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7.4.08 Issue #330 Forward This Newsletter To A Colleague
Strategies for Practice Success
Hygiene Paradigm Shifts
Dentist Coach

Seven Strategies For Success - Part One
by Sally McKenzie CEO
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When was the last time you sat down and really thought about what you want out of your practice? Oftentimes, the further we move into our professional lives and daily routines, the further we move away from the dreams that once fueled us to push through challenges in pursuit of our goals.

Certainly, our dreams and definitions of success change throughout our lives. How do you define success? Is it a full schedule with zero cancellations and no-shows? Perhaps it’s working three days a week. Maybe your definition of success is breaking the million-dollar mark in practice revenues. Or maybe you would consider it a success to get through one day without a major team blow-up.

Whatever your idea of success is, to achieve it in the dental practice you will need a few key components. Many of these are tangible, such as a solid hiring procedures, clear job descriptions, effective practice systems, etc., but there are a few other areas that have a powerful impact on your success. I call them the “Seven Subtle Strategies for Success,” and they start with simply being curious.

#1 Ask and You Will ReceiveValuable Information
Quiz your team regularly about what they believe can be improved and pay close attention to what they tell you. What can the practice do better? What seems to irritate or frustrate patients? Where do bottlenecks occur and how can you fix them? Chances are very good that patients will make comments to staff that they wouldn’t make to the doctor. The team is your eyes and ears into what does and doesn’t work for the patients and the practice. While you’re at it, periodically ask patients directly what they think.

A straightforward patient questionnaire is the most cost-effective and efficient tool that practices can use to provide patients with an outlet to give feedback and raise concerns long before they become serious problems. Surveys are a means of gaining valuable feedback and insight from your “customers.” I recommend surveying staff routinely and conducting patient surveys once every 12 to 18 months.

#2 Just Say No to Status Quo
Take note: 80% of practices are losing more patients than are gaining new patients. Far too many of you assume that long-term patients will continue to return, will raise questions and will inquire about treatment options without your prompting. You fall into the “routine” trap and don’t take advantage of the fact that the routine appointment is one of only two contacts the patient will probably have with the practice during a 12-month period. Make the most of your routine.

Seize this opportunity to find out about what’s on patients’ minds from an oral health standpoint. Do they have questions about new treatments they’ve seen in the news media? Perhaps you and your team have recently participated in continuing education programs that will benefit your patients. Tell them! Educate them about services. Share your information, your time and your knowledge. You and your team are involved in a constant cycle of patient education. Talk to them and listen to them.

#3 Open Your Ears, Close Your Mouth
Listen, listen, listen. Everyone—patients and coworkers alike—wants a chance to be heard. Stop what you are doing, look at people when they are speaking and listen to what they tell you. If you’re too busy focusing on what you have to say to people, you will miss valuable opportunities to learn more about their needs, wants and expectations. While you’re listening attentively, pay attention to your body language; you don’t have to say a word to convey some very clear, if perhaps unintended, messages.

#4 Build Trust, Not Turmoil
Gossip is poison in any practice. In some, it runs rampant and leaves a wave of conflict and destruction. In others it’s a trickle that slowly and painfully wears away the infrastructure of the team. It is fuel for misunderstandings that quickly lead to anger and distrust. It can create such strain that some employees find it simply impossible to work together. And if you think patients don’t sense the tension or notice that every time they come into your office there is yet another new face, you’re kidding yourself. You cannot achieve success if you allow members of your team to continually undermine one another. Insist on a code of conduct based on communication, understanding and respect.

Next week, three little things that make a huge difference.

Interested in speaking to Sally about your practice concerns? Email her at
Interested in having Sally speak to your dental society or study club? Click Here.

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Angie Stone RDH, BS
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Is Your Hygiene Department Embracing the Shift?

As the days and years go by, new research in the medical field comes forth, resulting in new recommendations. Two recommendations that come to mind are those of cholesterol levels and blood pressure readings. Remember when it was ok to have cholesterol levels over 200? Now, over 200 is considered borderline high. No longer is the total cholesterol number looked at alone. The number is now broken out in HDL and LDL numbers. There has been a paradigm shift regarding cholesterol levels.

Remember when blood pressure readings were within normal limits as long as they were under 140/90? Now normal is less than 120/80. 120–139 systolic reading and 80–89 diastolic readings are considered pre-hypertension. This represents a paradigm shift in blood pressure recommendations as well.

The dental profession has not escaped paradigm shifts either. Consider the treatment of occlusal caries. Previously, caries on occlusal surfaces would be watched until an explorer could be plunged into the occlusal grooves and then the decay (and healthy enamel) would be amputated with a high-speed hand piece and the hole would be plugged with amalgam. Today dentistry and patients benefit from technology such as laser caries detection, which can detect cavities well before an explorer can detect decay, the preparation of the carious tooth with micro abrasion and the placement of resin restorations. This paradigm shift is being made across the country.

There have also been enormous shifts in periodontal paradigms. The soft tissue management paradigm shift occurred in 1985. At that time, there was a void in the general dentists' treatment of periodontal disease. No treatment was rendered for the population that needed more than a prophy but did not require surgery for advanced disease. The shift closed this void by providing soft tissue management to patients exhibiting early stage periodontal disease. No longer were 5–6mm pockets “watched” until they got deeper for referral to the periodontist for surgery. Scaling and root planing of these pockets began taking place in the general dental practice.

Today dental hygiene is undergoing another paradigm shift as a result of current research. No longer should hygienists overlook bleeding tissues. No longer should patients be encouraged every six months for years on end to “floss more” with no resolution of bleeding. Current research supports proactive treatment of 4mm bleeding pockets; however, seasoned hygienists across the country are struggling with this shift. This is happening because whatever hygienists learned in their formative years is what sticks in their minds. Most people find it impossible to let go of their old paradigms and mind-sets.

Bill Landers, president of Oratec, said, “Sadly, it takes usually a generation or more for paradigm shifts to be fully accepted and integrated, not so much because the new ideas replace old ones, but because the holders of the old ideas start dying off. There’s a gradual transition as the new generation grows up with the knowledge of both old and new paradigms and can choose one or the other without having to abandon the old for the new. Some psychologists think we are genetically programmed against radical change. Most organisms thrive in a homeostatic environment where everything is the same all the time.”

That said, how can hygienists make the shift from beginning periodontal conditions at 5mm bleeding pockets to beginning it at 4mm? Change begins in the mind of hygienists. So, first and foremost, they need to be re-educated in interceptive periodontal theories. New textbooks need to be reviewed; current periodicals need to be read; up-to-date continuing education courses need to be attended. McKenzie Management’s Hygiene Enrichment Program provides this kind of education. With the awareness of new research, it is easier for the mind to let go of old ways of thinking. Once hygienists are confident that what they are proposing to patients is in their best interest, they will be successful in re-educating them.

Discussing periodontal disease with patients of record is always the most difficult for the hygienist. The question is always, "How do I tell Mrs. Jones that she has this gum disease when I've been treating her for years?" This is where scripts come in to play. Most often times saying something as simple as, “The research shows…,” or, “We now know about the connection between periodontal disease and heart disease <diabetes, etc.>. As a result of this new knowledge, we now treat this disease differently.” This conversation can be supported by giving the patient a newsletter developed by the doctor and/or hygiene department, pamphlets, articles, etc. that support what the hygienist has discussed. Patients are hard-pressed to decline recommendations when they are given researched-based information. Just as the hygienist needs to be educated about new research and treatment recommendations, so do the patients.

Dental hygienists need to decide that it’s time to push the current paradigm shift to ensure continued improvement in the oral and general health of the patients they serve.

Interested in knowing more about how to improve your hygiene department?

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Dr. Nancy Haller
Dentist Coach
McKenzie Management
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For a Roaring Practice, Get Some Tiger in Your Tank

An avid golfer and a San Diego resident, I was fortunate to attend the U.S. Open at Torrey Pines a couple of weeks ago. If you were there too, or if you viewed the telecast (even non-golfers tuned in!), you saw an amazing feat.

That Tiger Woods took home his 3rd U.S. Open trophy, won his 14th Major and 65th PGA Tour victory is indeed impressive. But true awe came two days later when we learned the extent of his injuries. He triumphed with a torn anterior cruciate ligament in his left knee and a double stress fracture in his left tibia! What he accomplished was small in comparison to what he overcame!

You may not be a golfer but you can learn a lot from this icon about putting some roar in your practice, especially in these turbulent economic times. Just like elite athletes, the ability to stay the course, especially in the face of obstacles, is what makes leaders great. Perseverance is the ultimate "stick-to-it-iveness" that breeds success.

What’s interesting is that we are all born with incredible perseverance. You would never have learned to walk if you didn’t get up and try it again, and again, and again. As children the only failure we knew was when we stopped trying.

Unfortunately, as humans age, we tend to give up too soon. Perhaps it is because we fear rejection or take it personally when someone discourages us. Maybe you were taught that it was wrong to take a stand, especially in the face of resistance. Perseverance and failure cannot coexist. Failure happens when you quit.

For example, the dental world is full of those who "tried" to get a practice going. After meeting with difficulty or rejections, they quit. They accepted failure and faded back into the crowd, never to be heard from again. The worst part is not that they quit their practice, but that they quit themselves.

Why should succeeding at a leadership be any easier than learning to ski or to playing the piano? We are likely to stumble at first. It's part of the learning process. Ultimately, people who persevere through the stumbling process learn enough to become successful. It's staying with it that separates the successful from the "wannabes." Remember the words of Vince Lombardi: "We never lost a game; we just ran out of time."

What’s your perseverance score? How are you currently equipped to persevere in pursuit of your dreams?

Answer the following questions on a scale of 1–10, 1 being “not at all" and 10 being perfect:

  1. Self-confidence and self-image: Do you believe in yourself?
  2. Independence in thought and action: Can you go against the crowd when you know they are wrong?
  3. Clarity of purpose and intensity of passion: Do you really know what you want? How hot is your fire?
  4. Integrity: Do your actions match your beliefs?
  5. Honest with yourself: Are you willing to address shortcomings?
  6. Ability to focus: Do you finish projects you start?
  7. Resilience: Do you bounce back quickly from disappointments?
  8. Adaptability to change in circumstances: How well do you adjust to surprises?
  9. Health: Do you have good stamina? A high energy level?
  10. The supportiveness of your family, and of your social and career environment: Do the people around you support you in your efforts to reach your goals?

Add up your scores. If you fall below 55, focus on your strengths first—the things you are doing well. Then, look at areas for development (the lowest scores).

If you fall between 56 and 69, you’re honest and that’s a good start. Now get started! What will you do to bring up your lowest category?

Did you fall between 70 and 84? If so, you’re in good shape. Identify where you can do a bit of “fine-tuning” and take your perseverance to the next level.

If you score between 85 and 94, congratulations! You are doing things right. Just don’t get complacent.

If you are between 95 and 100… well, keep up the great work! Your perseverance is at a Tiger level.

And in the words of Tiger Woods, “It’s about dealing with it and getting up there and giving your best, and seeing what happens. And there’s never any excuse. You just go play.”

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.

Interested in having Dr. Haller speak to your dental society or study club? Click here.

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