3.8.13 Issue #574 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Fall In Love All Over Again...with Dentistry
By Sally McKenzie, CEO

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Wedding season will soon be in full swing. While love may be in the air for couples, for many dentists, the strain of running a practice has them taking vows of a very different kind. Certainly, we all have bad days, bad weeks, and even bad years. The stress can pile up to the point where you feel trapped in the daily grind, living for the weekend, and just waiting for the moment you can afford to retire.

Maybe it’s time to start loving what you do today, rather than wishing for tomorrow. Consider the fundamentals: Does your practice give you the financial resources and the time to enjoy your work, your life, and your family? Second, and perhaps the most important question: If you could do it all again, would you choose this career path? If you answered “no” to either or both of the questions above, it’s time for change.

Evaluate what you want. If it’s a more successful practice that will provide you with the resources to achieve greater enjoyment from both your work and your personal life, I can assure you that you have the power to make that happen. If you are questioning your career choice, I am willing to bet that it’s because you pursued dentistry to be the dentist in your practice, not the VP of Human Resources, not the collections police, not the office counselor, not the chief rule maker, etc.

Consistently, we find that dentists who are the least satisfied professionally and personally have the weakest practice systems. They resign themselves to unhappiness and dissatisfaction because they either don’t realize that they have choices, or in some cases, are afraid to make different choices. And in those practices, I can assure you that nobody is feelin’ the love.

Let’s look at the areas that are most likely to have you considering a “professional divorce.”

  1. Employee Headaches
  2. Scheduling / Production Inconsistencies
  3. Collections Concerns

Those three affect multiple systems, and are commonly the source of a whole lot of heartache. Let’s look at #1 on most practitioners’ “No Love Lost Here” list: Employees. Consider this – it’s not necessarily the people, it may well be the place. Let me explain. The happiest teams and most satisfied doctors have the healthiest practice cultures. Coming to the office isn’t dreaded, and the team members genuinely respect each other. Sound like the stuff fairytales are made of? You won’t get this by wishing on a star; you have to create it. Disagreements arise in every practice, but when they are dealt with according to a clear set of conflict management strategies, the team knows that they can respectfully disagree.

Managing conflict begins with establishing specific standards for professional office behavior. Destructive personal attacks among team members simply cannot be tolerated. Moreover, every office must have clearly established office policies and follow them. Below are a few do’s and don’ts to build a stronger, more effective team in your practice.

Don’t ignore problems. Set aside time to address matters that cause conflict. Remember, conflict often begins with a minor disagreement, annoyance, or misunderstanding. Jane isn’t providing the production reports as promised. Anna is walking in late routinely. Chris is scheduling 60 minute patients in 40 minute slots.

Don’t react emotionally and judge, criticize, or attack. Emotional reactions tend to occur when there is no system for addressing conflict and the situation deteriorates into a destructive exchange that can lead to irreparable damage.

Don’t make excuses for ignoring conflict. She’s too nice. He’s too argumentative. They’ve been doing it that way forever.

Do identify those issues that commonly trigger conflict. Do talk to people not about them. Do focus on addressing the issue rather than proving who is right or wrong. Do admit when you are wrong. Do choose to be a problem solver. Do make the effort to address the issue calmly and long before it grows out of control.
Consciously working to shape the culture of your practice will not only profoundly impact the team that you work with day in and day out, it will directly affect patient retention and referrals. Your patients want to be cared for by a team of happy people who like and respect each other. If there’s tension, patients know it. It blares like a trumpet, and so will they when they are telling people about your practice. Make sure they are singing a love song instead.

For more information on this topic, visit my blog: The Lighter Side

Interested in speaking to me about your practice concerns? Email sallymck@mckenziemgmt.com
Interested in having Sally McKenzie Seminars speak to your dental society or study club? Click here.
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Nancy Haller, Ph.D.
Leadership Coach
McKenzie Management
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Which Wolf Are You Feeding?
By Nancy Haller, Ph.D.

There is a Native American parable about an elder Cherokee chief. He took his grandchildren into the forest, sat them down and said to them, “A fight is going on inside of me. This is a terrible fight and it is a fight between two wolves. One wolf is the wolf of fear, anger, arrogance and greed. The other wolf is the wolf of courage, kindness, humility and love.”

The children were very quiet and listening to their grandfather. He then said to them, “This same fight between the two wolves that is going on inside of me is going on inside of you, and inside of every person.” They thought about it for a minute and then one child asked the chief, “Grandfather, which wolf will win the fight?” He said quietly, “The one you feed.

The story is simple and true. The Evil Wolf or the Good Wolf is fed daily by the choices we make with our thoughts. What you think about and dwell on will influence your behavior.

The human brain produces approximately 70,000 thoughts on an average day. Not all of these thoughts are useful, and we certainly don’t act upon every one. We filter out those that we consider to be ‘useful’ and we disregard others. So essentially, we choose which thoughts we listen to. From time to time we all experience negative thoughts as well as angry or depressing feelings. Ups and downs are a part of life. But overall, do you see the best or the worst in situations?

I talked with a Doctor last week who is living in a constant state of fear - mostly the fear of financial insecurity/business failure. Although he’s financially comfortable - always has been and in all likelihood always will be - he thinks about how much money he has and how much money he’s likely to have next year, in five years, in ten years, and beyond. This may not sound so bad except he’s in a constant state of anxiety, which has made him a pretty unhappy person. He worries whether his practice will stay afloat. You can imagine his impact on the dental team! He’s definitely feeding the ‘bad wolf’.

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. We are wired for survival, so it makes sense that a part of us serves as a protector. But be careful about attributing intentions to other people. Although our prefrontal network of neurons attribute intentions routinely, they are often wrong. Most of the time you are just a bit player in other people's dramas. In other words, it’s often not about you but all about them!

The starting point toward feeding the good wolf 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.

Feeding the good wolf is about finding alternative ways to look at adversities when they occur. Because we spend much of our time on auto-pilot, we may not be realizing how often we are feeding the hurtful wolf. 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.

Once you gain an awareness of your negative thinking, resist the temptation to react. Instead, have a neutral response such as, “That’s interesting - there’s a negative thought.” Don’t criticize or judge yourself, because that’s feeding the bad wolf. Simply ask yourself, “Is this thought useful to me? Is it helping me to feel the way I want to feel?”

Perhaps today you might consider an intentional practice toward feeding the good wolf by practicing kindness to yourself and others. Is there something you’ve been putting off that you wanted to do for yourself or for your staff? If you’re used to overdoing it at work, is there a way to ease up on yourself and remember that your “to-do” list will never be done?

Negative thoughts are contagious. Once the bad wolf takes hold, your mind will seek ‘support’ that your thinking is true. Don’t feed the escalation. Rather, look for contradictory facts that refute the negative thought. Challenge your mental models. Manage your thoughts, feelings and actions. I urge you...feed the good wolf.

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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Carol Tekavec, RDH
Hygiene Consultant
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Helping Patients Accept Scaling and Root Planing
Carol Tekavec RDH

One of the most problematic and common issues facing hygienists and dentists is helping patients come to grips with their periodontal conditions. Many of our patients have become accustomed to the six-month cleaning and exam routine, regardless of what might really be happening in their mouths. As hygienists, we too can become accustomed to the “prophy routine” and may postpone our responsibility to inform and perform appropriate dental treatment for our patients with perio conditions. Patients don’t want to hear about needing further treatment, and we can become weary of trying to help them see what we see.

Every now and then it helps to re-invigorate ourselves by setting into place a definite plan (or reinstituting a previous plan if we had one), to approach patients with perio conditions.  What follows is one such plan based on information from the American Academy of Periodontology. Keep in mind that every office needs to decide when scaling and root planing is appropriate for their patients, and all team members need to be “on the same page” about what that means.

This simple format classifies patients and treatment to clarify what is happening or has happened to the patient’s health, and what we need to do.

Class I - Gingivitis

  • Bleeding on probing on 5 or more sites
  • Probing depths of no more than 3mm
  • No bone loss evident on radiographs

Treatment: Prophy with possible additional prophys (three or four per year) scheduled. Detailed home care instructions and tools. Be sure patients understand that most insurance plans will only cover two prophys annually, and any additional will be their financial responsibility.

Class II - Periodontitis - Slight

  • Bleeding on probing in many areas
  • Probing depths of at least 4mm in one to three teeth in a quadrant
  • Bone loss may or may not be seen on radiographs
  • No furcation involvement

Treatment: Localized scaling and root planing, detailed home care instructions and tools, 3 month periodontal maintenance. When filing insurance use the code for SRP 1-3 teeth per quadrant and indicate the tooth numbers on the claim form. It is recommended to have one fee whether there is one tooth or three teeth involved. Some carriers will cover subsequent periodontal maintenance.

Class II - Periodontitis - Moderate

  • Bleeding on probing in many areas
  • Probing depths of 4-5mm on four or more teeth in a quadrant
  • Bone loss likely seen on radiographs
  • Possible furcation involvement

Treatment: Scaling and root planing of complete quadrants, detailed home care instructions and tools. May utilize adjunctive laser and/or antibiotic therapy. Three month periodontal maintenance. When filing insurance use SRP of four or more teeth per quadrant. Perform only two quadrants per appointment or benefit may be reduced. Many carriers will cover subsequent periodontal maintenance.

Class II - Periodontitis - Severe

  • Bleeding on probing in many areas
  • Probing depths greater than 6mm
  • Bone loss visible on radiographs
  • Furcation involvement seen
  • Mobility likely on some teeth

Treatment: Scaling and root planing of complete quadrants, detailed home care instructions and tools. May utilize adjunctive laser and/or antibiotic therapy. Three month periodontal maintenance. If improvement is not seen, possible referral to a periodontist. When filing insurance use SRP of four or more teeth per quadrant. Perform only two quadrants per appointment or benefit may be reduced. Many carriers will cover subsequent periodontal maintenance.

While these possible guidelines provide a treatment format, explaining the need for treatment is often an obstacle. Patients who have been receiving prophys may balk at the idea of scaling and root planing. They may ask why their perio condition had not been mentioned previously. One way to address this is to use the example of high blood pressure.  A person may have never had high blood pressure before, but upon a routine exam with their physician, high blood pressure may be recognized. Our bodies are always undergoing changes, and periodontal disease is a common occurrence for many adults. Showing patients the periodontal probe descending into a pocket by using a hand mirror or on a photo can be very effective. Showing a radiograph with visible patient bone loss is instructive. Providing patients with a copy of their probing depths can also be helpful.

The hygienist can set the stage by giving information prior to the dentist’s exam, with the dentist reinforcing what the hygienist has explained. Often a patient’s primary concern is the cost of treatment.  Most insurance plans will cover scaling and root planing on teeth with 4mm or deeper probing depths. The hygienist and dentist can state that plans cover scaling and root planing because it is a treatment that patients need for their general oral health. Knowing that insurance will help with the fee can often provide the final encouragement patients need to go ahead with treatment.

Hygienists need to focus on what patients really need at each and every appointment. If patients decline treatment, we need to keep trying to help them understand! Periodontal disease is common and treatable, and we are in the front lines of the fight. It is important not to become complacent and let inadequate “prophys” become the norm, simply because it may be easier.

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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