlook small slights and mistakes, and to see the good in each other, don't we?  What percentage of each day can you say you see that happening?  In our office I'd say that on any given day it happens at least 98% of the time.  I'm not kidding, our staff likes each other, enjoys each other's company, shares information willingly, and doesn't gossip.  Really, I'm not kidding.

Did we just get lucky and get a magical mix of personalities that meshed perfectly right off the bat?  Yeah right, let me tell you about this bridge I want to sell you, it's in Brooklyn.  Nope, we've had our share of ups and downs, or should I say knock downs and drag outs?  I would bring the offenders into my office and chat with one or both, but it always went back to the same petty arguments and tensions.  Sound familiar?  Here's how to fix it:

Buy each staff member a small notebook.  Have them write down everyone else's name, including your's, on separate pages.   For the next week they should jot down 3 things they found themselves appreciating or admiring about each other person.  

At your next staff meeting have everyone bring their notebooks. Now pick someone to start, and they should tell the person to the right the 3 compliments that they wrote down over the first week.  The person receiving the compliment may only respond by saying "Thank you."  We tend to through off compliments rather than take them in.  The person complimenting should continue with the next person to the right until she's given everyone 3 compliments.  Then the person to her immediate right starts and you go on until everyone has given everyone 3 compliments.  You will be amazed at what that will do.  

First, you'll notice that while some people will get the same compliment from a few people, there will be some things said that will be very surprising and heart-warming.  If you're the dentist or manager, you might find yourself very surprised about how the staff feels about you.  It will probably feel awkward at first, but keep encouraging everyone to really hear and enjoy the nice things that other's are saying about them.

Ok, so that's your nice, feel-good meeting that will help your staff see each other as good people who appreciate each other. You may also realize that you never really looked at your staff members in that way and you may see that they have qualities that you didn't notice. This helps build trust and openness.  

Now, tell your staff that they'll be using their notebooks again.  This time they'll be writing about themselves.  As the week goes on, tell them to jot down things that they find themselves doing that keeps them from being the best they can be.  Maybe they don't share information, they don't respect other's boundaries, they're pushy, they don't feel comfortable talking about treatment, they're judgmental, etc.  

At your next staff meeting (hopefully you can arrange to have one within the next week or two) ask for someone to volunteer to read something off their list that they'd most like to change.  Now, ask if anyone has any ideas for how they can improve with that.  Your job is to facilitate by asking questions as people give suggestions that will help everyone picture how the solution will look, how it will work, and how it will make life better in the practice. Also, you must ensure that the suggestions stay positive and productive.  This is not the time to let anyone slip a dig in, ("bless their hearts.")  Finally, ask the person who gave the problem if they will be ok, if staff members give them gentle reminders when they fall back into the behavior.  It works, we solved a very annoying and tenacious issue between our hygienists who now support and love each other tremendously.  

You don't have to live with the Bad, Ugly and Annoying any longer than you want to, and you can bring the Good into focus and keep it going and growing.

 

Keep Your Garden

"If there is no gardener, there is no garden."~Steven Covey - First Things First~

As a manager, I can't tell you how many times I've been frustrated, or disappointed about something a team member has done.  I'll even admit to self-pity, now and then.  I wonder sometimes, "Why can't they figure out what to do?  We've spent hours in staff meeting discussions, shouldn't they know by now?"  Then I realize that I'm expecting them to read my mind, or do what I would do.  Sometimes what might seem obvious to me, never enters someone else's mind.  It is then I realize that we are all different, we all see the world differently, and we all see different solutions to situations and problems.

What does this have to do with gardening?  Try to see your practice as a garden and yourself as the gardener.  First things first, you have to prepare the ground, in this case, your staff.  At first, you'll probably be filled with enthusiasm, you just can't wait to get in there and get things, or people, growing.  If you're like me when I attempt to garden, after about an hour or two, it just becomes tedious and you really wish someone else would come along and finish up.  You can't do that with people, once you start, you need to stick it out or you won't like the result.  

Just like an attentive gardener, you need to fertilize the thoughts you plant with acknowledgement, praise and encouragement.  When you see the thoughts and ideas you've planted start to grow, you have to help them along.  You can't just plant and walk away, or it will all dry up and disintegrate.  Keep at it and before long, you'll have the results you worked for.  

An experienced gardener also knows that he must be watchful for the weeds that will choke out the plants he is trying to cultivate.  In our practices, there are times when a team member is not ready to be productive and work toward service to others.  So, to begin with we can see their attitude as a weed.  If we can help them change their attitude, we can keep them in our garden and let them produce.  If they persist in their attitude, they become a weed and we risk letting them choke the good attitude out of the rest of the staff.  Just like gardeners dislike weeding the garden, so do managers and owners dislike weeding their staff, but it must be done when needed to ensure healthy growth.

Now, let me turn my attention to the seed itself.  A gardener knows that the purpose of growing flowers, fruit or vegetables is to give nourishment and pleasure to ourselves and others.  Do you realize that your purpose is the same?  When you are considering the seeds of thought you will plant, consider their purpose.  Will this make someone's life better?  Will it have a positive effect in the life of anyone?  Will it help you and your team serve others?  

These are simple questions with one word answers.  If you can't answer "Yes", you have some work to do.  Does your practice have a gardener, or is everything just growing haphazardly?  Is it you?  If not, who will it be? 

Oh Come On, Hug Me

"Go out into the world today and love the people you meet. Let your presence light new light in the hearts of people."   ~Mother Theresa

I remember reading a book by Dr. Paddi Lund, a dentist in Australia.  He says that he and his staff begin each day with a hug.  We tease one of the hygienists in our office that we're going to start doing that because she is notoriously uncomfortable with hugging.  We make her hug us every now and then on special occasions, like Christmas, but she hates it.  I bet a lot of people would be uncomfortable with it, buy why?  It's a sign of affection so shouldn't we love to hug?  Maybe it's the full, frontal body contact that makes us squeamish, but there's nothing worse than an awkward hug.  Better never to have hugged at all, than to have hugged like a klutz.

I have to wonder why it's so much easier to pass along gossip, than it is to hug.  We only feel uncomfortable gossiping if we get caught.  Why is it easier to stab someone in the bag, than it is to hug them?  If you ask me, it's what we're used to.  Those juicy tidbits flow so easily from our mouths that half the time we don't even stop to think of it as gossip.  It's interesting to watch someone try to seem like they're not gossiping.  They smile while they're blabbing and sometimes even end with a tinkling laugh and say, "I'd tell you the same thing if she were sitting right here."  Really?  Let's go get her.  

So, what if you decided to spend today loving everyone you meet?  What would that look like?  What would that feel like for you and for them?  You don't have to hug them to love them, you can just find the best in them and bring it out for you and for them.  Bring it out for yourself first so you can feel appreciation for them.  Then express that appreciation to them.  It might be just as awkward as that hug at first, but they'll hold it in their heart all day long.  You'll light a light in their heart and they may be moved to love someone too.  Imagine what the day will be like if you do the same with everyone you see.  Your patients might think you're crazy, but it will be crazy in a good way.  They'll love the way you made them feel and that's everything.  At the end of the day, thank everyone for all they did that day.  Send them all home with one last dose of love.  Now you've set them up to go home and be loving toward their family.  Will it never end?  Let's hope not.

Leading To a Higher Power

"You are not here merely to make a living.  You are here in order to enable the world to live more amply, with greater vision, with a finer spirit of hope and achievement.  You are here to enrich the world, and you impoverish yourself if you forget the errand."    ~Woodrow Wilson~

 

Ok, I'm going to take a giant leap of faith.  This blog will be changing a little.  I'll still be giving you tips and ideas about how to lead your staff and increase the health of your practice, but the focus is going to shift somewhat because my focus has shifted.  

Last July 4th, my life as I knew it changed forever.  I'm not going to give you the particulars about what changed, but I'm going to tell you everything about what inspired and saved me from utter despair.  

I'm Catholic and for the previous two years, I had stopped going to church.  I had a bunch of reasons that all seemed valid, which now just seem stupid and pompous.  On the morning of July 4th, I had the strong feeling that I should go to church, 7:30 mass to be exact.  Are you kidding, no way, that's way too early.  The was insistent though, so I got dressed and went.  I realized that I missed all the ceremony of the mass and the community with God and my fellow parishioners.  I had been kidding myself to think I could take care of my faith at home, I knew I was back for good.  That night, at 10:30, the life I had spent my entire adulthood building, disintegrated.  

I got through the rest of the night and amazingly, went to work where I kept my problem to myself.  The only thought that got me through that day, was that I would go to the church and talk to the pastor after work.  When I got to the church office the secretary told me that he had already gone home to the rectory.  I was distraught and she saw that I had a true need so she called him and he agreed to come back and see me. 

I told him what had happened and he counseled me for over an hour.  I could see he was tired, but he saw my need. He told me that God had called me to church that morning so he could embrace me in my trouble and heartache.  He met with me two more times after that and then told me what I needed to do.  First, I needed to forgive myself for not going to church.  It was part of my journey, and the necessity for it would be revealed later.  Next, I needed to spend time alone in the chapel with God, building my relationship with Him and strengthening my prayer life.  So basically, Fr. Nick set me on my feet and gave me a gentle push in the right direction.  Smart man, now rather than depend on him, I depend on God, and rightly so.  Fr. Nick was always available to me if I needed his counsel, but I learned to lean on God more and more.  One more thing Fr. Nick said that seemed a little odd at the time was, "Let's see what good will come of this."  At first, I was skeptical that any good could come of the situation I was in,  now I could make a long list.

Now, 8 months later I am re-building my life and stronger than ever in my faith.  I also know the answer to why leaving the church for a while was a part of my journey.  I would have continued to be a "Sunday Catholic" if I'd never left.  I'd never have gone any deeper into my faith.  So, yes, I forgive myself.

Recently we had a speaker, Matthew Kelly, at our church for an all day seminar.  He is calling all Catholics to become the best possible version of themselves, as God created us to be.  I believe that God has created all mankind, regardless of their particular faith, to become the best possible version of themselves.  Hearing Matthew inspired me to take his message into my daily life.

That is where I intend to take this blog.  Being Catholic, I will introduce ideas from scripture, knowledge I gain from reading works by authors like Matthew Kelly, C.S. Lewis, Henri Nouwen, and writers of all faiths.  My focus is on leading to serve a higher power.  When we serve God, or any benign higher power, we work toward a greater good, and that is how to find true success.  

The difference you may see will be in some of the quotes I use, some of the ideas I base the content of a post on, and some of the books I may list on the side panel.  It's an addition and somewhat of a shift, but not that far from where I've always come from.  I will also, for the first time, allow guest writers.  I would be happy to have contributions from readers of other faiths to discuss how their faith can be applied to building a better practice, or just to help us understand other faiths so we can better relate to our co-workers and patients.  I think there is a lot of confusion and misplaced fear of other religions, and maybe we can ease that a little.

I hope you'll stick with me and see where we'll go with this new focus.  Take this leap of faith with me and "Let's see what good will come of this."

Sing Your Song

"Most men lead lives of quiet desperation, and go to the grave with the song still in them."   ~Henry David Thoreau~

Can you relate to this quote?  I think that many dentists have fallen into lives of quietly and quite desperately wishing that they could have the practice they want.  The vision that they started out with seemed exciting and attainable.  So often, a young dentist enters practice with a sense of excitement and a feeling that no that he or she is out of school, life will be so much easier.  Unfortunately, even in the best of circumstances, there will be some stressful, disappointing days.  I an average set of circumstances it will seem that there's always a problem to solve.  In the worst situation, it will seem like never-ending drama and stress.  Where do you fall into these scenarios?

Where are you now, are you still hoping to get the perfect staff and grateful patients?  A sane schedule and a reasonable A/R?  Equipment that never breaks down and patients that show up on time and never cancels?  The only thing that hoping does is this: it keeps you moving in the same direction.  Hoping doesn't change anything, sometimes fate steps in a improves things and we give hope all the credit, but it really just keeps us from finding out how to take action.

Why did it happen?  Do you avoid confrontation?  Are you trying to be a nice guy?  Do you want everyone to love you?  Are you tired of the fight to get things the way you want them?  Does it seem impossible to get a team that wants to work for your vision?  Address any question that you answered yes to and decide on a solution.

What is the song that is in you that is slowly being choked out by desperation?  You may have to dig down deep, but it's still there and you can still hum it if you try.  Let it inspire you and help you see what you really want.  There's no reason to settle for anything less than the full song and all it's verses.  You get it by making it your intention.  Decide now that you will stop the desperation and move to a realization of those long ago dreams.  Make up your mind to take charge of your practice and sing the song you wanted to sing loud and clear.  

Grow Your Own

How do you get an amazing staff?  You grow it yourself.  I think it's very unusual for a great staff to just assemble in one practice without a concentrated effort that starts with the dentist and manager and grows with each staff member as they are initiated into the integrity of the culture of the practice.

You are the starting point because you have the knowledge of your vision for the practice.  To initiate your staff, you have to share your vision with them.  You must explain your ideals and values and ask them to accept them as their own regarding the practice. 

If you think about anything that you care about and want to see thrive, you realize that you make sure that you create the proper environment to give it the best possible chance.  If you are expecting a new baby, you get the room ready, buy baby clothes and toys and read up on all the best parenting information.  You want your baby to have the best possible start in life.

Try to think about your employees in the same way, whether they're brand new to the practice, or they've been with you a while.  Think of it and explain it this way:  You want to go in a new direction, so everyone's starting at the beginning with this vision for your practice.  There will be some stumbles, maybe some tears, maybe some laughter, but you'll all learn to ride this new bike.  

Some staff members may offer resistance, but with patience and time proven results, they'll learn that doing things in a new way doesn't have to be painful or stressful, and it can be so much better.  Some might not make it if they refuse to let go of what no longer works.  That will become so apparent to everyone that it will be almost a natural falling away.  

As time goes by and the value of working in this new way becomes clear, those that work with the changes will begin to take ownership of the new culture they've helped to create. They will become less dependent and accept more responsibility and continue to grow in confidence and loyalty.  They will uphold the standards and practices with new staff members because they want to protect what they helped grow.  As new staff members enter the team, they too will soon value and appreciate the healthy and positive atmosphere you've created.  

What began as something that you had to grow and tend with little help, will become a thriving co-op that benefits everyone involved.  As you consider the vision you started with and look at what you've grown, you'll experience the satisfaction that comes from working with determination and belief in yourself and those who you've asked to work with you.

Don't Just Stand There Impress

I love experiencing great customer service.  I was shopping at Williams Sonoma with a friend today and the entire experience was a Wow!  We were greeted warmly as soon as we walked in.  My friend raved about some of their simmering sauces, so I ended up picking up three jars of sauce (word of mouth advertising at it's finest).  When the woman behind the counter noticed that I was walking around holding all that she immediately came over and offered to set them aside for me while I continued shopping.  Great for me because I was relieved of my burden, great for the store because now I was free to pick up more items.  

When we were ready to check out the clerk wrapped up the jars and started to reach for a bag, only to realize that her co-worker had noticed that she was wrapping three jars and had already doubled two shopping bags for her so that I wouldn't have to worry about bag failure and broken jars.  Now that's a giving team member.  The clerk mentioned that she loved the sauces I was buying and gave me some ideas for some added ingredients.  She then offered to sign me up for their newsletter so that I could keep up on cooking classes and receive recipes and cooking tips.  All in all a nice experience for me, and a good sale to someone who was just intending to browse.

So, here's what impressed me.  The clerk was alert to our needs and quick to respond.  We were greeted as guests as soon as we entered.  The store displays were interesting and appealing.  I loved the way the co-worker supported the person helping us and I enjoyed her pleasant conversation.  Basically, we were treated like welcome guests and it was effortless.

It's easy to transfer that to a dental office.  It's actually easier because we're familiar with our patients and can keep notes on their preferences and special occasions.  Make it a habit to pass on information so that everyone gets a chance to impress.  Then let the word of mouth advertising do the rest.

 

 

React To Their Humanity

I was driving home the other day and saw a man and his wife walking their dog.  Usually, if it was any other couple, I would just wave and think no more of it.  The husband in this couple made it different.  He used to own a small business in town where I shopped occasionally and he was known for being unfriendly to the point of being unpleasant and rude.  He was so off-putting that I found myself debating, in the few seconds it took to drive toward them, whether I should bother to wave or not.  Silly, isn't it?  What would a wave cost me?  At the point of decision, I decided to wave.   He didn't respond, but his wife smiled and waved back.  As I went on this thought went through my mind;  Don't react to his personality, react to his humanity.

After I had that thought, I felt relieved that I had chosen to do the right thing.  It would have been perfectly justifiable to have gone on without a wave, but it made his wife smile.  She might not get many opportunities to smile, living with someone who seems to begrudge cheerfulness like he seems to.  Then again, maybe she understands the reason for his demeanor and loves him not only in spite of it, but even more because of it.  I don't know, but the possibility calls me to honor their humanity.

I know from personal experience, that we don't know each other's heartaches, disappointments, sorrows, or desires.  People may wear their joys and sorrows on their face, but they hide their scars in their hearts and souls.  Disappointment may crush the spirit and make each day an effort, but each day arrives, over and over again and must be lived.  It just may be that the way we meet and treat each other, can give someone who is struggling strength and hope.  You never know when a kind word can lift a bruised and battered heart and shine a light where there seemed no hope of happiness.  

It doesn't matter who we are, what we have, where we're from.  Our humanity is our common bond.  Whether we are the cheerful, grateful patient, or the unpleasant curmudgeon, we have our humanity to unite us.  She's annoying, he's too loud, she's lazy, he's a grouch, that's ok, we can care for them anyway, their personality doesn't have to blind us to their need for love.  We just have to fight the urge to react to the personality they're wearing on the outside and find even a glimmer of the human being that they are.  If you can do it, you will make a difference, even if you never know it, and you will be happier for it.

I'm not a Pollyanna, I struggle every day, throughout each day to do this myself.  I fail often, but I keep renewing my determination to treat others with understanding and patience.  I have been facing life-changing, heart-breaking events myself in the last year and I know what the kindness of others can do.  A smile from a stranger for no reason is uplifting.  An embrace from a friend is a reminder that I am lucky.  I realize that we can rescue someone who is struggling from despair. Dealing with pain and receiving the grace of kindness from others, has been a gift because I have gained the awareness of the power of compassion.  Who will you grace with your compassion?  Maybe it will be a friend, a spouse, a child, a co-worker, a patient or a stranger, but what greater good is there?  Even a wave can have an impact that we may never know, but we can hope to do some good each day.  It's the hope that makes us human and the grace that makes us good.

Great Attitude Moment of the day

Isn't it great when you see a staff member go above and beyond?  We've had a good bit of snow here in NC, and it doesn't take much to shut everything down.  We were closed yesterday and planned to close today.  About halfway through the morning I realized that we actually could have gone in for the afternoon.  When I called my boss to see what he thought, he told me that a patient had just called with a broken tooth so it would be a great idea to go in and take care of her.  We had three hygiene patients that needed to come in for recall before the end of the week, as well, so I called one of our hygienists, Julie, to see if she could come in.

She said that she didn't think her roads were passable and I could hear that she felt bad about it.  I told her not to worry about it and prepared to go to work.  Within a few minutes, she called and said her husband would bring her in.  Now, she could have easily stayed home and enjoyed a day off.  She wanted to do what was good for the patients and practice enough to make the effort, even though I wouldn't have thought anything about it if she didn't come in.  That's a really committed staff member and we're lucky to have her.  

Back To Aristotle - Goodness

"Ethics is all about spiritually healthy people in socially harmonious relationships."  ~Tom Morris~

 

When I read Tom's definition of ethics I can't help but think that we can't have one without the other.  A spiritually healthy person will quickly reject and leave a socially unharmonious workplace...or she will eventually become spiritually unhealthy.  By the same token, a spiritually unhealthy person will cause disruption in a socially harmonious workplace.  She will either be asked to leave, or the workplace will soon become full of discord and the harmony will be destroyed.  

Take a minute right now and think, do you have spiritually healthy people working harmoniously in your practice?  Are you spiritually healthy?  Do you bring goodness into the atmosphere and culture of your practice?  It doesn't matter if you are the owner, the manager, the hygienist, the assistant, the patient, or the person who cleans the office;  you get what you bring and you make it what you bring.  Your attitude of goodness, or not, will determine your experience.  

Tom explains that when he talks about spirituality in this sense, he is talking about the inner person.  Who and how are you in there?  Are you whole, stable and strong?  Are you willing and interested in growing as a person?  As for harmony, he explains that it is not a state in which there is no conflict, rather a state in which conflicts can be discussed and dealt with in a respectful, open atmosphere with a desire to understand and learn.  

Sometimes goodness is about small things, things like manners.  So often we think of "manners" as being an old-fashioned word, something our grandmother cared about.  Who has time to worry about feelings, when we are so busy?  The reality is this:  how we make people feel will make or break us so we better take or make the time to make them feel good.  Of course, the popular wisdom these days is that we can't make anyone feel a certain way.  I think that's ridiculous.  If you slap someone you've affected how they feel about you.  Most of the time they won't feel like you're very nice at that moment.  If you smile at them sincerely, they will usually feel good about you.  It's called being human.  So, think the manners in your practice.  Often, we hear clinical staff referring to the patient on their schedule as "my patient".  That is who they put there focus on in that hour.  Many times they walk blindly past other patients or don't even notice them in the waiting room.  Slow down and be sure to recognize each patient with a smile or greeting.  Otherwise, they will start to feel that you're not sincere with them.  

We need to create a climate or culture of goodness in our practice and that begins with the staff.  Does everyone respect what everyone else does?  I remember a new front desk assistant that we had about 7 years ago.  She seemed to have a defensive attitude toward patients and they felt it.  If someone was a minute late, she gave them a disapproving look.  If a patient had a problem, she was quick to try to make it the patient's fault.  I realized quickly that she was going to need an attitude adjustment if she'd have any chance to survive with us.  My attempt to talk to her was met with defensiveness and the impression I got was that she thought I was misinterpreting her behavior.  I let her know that our expectations for the way our patients and staff should be treated must be met.  The deciding incident came one evening when our long term cleaning person arrived to clean the office at the end of the day.  The employee was demeaning and disrespectful to her.  It was unprovoked and inappropriate and it told us what we needed to know.  There was not enough goodness in her at that time to work for us.  It was evident in the way she treated someone who she felt had nothing to offer to her.

Have you worked with your staff to develop harmony?  Do they know that they can come to you with any problems or complaints and be heard, and that you'll come to a solution that you all can live with?  You have to keep at it and take the "temperature" of your practice on a regular basis.  Don't let the goodness element slip, it's easy to become complacent once you get to a level where people are satisfied.  Contentment can lead to decline if you ignore the need to pay attention.  Goodness must be sown at home, cultivated consistently and then the benefits are endless.  

Great Attitude Moment of the Day

Just a quickie. I'm going to start posting great attitude moments whenever I catch someone on our staff being particularly wonderful. This morning I noticed that our new young front desk assistant has some pretty funky nail polish on. We're pretty conservative about staff appearance and those nails would be better left for the weekend. When I mentioned it at the end of the day she immediately said, "Say no more, I completely understand. I'll just wear basic polish from now on." Huh? I was ready for drama and was delighted to be met with a mature response. now that's an attitude that impresses me. Way to go Ericka! Feel free to send me great attitude moments from your day and I'll post those, too.

Back To Aristotle - Beauty

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

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

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

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

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

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

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

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

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

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

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

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

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

 

Back To Aristotle - Truth

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

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Well, What Did You Expect?

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

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

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

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

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

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

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

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

Back To Aristotle

Ok, let's get back to our staff meeting on If Aristotle Ran General Motors.  As I said, there are four dimensions of human experience: Truth, Beauty, Goodness and Unity.  What you and your staff will discover is this: if you don't consciously think about things like what makes us happy,or even what does being happy mean, what motivates us and what brings fulfillment, you'll usually go through most days the same way you went through most every day that preceeded this one.  The only things that get your attention are really great things and really terrible things.  Otherwise, you're most likely on auto-pilot.  That means that most of your life is spent on auto-pilot.  Is that what you want?

Take a moment and ask your staff what life would be like in your practice if you were more aware of happiness, motivation and fulfillment.  By the way, if you don't have a big white board in your staff meeting room, please get one.  Now make three columns and head them happiness, motivation and fulfillment and let the staff start listing what each means for them.  You'll see some pretty expected answers, and some that will surprise you.  Your staff will start out slow and then as they get into it, they'll get excited and start getting into it.  Once they get a good list, and by the way, you list your own thoughts too, you can start talking about what you would all need to do to make the list come true.  What would life be like in your practice if you did?  How would your patients be impacted if you did?  How would everyone's life outside the office be affected if you could all be happier, motivated and more fulfilled at work?

Next time we'll go through the four dimensions and how to discuss them with your staff.

Blessed or Cursed

Let's depart from staff meetings for a day.  I was talking to one of our hygienists today about the ways patients are reacting to the economy.  It seems to be different in every office.  It's not only state to state, one town or another, it's different in the office down the street, too.  We've had our ups and downs, but I think the real difference is in how we choose to respond to the needs and situations of our patients and our staff. 

Let's face it, the economy concerns everyone at this point.  One thing that I always remember is something I read in The Success Principle: E + R = O.  Event + Reaction + Outcome.  We can't always control events, but we can always control our reaction and that will have a lot of impact on the outcome.  There are things we can control like our reactions and things that we are not able to influence like the actions of others.  Sometimes you'll hear someone explain a poor decision they've made or reaction they've had like this, "I couldn't help it" or "I can't stand it."  Well, guess what, yes you can.  If you want to.  You always have a choice and you have to think and understand that each action that you choose will have a corresponding result, pretty much completely controlled by you.  Can't stand it?  Well, sure you can, you're already standing it even while you say that, aren't you?

So, where am I going with this?  So many people react to temporary problems with pretty permanent responses.  Let's look at openings in hygiene.  I've heard of dentists firing their hygienists and doing hygiene themselves.  Unless the situation is dire, and the dentist is sitting around with nothing to do, I wouldn't do this.  Instead, I'd try to figure out why the waiting room is empty and I'd brainstorm with the staff about how to get people coming in the door.  Think outside the box.  It's not easy because we're used to our rules and policies, but they may not work when the world changes.  Make it easier for patients to accept the treatment they need by offering payment plans, phasing treatment and working with them to find treatment options that can get them through the hard times until they can afford something more comprehensive.  Patients remember when people are good and fair.  When they speak of you to others, that is how they will describe you.  They will bless you for it when they remember.

Staff know when the people they work for care about their well-being.  At the same time, employers know when their staff is willing to do whatever it takes to get through tough times.  Don't think your staff isn't worried, they are probably worried sick, even if they don't seem to be.  A lot of times people don't communicate their worry and fear because saying it makes it too real.  The dentist is worried that his practice will fail and he will lose his livlihood.  The staff is worried that the dentist will decide to respond to a decline in patient numbers by reducing staff and they will lose their livlihood.  Rather than hugging your fears to your chest, open the door to communication.  Talking about it will draw you together and together you are more likely to come up with ideas and solutions that will help improve things.

So, will you be blessed or cursed?  When the economy improves, what will you see when you look around your office?  Will you see a diminished, nervous staff and a depleted patient base?  Or, will you see a strong, dedicated staff who will tell everyone how fortunate they are to work for you.  Will your patients say that you are decent and caring and that you you were generous and caring when they needed it?  Blessed or cursed?              E + R = O

 

Might As Well Start With Aristotle

I told you I'd go over some staff meetings that we've done, so I'm going to start at the beginning.  My first really effective staff meeting was based on Tom Morris' book, If Aristotle Ran General Motors.  This was my first major staff meeting after becoming office manager.  My boss had given me the book and I loved it and wanted to share it with our staff so that we could all grow together and build our team to encompass the philosophies that Tom describes as the four basic dimensions of human experience: Truth - the intellectual dimension, Beauty - the aesthetic dimension, Goodness - the moral dimension, and Unity - the spiritual dimension.  Nurturing and respecting these and incorporating them into your practice can bring a new level happiness and fulfillment that you have always hoped for, but didn't think possible to achieve.

As we moved through each section of the book, we realized that even though we were good people doing a better than average job, we could truly become people of increased high character offering exceptional care to our patients.  We also quickly understood that by incorporating these dimensions into our lives we could support and enjoy each other more than we ever thought possible.

We started out slowly, and I realized that I was doing most of the talking.  When I asked what anyone thought, I was met with silence or shrugs.  By the end of the first meeting I realized that I needed to shake things up a little.  I told everyone that at each meeting everyone would be responsible to lead the discussion for a designated group of pages.  They immediately expressed anxiety about talking in front of the group.  I pointed out that they very comfortably talked almost non-stop through every lunch hour.  Finally we got down to what really had them worried, they feared saying something stupid.  They feared ridicule or losing face.  I asked everyone to agree that what's said in meetings is safe and not subject to ridicule.  We would respect each other's thought, but also agree not to be upset if someone expressed a different point of view.  In other words, we'd show consideration for each other.  Seemed like a good first lesson in character.

There was a good bit of hesitation during the first person's summary of their pages.  With a little encouragement and a few probing questions, the conversation took off and everyone relaxed.  Now we were getting somewhere.  As the team became more aware of the way the dimensions were already at play in our day, we were able to discuss new ways to apply them to our work and relationships with our patients and each other. 

I give this book so much credit for helping us build the character of our team and the culture of our practice.  Next time I'll get a little deeper into each dimension and talk about how you can help your staff understand how to apply them to your life and work everyday.

 

The Character of a Hero

I just returned from visiting my brother Charlie in Pennsylvania.  Charlie is my big brother and he's fighting his sixth bout with cancer.  He started his fight when he was in his early 20's.  That was back when they didn't know much about how to use radiation so they gave a lot of it.  As a result, Charlie has dealt with radiation poisoning ever since.  About 12 years ago he was diagnosed with stage 4 malignant melanoma on his scalp.  He went through some pretty rough surgery and seemed ok for a long time, so he got back to his life.  Three years ago he was coughing a lot and went for a check-up.  The melanoma had metastasized to his lungs and esophaegus.  He just finished his third round of chemo.  He's wiped out and his breathing sounds horrible.  His coughing fits are nerve-wracking and scary.  He never complains.  He never says much about feeling sorry for himself.  He brushes off the worry that we have for him and gets on with life.  He worries about the rest of us.  When I was there this weekend, he kept trying to entertain me with outings.  Walking down the hall is an effort, and he's worried that I'm bored.  I was happy to just spend time with him.  He talks about the things and people that matter to him and it's all very simple.  His family and friends matter.  His cat Bandit and his dog Pudge matter.  His love appreciation for his wife and sons is immense.  Making sure that everyone is ok matters to him.  He's the patriarch of this family and he's in charge.  He may have cancer, but cancer will never have him.  It's all so simple.

How often do we forget how simple life really is every day?  We get so worked up about cancelled appointments, staff mistakes and other things that don't really matter in the long run.  What matters in the end is people.  It matters how you care for them.  It matters how you show them you care.  It matters how you make them feel when they're around you.  That's what's important.  You may be thinking that it's easy for me to say that, I don't own a practice, so I can't possibly care like an owner does.  Well, if the practice doesn't do well, I'll be out of a job, so you bet I care.  What I know is this:  If you treat people right, both staff and patients, the practice will thrive.  If you are a staff member and you give it your best and keep trying to improve, work with your boss as an asset, and treat your patients well, you will thrive with the practice.  

What happens when we give in to self-pity and exaggerate every negative thing that happens?  We become victims, helpless to help ourselves.  What if we give into frustration and lose our patience with our staff and patients?  Everyone suffers and the practice does, too.  It's easy to fall into the trap of negativity and victimhood.  Maybe it's just as easy to focus on the positive.  It may just be a matter of consciously trying to see what's good, rather than worrying or complaining about problems.  It will at least make us easier to be around.  Or, like Charlie, we may inspire everyone around us and fill them with pride.  Try this the next time you feel over-worked, over-stressed or misunderstood: brush it off and get on with life.  You might be surprised at how easy it is to do, and how much more pleasant life can be without all the drama.

Do me a favor, next time you feel yourself getting annoyed with someone at work, stop and say a prayer for Charlie Otranto.  I bet when you're done, you'll feel less annoyed.  At any rate, Charlie would like to know you're praying for him and it would make me happy, too.  See, a lot of good can come out of ingoring a little bad that really doesn't matter much anyway.

 

 

Build A Better Staff Meeting

When you hear the words "Staff meeting today", what comes to mind?  "Ugh, another boring hour to sit through."?  "Yay, if he finishes early we'll get a longer lunch!"?  Or maybe, if you're leading the meeting, "Oh, this is agony.  They all just sit there while I talk."  Well, here's the good news, staff meetings don't have to be boring ordeals that one person leads while everyone else examines their fingernails or doodles flowers on their notebooks.

I remember the first staff meetings I attended.  Before the dentist ever entered the room, one staff member laid down the law.  "Don't ask any questions so we can get out of here early and go out to lunch!"    You didn't mess with that chick so nobody said a word.  For his part, the poor dentist was obviously anxious and basically rattled off dull information as fast as he could.  "Any questions?  No?  Ok, I guess we all get a long lunch."  I have to admit, I welcomed the long lunch, but I also wondered at the huge waste of time that was occurring.  Why couldn't staff meetings be fun and interesting?  Well, they can, you just have to build them that way.

When I became the office manager, I was handed the responsibility of developing and running staff meetings.  The first few didn't seem much different than they did when the dentist ran the meeting.  I understood his anxiety as I talked through the hour with little to no response or input from the staff.  One day I said, "Ok, this is not an office manager meeting, it's a staff meeting, so you guys need to get in on this."  Rather than making statements and rattling off information, I started introducing question marks into the meeting.  I would talk about whatever topic was at hand and then say, "What do you think?" or "How can we improve that?", etc.  Then I would just wait.  Now, here's where you have to discipline yourself because people like to fill the silence.  You have to wait them out so it's not always you filling it.  I also had a bag full of Hersey's miniatures ready to reward anyone daring enough to put forth a thought or opinion.  At long last, one brave staff member verbalized a thought.  She got three chocolates and was automatically happy she had spoken up.  You could also see a little pride there.  When people receive a reward, no matter how insignificant or small, they understand they have done something worth merit.  Little by little, others started earning their candy, too and we finally, at long last, had a discussion going.

Your job as the meeting leader is to get the ball rolling.  You don't want to kick the ball to yourself and then run it all the way to the goal.  You want to get your team involved.  You build it and let them in.  So, how do you build a good staff meeting?  First, make an agenda, print it out and distribute it the day before the meeting.  If anyone wants to add something, they must let you know by the morning of the meeting.  If time will allow, add it.  If not, put it on the agenda for the next meeting or handle it separately if it can't wait.  Start with a review of old business from the last meeting.  Where there any action items that need to be revisited?  Next, go over new business.  This is the time to discuss new procedures, new products, or new protocols.  Ask the hygiene department to give a hygiene report.  Have a section on trouble-shooting.  This can be anything from equipment that needs work, problems with running behind schedule, or communication issues.  Finally, have a main topic that you will spend most of the meeting on.  This is a time for team building and increasing patient service.  You will be amazed at the way you can increase team solidarity and patient care by taking the time to develop this part of your staff meeting.  I will be following this post up with a series of staff meetings that have greatly improved our team and that you can adapt to work with yours.  I think you'll be surprised to find that staff meetings can actually be fun and exciting.

Be patient with me. I haven't been posting much lately because I'm dealing with some stress in my life. I'm down, but not out. If you want to be sure to catch posts, you can subscribe so that new posts will go right to your email. Sorry for the sporadic posting, but we'll get back to normal soon.

Do You Take My Insurance?

How do you talk about dental insurance in your practice?  Does everyone in your office understand how you handle insurance?  Do your patients?  A good description of the way your practice handles dental insurance should be covered in your practice's financial policy brochure.  When new patients enter the practice someone should go over that policy with them and let them know what they can expect from the practice.  All staff should be confident in discussing dental insurance plans with patients.  The person who handles insurance in the practice must be well-versed in your state's insurance rules and regulations.

In these challenging economic times, patients want to know that they will be able to get as much help paying for their dental care as possible.  Even fee for service practices would be wise to use their computer software capabilities to quickly generate forms for their patients and to go a step further and be willing to assist to some degree with complications that sometimes arise.  Some practices extend 3 months grace period with no interest which allows patients to receive their payment and ask for an amount at the time of service with the remainder divided over the three months.  Often the patient receives their payment and pays the balances well before the three months is up.  Patients appreciate the consideration and seem to accept treatment more readily. 

One of the most confusing things for patients is the PPO plan.  Patients are starting to worry when they receive a notice from their insurer saying that their dentist is not in-network and that they will receive better coverage if they choose an in-network provider.  The wording often implies that they must choose an in-network provider and that's often not the case.  Be careful to assure them that they can still use their benefit with you and explain that while they may see less of a percentage per procedure, they will still have a reasonable coverage amount available to them.

Finally, patients often don't understand the difference between medical and dental insurance.  Dental insurance is great for preventive care and general restorative care.  For patients who are in good dental health and don't have the need for extensive restorative care, it should cover a good deal of their treatment.  Medical insurance gives the most bang for the buck when things get big.  Most medical insurance has a deductible that must be met before the patient receives any real help, but if they are facing surgery or an extensive illness, medical insurance should be a big help.

Like most things success depends on knowledge and preparation.  If everyone knows how to interpret the patients plan, how to explain it so they can understand, and how your practice handles insurance, it can be a great benefit to the patient and the practice.  The next time a patient asks, "Do you take my insurance?", how will you answer?

Tell Her, Not Me

When you think about your job as a manager, do you think that you have to have all the answers and fix all the problems?  If you do, you may be more trouble to yourself than you need to be.  If you want to be a really good manager, you have to learn to lead others to learn how to think and act for themselves.

How do you teach adults to do that?  Aren't they already set in their ways?  Nope.  You have to teach them to believe that they can be right, and you also have to show them that they can survive being wrong.  That's the tough one.  People hate being caught in the wrong.  So, don't catch them, let them catch themselves.  To do that you have to trust them as people who want to do things right and believe in their character.  That means you have to know that you are hiring the right people.  Someone commented on my last post and said that to avoid the curse of the employee who is dead in the water after 6 months, you have to be very careful in your hiring. 

I agree, but I also think that it's very hard for an employee to dazzle at the interview and fizzle on the job. Recently, we hired another person in our office who would be a roving assistant, working at both the front desk, as well as helping out in the back. The idea was that the current front desk and the new staff member would function in these roles together so that one would always be at the front and the other would be available if we needed her in the back. The front desk assistant already knew all the tasks for both areas and she was to teach the new employee. In my mind, I felt she'd be happy to have the help since she seemed to be getting run a little ragged. After a few days I asked the new staff memeber how it was going and she said, "She doesn't want to train me, she's worried for her job." Since I had made it clear that I wanted them both to work in tandem and that we would work this way from now on, I was somewhat disappointed, but not shocked. The new employee said that the other employee showed her things too fast and didn't wait for her to catch on. I told her I'd talk to her the next morning. In the morning I sat them both down and told them that each of their personal success would be measured by the success of the other. If one sabotaged the other, they would both fall. I also told the new person that if she felt the other wasn't trying to teach her she needed to stop and ask her if that was true. If you haven't told her, why would you tell me? At least give her the chance to know how you feel." And it would be the same if the other employee had an issue. Talk to each other, it doesn't have to be a fight, it can just be a way to understand each other. If they needed me to intervene, it would be a conversation that included all three of us. I let them know that together, they could cause wonderful things to happen for the patients, the practice, the staff, and last, but not least, themselves. "Imagine the satisfaction of knowing you made the practice run smoothly and the patients feel wonderful because you tried and managed to put your own insecurities and self interest aside and just trust each other. Just try it today and let me know how it feels. If you don't like it, we'll talk about a different approach." At the end of the day they were stamping cards and I said, "So ladies, how did it go today." The new employee said, "I was just going to come and tell you...it was great! I learned so much from her today and I just love it!" I smiled and said, "Ok, tell her, not me."

The Six Month Curse

What is it about being in a position for 6 months that makes some people think they've got it for life?  I think it's unfortunate for everyone when an employee gets too comfortable in their progress once they hit 6 months.  I guess that they feel like they know enough to get through the day pretty well, but they don't add anything new.  Imagine if everyone in the practice, including the dentist was satisfied to stay as is after 6 months.  Now that's a scary thought.

Comfortable can be a dangerous place to be and it's a disastrous place to stay.  It's ok to hang out there for a little while, but only to get ready to move on the the next challenge and to learn more.  It is crippling to a practice to allow lethargy or complacency to take hold.  In other words, laziness and lack of interest will bring your practice down. 

Sometimes really nice people can be lazy and lack the desire to grow.  Try to push them a little and they'll spend more effort trying to push you away and throw up blocks than they will trying to go along with you.  The problem is staff gets attached and so do patients.  They don't realize that there is more to it than just being nice.  You need the total package and have a right to expect it.  If you keep up with feedback and setting goals, you have a right to expect the person to work toward those goals.  If not, you may just be faced with the six month curse.  What are you going to do about it?

Unity

"What we must decide is perhaps how we are valuable rather than how valuable we are."   ~Edgar Z. Friedenberg~

The days of an employee in a dental practice being more valuable than another, just because they have certain credentials are coming to an end.  In this new, challenging economy, it becomes ever more clear that how and what we contribute is just as important, maybe even more important, than the credentials we insert after our name.  Every person in every position has worth and the way they perform, the way they interact and treat others determines their value to the practice.

The fact that I can use CDA/CDPMA after my name doesn't mean that I'm better than someone who doesn't have the letters.  It doesn't make me work harder, behave better, or think smarter than someone who doesn't have it.  It only means that I went through a course and then  took and passed a test.  The real test is in what I do with what I know.  If I use it to help my co-workers, serve my patients and boost our practice, I'm doing something good.  It's the same with the DDS and the RDH.  They are letters that stand for the education required to earn the right to use them.  They represent long hours, dedication and some amount of personal sacrifice.  The value they represent is in the potential to serve that they allow the bearer.  To be of value, the bearer must serve and create unity between those they work with.

When a person stands on their credentials and believe that it somehow makes them more valuable than others, they are at cross-purposes with the thing they desire; to feel important.  When they take their accomplishment as see it as a means to increase the level of the work they do with others, there is true value and importance in that.  Sharing knowledge and teaching skills never diminishes what we already have, no one can take that from you.  Rather, it increases your own value and that of the person you share with.  Knowledge shared is knowledge squared.  When you share and increase the value of another to the practice and the patients, you create unity.  It is the best use of your knowledge and skill and by using those in that way, you have found the way to be of value.

Let It Be

"I made it a rule to forbear all direct contradiction to the sentiments of others, and all positive assertion of my own. ...I  soon found the advantage of this change in my manner; the conversations I engaged in went on more pleasantly.  The modest way in which I proposed my opinions procured them a readier reception and less contradiction."   ~Benjamin Franklin~

I don't know about you, but I'm one of those people whose brain has a direct path to my mouth, and unfortunately, the restraint of wisdom always seems to be a few beats late.  I'm telling you, in a world where anything goes, I would probably be clasping my hand over everyone else's mouth so I could release all the fabulous ideas that are bursting forth at any given moment.  Thank goodness I do have some self-control, or I'm sure everyone would hate me.  At some point in life, we all have to grow up and let other people talk.  I can remember sitting with my friend Diane when we were younger.  We would be sitting and talking and I'd find myself really frustrated with having to listen to her.  Why couldn't she just quiet down (nice way of saying shut up) and let me talk.  What I had to say was infinitely more interesting than what she was putting forth.  At some point, we both admitted that we were just waiting for the other to stop talking so we could get our 2 cents in.  That admission was undoubtedly fueled by wine and tolerated only because we love each other.  We laughed about, but as I go through life, I realize that the same feeling often reappears with others who are stone cold sober and would tolerate less and who don't love me enough to put up with it.  Therefore, the need for self-control.

Why are we so enamored with the sound of our own voice sending forth wise thoughts and advice?  Why do we think others want to hear our contradictions of their own wisdom and thoughts?  How come we can enjoy repeating the same story as if we've never told it before?  I think part of it is a certain amount of insecurity.  We have to show others that we have worthwhile ideas.  Part of it is a need for attention.  Some of it may just be inattention and thoughtlessness.  We don't realize that we are driving other people crazy and making ourselves look self-involved and insensitive.  Well, now we do, right?  I don't want to ruin anyone's fun, but sometimes you can have more fun when you engage and interact, rather than just conducting a one woman show.

If you've ever been around a blabber-mouth (and I sincerely hope it wasn't me), you know that it's a bore.  "When will she stop, I can't listen to one more word?", is a thought you're probably familiar with.  Now, think about friends that are quieter, and more laid-back.  When you talk to them you can tell they are interested.  When they talk, you want to hear what they have to say.  Now, think about that when you consider discussions with patients and staff.  I remember working with a hygienist that kept a running monologue going with all her patients.  She would spend an hour spouting off about her own life.  Even when she did ask the patient a question, she'd end up interrupting and answering it herself because she couldn't stand the lag time between her words entering their brain and them formulating an answer.  The patients seemed to love her though and no one bothered to mess up what seemed to be a good thing.  When she left our practice, we got the real story from the formally silent, or should I say silenced, patients.  Many missed her pleasant demeanor, but no one seemed to miss being a captive audience.  Quite a few commented that she never asked them about their oral health and never let them finish a sentence.  So, was she beloved, or tolerated?  Which would you rather be?

Let's think about staff.  Do you realize how easy it is for an out-spoken, confident, knowledgeable person to intimidate and less confident staff member into silence?  When that happens it can be a double-edged sword because the staff member may be perceived as disengaged or disinterested.  It is no accomplishment for a manager to have all the ideas, even if they're great ideas.  Why?  Because people get tired of carrying out the ideas of others.  You can conceive the idea, but sometimes you have to let your staff be the ones to come out with them.  How?  You have to guide them to the thought.  You can do this by giving examples and asking questions that will lead them to the thought.  Let's say you want your hygienists to be more proactive in developing protocols for their patients. 

Here's how the dialogue might go.  I'd sit down with them and ask them if they were seeing a lot of the same type of problem in different types of patients.  They may remark that older patients have a lot of root caries.  "Oh really, why?"  "Well, they have a lot of dry mouth issues, they have poor dexterity, they eat a lot of carbs."  "Oh, what do you think would help?"  "They could use an electric toothbrush, use Xylitol products, extra fluoride, etc."  "Ok, so what do you think we can do to get them to do that?"  We could show them a Sonicare, talk about Theramints, offer to do a fluoride treatment at their recall, and even put them on shorter recalls."  "Ok, great ideas, will you please write out that protocol and put it in your hygiene manual so it's official.  You can start implementing it right away.  Great idea!  Will you keep track of how many patients you suggest this to, how many accept, and what the results are?  We'll have a special meeting with Dr. Smith to go over your findings in three months.  I'm excited by the ideas you came up with!"  Enthusiasm, encouragement and expectation of success all help to ensure that there will be follow through.

Now, that's exactly what you had in mind.  Do you think they'll be more likely to incorporate the above into their routine interactions with patients that fit the example if you just tell them to do it, or will they be more likely to implement ideas that they thought through and verbalized themselves?  It's always much more comfortable to brainstorm than to be told what to do.

Finally, you don't always have to contradict or put forth opposing ideas.  Sometimes we can feel someone is dead wrong and still survive if we keep it to ourselves.  As long as no harm will come of it, respect the right of others to hold true to their own thoughts.  Sometimes even a gently put forth opposing thought can demoralize and deflate, and that's not what you would ever intend, is it?  So every now and then, resist and let it be.  You can't dim a shining star; if you sparkle, believe me, everyone is aware of your glow.  But too bright can be blinding and hard to stand for very long.  You can polish a glare to a luster by letting others have their own light.  

"Let your light shine within you, so that it can shine on someone else."

                                    ~Oprah Winfrey~

Ok, so a lot of people make fun of me (my husband, my daughter, my boss) because I like Oprah, but you have to admit she comes up with some pretty quotable sayings.

Basically, what I'm saying is give someone else a chance to shine.  Let others be the star.  You be the soft glow that warms the room and draws the whole world in.  Then everything will be just fine.

Total Medical Compliance Rocks

 You know me, when I like something I let you know.  Our staff and I just spent the day in training and it flew by.  Never thought I'd say that about OSHA and HIPPA training.  Casey Morris from Total Medical Compliance (TMC)did a fantastic job making what can be a boring subject, interesting.  She worked with our staff to make sure everyone understood, in everyday terms, everything we need to know to keep our staff, patients and practice safe. 

People tend to groan when they think about OSHA, but to be realistic, it's good to be safe.  We owe it to our staff to keep them healthy and injury-free.  Staff owes it to the practice to practice good work safety habits.  That is much more likely to happen with education and enforcement.  Our patients need to know that we are doing everything we can to safeguard their personal and medical information.  Again, education and enforcement makes it much more likely that it will happen.

What was so great about Casey in particular?  She's down to earth and doesn't come off as if she's here to shove your shortcomings in your face.  She's not a know it all, but she truly seems to know everything.  We've had in office training before and felt like we'd been told off by the time the person left.  Not with Casey, she was professional, yet personable and she welcomed questions and scenarios.  That helped our staff feel that they could understand how to apply what they learned in a normal working day. 

If you need training, I'd check them out.  We are now the happy owners of both a very concise and easily usable HIPPA and OSHA handbook.  There were things that came up that I never thought we needed, but that will make responding in emergencies and unusual situations easier and less stressful. Who ever thought anyone could make these subjects something to write a blog about? 

The Nobility of Labor

"It is impossible to enjoy idling thoroughly unless one has plenty of work to do."            ~Jerome K. Jerome~

Happy Labor Day, I hope you're getting a chance to relax.  I want to ask you something;  When you think about what you do for a living do you think of it as a job, or a profession?  Do you enjoy what you do?  In the past few years I've heard more and more about things that make me feel sad for people.  Assistants who read text messages while they are assisting chairside, hygienists reading magazines during downtime, front desk assistants checking out their Facebook page,  and dentists calculating the amount of years they have to endure until they can retire.  What's up with all that?  Why are people so disengaged from their work, or even just plain loathe to do it? 

I think it all begins with finding work you love.  Let's start there.  If you keep going back to a job you hate, day after day, you have three choices; quit and find something you love to do, stay and find a way to love it, or stay and be miserable.  I don't suggest the third option because not only will you be miserable, you'll make everyone around you miserable, too.    Let's see if we can fix that.

Dentists,  I'll start with you.

1. Don't keep bad staff.  These are the people you fixate on, wonder what you should do about, and dread seeing.  They keep you from being happy in your work.  They drag good employees down and cause chaos and resentment.  They are more interested in drama then their work.  Set them free, they'll have a better chance of finding something they love to do, too.  You ruin people when you tell them they need to change and then tolerate it when they don't.  Discipline has to be learned at some point, let it start with you.  They may eventually come back and thank you.
2. Find a manager that is obsessed with the business of your practice.  As Warren Buffet says, "Obsession is the price for perfection."  People who are obsessed with their profession would do it even if they weren't paid as handsomely.  They do what they do because they love it.  An obsessed manager will not only keep your team going, they'll keep pointing out the best way to go to you, too. They'll watch your money and keep an eye on the next thing that needs to be done.
3. Develop a great team.  Once you've gotten any bad employees out, work with your obsessed manager to develop a fantastic team.  It is work, but it's worth it.  It never ends, you don't get to rest on your laurels, but after a while you look at your great team, hear them serving your patients and realize, you love the process of creating this team, so why would you ever want to stop.
4. Decide what you want your practice to be, because it will evolve with or without your direction.  Do you want to stay small, or bring in associates and partners and open satellite offices?  Do you want to get out on the lecture circuit and become nationally known or are you happy in the comfortable niche you've created?  Whatever your practice becomes, be sure that your vision drove it there.  Make it a practice that you love returning to day after day, one that really makes you feel great about what you've built.
5. Look at what you do and how you do it.  Do you slow down and enjoy your patients and get to know them?  Do you understand the role that your work plays in their lives?   Do you see that your employees come to work every day to help you with your vision for your practice?  Can you make that all true for yourself?

Staff, it's your turn

1. Do you like what you do and see the value in it?  Really think about what you do.  Of course some of it seems routine or maybe even too simple.  It depends on how you think about it.  I get a lot of satisfaction from keeping the lab clean.  You might wonder how I see that as helping our patients, or even why I'd enjoy it.  If things are clean and orderly there will be less retakes of impressions and more time to spend on more satisfying patient care. It's background work and maybe no one else notices it, but it satisfies me to see it look so good.  Find the satisfaction in doing something just a little better than would be merely acceptable.
2. Value each other.  Really look at your co-workers, including your boss, and see how wonderful they are.  We all have something wonderful about us, it's just that many times the bad stuff is what we notice in the moment.  Think about it, someone else may do something annoying or ridiculous once or twice in the course of the 8 hours we spend with them.  The rest of the time they are perfectly fine and we take it for granted.  It's the 2 minutes of obnoxiousness, or aggravation that we tend to focus on for the remainder of the day.  Find a way to turn it around and brush off the annoying quirks and embrace the perfectly fine behavior that fills the rest of the day.
3. Value your patients.  They are trusting you and depending on you to care.  Do your best for them, get to know them and understand them.  Don't judge them, try to make them feel cared for.  Find pleasure in making something easier for them or helping them care for themself better.

Get it together people.  One of these days you're going to run out of time and then it's too late.  You'll have spent your life in an unhappy state.  Work hard with your head and your heart and then enjoy your rest.  Appreciate the opportunity to work, it's not a guaranteed right, just ask someone who can't find a job.  Hold up your end, find the right profession, educate yourself continuously and strive for excellence every day.  Then you will understand the nobility of labor.

Be The Change

"You must be the change you want to see in the world."

                                    ~Mahatma Ghandi~

What are things like in your world these days?  Are you and your family feeling an economic pinch?  I read an article the other day that said if you're hurting because of the economy now, you'll still be hurting in a year, but if you're doing ok, you'll still be doing ok in a year.  Seems pretty random, doesn't it?  Why do some hardly feel any effect while others are truly suffering?

It seems to be the same in dental practices.  While some dentists are laying off staff, shortening hours and even cutting back on days, others can't find enough hours in the day to see all their patients.  Some of it has to do with demographics.  In areas where many patients have been laid off and lost their insurance, practices are feeling it, too. 

Some of it has to do with attitudes.  If a dentist and his staff are constantly bemoaning the economy it can affect the way they present treatment and even the treatment the dentist recommends.  It's easy to allow discomfort or fear to guide your thoughts, but be careful not to let your concerns keep you from giving patients all their options. 

Finally, sometimes we just forget to think outside the box.  In this case, the box becomes the economy.  The in the box thinking might be: "The economy stinks so patients won't want treatment.  If I tell them they need a crown, they'll think I'm just trying to help myself and that I don't care about how they're doing.  They'll get mad and go somewhere else."  Outside the box thinking goes like this: "Mrs. Jones would really benefit from a crown, but she might need to just do a composite right now.  I'll let her know that the composite can take the place of the build-up I'd have to do and have my office manager talk to her about a payment plan so that she can get the treatment she needs as soon as possible and pay in a way that doesn't stress her too much."

Some dentists are seeing a slow down in their hygiene schedules.  A lot of them might be cutting hygiene hours or doing their own hygiene.  When they do this they not only do their hygienists suffer, they hurt themselves, as well.  If you don't have patients in your hygiene chair, you don't have patients to examine and schedule treatment for. 

Oh, I can hear you now.  You think I've lost my mind.  Why are you going to let a hygienist keep her hours if she has nothing to do?  Yes, that would be crazy, so don't let that happen.  Here's the inside the box thinking: "If my hygienist isn't cleaning teeth, I'm just paying her to sit there and do nothing."  Here's the out of the box mentality:  "Julie's schedule has been really open lately.  How can we use her open time in a way that will help our patients and the practice?"  Your hygienist can help out with some assisting duties and enable you to move more easily from patient to patient by cleaning temporary cement, taking impressions, or assisting chairside.  She can get on the phone and try to find patients who've fallen through the cracks. 

Now, here's the change you can be in your world.  Think of the many patients who have been in your practice for years, that may now be struggling financially.  Ask your front desk assistant if patients have been declining recall appointments because they just can't afford it right now.  Make a list of the long term, "good" patients who fall into this category.  Have your most diplomatic, well-spoken employee, maybe that hygienist with downtime, call the patient and offer a recall free of charge.  Just remember, you have to do it in a way that allows the patient to keep their dignity.  Here's a suggestion: "Mr. Davis, Cindy told me that when she called you the other day to schedule your recall, you said you couldn't afford it now because your business is really struggling.  I'm sorry to hear that you are having difficulty, but we don't want to see dental problems added to your worries.  You've been a wonderful patient for years and we'd like to schedule a recall for you at no fee in gratitude for your loyalty all these years.  Dr. Jones wants to play a part in making things better for our patients.  We ask that you pay it forward by helping someone else in whatever way you can.  If we all help each other, we'll all be better off."  This is a good thing to do because it's a humanitarian thing to do.  It's also a good business decision because it keeps patients involved in their dental care and keeps it a routine part of their life.   When things get better it's much easier to continue treatment with a patient who has been seen regularly, then it is to reactivate patients who've drifted off.  The savings in staff time spent trying to reactivate patients may alone make up the cost of those prophies provided at no fee.

We have choices, we can sit and bemoan our fate or situation or we can do something positive.  It costs little in materials to provide a prophy.  It creates a lasting impression when we reach out to care in this way.  People don't forget it when someone helps them when they are down.  They tell other people, too.  Your staff sees your goodness and it cements them in their loyalty to you.  You are truly being a caring provider and walking your talk.  When you do good, you feel good.  Generous acts beget good feelings and positive results.  You become a positive influence in the lives of others.  You become the change you want to see in the world.

The Do's and Don'ts of Interviewing

The internet has had an impact on just about everyone's life by now and on every business in some way or another.  I kept thinking that jobs in our town must be really scarce due to the economy and then I realized that just because there are no jobs in the paper, doesn't mean there are no jobs.  They're posted on-line on Craig's List, Dental Finders, or other sites.  I post job openings on Craigs List and the response is usually immediate and enormous.  So, here's your first do and don't:

Don't depend solely on your local newspaper when searching for a job, you'll miss out.

Do search the listings on Craig's List and post your own ad for work wanted, as well.

Just because you're replying to an on-line ad, it doesn't mean you can loosen up on protocol.  The response that gets my attention is still professional and well written, and that means correct grammar.  I would strongly suggest spell checker and having someone else read your reply to check for mistakes.  You wouldn't believe how many grammatical mistakes I see in replies.  That usually weeds out that applicant right from the start.

Don't reply as if you're e-mailing a friend.  Don't start out with: Hey, I want to apply for the job you have on Craig's List.

Don't copy and paste your resume to the body of the e-mail, add it as an attachment.  If you don't know how to attach documents, get someone to teach you. It's good to  show that you have computer processing experience.  Better yet, format it as a PDF file and attach it.  It's easy to make PDF documents.  Just download CuteWriter, it's free. 

Don't sign the letter too casually.  Don't write, "Thanks, Mindy" or Have a Blessed Day.  It's too casual.  I'm not your buddy, I'm your potential boss.

Don't reply to a position for a receptionist and tell me that you hope to be a practice manager someday.  I'm the practice manager, I'm not trying to hire my replacement.  I want to hire someone who wants the job that I've described.

Do reply graciously and respectfully: Dear Sir or Madam, I would like to apply for the position of Front Desk Assistant.  I have attached a cover letter and resume.  I hope that my experience will meet your requirements and I look forward to hearing from you.  You can reach me at 555-555-5555.  Thank you for your time.

Sincerely,_______________

Do write a professional, yet engaging cover letter, just as you would do if you were going to print it out and mail it.  A cover letter gets points from me and makes me feel like the applicant really cares about getting the position.  It shows effort and let's me see how well you express yourself.  In the cover letter, explain why you would like the position, why you are qualified for the position, and what benefits the employer will receive by hiring you.  Do sign the letter professional with either Sincerely or Best Regards.

Do write a concise, yet thorough resume that lists your past positions starting with the most recent, the responsibilities you had and the skills you acquired.  For each position, list your supervisor and their phone number.  Give the years (at least I hope it's years) you worked there and the reason you left.  If the reason involved conflict, don't get down and dirty about it, just say it was not a compatible fit . 

Do list references with phone numbers.  Do list supervisors, I don't want to talk to a bunch of your friends and relatives who will tell me how wonderful you are and that they can't think of a single negative thing about you.  I want to talk to someone who won't be sitting at the same table with you at Christmas.  I want to hear your strong points and the areas that you struggle with.  If you want to be a step ahead of the rest, give your supervisors permission to be candid when I call.  No one's perfect and I don't expect our employees to be either, I just want them to strive for excellence.  I need to know if you will.

If you've followed the do's and don'ts so far, I'd probably be calling to talk to you on the phone.  I want to hear how you sound and you'd be surprised at how people sound when they answer their phone.  About 90% of the time the person sounds bored, annoyed, or lazy when they answer.  I think it's got something to do with the fact that most list their mobile number and often the call is interrupting them. Once they hear it's me, calling them about the position listing they replied to, they brighten up and sound the way I was hoping they'd sound.  A surprising amount of people end up really bashing their former bosses or co-workers, or getting too casual with me.  That's the second group to weed themselves out.  Be positive and pleasant throughout the call.  Think of it as a pre-interview because it's your ticket to the real, in-person interview.  I also hate to sit through your choice of music while I wait for you to answer.  Your friends may not tell you that they're sick of listening to Kenny Roger's sing Lucille, but I'm telling you, get rid of it.

Do answer your phone pleasantly and politely.  You should do this anyway just to be nice, but at least do it while you have your resume out there.  Do maintain a pleasant, yet professional demeanor throughout the call, remain positive, and if offered an interview, thank the caller for the opportunity.

Don't answer your phone like a grouch, it makes a terrible first impression.  It's one that I write down immediately on my notebook under your name, so it stays there and when I'm comparing candidates I consider it. 

Don't say: "Now which job was that?  I answered so many of them."  Just listen and you'll figure it out from what the caller is saying.  It's fine to ask the name of the practice if they don't offer it from the start. 

Don't complain or speak negatively about any past employer.  Be gracious and discreet.  If a job was just plain hell, say that while you appreciated the opportunity, you felt you would like to work in a position that allowed you to contribute more to the growth of the practice.

I'll say it again, don't make callers listen to your favorite music while they wait for you to answer.  To me it seems a little immature and slightly self-indulgent.  It may be your signature song, but I may not want to hire someone who relates that closely to Lady Gaga.  I have nothing against Gaga, but I sure don't have her blaring on the radio at work.  

So, if all has gone well so far, I'll probably ask to set up an interview in the office.  Try to be available for any time I offer, or at least for the second time I offer.  If you're too hard to schedule, that will make me wonder if you'll be able to work the hours we need you to work.  Get to the interview about 5-10 minutes early.  Any earlier and you'll seem obsessive and I'll feel rushed to get to you. If you're late, I won't be interested unless you were caught behind an accident.  Don't tell me you were caught behind an accident if you weren't, I'll check.  Be prepared to answer questions intelligently.  I ask candidates to answer a list of questions about themselves that will give me an idea of who and how they are.  If you are handed something like this, give good information, but don't take overly long doing it.  Don't try  to make yourself sound like a saint, I won't believe you.  If I ask what your least favorite task in the position it, it's ok to say you don't like to take out the garbage, but fully intend to do it whenever needed.

Don't dress like a slob.  Sorry to be so blunt, but you wouldn't believe how people show up.  I had one lady show up in a black sweatsuit that was covered in cat hair.  She wanted to know how long the interview would take because she had to get home to feed her cats.  How this lady didn't weed herself out to begin with, I'll never know, but she sounded great on the phone.  Needless to say, she was quickly on her way home to feed those kitties. 

Don't slouch, look bored, or put your feet up on the seat of the chair you're sitting in.  Don't call me sweetie, honey, or darling.  Believe it or not, one woman did all the above during her interview.  My boss witnessed some of it and was horrified, literally, you should have seen his face.  It was worth sitting through it.

Don't be scary, creepy or weird.  Don't be crazy.  Don't be too familiar.  Don't be gross.  I've seen it all and I don't want to see it again.

Do dress professionally.  Wear conservative make-up and style your hair neatly.  This isn't the time to break out your green-gold glitter eyeliner.  Wear neutral colors.  Black and white or beige and black are classic for a reason. 

Do speak politely and shake my hand when I introduce myself to you.  Make eye contact.  I can't tell you how important this is.  If you can't look me in the eye, I wonder about you, so will the patients.  It's uncomfortable and distracting to speak to someone who never looks at your face. 

Give me the information I ask for, but don't give me every last detail of the bad stuff.  If you didn't like your last supervisor, I understand, but don't bash her.  Don't try to bs me.  Tell me what you're good at and what you'd like to improve in.  Don't tell me that you're the best assistant, receptionist, etc., that ever lived.  I won't believe you and I won't like that you are so conceited.

Be someone I'll want to spend my days around.  Show me that you'll work hard, get along with our staff and treat our patients well.  Be prepared to give me examples of how you've done that in the past.  Then, be determined to live up to it if you get the job. 

When you're leaving smile, shake my hand and thank me for the interview.  Tell me you feel that you'd really love working with us and that you'd work hard to make me happy that I made the decision to hire you.  When you get home, send me an e-mail thanking me for the opportunity to interview and tell me a reason you feel you be a good fit for the position and why you'd enjoy working with us.  Hint: make sure you send it to the right person.  I received one today thanking me for the interview and telling me that she just knows she'd love working for our office.  The problem was that the office she referred to in her e-mail wasn't our's.  Ouch.

It's competitive out there and for every position listed, there are at least 50 applicants or more.  You have to take every opportunity to stand out in a positive way.  Here's a little secret:  It's not hard to do because there are so many people out there who have no idea how to do it.  I'm telling you here.  Use my do's and don'ts properly and you'll make a better impression.

Good Luck With That Pal!

If you watched the video above, you see what can happen when people say no instead of yes. You can be sure that anyone from United Airlines that was involved in this case, wishes that they had chosen a different path. Some mistakes can't be fixed and the repercussions can be relentless. I'm sure you can think of times when you, or someone else in your practice, made a poor choice when interacting with a patient, or with each other. Sometimes people get too caught up in protocols, rules and guidelines and forget to use their imagination and be creative in solving problems. As we've been working with a staff member to help her develop a better manner of handling phone calls, we've realized that many times people react, rather than respond to what others are saying. On Monday morning, an older woman came into the office and told our front desk assistant that she was here for the summer from Florida and had lost a crown from her front tooth. She said she had gone into an office down the street and they had said they were too booked to see her, and suggested that she try our office. I came up front and looked at her and saw that she was missing crown #9. Now, I don't know about you, but if I was in that condition I'd hope that someone would have compassion for me and help me out. We were also fully scheduled and didn't have an open room right then, but I asked if she'd mind coming back in a few hours. She happily agreed and returned at the agreed upon time. Upon examination she told my boss that her dentist in Florida had told her she needed to replace an adjacent bridge, so she wanted us to do that and incorporate #9 into a new 4 unit bridge. As it happened, a patient that was scheduled for Wednesday had to postpone her treatment and we appointed this lady for that time. We prepped the bridge yesterday and found her to be a wonderful patient. I had to wonder if the dentist in the other office even knew that his front desk assistant had sent away a patient in need, who ended up needing and accepting a bridge, and who happily paid the fee. If only she had thought yes, rather than no. Patients are happier with staff who say yes. Sometimes it seems like it is impossible to say yes, and sometimes there are things you just can't do. You still don't have to say no. If you can find a way to align yourself with the patient, you can still do what you need to do, without a resounding no. For example, a patient came into the office one day very irate because his insurance told him they wouldn't cover perio maintenance for him. He was demanding that we change the code and file for a prophy instead. Our front desk assistant at the time immediately said, "I'm sorry, we can't do that." The patient was now angry, not only at the insurance company, but at our staff member, as well. She wouldn't back down and his face progressed from irritated to ready to blow. I got there before the impending explosion and told him I had overheard and could see why he was annoyed. His anger began to fade and you could see he felt he'd found someone who he might just get somewhere with. Now, I was not going to change the code either, but I was going to help him see that it wasn't the answer. Rather than tell him what I couldn't do, I told him what I would do. I told him I would call his insurance and ask them what we could do to help the patient get coverage for perio maintenace. I then pointed out to him that he had a lot of treatment scheduled. In the end, even if they didn't pay for the perio maintenance, he'd still hit his maximum with the rest of his treatment. By the time he left he was satisfied that his insurance would be handled correctly and that we were on his side. I didn't say yes, but I didn't say no, either. Always look for the yes that is available every time you start thinking you'll have to say no. Be as flexible as you can, and when you do have to enforce rules, you do it as positively as possible. Still determined to stick to your rules, scripts and regulations? Good luck with that, pal!

It Takes Two

"It takes two to speak the truth – one to speak and another to hear. "

                                                                            –Henry David Thoreau

How many times have you been in a conversation with someone and realized that they weren't really listening to what you were saying, they were just waiting for you to take a breath so that they could start talking.  Let's face it, we all love to hear ourselves talk.  The problem is this, if we only talk and never listen, we never learn anything new.  We only know our own truth, and it's not always the real truth. 

Think about a time when you've tried to give critical feedback.  As a manager, you know that a lot happens before you actually utter the words.  You've already spent lots of time thinking about the problem, documenting the behavior, and figuring out how to approach the person in a positive, yet firm manner.  You've put all that effort into this and now you're finally started the discussion.  Unfortunately, you find yourself face to face with someone who doesn't want to hear a word you're saying.  You see the shades come down as they go inside their head to prepare their defense.  There's not a chance that they will even consider the validity of what you're trying to say.  Many times, a staff member would rather quit than admit you're right and try to change.

Who's to blame?  Well, maybe both of you.  How are you bringing up the issue?  Are you being positive and reinforcing their good points, or are you jumping right in and slamming them with the bad news without any finesse?  I'm not suggesting that you baby adults, but I am saying that you set the stage for success.  When you give a staff member the opportunity to feel good about themself, they can accept that a few things need work.  Defensiveness is usually in response to an attack.  People who are being attacked react by shutting down, it's a self protective mechanism.  People let in what they can handle.  Most people can handle critical feedback, as long as the delivery is respectful and considerate.

It's the same with patients.  You have to talk to them in a way that makes them willing to listen.  You also have to listen, wanting to understand so that you can find out what they want for themselves.  If you want them to listen to you, you have to appeal to their hopes and dreams, and to what's important to them.  When you listen attentively, you can then speak in a way that shows them that you heard them and understand them.  

It all comes down to respect and honesty.  It's respectful to listen when someone is talking and it's the only way to really achieve true honesty between people.  Show that you'll do your part and you may find that others will do the same.

So What?

"When I start to be too impressed with myself, I think, "So what?"  When I start to be too impressed with someone else, I think, "So What?"  ~Father Nick~

I was in church the other day and those were the sentences Father Nick started his sermon with.  What he was saying was, "What's the importance?"  I recalled when I first became the office manager in our practice.  I have to admit, I was somewhat impressed with myself.  So what?  What did it really mean?  In actuality, office manager is just two words, a title.  Just being told I was becoming the office manager didn't make me a good one.  Seven years later I can tell you what the so what is; it's the whole thing.  If the whole team didn't work with me, I wouldn't be successful at what I do.  I would just be an office manager with a chaotic team.  Actually, if that was the truth, I probably wouldn't be an office manager anymore, would I?

I thought about how "So what?" could be applied to just about anything to bring clarity and to give direction.  Let's think about our staff member that's having difficulty with phone calls.  So what?  Well, if she doesn't get better at it, she may need to be reassigned.  If we let her keep going as she is, we may have dissatisfied patients.  So, that brings a very specific consequence to this situation.

How about a staff member who wants a pay increase.  She goes to the dentist or manager with her request.  "Why do you think you deserve a raise?"  I work hard, I'm never late, and I never complain."  "So what?"  If she is prepared to answer that question, she'll be much more likely to get a raise.  "I've developed a recall system that works and as a result the hygiene department production increased 30% last year.  Staying on time keeps my patients happy and satisfied. I have time to educate my patients about their conditions and I believe that's why they are more receptive to treatment recommendations.  I researched it and 95% of my patients schedule recommended treatment at their recall appointment.  Not only do I refrain from complaining, I try to help others when I can and I believe I play my part in helping keep a positive atmosphere in the office, which patients frequently notice." 

Maybe you have a patient that needs a good deal of dental work, but nothing is hurting...yet.  "You have five large old fillings that are leaking and need crowns."   "So what?"  "Well, you're right, you can just keep going on as you are until something breaks or the decay progresses, but then you may need to have root canals or, depending on the severity of the damage, you may lose teeth.  That could double the cost of the treatment you need.  We always try to catch problems when they are less expensive to fix.  Bacteria can seep into leaking fillings and cause decay.  Once the tooth starts to hurt, your problem will be bigger than it is now."  Ok, now I see what you mean, I'd rather take care of it before we get to that stage."

"So what?" is a great question.  It's a grounding question.  It can show you something about yourself, and it can help others understand where you're coming from and vice versa.  "So what?" is a preparatory question.  It helps you to be ready for whatever may come up.  It's like doing your homework before the teacher actually assigns it.  Don't be afraid to look, it's a question that gives you a chance to make things right before they go wrong.  "So what?"  I don't know about you, but I like getting things right.

Reality Check

We were doing an amalgam for a physician today and the conversation turned to just what it's like to be a doctor these days.  This patient is also a friend of mine and I've known him for years.  I've watched him become more stressed with each passing year.  He started talking about how managed care is affecting physicians and just how tough it's getting.  He said he's seeing more and more emails advertising for doctors, which he said he hadn't seen in the past.  He talked about the feeling that patients and staff look at him and think he's got it made.  He said, "They don't think about the fortune that it costs to go to medical school or the hours and years of studying and hard work."

I started thinking that it's the same for dentists.  They also spend a lot of time and money preparing for their career.  A lot of people look at them and think they take home a lot more money than they actually do.  Don't get me wrong, dentists make a decent living, but it's not what some patients and staff think it is.  And, it's not a snap to make it happen.  Here's the reality.  First of all, the dentist assumes all the risk.  If an assistant drops an instrument in a patients eye, the dentist pays.  If a hygienist messes up, she may have to defend her license, but the dentist will bear the ultimate responsibility.  If a patient keels over with a heart attack, everyone gets upset and stressed, but imagine being the owner.  Think about how it feels to tell a patient who just needed a crown at her last recall, that she needs another one.  The dentist knows he's telling the truth, but that skeptical look from the patient could make anyone squirm.  Some even go a step further and ask him if they're funding his trip to Europe or a new boat.  How would you like it if your boss asked those kinds of questions every payday?  Staff sees a patient accept a $40,000 treatment plan and start thinking that they should get a bonus since he just got that big case.  What they don't realize is that those big cases end up costing more than expected and the dentist just eats the difference.  That doesn't take into account the time spent planning the best treatment and trying to anticipate any problems that may arise.  They still end up waking up at night worrying about something they may be missing.

I'm not trying to make you feel sorry for dentists, and they wouldn't want you to either.  They'd just want you to understand that they have their own share of worries, pressures, and demands on their time and resources.  They also went into dentistry because they want to help people and make a difference.  They're interested in their work and want to feel respected and appreciated, just like the rest of us.  They depend on their staff to work with them to achieve their vision for their practice, but  they end up being in a weird place with their staff, too.  They own the practice, but they can't really be friends with their co-workers, they have to keep a little distance, so it can be lonely for them in their own office. They want their patients to take responsibility for their oral health and to care about it as much as they do.    We need to realize, that everything isn't always what it seems.  Health care professionals dedicate themselves to helping others. Where would people be without doctors, dentists, nurses, hygienists, and assistants?  We all work together and have the same focus and vision.  We need to look at each other fairly, realizing that we're more alike than we are different, and give each other the respect and appreciation that everyone wants.

Time To Put On Your Big Girl Pants

I don't know about you, but I find giving critical feedback to staff members to be one of the most anxiety producing aspects of management.  When I think back to my beginnings in dentistry, I remember getting some pretty harsh critical feedback from a dentist.  I thought I'd been doing ok, but he thought otherwise.  He let me know that if I didn't improve by the end of the next week, I'd be outta there.  I was stunned and asked him what I was doing wrong and he listed everything he was dissatisfied with.  I had only been working there for a week and I was horrified to see how much he didn't like about what I'd been doing.  I was 19 years old.  I made up my mind to take every point he'd complained about and improve it.  At the end of the week he handed me a $10 bonus.  That was more than 10% of my take home back then, so a very big deal to me.  More important, I had overcome my shortcomings and given him what he wanted.  I was thrilled.

Notice, my boss didn't sit and plan out how he was going to tell me that he was dissatisfied, he didn't worry about my psyche, he didn't cushion his complaints with compliments about my personality or anything else.  He cut to the point and told me what he thought.  He didn't attack me personally either, and I didn't take it that way.  I understood that he didn't like my performance that week and if I could improve it, I could stay.  If I couldn't, or wouldn't, I would be let go.  Simple, easy to understand, and all the onus where it should have been, on me.

Contrast that to how we handle these problems today.  First, we have to document instances of poor performance and discuss them with the employee.  We have to make sure that we tell them that they are wonderful, and then back into the real issue.  By the time we finally get there, we will likely face an employee who wants to tell us why we're wrong, ungrateful, or too demanding.  We may find that we are facing an employee who refuses to let herself consider the validity of any criticism we may dare to put forth.  It's like bouncing a ball against a wall; everything you say bounces right off and just comes back to you.  You realize it never gets in and you're playing by yourself.  Since we're not psychologists, it's not our place to try to figure out what makes people do what they do.  Our job is to teach people how to do their jobs the way we want them done, work with them to find better ways to do things, and give feedback that will help them succeed.

In our practice, our staff understands that every critical feedback is given with the intention to help them excel in what they are doing.  They are open to it and look at it as information about what they are doing, not as a condemnation of them as people, or even about their overall ability or intent.  It is specific to whatever task they are struggling with or not performing satisfactorily.  They allow themselves to hear what I am telling them, to consider the problem, and to work with me to solve it.  In other words, they wear their big girl pants to work every day.

In a situation in which the dentist or manager is fair in their feedback, staff members who put up walls, turn the criticism back on the manager, or try to discourage feedback with tears or anger, are being immature, self-centered, and unfocused.  The reason I say self-centered is because they are looking at the situation as all about them, when it is really all about giving our patients the service that we are promising them. They are not looking at this as information meant to help them excel.  They become their own worst enemy and determine an unhappy future in their work life. 

There are times when the dentist or manager is unfair, unkind, or has taken a dislike to a staff member.  Even then, it is crucial for the staff member to pursue the problem and try to solve it.  It could be a misunderstanding, or it could be an unworkable situation.  There is no honor in staying in a situation that will never work.  In that case, putting on your big girl pants means being proactive about finding a position elsewhere that will allow you to thrive.  Everyone involved can only be responsible for their own actions and reactions, and the ones wearing the big girl pants will always do best.