By Robert E. Hamric, DMD
If you are like me, you try to read as many dental publication articles as possible. Over the years, I have torn out articles and used them in staff sessions or training periods. I have a file cabinet full of outstanding articles written by some of the giants of our profession, both past and present. Someday, I guess I can donate all of this "stuff" to a dental school. (On second thought, most of this "stuff" is on practice management — dental schools aren't interested in that subject!) Like you, I also subscribe to several newsletters that interest me, and I save the best ones. (Another full filing cabinet!). Yes, I had to take a speed-reading course to help me with this information overload, and I still can't find time to read a trashy novel. If you are like me, when you go to the beach or on vacation, you carry some of this material along. If it's not dental-related, it's management, leadership, motivational, or self-help information.
I am a strong advocate of regular staff sessions. I recommend holding these meetings at least once a week. Aim for at least a one-hour session. Avoid holding these over lunch breaks; instead, incorporate them into your usual routine. The hour that immediately follows lunch often is ideal. These meetings should be in addition to a 15-minute morning huddle to start the day, which, of course, has a different agenda.
My friends tell me they don't know what to talk about during staff meetings. They claim that these meetings often turn into gripe sessions and are unproductive. A dental practice is a big business, one that requires leadership skills. But the problem is, most dentists are not trained to manage a big business; they know absolutely nothing about leadership. Sad, but true. Your local bookstore has an infinite wealth of information on leadership. For staff meetings, let me suggest that you start with Steven Covey's The 7 Habits of Highly Effective People. Give each team member a copy. Then, have a different staff member lead the session each week. Review one of Covey's habits each month and discuss how this habit can be applied to your practice. You may be surprised at the results.
Leadership training is just as important as learning to do a crown prep or a MOD amalgam. Leadership and business training should be required elements in dental school. Frankly, it is far more important than some of those basic science courses we were forced to take (and never used). You will use leadership training and business management every day. Here are a few tips I hope will help you. Remember, you lead people — you manage things.
• As the practice leader, it's up to you to set the tone of your office every day. Your staff is looking to you for clues: What mood is he in today? As the leader, you must be positive, energetic, and happy to be in the office. Your job is to create a climate where everyone in the organization is happy and can reach his full potential. The difference between being merely successful and reaching full potential is staggering. When the doctor enters the office, it's showtime.
• Staff selection is absolutely critical. Seek people who are mature and who are looking for a career, not just an 8 to 5 job. Your practice should not be a stepping-stone to a better job. Don't hire a duck and expect an eagle. Eagles will demand higher pay and will be worth every penny. Don't ever doubt it — a great staff makes a great practice. A great staff is the result of thorough training and careful selection. Often great staff members may not be trained in dentistry. This can be a positive attribute because they won't have any bad habits to unlearn. The key in a good selection process is attitude. Look for a good, positive attitude and a great smile. You can teach technique and verbal skills to an energetic eagle, but it is hard to change a rotten, negative attitude. Eagle staff members also desire decent benefits, and today that is one way to find the best and keep them. People seeking careers want benefits and good pay. In the long run, good staff members are not an expense — they are an investment.
• Leaders train their staffs. There are so many "average" or "below average" people in dentistry because there are so many average dental leaders. Training takes time, money, and commitment, but if you think training or coaching is expensive ... try ignorance. The only thing worse than training your people and having them leave is not training your people and having them stay. Have you ever called another office and wondered how on earth the snarly, unprofessional person on the other line stays employed? Patients think that way too. I would honestly prefer for people to believe we are out of the office than to think we are stupid or unprofessional. Your practice is in the your staff's hands; they can make you or break you. Training with role-playing is essential. No business just turns people loose to do their own thing any way they want to ... except a dentist.
• Focus on results, not best efforts. If you and your staff cannot get results, then there is no value added to the practice. If people don't get results after training, then you have the wrong people. Make changes! Get people better — or get better people. Example: Your hygiene department can be a profit center. Suppose you and your staff attend a class on detecting and correcting early periodontal disease. Upon your return, you have every intent of implementing the new program and upgrading your practice. You make a solid commitment. You go back to the office and hold a half-day training session on how you want to implement this new process. You script the program, role-play with the staff, yet nothing happens! You try again and again, but still no changes.
Do you just give up, or do you make a change? Perhaps this is the time to start looking for team members who will adapt to your agenda and practice philosophy and who will move the practice in a more positive direction. Change is inevitable, growth is optional. As Coach Bear Bryant said, "Be good or be gone".
• Develop a mission statement and specific goals for each department. Your departments include hygiene, business, clinical, and lab (if you have one!) As your practice grows, you can develop a department leader in each area. Don't expect your staff to be inspired or work harder if they are in a fog and working without direction. You must establish goals as a team. Goals must be realistic and challenging, yet possible to achieve. Nothing is more discouraging than never achieving your goals — and there is no better feeling than reaching your goals. Have a celebration! If the staff participates in goal-setting, they inherit a responsibility toward making things happen. Goals become a team effort. Clock watching stops, and patients become important. When your staff accomplishes a major goal, a reward is in order. Yes, I believe money motivates, and I believe in a bonus program. Only monkeys work for peanuts.
• "Busy" does not mean "productive." I recently spoke with a dentist who stated that he was so booked up and behind that he needed extra help. The truth was that while he was busy, he was not productive. His scheduling was inefficient and he did not use his assistants properly to get more quality dentistry done in less time.
What's important is not how many people you can see in a day, but how productive your time is. You are only as good as your collections. Production is important, but if you don't collect it, you have nothing. I have seen doctors who pay everyone but themselves. The sooner you learn how to be business leader, the more profitable you will become. That difference can be measured in hundreds of thousands of dollars.
• Create a climate where change is welcome. Your staff members should not be afraid to express their opinions. Create an atmosphere that feels safe for your staff. That means you must listen with an open mind and take all suggestions into consideration. Just because you're the doctor doesn't mean you're the only person allowed to think. If you continue to do what you have always done, you will continue to get what you always got, and you will get left behind in today's marketplace. Don't fall for the theory that if something isn't broke just break it! If something is working well, polish it and make it better.
• Now what? Ask yourself: How much dentistry do I refer? Is there some way I could receive additional training to stymie this trend? Should I add more endo, ortho, and perio? Maybe implants or more cosmetic training? Do I have the equipment to be more relaxed and productive? Am I completing procedures within my hourly goals? When is it best to refer? Do I need to delegate more to my assistants? Do I have enough staff — or too much? Why am I constantly behind schedule? What causes the most stress around my office? How can I alleviate stress and its causes?
• Use the 80/20 rule. Walter Hailey reminded me in his "Boot Kamp" of the familiar 80/20 rule. (If you have not been to "Boot Kamp, I recommend attend as soon as possible. I saw a tremendous change in my attitude and practice after I attended. Call (800) BOOTKAMP).
The 80/20 rule states that you receive 80 percent of your results from 20 percent of your activities. Identify those productive areas and make sure they are addressed first.
Don't just prioritize your schedule — schedule your priorities. That's the philosophy behind block scheduling. Do big cases in the morning when you are fresh. Eighty percent of your problems also are generated by 20 percent of your patients. Identify who these problem patients are and dismiss them from your practice. Perhaps raising fees or dropping certain insurance plans will eliminate some headaches. Above all, accept that you can't be all things to all people.
• Evaluate new patient procedures. New-patient exams should be comprehensive. There are two classifications of patients — those with discomfort and those without discomfort. Patients with discomfort should be seen immediately and their problems solved as soon as possible.
For patients who are not experiencing discomfort, begin with a thorough oral exam. Every patient deserves to have a proper exam, not a quickie "look and see." Anything less is malpractice. Every patient deserves to know what dental problems they have and how they can solve those problems and prevent them from recurring.
• Don't fear failure — fear standing still. You learn more from failure than you do from success. The key is not to make the same mistake twice. What happens when you feel burnout? How can you keep from standing still? How much is enough? When do you become the rat in the rat race? I believe these questions lead us directly to The Pankey Philosophy, which promotes four elements in life that must be balanced to maintain happiness: love, worship, work, and play. In dentistry, we tend to become overbalanced in the work area, which leads to stagnation, burnout, and boredom.
Take time to enjoy watching your children grow up. Plan a cruise with your family. Go fishing; go hunting. Take your wife to Aruba for a surprise birthday. Life is too short not to enjoy the little things. Dentists need to work no more than four days a week, and they should take a week off every quarter for rest (play!). Nowhere does the equation state that money gives us happiness. In Covey's book, "Sharpen the Saw" is the 7th habit. This means take time for recreation. When you are rested, you do better dentistry and enjoy the profession more. Making a living is not the same as making a life. I like to see a practice with at least two doctors. You can use a facility and your investment to its fullest, and take alternate time off — not a bad arrangement.
Remember, you're not comparing yourself to others — you're measuring yourself against your own God-given potential. No matter how good you think you are, there is always room for growth!
Enjoy the fruits of your labor. Be a leader, and be a winner, but most of all, enjoy your life. You only have one to live.
