Change can be difficult even when it has benefits for everyone.

Some people are simply averse to any kind of change. As a result, we may encounter pushback from staff while attempting to initiate changes in protocols, practice policies, or practice systems. Anticipating and preparing for potential negative feedback is the best way to defuse staff concerns and smooth the way for needed change.

There are two prerequisites to navigating change successfully. First, the staff must believe that we have their best interest in mind. This is a matter of trust that is developed over time. Secondly, the staff must feel safe in offering unfiltered feedback before and during the change initiative. As the leaders of our practice, we are responsible for creating a practice environment that makes both of these essential prerequisites possible.

The following suggestions will prove helpful in developing a change strategy.

1. Be prepared.

Before introducing any change initiative, we must have clarity regarding the necessity and advantages of the proposed change. Painting a clear picture for the staff that includes the specifics and anticipated benefits is an essential first step. Anticipating the staff’s concerns and potential questions as well as our response will help in creating a smooth presentation. Set the expectations for how everyone might feel throughout the different stages of the transition, for example: resistance, frustration, skepticism, excitement, relief, and high energy.

2. Seek early adopter support.

Identify those people that are likely to support your ideas and seek their help in moving a change initiative forward. Most likely, these will be the leaders of the clinical and administrative staff. Collaborate with them in creating the best possible change model. By allowing them to contribute their input, they are much more likely to buy into the concept.

3. Present the change Initiative with humility and transparency.

“My way or the highway!” is the worst possible way to present any significant change. We gain acceptance by being as transparent as possible and patiently addressing staff questions and concerns. Seek collaboration and request input. Be more coach-like by using open-ended questions to draw out their underlying concerns, for example, “What concerns you about this?” and “What would need to happen for you to feel better about this change?”

4. Ask for their help.

There is something about asking for help that creates buy-in. Let your team know that you cannot achieve the desired result without their help. If the intended change is experimental in nature, let the staff know that it is reversible if the desired results are not achieved. Ask them how they think that they can positively contribute and re-affirm how important their role is in the process.

5. Consider scheduling more frequent staff meetings during periods of change.

Depending on the nature of the anticipated change, more frequent staff meetings may be necessary to address concerns and problems that may arise. For example, changing practice computer software seems to be problematic and frustrating for both clinical and administrative staff. Allowing more time to address the technical issues and frustrations of the staff has proven to the most effective means of addressing both issues.

6. Check in frequently with the staff:

Although checking in with our staff should be a common practice, it is most beneficial during periods of change. Simple questions like “How is it going?” or “What do you need from me now?” are a quick and simple way of letting your staff know that you recognize and appreciate their efforts in making the change a reality.

7. Celebrate the staff’s accomplishment:

Whenever the change is fully implemented there should be time for celebration. Consider doing something special for the team as a means of recognition for a job well done. An appropriate bonus and/or a special event away from the office are ways of expressing gratitude. Never pass up celebrating a team’s successful effort in achieving change.

All of you have heard me quote the famous proverb: “Guard your heart for it is the wellspring of life.” It is great wisdom. It is also very practical.

To remain healthy and safe, our “hearts” need to be protected. We need rest, downtime, and peace of mind. We need a life that gives energy as well as demands it. We need people around us to remind us of who we really are and what is important. We need to say yes to what is most essential and no to the things that aren’t essential.

In recent weeks I have heard a podcast interview of two people on the other side of burnout and a forced six-month sabbatical. I have had multiple conversations with dentists and dental teams that are overwhelmed and disillusioned. In addition, I have listened to a sad story of a friend who started behaving carelessly and out of character secondary to the fatigue and frustration of unrelenting pressure and career demands. He just wasn’t himself.

Many of you are running full speed, meeting the relentless demands of your practice as well as pursuing teaching and writing opportunities. The question I pose to each of you is “Which opportunities and demands are the most important—essential, to you and your unique life?”

We needlessly increase stress when we compare ourselves to others and think we should achieve what they are achieving. We create pressure on ourselves when we feel we should say yes to others’ requests for our energy and time. In contrast, we honor health when we pause to consider what is best for ourselves and recall our personal priorities.

Our purpose, capacity, energy, desires, loves, dislikes, and circumstances are unique to each of us and unlike those of anyone else.

I have listened to and read about people, who have been through periods when they struggled with their physical health, energy, and emotional state. To recover, they found that vacations were only a part of the solution. They had to find a community of peer support. They had to find ways to make each day healthier and more productive. They had to intentionally create “white space” in their life, place only the most important events on their schedule, and develop a respectful way to say “no” or “not now.”

Saying no is difficult for most of us but is required to live our one short life on purpose. In addition to living on purpose, there are other essentials for wellness. I’m thinking of:

• Resilience—Restoring physical, mental, and emotional strength often requires more rest, exercise, and recreative interaction outside of work with family and friends to reframe perspective.
• Meaningful work—Do what you love at least 50% of the time.
• Energy management—Pace yourself, take breaks, enjoy the “flow” that occurs when you are highly engaged in your work, and respectfully rely on your leadership team to help you maintain a schedule that prioritizes the most important activities.
• A peer-to-peer community of support—We have the human need to give and receive empathy, understanding, wise counsel, sparks of creativity, and encouragement.
• Dedicated time to recreate the self—Think in terms of daily, weekly, monthly, and seasonal-yearly rhythms. Create time to regularly relax, relate, and play outside of dental practice. Like a surfer running to the beach when the waves are perfect, allow yourself some flexibility to embrace spontaneous opportunities.
• Spiritual nourishment and expression—What nourishes the most foundational part of you? Seek the goodness that elevates your soul and feed on those nutrients. Celebrate that goodness with gratitude.

We talk a lot about balance at Pankey, and we do this because it is all too easy for healthcare providers to run out of steam…to run out of oxygen. Like the airline steward says, “Put on your emergency oxygen mask first before assisting others.”

Our positive thoughts, emotions, words, and actions—our joyful hearts, are what make it possible for us to be a wellspring of understanding, compassion, and love. We need to protect our hearts to enjoy our work and improve the wellness of everyone around us.

Ancient wisdom has taught us that as “Iron sharpens iron, so one person sharpens another.”

I love education and learning. As a long-time student and faculty member at The Pankey Institute, I am challenged by and learn from all of my colleagues every time that we gather for an educational event, whether in person or online.

Some of that learning is from the program. Much of it is from one another as we discuss and share what is pertinent in our practices and careers and how we apply what we are learning. In short, these experiences improve my performance as a dentist, leader, and practice owner.

The grid of improving performance according to Todd Herman, performance coach, looks like this:

1. Observe & measure past action (Data from yourself & others)
2. Reflect on that data and the feedback from other key trusted people
3. Reflect / Visualize on the future, especially with key trusted people
4. Design Future Action (Experiments) & Acclimate to this new behavior
5. Repeat

This formula for change is almost always best done with other likeminded people who are on similar journeys. They can give you encouragement, feedback, perspective, resources, & connections.

Even more importantly, it can be very therapeutic to hear the stories and experiences of others to realize that you are not alone in your challenges and the ups and downs of attempting to do something difficult. It is simply reassuring to come face to face with the humanness of friends and colleagues that you respect. It makes our own human frailty much easier to accept and can give us the courage to try again and again.

Keep in mind that every thriving and durable organization has gone through countless failures in route to accomplishing their vision.

The highest performing individuals in any endeavor are working in a team of likeminded individuals who are seeking to accomplish similar things. Those individuals have a much-expanded capacity to understand one another’s challenges and needs. This expanded capacity is often the difference between success and failure.

Isolation is the enemy of progress. Don’t let it determine your possibilities.

Seek out ways to include shared experiences in your personal and professional development by joining like-minded groups like Pankey study groups, group masterminds, and group coaching programs. You even can create groups of your own to surround yourself with positive energy.

Once you have experienced the power of shared experiences like these, you will see the difference from working in isolation.

In previous parts of this series, we looked at leadership, the commitment it requires, and the first three of four universal promises of leadership. The first promise was the promise to set a clear direction and create meaningful work for the organization you lead. The second was the promise to engage all stakeholders and hold them accountable for performance. The third was the promise to ensure your strategies, systems and processes facilitate focus and execution.

Now we will look at promise four.

The Fourth Universal Promise

You will lead effectively by maintaining relationships of trust to achieve and sustain results.

Why would someone want to follow you? The answer is trust. In order to keep the first three promises of leadership, you must value the priceless currency of relationships built upon trust.

Trust is one of the most difficult concepts for sociologists to describe and define. Two exceptional thought leaders on trust in our culture said this:

Steven M. R. Covey: “Trust lives at the intersection of character and competence.”

Rachel Botsman: “Trust is a confident relationship with the unknown.”

Becoming Trustworthy

Because trust builds confidence and frees up hearts and minds to commit, it forms the basis for a thriving practice culture and draws out the inherent potential of your team (their individual talents, energy and passion). Traditionally, I focused my energy on building trust.

Rachel Botsman proposed that in creating a culture built on trust, we would be served better by focusing on becoming more trustworthy. Rachel’s idea hit me hard. It was spot on. Trust demands the best that we have to offer. Perhaps, it demands all that we have to offer. It is the secret sauce of why people decide to surrender themselves to the great vision you offer.

If you take one thing away from this, take away a renewed devotion to becoming a more trustworthy person. You will likely find that your aspirational identity shows up with more clarity, courage, conviction and compassion.

And So, Back to Clarity

People follow leaders they trust by surrendering to a compelling vision that engages their hearts and minds. Others will trust your vision if you are clear, courageous, have conviction, and are compassionate. These are the building blocks of a shared (collective) style of operation and leadership in which each individual in the organization contributes, benefits and leads. This is relevant to your patients (clients) as well as the team you lead.

As I end this series, I leave you with my belief that developing and elevating your leadership competencies is the best investment you can make. Effective leaders who deliver on the four universal promises of leadership create strong cultures that outperform average cultures by multiples, not percentages, in every measurable dimension over time.

In previous parts of this series, we looked at a definition of leadership, the commitment it requires, and the first two of four universal promises of leadership. The first promise was the promise to set a clear direction and create meaningful work for the organization you lead. The second was the promise to engage all stakeholders and hold them accountable for performance. Now we will look at promise three.

The Third Universal Promise

You will ensure your strategies, systems and processes facilitate focus and execution.

Selecting the strategies, systems and processes that serve your vision best is a leadership function. Execution of the systems is a management function involving the entire team, including you, the dentist.

Strategies are designed to fit your destination. Strategies, systems and processes efficiently channel actions into results. The ongoing results create feedback for refining your focus, systems and processes. This promise of leadership is about keeping the team (and yourself) focused on execution and minimizing distractions.

Focus Versus Distractions

Practice owners are flooded with messages that distract them. The entire dental industry targets them with promotions for things, services, and behaviors. They are told many versions of what they should buy and should do in order to succeed. Other distractions come in the form of emotions and self-doubt that become barriers to living out their dreams. Those “should” messages, emotions and self-doubt serve as continuous distractions from everything that is important.

Leaders sometimes break the third universal promise of leadership by:

• Not providing or managing their critical resources.
• Allowing distractions that diminish their focus or lead to inaction.
• Ineffective or inadequate processes.
• Becoming addicted to the process rather than results.

Here are two examples:

• One of those distracting messages leads you to buy the latest and greatest technology. It uses up your capital resources, and you then hesitate to purchase the fundamental instruments, equipment and materials that your organization needs to perform at its best. If you were to live this all over again, you would have made a different decision. If you are clear that your strategies and budget are designed to get you to your destination, you can discipline yourself to refrain from such impulse purchases in the future.
• You read an article or talk to a colleague who is trying the latest hottest strategy for practice building. It is in conflict with everything that you have said that you believe in and hope for. You wonder if you are doing the right thing. Your doubt leads to team confusion and disillusion. This is getting you nowhere. Now you find you have to go back and clarify your vision, mission and values to reset your strategies, systems and processes as aligned steppingstones to your destination. With determination and hope, you can and will refocus and get back on track!

Keep Hope Alive

Breaking promises is exhausting and energy stealing. It builds resentment and degrades hope.

Our organizational brand and our effectiveness as a leader are about the promises that we make and keeping them. I firmly believe the first and last task of a leader is to keep hope alive…the hope that we are finding our way to a better place. That place is the destination we call our vision!

Until next week and Part 5

In previous parts of this series we looked at leadership, the self-commitment it requires, and the first of four universal promises of leadership. The first was the promise to set a clear direction and create meaningful work for the organization you lead.

The Second Universal Promise

You will engage all stakeholders and hold them accountable for performance.

Engaging your team members is about the connection with each of them individually and also as a team. Getting to know and understand each person requires intelligent and thoughtful communication. This communication includes asking insightful questions, listening with all of your senses to the language used and the emotions expressed and experienced. This will expand your understanding and communicate significance to each individual in a very powerful way. 

You have heard this expression: ”Getting the right people in the right seats on the bus.” One of the most important functions of a leader is to evaluate the gifts and talents of each person so that you can put them to work in the best position on the team. Facilitating each individual’s understanding of how their work contributes to reaching our destination provides motivation, clarity, meaning, and accountability. ”Coaching as a Leadership Style” focuses much of our work as a leader on the development of the gifts and talents of the individuals in our organization. When this happens, we have really begun to bring out their inherent potential…the gifts, talents, discretionary energy, and passion of the individuals we lead.

From Ordinary to Extraordinary

Ray McElroy speaks on the topic of “To Boldly Go – Stepping Out of the Ordinary to the Extraordinary.” Ray’s background includes spending six seasons in the NFL with the Indianapolis Colts, Detroit Lions, and the Chicago Bears. A native of Chicago and a graduate of Eastern Illinois University, Ray also served as Team Chaplain for the Chicago Bears Organization from 2008-2013.

McElroy says, “Ordinary people with average talent can accomplish extraordinary things.” He urges us to “see where you want to be and work on getting there.” He asks us to ponder these questions:

• What do you know that nobody else knows? 
• What do you see that nobody else sees? 
• What can you do that nobody else can do or will do? 
• We need a team around us in the valley … Who’s your crew? 

I ask you to ponder these questions:

• Who on the team knows things no one else knows?
• Who on the team sees things no one else sees?
• Who can and will do something no one else can and will do?
• How can you best position team members to contribute their best?
• What do you need to do to better lead your crew?

From Compliance to Commitment

When the organizational culture supports people in such a way that they thrive, strive to contribute, and are valued for their contributions, there is a shift from compliance to commitment to the cause, resulting in dramatic increases in individual and organizational performance. It is a 1 + 1 = 3 phenomenon. 

From Values to Accountability

Our deeply held values become our standard of accountability, both individually and collectively. In Part 2 of this series, I provided the example of performing an After Action Review (AAR) in a morning huddle. When we debrief on previous behavior as a team, everyone is invited to reflect on whether we could have performed better to support our foundational values. One of the foundational values of how we work as a team in my practice is to encourage team members to discern and discuss failures to support our agreed upon values. Anyone is welcome to point out violations. We then look at behavior that violated our values and discuss what would have been better behavior. It provides clarity for everyone.  

A primary goal of leadership is helping each individual and the team, as a whole, become clear on the essential vision, mission and values of the organization. If we confuse, we lose. Clarity wins and is a primary driver of performance. 

Until next week and Part 4

In Part 1 of this series, I introduced you to a discussion about leadership and four universal promises of leadership. My next goal is to discuss the first of four universal promises of leadership.

The First Universal Promise

You will set the right direction and create meaningful work.

Each of us needs structure to live and lead effectively. Setting the right direction requires you to be clear on what your destination is. What story do you want your life and your life’s work to tell? Is it a story worth telling? Will it inspire other people to want to go with you? What will it take to get there? How and where do you start?

Clarity Will Transform You

The structure of destination and meaning comes from your vision, mission and values. Your vision is critical to communicate a clear picture of your destination. Your mission is critical to understanding what you must overcome and connecting each person’s role to it. Values guide us from deep within.

The process of clarifying your vision, mission and values sets into motion self and organizational transformation.

Your vision transforms you into an Inspiration Maker.

Your mission transforms you into a Meaning Maker.

Your values transform you into a Behavior Maker.

Vision is the inspiration maker for the organization. It is the destination that the organization is traveling to. Jason Bourne’s vision was to get his identity back from the evil CIA unit that stole his identity. His mission was the very dangerous actions that he had to undertake in order to get rid of the bad guys and get to the truth.

Mission is the meaning maker for the organization…It is about the conflicts, barriers, and work that must be overcome to reach the destination. In a Nike commercial, the athletes are pushing their physical limits in training (Mission) to become a champion (Vision).

Values are the rules of behavior for everyone in the organization, including the leader. They are the boss. When anyone violates the values that they have agreed to, it becomes obvious to all. The leader makes himself/herself accountable to the team and asks for them to confront him/her if he/she violates them. Values are grounded in our most deeply held beliefs and often integrated to the framework of our faith.

In other words, vision-mission-values are for the benefit of the organization. And, yes, the leader must become them as well.

When your vision, mission and values saturate your organizational culture, you begin to enjoy the rewards of that effort. The shared mental model provides structure for thinking with one mind, speaking with one voice, and feeling with one heart. Your energy and effort are channeled into one powerful coherent force that is aligned at all levels and moving in the direction of your destination.

After Action Reviews

Here’s an example of how in my dental practice we routinely review whether we are on course to our destination in alignment with our values. Recently, in our morning huddle today, we did an After Action Review (ARR) of our performance as a team on the previous afternoon. It was a routinely busy day that got pushed in the last two hours with several important emergency appointments.

An AAR examines the performance of the entire team and asks key questions:

What did we intend to do?
What did we actually do?
What were the results?
What would we do next time?
Were our actions consistent with our values?

I started the discussion. Quickly, several key team members expressed their thoughts and emotions that our performance as a team did not produce the results that we want and were not consistent with “Who We Are” and “Who We Hope to Be” at our best. It was a difficult but very productive conversation…and I think essential to creating better future performance.

These kinds of conversations invite every team member to have a voice in the critical moments of how we perform as a team, which increases the meaning of their work and recognizes the value of their contributions. It also allows us to evaluate if our behavior and performance as a team is moving the practice in the direction of our vision. Clarity wins. These conversations clarify.

Until next week and Part 3

Warren Bennis, in his book, On Becoming A Leader, says, ”Becoming a leader is synonymous with becoming yourself. It is precisely that simple, and it’s also that difficult…First and foremost, find out what it is that you are all about, and be that.”

In other words, leadership development is about developing yourself. As appealing as that sounds, it is one of the most resisted journeys that any human being can attempt to make. One of the most extraordinary writers, thinkers, and influencers I have ever read is Auschwitz survivor Victor Frankl. He said, ”When we are no longer able to change a situation, we are challenged to change ourselves.”

Changing ourselves can appear to be a daunting task, but it is the work required to become a great leader.

Self-Deployment

My favorite definition of leadership says that Leadership is about the deployment of self into circumstances. But which of your selves is deployed? Is it your best self that shows up with clarity, conviction, courage, and compassion as the essential qualities of a great leader? Or is it some other less powerful version of you? The performance of the organization that you lead will be in large part determined by how you show up to the most important people that you have been given the gift of leading. That organization ranges from your family, to your community, as well as the business organization that you lead.

Four Universal Promises

When you decided to become a healthcare professional, you decided to become a leader, whether you knew it or not. That role as a leader comes with four promises that are universal. We will examine those promises in this blog series, and you will get the opportunity to determine how well you are keeping them. Your future and the future of the organization you lead depends upon it.

1. You promise you will set the right direction and create meaningful work.
2. You promise you will engage all stakeholders and hold them accountable for performance.
3. You promise you will ensure that your strategies, systems and processes facilitate focus and execution.
4. You promise you will lead effectively by maintaining relationships of trust to achieve and sustain results.

Until next week…

How can a patient trust you, if you don’t even trust yourself? Let’s dive in:

Trusting Yourself

The last frontier of trust is trusting yourself. Most people would say that trusting themselves is by far the most difficult.

When you have decided to place your trust in another person, you have surrendered some control to them that you previously held. When you decide to trust yourself, who or what are you giving up control to?

The answer, in my view, is a four letter word called ‘fear.’ Nothing gets in the way of human progress and performance more than fear. Often our fear is grounded in the inaccurate internal assumptions we use to organize our identity, define how we see ourself, and define our relationship with the world.

When fear dominates our inner world, meaning, happiness, achievement, and our relationships suffer.

Performance and Attention

In pursuit of high achievement, ancient philosophers, theologians, and modern brain science all agree: “We become what we give our attention to.” Our first option is simply to give our attention to the fear that lives within us and the possibility and consequences of failing.

It often sounds like this: “What will happen….What does it mean…How bad will it hurt…What will people think…If I fail.” It is uncertain, unknown, improbable, and anxious. The other option is to create all of the certainty that I can and attack the fear head on.

In this approach, I study my performance as much as possible in order to learn. I structure a plan and rehearse every sequence. I practice this plan for as many hours as needed. I identify and create solutions for each potential problem in advance.

I create a very clear picture of the final result that captures my attention and focuses my energy and creativity. By spending the time and energy in advance to prepare myself, I have created all the certainty for success that I can.

At that point, it is all about trust. Trusting in my preparation to create certainty. The certainty of success.

The white hot center of human performance is trust. There is no substitute for a deeply held trust in yourself. As Covey said, that kind of trust changes everything!

What is trust and why does it matter in the relationship-based practice? 

Writer and public speaker Steven M. R. Covey says that trust is the one thing that changes everything. Trust lives at the intersection of competence and character. In other words, great skills alone are not enough because you might use them to benefit yourself and not your patient/client.

Trust in Relationships

Character alone is not enough because you might not be able to deliver great clinical results. When character and competence are both present, then what is possible within that professional relationship becomes different.

A strategy to establish and build high trust working relationships in a professional practice is equally as essential as developing high clinical competency. In fact, they are synergistic and will provide energy for one another.

Trust then is not just a philosophical construct. It is not just a means to bring your personal mission to life. It is also a critical business strategy in building a relationship-based professional practice. This is the face of the trust that lives between a dentist and their patient.

Strong Leadership

Much research has shown observable trust to be the number one factor in a patient’s decision to trust the practice as a whole and the dentist in particular. This is simply a measurable function of leadership and the culture that results when great leaders are at their best.

A high performing leader will have strong relating competencies, high integrity, courageous authenticity, self-awareness, and a focus on achievement. These competencies will attract like-minded team members, establishing a culture of respect, appreciation, accountability, and trust.

When this happens, trust will flow in both directions and be visible and experienced by all. This entire process is nonlinear. It is very interdependent and, by necessity, simultaneous. Much like each biochemical system in a cell is necessary for proper cellular function, each complex biochemical unit is also necessary for the other systems to form in the first place. Together, they ensure the entire cell functions properly.

Similarly, while the dynamics of respect, trust, appreciation, and accountability are essential ingredients to establish a healthy practice culture, they also rely on one another to sustain a successful system. They are necessary for the entire practice to function at its best.

Check out this article for quick and easy body language tips that develop trust! What’s your take on this oft-debated topic?