12.16.11 Issue #510 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Is Being "In Charge" Worth the Stress?
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. Is it any wonder that many dentists struggle with this unenviable role?

They bumble along on a trial and error course. Some strategies work for a while and then suddenly seem to fail altogether.There's no explanation as far as you can see for what works and what doesn't. The only thing you know is that you didn't sign onto this dentistry gig just to continually worry about who's going to serve up their two-week's notice next, to be mediator between the warring factions on the team, or manage one patient complaint after another.

Certainly, life as the Big Kahuna is not easy. There are enormous expectations and demands. Far too many dentists experience and cause an enormous amount of stress in their practices because they have never been trained to lead their teams. While a few are natural born leaders, the vast majority spend far too many years and waste tens of thousands of dollars trying to simply figure it out as they go along. Answer the questions below andconsider honestly if you are a significant contributor to stress and anxiety in your own practice.

Has one or more of your employees left for another job in the past 12-18 months? If employees seem to come and go with the seasons, 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 the leader of your team. Improving your leadership abilities enables you to build a much more cohesive and successful team.

When it comes to working effectively with staff, the most successful bosses are solid “tough love” supervisors. They provide clear guidelines, necessary training, plenty of praise, and corrective measures when necessary.

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.” You don’t just tell employees what to do; 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 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 avoid making critical decisions, such as firing an employee who is bringing down both the team and the practice. 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.

Is listening a part of your management strategy?
If so, you seek input from the team. Listen and learn from your employees, encourage their input, and use the collective intelligence of the group to address system problems and concerns.

Do you provide ongoing constructive feedback?
If so, you are generous with your positive feedback, you ensure that it is sincere, and when possible, you give it in front of others. You are constructive with your negative feedback. You provide it in private and use it as a precise instructional tool. You don't mix positive and negative feedback because the employee will only focus on the negative and the positive will mean nothing.

Like dentistry, being the boss is challenging. Just as maximizing your skills as a superior clinician requires ongoing training, oftentimes achieving your full potential as a leader requires additional training and assistance as well.

Want more of me? Click here to visit my blog, The Lighter Side, for more Dental Practice Management info.

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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Carol Tekavec, RDH
Hygiene Consultant
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What I Read on AOL
By Carol Tekavec, RDH

Last night I was reading some news articles online, and came across one about dental disease being related to heart attacks and stroke. I'm always interested in what is being published about dentistry in non-dental sources, and went straight to the article. In laymen's terms, it covered current thinking about bacteria and inflammation in the mouth being related to many types of systemic diseases. It was factual, straightforward and easy to read. I was curious about reader comments that might have been posted, and scrolled down to see what people had to say. What I read was upsetting and really sad.

 Over 50 people had taken the time to attack the information in the article for a variety of reasons.  Several said it was “ADA propaganda” designed to get the poor unsuspecting public to rush to their dentists for unneeded dental treatment. Others began going off topic by relating their past dealings with dentists concerning demands for payment up front, unwillingness of the office to help with insurance, sub-standard care, and general “greediness” of the dental profession. One poster spent three paragraphs talking about a dirty office!

It is a fact that many people who post on websites may be doing so because they are angry for some reason. Happy posters don't post as often. But it remains concerning that so many people vented their outrage on an AOL site. I worried, was one of them a patient I had seen? Was one from an office with a dentist and staff I knew? Were the complaints that were listed true? If they were true - then what, if anything, does that mean for our own practices; where we are all trying hard to take care of patients appropriately AND stay in business?

At the very least, the article highlighted some topics that we might be able to address with our own patients, hopefully in such a way as to encourage understanding and trust.  Let’s look at the allegation of “ADA propaganda.” Dental professionals have long known about the relationship between oral health and systemic health. Now that the connection is getting more publicity, the general public is hearing more about this. It is far from “ADA propaganda.” Therefore, it might be worthwhile to post something on our practice websites explaining this association and how it works, such as the following article: Chronic Illness is Related to Mouth Germs. What you Need to Know.

In addition, when patients are in your chair, bring up the topic and tell them what you know.  As a hygienist, I mention the “mouth/body” connection with each and every one of my patients.

Concerning demands for payment up front; does your office provide information about financing? Payment plans? Short term “no interest” loans with a local bank? Care Credit? All of these can help your patients accept your treatment recommendations more readily. Simply demanding payment up-front may push potential patients right out the door. This does not mean that you should let payment slide or back away from definite arrangements. It just might be helpful to assist your patients in finding a way to get the care they deserve in the easiest way possible.

Unwillingness to help with insurance is a non-starter in these tough times (which does not mean that you must be at the mercy of the dental insurance industry!) While it may not be fair that your patients are expecting you to explain their dental benefits and file claims for them (or at the very least, provide them with the information to do so themselves), it is a fact that most people have little understanding of their benefits and how they work. Again, an insurance article on your website or a print-out taken from it and given to a patient can be a big help. In addition, address this with staff at your next meeting. Talk with all team members and come to an agreement about what to say and how to say it.

What about greediness? We have to face the fact that many of our patients believe they are paying too much for their dental treatment. Twice a week I have patients ask me why dental care is so expensive. I tell them that dentistry is expensive because all treatment, restorations, and replacements are personal and tailor made just for them. If a person could buy a mass produced, ready-made crown at Walmart, like a pair of sneakers, it would likely not cost much. I also comment on the long-lasting nature of any “good” dental restorations they already have. I mention that it would be amazing if they were still wearing a coat that they had received when they were ten years old! Many 40-year-olds have first molar restorations that have lasted just that long.

Sub-standard care? It goes without saying that your office is not providing sub-standard care! Stand behind your treatment and follow-up on any problems your patients mention.

Lastly, no office should be “dirty.” Sit in your reception area and look at the condition of the carpet, flooring, chairs, tables, and plants. Imagine that you are entering your office for the first time. Sometimes we become so accustomed to seeing that little stain by the front door, the less than healthy looking plant, or the dead moths in an overhead light fixture, that we really no longer “see” them. The front area must be immaculate and cleaned daily.  Be sure the bathroom that patients use is super-clean as well. Many patients equate a clean bathroom with clean treatment rooms. And finally - evaluate your treatment rooms. Clean counters, chairs, overhead lights, chair lights, and flooring is a must.

We all want our patients to be pleased with their treatment and happy with their experiences in our offices. We don't want our patients to be venting their frustrations on AOL!

Carol Tekavec RDH is the director of Hygiene for McKenzie Management.  Carol can improve your hygiene department in just one day of training “in your office.” Interested in knowing more about how to improve your hygiene department?  Email hygiene@mckenziemgmt.com.

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Nancy Haller, Ph.D.
Leadership Coach
McKenzie Management
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You Can't Afford to Tolerate Bad Behavior
By Nancy Haller, Ph.D.

Overwhelmed by the constant bickering and low morale in his office, Doctor Smith called me. During the conversation I heard all about how Suzie Jones had created a toxic work environment. She pushed the limits with her comments and behavior for years. Her actions conveyed an over-valued sense of importance. Co-workers were resentful and repeatedly complained about this prima donna. It didn't surprise me that there was turnover in the practice.

Doctor Smith didn’t know what to do to rectify the situation. I asked him why he hadn’t terminated Suzie. He replied, “She’s the Office Manager. She has a lot of experience. And she’s been with me for five years. She does a great job at insurance and billing. I’d be lost without her.”

Perio DiseaseWhile I understood the frustration and fear, the real issue was Doctor Smith's narrow view. Certainly Suzie Jones had a ton of knowledge about the practice. But, when bad behavior is ignored, it's like a cancer that metastasizes. According to studies, 68% of employees and customers will quit or leave a company because of one employee's bad behavior. Factor in the turnover you experience when you lose those employees, and it may cost 150% of each salary.

Can you really afford to ignore even one negative comment on your team? Are you willing to let one employee bring down the rest of your staff or chase away patients…especially in today's economy?

It is uncomfortable to confront bad behavior. And you don't want to take it lightly. Therefore it's important to plan and prepare for a smooth dismissal if that's what is necessary. The first step is to schedule a serious and formal conversation that is done privately. The best location would either be in your office, with the door closed, or in a neutral setting like a conference or break room.

Communicate expectations clearly in terms of performance and behavior. For example, emphasize that while she has excellent “technical” skills, Suzie also needs to have positive interpersonal behavior such as helpfulness and cooperation with co-workers. As the Office Manager, she must build team identity and handle situations with diplomacy and tact. This requires listening well and seeking mutual understanding. Although she does not need to “like” everyone on the team, she absolutely must be respectful…no matter how upset she is.

Identify the gap between expectations and observed behavior. Be specific by focusing on changeable actions. For Suzie these might include rolling her eyes when team members ask questions or suggest ideas, coming back late from lunch, making personal phone calls or surfing the internet during work hours, or talking in a loud and demeaning tone to others. Stay focused on what Suzie says and does in the most concrete descriptions.

Clarify the rewards of meeting the expectations - i.e. job security, future opportunity, appreciation and value to the practice. Be sure to express your appreciation to Suzie and emphasize what a great job she does with insurance and billing. Let her know that you want her to continue to work with you and that she needs to make changes in her behavior.

Spell out the consequences of not meeting expectations. Voice concern to Suzie that the way she has treated co-workers suggests that she is not happy. Underscore that you want her to feel satisfied and to enjoy her job. Avoid ultimatums. Focus on the impact of poor performance, to the team and ultimately to the employee.

Allow the employee an opportunity to choose his/her own path. One road leads to rewards, and the other leads to new adventures - including the option to leave. Your practice may not be the best place for Suzie if she can't get along with the other members of the team. Be truthful and kind as you lay out the choice.

Inform the employee that you will support him/her in whatever they decide. Convey that the choice and the responsibility ultimately belongs to Suzie.

Confirm that the employee understands your expectations and that you will do your part by supporting her and holding her accountable.

Once you have had this discussion, document it and put your notes in the employee's personnel file. If it's necessary to have a second conversation about poor performance, be sure to have the employee sign the written warning. Then empower the employee to create his/her own destiny. Their actions will signal their "choice." Show support. Reward them for progress, or release them from a situation that neither party is happy with.

It's never easy to let someone go, but it is the right thing to do if that's the employee's "choice." By following the above guidelines, your team will respect you for fair and decisive leadership.

Dr. Haller provides training for leadership effectiveness, interpersonal communication, conflict management, and team building. If you would like to learn more contact her at coach@mckenziemgmt.com

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

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