5.30.14 Issue #638 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Staff: Pain or Profit?
By Sally McKenzie, CEO

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Are your systems providing a solid foundation for growth, or is everything you’re working so hard to build being slowly chiseled away because of circumstances beyond your control - namely, staff. Far too many dentists are convinced that their practice would be going gangbusters if they could just find good help. Ah yes, staff are such an easy target. She’s controlling. He’s demanding. She’ll cry over a paper cut. He couldn’t problem solve 2 + 2, and so on.

Without exception, practices that struggle, struggle with staff. Listen to the doctors and they claim to be doing everything in their power to hire and keep good staff. But they are victims. Yes, they are victims indeed. They have failed themselves, each time they rush to simply fill a position with a warm body rather than the ideal candidate, or when they choose to withhold praise and acknowledgement for a job well done, or when they don’t take the time to give clear direction. And as a result, these struggling practices have employees, but they are far from having highly functioning teams. Consequently, turnover is an ongoing issue.

Certainly, employees leave for a variety of reasons. They move away, retire, choose to stay home with children. But many walk because of their boss and/or coworkers. And staff turnover that occurs every 12-18 months or less is a strong indicator of serious flaws in your hiring and employee retention systems as well as your leadership.

Oftentimes, staff will leave because they feel they’ve been tossed into the deep end of the pool. It’s sink or swim and they can’t count on you to throw them a line. Do you provide clear job descriptions so that your staff know what is expected of them and how you will measure their performance? Or do you assume that they know what to do but become upset when they don’t do it “right”?  Your employees must be able to count on you for direction, feedback, and vision.

Do you create a culture of cooperation and collaboration among your staff, or do you have warring factions lobbing verbal grenades and razor sharp sneers at one another? It’s a good day when no one corners you in your office sobbing, finger pointing, or threatening to quit. Nothing will send staff running for the exits quicker than a toxic workplace in which high drama and low accountability go unaddressed because the “leader” refuses to lead.

Running a practice and building a team takes courage. The team mirrors the leadership of the practice. Look carefully at your employees. Do they reflect your commitment to excellence? Do they represent a culture of collaboration and cooperation? Are you willing to challenge them to improve? And are they open to embracing new and better ways of doing things? Or do you shun more efficient systems and procedures because the transition will be difficult. They won’t go for it. You don’t want to hurt anyone’s feelings or make anyone mad. You rationalize your fear of addressing the problems by telling yourself that you’re better off leaving well enough alone.

If you’ve chosen to ignore the problem, you’ve abdicated your responsibility as the leader. And I guarantee, there will be trouble ahead. Most likely it will result in patient attrition. Staff turnover and lack of leadership invariably lead to poor customer service. Morale is low, and employees will check out of the practice mentally long before they turn in their two weeks’ notice.

“Mary” knows she’s leaving; she hasn’t told you yet, but the fact that she’s a short-timer comes through loud and clear to your patients. And if “Mary” is the second or third person they’ve seen in that position over the last 12-24 months, you can bet patients sense there is a problem.  

I’ll be the first to admit that effective leadership is not easy. It’s like exercise. It can be painful. It requires time and commitment, and you may not see the results for months. You must be intentional. You must have a plan. You must have realistic goals. You’re not going to get that beach body overnight, nor will you increase practice efficiency and profitability in 24 hours. Yet, just like exercise, strong leadership results in a strong team and will most certainly yield the rewards, provided you’re willing to do some heavy lifting.

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 McKenzie Management 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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How Often Are You a Cookie Thief?
By Nancy Haller, Ph.D.

Your case presentation was outstanding and you felt confident about acceptance, but the patient told the coordinator he needs to “think about it”. Or perhaps you hired an employee whose resume indicated previous dental experience, only to find out she had insufficient know-how about running the front desk. All of us have hastily and mistakenly passed judgment of a situation or a person. We can be absolutely convinced of something and then find out later that we were wrong. How often do you make assumptions without having all the facts?

Every day you make a series of assumptions. Many of them are done unconsciously. When you reached for your alarm clock this morning, you assumed it would be there. It was. While getting ready for your day, you assumed many things as part of your morning routine. Nothing wrong with that. We’re programmed to make assumptions. An assumption is something we take for granted or presuppose. Usually it is something we previously learned and don’t question. It’s part of our system of beliefs or schemas, our internal representations of the way the world works. We assume our beliefs to be true and use them to interpret the world about us.

Our brains love assumptions and we get very comfortable with assumptions. A little too comfortable. Assumptions mean less work. They are more efficient use of brain power. We tread along these same cozy neural pathways again and again and again until they are well worn and grooved. When similar situations arise, our brains default to this groove and its associative memories, information, and assumptions.

At its core, our schema is that everyone sees life the way we do. But your thinking habits also can lead you astray. We make false predictions about others, from their motivations to their emotions. In other words, we mind-read. And those mental short cuts are often wrong. We make an assumption, we misunderstand, we take it personally, and we end up creating a whole big drama for nothing. Beliefs that are accompanied with high emotionality create the greatest distortions. Drama easily overshadows logic. And when we experience things on a visceral level, our thinking is much more likely to appear factual to us.

Because we regard our beliefs as truths, we seek information to confirm our expectations, and we ignore things that don’t fit. This is one of the  reasons that many of us get stuck and can’t really grow or improve.

I recently came across a great YouTube clip that illustrates the danger of assumptions. It’s called The Cookie Thief. Based on a wonderful poem by Valerie Cox, the video is a fun but strikingly accurate example of bad assumptions. The ending might surprise you. I strongly recommend that you make time to watch it with your employees. Put it on the next staff meeting agenda and use it as a springboard to discussion. My prediction…ok, my assumption…is that you have a whole team of ‘cookie thieves’. Once you identify the culprits, make a commitment to one another that you will all work on purging yourselves of the tendency to make bad assumptions.

It starts with humility…the admission that you don’t know everything. No one does. No matter how ‘real’ a situation may look, you never know what truths you might find out later. Make a commitment to challenge your thinking at least once each day. This requires you to keep an open mind.

Practice active listening. There is much to learn by being quiet and really paying attention to what others have to say. When people share their ideas, beliefs, and perspectives, avoid looking for ways to criticize them or prove them wrong. It's only when you know that you don't know that you're in a position to learn.

Assume positive intention from others. What you think may be quite different from reality. Try to see other sides of the story rather than focusing on what you "think" you know. Realize that not everyone thinks as you do. Seek out the facts before you react.

Stop personalizing. Take a step back to really look at the situation. Breathe. Be curious and ask yourself, “What assumption am I making about this person/situation?” Cultivating awareness about the habit of assumption is the best way to beat it.

Let me know your thoughts on the video. If you do use it as a team activity, send me a summary. In exchange, I’ll email you a copy of one of our Ideas into Action leadership guidebooks.

Wishing all of you clear thinking!

Dr. Haller provides training for leadership effectiveness, interpersonal communication, conflict management, and team building. If you would like to learn more contact her at nhaller@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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Your Fees are Too High!
By Carol Tekavec RDH

A common complaint among patients is the notion that dentistry is too expensive. It is likely that if you asked any group of dental patients sitting in any reception room in any part of the country if their dentist charges high fees, they would probably say yes. I have had conversations with patients that go something like this:

Hygienist: The dentist recommends placing a crown on the tooth we talked about. It has a cracked filling and one of the cusps has also been broken off. 
Patient: A crown! Can’t he just replace the filling?
Hygienist: More than just the filling has been damaged. The filling is cracked and leaking and the cusp is broken off. That is why you feel that sharp edge and discomfort in the area. A filling can’t be used because there is not enough of the tooth remaining to hold it in place. A crown covers the top and sides of the tooth and replaces the broken-off cusp. It restores the tooth to the function that you had  previously.
Patient: Well, what does a crown cost?
Hygienist: A porcelain crown, which will be fabricated here in our office while you wait, runs around $1,200. (Fee just for this example)
Patient: Over a thousand dollars for just one tooth! That is outrageous!

Hygienist: Well, when you think about it, the tooth that is being crowned emerged in your mouth when you were six years old. You are now fifty-six. That tooth has been doing its job for you for fifty years. To keep that tooth doing its job, it needs a little help. A crown can do it. With reasonable care, a crown can help that tooth last a good long while. Years in fact. Just think about the cost of a good pair of running shoes. Those shoes take a beating, and you do not expect them to last more than a few months. A crown can last years, taking much more stress than running shoes. Plus a crown is made for you individually. It is custom made, not assembly line made. Without a crown the tooth will continue to break down, perhaps even allowing bacteria to get into the pulp chamber inside the root, eventually causing an infection. Then our choices about what to do go down. You might need a root-canal plus a crown. This would be about three times as expensive as a crown alone.
Patient: Well, I could just have that tooth extracted then. That sharp edge isn’t bothering me that much right now anyway.

Hygienist: Having such an important tooth extracted is a last resort fix under current dental thinking. A series of events can happen after a tooth is extracted. The opposing tooth can super-erupt, and the teeth on either side can start to tilt. Our teeth work together inside our mouths, like gears on a bicycle. Remove a section of the gears, so to speak, and our teeth cease to function properly.
Patient: I could have the tooth extracted and just get an implant. I hear commercials on TV all the time about this.

Hygienist: Yes, implants are a good solution in many cases, but compared to the cost of a single crown, they are more expensive. You have the cost of the implant and then the cost of the crown on top of that.
Patient:  Well, I will just have to think about this. The cost of a crown is really high! My wife and I have a trip to Europe planned in two months, and we just finished redoing our kitchen and bathrooms. 
Hygienist: You can let us know if you decide to schedule your crown. All the information is in our computer. If the tooth breaks down further it might be hard to have it fixed when you are on your trip.

Will the patient call back to schedule the crown? He might, or he might not. Should the hygienist have pressured him to set up an appointment? In my opinion, no. He can always simply call and cancel if he has not really accepted our advice.

What can we do when a patient expresses that he thinks the fees for dental treatment are too high? Going through a conversation like the one above at least opens the door to thoughtful consideration on the patient’s part. Explaining that crowns are custom made for each person can also be explored using the analogy of going to a tailor for an individually made suit, as opposed to buying one at Sears. Plus the fact that there are no mass-produced crowns in the first place!

Bringing up the fact that dentistry is performed by a trained, licensed, professional may also help. Trained professionals have standards that patients usually understand. In most cases they appreciate that what takes place in their mouths is important to their health, comfort and appearance. Getting a crown placed is not like buying a tee shirt!

Always keep in mind that regardless of the fee, a patient will likely think that it is high. A competitive, reasonable fee must be determined by the dentist, and the staff should be comfortable with it. If a patient is satisfied with his treatment he will usually tell others, “My dentist is expensive, but he is good.” 

Right or wrong, dentistry sometimes has to compete with other types of spending. Fees need to reflect the service that is being provided, despite the fact that patients may sometimes balk at the fee. Doing our best to place the importance of dental treatment in patient friendly terms can help them understand that their dental care deserves careful consideration.

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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