This is a continuation of a series of blogs exploring what it takes to become the leader you want to be. It’s all about breaking down Dr. Rich Green’s brilliant definition of a leader:

“A leader is a person…

Willing and Able

To influence behavior;

Their OWN FIRST

Then others

To a preferred future.”

-Rich Green, DDS

Know Thyself

In the previous blog, we looked at willingness and ability to influence behavior. The next piece of Dr. Green’s definition is “Their Own First.” Our ability to influence others starts with our ability to influence ourselves.

Just like our patients, we often “know” what we should do and even how to do it, but then we don’t do what we know we should. So, how do we influence our own behavior intentionally?

This is sometimes the hardest part. I believe it starts with “know thyself.” Dr. Pankey placed “know thyself” at the top of his Cross of Dentistry for a reason. I have observed (and experienced) that in general, dentists focus most of our attention and efforts on knowing our work and applying our knowledge.

Here at Pankey, we also focus on knowing our patients. But very few dentists, or humans for that matter, focus on really knowing ourselves—what matters to us, why it matters to us, why we do what we do, and what’s truly creating our results.

If we put attention and effort into knowing and growing ourselves first, our ability to lead others is exponentially improved. Here are the areas I believe are imperative to this:

Essential Concepts

1. Our competency and skill level is of course important. We do need to know what we’re doing.

Depending on our business model, it’s important that we are competent in these areas: clinical skills, how to run a successful business, and communication and relationship-building. We should continue to grow in each of these areas.

2. A basic understanding of how we are wired is crucial because this is where much of our behavior comes from. Each of us is a blank canvas from age 0-7. We are programmed during those years. We learn survival skills and form beliefs that shape our model of the world.

It is very helpful to understand how this shapes our world and how it drives our behavior. We can become aware of and change our programming with work and practice.

3. The ability to be with our emotions (and those of others) is also of utmost importance. As humans we have the ability to let emotions move through us. Not only that, it is vital and healthy to do so. Emotions have useful information in them as well.

4. The fourth area I’ll call ‘knowing your truth.’ This is the connection to your heart and soul. If we grow our clarity and trust in this and our worthiness of having what we desire, this will take us further than anything else.

What do you believe in your core? What matters most to you? What’s your purpose? What do you desire?

I hope this blog has convinced you that it is a worthy, worthwhile, and noble cause to spend time getting to know yourself better. Only by knowing ourselves can we really know others at the highest level. Then it is our honor and privilege to be able to influence them, which is what we will talk about in my next post …

I have heard many dentists say in one way or another that they are not leaders or don’t want to be. It feels to many of us like a big responsibility. Some would rather abdicate this responsibility as leaders in the dental practice (or life) because it can be hard.

Leadership & Growth

My favorite definition of a leader is from Dr. Rich Green:

“A leader is a person…

Willing and Able

To influence behavior;

Their OWN FIRST

Then others

To a preferred future.”

I started my own practice from scratch, owned it for 20 years, recently sold it, and now work in the practice part time. As the primary leader for so many years and now as a co-leader for 4, I know how hard it is.

We have a lot of other urgent and/or important things pulling for our time and attention. Even though growing and practicing our leadership is vitally important, it is seldom urgent, so it’s easy to put seemingly urgent things ahead of it.

But I would assert that leadership is ultimately the single most important tool we have to help us achieve success and happiness.

Willing and Able

As Rich says in his definition, a leader is a person willing and able to influence behavior.

The definition of willing is:

1. Ready, eager, or prepared to do something.

2. Given or done readily.

The definition of able is:

1. Having the power, skill, means, or opportunity to do something.

2. Having considerable skill, proficiency, or intelligence.

Let’s be honest, these definitions are a little bit daunting. Here’s the thing, leadership is a commitment that we “live into.” 

Feedback and Action

We learn leadership as we go. We will likely never feel 100% ready, eager, prepared, skilled, proficient, and intelligent at it. We shouldn’t constantly comparing ourselves against some ideal.

We must notice where we are and make strides toward where we want to be. We must also keep showing up, leading, and getting feedback about what’s working, what’s not, and where we had the impact we intended to have and where we didn’t.

It’s not as important what the feedback is as what we do with it. Many of us who were born, bred, and raised perfectionists have learned to focus mostly on the negative feedback. Then we beat ourselves up with it and defend or make excuses about why we did what we did.

Feedback can be really hard to hear … Part of being a great leader is learning to hear the feedback and looking to see what feels true and what doesn’t. We have to to see what created that result, even if it’s something we said and/or did (all without beating ourselves up).

And then, if there’s something that needs work, do the work to shift it so that things are better next time. We’ll be talking more about that in my next blog. Another part of being a great leader is to notice, acknowledge, and own even small improvements and to really celebrate when we (and others) do something well. So, are you willing and able to influence behavior? Even when it’s hard?

If we want to be intentional and impactful as leaders, it definitely takes willingness and effort to grow our ability. I have found that it is the most rewarding work we can possibly do!

We’re actually influencing all the time anyway, so wouldn’t it be wonderful to do so intentionally?

The trend today is to move away from writing patients prescriptions for opioid pain medications . We do still have to help patients who are experiencing pain and plan for post op pain management when performing procedures that induce tissue trauma.

Managing The Regulations

For most of us today we are required to register with our state prescription management service. These services allow all of the data from every prescriber, patient and pharmacy to be gathered and reviewed in one central database.  This information is then used to both monitor patients and prescribers, and to provide feedback information. Of course the information needs to be interpreted. I prescribe very little medication, for pain or otherwise. Probably the most common thing I write for is antibiotics, and with very few patients who need pre-med today even that is limited because of the nature of my practice. Last quarter when I got the review from the AZ prescribing service I had all these numbers in red. It turns out that I am way above the average in the percentage of my prescriptions that are opiods. If you look at the data closely this is because during the entire prescribing period being reported I wrote two prescriptions and one of them was for a pain med.

The other regulation that has taken affect in many states is the requirement for electronic prescriptions for schedule 2. Just int he last week we have been upgrading our dental software Open Dental to meet the e-prescribing prtal requirements so we can then complete the verification and be ready to go. With all of the changes making sure you are on top of whatever your state and the federal government requires is important.

Managing Pain Without Opioids

One of the things we have done with our patient sis move away from prescribing schedule 2 or opioid pain medications. I started to do this several years back after hearing Dr. Harold Crossley discuss a protocol. He recommends having your patients alternate 600mg of Ibuprofen and then 3 hours later 325mg of Acetaminophen, then 3 hours later 600 mg of Ibuprofen and so on. The protocol actually does a more effective job at managing pain then opioids. The medications work both locally and centrally so you get two different mechanisms of action.

I have the protocol written our and printed so we can give it to patients. You need to make sure they understand to use the 325mg of Acetaminophen to stay below the max daily dose of 3000mg. The protocol also requires making sure patients can take NSAID’s and aren’t on any medications that would be a contraindication. My patients have reported incredible success with pain management and no nausea, sleepiness or other side effects.

The ABCs of dental office organization tell us how to prioritize our time, energy, and resources so that we can provide the best care possible. In Part 1 of this series, I discussed the definition of the three main ABCs: administrative tasks, behavior tasks, and clinical treatment.

Read on for how to implement an understanding of these principles into your practice efficiency protocol:

Dental Office ABCs: Prioritizing

How can you get better at organization and adherence to the ABCs? Here are three steps – 

1. Ask each team member to list all possible administrative tasks. This includes tasks they do not need patients to be present for or where they need uninterrupted time for maximum efficiency. You should generate your list as well.
2. Next, have them create a list of behavioral tasks.
3. Finally, have your team members delineate their clinical processes. This should lead to discussions on tray/room set-up, treatment preparation, and efficiency.

These lists can be developed by each person in the office prior to a staff meeting. Then, in a team meeting you can discuss each person’s “top 3” and consider periods in the schedule throughout the week where each team member can carve out A – B – C times.

A Productive Daily Conversation

For example, our business associate at my dental practice sets aside Thursday morning for uninterrupted “A” time to catch up on delayed insurance claims, payment calls, etc. This means our relationship coordinator/primary chairside rotates to handle incoming calls and our assistant chairside rotates to chairside duties. Everyone loves the cross-training and variable challenges.

The coordinator answering the phone does not need to be under pressure. If a call comes in for the business associate, they simply state, “Sue is busy right now. May I have her return your call in an hour?” or some such reassurance.

When done well with open respect of each person’s priorities, this can evolve into a daily conversation. For example, the relationship coordinator may ask for uninterrupted time to call a certain patient about emotional support or a referral to a specialist. The business associate may request time to call an insurance company.

Have fun with it. Your approach will evolve and remember that mistakes are the fruit of great progress. Celebrate/laugh at them. Keep at it and the ABCs will change your practice.

Efficient office organization leads to effective office functioning. It frees team members up to take care of people. It can greatly increase effectiveness – defined as helping people make choices appropriate to their health and improving efficiency of care delivery.

Dental office organization starts with understanding tasks and roles:

ABCs in the Dental Practice

A = Administrative Tasks

These are tasks that can be done when patients are not present. For example, planning next week’s schedule for effectiveness or following up on and processing insurance claims.

More examples:

• Filling the hygiene schedule.
• Working the re-care system.
• Supply ordering.
• Treatment planning.
• Specific treatment pre-planning.
• Review of x-rays, charting, and chart notes. 

B = Behavioral Tasks

These are usually communication efforts with patients. Focused, uninterrupted time is available.

Examples:

• Talking to new patients on the phone.
• Care instructions following treatment.
• Treatment conversations.
• Financial arrangements.

C = Clinical Treatment

Here the patient is present. Ideally, treatment has been organized and so thoroughly thought-out beforehand that care proceeds rapidly and efficiently.

I have heard it said that treatment can be fast and good, fast and bad, or slow and bad. Slow and good is virtually never possible.

Speed and efficiency respects the patient’s time and emotions. This is why effective clinical organization must include pre-planning. 

Understanding Office Roles

If you understand these roles for yourself and each team member, your week can proceed much more effectively. Many dentists do not feel “productive” unless they are chairside spinning the high speed, but this is not always the case.

If you consider your role in the practice as similar to a CEO (vision and implementation) and/or COO (efficient operations) you must consider “A” time important.

If you consider yourself an advocate for your patients, your “B” time – especially quiet time to ponder treatment options as well as learn and grow in communication – is essential.

To increase your dollar per hour productivity, you must practice continual chairside improvement and time management in treatment procedures. This is the only way to accomplish more work in a single day.

To be continued …