7.26.13 Issue #594 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Feedback: What Goes Around Comes Around
By Sally McKenzie, CEO

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When was the last time you asked your employees to honestly tell you how you are doing. Scary thought, isn’t it? But just as staff need routine feedback and necessary course correction, so too do doctors. It can be handled as simply as asking every employee to anonymously write down one thing they would change about the office - no personal attacks allowed. The focus is constructive feedback on a system or procedure that they believe could be improved. It could be daily/monthly meetings, new patient packets, scheduling difficulties, increased training opportunities, clear office procedures, conflict resolution strategies, etc.

If you are particularly brave, ask your team to rate you personally on a set of skills such as your leadership, your ability to delegate, your adherence to following established office procedures, your openness to input from the team, and while you’re at it ask them to identify something specific they believe you could do to improve your role as leader of the practice.

Employees: This is for you. Feedback is only as good as what you do with it. No question, doctors need to provide feedback to employees daily. But this street runs both ways, and employees must be willing to accept the feedback and take action on it. In reality, if employees are open to it, feedback is all around them - particularly from their colleagues in the dental practice. The key is to take the feedback and turn it into positive action.

Some employees, no matter how carefully they are handled, will take every constructive comment as criticism. They only want to hear how well they are doing, not how they can improve. Take a good look at how you respond to suggestions and comments from those around you. Are you defensive? Do you take it as a personal affront? Are your feelings hurt or do you become angry when someone recommends doing something a different way? Do you dismiss feedback because you don’t like the person giving it? The key is to separate yourself from the action and look at feedback as an objective view of a particular task or procedure, and most importantly, as one of the most essential tools you can use to excel.

Too often supervisors and co-workers are so overly concerned about offending a staff member, they shun opportunities to give feedback. So when a co-worker does step forward and actually offer feedback, they are taking a major risk and should be thanked for their willingness to help you become a better employee. Ideally, the culture of the practice should encourage open feedback among the team members to continuously improve systems and patient services. 

The best way to become comfortable in receiving and acting on feedback is to ask for it. We are completely incapable of seeing ourselves as others see us, which is why being open to feedback is essential in achieving our greatest potential and recognizing those unprofessional habits and approaches that are interfering with that potential. When receiving feedback, make a conscious decision to listen carefully to what the person is saying and control your desire to respond. In other words, resist the urge to kill the messenger. Ask questions to better understand the specifics of the person’s feedback. If the person giving the feedback is angry, ask them if you can sit down and discuss the problem when you are both calmer and can respond wisely rather than emotionally.

Thank them for trying to help you improve, even if you didn’t particularly care for what they told you. Resist the urge to disregard the comments you consider to be negative. Push yourself to write the comments down and focus on the substance of the message rather than what you might perceive as a negative tone from the messenger. Over the next 48 hours think about the information you have been given and devise three to five steps you can take to change your approach.

Don’t sit back and wait for feedback, actively solicit it and use it! Recognize that feedback is one of the most critical tools you have in achieving your full potential.

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
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Carol Tekavec, RDH
Hygiene Consultant
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Success with a Patient!
By Carol Tekavec RDH

As every practicing hygienist knows, patients often resist perio treatment. It’s so common that we often have at least one patient per day, whom we have identified as needing periodontal care, tell us to “just do my cleaning.” Resistance to perio treatment has many sources. It can range from mistrust of the office, hygienist, dentist and other staff, to a perception that tooth loss is inevitable and unpreventable. I have had many patients even tell me that since they are so “old” (age 60) they don’t think it is worthwhile to spend the effort or the money to make their mouths healthier. That’s why it is such a great feeling when a patient believes that his or her oral health is worth protecting, accepts my explanation as to what is transpiring in their mouth, receives scaling and root planing, returns for periodontal maintenance four times a year, and gets healthy. Here is what happened with one such patient:

“Jim” is a nice-looking professional man in his late forties. He is always impeccably dressed and is intelligent and articulate. Incongruously, he has lost several teeth and did not have strong home care habits when he first came to our office. After radiographs and a complete exam with our dentist, we assessed him as having moderate to severe periodontitis. He came to me for scaling and root planing.

Our first visit was scheduled for two hours. He was very nervous when he came into the treatment room and told me, “I really hate coming to the dentist.” I proceeded very slowly and started by telling him what I wanted him to do in the way of self-care on a daily basis. Because of his history of limited interest in home care, this essentially boiled down to toothbrushing twice a day. I gave him a soft toothbrush and went over all quadrants of the mouth, sulcular technique, with him holding a handmirror to observe. I explained that even though all of us brush our teeth, often we are not as effective as we can be. When explaining brushing, I always try to make sure I am not perceived as talking down to anyone. It’s not surprising that many people may be somewhat insulted to be shown something as “rudimentary” as toothbrushing.

After this, topical and then local anesthesia was implemented on the maxillary and mandibular right, and I made sure that he was very numb. Scaling and root planing was arduous, and his tissues were swollen and bled extremely easily. He knew he was bleeding and I explained that after his tissues were healthy, this bleeding would become less and less evident. He told me that his teeth always bled when he brushed and he had assumed this was normal. I told him that when he was healthy, bleeding would be a thing of the past.

When our appointment was over, I scheduled him for the next week to complete the other half of the mouth. I called him that night to see how he was getting along, and he said that the numbness was gone and his mouth was sore, but he was doing ok. I reinforced my toothbrushing message and told him I would see him next week. The day before his next appointment I called him myself to be sure that he was confirmed and would be coming.

At our second appointment, I had Jim in my chair for 90 minutes and introduced interproximal brushing. I gave him several interproximal brushes which are small, portable, and designed with removable and replaceable covers so they can be carried in a pocket. In addition to regular brushing twice a day, I instructed him to clean between all of his teeth a minimum of once per day. I had him look at the tissues on the side of his mouth that we had cared for the previous week, and showed him the differences in appearance and bleeding from the opposite side. He could definitely see and feel the difference.

While I like to see scaling and root planing patients two weeks to a month after treatment for reassessment and further care if needed, our treatment coordinator had already told me that Jim did not want to schedule this because his insurance would only cover periodontal maintenance when performed at least three months subsequent. Therefore, I scheduled him for three months in the future. While I know that insurance coverage should not trump care, the reality is, it is very important to many patients. I certainly did not want to jeopardize his treatment due to a possible problem with fees and insurance. I crossed my fingers that he would continue to do what I had shown him for home care, and would be stable or improved at his three month visit.

The good news is that when he arrived for his periodontal maintenance, his condition was much improved! He told me that he felt so much different about himself, now that his mouth was clean and his gums were not bleeding. Several pocket areas had improved by at least a millimeter. He loved the interproximal brushes, and I gave him a handful as replacements. He asked why I had not told him to use floss, and I explained that the purpose of floss was to clean between the teeth, but that it was not the only mechanism to do this. I explained that I highly recommend floss, and showed him in his own mouth the best technique. I told him that the important thing was to remove plaque thoroughly and daily from all tooth surfaces, regardless of what implement is used.

It has been a year since his first maintenance visit and he continues to observe excellent home care. He is scheduled to receive implants in the areas where teeth had been previously lost later this month. I consider this patient to be a wonderful success story. Scaling and root planing followed by the use of very basic home care tools have resulted in a complete halt to, and in some areas reversal of, destructive periodontal disease.

Our patients are wonderfully individual, and we owe it to them to look for ways to connect with and help them. Some of my patients use electric brushes, some use yarn, some use waterpiks, some do well with chlorhexidine. I guessed correctly that Jim would accept and do well with the basics, and I couldn’t be more pleased. He told me at the end of his last appointment, “I just wish I would have come to this office sooner and had this type of care from a hygienist.” He has already referred several of his friends. The hygiene department is an essential part of a successful practice. We do well when our patients do well.    

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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Bridge the Gap Between Intention and Impact
By Nancy Haller, Ph.D.

Do you ever wonder why communication is so difficult? Are you baffled when your employees don’t understand you? The fact is, the majority of problems and conflicts we experience in our professional and personal lives stem from our failure to communicate effectively. It’s a common human phenomenon – in our interactions with others, we tend to assume that our words and actions are understood as we intended them. Unfortunately, it just doesn't always work out that way. The message people receive doesn’t match the one you intended. Here are some examples.

  • Dr. Smith complains that his employees seldom participate in the monthly staff meeting. He starts discussions by informing his team how he feels about issues and then asks for their input. His intention is to convey openness and put people at ease. The impact is that employees see him as the boss telling them what he wants, so they don’t contribute any additional ideas or comments.

  • Dr. Jones lowers her voice and speaks more slowly when she is frustrated. Her intention is positive because she wants to remain calm and logical. The impact is that her staff doesn’t have a clue about how angry she is nor the severity of the issue she raises. The same problem keeps happening.

  • When Dr. Miller addresses an employee performance problem he feels tense. His intention is to avoid conflict. In his discomfort he smiles. The impact is that staff members don’t take him seriously. His words fall on deaf ears and nothing changes.

  • Jessica the Clinical Assistant is new to dentistry. Dr. Roberts wants to train her to set up the tray correctly. Each morning he rearranges the instruments without saying a word. His intention is positive – he wants to train her to work efficiently with him. The impact is that she feels annoyed. She dismisses his actions as ‘obsessive compulsive’ and continues to do the tray set up the same way.

Intention is what you want to convey. Impact is what is received and understood. These two are often not the same! Furthermore, we tend to judge ourselves by our intention but others judge us by the impact of our behavior on them. Effective communication occurs when there is shared meaning - the message that is sent is the same message that is received. It’s easier to say “that’s not what I meant” as a defense, but if your message isn’t being received the way you expect, it’s time to take a look at your communication.

Your leadership effectiveness is directly related to your ability to win trust and gain respect through communication. You may think you have credibility, but your employees and patients are the final judges. Pay attention to the signs that there may be a mismatch between your intent and your impact on an employee, a patient, or someone at home. By adopting a more mindful approach, you can facilitate yourself to think about your impact and how you deal with others.

As you get really good at observing what happens in your interpersonal exchanges, ask yourself some questions: How is the outcome different from what I intended/expected? Where can I take responsibility? How do I correct this? Next, take action to clarify mismatches of intent and impact as quickly as you can. Be accountable for your words and actions. Have an open dialogue with the other person and get their perspective. Listen carefully. Inquire about how you could have handled the communication differently.

If you’re like most dentists, you underestimate the impact you have personally on the habits and effectiveness of your team. As the leader, you have the authority to authorize, encourage, or impede most aspects of their working day. This places you in a position of power and responsibility. Leadership development is often less about making big changes, but more about small modifications in your behavior. In turn, these kinds of shifts can create significant improvements in outcome. Many seemingly simple habits can have a huge impact upon your rapport with your team.

Simple misfires between intention and impact can result in a quagmire of errors, misdirected activity and utter frustration. Model interest and curiosity about how employees see you and what they experience in their interactions with you. Ask questions from a position of open-mindedness. React positively when you hear of communication misunderstandings. You might be the problem, but you also can be the solution.

I am available to help you strengthen your leadership and team impact. Contact me at coach@mckenziemgmt.com

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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