McKenzie Newsletter 408


	Top 10 for 2010 Improve Leadership Focus on Perio

Top 10 for 2010
by Sally McKenzie CEO
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The best thing about January is that with it comes the beginning of a whole New Year, which offers a host of new opportunities. It presents the chance to create a new mindset, and the occasion to renew your commitment to making the most of your career, your relationships, your strengths, your team, and your practice. There is no better time to ask yourself, what are you going to do to make 2010 a perfect 10? I have a few suggestions in this Top 10 countdown to making this your most successful year in dentistry yet.

#10 - If You Can See It, You Can Create It
It’s called creating your vision and goals. In terms of the growth and success of your practice, as well as your own professional satisfaction, where do you want to be one year from now? Share this with your entire staff and involve them directly in spelling out the plan to ensure that everyone is aiming for the same target, namely total practice success. Over the coming weeks and months, you and your team work through various aspects, including:

Improving communication skills and establishing dialogue
Providing a non-threatening forum for the team to evaluate strengths and weaknesses
Clearly defining jobs and responsibilities of the members
Assessing individual roles in the group and understanding how each contributes to the overall practice objectives
Developing specific team processes such as decision-making and conflict management
Improving problem-solving strategies
Creating a culture of accountability

Schedule a two-hour team meeting for January and every month thereafter to identify the vision, the goals, and the strategy for advancing practice success in the coming year.

#9 - Set Priorities
Take the broad goals and objectives and translate them into specific priorities that are individualized for each person. For example, define the priorities of the business team. Spell out how each person’s responsibilities and objectives help to achieve those priorities and how they fit into the larger practice goals.

#8 - Open The Lines Of Communication Wide
Feedback, celebrating progress, group problem solving and troubleshooting all involve ongoing constructive communication. But it is more than keeping everyone informed. A culture of accountability is built on a culture of open communication in which the cornerstone is a culture of respect and trust. Encourage staff to offer ongoing constructive suggestions, input, and insights aimed at moving the practice forward.

# 7 - Set The Example For Your Team
Pay close attention to your own actions, behaviors, and decisions daily to ensure they are consistent with practice values and priority. Do not expect your team to follow you if you are not willing to live by the same principles and uphold the same standards that you require of others.

#6 - Cut The Deadwood And Enjoy Smooth Sailing
Deal with the problem performers on your team. These are the people that you and your star performers have been carrying for far too long and at far too great an expense. There are few things more demoralizing to top-flight employees than a boss who looks the other way when one or more members of the team consistently disregard office policies, bring poor attitudes to work, generate conflict, make excuse after excuse for why they were late, why they were sick, why they simply cannot get their jobs done. Yet the deadwood workers that everyone is stepping over and forced to just “deal with” get the same pay raises, same vacation time, and the same perks as top performers on your team.

Understandably, your capable staff will only tolerate this for so long. As Vince Lombardi once said, "There is nothing more unequal than the equal treatment of unequals." You want a team of people eager to help you and your practice reach the pinnacle this year, not derail your efforts.

Next week, the top five goals for 2010 by the numbers.

Interested in speaking to Sally about your practice concerns? Email her at sallymck@mckenziemgmt.com. Interested in having Sally speak to your dental society or study club? Click here.

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Dr. Nancy Haller
Dentist Coach
McKenzie Management
coach@ mckenziemgmt.com

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Improve Your Leadership in 2010: Don’t Believe Everything You Think

What we don’t know is more important than what we do know. Or as Henry David Thoreau said it: “How can we remember our ignorance, which our growth requires, when we are using our knowledge all the time?”

If one of your 2010 goals is to grow your leadership skills, the most important thing you can do is to admit your ignorance. After all, if you don’t know what you don’t know, how will you know what you need to learn? Here are some questions to help explain this further.

What is more likely to kill you:
A) a deer or B) a shark?
A) a car accident or B) a plane crash?
A) the seasonal flu or B) The West Nile Virus?

If you chose “B” to all of the above, you are not alone. However, the correct answers are “A.”

#1 - You are 300 times more likely to be killed by a deer than a shark. Ever notice the warning signs along rural highways? Deer tend to jump out in front of cars. I know this first hand as a family member escaped death twice when she unexpectedly collided with deer. Shark attacks on the other hand are quite rare despite the visceral response such stories generate within us. They also are sensationalized in news reports. But according to the statistics, there were 108 authenticated unprovoked attacks along the Pacific Coast of the United States in the 20th century. Of those, only eight were fatal. Eight deaths in 100 years.

#2 - Transportation studies show that your chances of being involved in an airplane accident are about 1 in 11 million. On the other hand, the likelihood of being killed in an automobile accident is 1 in 5000. Over 50,000 people are killed on the highways every year. Statistically, this means you are at far greater risk driving to the airport than getting on the plane.

#3 - According to the Centers for Disease Control and Prevention, about one in 150 people infected with WNV will develop severe illness. In 2009 there have been 30 fatalities from West Nile Virus. Each year, in the United States, on average 36,000 people die from flu-related complications.

Human perception is at play in each of these commonly mistaken beliefs. Beliefs that are accompanied with high emotionality tend to distort thinking. Drama easily overshadows logic. When we experience things on a visceral level, our thinking is much more likely to appear factual to us. We regard our beliefs as truths. For example, deer are associated with Bambi who is cute and shy. However sharks provoke intensely aggressive reactions, even if the attack occurred thousands of miles away. Therefore we believe that sharks are the greater danger when that is not the truth. The unfortunate factor involved here is that we don’t question our beliefs when we have strong feelings about them. We convince ourselves that we know.

To some degree everyone has a gap between what they actually know and how much they think they know. Unfortunately, as humans we are frequently trapped by our reluctance to say, “I don’t know.” That kind of mindset, sadly, prevents you from knowing what the missing knowledge is! The solution is to stay intellectually humble.

Make a commitment to challenge your thinking at least once each day. It’s important to seek outside data. Read a professional or business article. Request input from an objective, respected colleague or mentor. Solicit feedback from your staff about how they perceive you. Above all, keep “learning” as a concept at the top of your mind. Recognize that in the complexity of today’s world, no one can know everything. Get comfortable saying “I don’t know,” even if you need to add “but I’ll find out.” Ask for help. Embrace the image of being a life-long learner. And remember, what you don’t know might kill you… almost as likely as a deer, a car or the flu.

As 2009 comes to a close, my wish is that you pause to celebrate your successes and learn from your mistakes. And may that enable you to imagine new dreams and new visions for 2010.

Dr. Haller provides training for leadership effectiveness, interpersonal communication, conflict management, and team building. If you would like to learn more contact her at coach@mckenziemgmt.com

Interested in having Dr. Haller speak to your dental society or study club? Click here.

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Jean Gallienne RDH BS
Hygiene Consultant
McKenzie Management
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Becoming More Periodontally Focused

In my last article we looked at why the hygiene department may not be producing to its full potential. Now let’s look at a couple of ways to fix what may have happened.

New patients are easy because they don’t know what the office has done in the past. The new patient that needs root planing will have a periodontal maintenance appointment in the time frame determined necessary by the clinician. The appointment will be included in the original treatment plan in the computer. It is the existing patients that will be the biggest challenge to convert over to the periodontal therapy program.

Let’s talk about probing first. Six point probings and recession needs to be charted on patients. It is recommended to do six point probings at every visit. Not only should both be done, but the practitioner should be telling and educating the patient about what the numbers mean before they are done. This will enable the patient to co-diagnose their periodontal health or disease.The hygienist or doctor will first tell the patient:

“Sam, I am going to do what is called probing. This is where I will go around and measure the level of attachment to your tooth. You want to hear 2’s and 3’s. If the number is higher than that, you may need more advanced and aggressive treatment to slow down the periodontal disease in your mouth. This treatment is called root planing and it is where we concentrate in one particular area of your mouth for a specific amount of time. You will be numb so it will not be uncomfortable. We also do not want to have any bleeding upon probing or during the actual procedure.”

It is also recommended that the probings be done out loud at least once a year so the patient can hear them. This is also the time to tell the existing patients that if there is bleeding upon probing, they may need to have root planning. This verbiage, or something similar, should be told to not only new patients but existing patients, especially if you have not been doing the probings out loud on your existing patients. You will be surprised at how many of them forget what the numbers mean and are not inclined to ask – particularly if you have not done the probings and recession out loud in the past or have not done them out loud in quite awhile.

Once you are done probing the pockets, recession should be charted. We all know that the pocket depth is not the only thing that needs to be documented in the patient’s record. The level of attachment is what really matters. If you have a patient with a 3 mm pocket and 6 mm’s of recession, this patient is going to be treated differently than the patient with a 3mm pocket and 1 mm of recession.

Again, a conversation something like this should happen before the recession is charted: “Sam, I am going to chart recession now. This time you want to hear zero. What happens is we take the first set of numbers and add it with the second set of numbers in order to come up with how much attachment you have lost. The lower the number is, the healthier your periodontal/gum health is.”

As you are probing the patient may actually start asking questions about what the numbers mean once they realize they have higher than 2’s and 3’s and zero. This is your time to talk to them about what root planing is and where the numbers are compared to the past. Even if the numbers are the same as they have been in the past, and there is no sign of the patient’s health improving, then it may be time to root plane. If the patient has not been referred to a periodontist this may be the time to refer the patient out. If the patient refuses to go to the periodontist or is non-compliant with home care, this may be the time to root plane again, as this may help slow the disease down.

Bleeding gums during instrumentation are not healthy gums. The patient should be treatment planed according to their individual needs. The treatment plan should be given to the front office and the three-month periodontal maintenance appointment should be included in the treatment plan. This way, the patient is aware they are no longer going to be receiving a prophylaxis, and they will be made aware of the difference between a periodontal maintenance appointment and a prophylaxis. This should be explained to the patient not only in the hygienist’s chair, but the person going over the treatment plan and the financials should explain the difference to the patient also. Before either staff person finishes with the patient, they should ask: “What questions do you have?”

Some of you really know your patients and know that some of them are going to want a chance to try and improve the numbers. These are the people that you will inform at the end of the appointment that if their mouth does not look healthier at their next visit, they will need to be root planed. Document, document, document that they may need to have root planing done and make a note to treatment plan if the health of their mouth does not improve by the next visit. This way when they come in and their health has not improved like they were expecting and treatment needs to be done, it will not be a surprise to them. This will also help with patient acceptance.

Converting existing prophylaxis patients to the periodontal maintenance patient that they should be is not an overnight fix. This will take some time and effort on the entire practice. Becoming a periodontally focused office is a team effort.

Interested in knowing more about how to improve your hygiene department? Email hygiene@mckenziemgmt.com.

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