Technology overload?

Aug. 1, 1996
Change often is difficult. Being successful by doing things the way we have in the past is even more difficult. James Belasco, in his book, Teaching the Elephant to Dance, Empowering Change in Your Organization, states that, "We need to change. We`re in trouble. Business as usual is out. The very successes that got us to where we are today might be the shackles that keep us back from achieving in the future. It takes guts to change, but if you don`t, the economic end is no less certain, only mor

Dentists who practice high technique will master their high-tech equipment.

Steve Seltzer and

Bill Kimball, DDS

Change often is difficult. Being successful by doing things the way we have in the past is even more difficult. James Belasco, in his book, Teaching the Elephant to Dance, Empowering Change in Your Organization, states that, "We need to change. We`re in trouble. Business as usual is out. The very successes that got us to where we are today might be the shackles that keep us back from achieving in the future. It takes guts to change, but if you don`t, the economic end is no less certain, only more painfully time-consuming."

High tech is invading dentistry. Offices now are computerized and use faxes and voice mail. According to the 1995 Dental Economics Practice Survey, 74.6 percent of dental offices use a computer in some form. Lasers cure composite resin, while patients enjoy video and television, sometimes using individual headsets. The new equipment seems limitless in its ability to improve the practice of dentistry, yet few dentists are benefiting in ways that they could.

Why are so many dentists spending thousands of dollars on intraoral cameras, only to let them sit and collect dust? Why do offices purchase computer software for scheduling and still use a paper book? Why are so many dentists discovering that their new, flashy computer systems do not perform as well as their old ones?

The answer is a lack of "high-tech" training. This article will explore the secrets to your successful implementation of any piece of equipment (or idea) into your practice. New equipment is only as good as the operators who use it! Once trained, doctors and staff need to be motivated enough to maximize it. Most high-tech equipment will deliver the promised results if the team invests in the necessary training!

New Paradigm of High Tech

The secret to advancing your practice in the coming millennium is understanding where the real power of high tech lies. To do this, we first need to redefine what we mean by high tech. The authors see the most powerful way to define high tech in dentistry is high technique, not high technology. High technique is knowledge about how you want to use the resources in the office. This knowledge, only when it is shared and personalized, is the most powerful technology around.

The Challenge

Patients want individualized recommendations about various products, not just brochures left for them to pick up in the reception area. The media is playing a bigger and bigger role in educating our patients. High-powered advertising executives are used by managed-care organizations to exploit an uneducated public about their "rights" to dental care in this new, capitated environment. The stakes are high. We need to adjust just to keep current!

We all know that the human mind is much more powerful than the best computers. Empowering staff to use the high techniques that we discuss will propel your practice to new heights and create a more enjoyable work environment for you, your staff and patients. This new paradigm in dentistry awaits you and offers benefits that cannot be achieved using "information-age" thinking.


Seeing the benefits for using the new technology is the starting place for our journey into high-tech training in a rotary-dial environment. Leadership, rather than management, is the challenge for dentists today and represents the cornerstone for this new paradigm. Most of us, if we have had any business training at all, have been taught how to "manage employees" and "teach staff" how we want things done. This is, of course, better than no training at all, but in our environment of rapid change, a new model is needed.


In this post-information age, an important paradigm shift is the change from managing a staff to leading a staff. A leader is someone who people will follow even if they don`t have to; someone with influence. Leaders share a vision of their practice with their team. A vision is what the doctor would like his practice to be or look like. Each dentist needs to find a model and/or consultant to help refine what the practice can look like. Using a vision, or destination, of where you want the practice to go should be supported with some practical research and good counsel. Writing down your vision for the practice can be a powerful exercise and is recommended strongly by the authors.


Once we have written down what we would like to see in our practice and shared it with the staff, a mission statement can be created. Often, dentists hear somewhere that they need a mission statement for their offices and set out to write one with the staff. The challenge here is that a mission must support something. How do you know when you get there? Or, more basically, where are you going?

In nautical terms, the vision is the destination; the mission is the ship used to get there. Steven Covey`s second habit, from his Seven Habits of Highly Effective People, is "Begin with the end in mind." Once we have the vision written, the mission is the means to that end. The doctor is the one who must create the vision. Then, the entire team should be involved in creating the mission. Many doctors have been surprised with the enthusiasm generated from allowing the staff to be in on creating systems in the office. Your team now can use its resources to fulfill the written mission statement and achieve the vision. A sample mission statement could be: "Our office is committed to the health and appearance of our patients. We offer the highest quality treatment and personalized service to each and every patient." Take some time with this and come up with a mission statement that the entire team can whole-heartedly support!

Action and Accountability

Action, a key factor for success, comes into play after the plan has been written. How often have we heard about an idea (vision and mission), discussed it with the staff, planned on doing it and that is as far as it got? "I`ll get around to it." "I`ll do it tomorrow." "As soon as we get those other bills paid off." Why don`t we do better in so many areas of our lives? Why don`t we act? The answer is accountability or coaching!


To get action, we need accountability. Professional athletes have coaches. Professional speakers have coaches. Professional musicians have coaches. Professional dentists practice...usually without coaches. According to Gary Takacs, a contributing editor to Dental Economics, consultants [business coaches] are something that the most successful practices in America take advantage of. As we make the shift from manager to leader, we need a coach. Dental practices have been "managed" by well-meaning dentists for years with some success. The real rewards to be found in this new environment of change center around outside coaching and leadership from the dentist!

The dental "team" has become very popular in the profession over the last decade. What often is lacking in this concept is the focus on the "leader," the dentist. A team needs a coach, or leader, for direction, just as the dentist needs a coach, or consultant, to encourage and guide him or her.

A leader dentist must encourage change in an office by example. Our staff watches us more than we might think. High-technology equipment takes time for doctor and staff to learn. The high-technique model provides the power to make these changes. Take intraoral cameras for example: The advent of the intraoral camera in dentistry has become one of the most talked about and written about technologies in modern dentistry.

In Seltzer Institute`s new video series, Maximize Your Intraoral Camera, one of the country`s leading authorities comments that "cameras are capable of being used four main ways in a dental practice: education, documentation, augmentation of natural vision and replacement of natural vision." So far, we have just begun to scratch the surface of the first three. Cameras have become common, yet represent only about 30 percent of the offices nationwide. These cameras are so powerful, yet are not being used close to their potential in most offices.

With such a powerful, practice-changing piece of equipment, why do we see such a lack of use, and why do we so often hear stories about the cameras not being used to their fullest potential? The answer, as you can guess by now, is high technique: training and leadership from the doctor!

This is what is happening today in dentistry with the intraoral camera! We are purchasing the cameras, placing them in our offices with a minimum amount of training from the vendor (and we commend the companies that offer this valuable service), then expect the camera to produce wonderful results without further training. How naive we are to try to introduce such a powerful piece of equipment into our offices without real training! Imagine trying to use a high-speed handpiece with only manufacturers` training and some good lectures on the subject.

The intraoral camera is more than just a new and exciting piece of equipment. It represents a new way of thinking in presenting dentistry to our patients. It is a true post-information-age piece of equipment. Rather than showing our patients generic pictures of other patients` teeth, we can customize our presentation and show them real-time video pictures of their own teeth. Intraoral-video images represent the missing link in patient education and patient appreciation. However, to truly maximize the use of your intraoral camera, this new thinking must take place in the entire office. The intraoral camera should be a clinical skill all staff members possess. You might choose to have staff be the primary user of your intraoral camera.

To come full circle, conventional intraoral-camera training is becoming popular, but has only scratched the surface of the potential available in your camera.

More Keys to Success

Another key is to be familiar with various ways high technology can be used and have a base of knowledge to draw from in making these important decisions. Read your journals, attend CE courses and do your homework. The second and more important key to your success with high technology is to use it (action)! Use a coach to keep you accountable. Write out your vision of what you want your practice to look like and work with your staff on creating a mission statement for the office. Of course, include high technology and high technique in your plan.

You cannot learn to prepare a tooth with skill and finesse without hands-on training and repetition. Likewise, you cannot keep your skill level up in other areas unless you continue to learn and practice. Dr. Michael Schuster, founder of the Center for Professional Development in Scottsdale, Arizona, says that, "The successful dentist has an insatiable desire to learn more, and the unsuccessful dentist thinks he knows enough!" Where do you fit along this continuum?

Introducing New Equipment

As with any new system in your office, writing out exactly how you plan to use it is most valuable in its implementation. Once you have your mission as the filter to guide your practice into the future, specific objectives need to be written out for everyone in the office to see. Staff members, first and foremost, need to see the benefits this new technology offers them. Most of the time, a new piece of high-tech equipment in the office causes apprehension as to how the staff will be expected to use it or the difficulty and extra time it might take to implement. Keep your staff up-to-date on what you are doing (vision). Be excited about the new equipment (leadership)! Let staff members see your enthusiasm and they will catch it, too. Don`t let them say, "Here we go again," and wait for you to change your enthusiasm to another "equipment du jour." Write down the process for implementing your new technology, specifying who will use it, where it will be used, when it will be used and, again, the benefits to the staff members and patients. Have a meeting centered on the high technique, as well as the high technology.

Make Tech Use Habitual

We know it takes about a month of working at something to make it a habit. Repetition builds skill and confidence, making patients appointments run smoother. With training and vision, the operator has the opportunity to focus on language skills (scripting) and the patient, rather than being distracted with operating a piece of equipment that can be sensed easily by the patient. The confidence you exude in utilizing the new equipment should be the same as when you handle a mirror and explorer. Your "relaxed enthusiasm" is the first impression you want a patient to have. You want the patient to feel you are not even thinking about it (like the mirror and explorer). The "perfect office" system has worked great in many dental offices.

You never get a second chance to make a good first impression. Challenge yourself to rise to the opportunity you have in your office of maximizing new technologies. Practice the "high techniques" until they are ingrained into your daily routine, so you can reap the tremendous benefits high tech offers.

Use this article not only to bring yourself to an increased skill level with your new equipment, but as a valuable tool to rethink the way you are practicing dentistry now and how you plan to practice in the 21st century. Above all, keep learning. Find a coach. Attend as many continuing-education courses as you possibly can concerning new technologies and the needed changes to remain successful, or even become successful, in the years ahead.

Indeed, it definitely is an exciting time to be in dentistry, if you learn the new rules that apply. Our hope is that this article brings you closer to your goals and happier in your practices! Be a leader, have a written vision and mission statement and certainly think technique whenever you deal with technology in your dental practice.

Specific Objectives to Intraoral-Camera Success

Similar steps can be adapted for any new high-tech equipment in your office

1. Make sure the team members appreciate how using the camera helps them..

2. Become comfortable with the camera by role-playing with staff and family members.

3. Make sure the entire team understands how to perform a video tour of the mouth.

4. Follow a prioritized list of images the doctor feels are most important.

5. The video-tour provider must update other clinicians on the patient`s situation.

6. Document what was imaged and what needs to be imaged at future visits.

7. Balance positive and negative comments when showing the patient his/her teeth.

8. Ask patients questions to confirm their understanding.

9. Discuss potential future steps with the patient for the best possible care.

10. Start slowly: Use it on the first patient in the morning and the first patient after lunch to keep you from feeling behind.

11. Begin using the camera on patients with whom you have established good rapport.

12. Review the charts for imaging patient needs at the morning staff meeting. Document on your daily schedule what needs to be imaged.

13. Indicate patients on your schedule with pending treatment. Use the camera to help them see the need for the dentistry.

14. Be flexible enough to change the format of your typical recall visit.

15. Image the areas needing treatment at the start of the appointment, especially in hygiene. Be sure to have the images displayed when the doctor comes in for the exam.

16. Make a commitment to use and become familiar with the camera you already have before buying a new one.

17. Enjoy the way your patients respond with greater interest in you as well as their teeth and gums.

Both authors are management consultants. Mr. Seltzer has been lecturing about high-tech dentistry for more than a decade. Dr. Kimball practices in San Diego, CA. Both authors appear in a marketing video series, Maximize Your Intraoral Camera. Mr. Seltzer recently published a critically-acclaimed book called 101 Technology Pearls for Dentistry. For additional information, contact Kimball Consulting Group at 800-357-8346, or contact Seltzer Institute at 800-229-8967 or E-mail to [email protected].