How Long is Too Long?

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The Impact of Delaying the Inevitable

It is not at all uncommon for me to connect with a dentist who approaches me simply for advice, although often it is followed up by a full engagement.  The struggles and challenges vary, but one problem seems to be more and more prevalent; and that is the long-term employee who has actually stayed way too long. 

All too often when asked, “How long has this employee been with you and when did you realize that they were not right for you and your practice?”  I have heard things like, “Oh, about 25 years and I knew this wasn’t going to work about 24 years ago.”  The first time I ran into this I was shocked, but having heard a similar strain a number of times I am no longer shocked and have almost learned to understand the dynamics of why this happens.

Once again, we are back to the behavioral style of us dental folk.  We are not comfortable with change or confrontation, and in some cases to such a degree that we would rather deal with less than competent employees year after year than to either address their weaknesses or try to help them correct their inefficiencies.  After a while it gets to a point where the employer just accepts what “is” and learns to deal with it, at the expense of ideal practice culture, harmony, and effectiveness.  In some cases they are even willing to sacrifice good team members who leave the practice, unable to work alongside of the bad apple or non-productive, disinterested employee.

There’s no one “moment of truth” that puts the employer over the edge or gets them to a place where they know it is time to dismiss this person.  I haven’t been able to isolate one specific thing that seems to be the catalyst or “inspiration” that finally makes them wake up and realize that it’s time! I’m also amazed at how often I observe them saying goodbye to outstanding and valuable employees over and over again, knowing quite well that the contributing factor to their resignation is clearly based on the one employee that they also know is bringing the team and often the production down.

So are we slow learners?  Would a major catastrophe be something to get us going? What type of stimulus does it take to motivate an employer to do what they should have done many years ago?

I’ve written before about those dentist/employers that prefer to keep their heads in the sand. As for a recommendation going forward, there’s really no “secret”.  I think it’s just a matter of recognizing the problem team member and having the will to take action.

Less is More

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Think Quality over Quantity

I’m not one to set New Year’s Resolutions for myself, but I do make it a habit to live by a phrase that those who know me hear from me quite often; and that is “Less is more”.  My goal for 2017 is to continue to live by this as best I can.  I apply this in numerous ways, and would like to share my mantra with you and how it aligns to much of our day-to-day living both personally and professionally.

Often during a casual conversation I will catch myself unconsciously monopolizing it, and when I do I adjust my participation in the banter.  This applies most often when I am communicating with clients who clearly want to vent or fill me in with the details that are obviously important to them and the operation of their practice as it relates to the team.  Team issues can be trying and challenging and I understand this all too well.

When it comes to creating ads, I coach to remove as much of the “fluff” and stick to the facts and verbiage as it applies to your business style, avoiding reference to what people will receive in the way of compensation, perks and extras. Instead I speak more to the unique dynamics of what you and your approach to dentistry is all about.

How about the perception that if one consultant is great, then why not enroll 5 or 10 of them? This should be 5 or 10 times better, correct? I contend that is a common (and potentially devastating) mistake. Do your homework!  Research the consultants and advisors that you are considering and then narrow the field to those that appear to be right for your practice and offer the guidance and teachings that best relate to your specific needs.

I like to use baking a cake as an example.  If you don’t follow the recipe utilizing just the ingredients recommended in the right proportions and throwing in additional ingredients assuming it will make it even better, it very often results in disaster.

What about once the responses from your advertising efforts begin to roll in?  Are you elated when you see lots of resumes and interest from all types of job seekers, or do you see the value in narrowing your field to just a few that closely fit the demographic you are seeking?

Obviously “Less is more” is not apropos for all situations, but in relation to the examples I’ve shared I think you’ll agree that it does make sense.  Wishing you all a wonderful 2017 with Less negatives and many More positives.

 

I Was Possessed By Serena Williams

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Sometimes we can surprise ourselves

For those of you familiar with DiSC–or even better–have been exposed to my own S E L F Profile Assessments that relate directly to the dental industry, I made a very interesting observation on the tennis court with my husband, Russ the other day. Russ is an unusual combination of “S” “L” which is equivalent to the “C” “D” in DiSC. I am a Structured Caregiver while he is an Organized Driver.

His behavior, as does everyone’s, shows up all the time in day-to-day activities and interaction. For example, when we are escorted to our seats in a restaurant I have him pick the table and where we sit.  For me it’s easier to make him happy, and I truly don’t care.

Today on the tennis court he got impatient waiting for me to get back after retrieving some balls.  He was so anxious and VERY ready to start playing that he served without looking across the court to notice that I wasn’t ready. With my head down I was moving into position as the ball bounced into the serving box and then hit me in the head with some force.  Understand that I love to play and make sure he is never easy on me, so the ball was served to me without easing–up hitting it with some force as a strong tennis player would. I enjoy trying to get them back and many times I do, but he is clearly a much stronger player than I.

What upset me so much was that he couldn’t stop long enough to see that I wasn’t ready to accept the serve. He apologized of course, but from that moment I began to play like I have never played before.  I started to smack the balls as hard as I could and they were all going in. I actually had him running and missing many of my shots.  It was as though I was possessed, channeling my Serena Williams.  This brought out a side of me that I never saw before and Russ was amazed too!

What’s interesting about this is that it was such a change from my normal demeanor that I found I could only hold out for 2 games and then resorted back to my comfort zone.  It wasn’t due to fatigue. It was due to a behavioral style that was not at all familiar to me.

This is what I coach all the time regarding how our behavioral makeup can be adjusted only to a certain degree, and we will inevitably return to the style that with which we identify.  We can make small changes in how we accomplish things, yet changing our behaviorial style completely is something that really can’t be done.

What I did learn is that I do have it in me if/when I want to get a little aggressive–at least on the tennis court.

Prioritizing – Maybe the Most Valuable Skill of All

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It’s really NOT about multitasking

Many of my clients, when asked about skill sets and behavioral style, tell me what they hope to find in job candidates. One thing they will say often is that they really need individuals who are able to multitask. This seems to be the attribute that is most valued for the hiring dentist and has always been a recurring request.
Truthfully, studies have proven that multitasking is not possible from a literal standpoint. Our minds can only process one thought at a time, although we are able to switch from one to another very rapidly. Rather than hoping to find someone who can “multitask”, I look for those who are able to prioritize, whether it be in everyday conversations with fellow team members, patients, or simply having the ability to quickly identify the most logical order of things based on importance. These people tend to be visionaries who can see beyond the “clutter” of daily activity, and are able to quickly assess what should be accomplished in what order.
When we look at running a successful business we need to prioritize the order of things to assure the most effective use of time and resources.
As an example; when might be the best time to develop and launch a marketing campaign? Some would believe that anytime we feel the business is in need of additional patients and growth would be appropriate. I understand the need for marketing, although I believe in an “inside/out” philosophy. In other words, it’s internal marketing that needs to be polished up first before we even begin to think about increasing the patient base from external sources.
• What if the team you have in place is not prepared to welcome the newly acquired patients?
• What if you are short-handed, lacking team members to sufficiently handle the possible active influx of new patients?
• What if you haven’t developed systems or proper protocols to track those that you are marketing?
• What good is it to bring in new patients and find that you can’t maintain them?
• What if you do get some good response and begin to gather a lot of new patients on the phone and hopefully through the doors, but you’re not prepared to serve them and the bottom falls out?
Can you see how valuable proper prioritizing is here? You’ve spent money and time and possibly taken some of your team away from their daily responsibilities just to put their energy into the marketing process only to find that you were not totally prepared to bring in and welcome new patients properly.
Let’s talk about your business team and their need for prioritizing acumen. Imagine that you are having a particularly busy day and the phones are ringing, patients are coming up to the business office to be dismissed, the door to the reception area is opening and closing every few minutes with patients coming and going.
How might the administrative team prioritize all of this activity? Do they quickly recognize what they need to do first? Sometimes thinking fast on one’s feet is very challenging when lots of things occur at once.
Then there’s the clinical team and the quick decisions they need to make almost daily. There’s the patient that came in 5 minutes late, the patient who has been waiting to have the doctor check the dry socket they developed after yesterday’s extraction, and Mrs. Snodgrass who vowed that if she had to wait longer than 15 minutes for her appointment she was going to take her records and her family elsewhere.
In hygiene, the patient that was scheduled for a standard 1110 adult prophy was actually a quad scale requiring 1 ½ hours of chair time when she has only an hour reserved. This particular patient has been hard to get in the system since her schedule is a busy one with little time available. Then there is the special needs patient who is clearly sharing her anxiety with the other patients in the reception area and along with everything else, the doctor is behind schedule to check the hygiene patient waiting in the chair.
Handling these scenarios (which do occur all the time) is far more important than the ability to multitask. I believe that many tend to confuse the two. Multitasking is not a “talent”, but the really valuable ability is to think fast on our feet and come up with solutions that are acceptable and productive.

Solving the Mystery of Dental Team Turnover

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A true story

We always talk about the tremendous turnover in our business and wonder why it is so challenging for us to maintain a talented dental team with significant tenure.  There are numerous reasons that contribute to the consistent change in personnel in our industry. Granted, there are some things that can’t be avoided but many things that can.  I hope over time to touch on each of them, but for now I’d like to share a true story that occurred just today.  There are many instances just like it that I have experienced over my career as a placement specialist and dental team development expert and I’m sure many of you have too.

A Business Office professional transferred with her family from a part of the country with a high cost of living. She presented with a stellar background and history and successfully worked in the same high end practice for 10 years.  There was no question that she came with some substantial experience although we ALL know that there is always a learning curve when moving from one practice to another, whether they are in the same state, same town, or same building. No two offices function and operate exactly the same; there are always new things to learn.

This particular candidate responded to my ad, knowing it was in the area she was relocating to with her family; and based on the comprehensive job description I offered, she felt as though she was a solid applicant for the position.  After going through the vetting process we agreed that in fact she could be perfect to fill the position.  Everything seemed to move along well until we came to the usual roadblock which is challenging for everyone—that of compensation.

The area she was moving from was quite a bit different from the new locale that she and her family were moving to. Keep in mind also that with the tenure she had accrued with her 10 year position back home, she also received nice increases along the way (and rightfully so).  The trouble is that she wanted to make a lateral move with no changes to her compensation whatsoever. No matter how we tried to explain the rationale, she insisted that she was determined to shift from one job to another without missing a beat or dropping her salary even one penny.  I conveyed my feelings to my doctor, and of course he agreed.  There was no effective way for him to bring her on based on the wage she was fixed on, which was a good $10.00 an hour higher than this particular market (I check and go over these details closely when I work with my clients across the country).

Well, according to what she told my client doctor, she landed a position in this very town and was offered “just what she asked for”.  Now from years of similar experiences, I can tell you how this story will likely end. The new employer may accept this arrangement for a few days, weeks, or maybe months  until it is either brought to his attention that he is compensating way beyond market, or he realizes his compensation is much more than it should be and the thought of paying out so much begins to disturb him.  Here are some of the things that begin to give him “buyer’s remorse”:

  • She should be a Superstar and prove herself immediately. Why must I wait for her to become totally proficient when I’m paying her so much? Why am I not seeing my numbers rise so that I can justify paying her so much?
  • The high dollars she commanded would mean she is the one who should carry extra weight. She should be the one to take on most of the responsibilities. After all, look at what I’m paying her!
  • Sometimes the price the employer is paying them gnaws at them to a point where they have trouble even encountering the employee under their roof. They can’t help but envision dollar signs every time she passes.

The final outcome with the employer is most often  “Sorry I can’t afford you any longer” or “Sorry, I don’t see that you are worth what I am paying you.”  The outcome is of course that they part ways.  The fallout from this can be:

  • Doctor and team are right back where they started, placing ads and interviewing once again.
  • The team member may have a blemish on what used to be a stellar resume (hence the turnover).
  • The team member just wasted days weeks or months learning the ropes only to find out they are on the market again.
  • The team members will often say “I knew it was too good to be true, but I was hoping………”.

This is one example as to why we have turnover in our business and once again I strongly believe that employers really need to change the way they hire and help everyone to eliminate some of the unnecessary hires as well as dismissals in our industry.

Now here is one disclaimer:  In some very few isolated cases the dentist hangs on long enough to realize their return of investment.  They are also employers who support the new hire with extra coaching and training to integrate them rapidly, as well as to allow them to understand the responsibilities and prove themselves rapidly. The problem is that paying out a large salary will often result in “I’m not investing another dime here. She is being paid so well I expect her to handle everything without any additional layout of funds for me.”  Hence, the lack of salary increase over a long period will naturally de-motivate the employee.

Emotions in the Dental Practice

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What is the price we pay for our sensitive, caring ways?

As far back as I can remember the vast majority of dental teams have been made up of a group of females lead by a male dentist/provider. Over the years the dynamics have changed a bit, with many more female dentists at the helm and a number of males comprising the auxiliary team. However the team structure is divided, the one thing that is still constant is that the majority of the team is comprised of females. The reason we see this in our “patient treatment” industry is that the caregiver and nurturing side tends to be more prevalent in females than in males.

With this said, it should not be a surprise to know that often the blending of females in the workplace can get tricky. Emotions can run high, and insecurities will show up loud and clear. The sensitivities that exist amongst a team of females can be great, and many tend to thrive on acceptance and appreciation.

The “story lines” that come from this environment have been of great interest to me. The situations that I’ve personally experienced have been mindboggling. From the assistant who was really distraught after the patient refused to have x-rays taken, to the front office manager that could not a get a grip after the patient with her bill in hand yelled, “And you will adjust my balance NOW!”. The assistant left work early and the front office manager sat at her desk and cried for hours.

So how do we work to focus on staying cool, thinking things out and making things right before everyone’s day is ruined?

First, we must realize that “people will be people”. Then we throw in the inherent stress of a dental office environment, plus the concern the patients have for the treatment they require, and then, “And we have to pay for this?”

We now have a true dichotomy here; a double edged sword if you will. In dentistry we must be caregivers- kind, sympathetic, understanding and calm. These are all wonderful qualities that comprise the majority of all dental professionals. With this comes a sensitive, emotional, “wanting to please” persona.

Of course, these traits are not exclusive to females. Males within our industry tend to be wired much the same. This is why so many dentists “fear” telling a patient that they see a hairline fracture in the upper right first molar, and may say “Let’s just put a watch on that” rather than explain the ramifications that can occur from ignoring it and waiting for things to get worse until the tooth cracks entirely, or becomes exposed and now requires a root canal and build-up.

Why would they not take the proactive approach? Because they don’t want to be the bearer of bad things. They don’t want the patient to not like them, perhaps not keep future appointments, and most of all, leave the practice altogether.

Why? Did you cause this tooth to fracture? Was this your fault? Of course not, but their “sensitive” antenna immediately goes up and they feel the need to lessen the blow.

The dynamics and emotional blend in a dental practice is fascinating, right down to the team member that will sooner blame someone else than to admit their mistakes. I always found it refreshing to see someone raise their hand and say “Oops, I forgot to empty the garbage”, or “Yes, it was me that neglected to confirm Mrs. Smith for today.”

Honoring one’s mistakes is a great advantage when it comes to maintaining harmony and respect within a dental practice. The balancing of our emotions will not necessarily change, and mistakes will continue to be made. But how we recognize and respond to them is what will help to manage the stress we put on ourselves and the fall-out that results from the delicate emotions that we bring to the rest of the team and to the practice.

Does A Practice Overview Have Any REAL Value?

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What is its advantage for the Team? What is its advantage for managing the practice?

 

What is a “Practice Overview”?

It is a document that includes all things pertaining to the structure, business model and inner workings of your dental practice.

What might it include?

It should include as much information as you can compile dealing with every area of the practice.

Administrative:

All things pertaining to the Business Office

Examples might be:

  • All team members that comprise the business office, including a breakdown of each employee’s job description
  • Software utilized
  • Business hours
  • List of all insurance products (PPO, HMO, etc.)
  • List of all vendors
  • Location of all printed materials
  • Location of supplies
  • List of all business procedures (i.e.; confirming traditionally, by email or by text?)
  • List of all specialists (if applicable)
  • Scheduling template

Clinical:

Everything pertaining to the Clinical Area

Examples might be:

  • List of labs and systems for handling cases
  • What materials are preferred?
  • Where are things kept?
  • What things are “routinely” done for every patient? (i.e.; offering them a pillow or blanket)
  • Special instructions for setting up and breaking down the room?
  • Utilization of IO camera?
  • Specific tray set ups (some will actually take photos of this for the overview)

Hygiene:

Everything pertaining to the Hygiene Department

Examples might be:

  • Visual oral cancer screening or utilization of ViziLite or other advanced technology
  • When might patient be referred to periodontist? (probe numbers?)
  • How long for each procedure?
  • Assisted hygiene?
  • Products sold
  • What is the arrangement for doctor to come in and conduct his exam?
  • Does doctor check in to say hello to every patient?
  • Where are supplies kept?
  • Does hygienist schedule her/his own patients?
  • Hand out educational materials?

 

These are simply examples. You can make yours rich with information, since the more you include the better informed everyone will be.

Uses for this document:

  1. During the interview process this can be presented so the job candidate can see what their position might entail
  2. As a periodic reminder for current employees who can utilize it as a “refresher”
  3. If someone on the team is filling in for a missing member
  4. When a temporary employee is required to fill in
  5. As a reference guide to use to make sure all systems are maintained
  6. Excellent information to transfer to new owner should a practice sale be made

Once your Overview is created, it should be updated regularly with the entire team present to contribute, making sure all information is included.