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? 

Trust is a central facet of human interaction, one that cannot be ignored in a dental or business setting. This blog reviews some interesting concepts on trust from Oxford professor Rachel Botsman: 

Trust: Known and Unknown

Botsman is a thought leader and significant contributor to the current conversation surrounding the role of trust in our personal and business relationships as well as our culture. She says that trust lives in the unique tension between our hopes and fears. It is about vulnerability and expectations.

Trust acts as the bridge between the known, where we are comfortable, and the unknown, where we are fearful. She defines trust as, “a confident relationship to the unknown.”

Similarly, when we enter into a relationship with a patient, there is a great deal unknown to them concerning their dental condition. They don’t necessarily sense what is required to establish good health, function, and esthetics.

A Relationship Strategy

According to Botsman, in developing our strategy of building high trust relationships, our goal should not be to build more trust. Our goal should be to become more trustworthy.

The established science of trustworthiness says that it requires high levels of competence, reliability, benevolence, and integrity in our life and practice to be present and experienced by others. Integrity, or aligning our intentions with our actions, is the most important.  

That same science says that real trust takes time and friction, at least some minimal friction, to establish. When a relationship is established seamlessly and instantly, there isn’t even the time and opportunity to ask the question: “Should I trust this person with something that is important to me?” That is the minimum amount of friction required.

Many organizations and a significant amount of behavioral research conclude that the strongest relationships are those that have experienced a problem and found a way to reconcile the issue. In other words, friction strengthened the relationship through solving the problem.

Have you listened to or read anything by Rachel Botsman? Join the conversation below … !

How do you make your dental practice resilient? 

In a recent article in INC magazine, venture capitalist Dave Whorton and Red Herring co-founder Chris Alden used the term ‘evergreen’ to describe the increasing number of private, profitable, market leading businesses designed to remain independent for a long, long time.

In other words, they possess abundant, healthy longevity that is grounded in their very nature. To me, that sounds exactly like the high quality, relationship-based practice each of us is attempting to create and develop all day every day in our professional lives.

Whorton and Alden identified seven very instructive characteristics of an evergreen company. I adapted them to be relative to a relationship-based dental practice. Let’s take a look.

How to Create a Relationship-Based Evergreen Dental Practice

1. Purpose

Being passionately driven by a compelling vision and mission. There is no substitute for clarity around your WHY. It is your unique story.

2. Perseverance

Having the grit to get through and past barriers. When you have a long term perspective of your practice, professional career, and life, the short term trials seem much less daunting. Those trials also occupy much less space in what you measure as important. The destination is a fixed standard. The time required to get there is a variable. I call that standard an ‘unchanging point of light.’

3. People First

The people of your world are both the reason for your work and the vehicle to make that work come to life. Surrounding yourself with the best and most talented people available to you is the most powerful accelerator to your practice development.

4. Private

Your dental practice, even with multiple dentists and a large team, is still a micro enterprise owned and operated by practicing dentists within the practice. This makes your enterprise much more agile, responsive, and tactical. It is one of the critical advantages we have over large corporate ownership.

5. Profitability

Profitability is a measure of value delivered to the patient. By building high trust relationships that essentially function as partnerships, the patient is much more likely to choose comprehensive solutions to their problems. This builds productivity and profitability.

6. Paced Growth

Focusing on long term strategies of practice growth and development creates a mindset of investment in people, technology, and skills. This creates a brand and practice culture that are unique in the marketplace with the power to attract and retain great people. These people are your team, your patients, and your interdisciplinary team of specialists and technicians.

7. Pragmatic Innovation

The best dental practices we know continually educate themselves and their patients. They employ contemporary technologies that are critical to their performance and results. They never stop seeking a better way to do what they do. In short, they lead, they innovate, and they teach others to do the same. It is a mindset and a way of life.

The best dentists I know mastered the art of examination and discovery first. They learned to understand their patients’ conditions and how they relate to one another.

Leadership Through Discovery & Complexity

In that process of discovery, highly competent dentists learn to navigate complexity by confidently using reference points. These guide their understanding of what they discover. They train their eyes to see the details of esthetics, tooth structure, function, and periodontal type and status. Their fingers learn to feel the dynamic nature of the patient’s functional system.

They use every available form of imaging and records that add meaning to their discovery. Ultimately, they intentionally, systematically, and thoroughly develop a diagnosis that can determine the treatment plan. They manage complexity by moving toward simplicity.

Absolute and relative reference points serve as guides in designing the optimal scheme for the patient. When the patient’s teeth, gingiva, bone, functional scheme, and esthetics have been lost, those reference points tell you where to start and where to end. They both establish and limit what needs to be created.

Managing Complex Cases

Dentists at this level possess a very sound understanding of the dental functional system and a very detailed understanding of dental esthetics. They specially focus on how these two systems relate to one another.

They also understand their role in coordinating, guiding, and leading their interdisciplinary team in managing the complex case. To be certain, every member has a strong voice in developing and executing the treatment plan. Leadership in knowing your work really becomes visible in this process.

Someone has to decide where the case is going and how it is going to get there. There are many voices in the process, but at the end of the day that someone has to be you the leader, who also happens to be the first and final designer of the beautiful smile that is being restored to health.

Clinical competence is a requirement of a successful practice. If people are going to seek you out rather than just going to someone who is contracted with their benefit provider, they need a reason. Clinical results are clearly one of those reasons.

Leadership Through Knowing Your Work

That being said, how well do you know your work? How well does your team know their work? Do the specialists and technicians that you work with make you better? Becoming highly competent in clinical dentistry begins with a decision. Have you made it?

If you have, are you maintaining that decision in the midst of all the resistance that you encounter as you try? Leadership, at its core, is about making a decision and maintaining that decision in the midst of pressure to do otherwise. Your clinical competence begins with a decision to be competent. How well it continues and develops depends on how important being highly competent is to you.

8 Complex Skills of Clinical Dentistry

Although clinical dentistry is not always complex, it requires a variety of complex skills. This includes:

1. Examination, Diagnosis, and Treatment Planning
2. Spatial Relationships & Esthetics
3. Biologic Principles
4. Local Anesthesia
5. Tooth Preparations
6. Provisionalization
7. Materials Application
8. Patient Management

You can add many more to my list. All of these skills are important in uniquely different ways. This is why continuing education and professional development in dentistry is so vital.

It is just plain difficult to develop so many skills and move them toward competence and mastery. Dentistry is both extremely rewarding and extremely demanding. So how are we going to develop competence that is moving toward mastery?

We need a plan that develops specific habits. We need the habits to serve our WHY. We need great teachers, leaders, and institutions that help us pursue the limits of our possibilities. It is a journey that never ends as long as we are given the gift of caring for another human being.