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Delivering tough conversations in dentistry with integrity (Part 2)

Oct. 1, 2011
If you missed the first part of this article, I would like to suggest that you go back to the September issue of DE and read it.

by JoAn Majors, RDA

For more on this topic, go to and search using the following key words: tough conversations, integrity, permission, honesty, innocence, JoAn Majors, RDA.

If you missed the first part of this article, I would like to suggest that you go back to the September issue of DE and read it. This should help you and your team have a more complete understanding of how changing a few thoughts, questions, and insights can greatly improve your tough conversations in the practice.

In Part 1, I shared a statement that is at the heart of these conversations, “When it comes to delivering tough conversations, starting with the right question and the right attitude can change everything about the encounter and the outcome.” In short, are you starting with your arms open or closed? Whether the conversation is from doctor or administrator to team, team to doctor, practice member to patient, or even practice to lab or vendor, the system to communicate with an effective outcome is the same.

Briefly, in Part 1, I suggested that you use four techniques:

1) Ask permission to coach, or
2) Ask permission to be honest

With Step 1 or 2, you start by asking the party if you can share. This takes the edge off, almost as if the person who is being asked is in charge. For years, a staple idea taught in sales classes was, “He who asks the questions is in control.” This allows both parties to choose to participate. He or she is now engaged in the process by saying “yes.” It is a symbiotic relationship, not a reprimand.

In 17 years of using and sharing these systems, I do not remember a case in which the party being asked said “no.” For any doubting Thomases, you can mark this off your “that would never work in our office” list. You will have to do better than that!

3) Leave out the limiting terms
4) Assume innocence

Using Steps 3 and 4 in these types of conversations changes the dynamics. Remember not to minimize the offense, behavior, or issue by using terms that limit the impact. This is not to say that there are no instances to use words such as we, little, sort of, or kind of. It’s just that when you are discussing someone else’s issue, it is not the time.

If you think you need to use these words, then perhaps the issue is not important enough for a formal conversation. On the other hand, it’s important that you assume innocence.

There is just no way to know the story unless you ask the right questions. The issue at hand could be, and probably is, a symptom of something much bigger happening. Keeping an open mind is the first step of open sharing.

If you are anything like I am, a team member or manager who wants to be a better leader or like my husband — a practicing dentist and wants to grow — you might have read Part 1 and thought, “What else?”

In other words, how do we finalize the next step and measure the result with an agreed-upon outcome? We use accountability and measurable results.

If the individual who is being asked the questions (because of a performance or behavior issue) is one who rarely says much, you need to help the person make a good decision or urge the person to take part in the outcome. If this conversation is with someone of many words, it is important to stay out of the way and let the person outline the next step and outcome. Some examples are listed below.

If you covered with the team member that you are concerned (as he or she should be) about that person’s tardiness (personal texting, Facebook use during office time, or whatever the issue is) and you have documented this, there is one of two options to finalize this often difficult conversation. In addition, both parties should document the conversation with their signatures and the date.

If you have a conversation with someone who has a strong personality or is outspoken, I suggest something such as this: “Susan, now that you and I have discussed your tardiness, how do you suggest we move forward?” Once documented, you could ask, “What do you think should happen if this agreement is violated?”

On the other hand, if your conversation is with someone who is a more timid individual, it is best to try to engage this type of person evenly. For example, “Susan, now that you and I have discussed your tardiness, how should we move forward?” Once documented, you could ask, “What are we going to decide what will happen if our agreement is violated?”

These final steps should give everyone an understanding of the documented concern, how to move forward, and the action to be taken if violated. Remember, this conversation started out with a question.

The question allowed the team member to choose to become engaged by saying “yes” when he or she was asked about being coached or being honest. This puts the situation in a different mindset than the traditional, “I want to see you in my office” attitude.

The rule of thumb is: Don’t leave it to chance. Make a choice of how it will be handled and what will happen if it is not. Therefore, the bottom line to this system is:

5) Document an agreement of how to move forward with the issue
6) Document an action of what will happen if the agreement is violated

Let me share some “big business” statistics on conflict resolution. From the statistics in the following section, it is evident that it is important to be proactive.

It pays to have a documented system to resolve issues while they are small. It may not be comfortable to proceed in this manner, simply because it is new to you, but it is more likely to provide the long-term results most desired within and close to our dental teams.

Workplace conflict statistics

  • It is important to understand that conflict in the workplace always starts small. In the Department of Human Resource Management article titled, “Workplace Conflict Statistics,” poor relationships between employees create 60% to 80% of conflict within a business.
  • Research shows that 60% to 80% of difficulties in organizations stem from strained relationships between employees, not from deficits in an individual employee’s skill or motivation. — Daniel Dana, Managing Differences: How to Build Better Relationships at Work and Home (2005, 4th ed.); Barbara J. Kreisman, Insights into Employee Motivation, Commitment and Retention (2002).
  • The typical manager spends 25% to 40% of his or her time (one to two days of every work week) dealing with workplace conflicts. — Washington Business Journal, May 2005.
  • Ernst & Young reports that the cost of losing and replacing an employee may be as high as 150% of the departing employee’s annual salary. —
  • In closing, let me suggest that this system can create better retention and immediate results outlined by both the offender and the one with expectations.

My husband, Dr. Chuck Majors, has practiced almost 30 years. He often shares that, “Our greatest disappointments are our expectations of others.” Don’t let your expectations go undocumented, and you will not have to be disappointed.

In January 2012, I will start a new column, “For the Dental Team.” In the column, I plan to tackle a sore subject — costly cancellations and no shows. I hope to help you understand the accountability measures and verbal skills that are simple, yet so effective.

Let’s banish the saying, “Your 10 o’clock just cancelled!” and avoid that sinking feeling in the pit of your stomach when it happens. Until next time, here’s a quote to contemplate from the book “Encouragementors”: “One must be responsible for input and be accountable for outcomes.” See you on the road.

JoAn Majors is a registered dental assistant, published author, and professional speaker. In addition to her speaking, she has the team training faculty position for the Misch International Implant Institute. For more information on JoAn’s seminars and her latest book, “EncourageMentors: Sixteen Attitude Steps for Building Your Business, Family and Future,” visit or call (866) 51-CHOICE. The time is now; the choice is yours!

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