Catch o' the day: A new method of capturing staff and patient commitment

Oct. 1, 2002
Something is fishy in dentistry, and we are to blame. At Pride Institute, we have introduced ideas on team-building and morale-boosting used in corporate America into the dental practice.

by James R. Pride, DDS; Amy Morgan; and Pam Haffner

Something is fishy in dentistry, and we are to blame. At Pride Institute, we have introduced ideas on team-building and morale-boosting used in corporate America into the dental practice. But to explain these ideas and their results, we must first go fishing.

An unusual fish market in Seattle called Pike Place Fish has captured national attention by redefining the jobs of its employees (called "fishmongers") in fantastic new ways that motivate them and delight their customers. Encouraged by management to think "outside the box," the employees decided that they would be the best in the world at what they do. Here's how their craziness works: You walk in to buy a fish. You select a five-pound snapper that looks as if it wants to be eaten. The gloved fishmongers joke with each other, toss your fish in the air, play catch with the slippery thing, and talk to you while your future dinner is in flight. Eventually, your fish lands and you make your purchase. The result? The fishmongers made you laugh; they surprised you with the unexpected; they had fun; and you got your fish! The fishmongers used a few simple, but powerful, concepts to transform their work into something special for themselves and their customers. You can read about these concepts in FISH!, a book by Stephen Ludin, John Christensen, and Harry Paul of the Ken Blanchard Companies.

We decided to see how these ideas could be applied to dentistry (and, no, we didn't throw instruments around!). Our research and development team worked directly with the authors and fish coaches to create a workshop based on the "fish" concepts, but customized to the dental office.

The concepts

Simple, but overlooked by many, the following core ideas are at work to transform the fishmongers from humdrum job-holders to people having fun and doing something exciting:

•Choose your attitude. Employees may not be able to do the job they love, but they can love the job they do. Their attitude is the bedrock upon which all else is built. If Mary Smith has always longed to be a spy for the CIA, but has become your dental assistant instead, she can either be frustrated with her job — venting her dissatisfaction on you, her co-workers, her patients, and herself — or she can decide to enjoy what she is doing and make the most of her situation. The fishmongers decided that they wanted to be famous at what they do. This ambitious approach to an otherwise routine job uniquely colors the way they work. A leader can help an employee gain awareness of his or her attitude and make a conscious commitment to choose a positive one. For example, if three emergency patients are expected on a given day, the dental staff does not have to feel harried. The staff can choose their attitude and challenge themselves to do or say something to make that last emergency patient smile.

•Be present. The fishmongers have the presence of mind to note their customers' moods, know how long they have been waiting, and interact with them. Daydreaming, making excessive personal phone calls, or doing tasks halfheartedly are not ways of being fully focused at work.

Making routine tasks more interesting sharpens the staff's focus. For example, an appointment coordinator can challenge herself to find a new way to greet patients, such as shaking hands or making a game of mentioning the patient's name before he or she has a chance to give it. ("You must be Mr. Smith. I'm Janet. We spoke yesterday. It's nice to meet you."). A fresh approach can dramatically improve the staff member's focus on her task.

•Play. Too often, routine tasks become tedious and boring. The fishmongers face this too. Their jobs are no more interesting than anyone else's, but their sense of playfulness makes a huge difference. They have to pick up their fish before sunrise, ice it, and pack it — not the most exciting existence. But then one of them will do a little dance, and his co-workers will laugh.

The fishmongers try to make a kind of adult playground of their workplace to replace the boredom. This also can be done in the dental office. While it is easy to enjoy interacting with your favorites, the challenge becomes how to have fun with a cranky patient. Creating that challenge can turn a disagreeable task into a fun one. Can we make Mr. Cranky smile? The new approach might just draw Mr. Cranky out and improve the entire relationship.

•Make someone's day. The fishmongers derive great satisfaction from delighting their customers. They accomplish this by doing things that surprise their patrons, thus adding value to their service. In a retail fish store, a customer expects to buy a good product from an efficient, courteous employee. If the customer can get all of this, plus have a few laughs and be entertained, an adequate or good experience becomes memorable. The same is true in a dental practice. A patient undergoing a crown prep will have a good experience if he gets timely treatment from an efficient, friendly doctor and staff. This patient could have a memorable experience instead if, in addition to the standard good things, he receives something extra. You could offer the patient a smoothie, for instance, while his temporary crown is being prepared. This unusual gesture elevates the entire experience.

The results

We presented these same concepts to dentists and their staffs through workshops and training exercises. Our goal was to spark their imaginations so they would create ways to apply these concepts to their situations. We even took the participants to Seattle to visit the fishmongers.

The doctors and staff members who completed the training indicate that they not only enjoy their work more and have better interaction with each other, but they also have a significant impact on their practices through innovative ideas. Production, new-patient referrals, and treatment acceptance all have increased, while cancellations and no-shows have decreased. The training increased staff contentment, which led to better patient relations. Happier, better-cared-for patients follow through on their treatment, stay loyal to the practice, and often refer new patients.

Here are some of the results that doctors and their staff members have reported to us:

Choose your attitude

  • Feel comfortable asking others for help if you're having problems.
  • Keep a "crab magnet" around to playfully give to a "crabby" co-worker.
  • Put an electronic fish aquarium in the office as a reminder of "fishy" things.
  • Post a list of desired improvements on lockers or bulletin boards.
  • Keep raising the bar and trying new things to avoid stagnation.

Be present

  • Even though you may say the same thing over and over again, remember that, each time, a different patient hears you.
  • Listen to co-workers, patients, and the dentist, rather than just waiting for your turn to speak.
  • Be involved in your community. Our dental office participated in a Walk for Multiple Sclerosis and a Habitat-for-Humanity building project. We also took a booth at our community's health fair.

Give your complete attention to every patient. Avoid using one patient's appointment time to finish a chart from another or prepare for the next patient.


  • Go on field trips. We visit specialists and laboratories, and drop off thank-you gifts to patients at their workplaces.
  • Patronize your patients' workplaces. One patient from our office manages a restaurant; another runs a dry-cleaning business. Our staff and doctors make a point of using their services.
  • Have lunch together — doctor and team — once a month, and schedule outings that involve families. We had an outing at an amusement park for our doctor and team with our families.
  • At quitting time, our doctor says "Yabba dabba do!" like Fred Flintstone, making everyone laugh.
  • Our doctor bakes flower-shaped cookies for staff meetings.
  • Place pictures of doctors and staff with their families on a bulletin board in the reception area. We post drawings of fishes on which each of us write our personal goals. The patients think this is interesting.

Make someone's day

  • Bake bread twice a week and give it to someone the staff selects as "patient of the day." This could be someone we want to show appreciation to for filling an open block in the schedule, giving us a referral, or just being nice.
  • Hold a children's drawing contest and give away electric toothbrushes to the winners.
  • Keep snacks on hand, such as fruit juices, for patients having long procedures.
  • Acknowledge your mistakes. We had difficulty with a patient's bridge and needed to switch labs. To thank the patient for her understanding, we gave her an electric toothbrush and movie tickets.
  • Whenever one of our patients is featured in the local newspaper, the doctor cuts out the clipping for all of us to read. We show it to the patient at his or her next appointment. Patients love to see the clippings. Knowing that we took time to honor them makes them feel good.
  • Send greeting cards to patients when something special is happening in their lives, such as a marriage, a new baby, or a new job.
  • Send cookie bouquets to offices around town that employ your patients.
  • Hold a "theme" day. One of ours was "Back to the Fifties," complete with bobby socks, flaired skirts, and ponytails. We had fun dressing up, and patients got their pictures taken with a life-sized cardboard Elvis Presley. We thought up the 1950s theme because our office donated 50 percent of the day's hygiene revenue to charities preselected by our patients.

One office manager sums up the "fish training" and our workshop as follows: "We have a lot of fun in our office, and that makes the work bearable. I've been here for 11 years, and I still like getting up in the morning and coming to work. As staff members, we'll never be the doctor, so there's no corporate ladder to climb. We have to grow outward, not upward. This means constantly being better at what we already do, rather than starting all over again at a new job. In our town, we're the best dental practice. When we impress patients by something we did, it means we have to find a new way to impress those same people again six months later when they come back. We can't stagnate, and this keeps the job interesting."

Making the "fish training" endure over time involves the use of many leadership tools. To keep the staff focused, keep little reminders of the training visible. In our case, we posted fish in various places, along with workshop exercises and commitments each staff member made. On a deeper level, making the training stick requires that a practice define its vision and gain every staff member's commitment. This, of course, is an ongoing process.

The basic lesson from the fishmongers is that every job can be interesting and fun if the employee views it that way and if the leader encourages him to do so. Unleashing your staff's creativity to make their jobs more enjoyable directly improves their relationship with patients and leads to other practice improvements. It's time to try your hand at finding a pearl in the oyster!

Happier, better-cared-for patients follow through on their treatment, stay loyal to the practice, and often refer new patients.

Every job can be interesting and fun if the employee views it that way and if the leader encourages him to do so.

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