Category Archives: Business Improvement

PPE (Please Practice Empathy)

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Training our team and on-boarding new members

Integrating new team members has become more of a challenge today than ever before. As a result, I suggest we all need to regroup and take a step back. We owe it to the new hires as well as to ourselves to consider the approach to onboarding in a whole new way.

The myriad of adjustments required along with added precautions as to how we now practice, as well as re-adjusted protocols and systems make it near impossible to “support” a new hire efficiently and effectively as they enter your practice. After all, you are still trying to figure things out and learn how to streamline operations almost daily that had been working just fine for years. With all of you trying to get into a rhythm and a system, how can you possibly train and coach others new to your practice? Yet without your employees, how can we possibly function today?

How do we manage this? For starters with patience! Patience is incredibly important right now. Don’t expect a new hire to pick things up quickly and be 100% compliant with your practice culture and practice style while you are all involved in the learning curve too! The practice you created and maintained pre-Covid is not the same practice you are working in today.

I am so discouraged by some of my clients who are pushing their new hires to learn quickly so that they can help immediately. This is occurring while the existing team members are also trying to figure things out. No one had a playbook to work from, making things nearly impossible to hand off or share responsibilities with others. We are all taking things day by day and hopefully developing new ways of adjusting to learn how to manage things that in many cases have been done one way for years.

Based on the nature of our business environment, we all know that change is stressful and nerve-racking as dental professionals under normal conditions. Add to it all the other components that we are now required to oversee, and we have a prescription for heightened emotions.

Please show some patience. And if you haven’t been a patient person in the past, please try your absolute best to pull from within to attempt to display this quality. It’s difficult enough to locate dental personnel today. Not offering them a safe and welcoming haven professionally and personally and providing reasonable time to learn the ropes can assure you of a rapid turnover.

If you have been lucky enough to locate quality job seekers that are passionate about dentistry and value the position they hold within the practice, give them what they need to succeed and a little more time than usual to get into the swing of things.

Today many new hires are going to lack the attention we would normally be giving as we are all looking to find our way. Let’s all try to be kind to one another as we all navigate through uncharted waters.

 

Try Creating Long-term Business Relationships

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Minimizing employment turnover

 

It’s the time of year that historically marks one of the biggest shifts in dental team structure. The turnover!
Employers will typically wait until the end of Christmas before they dismiss employees. Employees will typically wait until the end of Christmas to see if they receive the increase they were expecting or at least receive the bonus they were hoping for.

 

With this–the scramble is on!

 

Ads are being placed and hiring search engines are buzzing, while job seekers frantically seek out the position that will deliver all they have been seeking in their new (forever) employment.
What about attempting to put a stop to this holiday madness and consider creating some stability in your practice?

 

Employees, how about creating a work history with long-term employment? What about a resume that depicts less short “stays” and rather substantial employment commitments? I believe that both employers and employees can enjoy less “job movement” and more lengthy, healthy business relationships with some system adjustments.

 

Think of the time and money that everyone will save, not to mention the peace of mind.

 

It starts with three words that will reverse the paradigm which are: Take Your Time!

 

Employers–TAKE YOUR TIME to plan out every step of the hiring process from the mode used to attract viable candidates, to the interview process, comprehensive on-boarding protocols, and of course continuing employee maintenance.

 

Be prepared to do things the right way this time.  It’s YOU that determines salary and not the employee.  Asking them “what they need, want, or made in their last job” is a recipe for major problems. Eliminate the Working Interview and replace it with a well thought out, structured Skills Assessment. Skills Assessments differ from Working Interviews in that the assessments allow both parties to better evaluate each other.  Giving both the opportunity to view whether this would be the best business relationship–one that would enable the employer and employee to build tenure and a long-lasting commitment where everyone will benefit!

 

Employees, TAKE YOUR TIME to conduct thorough due diligence in order to learn as much as possible regarding the style, culture and flavor of the practice. Be totally sure that the hours, days and location are acceptable prior to starting the process. Ask questions during your initial interview that pertain to the practice philosophy so that you are able gather valuable information in order to make an educated decision before you move to the next step. Stay present with the PROCESS and celebrate when a potential employer has one.

 

If you dread turnover/change from either the employer or employee side, perhaps it is time to consider doing things differently. Change is never easy for most of us, but if you find that nothing seems to change and you continue to walk down the same road year after year, I can assure you that IT’S TIME!  Best wishes and much success in 2020 to all!

 

The Cell Phone “Connection”

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Ah, the cell phone!

How did we ever manage without it?

Well, we did for hundreds of years and many lived to talk about it.

One of the many frustrations that I hear from clients is the “relationship” their team members have to their phones. My clients share: “They need them by their side all day long” or “The employees with children are always insisting that it is imperative for them to have access to their phones in the event of an emergency” or “I only use my phone during breaks and during lunch” is the promise of many.

But how many team members are truly disciplined enough to restrict their phone usage when there are no firm cell usage practice rules?

How did we ever exist without cell phones back in the 60’s or 70’s? How did we care for our families, check in with our spouses, learn that our mother needed an emergency appendectomy?

They called the office and asked to be connected to you either immediately or if it wasn’t necessarily a critical situation, then as soon as you, the employee, had an opportunity to call them back. This is how it was accomplished during the pre-cell phone era.

While some employers have successfully managed to develop these office protocols, there are still many that have lost control and subsequently the ability to restrict cell phone usage. The Morning Huddle Phone Protocol is one that I endorse and is observed in many practices. This requires relinquishing all cell phones into one common location, away from the business of the day including all patient interaction. And would you believe that the teams that follow these

guidelines manage very well. No children are neglected, no parents or husbands stress due to not being able to get a message to you at work, and yet no emergency calls go unanswered.

This is managed very simply. All it takes is a phone call to the office with the caller either leaving a detailed message for the recipient of the call, or perhaps the timing is such that the person who is meant to receive the call happens to answer it as it comes in. Nonetheless, this is a much more efficient way to manage calls as well as assuring that many more messages get to the right person immediately. After all it’s highly unlikely that one can carry a phone around in their pocket and continue to be an effective employee.

Let’s face it, even on vibrate the timing to take the call must be perfect. It’s difficult to answer a cell phone during a procedure, while checking out patients, answering the business line or simply when trying to stay on schedule.

I know we have all been on fast-track since technology has played a big role in our lives, but I do believe that there are some situations where we need to allow technology to take a back seat and instill old values and go back to simpler times.

Transparency

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A business practice that seems to be disappearing

“Transparency” is a word we are hearing more and more today, whether it be related to politics, everyday life or in business. Along with transparency, I like to include good old-fashioned healthy communication and valuable exchange of ideas. Technology has enabled us to communicate in several additional formats that were not available to us as recently as 20 years ago. Emails and texts are a lot more convenient and quicker than face-to-face communication and even voice-to-voice interaction is becoming an archaic form of interaction. I feel this has added an additional layer of stress to the current climate of dental team development/maintenance.

From my vantage point I have observed a considerable amount of non-transparency and in some cases, avoidance of sharing and addressing issues that were once approached via reasonable and considerate personal interaction. There appears to be some avoidance of sharing information to eliminate any form of possible confrontation. Texting a message from an employee to an employer that they will not be in today. Really? Or even worse, texting a message to an employer that they will not be back to work–ever! The convenience of non-confrontational interaction appears to be more and more widespread and this includes employers as well. Although I have never been comfortable supporting the dismissal of an employee in a very clandestine manner, I used to feel that in many cases there were no choices but to handle things on the QT. I’ll be totally transparent to admit that in the past I felt that in some instances there were not many options to manage the replacement of an employee unless it was handled secretly. Today I have come to realize that this difficult business decision can be approached differently.

There is nothing more stressful to an employee to learn that their employer is secretly looking to replace them. The release of this information can show up in numerous ways as many of us have been on either side of the process.

Quite frankly, over the years I’ve had a change of heart and no longer support nor understand why it must be done in this fashion. Before the proverbial rug is pulled out from under someone, initially I have always encouraged the need to share the performance concerns with the employee, along with giving them the tools and the opportunity to correct their shortcomings. If the necessity for dismissal stems from disciplinary reasons that although once addressed are not resolved, then this would be due cause to sever the business relationship as well. Nonetheless, secretive measures are almost never the way to go and I now feel strongly that there are better ways to address this.

My proposal is to apply some transparency, open healthy communication, and an approach of “honesty first” prior to cautiously getting the word out that you are seeking a replacement for a current employee. If the attempts of cross-correction doesn’t appear to resolve the issue at hand, then a one-on-one conversation regarding the need for both parties to move on in a healthy, respectful manner might be in order.

I will often hear a client voicing their concerns about sabotaging the practice, abusing other team members, or just downright leaving the practice. Truthfully, I have found that transparency and honesty does make a tremendous difference. There is suddenly a level of respect that flows from the employee in question, an appreciation for the openness and the fact that they were shown respect for an uncomfortable situation.

That’s not to say that they still might leave based on being disappointed or hurt, but the employer can’t ever feel as though they didn’t try their best to make a difficult situation as comfortable as possible. As

for the existing employees, it sends a message of “our employer tried his/her best and handled things as fairly as possible”.

We tend to forget the effect that this all has on the valuable employees that are excellent performers but that could possibly fear for their jobs.

What Do You Want?

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Preparing for appropriate compensation

One of the topics that I see recurring on a regular basis in many social media forums is that of dental team compensation. It’s a subject that seems to show up more often than any other.

Questions such as “what do you pay your dental assistant?” to “when do you give increases?” While these inquiries are important, I find that the one major addition to the hiring process is simply going back to an area that should be obvious–yet so many simply skip it. Few prepare for this, the most important facet of the hiring process.

How many are aware of their market?

The range of salaries for the various positions?

How many have even an idea as to how much the position they are wanting to fill is worth?

I have some concrete protocols in place for my clients, but before we can even move forward with the process, I ask that they not only check their budget, but also conduct some due diligence related to their specific market. I’m not sure how we all drifted off from these very basic standard guidelines, but somehow we often count on the job candidate to set the standards.

Compensation based on what the job candidate made in their past position, what they “want” to make or what they “need” to make is not only a completely illogical approach, but one that will typically result in major problems down the road.

In preparation for hire, consider some valuable diligence so that YOU set the stage.

What’s your budget?

What does the job entail?

Are they the only business office employee, clinical assistant or hygienist in the practice? Working alone can require more responsibilities and could affect salary.

Are there specific certifications required?

Are you asking this employee to participate out of the traditional 8-5 4 day/week schedule? Yes, this can warrant additional compensation in some cases.

I work with my clients on touching many points prior to making the final hire, but if you consider applying one of the above parameters, I can assure you that you will be ahead of the curve. Heck, you may even find that you are much more successful onboarding new employees and experience a lot less costly turnover.

Think You Can Juggle? Think Again.

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How much can one person accomplish and manage to do everything well? Multi-tasking can, in a literal sense, be considered a misnomer in that we can technically only process one thought at a given time. Accordingly, those that believe they can simultaneously perform a number of tasks with equal efficiency are basically deceiving themselves.

The secret of getting ahead is getting started. The secret of getting started is breaking your complex overwhelming tasks into small manageable tasks, and starting on the first one.

– Mark Twain

I learned a long time ago that I must budget my time wisely, prioritize my lists and not take on too much on at once. Full disclosure–learning did not come naturally to me so making sure I was disciplined and structured was something I needed to pay close attention to since I started school.

Recently I found myself a little more “over-extended” with my workload than usual. I thought for sure that I could manage and balance things well, but quickly saw things starting to “slip”. I continued to utilize my online calendar and reminders on my phone, but even my support rituals were not helping me to manage all that I agreed to undertake. Granted, this is me and I’m sure many of you can handle perhaps more than I am able to effectively. But in reality, I suspect that some tasks have to suffer for others that juggle too much as well. My guess is that they don’t let things get to them as much as I do, so they just take things on until the bottom falls out.

I don’t like to be late, not even a minute. I get upset with myself when I find I have to ask a colleague for an extension on a deadline. And I really begin to lose sleep when I feel as though a presentation I worked on is not quite where I want it to be with little time to make adjustments.

For those of you that regularly juggle both your personal and professional lives and rarely (if ever) say no to a new project, do you feel that you cover everything successfully? Do you ever find yourselves scrambling to pull responsibilities, dead-lines, phone calls and appointments together without messing up or dropping the ball? I’m sure for some of you, there are friends and relatives that know that they

can count on you for always being late or forgetting a lunch or business date. What about events like birthdays and anniversaries? I admit that I’ve been known to get very creative with those who are habitually late.

Why is it that some people feel that if they excel in one area that they probably can “knock it out of the park” with many other things as well? How many areas of expertise can one person manage without failing, or worse, not being able to pay attention to such a degree that they might be compromising their reputation?

I say stick to what you know best and cultivate your knowledge. Become an authority on the subject in which you have invested most of your time and effort. Pay attention to the successes that have been achieved from your guidance and listen to those that you have influenced and made a difference for.

Don’t try to be everything to everybody. You will burn out way too fast.

She Did It!

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Taking responsibility and honoring our mistakes

Why is it that some people just cannot admit that they have been wrong or have made a mistake? 

We see this type of behavior all the time within dental practices.  Clinical team members blaming the cleaning service for broken equipment. An Administrative employee accusing the patient of not informing the front desk of an insurance carrier change, when in fact it was never adjusted in the system.  Even the doctor can be guilty of this when they blame an ill-fitting crown based on the incompetence of the lab. 

Why is it so difficult to recognize and honor our mistakes?  Is it easier to throw someone else under the bus than to stand up and admit to a mistake and fess up to the fact that it happens to all of us? 

Granted, mistakes on a consistent basis or making the same mistakes time and time again is a significant cause for concern, but on occasion we all “slip up”, is a sign that we are all human.

How might we correct this?  What can we do as a team to ensure that we take total responsibility for our own actions?

I believe that we should revert to the “elephant in the living room” concept. This implies that we all know it’s an issue, yet it is never addressed properly so it becomes an ongoing situation.  As a group we need to publicly give each other permission to not only make a mistake now and then, but to admit it and claim it.  Passing the blame to someone else or even more upsetting, passing the blame on to another team member, is downright unacceptable. 

Perhaps this is a character flaw which almost relates to a sign of immaturity and insecurity.  As kids we never wanted to be punished for mistakes that we made since we hated for our parents to be angry with us, possibly causing us to lose some privileges like our allowance or some freedoms.  As adults we don’t want to have to answer to a disappointed employer, fellow team member, or patient, possibly losing respect and credibility.  This can be quite hurtful to many of us in the dental profession and I include myself.

Once the “playing field” and team rules are spelled out with everyone coming from the same place with the same standards, much of this petty and unnecessary dynamic should diminish greatly.

The Fear of Change- One Gal’s Observation

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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.

 

On My Soap Box to Promote Elimination of the “Working Interview”

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Opting for a Much Improved “Skill Assessment”

In my last blog post I posed the suggestion to do away with the traditional not-so-effective “Working Interview” that has become such an intricate segment of the hiring process within the dental profession. To reiterate my concerns, the structure for the day is generally non-existent with the job seeker coming in for the day or a few hours and is rarely given any guidelines as to where things are, little or no information on the operation and culture of the practice, no support materials to reference, and usually there is no one within the practice to answer their questions due to the fact that everyone is busy handling their personal assigned chores and duties.

Then there is always the issue regarding compensation.  How much is appropriate?  Must we pay them at all? Should we set them up as a hire, gathering all the necessary paperwork whether we hire them or not? And what about the fact that we are often exposing them to personal patient information (social security numbers, addresses, etc.).

My vast experience keeps telling me it is time for a change.  A change to safeguard these issues, along with giving us a much better picture of the candidate’s skill sets (or lack thereof) so that we have more substantial evidence in order to move forward and secure this hire or continue to search for additional candidates.

What I propose is to take an extra hour or two on a day without patients, perhaps a Friday if the office is closed, a weekend or even an evening if that is better. Having this event afterhours enables the doctor to pay close attention and observe the knowledge and ability of the job seeker. There is no need for concern over the confidential information that truly should not be shared at this point. With this planned extension of the hiring process, I recommend that you have a team member join you during this evaluation.  It would make the most sense to have your dental assistant present if you are seeking another assistant, your hygienist there to fill a hygiene position and someone from your business office if it is an administrative position.

You would pay the team member their regular hourly wage for the hour or two they are there, but you can also have your Employee Manual reflect this day and set a slightly different pay scale JUST for this particular segment of the process.  I’d much prefer that a current team member not only participate in this evaluation, but that THEY are paid for their time, in that this process should deliver much more valuable information than the old traditional “Working Interview”.

I would suggest that for whatever position you are looking to fill, you create a specific overview so that you are able to judge the ability they have for manual and hands-on dexterity, math skills, the writing and penmanship skills, as well as giving scenarios to assess how well they think on their feet and solve what could be difficult problems.

I encourage team involvement as much as possible when it comes to changing to new materials, new systems, new equipment and especially when it involves a new team hire.  Incorporating this additional step to the hiring process should not only assure you of a better chance for the right hire, it should also give you a much clearer picture of the capability of your candidate. Besides, I like the fact that your team member is not only involved in helping to make a more educated hiring decision, but that “they” will be the one to receive compensation for their time.  The evaluation is conducted during off hours and would be considered an extension of the hiring process so you are no longer at risk, nor is there any confusion regarding the job candidate’s compensation.

 

With this, I strongly recommend that you make sure to include reference (in writing) to a 30 day trial period so that you and the team are able to observe their interaction with all the team members, vendors and of course the patients.

Why not consider this new approach to hiring?  I’d be happy to guide those of you that might have additional questions.

Making Changes To Assure Success

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Quick fixes Rarely Bring Long-term Results

Making adjustments to the way we run our lives and our businesses is never easy. So much of who we are is ingrained in the day-to-day manner in which we conduct ourselves and manage our lives. Fear can easily take over when we attempt to change our comfort zone. Making alterations to the way we operate and handle things can be a shock to our systems.

All of us know to some degree that if things aren’t working satisfactorily then the only way to turn things around is to make changes. Recognizing the importance of making necessary change is not so much the act of enacting it, but sticking with it! We begin with all good intentions and a desire to move forward quickly for immediate results on what is needed. Then why is it that more often than not this determination begins to fade out and eventually disappear, and before we know it our old ways have resurfaced.

We know we need to lose weight, so leap straight ahead with a burst of determination. We don’t just join a health club, but start off BIG by joining a spin class and perhaps a very aggressive Zumba group. We don’t just cut back on some of our poor food choices, but we instead go on a fast routine working to stick with 1,000 calories or less a day. We don’t stop smoking with the aid of a counselor or support meds, but we choose to throw the cigarettes out the window (including the carton we just purchased) and go it cold turkey.

So what’s wrong with these approaches? Shouldn’t we be commended for the strong desire shown and a demonstration that says “we really mean business”?

Yes, a statement is being made and to the outsiders looking in they are quite impressed with your expression of sincerity. Truthfully though, these examples of making changes in one’s life will most likely be short lived. Taking an aggressive approach may sound encouraging yet when it comes to change, change that will stick, it takes planning and at a pace that doesn’t overwhelm.

This same principle applies to changes we make to our businesses. Bringing in new systems, crafting new protocols and getting those “cultural” issues set up and spelled out in the brand new Office Handbook that you are excited to implement can be exciting. Many employers apply these new ways of managing their business and teams in the very same way. Now that they are ready and focused to make the changes they are recognizing as needing to be fixed, making the shift can’t come soon enough. They are ready to roll and can’t wait to implement all that is suggested as soon as possible.

Again, enthusiasm and the desire to get things going is a wonderful thing, but being anxious to get as many changes made as possible as quickly as possible is a prescription for a quick failure. Just as weight loss programs bring long-term success through a slow and steady process, so does the process of making changes in policies and programs that have been a part of a business model for years.

Take one new format at a time and don’t necessarily put a timeframe on what needs to be revised, that is unless you are changing methods that are causing immediate harm to the business/team in some way. When an advisor that you respect and admire offers you advice that you know you need to pay attention to and strongly consider for the betterment of your practice, don’t let any of it throw you.

Between the two of you, evaluate the priority order for the changes you need to make and then slowly integrate step by step. Slowly incorporating new ways of handling things is definitely not easy for most of us, but slowing things down as much as possible will help us to become more and more secure with the change.

Slow and steady DOES win the race.