Are you in or out of the box?

Sept. 1, 1999
Some companies in America have started a new breed of business management. Could this new style be right for your practice?

Some companies in America have started a new breed of business management. Could this new style be right for your practice?

Dr. Ronald Linden

A quiet revolution is occurring today in businesses throughout the United States. Consider the following:

- A manufacturer of welding equipment in Ohio hires almost all of its employees from friends and relatives of employees. But, if an employee comes up short of expectations, those same friends and relatives will want that person removed.

- A bank executive, in his early 30s, was named the president and chief executive officer of a multi-billion dollar bank in Philadelphia. After a few years, he was fired for trying to topple the bank`s hierarchy. He now teaches leadership seminars that advocate alignment with talented people in a company, as well as being authentic in both one`s public and private persona.

- A software development firm in the South mandates a limited number of hours that employees can work during the week. This in an industry where 24-hour days are sometimes the norm.

What`s the common thread and what does this have to do with dentistry? These companies and individuals practice a style of management that might be called "out of the box" or "on the edge" thinking. The companies are not household names, but they adhere to a set of core values that might be significant for those dental practices wishing to rise above the fray.

A new business magazine called Fast Company has most vigorously advocated these kinds of values. Over the last several years, a large number of followers of this new style of management have popped up around the world, in groupings known as cells or friends of Fast Company.

Among the core values, and their relevance to dentistry, are the following:

1. The critical importance of relationships. Relationships in a dental office involve the interactions between staff, doctor, and patients. Anything that enhances and promotes these relationships will enhance and promote the office.

2. The recognition of employee value. Without high-level employees who are sincerely valued, a dental office will be limited in what can be accomplished. There needs to be an absolute tolerance of, and encouragement of, making mistakes. This serves as a learning tool for doctor and employee. There needs to be recognition that employees have a life outside of the office, requiring flexibility in terms of hours and time-commitments to the office. There needs to be a power structure in the office that flattens out, the opposite of the vertical structure where power flows from the doctor downward. In a flat structure, the power to move a dental office forward comes equally from the employees and employer.

3. The need for controlled chaos. The business world, and the dental world, is now changing so rapidly that as soon as an office policy manual is written, it will be outdated. Policies and procedures need to be established, but also re-written, varied and modified as dental personnel adapt to different patient styles, different insurance mandates, and new treatments. It is a process in continual flux, yet continually in control.

4. The constant need for communication. Communication and training are key in a dental office. Training is not just a one-hour exercise per week or month. It is done when patients cancel their appointments. It is practiced on the run when a procedure needs to be questioned and/or modified by the employer and employee. It needs to flow two ways - from employer to employee and vice versa. Communication needs to be a key to patient relationships. Doctors, as well as employees, must develop sensitive antennae to perceive not only what`s said, but, more importantly, what`s not being said. Dentists need to make their offices safe for employees, staff, and colleagues to say what`s on their minds, knowing that the consequences will be a beneficial change, and not a defensive protection on the part of the dentist.

5. Private is public and public is private. There needs to be consistency in what we say and do in public and private. We need to be genuine. When we communicate to each other in a dental office, the role of artifice and dishonesty needs to be eliminated. We need to pay attention to how we say certain things. If we have a problem with someone in the office, we need not offend that person, but manage to get our message across to him or her in a respectful way. When dentists do not honestly believe in their treatment objectives, costs, and procedures (or in their own true set of core values) and do not proceed at a high level of commitment, then they will sabotage their outcomes.

6. Learning does not stop. As a dentist, you are never there and never will get there. The road to enhancement, learning, discovery and change is always present and constant. Seminars, reading, making mistakes, and interactions are continual, additive processes.

These are only some of the concepts that "out of the box" thinking encompasses. They do not conflict with those management philosophies that express what can be measured and/or can be improved. There still needs to be control of receivables, production, collection, and scheduling. The basics of dental practice are not abandoned. These principles revolve predominantly around people management. They enhance and do not replace fundamental dental management skills.

From these set of core values, a myriad of alterations and enhancements can arise that can be made very specific for each office. They are an extraordinarily difficult set of values to master and require a strong, lifetime commitment on the part of a dentist. I don`t feel that every office should attempt the types of changes spelled out unless it feels the changes fit and are intrinsically right for it.

However, I feel the reward for following this new set of concepts can truly mean a new paradigm for dental practice. I envision practices where the stress level of the office environment subsides. Where employees are no longer perceived as the most difficult part of the practice, but exactly the opposite. Where profit follows but does not stand out as the top priority. Where life gets more balanced and more into perspective.

I also see "out of the box" principles as an excellent way to deal with the rapid changes in dentistry today. By going through this process, dentists can better define who they are, what they want out of dentistry, and what they are willing to do to create an environment that fosters better commitment, better dentistry, and happier people.


Basics: Founding Editors William Taylor and Alan Webber started Fast Company magazine with two fundamental propositions: there is a new world of business evolving, and there is a community committed to new ways of working, competing, living, and growing. The magazine states that it writes about the new economy and workplace for people who believe in fusing tough-minded performance with sane human values.

For more information: Log on to


Background: In 1992, Dr. Hazel Taylor created B9D, Inc. (short for Beyond 9 Dots), a company located in the northwest suburbs of Chicago that practices "out of the box" thinking. Dr. Taylor founded the company in response to strategic opportunities presented by the convergence of telecommunications, consumer electronics, and information technology industries. B9D`s client roster embraces both new and established companies across these three industries, including such firms of Amoco, Lucent Technologies, and Motorola.

Q&A with Dr. Hazel Taylor, founder, president and chief executive officer of B9D, Inc.

Q: How do you or your company define "out of the box" thinking?

A: Our logo is the 9 dot puzzle out of which came the expression thinking outside the box. Just as when someone tries to solve the puzzle for the first time, it is normal to use the imaginary lines formed by the outside of the box as if they are limits. Yet the puzzle has no solution unless one extends the lines outside that imaginary frame. Each of us has a frame of reference in which we normally think about things. Even companies and/or departments within companies develop frames of reference. B9D works with clients to create expanded and different frames of reference while solving basic sales, marketing, and information technology challenges.

Q: Why is this way of thinking becoming so popular?

A: The expression has become popular yet it is still not easy for people to know when they are stuck in their frame of reference and when they have actually stepped out of it. It`s difficult to break free of typical ways of thinking if you don`t know you`re limiting yourself. It`s a human characteristic and a natural human tendency to have a frame of reference. Companies have tendencies as well. If we work together with a company, that company will realize it can step out of its usual patterns.

Q: What is your company`s typical interaction with clients?

A: We start by having discussions with everyone involved with the project separately and together, just listening to what they perceive as the problems they are facing and what they have already tried. We talk about how to measure success. Then we start listing all the people they can think of who might have some information or ideas related to the problem, not limiting ourselves to the company and the obvious.

Q: What goes into a typical "out of the box" thinking session when a client comes to you for help?

A: We don`t really have typical sessions. Often, we can create an atmosphere that encourages such good brainstorming that they realize they had the ability all along but just did not recognize it.

Q: In what ways do your clients benefit from "out of the box" thinking?

A: It helps them to understand what has been limiting them. We often use humor to make it easy for people who work together to tease someone about "going back into the box." If one hears a lot of "that is the way we have always done it" or if they use a "methodology" that is very rigid, they could probably benefit from thinking outside the box.

For more information on B9D, Inc., log on to, or call 847-304-4999.

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