– Give it. Get it. Good.
Most dentists pat themselves
on the back if they give employees feedback once or twice a year.
More often than not it’s a perfunctory exchange that is commonly
attached to the annual salary review. If there
are no problems you tell the employee they are doing a fine job,
slap a couple extra percentage points on the paycheck and quickly
get this routine matter off your to-do list.
there are issues of concern with the employee you might dance around
them, give a little hint here and there that maybe a few things
be ever so slightly improved. All the while you are extra careful
not to be too specific about anything so as not
to offend the staff member who just might get mad and – heaven
forbid – walk out. In the end you give the employee the same
percentage increase you are giving everyone else and call it a day.
The staff member leaves the meeting assuming everything is fine
and convinced they are an effective and contributing member
of the team. Meanwhile, you are sure they are going to take some
real steps to improve their performance. Six months later nothing
has changed. Why not? Feedback once or twice a year is not feedback.
It’s an exercise in futility. So how does the dental practice
actually incorporate effective feedback into its systems? First
drop the notion that feedback is part of the performance/salary
review. They are separate issues. Performance rewards must be based
on performance measurements, but that is another article.
feedback should be given and received daily to help employees
continuously fine tune and improve the manner in which they carry
out their responsibilities. And just as dentists must be committed
to giving feedback often and clearly, staff members must be open
to receiving feedback and making improvements.
It becomes another aspect of the regular doctor/staff daily routine.
given and received constructively is professional sustenance for
the employee, the fuel that drives them to improve and to grow.
It’s also the dentist’s most vital tool in shaping and
guiding average employees into effective, high-performing
team members. But expecting anything constructive or positive to
come out of annual or biannual doses of feedback is like having
a patient who brushes their teeth once every 6-12 months yet expects
to have excellent oral health. Doesn’t happen.
feedback can be given at any time but it is most effective at the
moment the employee is engaging in the behavior that you either
want to praise or correct. If Sue at the front desk negotiated payment
from the ever difficult Mrs. Jones with the deft and political acumen
of a highly trained peace keeper/financial genius, tell her! Similarly
if her handling of a situation is not consistent with the practice’s
overall performance objectives and/or your practice
philosophy explain to her constructively how you would like for
her to handle similar situations in the future. Verbal, on-the-spot
feedback should be the goal. The environment of the practice should
be one that encourages positive feedback and openly provides constructive
feedback when necessary. Choosing to avoid opportunities to give
employees feedback is like choosing to help them to fail.
week, feedback – it’s just as important to receive as
it is to give.
you have any questions or comments, please email Sally McKenzie
in having Sally speak to your dental society or study club?
the Patient’s Perspective
is one of the best skills that humans have to touch other humans.
Most people think of only verbal communication and forget about
the non-verbal aspects of communication. Dentists
and dental offices do a lot of non-verbal communication which impacts
on the patient perception of the dentist and
Have you ever walked into your office as if you were a patient vs.
a high speed sprint to start your day? Take a few minutes and walk
into your reception area as if you were coming as a patient.
your reception desk neat and free of clutter?
there a clear place for your patient to talk to the receptionist?
Is there a clear place to write down the next appointment?
there a clear place to write a check?
cluttered reception area conveys a cluttered office and a cluttered
mind. Will the patient think that the doctor’s mind is so
cluttered that the doctor won’t remember what they had discussed?
Look around the reception area and see what your patient
sees when they sit down.
the magazines neatly put away?
the magazines and educational material easily available to the
on your staff should be straightening the reception room or at least
checking to make sure that the room is neat a few times a day. It
only takes a few minutes, but it communicates to the patients that
you run a neat and orderly office.
down in one of the chairs in your waiting area and look around.
What do you see?
there dust on the windowsills?
there tissues under the chairs?
there toys or books on the floor where someone can slip on them?
the walls need repainting or new wallpaper?
the chairs in good condition?
the flooring in good condition?
waiting area is the first area that the patient actually has a good
look at and is the first area of communication
from the office. A sloppy reception area can convey a sloppy doctor.
The next area of importance is the operatory. Sit in the patient
seat and look up. The patient sees the ceiling during most of the
visit. Make sure that the lighting is clean and free of insects.
Make sure the ceiling has no webs or dust hanging from the lights
and corners. The next thing the patient looks at most is the doctor’s
face and especially the eyes. Make sure that your safety
glasses are clean. You should check them in between patients. You
don’t want to communicate to your patients that you or your
office is not clean.
you think that your private office, which is often used as the consulting
office, is really your private office, you are wrong. As long as
patients come in your office, your office is communicating
your outlook to the patient. A neat, clean and orderly
office says to the patient that you have put everything in order
and there is nothing that will keep you from listening to your patient.
Listening to a patient is one of the most important skills
that a doctor should learn. Many doctors want to put the patient
at ease and start by calling a patient by their first name. This
should never be done unless the patient has told the doctor that
they want to be addressed that way. If the patient has not given
a preference, the doctor should ask the patient how the patient
would like to be addressed. Body language is also
important when you are talking to the patient. Talking with your
hands folded in front of you puts a barrier between you and the
patient. When you shake hands with patients, do not wear your plastic
gloves. Shake hands with both hands. Some patients like to be touched
and some don’t. Putting your hand on a patient’s back
as you are walking can be reassuring to some patients and offensive
to others. The only way is to watch the reaction
if you do it. It is important to look in the patient’s eyes
when you talk whether it is a social conversation or a consultation.
Patients feel that they can trust someone who “looks
them straight in the eye”.
are many aspects of non-verbal communication that you should be
aware of in your office. Take a few minutes to look at your office,
which is an extension of you, and make sure that things are the
way you want them to be. Are you communicating to your patient what
you want them to know about you?
... a concerned patient’s perspective.
DOES YOUR OVERHEAD
Your Hygiene Department
Dr. Allan Monack
Hygiene Clinical Director
lot of people feel going to their beautician is more important than
going to their dental recall appointment. “Why should
I go to the dentist if nothing hurts? If it isn’t broken why
fix it? If it doesn’t smell or look bad why show up?”
When these are the prevailing attitudes of your
patients then you have failed in your efforts to communicate the
value of the return visit. Patients will only show up when their
dental insurance pays in full, they have nothing better to do that
day, they want to look better, or they are in
How do you know if you have a problem hygiene department?
Pay attention to the indicators. Do you have more than one opening
per hygienist per day on average? Has your hygiene department not
grown steadily the past couple of years even though you
are getting your usual number of new patients? Is your hygiene department
profitable? Does your hygienist produce at least three times
their salary including benefit costs? Do they produce 30%
of the hygiene services offered with ancillary services such as
scaling and root planing, bleaching, halitosis correction, and other
treatments that your hygienist is qualified to perform? Do you have
a very short or nonexistent list of patients who can fill in hygiene
openings? Just as bad, do you have no where to put someone who had
to cancel a hygiene visit less than four weeks ahead and still have
some of the problems discussed above?
are the all to common problems I must solve when analyzing hygiene
departments. Actually most of these problems are connected. They
usually are caused by inconsistent and poor communication
with your patients. Patients don’t understand the value of
their hygiene visit. No one told them that their visit involves
a lot more than a “cleaning”. They “clean”
their teeth every day. We hope! Why do they need you to
“clean” them? Does the hygienist give the right
message during their visit only to be sabotaged by the front desk
or the doctor? Yes, doctors sometimes do sabotage the hygienist’s
communications with the patient. Is everyone in the office giving
the same consistent message on how important it is to return at
the appropriate interval?
same consistent communication skills also improve treatment acceptance.
Your hygienists are great educators. They teach
the patients the proper home care and preventive skills. They have
the time to show the patient the health status of the periodontal
and restorative condition. They discuss the patient’s concerns
and suggest treatment options that may be appropriate. Your hygienist
should also inform the patient of cosmetic improvements to the patient’s
smile that are available in the office or available at a specialist’s
office. Bleaching, veneers, orthodontics, implants, and gingival
reshaping can also be discussed. The hygienist can also discuss
overall health concerns such as halitosis, snoring, high blood pressure,
temporal-mandibular disease, diet and smoking.
it is important for the rest of the staff to know what your hygienist
has told the patient. The office needs a plan that will allow the
doctor and staff to reinforce the information presented by your
hygienist to the patient. This information needs to be repeated
in the proper way so the patient will understand and retain
what has been told to them. The patient needs to own their problem
and then they will be more likely to accept treatment. Once the
protocols and communication skills are learned by the office, the
patient will have a greater appreciation of the hygiene visit, more
readily accept necessary treatment and be aware of the need to return
at the proper interval for their hygiene professional cleaning or
periodontal maintenance visit.
teach the skills that will solve a lot of the problems you encounter
in the hygiene department. In most cases, the typical dental office
increases hygiene production from 20-30% within four months of learning
HOW to ENRICH their hygiene department. The doctor’s
production also increases because of the higher percentage of treatment
acceptance. Consider enriching your hygiene department.
you have any questions concerning your hygiene program submit them
to me at allan@
mckenziemgmt.com and I will answer them in future articles.
in having Dr. Allan Monack speak to your dental society or study
YOU LIKE TO IMPROVE YOUR HYGIENE DEPARTMENT?
Clinical Practice Enrichment Program is
designed to improve Hygiene Clinical Skills and develop
and implement a step-by-step Interceptive Periodontal Therapy
Program that will immediately bring greater productivity,
with enhanced patient care. For more information...GO
PAST ISSUES OF OUR E-MOTIVATOR NEWSLETTER?
Management welcomes Bob Ankrom, RDH, BS as Director
of Consulting Services
and I worked together in the early 90’s when McKenzie
Management was located in Ohio. Over that time we never
lost touch with each other and I’m pleased to
have him back as part of the McKenzie Management Team.
Bob can be reached at: firstname.lastname@example.org.
to find out about
YOUR HYGIENE DEPARTMENT TO THE NEXT LEVEL
your hygienist producing at least 33% of her total production
in periodontal services? Are the majority of your patients on
6 month recalls?
Most hygienists perform way below the industry standards. Why?
Because they can lack disease assessment skills or performance
skills, or because they don't know how to communicate to the
patient they have been treating every 6 months that they now
have gum disease.
This "how to" manual will help you to establish a
protocol for your hygienist to implement new strategies, formulas,
and techniques for developing an ultra-successful hygiene department.
Scripting and Treatment Plans
by Dr. Allan Monack, DMD, FAGD, Hygiene/Clinical Consultant
GOALS IN 2004?
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