Do you utilize a total team concept?

The doctor-technician relationship is essential to your success. Time for a thorough evaluation.

The doctor-technician relationship is essential to your success. Time for a thorough evaluation.

Change is inevitable! Dentistry stands at a new crossroad. We face a dynamic explosion of material and technical change that has us mesmerized regardless of where or how we practice. All eyes seem to be fixed on the latest technologies, and much of our continuing education is aimed at building the technical and marketing skills to deliver them. Yet, one of the biggest challenges we face is developing our basic leadership and people skills. Assembling and leading the right team through the vast jungle of expanding knowledge and new technical skills needed to achieve our best dentistry is no easy task.

Doctors in the United States are potentially facing a collision of events because many dental technicians are approaching retirement age and 60 percent of the dental technician schools have been closed. The increased demand for sophisticated dental laboratory products combined with this potential decrease in the number of experienced technicians means the dental world is about to change in a big way! The time is coming when many doctors will find themselves scrambling to locate - and be accepted by - a higher-end dental laboratory capable of producing proper esthetic and functional results. In fact, dental laboratories with exceptional technicians are already choosing the doctors with whom they would like to partner in order to serve patients at the highest level possible.

Esthetic demands by the public driven by aggressive international marketing combined with dramatic advances in technology ignited this revolution in healthcare delivery. It will continue to grow at a rapid pace. The public is becoming ever more aware of the possibilities available at the higher end of the dental spectrum. This is putting increased pressure on all doctors and support teams, including their dental laboratories, to increase their knowledge and abilities to deliver a high-end product and exceptional service.

Is your business vision inclusive of your total team?

We must gather the knowledge and skills to create a vision and practice (business) philosophy that will accommodate these new challenges. Hard work is needed in relationship-building skills, communication skills, teamwork, and interbusiness networking skills. This is paramount to any long-term business success for the well-run dental practice. These skills also will be vital to our business relationship with the dental laboratory.

Is your practice on the same page as your dental laboratory?

Although the steps for developing your vision are outside the scope of this article, some general comments are in order relating to your dental laboratory relationship. As Dr. Bill Blatchford so eloquently stated in the Journal of the American Academy of Cosmetic Dentistry (1998), “A strong vision demonstrates itself in every move you make as a dentist. Your actions speak your vision.” Can you articulate a vision that will inspire you and your staff as your practice grows? That is the first task you must accomplish to have “actions that speak your vision.” Other team members should be considered in your overall plans. What is the vision of your dental laboratory? Is your practice vision compatible with your laboratory’s vision? Or, is the laboratory’s vision in conflict with, or maybe even diametrically opposed to your practice vision? The vision statement should be supported by an underlying practice philosophy that is realistic and inclusive of the kind of care you wish to deliver. This vision should be parallel and symbiotic with the vision and business philosophy of your laboratory if you are to collaborate at the highest levels. We can then put our collective vision into action and our businesses will become a synergistic firestorm of growth and ideas.

Are your business philosophy and methods consistent with your current laboratory? Do both of you believe in open and honest communication to improve the functional and esthetic end-result? Are ego barriers and prejudices put aside to allow a healthy flow of constructive, two-way criticism? Do you share a common goal of wanting to reduce stress and loss of profits by decreasing the incidence of re-makes through co-investigation and meaningful responses, regardless of who is at fault? Can you have an agreement to discuss what went wrong with a case and be willing to share or accept the responsibility? Do you have a common goal of motivating all your team members with specific positive feedback when things go splendidly?

This focus on checking to see where we are in relation to each other’s business is a concern that deserves high priority. It will help move us toward a coordinated effort that will pay huge dividends.

Can my office be on roller skates while my laboratory is on a luxury cruise?

Many doctors profess to practice in (what they believe to be) a fee-for-service-based practice. Without realizing it, many of these same doctors, like their laboratories, are actually deeply engrained in a fee-for-commodity business philosophy. They are often hopelessly bogged down in an “all-my-patients-are-insurance-dependent” world. They feel they are on a no-way-out, dead-end professional ride. Does this have to be the case?

It all boils down to making some tough leadership choices in operating our businesses. How can we afford to get work from a high-end dental laboratory that puts the quality of its people and work first - above its production numbers? This is the kind of laboratory many like-minded doctors are now searching for to achieve a marketing edge in providing superior restorations. Many of the teachers in well-known centers for continuing education are encouraging attendees to select only the very best dental laboratories and to adjust patient fees accordingly. It has been said that insurance- or government-determined fees are not compatible with a high-end, patient-centered, high service-oriented practice. As the CEOs (leaders) of our businesses, we must sometimes make the tough decisions that will allow us the financial freedom to choose the absolute best teams possible.

Setting a total team example

Many times as I have presented seminars for doctors and dental technicians, I have noticed there is at least some feeling or evidence of separation in the professional relationships between these interdependent team members. Although there are certainly exceptions, as a whole the dental profession still seems to be taking an “us versus them” business approach to the dental laboratories.

Our collective actions often speak louder than words or intentions. Let’s look at our professional dental meetings as a prime example. How many dental meetings have you attended where the dental technicians are present in any significant numbers to exchange ideas and help make an impact on the profession? (This assumes they were officially invited and encouraged to attend mutually relevant meetings.) Of course, like some of our colleagues, there may be those who would not attend for any other reason than to fulfill minimum CE requirements. There also may be various barriers such as a bit of professional uncertainty or possibly even negative interprofessional experiences in their backgrounds.

For many years now, dental technicians have been meeting in separate locations from their dentist colleagues. Meanwhile, doctors and “all” their staff members have been building their relationships and learning together as a team at their own meetings. Can you begin to see what is wrong with this picture? What kind of message does this send to our valuable dental technicians - our other team members? Ideally, leaders in dentistry should be looking out for all the team members involved in the process of serving their patients. Have we all been waiting for someone else to invite our dental technicians to join us? Perhaps, until now, we have not given it much thought. Leadership is about knowing when and how to empower all of our team members to become all that they can be. It is also about making them feel included and therefore valued as major contributing members of the same patient-care team.

United we stand, divided we all work harder!

Let’s look closer to home, in our own practices. Do you view the dental practice and dental laboratory as two separate business entities, or do you see them as being on the same team? Instead of sending carefully prepared cases to a technician or the laboratory, I often encourage my colleagues to view their dental technicians as their extended staff. Even though the technical work is usually accomplished under two different roofs and in distinctly different work cultures, the goal should be to identify and develop that which is most vital for our mutual success. This effort will be paid for many times over. It will be evident in the delivery of superior work for the patient. How can these moves toward a joint effort begin to take shape in your practice? Are you working with a laboratory that is truly compatible with your business goals? Is it even possible to be on the same page with respect to vision and practice philosophy with your current dental laboratory? How do we, as leaders in our businesses, reach out to our dental technicians? Will they embrace our efforts to reach out to them and bridge the gap between us? How can we begin to build great relationships with our dental technicians? How do we sustain our relationships?

Let�s look in the mirror. What do we see?

Begin with an exercise that requires a little self-reflection to gauge your personal feelings and positions on important doctor-technician issues. Read the following questions and answer each one True or False. This exercise will help you only if you are completely honest.

I expect my laboratory to do work for me that meets or exceeds my expectations.

I want my laboratory technicians to understand my needs, to appreciate and respect me as a caring dental health professional.

I truly appreciate, respect, and value the relationship I have with my technicians or laboratory owner.

I have visited my laboratory at least once and have met all the technicians who work on my cases.

I visit my laboratory occasionally to discuss a complex or an esthetic case and to build our working relationship.

I have routinely taken, or at least invited, my technician(s) to attend relevant dental, management, marketing, or communication continuing-education courses with the rest of my office team.

If you are like most doctors, the first two questions are no-brainers. It should have been easy to answer “True” to both. However, and more important, how did you answer the rest? Statements such as, “I really care about my dental technician,” or “I deeply respect my dental laboratory” seem to ring quite hollow if we cannot answer “True” to all of the above. Please do not get discouraged as a result of this exercise or the challenges contained in the many questions in this article. You are not alone! Nearly all of us have been through similar experiences related to our relationships with our dental technicians. I know we would never be intentionally unappreciative of our laboratory colleagues. Let’s simply take the first steps at putting our revelations from this exercise into a perspective for growth. We need to develop real, meaningful business and personal relationships with all the people who make a huge difference in our professional lives. That is how to utilize the total team concept for collective success!

Dr. Damon C. Adams is an assistant professor at Medical College of Ohio, Division of Dentistry, Department of Otolaryngology, in Toledo, Ohio. He lectures nationally and internationally for many dental organizations and laboratories, and served as the doctor/technician liaison for DH Baker Dental Laboratory in Traverse City, Mich., for more than eight years. Dr. Adams presents lectures and hands-on seminars on topics such as “Excellence in Everyday Esthetics,” and others. For questions or lecture information, e-mail him at damona11@hotmail.com.

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