She Did It!

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.

One Man’s Treasure

What might not be the best employee for one dentist, might be perfect for another

It’s time to seek a new employee. You go through the necessary “drill” to help you locate as many viable, appropriate candidates as you can. You narrow the field down to 3, the two then the one remaining that appears to be a good fit for your practice. You see a name on her resume that is very familiar to you, and upon further research you remember where you heard the name. He was a fellow dental school student and although you haven’t seen or spoken to him in years, you take the time to track him down.

Without first asking permission of the potential employee (which should never be done) you call to speak with him about the candidate you are considering. “Oh no”, says your old friend, “stay clear of her.” Wow, you think to yourself–this is a pretty strong statement. You’ve actually completed much of your hiring process and find this hard to believe.

Every instruction has been followed perfectly. She is well spoken and professional, had a long history in the two other practices where she worked during her career and was legitimately interested in working in your practice and oh—the team loved her! No doubt the once statement from the past contemporary caused you to stop dead in your tracks. You couldn’t help but wonder that maybe she isn’t all that you thought she was.

In light of the fact that you believed she could be the perfect employee for your practice and you were excited and prepared to continue the process, you still choose to move on and continue to interview others. Unfortunately, no one even came close to this particular candidate, and what was also quite interesting is that as she continued to interview, she too found that no practice or employer compared to this one.

With all the due diligence conducted successfully (the background check and drug testing came back clean as a whistle) the hiring dentist chose to pass on this person and continue to seek additional candidates. Days went by and then it became weeks. Neither one (the employer or the job candidate) were able to find another situation that felt quite as “right”. The frustration level was rising for both of them not being able to find a better option.

I am then approached by the employer/dentist who asked me for help and advice. My advice was this: there are so many reasons why one sees an employee as a great asset when someone else may not.

It could be as innocent as the employee being quiet by nature when the last employer preferred a gregarious and outgoing behavioral style.

What if another employee was threatened by the advanced skill sets of the employee in question?

Another common problem is the jealousy issue—not to generalize, but women can often be this way.

Nonetheless, are these reasons for you to move on? Whether they are or are not, I always advise my clients to continue to conduct “your” screening in “your” way and make a decision based on “your” specific situation. Take it slowly, hire gradually, make certain this candidate is a good fit for you in spite of what someone else is feeling more on a “personal level” than a “professional level”.

Granted, if the concerns have to do with performance or ethical issues, then there would be no reason to conduct additional due diligence. It’s these rare occasions that would be more legitimate cause to warrant some reservations on your part.

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!

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.

 

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.

Are You Totally Prepared to Jump In?

Changing your wrong hires and short-term hires to winning employees!

The majority of dentists, when realizing it is time to hire a new team member, will either contract with an agency, search internet “resume clearing houses”, write an ad (or assign someone in the practice to construct one), or simply start asking local colleagues and dental peers for referrals. And let us not forget asking patients if they “know someone” (which I believe is the worst mistake of all).

No matter what avenue you take or the vehicle you use to attract candidates, the same applies in every case and that is that you need to have a well-developed plan in place prior to starting the process.  It isn’t simply ” Okay, let’s start interviewing people as soon as we start to see some good resumes or responses coming through.” I think not! It’s a bit more involved than this.

That is “if” you are seeking the best employees for you and your practice.  That is “if” you are wanting to hire passionate, honest, high integrity employees and “if” you can expect them to stay with you as long as possible.  You see, anyone can locate interested personnel, but are they the right people for your practice, do they align with your practice culture, philosophy and business model?  These are the things that will help assure you of not just filling an opening, but bringing in the quality employees you are truly seeking.

It may seem like a waste of time and effort, but honestly once the groundwork is laid and the systems and protocols are in place, it’s just a matter of reusing these materials each time you require additional team members and tweaking them to fit the specific requirements of the new employee. Although following this methodology will add this type of discipline into your hiring routine, you will probably find that you will not be going through this “drill” nearly as often as you have prior to working with structure in your hiring process.

I will list for you chronologically what you will require to change things for the better:

  1. Know exactly what you are looking for. Create a thorough, comprehensive Job Description for this position before you do anything else. Type it out with your letterhead.  This should be presented to every candidate that makes it in for a face-to-face-interview.
  2. Be prepared with a salary range (this is a RANGE that can fluctuate based on candidate).  This means that you do your homework.  Know what skill sets they MUST have to begin with. What licensures they MUST have.  Whether they will be working alone or have someone else with them (this can affect salary either up or down). Be well prepared and knowledgeable here even if you must conduct some due diligence.
  3. If you insist upon the traditional “Working Interview” (with which I discourage, by the way), I prefer a “Skill Assessment”, which is conducted during non-patient hours and is simply an extension of the interview process. If you have them in for a Working Interview then be prepared in advance with a compensation amount and paperwork that supports the time spent. This release should be signed by the doctor and the job applicant. You should have an amount per hour for this day preset so the candidates are aware of this prior to coming in. I can supply you with a sample if you email me @ deb@ourdentalteam.com Remember to have the WI overseen by a reliable team member or one of your family members.  They should not be alone to have access to patient records or information of any kind.
  4. Be prepared to supply the strong applicants with an overview of the hours and days that they will be responsible for.
  5. Having the finalists (you may have more than one) have lunch or coffee with your present team (without doctors). This is an excellent opportunity for the team to get a better feel for the candidate.
  6. If you don’t have a reputable company to conduct background checks and drug tests, please find one. This would be one of the very last steps prior to determining a starting wage. Until you have all these pieces completed you should not be offering anyone a position.
  7. Checking references is a tough one, although I do have a protocol I created a number of years ago.
  8. When everything clears and you and your team feel comfortable to offer this person the position, a Job Proposal should be created with every bit of information pertaining to their involvement with your practice.  This is when you should have them review your Employee/Practice Manual.  You must encourage them to read it and initial each page.  In it you should include things such as dress codes, CE courses, vacation information, well days, etc.  They should have everything understood and sign off on it all which will save you from those questions about time off, bereavement pay, etc., that so often comes up later.
  9. Your Job Proposal should also be thorough and comprehensive with regard to when checks are cut.  If you utilize my Progressive Salary Program System that gradually brings salary up as new skills are successfully acquired.
  10. Bringing in a new team member should also be an Office Event, especially when you find you are not hiring as often. Make their presence a big deal.  Balloons? A bio and picture of them set up in the Reception Room? Make sure every team member introduces them to each and every patient, vendor, mail/delivery people and others.