T's and Tats Causing a Stir
“Amber” is an assistant in “Dr. DiStasio’s” office. She’s what you picture when you think “free spirited.” Amber likes to color her hair a new shade every month - bleach blond, jet black, fiery red, etc. She has multiple ear piercings and an edgy style, but she’s not offensive… until recently. Her latest dye job is pink and green. She’s sporting a ring in her nose, sleeve tattoos wind their way up both forearms and the letters J-A-M-E-S are tattooed on her knuckles.
Dr. D. is about to drop dead. His practice is in Manhattan … Manhattan, Kansas, that is - in the heart of the Midwest. Even in this college town, it’s fair to say that there is a somewhat conservative view of individual “style.” Dr. DiStasio has been in practice for 25 years and has many aging boomers who’ve long since forgotten the concept of free spirit and the Psychedelic Revolution.
He's hoping appropriate dress is covered in the employee policies and procedures manual. Just one problem - he never actually got around to finishing and distributing the manual. There is no policy on appropriate dress or anything else. Truth be told, the doctor never really thought he would need the manual until, of course, he needed it.
According to Mike Moore, Director of McKenzie Management HR Policies, too often dentists look at human resource policies as an expense, rather than a necessary investment in protecting the doctor and the practice from potentially costly litigation. In other cases, a doctor may purchase a practice that has an existing manual and they simply assume that it is okay, that everything that should be addressed is… until they discover otherwise.
“When the economy tanked in 2008, the number of discrimination and wrongful termination lawsuits skyrocketed. When the economy is good and people can find jobs quickly, they don’t bother pursuing litigation. In this environment, it is much more likely that an unhappy employee will sue or file a complaint than it was five years ago. It is essential that employers get policies and procedures in place,” emphasizes Mike.
He acknowledges that dress and appearance are big issues in today’s workplace. “Doctors need a dress code and a policy. You can say that everyone is going to wear scrubs. You can say no jeans are allowed. You don’t have to put up with weird dress, T-shirts with inappropriate sayings, crazy hair, etc., but it’s essential to have policies in place.” However, Mike acknowledges that doctors do need to be aware that if the dress, such as a headscarf, is worn because of the employee’s religious practice, it is protected. “Case law in religious accommodation says when there is an issue about whether the employee’s dress is truly religion motivated or simply matters of style, the courts almost always give the employee the benefit of the doubt.”
He urges doctors to work with a professional to create a policies and procedures manual that is specific to the individual needs of the practice. The manual may cover as many or as few issues as the doctor chooses, but would probably serve its purpose most effectively if it included key practice policies, including:
Equal Opportunity Statement - This states that the employee's religion, age, sex, or race will not influence hiring, promotion, pay, or benefits in any way.
Definition of the Work Schedule - This indicates that all employees are to be at their assigned work areas and ready to provide care for patients at a certain time.
Salary/Payment Policies - This details when the employee can expect to be paid, how wage increases are handled, overtime, etc.
Professional Code of Conduct - This section clarifies the practice's expectations regarding employee dress, punctuality, use of tobacco, alcohol, and drugs, as well as policies regarding personal phone calls, Internet usage, and personal visits.
Performance Review Policy - This section explains exactly how and when employee performance is evaluated, including samples of performance evaluation forms. It may also spell out the practice's policy on progressive discipline and unsatisfactory performance. And it may list those infractions that could result in termination of employment.
Time Off Policies - This section explains policies on vacation, parental/maternity leave, illness, military, funeral, jury duty, holidays, personal days, etc.
The key is preparation. Waiting until employee behaviors are so problematic that they are damaging the practice or dealing with issues such as tardiness, family leave, unprofessional conduct, dress code, etc. inconsistently make the dentist and practice highly vulnerable to litigation.
Want more of me? Click here to visit my blog, The Lighter Side, for more Dental Practice Management info.
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Lessons from a Power-Grid Apocalypse
It happened two weeks ago in the late afternoon. An unprecedented power outage led to a historic blackout that left almost 7 million people without electricity. From Mexico to southern Orange County, people were stranded in office buildings and trapped in elevators. Retail shoppers plunged into darkness. Loss of computer and security systems grounded planes at the airport. It was controlled chaos.
Born and raised in Connecticut, I was very familiar with blackouts, be it hurricanes or snow and ice storms. But I’ve been in California for over 30 years and no longer dealing with this as a carefree kid. When the power went out I was in the midst of a coaching call with a Doctor. The phone went silent. My computer was dead. I thought, “Who’s going to fix this problem? After all, I have work to do!”
When I learned the extensiveness of the power outage, my worries shifted. How was I going to print the remaining materials I needed for my leadership training the next day? What would I do with the food in my refrigerator? How will the traffic be without stop lights? As a child I would have relished the news that schools were cancelled for the next day. But as an adult, I was frustrated and annoyed…and very unsettled by the loss of ties to the outside world just days before the 10th anniversary of the Sept. 11 attacks on the World Trade Center and the Pentagon. In the absence of media, fears were rampant about whether this might be a terrorist attack.
But jitters gave way to a calm and even festive mood. People in my community lingered outside on a balmy evening. We caught up on one another’s lives. After concocting a make-shift oven in our BBQ, we warmed up a casserole that one neighbor had made earlier in the day. We enjoyed dinner and wine by candlelight on an outdoor patio table. The night passed too quickly before we used flashlights to find our way home. As we listened to the battery-powered radio for updates, I realized that there was nothing competing for our attention and we were truly ‘in the present’...and how rare that is in this age of technology. How easy and common it is to get distracted from the people and things that mean the most to us. This inconvenience was truly a reality check. An evening without power had some sweet advantages. We sat around and talked instead of zoning out in front of the TV. Soulful bonding, quiet walks down the streets, reconnecting with family and friends. In the positivity of spirit, differences melted away.
Linda Stone, a writer and consultant, coined the phrase “continuous partial attention.” This is the kind of attention that we’ve developed in the last 20 years with different devices and possibilities that allow us to be “on” 24/7, responding to everything. Continuous partial attention is motivated by a desire not to miss opportunities. We want to ensure our place on the network because we feel alive when we’re connected.
For 20 years we've been working to maximize opportunities and contacts in our life. So much social networking, so little time. Speed, agility, and connectivity are at the top of our minds - marketers have been humming that tune for two decades now. We've taken it to an extreme and it has made us overwhelmed, unfulfilled, exhausted. We may feel connected, but there is a lack of meaning. This high-tech way of life has made us feel empty. What would be better?
Engaged attention. We’re yearning for it. People want and need quality of life which is tied to the perception of “meaning.” The quest for meaning is central to the human condition. We are brought in touch with a sense of meaning when we reflect on that which we have created, loved, believed in or left as a legacy. We long for a quality of life that comes in meaningful connections to friends, colleagues, and family that we experience with full-focus attention on relationships.
Rather than “killing” time - we need to nurture it. Instead of “wasting” time we need to conserve it. Despite the seductive lures to live at the speed of time, we can live more in the moment. The challenge is to become more aware of time not as something we spend but as something we invest in.
If you really want to get to the heart of an issue and figure out some of the subtleties of running a practice, there's no substitute for personal contact. Implement meaningful acts into your practice. Maintain personal contact with your patients and your employees. Walk around and casually keep in touch with the people on your team. Talk with them informally several times a week. Give them a sense of what's on your mind, what leadership is all about, how you're thinking about the future. Get people together without modern technology and enable meaningful connections that build relationships. This is what gets employees moving in the same direction. This is what brings patients back to your office. It will get your power back too!
Dr. Haller provides training for leadership effectiveness, interpersonal communication, conflict management, and team building. If you would like to learn more contact her at firstname.lastname@example.org
Interested in having Dr. Haller speak to your dental society or study club? Click here.
What Do Patients Want?
What do patients value about your dental practice? What makes a new patient like what he/she sees enough to keep coming back? How do we keep patients happy and satisfied so that they refer their family and friends?
These are not new questions, but questions dentists and staff have been asking themselves for decades. While a patient survey can let you know where you stand with patients, and may be the only way to directly measure your effectiveness with your existing patients, there are some generalizations that can be made. Based on over 25 years as a practicing dental hygienist, I have discovered that the following considerations appear to be in the forefront of our patient's minds.
1. Patients want to know that their dentist, hygienist, and other office staff are competent. They want to trust that the treatment recommendations they are receiving are based on training, skill, care and judgment. If you listen to what people talk about when they are considering a practice, one of the first concerns that will be mentioned is: “Is the dentist good?”
What does this mean? How can patients, with limited knowledge of how dental treatment is accomplished, decide whether or not you are a “good” dentist? One way patients evaluate this quality is by how much or how little they are “hurt” when receiving dental care. While we in dentistry don’t like to use words like “hurt” and “pain,” our patients have no qualms about it. They will say things such as, “I had those fillings done and I wasn’t in pain afterwards,” or “When he gave me the shot, it didn’t hurt.” Conversely they might say, “I wasn’t really numb and getting that crown done was very painful.” Hygienists are also heavily judged on infliction of pain. If a hygienist is deemed to be gentle, her competence perception goes up. Therefore, the absence of pain is an important factor for patients in deciding that a dentist or hygienist is competent.
Patients also evaluate their treatment based on how long their restorations last. For example, how long did a crown stay cemented in the mouth? How long did their fillings last before having to be replaced? While no one presumes that dental restorations will last forever, patients do have an expectation as to how long “good” ones will function. In my experience, for most people it seems as if five years is a minimum acceptable amount of time for restorations to last. Patients who have to have crowns or fillings redone in less time are suspicious that the originals were not that good to begin with. Is this fair? Likely not. However, it is another way that patients decide whether or not their dentist is competent.
Where staff is concerned, knowledge of billing and insurance as well as general courtesy are important. Patients have been known to say, “I like Dr. X, but his front desk staff are rude.” Conversely, they may state, “Dr. X is good and his office staff are helpful. They helped me find a payment program that made it possible for me to get both of my crowns done this year.”
So, under the heading of competence, the absence of pain and long lasting restorations are two ways patients evaluate the clinical side of a practice. Knowledge and courtesy are important from the clerical side.
2. Patients want to know that you understand what is important to them. Patients are unhappy when they think that their main considerations are not being addressed. For example, a patient comes in with a small chip on the incisal edge of #8, along with generalized moderate periodontitis, and three posterior teeth that need MOD restorations. The patient hates the way his front tooth looks. If the dentist does not understand that the chip on #8 is the most important consideration for this patient, he risks driving him away. Making #8 a priority will likely result in the patient accepting treatment for his other more serious problems. Letting #8 “wait” can result in the patient looking for a dentist who listens a little better.
3. Patients want to know what their costs will be. Nothing seems to cause more trouble in a practice then confusion over fees and insurance. Patients don’t typically make fees their only consideration, but for most, the cost of dental care is a definite concern. They also don’t appear to object to paying what they think are “high” fees for their care, when the perception is that they are getting something of value. What really causes a rift is when a patient does not understand the limited nature of their insurance coverage, or when fees are not explained in detail in advance of treatment.
Many dentists worry that if a patient is given the total fee for their treatment in advance, they may think it is too expensive and therefore not return. However, it is worse if the patient receives all treatment, never pays for it, gets angry, tells all their friends and family, and also never returns. Frank discussion of fees is important to patients. They also appreciate your help with payment plans or programs such as Care Credit or a no or low interest short term loan from a local bank. When they discover a way to help them afford the treatment you have recommended, they will often go ahead with what they need.
These three considerations are certainly not the only reasons patients might keep coming to an office, but they do appear to be important. Dentists and staff who want to retain as many patients as possible can further this goal with ongoing efforts to keep treatment skills high (efficient and effective anesthesia and other types of pain control plus adequate restorative tools), honing their communication skills (addressing a patient's prime concerns), and dealing with finances realistically.
It is an old, old saying: “Patients make paydays possible.” Attracting and keeping patients is essential for any successful dental practice.
Carol Tekavec RDH is the director of Hygiene for McKenzie Management. Carol can improve your hygiene department in just one day of training “in your office”. Interested in knowing more about how to improve your hygiene department? Email email@example.com.
Carol is also a speaker on hygiene efficiency and profitability for McKenzie Management. Interested in having Carol speak to your dental society or study club? Click here
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