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Implementing Change

Nov. 1, 2006
Change is an essential element of growth, but fear surrounds any change in routine.
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Change is an essential element of growth, but fear surrounds any change in routine. Here are some of the reasons why. Part 1

Mention the word “change” and most people get a bit uncomfortable. Most people would agree that change is a challenge - and many feel it should be avoided at all costs! However, change is inevitable. It is a process that is imperative if growth, development, and success are to be achieved.

People live and work in their comfort zone-the place in which they

  • 1) know the routine,
  • (2) are sure of themselves and their results, and
  • (3) don’t have to learn anything new.
  • Then, all of a sudden, someone or something encourages or initiates a change in that routine and whoops - nothing is the same anymore. Discomfort, confusion, and dysfunction are evident everywhere.However, if there is valid reason for the change and improvement is the desired result, the new way becomes the established way if those affected by the change stay “out there” in the new realm long enough and practice the new routine diligently. Then, the comfort zone becomes larger and they enter the “stretch” that accompanies change and growth.Let’s look at some of the reasons why people resist change. You may identify with one - or all - of these reasons. The change isn’t self-initiated.Some people do not respond well to ideas from someone else. If you want to initiate a change in your practice - but find people are resistant - get them involved. Let them identify problems within a system - things in the system that either aren’t working well or that could be improved. Then, have everyone brainstorm some possibilities for improvement or change.If you involve people on your team, they will be more likely to support the change. This follows a proven management principle: “If a person is allowed to be a part of a decision-making process, that person will be more likely to ‘buy into’ the decision.” Routine is disrupted. You know what I am talking about here! “I’ve been doing this the same way for ‘x’ number of years and so far, things have been going pretty well. This seems to work for us.”You may be hearing the voice of a team member saying this - or you may be hearing your own voice. It may be more comfortable for you just to stay the same rather than disrupt the routine and try something is different. It may be more comfortable, but you must ask yourself - “If we stay the same forever, will lack of growth lead to a healthier business each year?” More than likely, the answer is no. Growth and change go hand-in-hand. Don’t stifle growth because you have grown lackadaisical, lazy, or too comfortable. Too satisfied with the “status quo.”There is no such thing as the “status quo.” Your practice is either going up or down. If you choose to stay the same, the rest of the world will pass you by. Another word for status quo is “stagnation.” Nothing saps the life out of an individual or a business more than sitting still, floating in a state of suspension, and remaining the same. The laws of physics validate that if you are not moving forward, you are sliding toward decay. It is always good to evaluate the status of your practice - to take the temperature by evaluating the systems in place. Ask yourself the following questions:(1) “What are we doing well? Let’s keep doing that.”It’s just fine to pat yourselves on the back for work well done. However, the more important question - and the one that keeps you in a state of development and progress is:(2) “How can we do this a little bit better?”Frequently, if something has become a tradition in a group, family, or practice, resistance to change of any kind may result. There is something about a “history” that creates a particular aura. People do like tradition, and there is value in commitment to tradition. However, when a tradition becomes stale - when it no longer serves a purpose or has the desired results - then honor that tradition for what it brought forth by putting it to rest and moving forward. Will Rogers said, “Even if you are on the right track, you’ll get run over if you just sit there.”The purpose of the change is unknown. As a leader, one of the most important things you will do is to clearly inform your teammates of the purpose of any change. It is always best to describe a recommended change in terms of how that change will impact the participants. Let people know how the change will benefit them. All human behavior is driven by “what’s in it for me.” So present your desired change in just that way ... show how it will have a positive impact on the people involved. If you don’t do this, no one will approach any change with enthusiasm. Certainly, there are times when a change of performance or behavior is required or there will be negative consequences. But for the most part, if you want a change in protocol, performance, behavior, or how you are doing something, the best way to enroll people in the process is to motivate them. Motivation comes from within ... people have to want to change. They must see how the change will benefit them, the patients, and the practice. Be clear. Be precise. Be a motivator. Be a leader. Rewards don’t match the required effort. Frederick Herzberg, one of management’s great contributors and theorists, determined what he called motivators and “hygienic” factors in the workplace. Hygienic factors are defined as the things employees need to do their jobs - i.e., adequate workspace, light, heat, telephone, computer, salary, benefits, etc. However, these hygienic factors will not encourage people to do their best job. That is where the intrinsic “motivators” come into play. These motivators include praise, recognition, challenging work, growth opportunity, being included, and being appreciated. If your team members are asking for more money or complaining that you don’t “share” enough, more than likely internal issues are involved. This is not to say that physical rewards are not valued. They are. People need money to survive. That’s a motivator. In today’s workplace, surveys show that time off is a greater motivator than more money. Find out what kinds of rewards interest your team members. Then, when everyone is working together for the betterment of the practice, be willing to share the rewards for work well done. However, never lose sight of the fact that the intrinsic motivators (appreciation is rated No. 1 by employees) will always outweigh any other type of reward.Negative thinking stifles attitudes. What a subject! Negative thinking. Negative attitude. If someone doesn’t think something can happen ... he or she is right. Why? Because the actions of a human being (and thus your practice) will follow the main thought process of that person. Actions follow thought. You become what you think about. That’s not a theory. It’s a fact. So if someone says, “I can’t,” it becomes a self-fulfilling prophecy. Much of the resistance to change occurs from this debilitating disease. If 90 percent of your team members think something could be changed and would be a great change, but one person (the doomsayer) throws cold water on the idea, that negative attitude will tear down the energy and enthusiasm of all the other team members. Do you want that? I don’t know about you, but I don’t have time in this very short life to surround myself with people who are negative ... and I choose not to. If someone on your team is negative and constantly knocking great ideas, sit down with that person and find out what the problem is - i.e., a lack of confidence, boredom, whatever. Try to get to the root of the negativity and see if there is anything you can do about it. If not, you may have to make a decision about whether you are going to let the health and well-being of the practice slide due to negativity. The choice of facing each day - and a lifetime with a positive or negative attitude - is a choice that each and every one of us gets to make. William Jennings Bryan said: “Destiny is not a matter of chance, it is a matter of choice; it is not a thing to be waited for, it is a thing to be achieved.”No matter what has happened to someone in the past or what is happening to someone in the present, that individual can choose to wallow in negativity and spend his or her life having a pity party or he or she can learn from the experience, no matter how difficult, and gain wisdom, insight, and knowledge. A gentle soul is usually developed from a life of hard knocks. Followers may lack respect for the leader. In my opinion, each member of the team must be a leader. First, you are a leader of yourself. You decide if you will be an asset to the practice or not. You decide if you will be productive or not. As I said earlier, you decide whether you will face each day, each project, and each developmental change within the practice with a positive or a negative attitude. You are a leader of yourself.Secondly, you must be a leader in the eyes of your fellow team members. Your team must be able to count on you to do what you are supposed to do ... and trust that you will do so in a timely fashion and with excellence. Because of the intricate interactions of each member of the team - and the intertwined activities within each management and clinical system - each team member is critical to the success of each system and the practice as a whole. Can your team members count on you? In addition, as a leader each team member must help other team members to be successful, reach their individual goals, and communicate openly and honestly. Teamwork is all about supporting one another.Last, but certainly not least, each team member must be a leader of patients - leading them to make good decisions. Each person on the team has a “moment of truth” with each encounter with a patient, and that moment can make or break whether the patient decides to proceed with treatment. It is not just the doctor’s responsibility to gain high levels of treatment acceptance. Each team member also holds that responsibility.If change is to be approached with a positive attitude, team members must have respect for the leaders. The leaders (each team member) must be trustworthy. People must feel confident that when you say you will do something, you really will do it. They shouldn’t have to worry about whether something was done. This saps valuable energy. Confidence in another person’s performance is gained. It is not a given. Respect is earned. It is not given. Leadership is earned. It is not given.Leadership is susceptible to criticism. This is a tough one. The personality of many doctors and team members reflects a desire to be liked, to not be at odds with anyone, to be accepted, to not be rejected. Depending on the strength of this personality trait, some people are hesitant to rock the boat because they don’t want people to get mad, leave them, be critical, or confrontational. So, they just abide by the status quo, even if they aren’t pleased with it. This quandary can lead doctors to give up on the idea of having their ideal practice. They become complacent and say, “Oh, I guess this is as good as it’s going to get. I just don’t want to upset anyone, so if everyone likes it this way, I guess it’s OK with me.” How sad. I don’t think there is any dentist who does not have the right and opportunity to have the practice of his or her dreams. The only thing that stops a doctor from having the ideal practice is the person in the mirror. Sit down. Write out what you consider to be an ideal practice. Then, go to work to make that happen. Do not let anyone or anything get in the way of you creating your ideal practice - whatever it is to you. Make sure that you are not getting in your own way. Make whatever changes are necessary to make your dreams become a reality. Change requires additional commitment.“I am doing all I can do right now. Don’t ask me to do anything more. There is not enough time to do everything that’s on my plate right now. Don’t mess up my routine.”That is frequently the immediate response of someone who is being asked to change. Or it may be exactly how you would feel if anyone suggested change to you. It is very understandable. Change does take effort. It does take time.It is important to identify and continually be reminded of the advantages and the benefits of the change - whatever that change might be. You may find that you must invest time to save time. You may find that you must invest time, money, and effort to incorporate a new process or procedure, but the result will more than pay for itself if you have carefully identified the benefits. If you become weary of the effort being needed to institute change, pause and remind yourself of the reason behind the change. Always focus on the results and benefits you are seeking.People who believe in you will be people who will push you, encourage you to stretch, and give you opportunities to grow. They will support you as you spread your wings. They may take you to the edge of the cliff and push you off, but they will only do so if they are confident that you can and will fly. If you falter, they will be there to scoop you up. More than likely, the people who mean the most to you are the people who push you the hardest. They do so because they see your talent and ability, and want to help you maximize that talent. These are your true friends.Don’t back away from commitment. It is through commitment to expansion that you spread your wings and soar to places you may not have believed possible. Narrow-mindedness thwarts new ideas.Narrow-mindedness is a painful characteristic. The very term conjures up an image of people who are so set in their ways that they are unresponsive to any new ideas. So many people get stuck in their ways. They do the same thing in the same way, over and over, for years on end. They shut out the possibilities for exploration, discovery, and expansion of their potential.Narrow-mindedness shuts out all ideas or opinions of anyone else. It’s as if there is only one way ... and that way is their way. Just because something has been done a certain way for a long time doesn’t necessarily mean that it is the only way or the best way.Open your mind to listening to the potential benefits when change is recommended. You may or may not accept the recommendations, but at least be willing to listen without making a judgment. Not doing so not only hurts your chances for development, but could curtail the advancement of others.Now that I have outlined some of the major obstacles to change, I am quite sure that you recognize some of these obstacles in yourself or members of your organization. Next month, we’ll conclude this two-part series by discussing 10 ways to solicit support for change in your organization.
    Cathy Jameson is the president and CEO of Jameson Management, Inc., an international dental practice-management consulting, lecturing, seminar, and product provider. An accomplished speaker, writer, and workshop leader, Cathy’s work in organizational psychology focuses on effective stress-controlled management. Cathy’s books, “Great Communication = Great Production” and “Collect What You Produce,” are top sellers for PennWell Books. You may reach her toll-free at (877) 369-5558, via e-mail at [email protected], or on the Web at is paralyzingThe ultimate fear of the unknown hovers around change. Most fears arise from not being sure about something:
  • not being sure how to do something;
  • not being sure if something will work;
  • not being sure that the investment in time and money will pay off;
  • not knowing if you are capable of executing something well;
  • not being sure if doing something differently will make a positive difference or if the change will bring about a better result than the one you are now getting.
  • Fear of the unknown is a real concern for most people in one circumstance or another. Certainly, if someone has been “burned” by a situation, it is a true “leap of faith” to try it again, even if the efforts involve a new method, scenario, or discipline.The best way to debilitate fear is to face it “head on.” There is nothing that will stifle a person’s growth more than fear. The worst thing that can happen if you try something and it doesn’t work is that you will have learned something. You will have learned that this method, this system, this “whatever” doesn’t work for you. Once you realize that something isn’t working, ask yourself: “Did we really give it a fair chance? Did we do our best to implement this change? Did we do everything exactly as we were instructed?” Then ask yourself another question: “Does this system (or whatever) not work or are we not working the system?”This is one of the best questions you will ever ask yourself ... and if you answer it honestly, you will probably acknowledge that you haven’t put forth a 100 percent effort. As a result, you did not obtain the excellent results you had hoped for. The efforts you put forth will be in direct proportion to the results you receive.Then there’s the fear of failure. Do not let fear stifle your growth. Marianne Williamson, in her book, “The Gift of Change,” says, “The only real failure in life is the failure to grow from what we go through.” There is no such thing as failure if you approach each and every endeavor with an open mind and a commitment to do your best. If you have a positive attitude, you will learn and grow - even if things don’t work out as you expected. Some of the greatest inventions and discoveries occurred when the expected result was not accomplished, but a new, unexpected result turned out to be better.Is there risk involved with trying something new? Of course! Think of risk as a two-sided coin. On the one side of the coin called “risk,” there is the chance that you might make a mistake or that things won’t work out as you had anticipated. However, if you choose to learn from each and every activity - even your mistakes - you’ll find ultimate success on the other side of the coin.You also need to realize that there is a very real fear of personal loss for some people who are resistant to change. They decide that they don’t want to make any changes, don’t want to do anything differently, and in fact, aren’t going to make any changes. Sometimes people on the team are very territorial.They do not want anyone “messing” in their area. They have fallen into a routine and have a sense of ownership of their area, their way of working, and their routine. They are quite often afraid of loss if change is recommended or implemented. In addition, some team members fear that if changes are recommended, the doctor must feel they weren’t doing a good job. They may fear a personal loss of respect on the part of the doctor. Team members become possessive of their relationship with the doctor and want the doctor to admire their work. If there is any suggestion of change, they may feel this is an assault on what they have been doing up to that point. Neither of these assumptions is true in most cases. If change is encouraged, that doesn’t mean that the doctor is unhappy with anyone. It means he or she is ready to go to the next level, and change goes hand in hand with that elevation.The sense of personal loss some staff members feel when a system or work area is changed will usually subside when the new way becomes the norm. It’s like getting used to anything new. It may feel awkward or uncomfortable at first, but will become the norm with time. And, hopefully, the new way will be better, and once the new comfort zone is established, staff members wouldn’t want to go back to the old way even if they could.

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