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2.24.06 Issue #207  
Face Your Fears, Surrender Control

Sally McKenzie, CEO
The McKenzie Company

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Wouldn’t it be great if you could clone yourself? All of your employees would handle everything just like you because they would essentially be you. Or what if you could perform some type of Vulcan mind meld and your team would know exactly how you would handle every situation, every system, and every patient. They would be extensions of you, and you would have total control. Unfortunately, recent setbacks in the cloning research world aren’t going to make this possible anytime soon. And, to the best of my knowledge, we earthlings have yet to master Mr. Spock’s technique.

Understandably, dentists want to control the way in which many processes are handled in their practices, and they should. But there is a limit. Problems often arise when doctors burden themselves by insisting that they be the “go-to-guy or go-to-gal” on too many day-to-day operations. There aren’t enough hours for you to single-handedly make the decisions, give the necessary direction, answer the questions, double check the details, address the problems, generate the ideas, etcetera, etcetera, etcetera. Sure nobody can handle certain things as well as you can, but maybe it’s time to pull the plug on this one-man/one-woman show and give a few other players on your team some stage time. It’s called delegating.

Delegating isn’t about losing control, it’s about directing the players and managing the outcomes so that you have greater control over those processes that are worth the investment of your time – such as direct patient care. It starts with identifying the right people for the right responsibilities, explaining the project and your expectations, giving employees the latitude to get the job done, and being open to recommendations that may be somewhat different from how you would have personally handled the task.

For example, if you want to implement a new system in which the practice collects from patients at the time of service, ask an employee or a small group of employees to develop a strategy for implementing the policy. Give them a deadline by which they present their proposed strategy to you and the rest of the team. If you have strong feelings about how certain aspects of the policy should be handled share those and explain why, but don’t box them in. Force yourself to be open to recommendations you’ve charged the employees to make.

Ask them to provide progress reports on a regular basis, such as at the weekly staff meeting and urge them to ask as many questions as necessary throughout the process to ensure they have all the information and data necessary to make a solid recommendation. Encourage the employees to take ownership of the project and to use their professional creativity. When it is time for the employees to present the recommended policy, sit back and listen.

This is not the opportunity for you to swoop in, wrestle back control, and rewrite the proposed strategy. If delegation is to work in your practice, you must give your employees freedom to share views and opinions and make recommendations that don’t necessarily parrot yours, but may enable the practice to advance to the next desired level. Resist the urge to measure every member of your team by whether they perform a task precisely as you would. If you do, it’s unlikely they will ever measure up and you will stymie their efforts. Force yourself to withhold judgment until you see results.

If you have strong feelings about their approach on a task delegated, redirect respectfully, further educate the employees on your expectations. But be careful you’re not squelching a plan or process recommended just because it’s different from the way you would handle it. Congratulate the employees on a job well done and make sure they know how much you appreciate their efforts.

Remember delegating responsibility should be an opportunity for individual employees to grow and learn and for the team as a whole to build trust in each other and the doctor. You are the coach, you guide, you direct, but if your group of employees is indeed a team, you’re not the one who should be performing every play.

For more information on how to improve your leadership skills- read this

Interested in having Sally speak to your dental society or study club? Click Here.

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The Gold Medal of Leadership: Do you think like a winner?

Dr. Nancy Haller
Executive Coach
McKenzie Management

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I’ve been watching the Olympics. Those athletes have a remarkable drive to succeed. Take China’s Zhange Dan for example. She suffered an Indy 500-like crash just 25 seconds into her free program with her partner, then glided off the ice doubled over in pain. Four minutes later the music was started again, and the couple went on to win the silver medal.

Then there was American skiing ace, Lindsey Kildow who also had a horrific crash. She was taken by helicopter to a Turin trauma center where she remained overnight for monitoring of contusions and back pain. One day later she returned to the slopes and in an awesome run she finished and tied for eighth in the women’s downhill.

What’s the connection to dental leadership? Resiliency.

You may not be vying for Olympic gold, nor are you likely to be slammed into a frozen course at 50 mph, but when your chairside fails to show up at work it can feel just as harrowing.

Succeeding in the competitive world of dentistry requires creativity, imagination and, most important, mental toughness. Resiliency - the ability to ‘bounce back’ when circumstances are difficult - is the key factor to surviving in these enormously challenging times in which you live and work. Remember that you have no control over others, but you have full control over yourself. And by managing your thoughts, you put yourself in a better position to succeed. 

It’s easy to manage yourself in the ‘the thrill of victory’, when things are going well. But how do you handle the ‘agony of defeat’? Indeed, the toughest leadership course is the six inches between your ears.

In the case of the missing chairside, your initial thoughts may be, “Oh (expletive deleted)...this is going to be a miserable day!” Your mood follows suit. You feel defeated. This sets off a chain of events. You might brood or even snap at your front desk staff when she brings you the schedule. Your negative thinking leads to negative actions. It even ‘leaks’ into your interactions with patients.    

If you expect to vie for leadership ‘gold’, you’ve got to put a ‘psychological tourniquet” on your thinking. Unexpected or unwanted events are part of life. And while you don’t have control over what happens to you, you do have control of how you respond to those events. Evaluate your situations objectively.Yes, it will be a challenging day but it’s not the end of the world.”
Your thoughts affect your emotions and your actions. It’s normal to be angry, disappointed, or anxious when a member of your dental team calls in sick…or worse, just doesn’t show up. But the starting point toward better leadership isn’t with your feelings. That’s because emotions are almost impossible to change directly. If you’ve ever tried to tell yourself not to feel something or to feel something different, you know what I mean.

Similarly, telling yourself the opposite of what you have been negatively saying to yourself rarely works. “Oh great, I don’t have a clinical assistant today. It’s going to be a terrific day” is just as inaccurate as “It’s going to be a miserable day”.

Resiliency is about finding alternative ways of looking at adversities when they occur. Start by remembering other times when you were short-staffed and how understanding your patients were. Even if your dental experience in working alone is not particularly stellar, there must be moments in your past when you achieved something and did it well. Drawing from those basic and pure images – mental scenes when you accomplished a task better than you expected – enables you to shift your thoughts and to change your mood.

If you have been experiencing lowered productivity and/or a tendency to become overstressed with life’s inevitable downturns, evaluate your thoughts. Challenge automatic beliefs. Start thinking like a winner! 

If you want to break out of a slump and sharpen your ‘game’, contact Dr. Haller at She’ll help you to build confidence and develop your leadership performance. 

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Patient Acceptance and X-rays

Jean Gallienne RDH BS
Hygiene Consultant McKenzie Management

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In reviewing your records before the morning meeting, you have noted which patients will be due for x-rays. The reason you were able to do this is simple. Your office has established an x-ray protocol.

For instance, when it comes to a recall patient with periodontal disease, the doctor may want a full mouth series of x-rays every three to five years. This may be a panoramic and bitewings or periapicals. Your office may have even determined that at one interval doctor wants periapicals and at the next three or five-year interval the doctor may want a panoramic and 4 vertical bitewings. Then depending on the health of the patient, the doctor has informed the staff if 4 bitewings are to be taken once a year or twice a year.  A healthy adult or child may only require a full mouth series every 5 years.

The office protocol was developed by the doctor or doctor and staff based on guidelines posted by the American Dental Association on January 20, 2005 and revised in November, 2005. The guidelines for prescribing dental radiographs can be found on their web page at These guidelines are to be used as an adjunct to the dentist’s clinical and professional opinion on how and when to take radiographs on their patients, always keeping in mind to follow the “As Low As Reasonably Achievable” (ALARA) principle.

The protocol is established in order to give clinicians a working protocol. However, there will always be those patients that are exceptions to the office protocol. For instance a forty year old that does not have any bone loss, cavities, or recession, and has never had a filling may only require four bitewings every two years, unless a change in their risk factor is noted. The x-ray protocol was developed in order to limit the questions and confusion on when x-rays are needed on a patient.

Granted, the way the patient is approached with the need of x-rays will determine acceptance of treatment or if the treatment is declined. Having scripts and going over the verbiage that is the most successful at staff meetings will help with the patient agreeing to have x-rays taken. Below are some of the recommended scripts that have proven to be successful:

  • "Mr. Jones, I need to get your x-rays now.
  •  I am going to get your x-rays now as the doctor requested.
  •  As the doctor requested I am going to get your x-rays now."

The hygienist will not want to ask permission. That is just saying to the patient that it is not really a required treatment but optional, and that is why the hygienist is asking permission.

Of course there will always be exceptions to the office protocol and those patients that respond back with some of the following comments:

"Will my insurance cover them?"  “Mr. Jones, we cannot be sure that your insurance company will cover them. You have to keep in mind that dental insurance isn't really insurance at all. It is actually a money benefit provided by your employer to help you pay for routine dental treatment. Most benefit plans are only designed to cover a portion of the total cost. However, many insurance companies do cover x-rays because they are considered preventive treatment. The doctor has determined that for clinical reasons we need to have these x-rays taken. Without them we will not have all of the information we need to be able to make a thorough diagnosis." This and many other questions are answered in the pamphlet, “My Insurance Covers This RIGHT?”  Any time a patient questions if insurance will cover something it is best to educate them about why the treatment is needed and about insurance. Handing a pamphlet to them in addition to verbally explaining to the patient is a great way to approach the questioning patient.

Another scenario may be, "Mr. Jones, I am going to get your x-rays now as the doctor requested." "Why do I need x-rays? I don't need x-rays. My old dentist never took these x-rays"  "Well, Mr. Jones, I cannot answer for your previous dentist, but we want to make sure that your bone levels are healthy, your teeth are cavity free, and that you are dentally healthy. Without these pictures we will not be able to perform as comprehensive or thorough exam." 

This verbiage is designed that you may modify the above words and find the conversation that best suits you.

The recommendations set in your office protocol are subject to clinical judgment and may not apply to every patient, but it is a good  script to go by for the entire office, and a good place to start when it comes to determining if patients are due for x-rays and how to approach the objective patient.

If you are interested in enhancing the skills of your hygienist or having Jean speak to your study club or dental group email

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