What You Say or Don't Say Will Be Held Against You
“It all comes down to communication.” Those immortal words have been used to describe success or failure in business, on the playing field and the battlefield, in the classroom, the treatment room, and virtually every other environment in which information must be effectively conveyed from one person to another to ensure a desired outcome. In the dental practice, your communication with staff and patients has a profound and powerful impact on whether you struggle or sail through your days.
Consider the case of “Dr. Robert.” He is a truly gifted clinician. His patients are tremendously fortunate, yet I suspect few have any real understanding of the talent this practitioner brings to the profession of dentistry. His employees, tragically, do not understand Dr. Robert. Few have lasted more than a year. He doesn’t have a “team” because the non-stop turnover in the office never allows a “team” to take shape. Thus, Dr. Robert has employees - mostly temporary. He does not understand how other practitioners can keep staff - sometimes for years - and he is on a seemingly perpetual quest to secure just one good worker who will not “find a better opportunity” within months.
In Dr. Robert’s mind, perfection is a must. He learned long ago that it is important to give “feedback” to employees immediately. Thus, as soon as he witnesses an employee performing a task that is not the way he would perform it, he gives immediate “feedback.”
The scenario typically unfolds something like this: “Nicole” is preparing instrument set-ups. Dr. Robert walks in and asks, “What are you doing?” Immediately, Nicole is put on the defensive. She can sense that Dr. Robert is upset. She responds sheepishly, “I’m preparing instrument set-ups, doctor. Is there something else you would like me to do?” Dr. Robert’s response: “Why are you doing it like THAT? They should be set up THIS way.” Dr. Robert has no regard for the impact of his communication. His intention is to set the employee straight on how he thinks the task, no matter how seemingly trivial, should be done.
Dr. Robert believes that to ensure things are done “just right” in his practice, it’s not important how the message is communicated. He has totally disregarded one of the most critical rules for effective communication: How you say it has far more weight than the actual words you use. In fact, as Dr. Nancy Haller explains in the McKenzie Management educational DVD You Said What? Mastering Communication - words alone are only 7% of the message you convey. Tone, attitude, body language and facial expression have a far greater impact on whether the recipient of your message actually receives it or shuts it out because your delivery of that message made them angry, upset, or uncomfortable.
Dr. Robert is both impatient and extremely direct. He doesn’t care to beat around the bush. His “feedback” comes across as criticism. It is neither helpful nor constructive. Sadly, because Dr. Robert is a boss whom his employees fear, no one is giving him feedback regarding his communication style. Thus, until he seeks to understand why he has a revolving door practice, his productivity will continue to fall well below its full potential.
Conversely, “Dr. Roseanne’s” practice is lined with mediocre performers, most of whom are convinced they are the “American Idol Superstars” of the dental team. Dr. Roseanne has made this bed of roses, or thorns as the case may be, herself. If there are issues or concerns with an employee she might dance around them, give a little hint here and there that maybe a few things could quite possibly be ever so slightly improved. She is 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.
The employees all go along assuming everything is fine and believing they are effective and contributing members of the team. Meanwhile, Dr. Roseanne is convinced that if she keeps dropping hints, the staff will figure it out and take steps to improve their performance. Nothing ever changes, except the percentage of lost revenues, which only increases.
“Hints” and subtle “clues” are not feedback. Constructive feedback, not criticism, should be given and received daily to help employees continuously fine tune and improve the manner in which the entire team carries out its responsibilities.
Next week - turning feedback into positive action.
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Playing the Blame Game in Your Practice?
In the process of business management training, the discussion of what kind of leadership role the dentist CEO takes is critical to the success of the practice. Some dentist CEOs take responsibility for their decisions and actions, and some do not. Some accurately and fairly determine responsibility for problems and mistakes and make the corrections, and some do not. Dodging issues that seem confrontational or controversial is the mode of many dentists when things go wrong. Others take the response of blaming a member of the team or the entire team when there are mistakes. Often the Dental Business Manager will be held responsible for the outcome of this dilemma.
Fostering an environment where team members can step up and take responsibility for their mistakes and repair them without drama and guilt is the healthy way to manage a practice. Mistakes will be made. Identifying whether it is a broken system, an untrained team member or the work of carelessness by someone who knows the difference should be researched before any action is taken. The boss who rarely is the blamer or the boss who uses blame as an integral management style often will determine the outcome of the situation. Usually there is low staff morale in the latter of the two bosses.
As a business manager, your first action is to calmly collect the facts. This action will calm the boss who is wanting to blame and reprimand immediately. Assure the boss that you will meet with him/her with the facts so that you can resolve the problem correctly.
Getting the facts is not always easy and sometimes a decision has to be focused on the events or system, rather than the person. Team members have learned to “blame” as part of a defense mechanism, so approaching them with a question like “How can we prevent this from happening in the future?” Instead of “Why did YOU do this?” is recommended.
A habitual blamer boss will shift the responsibility from him/herself to you or someone else because the “shift” is the focus, not the facts. To prepare for this, offer a willingness to take the responsibility, not the blame. Whether the problem has been determined to be a faulty system or a negligent team member, you the manager are willing to work to resolve the problem.
Here is a sample script to practice communicating with the boss:
Dr. Blame: “I thought we talked about this at the last meeting? I am tired of this same issue over and over. Do you think I am made of money? My overhead is through the roof here.”
Betty Manager: “Dr. Blame, I have the notes from the last meeting and this issue was not discussed. This is the first I have heard. Please give me all of the details so that we can solve this problem immediately.”
Dr. Blame: “What are you talking about, this cannot be the first time you have heard this issue. Where have you been all this time?
Betty Manager: “I have been right here, but I have not had the facts and you have been trying to deal with the issue yourself. What I am saying is after I get the entire story and the facts, I am willing to solve this problem.”
Dr. Blame: “I don’t know if I can trust that this problem will be solved unless I handle it my way.”
Betty Manager: “I completely understand, Dr. Blame, all I can do is my best and I am confident that once I know the facts, I will be able to correct the problem. Let’s go over the details together and work out a solution.”
The next step for the business manager, once all the facts are in, is to make the resolution of the problem top priority for her/his work day. If the situation looks to be one that will require more than a day, make sure to communicate an accurate timeline to the boss or you will be setting yourself up for another “blame game” scenario. Work the solving of the problem into the task list for that day. Don’t say to yourself that you will work on it after other tasks are completed, because you will end up with no time left at the end of the day. Delegate some of your tasks to other team members if you can so that you have real time to solve the problem at hand.
Sharpen your business management skills by signing up for one of McKenzie Management’s Business Training Courses today.
Yes to Doctor, No to Susie - Then What Happens?
We all know that those patient records sitting ever so proudly on your shelves or in file cabinets behind the front desk are NOT active patients. Active meaning that they have been seen by your hygienist or you for their professional cleaning or periodontal maintenance appointment in the past 12 months, and Inactive meaning that they have not been seen…
First, why is this so important to know? Active vs. inactive? It is not uncommon for an office to have1500 patient records that the doctor considers “active” patients because their record is still “up front.” However, a recall/recare report for the upcoming 12 months for patients with and without appointments reveals 750 “active” patients and 200 “past due.” What happened to the other 550 patients?
You probably are feeling and thinking that the 550 patients that are MIA, as well as the 200 that are past due in the past 12 months, will return - at some point. Maybe they will and maybe they won’t. How do you know?
Importance of a Follow-up Plan
Patients with incomplete treatment also need to be contacted to encourage them to complete the recommended treatment. Scheduling for a crown on a tooth that is asymptomatic is not high on most patients’ priority lists. They must be gently reminded of the benefits of treatment and the risks of non-treatment.
The Recall System
There are five steps involved, starting with the initial contact to “remind” the patient of a previously scheduled appointment, or for those patients that elected not to schedule in advance due to their busy personal and business schedule. These contacts can be made using text messages, emails, notices mailed or phone calls placed. These contacts should be made 2-4 weeks in advance of their due or scheduled dates.
In the same month that you are contacting the patients for the upcoming month, the Patient Coordinator is also contacting those patients that are due this month that have not scheduled. A phone call is placed in hopes of reaching the patient. “Hello Mrs. Jones. This is Nancy at Dr. Brown’s dental office. Dr. Brown noticed that we failed to make your professional cleaning appointment that is due this month. Do you prefer a morning or an afternoon appointment?”
By accepting the fault of not scheduling her appointment, opposed to insinuating that she didn’t make her appointment when she received her notice, the patient is not put on the defensive and becomes more approachable.
Patients that are one month past due should be called as well, using the same script. The 2-month past-due report reflects those patients that should receive a friendly and informative letter relative to the necessity of being seen on a specific time schedule. This letter should be printed on letterhead stationery and mailed with a first-class stamp. 6-month past due patients should be contacted by phone, text or email and subsequently sent a letter, again on letterhead stationery.
Lastly, those few (hopefully) patients that are on the 12-months past due report would receive a final letter, indicating a waiver of responsibility due to their non-response to the previous efforts to schedule their hygiene appointment. This also concludes any future attempts to contact the patient at this point.
When a procedure(s) is recommended to the patient AND the patient does not schedule the appointment, unless the treatment that is recommended is entered as a “treatment planned” item, there are no computer-driven reports that can be generated to follow up with this patient. In some practice management software systems, even if an appointment was made, but a treatment plan was not created, should the appointment be cancelled/deleted, there is no record.
Not all patients schedule their “next” dentist appointment, unfortunately. Patients say “Yes” to the doctor, and then quickly tell Susie, your Schedule Coordinator “No.” When they say “No” to Susie, if the treatment that was recommended is not entered as a treatment planned item, the “needed” treatment will not show up on any report. Short of auditing all your patient records and yellow sticky notes, there is no method of follow-up for these patients. You wonder what happened to those 550 patients whose records are on your shelves, they are still waiting to be “followed up” with!
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