The TEAM: Ready to Engage or Exit?
An ineffective team is expensive. It costs time, money, patients, staff, and stress. That being said, creating and maintaining a highly functioning team is no walk in the park either. It can feel more like herding cats, particularly in the early stages. There are plenty of howling cries, sharp claws exposed, hissing, and more than a few scratches. After all, what will become a “team” starts with a complex group of individuals each bringing differing levels of experience, education, issues, agendas, biases, and attitudes.
Today, the most effective teams are “engaged.” The concept of employee engagement has developed over the last 10 years as an essential business strategy. Why? Because study after study has revealed that a highly engaged employee base translates into a higher profit margin.
According to a 2011 Aon Hewitt report, there is a strong correlation between employee engagement and financial performance, even in turbulent financial times. Organizations with high levels of engagement (65% or greater) posted total shareholder returns 22% higher than average in 2010. On the other hand, companies with low engagement (45% or less) had a return that was 28% lower than the average. A Towers Perrin study revealed that net profits are 6% higher in companies with engaged employees.
While the payoff is significant, getting there is a challenge. A recent Gallup study showed employee engagement levels at a mere 30%. In other words, 70% of the workforce is either not engaged at work or is actively disengaged.What does that mean to your practice? Let’s say you have a staff of 10 - only three of them genuinely care about your patients, your practice, and the work product that they deliver. Low employee engagement will manifest in poor patient experiences, which will directly affect treatment acceptance and completion, payment for services, and patient retention.
But what is employee engagement and how do you build a team of “engaged” employees? “Engaged” employees have an ownership mentality. They sincerely care about the success of the business. It’s more than motivation; it’s the genuine desire to do their best for the business in both good times and bad. Engaged employees bring ideas, passion, and initiative. They are positive and optimistic; they support their co-workers. They are focused and persistent. Bottom line: When employees are “engaged,” they care more and they work harder. But perhaps the most important point to note, engaged employees are not born; they are made.
Employee engagement takes place on multiple levels, but it begins with the relationship they have with you, the boss. You communicate clearly with your team and they communicate with you – honestly and respectfully. You provide them with opportunities to grow professionally, learn about the business, and become better, more valuable, and more effective employees. You show appreciation for each member of your team. You make a concerted effort to acknowledge a job well done and thank each for her/his contribution to the practice. Your team trusts you and you trust them. They know that their teammates will not throw them under the bus, and you will not be looking for the first person to blame when things don’t go exactly as planned. They have confidence in the future of the practice and in you as the leader.
How do you build a team of truly engaged employees? It takes time and effort, but it all begins with a simple conversation. You want to gather information first, such as: How does the employee define success? What additional knowledge, skills, tools and training does the employee need to become truly excellent in her/his current role? What goals does the employee have for professional growth within the practice?
For example, perhaps “Shelly” your assistant would like to gain greater experience in treatment presentation and treatment acceptance. Maybe Liz at the front desk would like to learn more about new treatments that the practice is providing, so she can be more effective in answering patient questions. You also want to understand what, if any, challenges or obstacles in the practice are keeping employees from becoming engaged.
If staff do not clearly understand their job responsibilities and how their success is measured, it can be a significant barrier to employee engagement. After all, how can they become top performers if they don’t know what you expect or how you view excellent performance? While building a culture of employee engagement begins with a simple conversation, it becomes a practice-wide process for ongoing growth, development, and improvement.
For more information on this topic, visit my blog: The Lighter Side
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When a Team Member Dies
Though it is upsetting to even think about, there may come a time in your career when a person you work with suddenly dies. Whether it's a patient or a colleague, or whether you worked side-by-side or in different offices, the tragedy of an unanticipated death will produce intense emotions and lead to a multitude of previously unthinkable questions. This is, after all, not a topic that normally comes up in the lunchroom.
I was recently approached to “debrief” a dental team who experienced this kind of tragedy. During the two-hour meeting, the employees tearfully talked about the unexpected death of one of their colleagues. They were in shock. Some of them had never attended a funeral before and most of them did not know what to do or say to their co-worker’s family. Dealing with their own grief was a huge burden in and of itself. The purpose of my ‘intervention’ was to help them begin to come to terms with the loss, and to give them information about what to anticipate in the bereavement process.
Grief is the emotion we feel when we experience a loss. It is a challenge like no other. It can feel like a dagger in the heart. All deaths may be traumatic in some way, but a sudden death is always traumatic. Not only do we suffer with sadness, but our minds are trying to integrate a new reality - one that is different from the way reality should be. An unexpected death causes a uniquely difficult kind of grief. It challenges our basic assumptions about life, its goodness and its meaning. Without a goodbye and with much left unsaid, a sudden death can also bring about regrets such as, "I wish I had told her this," or "I hope he knew how much I liked him." These regrets are a normal part of grieving, especially when death comes suddenly to a person you love.
Trying to make sense of or understand sudden losses can be difficult. It is human nature to want to answer the question "Why?" Yet, it may be difficult if not impossible to find an answer. Instead, the question "Why?" is more of a plea for meaning and understanding. The thoughts of Rabbi Earl Grollman provide a useful perspective for coping with this difficult question:
Now death has shaken your faith. ‘Why’ must life be one of sorrow? ‘Why?’ There are no pat answers. No one completely understands the mystery of death. Even if the question were answered, would your pain be eased, your loneliness less terrible? ‘Why’ may be more than a question. It may be an agonizing cry for a heart-breaking loss, an expression of distress, disappointment, bewilderment, alienation, and betrayal. There is no answer that bridges the chasm of irreparable separation. There is no satisfactory response for an unresolvable dilemma. Not all questions have complete answers. Unanswered ‘Why's’ are part of life. The search may continue but the real question might be ‘How [do I] pick up the pieces and go on living as meaningful as possible?’
There is no 'right' or 'wrong' or 'normal' way to deal with the sudden death of someone we know. How we grieve is as individual as who we are. Our cultural, personal and religious backgrounds all play a role in our response. Take care of yourself. Although your appetite may be nonexistent and sleep may elude you, eat healthful foods, drink plenty of fluids, rest, exercise and avoid alcohol at this time. Returning to work may be difficult, and a period of adjustment can be expected. Continue to reflect with your co-workers. You have lost a special member of your professional family. Be patient and kind, to yourself and to one another.
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
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New Patients in the Doctor’s Schedule
In my last article, we looked at different scenarios when new patients are scheduled in the hygienist’s schedule first. This time we are going to look at the new patient being scheduled with the doctor first. There are some patients that insist on scheduling an appointment for a cleaning, even though they are a new patient to the practice. In some states, it is illegal for the hygienist to see the patient first, and the doctor will come in and do a cursory exam before the hygienist gets started.
When new patients call, are they really telling the front office person that they would like to schedule “just” a cleaning appointment, or is this the perception of the front office person? It may be possible that the new patient does not know the terminology, therefore they automatically ask for a cleaning. The front office person should be explaining to the patient on the phone that: “In our office, we like to schedule new patients with the doctor first. This will enable the doctor to take time with you and really see what your wants are and what is needed. However, if you would like to schedule a hygiene appointment after your comprehensive exam, we are thrilled to do that for you.”
The verbiage above may be changed to better fit your office and personality. However, there are two specific items in this verbiage that are important:
These two points tell the patient that what they want is important, that the doctor is going to spend extra time with them, and that you will schedule them for a hygiene appointment. You have not told the patient specifically that they will be scheduled for a cleaning. So if the patient ends up needing to have four quadrants of root planing, they will not be expecting a cleaning.
If the patient is scheduled with the doctor first and will then be going to hygiene, it’s important to schedule enough time between the two appointments to allow the financial coordinator to go over the patient’s treatment plan and financials. When scheduling back-to-back appointments with a new patient, you do risk the chance of them not keeping their appointment. You do not know the new patient’s history when it comes to accountability with their appointments. The other disadvantage with back-to-back appointments is that if the patient needs to have four quadrants of root planing and they are not expecting treatment, you may lose the hygiene appointment they scheduled. However, this could happen even if they are scheduled in hygiene first.
One of the biggest advantages to scheduling new patients in the doctor’s schedule first is that the doctor will be enabled to establish doctor/patient rapport. How the new patient exam is handled is crucial, as this is a huge part of the trust relationship you are building with the patient. This is where it becomes very important for the doctor to listen to the patient’s wants and address those first. Then it is the hygienist’s turn to inform the patient about what they need. Listening to the patient, observing the patient’s non-verbal communication and enabling the patient to co-diagnose as often as possible is key.
During the exam the doctor should be explaining what s/he is looking for, what the hygienist is doing, and what the findings are - even if they are within normal limits. This means informing the patient as you are doing an oral cancer exam and showing them the normal findings as well as the abnormal. Even if it is tori or linea alba, when you tell a patient the normal findings, you are building trust. This way when you show them something that is not the norm, they are better educated themselves.
The same is true when it comes to the restorative exam that is done with an intraoral camera. Take pictures of normal findings, so you can show them the difference compared to what may be abnormal in their mouth. If a tooth needs a crown because the filling is broken, take a picture of not only the large filling that needs a crown, but also of a filling that is small and does not need anything or that needs to be replaced with a filling and not a crown. Then teach the patient the difference.
Doctor, you may want to consider doing the restorative portion of the exam first with the intraoral camera, as this will help build trust quicker than the periodontal portion. Seeing is believing, and once the patient sees the pictures and is better educated, the periodontal exam will be icing on the cake. Another advantage to scheduling new patients with the doctor first is that the patient will know what to expect at the next appointment, and why. They will also know the financials, and as a result there will be no threat of the patient feeling pressured into treatment.
It is up to each individual practice to determine how new patients are scheduled. There are many things to consider before making this important decision, such as the socio-economics of the population around your practice location. Remember that information is power. Keeping track statistically of how many patients do and do not keep their appointments based on what they want vs. what you schedule them for will help you make an informed decision. After all, the new patient is a valuable part of your future, and a possible referral source.
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