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.

If I were to select one word most strongly associated with a successful relationship-based, health-centered practice, it would be the word growth.

What kinds of growth? The kinds I am thinking of are growth in knowledge and growth in sophistication of attitudes toward people and dentistry. As I meditate on this, I am enlarging my hope for and commitment to fostering personal growth … interpersonal growth … care team growth … patient growth … and, of course, practice growth. I welcome you to come along with me as I breathe fresh energy into leaving 2020 behind and growing in 2021.

Notice I didn’t mention a single word about teeth or techniques. I didn’t mention a word about technology, or what you must physically own to achieve growth. And that’s because growth isn’t a material thing; it’s a spiritual thing.

Growth can be promoted, or it can be impaired by the way we think, and consequently the things that we do and say day-in and day-out. And what we do repeatedly is driven by what we believe … what we believe about ourselves … what we believe about others … and what we believe about the purpose of dentistry.

What is your purpose in dentistry?

Each of us have a purpose that is driven by our philosophy … our world view … our perspective of things … and therefore what it all means to us. This changes as we grow in knowledge and sophistication of attitudes.

Avrom King said that it all boils down to these three questions:

1. Who am I?
2. Why am I here?
3. What is it that I am trying to achieve?

All three of them are philosophical questions, and all three lead us to answers which directly influence almost everything else. If we do not understand who we are on a values and beliefs level—what Mac McDonald likes to refer to as “the deep structures of ourselves,” we cannot predictably lead ourselves in any desired direction. And as a result, we cannot predictably lead others in a desired direction either.

Growing with Purpose

Growing with purpose requires Hope and Agency. If we do not hope for something of greater meaning to ourselves and we think we have truly little personal agency, we flounder.

In a world where we believe we have minimal personal value, everything around us starts to look scarce, and everything around us starts to look scary, so we’re tempted to take short cuts. We’re tempted to just grab what we can get for ourselves as quickly as possible. After all, who knows what tomorrow will bring? If we “stay on shore” with feelings of disempowerment and a little too much wine and whining, we ultimately achieve very little with our lives.

If we “stay on shore,” we will attract others who similarly think and behave. Like attracts like. Avrom King liked to call this “King’s Law.”

We tend to create our practice in the exact image of what we believe about ourselves, and consequently, that could be some version of heaven or hell. All of this happens because we choose to grow or to not grow.

Growth requires hope, courage, attitude, energy, and action, i.e., self-determination and self-control. Talk is cheap, so what will you do to master these? Surround yourself with a vision of your preferred self … your preferred career … your preferred dental practice. Acting on that vision leads to a next step and a next. In doing this, you will attract “likes,” and this positive reinforcement will help keep you on the road of your personally purposeful life. How much growth is happening in your practice today?

Can you see the green shoots of enthusiasm and creative change all around you, evidence of constant renewal? Or do you see an ossified structure struggling to maintain the status quo? Are you surrounded by people who are down, frustrated, and thinking that they have no other choice but to keep plodding on as they are?

Who are you?

Why are you here?

What is it that you are trying to achieve?

Philosophy Matters.

And that’s why L.D. Pankey, Bob Barkley, and other of our dental heroes constantly talked about it.

When I was 19 years old, I started to work as a dental assistant and front office person. In 2003, after 9 years of temporary hygiene work and multiple associate positions, I opened my own dental practice. To obtain bank funding, I had to write a business plan and a vision statement. In 2001, I wrote the following vision statement for the practice I wanted to create. I often look at this statement and find that it still stands true and even more so as time goes on.

My Vision, circa 2001: To create an environment full of learning and growing, that is open and honest, in order to provide individual optimal care with compassion and mutual professional respect for each other and our clients.

Over my years in practice, I have increasingly realized that that a culture of collaboration in the practice is essential for providing the comprehensive quality care that I’ve learned at The Pankey Institute—the care I believe patients deserve to receive.

The Benefits of Team Collaboration

A healthy and positive office culture is not only important for patients, but also for the team, including the leader!

• Healthy Relationships: A culture that is inclusive, compassionate, empathetic, and safe creates healthy relationships that are supportive, understanding, and positive.
• More Appropriate Solutions: An environment that is based on abundance versus scarcity is one that allows an organization to build on all the strengths and positive aspects of every team member. In fact, it is my belief that all team members’ perspectives are valuable. Solutions are more creative and appropriate when there is input from all perspectives of the team. Diversity in thoughts and ideas provides a pathway toward implementation and outcomes that are sustainable, because collaborative agreements are better suited for everyone involved—the leader, team, and patients!
• Increased Trust, Individual Growth, Leadership, and Fun: The fruits of genuine collaboration are trust, appreciation, and ownership…and so much more! Genuine collaboration facilitates learning, growth, accountability, and individual leadership for all members of the practice team. Collaboration breeds shared responsibility, less isolation, and more fun!

Steps Towards the Creation of a Collaborative Team

1. Establish your WHY. The first step is to create a shared vision of your purpose. Why do you do what you do every day? What brings you joy?
2. Stay in Kindness. An office culture built on mutual respect and trust allows for more effective collaboration. Be humble and focus on the strengths of each team member. Stay centered in giving one another the benefit of the doubt. Others will reciprocate with kindness when you are kind and fair. I always think, Do the right thing and the rest will follow.
3. Share. Share your expectations of how you will achieve your shared purpose and vision. Be vulnerable by sharing your needs and desires for achieving the shared purpose and vision.
4. Formulate agreements. Come to shared agreements to help, support, and keep one another accountable in the process of collaboratively reaching your shared vision of your purpose.
5. Celebrate. An important, solidifying step is to enjoy the process of collaboration, celebrate your successes, and have fun along the way!

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Christine Shigaki, DDS is a private practicing dentist in Seattle, WA.
She can be reached at cshigaki@gmail.com

If you watch one episode of Gordon Ramsay’s Kitchen Nightmares, you will see a repeating theme. Previously great restaurants have come close to shutting their door, because the owners’ passion for maintaining high standards has waned. Diners have dropped them from their A list, their B list, maybe even their C list. Without a dramatic makeover and grand opening, diners are not going to come through the door.

Bring this forward to 2020 and the pandemic. Patrons… clients… customers… have legitimate concerns about moving forward with their lives. Dental teams are doubling down on conversations with patients, along with adopting and adapting to many changes in how they practice. And, then, there is another problem I am seeing in all businesses, not just dental practices. The government gave money to employees to “not work.” Now when they are needed (especially in dental practices and labs), employees want to stay out not only for more “free lunch” but also out of health concerns of their own. They don’t want to take coronavirus back to their family members at risk.

Some of this comes down to the history of the business and how they practiced before and the culture they created…that went way beyond “money.” I’m not saying this is true of all dental practices and less so in the relationship-based practices, The Pankey Institute and other thought leaders promote. But, practicing every day consistently at the quality level of the past takes tremendous commitment. The moral compass of the practice leader—the dentist, must continue to show courage, trust, respect, authenticity, integrity, communication, education and growth, excellence, resilience, purpose, and alignment. Whew! That’s a tall order when you are feeling stressed and exhausted.

It’s no wonder if some of your pre-pandemic passion for spending time with individual patients has waned. When I came out of dental school in 1973, Paul Simon had not yet written his monumental song Slip Slidin’ Away, but within my first decade of practice, I knew the song well and already sensed that life was not on the trajectory I wanted. My passion for dentistry had waned.

We work our jobs
Collect our pay
Believe we’re gliding down the highway
When in fact we’re slip slidin’ away

With inspiration at Pankey and Dawson, wide-wide reading, and encouraging colleagues, I found my way… my passion… my balance… my joie de vivre in dentistry. I discovered how to not only conserve my personal energy but also generate more energy through personal contemplation time and daily exercise. The greatest discovery I made was that my practice of dentistry actually centered around one specific system: the comprehensive patient examination and the meaningful conversations I had with patients during the exam.

The One Thing to look out for is the quality of your comprehensive patient exam. Is it at the highest level?

The comprehensive examination is the “one procedure” or process that gives the dentist the opportunity to express and display his or her leadership “virtues.” Don’t let it slip slide away.

Conversation is where the human side of health care takes place. Continue to spend extra minutes in conversation. The meaningful moments you share with your patients will energize you and help you get through current stressful days. Just remember that having a meaningful conversation, in many cases, requires us to let our guards down and become vulnerable. It means sharing our philosophy and showing our human side… maybe even how challenging dentistry is right now… and yet still so rewarding.

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.

It may not be this week. It may be next before you have a practice continuation plan in place and have communicated fully with your team and patients. When you do find you have some time, I encourage you to sit back and think about everything you have experienced over the last month and what new learning you have discovered. Then reach out to colleagues and talk over your learning. Continue sharing with each other throughout this time of social distancing. 

I am mindful of a quote from Carl R. Rogers: “The true wonder of learning is discovering for yourself.”  

Starting out in my career, I felt well trained technically, yet I must have subtly believed I was a “hardware” salesperson. Or, maybe it had to do with my tendency to be introverted. Whatever the reason, I found it easier to talk “hardware and technique” than to listen well and then help patients clarify their health objectives and the benefits they were seeking in their dental health care experience.  

I went to a workshop led by Carl R. Rogers titled Client-Centered Therapy. This workshop was significantly different than any of my previous educational experiences. It was a participatory experience. It took some time for me to assimilate his educational concepts into my life and practice, and I noticed right off that I had retained more from a workshop experience and could apply my understanding of what I had learned. When I returned to my office, I attempted to create a participatory learning experience for my patients. I learned from these early attempts more about learning and witnessed behavioral changes in myself and my patients.  

I sought out many other workshops at this time in my life. One was Parent Effectiveness Training, facilitated by a local devotee of Dr. Thomas Gordon. Then, I became reacquainted with Dr. Karl Olson, the retired President of North Park University where I had done my undergraduate schooling prior to going to Northwestern University Dental School.  

Olson had joined forces with Bruce Larson and Heidi Frost of Faith-At-Work and created The Leadership Training Institute, which focused on discovering your leadership potential through three separate weeks of “experiential learning.” The first week was focused on Know Yourself, the second-week focus was Know Yourself in a Small Group, and the third-week experience was focused on Designing Small Group Experiences for Others. Each of these three weeks was separated by six months of intentional application and reflection, which created a powerful learning period of discovering myself.  

From my point of view, there is nothing more rewarding than a learning experience in which one can become aware of one’s own learning in “the moment” or upon reflection. So, now that you have been thrust into participating in Knowing Yourself, your practice, your team, and your patients on a new level where there is a concern for everyone’s safety and wellbeing on an elevated scale take time to reflect on what you learned in “special moments” of the past month.  

Are any of your discoveries blog-worthy to stay in communication with your patients? They will appreciate your personal “touch.” 

Making a comment in response to this blog is one way you can encourage a “continuing conversation” of Pankey participants’ “new awarenesses.” 

After my presentation on High Engagement Leadership at the September 2019 Pankey Annual Meeting, a few people asked me about a term that I used in the presentation, VUCA. The acronym VUCA stands for volatility, uncertainty, complexity, and ambiguity—the challenges that we face in today’s world. The term originated in the late 1980s from a thought leader named Warren Bennis. Bennis was known for shaping the concept of authentic leadership, which at its center is the value of being true to one’s self.  

VUCA = Volatility, Uncertainty, Complexity, and Ambiguity 

Complexity in our culture and rapid change are our challenges as leaders. How shall we use all our creative gifts and talents to develop as leaders and influencers in a world that thrives on VUCA? 

The answer might be to start by deepening the trust we have in ourselves. Our ability to navigate through the noise and distractions of today requires high trust in self and a willingness to believe that others will follow us. 

In his recent book ‘Deep Work‘, Cal Newport describes the value of quiet focus in a formula defined by Adam Grant:  

High-Quality Work Produced = (Time Spent) X (Intensity of Focus) 

Slowing things down and eliminating the distractions around us can increase our productivity exponentially. As with exercising, when we commit to uninterrupted focus time, we tend to develop a resilience muscle that is strong when times are complex and distracting. When we are more focused and stay calm in our role as leaders, others appreciate this gift we bring to them—and there is likely to be another ripple effect, development of trust in ourselves.