08.11.06 - Issue # 231 Forward This Newsletter To A Colleague
The Good Boss
Employee Lies
Patient Rapport

Good Boss or Bad Boss? Find Out
by Sally McKenzie CEO
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So you’re the Boss. It’s not exactly an enviable position. After all, you have to be chief production officer, human resources expert, interpersonal relations guru, and while you’re at it, you also have to lead, inspire, motivate, reward, and discipline. Oh the joys of being in charge.

With all of the responsibility associated with being the Big Kahuna how do you know if you’re a good or bad boss and why should you care? Staff turnover is probably one of the clearest indicators. If yours is a revolving door team, chances are that you’re not exactly an easy person to work for. And putting an end to constant turnover in the practice is reason enough to care about your skills as a boss.

Improving your leadership abilities enables you to build a much more cohesive and successful team. Not that you have to be Dr. Pushover, in fact, most effective bosses are solid “tough love” supervisors. They provide clear guidelines, necessary training, plenty of praise, and corrective measures when necessary.

Answer a few questions and determine if you can be counted among the “good bosses.” 

Do you create an environment and a culture for success? If so, you set clear, challenging goals and specific expectations for your team. You explain the “why” behind the “what.” In other words, you don’t just tell employees what to do but you clarify why their responsibilities are important to the overall success of the practice. You monitor the team’s progress in achieving goals through regular staff meetings, system checks, and performance reviews. You celebrate and reward success.

Do you set your employees up to succeed? If so, you work with individuals and the team as a whole to define realistic goals that encourage the team to work at peak performance. You also invest in training for employees to maximize their potential.

Do you establish clear standards? If so, there is a code of conduct in the office, specific office policies, and business standards that everyone must follow.  

Do you communicate clearly and specifically? If so, you don’t make general comments about an issue and assume that someone will just pick up the ball and run with it. You recognize that if you don’t communicate your desires clearly no one can be held responsible except you when those desires aren’t met.

Are you decisive? If so, you make the decisions that have to be made, even when they are difficult. Too many dentists will hold off on critical decisions, such as firing an employee who is bringing down both the team and the practice. They want more time to study, to evaluate, to consider. Certainly, a major decision such as terminating a staff member requires careful evaluation, but too often the doctor simply continues to look the other way burdening the team and compromising the practice. As the owner of the practice the team depends on you to make the tough decisions.

Is listening a part of your management strategy? If so, you seek input from the team. The good boss realizes he/she doesn’t have all the answers just because her/his name is on the front door. Your practice culture should welcome and encourage open communication – bad news as well as good news. Listen and learn from your employees, encourage their input and use the collective intelligence of the group to address system problems and concerns.

Are you honest with your team and do you provide ongoing constructive feedback? Feedback is the pixie dust of your practice creating high performance magic. Be generous with your positive feedback, ensure that it is sincere and, if possible, given in front of others. Be constructive with your negative feedback. Provide it in private and use it as a precise instructional tool in which you are carefully carving out your perfect employee, not as a hammer in which you’re going to smash both the problem and the employee’s self esteem to smithereens. Don’t mix positive and negative feedback. The employee will only focus on the negative and the positive will mean nothing.

Like dentistry, supervision is hard work. Becoming a good boss requires that you are conscious of your behaviors, your strengths and weaknesses, and how you relate to each member of your team. At the end of the day, take a few minutes to evaluate yourself as a boss. Answer the question, would you have wanted to work for you today? 

Interested in speaking to Sally about your practice concerns?  Email her at sallymck@mckenziemgmt.com.

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

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Dealing with Employee "Lies"

Dr. Nancy Haller
Dentist Coach
McKenzie Management
coach@ mckenziemgmt.com
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In a perfect world, everyone would tell the truth. But at some point you will be confronted with an employee who lies. It may not be as scandalous as Floyd Landis’ protestations of innocence, but it’s important to have a plan about how you will deal with the untruths that pass through your office.

A study of more than 2,500 workers by CareerBuilder.com showed that about 13% of American workers show up late for work at least once a week, and about 25% are late at least once a month. Of those numbers, one in five people said that they make up lies to tell their boss.

The range of potential lies varies from failure to follow policies or rules, to excessive tardiness, to theft. Separate lies from fibs. That is, some lies aren’t worth a second thought. I’m talking about good performers who occasionally stretch the truth to save face and protect their relationship with you. Their claims of ‘traffic was heavier than I expected this morning’ should be dismissed if it happens only once in a while.

Unfortunately not all lies are so harmless. How about the chronic offenders? The employee who is constantly late and always has an excuse? The person with the routine flat tires or the alarm clock that fails on a regular basis? If you dismiss those ‘lies’, you give permission for him/her to take deception to a new level. 

Indeed there are two categories of serious lying that you need to confront – serial but inconsequential lies, and big lies. Intervening early is the key to both.

  • Be direct. Encourage your staff to be honest with you, to tell the truth, even on trivial issues. Only then will you be able to trust them on larger matters.

To the employee who always offers excuses, consider the following:
“Jane, I have a hard time believing what you are telling me. You're chronically late and you continue to tell me that traffic was heavy (or you had another flat tire, or your alarm didn’t go off, etc). No one can have that much bad luck. Now, tell me what's really going on. Perhaps together we can fix the problem. I want to help you but I need to know the truth.”

  • When you suspect a lie of a larger magnitude, investigate first.

Only in a true emergency should you act without thorough planning. It may take time and resources, but it’s important that you gather the facts and determine what action is necessary before talking to the employee. If the offense is serious, get guidance from a legal perspective.

  • Once you know the details, prepare.

Think through what you want to say to the employee and in what sequence. Practice by role playing. Anticipate the likely reactions and responses. Know your own communication style, how you are perceived, and how you will react in the event of a challenge or emotional outburst. Knowing what you intend to cover in a face-to-face meeting and sticking to the agenda is much easier if you have planned in advance.

  • Confront the employee privately. Have a witness.

Identify the problem as you understand it. Be brief but specific. Then offer the employee an opportunity to present their side. There may be a factor you didn't know about that will help the two of you to solve a problem jointly. Refusing to listen just builds resentment and makes improvement difficult. Be fair to the employee. Consider his or her side of the story and any evidence submitted. Never criticize the individual, but rather focus on the actual behavior. Avoid using the word ‘liar’ as it will enflame the situation. Advise the employee of the consequences of his/her actions. It may be a suspension, or even a termination.

  • Document.

There often is a misunderstanding about what and when to document. All disciplinary infractions should be recorded in some form. For minor, first-time offenses, write a note to remind yourself. The employee need not know about this, and it does not require formal entry into a personnel file. If the problem reoccurs or if it is a serious offense, be sure to formalize the process by having the employee sign the document. 

  • Be confident you made the right decision.

Lies are difficult to deal with. You are going to feel drained. Give yourself credit for having the courage to tackle a difficult situation. And remember, if you want to minimize your staff lying to you, never lie to them and always deal with lies when they happen. 

If you are interested in improving your performance as a “boss”, Contact Dr. Haller at coach@mckenziemgmt.com.

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

Building Patient Rapport

Jean Gallienne RDH BS
Hygiene Consultant
McKenzie Management
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Remember when you were a kid in school? You would go back to school after summer break and there would be new children that had moved into your area over the summer. How cool! A chance to make a new friend. You didn’t just push your way into their lives. You got to know them and to see if they were the type of person you wanted to run around with.

Well, nothing has changed over the years. The only difference now is that being the new kid is at work. Whether it is because you are a new hygienist to the practice or a patient is new to your practice. Building patient rapport is imperative.

Many hygienists will start at a practice and want to impress the doctor by treatment planning root planing, placing chemotherapeutic medicaments, or taking x-rays. That is great as long as the office protocol is being followed, and patient rapport is present.

I would like to tell a story about a patient that had been going to the same dentist for many years and really enjoyed the practice and the hygienist he had been seeing. One day he went in for his periodontal maintenance appointment and the new hygienist performed a periodontal probing. She immediately told him that the probings were deeper in the maxillary posterior teeth and that he would need root planing in these areas and multiple sites would need to have a chemotherapeutic medicament placed. He immediately explained to her that his home care had not changed at all, and he felt he was still doing the excellent home care that he had been doing in the past. He also asked why the pockets had gotten deeper. The hygienist did not have an explanation for him. Then he proceeded to ask the doctor, and the dentist’s reply was that he was getting older.

Then when he spoke to the financial person, four quadrants of root planning were treatment planned instead of two. The patient questioned why and the financial coordinator said that is what usually is done. He explained to her that he was only told two quadrants of root planing. The financial coordinator stated that they would start with the upper teeth and just keep the other ones on the treatment plan just in case.

The patient was very upset and frustrated with the practice he had been going to for so many years. Neither of these explanations were adequate to the patient. Therefore, he did something he never thought he would have to do. He sought a second opinion, and actually considered changing dentists.

How many patients do you lose because of this exact scenario? It could be more than you think.

Patient rapport is so important to build before presenting an involved treatment plan. Sometimes this happens immediately and other times it has to be developed.

 For instance, if the new hygienist would have explained to the patient, “Mr. Jones, in the years we have been treating you, we have been monitoring the condition of your mouth at each recall appointment. Although you have been brushing and flossing, there are areas that are continuing to show signs of infection and we are concerned that without treating these areas they will continue to get worse. (This is the perfect time to pause and see how the patient reacts.)

 This pause allows the patient time to react and possibly make a statement.

They may ask,” What do we have to do and when can we get started?” Great! You have patient rapport. Treatment plan the case and get started as soon as possible.

They may not say anything and give you a questioning look. You may not have built the patient rapport needed to get patient acceptance when it comes to the treatment plan, and it may be best to delay treatment.

The patient may ask, “Why have my pockets changed?” If this is the case, you do not quite have the patient rapport yet and it would be best to answer all of their questions and to possibly delay treatment. After answering their questions, the following information may be given just before dismissing the patient.

 “Mr. Jones, with your commitment to home care we may be able to experience improvement in your condition and see the infection decrease. If not, we will want to root plane the areas that are still infected. So, I will make a note in your record to evaluate your gums at your next periodontal maintenance appointment. If they are still in the same state of infection we will go ahead and have you back for root planing.” Now is the perfect time to go over home care and any specific home care regiment. Yes this delays treatment. However, we can treatment plan till our faces are blue, but if our patients end up going elsewhere or do not accept treatment it is not helping the patients or the practice grow.

Another way is to only treatment plan the two quadrants that this individual patient needs, do the two quadrants, and at the last quadrant appointment just mention, “Mr. Jones, we have finished root planing the two areas. We usually get good results by your good home care and the therapy we have provided. However, if the root planing does not give us the healthy results we want we will place a chemotherapeutic agent in the pockets at the re-evaluation or periodontal maintenance appointment. Should you ultimately need any surgical procedures, they are usually less involved because your gums are in much better health.”  Depending on what your office protocol is when it comes to treating periodontal patients will decide when and what the next appointment will be. 

Whether you are the new kid on the block or the patient is the new kid on the block, you will want to take the time to get to know them and allow them time to get to know you. Establishing patient rapport will help increase your over all patient retention.

Interested in knowing more about how to improve your hygiene department? Email hygiene@mckenziemgmt.com.

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

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