Making Changes To Assure Success


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.

Do You Hire for the Person Within or the Outside “Packaging”?

Talent may not be “visible”

I fear that we are seeing more and more superficial rationale when it comes to building a dental team. I find it so disturbing when a client paints a picture of the team member they envision and the first words they mention are that they should “look good”, which means what exactly?

While I would agree that taking care of one’s self from the hygienic standpoint as well as a professional presence is important, I don’t believe that we need to be seeking out potential beauty contest winners.

To me, it’s much more about professionalism, dedication, the ability to take direction, to work well with others, to think before they speak, and of course to not flood the office culture with unnecessary dialog or disrespectful banter. While presenting a healthy “look” would make sense in that we are in the healthcare field, I will never support refusing to offer a great employee a position based on some level of perceived physical attractiveness.

Are they neat? Are they well-spoken? Are they talented and skilled? Have they proven to you that they are perfectly qualified to manage the job that was offered to them? If all this fits then it’s not about them, it’s about you!

I realize that this is a touchy subject, but I’m at a point where I felt it was important to bring my concerns out into the open in the hopes that it will bring to light some very shallow thinking and stimulate some healthy assessment when situations of this nature are presented.

Don’t pass up an ideal team member based on superficial values. Many very special qualities are not visible to the naked eye.

Managing Team Conflict


Whose job is it anyway?

I Stopped at my favorite local Starbuck’s today and things were jumping.  Could it be coffee for your sweetheart on Valentine’s Day?  Nonetheless, after I placed my order I couldn’t help but overhear what sounded like a heated discussion between one of the baristas and the store manager, Erica.  The level of conversation was high and continued to escalate in spite of the crowds and cross-banter at the coffee bar that should have drowned it out.  I’m sure that not only could I hear the conversation, but I suspect many others could as well.

“She never picks up after herself”, said Trevor, “and with that she runs out the door as quickly as she can and the end of her shift and I never see her grab the garbage or do anything to help the rest of us. I’ve really had it with her. You need to address it as soon as possible.”

The body language was almost as interesting as the dialog, with Trevor leaning forward and Erica looking stunned with almost a glazed look in her eyes.  It appeared as though Erica was near tears and didn’t know how to respond.  I was hoping that with every word Trevor uttered she would be intentionally moving him toward the back room, but this never happened. With Trevor’s rambling, it was obviously difficult for her to get a word in, or move him away from the patrons at least. Erica was clearly very uncomfortable

My coffee was placed on the bar and as they called my name I grabbed it as I heard Erica say, “Okay, stay a little later with me and help me make a list of the things you want me to address with Stephanie. Is there anyone else that has similar issues with her?”

Whoa, really?, I thought to myself.  I see a couple of things here that are unacceptable and problematic at best.  Why not stop him right away noticing the crowd that had been forming in the store? Why not immediately take him to a quiet place for a moment so that others wouldn’t be privy to the conversation? And why oh why would you encourage this employee to continue his anger with you so publically? These aren’t your issues, they are between him and a fellow employee and should be resolved between them without any interaction from their managers, bosses or superiors.

My experience today reminded me of those I have witnessed while working in practices over the years. It’s the team members airing their issues and not always in the most healthy manner or most opportune time. It’s the dentist/employer who will stop and listen to this rhetoric getting much more engaged in the story than they should.

Have you established guidelines and very specific “language” in your practice culture overview or employee manual to manage issues of this nature?

Direct your employees to solve their own problems and become more self-sufficient, for if you continue to offer them a platform to vent, their problems will immediately become yours.

It Pays Dividends to Take Your Time


Rushing a Hire is One of the Biggest Mistakes an Employer can Make

I’m so frequently asked what the biggest mistake I see when it comes to dental team development. Although there are a number of things, by far the biggest mistake of all is hiring too quickly in my opinion.

The hiring dentist receives an ideal, picture perfect resume and almost sight unseen is ready to make the applicant an offer. Then there is the job candidate that presents beautifully, with a resume in hand in a shiny folder. Or it’s the applicant who arrives early and introduces herself to the front desk, shaking hands as she moves from one to the other. While all of this is admirable and great to experience, this is not enough to make a well educated hiring decision. Not by any means.

It’s a process that we need to go honor–one that takes time and one that requires much more than simply the superficial things that initially might impress. Making a hasty decision based on a first impression is not the way to enter into a long-term hire, one where you and your team member can celebrate years of “togetherness” and basically establish a match made in dental heaven.

They do happen, as I have seen many and the one commonality is that there was not a hasty decision made from the side of the new employee or the employer. It took time for everyone to see if the fit was right, if the personalities jibed, the practice culture was aligned, the dentistry was in synch and the mutual respect was reciprocal. These things take time and time is what should be invested by both parties in order to be sure that everyone can expect a long-term, healthy business relationship.

How many marriages have endured based on a very short courtship? Take the time to be sure–from both sides–and once everyone involved agrees, it’s a matter of maintaining the bond that you have created.

A Practice That A Practice Should Never Practice


How to weaken a strong team


There are 2 different “so called” business decisions that I am seeing which some doctors have instituted to bring up their bottom line.  You know what a dental team advocate I am and how much I support and stand up for all those dedicated, hardworking dental professionals. So hearing these two methods that some dentists support in an attempt to save money was appalling to me.

  1. The first one is unfortunately something I believe originally became somewhat “fashionable” during the tough times we and other businesses were having in 2008, and for some incredible reason I continue to see this approach maintained.


What I am referencing is sending hygienists home when their schedule appeared light on a particular day.  I can go into how to fix this, but this is not the point I want to make. Hygienists have lots of valuable chores they can attend to during down time, i.e., calling overdue patients, scheduling outstanding care, helping in the business office, etc.


Please don’t ever send them home, since there is so much they can do to contribute to the flow of your day, not to mention what a terrible message this is for team morale.  Your hygienist will stand for this just so long, and before you know it you are seeking a new employee. I don’t have to tell you what this will cost you in the long run.


  1. This one was new for me–one that I’ve only heard about once, yet I just can’t wrap my head around it nor do I believe that this particular doctor really believes that he is actually saving.


In this case, the team is all aware that this practice does not offer anyone any type of time off arrangement.  I’m not saying there is no time off, quite the contrary.  There is actually an open door policy to take off for any reason at any time as long as one key person in the practice is notified by that morning.  Many of you reading this might say “Wow, that’s amazing”. But there’s a catch.


There is absolutely no compensation when you are off for any reason as many times as you need, and there is never a temporary employee to take their place for the day.  Why, you ask?  The doctor feels that he saves anywhere from $160 to $350 per day.


Really doctor?

Here’s what’s lost and it isn’t all money, although everything converts to that:

  • The teams are quickly exhausted. Some so much so that after a while of this they gladly give notice. What kind of a message is this doctor sending to the team members that must carry the day minus one pair of hands?
  • Patients are not getting the same attention.
  • Phone calls are missed, as they may well go into voicemail, and in some cases they never receive a return call for a couple of days due to the catch-up that must take place.
  • Patients have to wait longer for their appointments.
  • Sometimes treatment is cut short and often the work is less than acceptable for obvious reasons.
  • With fewer team members to carry the load it’s not unusual for mistakes to be made, some of which can be major.

So let’s think this over.

It boils down to sacrificing a few hundred for what can be thousands.  Think about the patients that feel this the minute they enter your office. Think about the patients that will walk out the door and seek another practice. What about the team members that must carry the weight for others, and often it’s consistently the same employees who are guilty of taking advantage of this arrangement.

Yup, I’m That Ant


Pushing for Change

Last week I had the opportunity to present to teams and dentists from Northern California.  I’ve spoken to hundreds of teams and doctors over the years and one common thread seems to ring true for all of them.  Once a new concept, format, system or idea is presented, no matter how engaged or excited the group is to hear what it is that you are going to share, the energy and sometimes the laughter begins to subside.

I find this interesting in that the majority of the audience will lean forward in their seats, hanging on every word, and yet when asked, “Do you have any feedback or questions regarding these new ideas?”, they tend to fall silent almost as if they are trying hard to absorb some very new ways of handling some very old routines.

Typically, after my presentation a number of them will approach me privately and ask some additional questions or ask for more information on my topics and subject matter; or in some cases they ask if they can email me or call.  Of course I am always open to share and converse with them if they would rather not address their questions in front of the group, but more and more I’m beginning to understand and realize why it is that they tend to freeze up during my programs (and probably many of yours too); in particular those speakers that are presenting and discussing a major change within the normal day-to-day operations of the average dental practice.

Advancements in technology and science is something that doesn’t seem to intimidate many people, as they are current with all the new state-of-the-art materials and equipment.  It appears to be the changes in systems and protocols that take a little longer for some to buy into and feel comfortable enough to welcome change.

My focus and specialty is team hire, development, integration and maintenance, which from my observations nationwide have not been significantly changed or improved in, well…I’m going to say at least 50 years. So many paradigm shifts need to be made that I believe are urgent for the health of our industry.

My goal is to continue to push my boulder up the hill and encourage doctors and their teams to make adjustments to the archaic procedures used in dental team development.  Change is so overdue in this area, considering that we have progressed and come so far in the technical aspects of our business.

What is amazing to me is that “The Team”–the segment of our business that truly drives the business–continues to be managed with the same minimal systems, void of structure, entering into the hiring process with no plans in place, no clear idea as to exactly the person they are seeking and no idea what or how they will be paid.  I am happy to report that there were many “ah-ha” moments for the group I spoke with last week.  A number of team members and dentists seemed to get it and they were excited and anxious to make the changes!  There are always a number of positive reactions even though I would be elated to receive 100%!

If I can modernize even one of these antiquated methods that have been kicked around for all these years I will be one happy girl!

The Domino Effect

save2 chain1

How one bad decision can multiply your problems

Ever look at how one simple innocent decision can influence a not-so-pleasant chain of events? Often it is the outcome of wanting to make things easy and less complicated, along with being a kind, caring and trusting employer.

In the business of operating a dental practice while working in close proximity to your employees and fellow co-workers, often decisions are made as though we were interfacing with friends.  Granted, in our business the friendships are quickly developed.  We’re a small group so finding ourselves connected on a personal level is quite common.  There are some wonderful things that we can say about developing relationships like ours that become long lasting friendships (I know because I have made many of my own).  Nonetheless, lots of “fall-out”, as I call it, can result from not managing your practice as the business that it really is.

It can be as innocent as granting an employee time off without confirming that there aren’t any scheduling conflicts to make sure the loss of one person will not affect the efficiency and production for the day.  This doesn’t even take into account the hardships it could create for the team that is left to support the activities of the day.  And what about the lack of attention the patients might experience, or the fact that they can easily see the additional chaos and angst the team will most likely be exhibiting? Will all of your patients get the time that they deserve?

Another example I have experienced is when one of my client does not see the value or need in conducting background checks and drug testing for their employees.  “Oh gee Deb, I trust them, since most of them have been here a while and it’s just another thing that I have to incorporate into my already busy schedule”.

Talk about “fall-out” and what an undetected less-than-honorable employee can cause for the group and your practice!! Some of the most talented, well spoken, gifted dental professionals have been known to fool many sharp and intelligent employers.  The relatively easy process to safeguard future stress and heartache can be handled quite nicely via a number of very reputable and BBB approved websites.

Not only is an ounce of prevention worth a pound of cure, but once you initiate this as part of your interview process you will efficiently narrow your field of job candidates.  I always encourage sharing this information early during the interview process. This will enable you to eliminate candidates that do not fit your practice requirements prior to moving forward with your systems.  Please do note that you WILL need to retroactively screen all of your current employees once you put this element in play.  Otherwise it could be considered discrimination to the incoming team members who are being asked to comply.

So when you think about cutting corners with systems or protocols to save time and trouble you might want to think again. In some cases it is based on saving money. Really?  Are you aware that hundreds of thousands of dollars have been embezzled from dental practices over the past 20 or so years? Are you thinking that you strive to be more than a great boss and that you also want to be their trusted friend?

Think it over before you react and keep in mind that this is a business first.  Being a warm and caring boss is not a bad thing, but it is easy to slip into complacency if we are not consistently working to maintain professionalism and integrity. The chain reaction that a poor decision can cause will probably not be worth the precious little time and expense that would prevent serious issues.