Dentistry joins a global pursuit for quality

Oct. 1, 1997
Dr. Edward Deming`s teachings are just as relevant in today`s dentistry as they were in sparking Japan`s productivity revolution.

Dr. Edward Deming`s teachings are just as relevant in today`s dentistry as they were in sparking Japan`s productivity revolution.

Joe Blaes, DDS

Dr. W. Edwards Deming has been called "the Father of Quality," yet his message encompassed leadership principles for all fields of study and all types or organizations - even dental practices. Dr. Deming was the man whose teachings in Japan, from 1950 on, largely initiated a transformation in Japanese business, resulting in what is known today as the "Japanese Industrial Miracle." He maintained a worldwide consulting practice for more than 40 years and taught his methods of leadership and quality improvement to thousands of U. S. companies such as Ford, General Motors and Xerox.

Dr. Deming was quality`s leader for over 50 years. His teachings have had a profound effect on each and every business around the world. He was a tireless and cantankerous crusader against waste and misguided management. Deming might well become the best-remembered figure of the 20th century associated with quality. From humble beginnings, Deming became known worldwide. In addition to his teaching of statistical subjects, he was a harsh critic of corporate management practices, especially in the United States.

Bad systems, not bad workers

Check out today`s managerial buzzwords: continuous improvement (known as "kaizen" in Japan), workers empowerment and statistical process control. All are rooted in Deming`s basic philosophy that bad systems, not mistakes by workers, are responsible for the vast majority of the defects and errors made by an organization. The Japanese wholeheartedly embraced that philosophy.

Deming first visited Japan in 1947, initially to help with the Japanese census. The Japanese had heard about his theories and how U.S. companies used them to produce war materials with few defects, which was one reason the U.S. won WWII. They also appreciated his approach to life. Deming was never materialistic. He drove a 1969 Lincoln Continental and took the bus or subway whenever possible.

The war-ravaged Japanese invited Deming to lecture the presidents of Japan`s 21 leading businesses. They immediately saw the merits of what he advocated. Do you remember how Japanese products were perceived in 1950? One word describes them - cheap. They needed to export high-quality goods to buy food. So, they trained 20,000 engineers in his statistical methods and began to develop the world`s most sophisticated assembly lines and processes.

That led to products such as Honda Civics, Toyota Corollas, Sony Trinitrons and Panasonic stereos that almost never broke down. U.S. News and World Reports concluded that Japan`s Deming-inspired miracle was one of the nine most important turning points in world history.

A legend ignored

While Dr. Deming became a legend in Japan, he was ignored here. On June 24, 1980, NBC broadcast a 90-minute segment on quality and economics called "If Japan Can, Why Can`t We?" He was living in Washington, D.C., less than six miles from the White House. He was unaware the program was broadcast, because he did not watch television. His greatest frustration was what he understood about his fellow countrymen: they all wanted "instant pudding" results to fix their quality problems and profits.

After the application of his methods brought enormous commercial success to some Japanese companies, the Japanese created a Deming Prize for companies that made striking advances in quality. Deming used the later years of his long career to try to reform American management, for considerable fees, sometimes as much as $100,000 a year from a single client.

Although the core of his method to improve quality was the use of statistics to detect flaws in the production processes, he developed a broader management philosophy that emphasized empowering workers and using cooperative approaches to solving problems. Deming denounced management procedures like production quotas, performance ratings and individual bonuses, saying that they were inherently unfair and detrimental to quality.

Use mind, not body

He said customers would get better products and services when workers were encouraged to use their minds as well as their hands on the job.

One of the first, large U.S. corporations to seek Deming`s assistance was Ford Motor Company. Ford officials persuaded him to visit their headquarters in Dearborn, Mich., in 1981, when the company`s sales were faltering and it was losing hundreds of millions of dollars. Ford acted upon Deming`s philosophy and, as its success became obvious, demand for Deming`s services grew. Among the companies that turned to Deming and his disciples were Dow Chemical, Procter & Gamble, AT&T and the New York Times.

"Anybody can pay dividends by deferring maintenance, cutting out research or acquiring another company," charges Dr. Deming in his book. "Dividends and paper profits, the yardstick by which managers of money and heads of companies are judged, make no contribution to material living for people anywhere nor do they improve the competitive position of a company or of American industry.

"Paper profits do not make bread; improvement of quality and productivity do! People who depend on dividends to live on should be concerned, not merely with the size of the dividend today, but also with the question of whether there will be dividends three years from now. Management has the obligation to protect investment."

Work with pride, not fear

Then there are the managers who feel that quality would improve if only people would do their best or if workers were better motivated.

"Such nonsense," Dr. Deming retorts, "everybody`s motivated. All they ask for is the chance to work with pride, to work without fear. Best efforts, or working hard, or computers - none of them are the answer. The world is full of people trying to do their best ...doing something wrong. Sometimes I think we would be better off if fewer people would try to do their best."

Equally ridiculous to him is the management practice of imposing quotas. Workers, he says, will do anything, including producing defective parts, to meet their quotas. And then they will stop and do nothing so that the rate will not be increased. "Replace time standards and work quotas with leadership, and quality and productivity will go up; the people will be happier, and they will feel more important."

The Journal of the American Medical Association reported on 23 heart surgeons using the Deming management methods on 6,500 patients over a two- and-a-half-year period. They were able to reduce mortality by 24 percent. Maybe we could use some of these Deming management methods in dentistry.

In the coming months, Dental Economics will be looking at his principles. If you can`t wait to get started, I encourage you to order "Deming: Best Efforts Are Not Enough!" This is a two CD-ROM set that will prepare you to apply Deming to dentistry.