When No One is Perfect Enough

Demanding perfection can be a fool’s pursuit

Seeking an additional dental professional for hire is not an easy process, but what makes it even more challenging is integrating a new team member to join a team of very long-term employees.  It’s the equivalent of becoming a part of a tight, close knit family or joining a sorority and having to watch your p’s and q’s to simply gain acceptance.  Breaking through and being welcomed unconditionally can be a struggle for the candidates vying for a spot within a group that has moved together (with locked elbows) for years.

It’s interesting how critical and analytical a group can get when it comes to admitting a new team member to a long tenured team. “She doesn’t laugh at our jokes” says one. “She doesn’t want to eat lunch with us.” Says another. “I don’t think she gets us.”

The truth is, she will have some hills to climb since she doesn’t have the track record that the rest of you have accumulated over time.  It will be another learning curve for her until she understands the little innuendos that have floated around the office for years.  She won’t know that doctor absolutely despises mayonnaise and that Mary at the front desk lost her husband recently, so we are all careful as to not bring up anything that might remind her of his passing.

Understandably this new hire has her work cut out for her.  Not only will she need to learn new systems and new protocols, but she will also need to relate to the “lay of the land” and be adept at navigating through the little “teases” and inside jokes. These added “skills” are typically what come when one joins a practice of long-standing employees.  I find this interesting and these dynamics are only present in practices with extended team longevity.  It’s an additional component that does not exist in practices will less team commitment and short-term employees, but it’s an important segment for the team to learn to overcome for if they can’t get past these out of the ordinary requirements they will find it extremely difficult to ever bring in new team members.

It’s fascinating to me in that they will sacrifice the extra help in lieu of chugging that much harder to make it through each day.  Come on team members, give that well-trained, kind, considerate, hard-working and very worthy job candidate a chance.  Remember, at one time you were the new kid on the block and also had to learn the “inner circle” back stories too.

Playing Nicely in the Sandbox

Bullying can happen at any age

My earliest recollection of naughty playground behavior goes way back, to the days of elementary school. Once lunch was complete and our places cleaned, we all went out to the playground to mix and mingle until the bell rang that it was time for us to come back into our classrooms. This day, which I can remember quite clearly, there were lots of secretive “girl” conversations out on the playground, lots of buzzing about something. Turns out that two gals were handing out birthday party invitations both of which happened to be on the same day starting just a couple of hours apart.

I can clearly remember the word “disinvited”, was this even a word I wondered? Nonetheless this is basically what precipitated the chatter within the group. The two birthday girls were bantering back and forth as to which of them was going to change the date, neither would budge. This is when the subject regarding “disinvited” began to circulate. “If you choose her party over mine, I will disinvite you and you will NEVER ever be invited to anything I have in the future”, said one to the other. Hearing this the other classmate made the same announcement and the conversation began to escalate. I can’t recall all the details from here, but my mother who has always been the quintessential diplomat said, “Debbie, it’s easy. You will go to one party for half the time and the other for the other half of the time. The solution made total sense to me and I remember feeling the relief since even at that young age, I didn’t do well with conflicts.

Now looking back as an adult, I can see that each of my classmates were fighting to be the one recognized. Understandably at 8 or 10 they were not able to logically come up with a reasonable arrangement to appease both girls at the time. I was so grateful that my mother offered me a perfect solution to keep both girls as friends. Fast forwarding to today and here I am 60 years later continuing to see similar situations like this one occurring in my adult life. Adults challenging adults to be the top dog. Bullying on Facebook and not by kids, but by intelligent business professionals. Often, I read about plagiarism and stealing systems and protocols. Employers not giving employees the benefit of support when they are underperforming, helping them to make the changes required to meet the goals of their positions. Hearing their challenges and compassionately offering them the

help they may require. Then there are the employees, working just hard enough so that they can fly under the radar without being noticed. They could be taking advantage of CE meetings and seminars just so that they are able to get away, eat in nice restaurants and interface with fun and influential people. They have no interest in supporting your practice or have any interest in bringing some of new skills learned back with them. It’s more about serving their needs and enhancing their own interests.

Back then in grade school I learned that there are solutions that can be applied so that no one loses. I believe that today as adults we need to get back to old ways of working together. Why must so many feel that unless it helps to self-promote or get themselves noticed, they will simply take advantage of anything that benefits them and continue to step on or whoever/ whatever it takes to get them to the top!

What I Learned on the Court Had Nothing to do With Tennis

We never know where or when a valuable lesson can be learned

This weekend I got to meet one of the newest pros at Omni Golf and Tennis Club here in Tucson where Russ and I have been members. Although we are both busy with our professional lives, we make sure to get on the court no matter what may be happening to hit tennis balls once or twice a week. We heard there was a new pro–a true pro–one that was rated 300th in the world during his active participation on the circuit. While this might not sound like a great accomplishment to those non-tennis enthusiasts, to people who have actively played and/or followed the sport, I can tell you that it is an amazing feat considering the sheer number of great tennis players on the planet.

Jonathan Igbinovia is a remarkable 38-year-old who spent a bit of time with Russ and I after we finished a round of cross-court drills this weekend. He was on the court next to us coaching an up-and-coming local 20-year-old on backhands and serves. Watching Jonathan’s form and mechanics was akin to watching a Bolshoi Ballet, mesmerizing for both Russ and me. We were awestruck and could hardly keep our eyes on our own court. We hit for about an hour with occasional stops to grab a quick sip of water. At the end of our drills, we walked off as Jonathan and his student did.

The resident pro. Tom, who has been a friend of ours for years introduced us all. In Russ’ usual teasing fashion, he asked Jonathan if he thought it was too late to get me prepared to play competitively at his level. Of course, Jonathan was a gentleman and with a bit of a smile said, “it’s never too late.” With this a conversation ensued between us and I had the opportunity to hear his story. And what a story it is!

Born in a small village in Nigeria, he had the opportunity to view professional tennis on TV at a young age. He was fascinated by the “beauty” of the game as he put it, felt certain he could learn strictly by watching and emulating every motion, every position and every step they made. Apparently, he is someone that has an uncanny ability to perfectly emulate what he observed.

Before he knew it, he was playing on the very rustic tennis courts in his small village, shoeless yet playing for hours. Without even one formal lesson of any kind, he was asked to “play up” as we call it. Which means playing stronger, older, more experienced opponents. He practiced, practiced, and practiced some more, always watching the players he so wanted to replicate.

Before too long, he was approached by people who recognized and appreciated the natural talent he possessed. These enthusiasts supplied him with the proper shoes, rackets and a pipeline to connect with those that could promote and enhance the gift that he was given and to support his journey. By age 13, and without one lesson or one minute of formal training, he advanced to the number one ranked junior in South Africa, where he had moved to be mentored by his sponsors.

He’s played against the Nadals and Federers of the world and traveled everywhere, places he had only dreamed of. I could have listened to Jonathan all day, as it wasn’t just his captivating accent, but his gracious, appreciative and humble style that was so appealing. He now coaches the young adults here in Tucson that have aspired to make it further than local tournaments.

Jonathan began to share his thoughts on how he teaches and what he teaches, and from what we heard, neither are taught in the traditional way. He said, “Don’t try to do too much at once, rather focus on no more than three things at a time.” I can relate to this, for even after playing for the past 40 + years I still talk myself through every stroke and yet when I play a match or when I don’t try to focus on everything, I tend to get better results.

Jonathan asked me what I did for a living, and as I started to share it with him, something hit me. The methods he applied and the mindset he shared gave me some food for thought. His success came from watching closely, and concentration on trying to make it less complicated. He took his time, although clearly investing hours and hours in learning and perfecting things, he didn’t “muddy the waters” by trying to assimilate too much at once. It suddenly hit me that this is very much the same way I have coached and encouraged my clients to improve their skills. Listen to those who have been successful and work hard to mirror and duplicate the things that have worked well for them.

“Copy genius”, but don’t try to take on too much too fast. His words were words of wisdom that would apply to anything we are desperate to master.

The Fear of Change- One Gal’s Observation

Who Seems to Fear it More, the Clinical or Administrative Teams?

Ok, so I am going to date myself now and my hope is that my dental contemporaries out there are not shy to chime in.

Remember when x-rays required dipping tanks? We’d go into the small (very small) darkroom and carefully unwrap each x-ray taking care not to touch the film with our hands. If we were developing a full series we would clip them methodically to the rack and carefully dip the x-rays into the developer. We would slowly be sure to cover the tank so that no light streamed in, set our timer and slithered out of this tiny space. Usually we didn’t have to even wait for the buzzer to go off since we were so accustomed to this “drill” that knowing when the films were ready was instinctive.

We would then go in, dip the films in the water and place them in the fixer tank. This routine was repeated throughout the day and all of us on the clinical team worked together throughout the process. Boy, was that developer/fixer dangerous stuff! No matter how careful we were it was not unusual to get it on our uniforms (that were always white by the way). There were no other choices in colors and they were dresses! That’s right, no pants, no scrubs, no options.

Then came the birth of the Automatic Processor. It was a huge change for us, but we did adjust rather quickly and effortlessly. I believe that it was such a vast improvement to what we had before–damaging our clothes and staining our hands. That’s right, no one wore gloves back then or masks either for that matter.

This transition was really a pleasure and I can clearly remember my practice mates rejoicing as to how much cleaner and more efficient this new method was. It saved us time too, since the process was much faster than the old traditional way. There were lots of smiling faces walking the halls of the Medical/Dental Building I worked in on Long Island–happiness everywhere!

Of course, since then we have graduated to digital x-rays, intraoral cameras and a myriad of other technical advancements. For some reason, the changes that were developed for the clinical side of the practice appeared to be much more readily accepted than the improvements that were made to the Business Office. I don’t know why, and perhaps my assessment is not accurate but I can distinctly remember the fear that came over the administrative side of the practice when the peg board system was replaced by THE COMPUTER!

I can clearly recall one of my fellow front desk buddies refused to let go of the “One-Write” system and would enter her information both in the computer and on paper. “I’m terrified of losing information. Where does this all go? What happens if the computer breaks?” (crashing wasn’t even in our vocabulary back then). And if this wasn’t scary enough, what about replacing the Appointment Book with the computer? OH NO! This was frightening to the Business Team AND the doctor.

Technical transition can either make us or break us, at least this is how we felt. How many practices would you say continued to maintain both a computer version of the schedule and a hard-copy appointment book version? From what I observed, I would say perhaps 85-90% initially.

No secret that dental peeps fear change, but I have noticed that the advancements on the clinical side of a practice do not seem to rattle team members quite as much as advancements within the front desk. I’m really not sure why, but there seemed to be a little more resistance when it came to enhancing systems that pertained to the business office.

Of course, now in this day and age everyone is working with lots of technology. I can honestly say that with the hundreds of practices that I have worked with over the years, I don’t know of one that is not computerized—well for the most part anyway. There are still a number of practices that have slowly migrated to a paperless practice. As a matter of fact, as recently as 3 months ago I worked onsite with a practice that was actually making clinical notes in the paper charts as well as documenting all information in the computer.

I’d be interested to hear from you regarding your thoughts on the difference between the clinical side of the office and the administrative side. Do you feel one department is somewhat more resistant to changes than the other? The administrative team is often gun-shy with the possibility of more work, fear of crashes, and they “don’t have the time”. Whereas the clinical team often welcomes advancements and enjoys challenges.

 

Change Even Scares Me

Rewriting my job description

As we come to what has historically been the end of summer–Labor Day–I realized that it marks an end for me too.

For the past 25 years or so I have put all my efforts and professional energy into both onsite and virtual dental team development, team integration, team maintenance and related subjects. I’ve written for many dental publications over the years, spoken across the country and have contributed to many online social networks.

Like everything in life, there are always some challenges, but I managed to make it through them all unscathed and consistently came back for more. I’ve met some amazing people along the way and although I’ve coached and advised hundreds, I’ve learned a ton from all of you and know for sure that I could never have gotten this far without the lessons you have taught me. Here I stand, someone who should be thinking about retirement like most of my peers, yet instead I am re-inventing myself one more time as I create a new role and developing a totally new job description for myself. Sound vaguely familiar, Linda Miles?

I must say that this change is bittersweet and I’m not afraid to admit that I too fear change to some degree. I know this is an ongoing issue for most of us in the dental profession, and all of us discuss the fear of change quite a bit. But how can I not practice what I preach? Change must happen, for if we all lock ourselves in and choose to never make adjustments or changes, how can growth occur?

I’ve been here before, but each time it’s been a little difficult. If we become obsessed with the risks connected with this, then we should also be concerned about leaving our homes since we could get hit by a truck, or not taking chances with other things that we routinely do on a daily basis.

As OurPerioTeam begins to take off and show traction and the interest is beginning to percolate, I know that I’m needed here at this point, supporting the growth, development, and ongoing enhancement of the product. Although we have an amazing Sales and Marketing Liaison, Lisa Mergens, she is not only not going to be able to manage everything on her own, but in short time she will require help to support her efforts. I plan on being involved, but it’s been a tough adjustment for me to come to the reality that working with dental teams in the capacity that I had been for years is now going to change.

What is helping me with this “change” is that I have decided to continue to stay active on social networks, continue to write and contribute articles to support my peers, and give back to all those that helped me get to this place. I will not charge for any advice I offer, but I will only have time to offer limited suggestions and guidance based on my new job description and work schedule.

Believe it or not, setting up this arrangement with myself really did ease the anxiety so now I can sleep better.

How Did Things Get This Bad?

A referee isn’t the answer

I jumped in on a conversation that was streaming on one of the dental social media sites on which I participate. From what I could gather after showing up a little late, the question posed to the group was one in which there was an on-going feud occurring in one of the members’ practices. It was between a “strong” personality hygienist and a “want-to-take-charge” Office Manager. The doctor expressed his interest in wanting to keep them both, but really didn’t know how to resolve this problem. Based on what the latest “riff” was about, it appeared to me to be clearly a power struggle between them.

The way I look at these challenges is that the catalyst (or what perpetuated the challenges between them) is not always critical information to have in order to resolve their differences. It’s more about why they had been arguing and not necessarily what they had been arguing about.

From the little I had to go by, I felt as though they were having a power struggle. Their ultimate goals were the same–getting the patients to stay committed to keeping their appointments. The openings that were occurring at the last minute made the pressure and the stress of the moment take its toll on both of them. I did observe things that could have helped them both to be more successful, but I wanted to stay in my area of expertise so I really didn’t go into too much detail as to how they might remedy the issue causing their conflicts.

My suggestion was to have them work out their differences on their own, given a time frame in which they either come together and make amends without any future repercussions. Or if they are unable to work things out–remember that everyone is replaceable.

I feel strongly that unless the two of them come together without anyone else facilitating their truce, they and the rest of the team will never learn or understand that, as adults, childhood behavior is not acceptable. Behaving poorly sends a terrible message to the other team members, as well as the patients and there is no reason why adults in a professional working relationship should not be able to work in harmony.

I was shocked when the doctor who posted this thread responded with, “Well, I can’t leave them alone to cuss and scream at each other. I need a facilitator or “mediator.” Coincidentally I happen to be trained in Mediation and Arbitration and so I know that the purpose of a mediator is not to solve the problems, but to

guide the subjects in conflict to come to a decision on how to settle their differences on their own.

And how did this problem reach such proportions? Cursing and screaming at each other? Truly? How could an employer let their differences escalate to such a level? What about the team members that DO get along? How do they turn their heads the other way when they have to witness some of this aberrant behavior? Then there are the patients, many of them have had to observe these encounters.

My question is: How long as an employer, should you allow employees to not get along? If they can’t mend their fences and resolve their differences, then it’s time to move on. You are running a business, doctor. Who has time for this type of behavior in a professional environment? Why is it that you have so much difficultly abruptly ending this drama before things get so out of hand that it may require a referee?

Deb Roberge has been coaching and writing about dental team development and related areas for the past 25 years. During her onsite visits to numerous periodontal practices, she quickly recognized the very specific challenges that were prevalent in this particular specialty. She felt it was important to step up and support not only these clinicians, but the team members that work alongside of them, as well as the referring generalists and their teams. OurPerioTeam cloud-based software was created with Deb’s input along with perio practices and teams across the country. OPT is changing the way both periodontists and their referring generalists interact, as well as how they measure their mutual successes.

THIS is What Raises are Made of!

No team member should have to ask for an increase when they have clearly earned it

I talk about the value of team members all the time. I can’t stress enough how important it is to be able to clearly identify the employees that pull their weight “and then some.” I’m referring to those employees that get as much or possibly more satisfaction than you do when they can see their efforts paying off.

I recently worked with my wonderful “work sister”, Cyndee Johnson of scaler2schedule fame, and assisted one of her clients with a couple of team dilemmas. In this case the client believed that one of his business office personnel was not managing her post very well and with that, he asked that we review the additional office employee whom he thought was having her own difficulties with insurance filing and billing. These happened to be her primary responsibilities.

Upon conducting our usual due diligence, it was quite easy to see that there were even bigger problems than anyone expected, but the proof was in the numbers, and with comprehensive research we uncovered a myriad of unsettling issues.

Pre-determinations were filed, approved and tucked away with no appointments scheduled and apparently no follow-up calls even made to those patients that had their paperwork submitted and returned. There were 9 pages of problematic insurance issues that were never addressed where many simply needed an additional x-ray or even a simple narrative. Some claims that were discovered dated back to 2015!

Then there were the statements that had not been generated for a couple of months. And did I mention the major ADA code discrepancies? These were bogus codes obviously fabricated by past employees that were used periodically and sat in the system for years. No one seemed to know the origin of this.

Once we delivered our findings to the doctor (and administered his CPR), I knew it was time for us to now take charge and get his practice back on its feet again. Unfortunately, we had to dismiss the 2 team members, but we had clear documentation that they couldn’t defend, and apologized for not asking for help. They left the practice with the understanding that it was time.

To support the doctor, he like so many others in my experience hired quickly without properly checking to be sure the knowledge required to fill the positions was present. He also neglected to check on status, reports, numbers, etc. He loved his dentistry, was good at it, and felt he could count on his team to handle the business segment of his practice efficiently. This too is not uncommon. No strong hiring protocols, hiring with no formal systems, no information tracking, no period reviews and basically assuming all would be well.

I knew the caliber of candidates we needed to locate, and although it took about 6 weeks to find two great team members, the 2 we were fortunate to find were both perfect for the position. Both had ideal skill sets, terrific attitudes and worked extremely well together! We conducted our interviews with all my “road tested” systems in place, dotted all of our “i”s and crossed all our “t”s. Yes, it took time, but it was so worth it.

Here we are 2 weeks into the Superstar Front Office Team’s partnership and I got a report today. You see, we track the progress and we make sure the team members track their activities as well. We look at the challenges acquired and meet them head-on.

The main concerns were the time-sensitive issues, such as insurance re-filing. I spoke with the person who is managing the insurance this morning, and in only 2 weeks time she has recovered $6,000 of back claims and took the print-out list down from 9 to 7 pages! She has managed more in two weeks than the prior business team handled in 2 years. They actually moved the production back rather than forward.

This is an example of how increases are deserved and earned without a second thought or hesitation from the employer. My Progressive Salary Program is built around this premise and Suzie (not her real name) hit her first benchmark, exceeded her first goal, totally hit it out of the park . So…Suzie’s next pay check will reflect her first 2-week increase!

Deb Roberge has been coaching and writing about dental team development and related areas for the past 25 years. During her onsite visits to numerous periodontal practices, she quickly recognized the very specific challenges that were prevalent in this particular specialty. She felt it was important to step up and support not only these clinicians, but the team members that work alongside of them, as well as the referring generalists and their teams. Ourperioteam cloud-based software was created with Deb’s input along with perio practices and teams across the country. OPT is changing the way both periodontists and their referring generalists interact, as well as how they measure their mutual successes.