The True Cost of "Culture"
There’s a lot of talk about workplace “culture” these days. Are you creating a culture in which your team can effectively problem solve and advance the goals of the practice? Or do you even have goals? Is your culture conducive to creating a superior experience for your patients? Or do you figure they must be satisfied enough because as far as you know, you have probably 1500-2000 patient records. Not that you know how many of those are actually active patients, but the records are there. Perhaps most importantly, is the culture of your practice one that is energizing and enjoyable? Or do you find that you dread Monday mornings - the drama, backbiting, and whining is bleeding your emotional energy dry?
I recently had a conversation with a young dentist. He’s about seven years into his career. He loves dentistry. He hates dealing with staff. In his words, “Keeping them all happy is impossible. There’s always some problem, some issue that I get dragged into.” He loves his profession, but he despises the “culture” of his practice.
This young doctor is settling into a pattern that will plague him for decades to come, unless he seeks help. At some point, he will wonder why there are fewer and fewer new patients. He will be frustrated by the appointment failures and cancellations. You see, the thing about culture is that it not only affects the team directly, it has an impact on the patients as well. Patients can feel the tension. And if you think going to the dentist is stressful for patients, walking into a practice where the air is filled with discontent and stress will have the patients heading for the exits faster than yelling “FIRE!”
Doctors commonly blame staff for a negative culture, and staff commonly blame the doctor. Invariably, it is the practice systems - usually a lack thereof - that dictate practice culture. For example, the business employee can't get insurance claims filed because she's frantically trying to fill cancellations and putting patients in the wrong time slots in an effort to save a sliver of the month's production goal. The hygienist is irritated because s/he is either too busy or too slow. The assistants are plotting their revenge on the doctor because s/he just wants to pretend everything is fine. This too shall pass. Oh don't worry it's just a phase. The patients are giving sideways glances to each other because though staff try to hide it, the tempers among the team are hotter than the asphalt parking lot on a summer day.
Yet, time and again, issues are ignored until they become critical and the practice experiences the serious financial impact of a negative practice culture. The dollar amount lost is likely on par with the local Fourth of July fireworks budget. The obvious difference, however, is that your practice profits are going up in smoke without the collective “oohs and aahhs” of an appreciative crowd. An ineffective team, which is the result of poor practice systems, creates a negative practice culture and is very expensive. It costs time, money, patients, staff, and stress - five pretty important components of an effective practice, wouldn’t you say?
The irony is that oftentimes practices have employees who as individuals are dedicated, hard working, and knowledgeable, but they simply don't know how to function effectively as a group. Consequently, they become mired in conflict, turf wars, and pettiness.
The doctor wants to focus on what s/he does best and enjoys the most - the dentistry, not the drama. Sadly, most dentists have neither the understanding nor the skills to deal with the troubles facing the team. They don't know how to establish team goals and identify the strategies to achieve those goals. They don't have the time to dissect the systems and dig into the reports, the numbers, and the procedures to determine where the breakdowns are occurring. So it's easier to simply ignore it, until it can no longer be ignored. Interestingly, when doctors finally contact McKenzie Management seeking to improve their practices, typically their call is precipitated by the realization that the practice is in serious financial trouble or the doctor is so unhappy that s/he is ready to hand the keys over to someone, anyone else.
Ask yourself if your practice culture is one that you, your team, and your patients enjoy and appreciate. If not, contact me today at 877-777-6151 or firstname.lastname@example.org
Hygienists Role at the Morning Meeting
Morning meetings are a very important part of your day, as they allow the entire staff to be together and talk openly about the day's schedule. The amount of time and energy spent preparing for the morning meeting will determine whether the day will go by easily or be stressful and chaotic.
Oftentimes meetings consist of one person going over the schedule for the day, the daily goals are discussed, and then the meeting is over. During this time, I will look around to see who is really listening. The rest of the team does not have any input or give any specific information, and when the goals are gone over, it is just a number that nothing is really done with. Let's take a look at how a hygienist may prepare for the morning meeting to make it more effective.
Hygienists should be reviewing the next day hygiene patient charts the night before, or arriving to work early enough to go through them the day of their appointment. Any notes required should be written down, either on an appointment view of the appointment book for the schedule that day, or on the patient's individual route slip.
When the hygienist goes through the patient's charts, she should be looking not only at what is scheduled for the day, but also at what is not on the schedule. For instance, what was the notation made at the last visit for the reason to return? Are there any large or old fillings that the doctor is monitoring in case they crack or break, and should the intraoral camera be used to look at these fillings closer with the doctor and patient? Is there treatment pending that should have a picture taken to show the patient? Is the patient's periodontal disease under control or is s/he a candidate to have root planing or be referred out to a periodontist according to the office policy? Should this patient have an adult fluoride based on their dental treatment in the past? Then, make sure that the patient is not due to have a full mouth series of x-rays instead of the BWX that may be in the schedule.
The hygienist should be responsible for having all of this information together and should discuss it at the morning meeting. The hygienist can also bring up any scheduling concerns, such as times throughout the day when s/he may need help from other team members, or times when s/he may be able to help someone else. The hygienist may need help with recording probings on a patient, or may be able to give anesthetic to one of the doctor's patients to help the day go smoother. As the hygienist goes over her charts, other staff members can interject any additional information they may have.
If there are any last-minute changes in the schedule for the day, the entire team will be able to think of a way to possibly fill any openings. This is one of many reasons that it is recommended to use and have the routing forms with you at the meeting. By looking at the routing forms, the team members will be able to see if somebody else in the family is due for a hygiene appointment. There may be a parent coming in for an appointment with the doctor, and the child may be due for their hygiene appointment. With summer coming and the kids out of school, many parents will appreciate one less trip to the dentist if possible.
Most of the time everything on paper looks great - but it's the issues that are not on the schedule we really need to prepare ourselves for. The more we communicate at the beginning of our day, the more prepared we will be once the day is up and running and we are in the thick of everything going on around us. When something does not go how we thought it would, the patient should still perceive that we are a very well organized, stress-free office, and that we are always thinking of them.
As we know, in dentistry our schedules are continually changing - and the more prepared we are at the beginning of our day the smoother the day will go. Every team member needs to be actively listening and participating at the morning meetings.
Interested in improving your hygiene department? Email email@example.com
It Takes More Than Intuition
She has a pleasant smile and a charming personality. Her resume is notable for previous dental experience. You really like the way she handled herself in the interview. She seems like a great addition to your practice. And, after all, you are understaffed and need someone at the Front Desk as soon as possible. You just have a gut feeling that she will be a great employee. You offer her the Front Office position.
Research shows that most employers make a decision on an applicant during the first few minutes of the interview. This susceptibility to first impression is natural, but hiring an employee based on ‘gut feeling’ is a reckless business move. When you have a positive ‘gut’ reaction it’s more likely based on factors that really aren’t job-relevant. For example, the candidate is easy to engage in conversation, she worked in the office of someone you know, she reminds you of a good friend.
Unfortunately most dental leaders are eager to fill vacant positions rather than to select the right person. Traditionally they rely on interviews and resumes. The interview is one of the most flawed parts of the hiring process because they are subjective. Interviews measure social skills, not job suitability. Individuals who create a positive impression are viewed as more capable than quiet or nervous applicants. Because they are not objective, interviews are the least accurate predictors of job success.
Perhaps you rely on resumes and believe that this improves your hiring accuracy. However, the U.S. Department of Labor estimates that 90% of all resumes contain false information! 38% of employees have embellished their job responsibilities at some point, and 18% have lied about their skills, according to a CareerBuilder survey. Other common lies include information about employment start and end dates, academic degrees, previous employers and job titles.
You may plan to add reference checks, convinced that talking with previous employers will give you useful insights. Forget it. Former employers generally reveal nothing of significance. In fact, in many states it is illegal to give any information except for dates of employment.
Calculating the cost of a bad hire is difficult. It won't show up in a bill, and it may not be easy to detect in your P&L. Add in the extra unemployment insurance. And if that hiring mistake costs you a patient or two…well, you get the point. Wasted money.
With the cost of hiring the “wrong” person rising, you owe it to yourself to find a better way to hire employees. The solution is to match the applicant’s personality to the job. Personality predicts aspects of performance not necessarily related to knowledge, skills and abilities. Testing predicts what a person WILL do vs. what they CAN DO.
McKenzie Management is here to help. Partnering with the Institute for Personality and Ability Testing (IPAT), MM developed Internet personality testing exclusively for dentistry. GO HERE > The Employee Assessment Test strictly adheres to legal guidelines for employment testing. It assesses 12 essential personality traits so you know how closely your candidate or existing employee matches the profiles of peak performers in the dental industry. No more guessing. You have objective and scientific data to help you determine suitability for one of four dental positions.
Studies show that employment testing outperforms traditional interviews 4 to 1 in predicting job performance. As a complement to your selection process, testing is a proven, effective method of making the right hires, the first time, every time. Certainly there are no sure-bet methods to guarantee an applicant will be a peak performer in your practice, but there are ways you can increase the probability of success.
With the increasing importance on interpersonal effectiveness for job success, employers who add pre-employment testing will have a strategic advantage. Will you make your next hiring decision on intuition or intelligence?
Dr. Haller is available for consultation and coaching. If you would like to receive a sample report of the Employee Assessment Test, contact her at firstname.lastname@example.org
Dr. Haller provides training for leadership effectiveness, interpersonal communication, conflict management, and team building. If you would like to learn more contact her at email@example.com
Interested in having Dr. Haller speak to your dental society or study club? Click here.
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