Dentists in private practice face a myriad of uncomfortable problems that force us to find solutions or… S L O W L Y burn out. Do any of these resonate with you?

• Ineffective marketing for attracting the type of new patients you need and want
• Interpersonal problems among some team members
• Difficulty budgeting for and incorporating new technology you want to embrace
• Lack of energy to monitor your practice systems and staff
• Insufficient time for yourself and your family
• Overall fatigue

Hark, the Mind!

Often times, the problems we face in our practices are the result of our own “stinking thinking.”

I recently retired at age 60 after practicing for 28 years as a solo practitioner in Wolfeboro, NH. Over the years, I went through my fair share of issues but found a way to thrive with the influence of programs like The Pankey Institute and Dawson Academy. I focused on developing deep relationships with my patients and team. So, when I say your life and your practice will be more productive and fun when you live your life in alignment with your Values, your Vision, and your Voice, I speak from experience.

To makeover your “thinking,” you’ll need to engage you mind and consider these three Vs.

Values – Exercises 1-3

Values are the non-negotiables in our lives. These are the things that are most meaningful to us, things we would “go to the mat for.” They are personal and unique for each of us, for example, honesty, integrity, transparency, spending time with family, etc. Some practice values might include technical excellence, timeliness, cleanliness, appreciation, efficiency, scheduling sufficient time for conversations with patients, and fiscal responsibility.

So why are values so important? When violated, our personal and practice lives will be “out of whack.” Frustration, anger, helplessness, and despair are some emotions we might feel. So, start with Exercise 1.

• Exercise 1. Take an inventory of your values. Make a list of what’s most important to you, as many as come to mind. Then choose your top ten and prioritize them. Once you know what’s most important to you, figure out the steps you need to take to make them a reality.
• Exercise 2. Do Exercise 1 with your team. Have them each identify and prioritize their own personal values.
• Exercise 3. Combine your findings and do the same exercise with your team to identify your shared practice values. This exercise alone will propel you and your team forward towards a more fun and productive workplace.

Vision – Exercise 4

Once you and your team know what you value the most, write out the vision for your dental practice. As you write out your practice vision statement, think about how you want to practice and what the ideal team member looks like. Think about your practice setting and how you want to relate to your patients. Get a clear picture in your mind, write it down, and then communicate it. You should be able to articulate it clearly and succinctly if someone asks you, “What is the vision for your practice?” Stating your practice vision should be as automatic as breathing.

Voice – Exercise 5

When you know who you are (your values) and how you want to live (your vision), your thinking changes­­–and with it your voice. Your words and actions will become authentic, intentional, and magnetic. Patients will be attracted to you and your staff because you are “the real deal.”

A “Magic” Process

The five steps to establishing your three Vs compose a highly effective process that bonds team members and clarifies a common direction for your team, as well as your office systems. Many times, we are tempted to evaluate and make changes in office systems when we are faced with problems. What I learned is that, as you strive for more happiness, more joy, and more financial success, looking at “The Three Vs” first, before looking at the office systems, is optimal. In my practice life, we took a fresh look at our three Vs frequently.

Lin-Manuel Miranda concludes his iconic musical Hamilton with a piece titled, “Who Lives, Who Dies, Who Tells Your Story.” The song causes the audience to reflect on why certain people in history are remembered, while others are forgotten. It draws them in and includes them in the drama to discover personal meaning through the experience.

L.D. Pankey knew and told his story. Others told it too.

One of my favorite quotes from Peter Drucker is, “The aim of marketing is to know and understand the customer so well the product or service fits him and sells itself… The aim of marketing is to make selling superfluous.” When I first read Drucker, is was a true “a-ha” moment for me; it completely shifted my paradigm about marketing while simultaneously connecting it to L.D. Pankey.

The light came on. L.D. Pankey was one of the greatest marketers in the history of dentistry. And he achieved it by first knowing who he was, and then clearly and consistently communicating it to the world. In other words, he was very good at telling his story, and it was through that narrative that others learned, grew, and our entire profession benefited.

Clarify your story to tell it well.

If we are to thrive in this rapidly-changing marketplace, our own compelling story must be known. Our story must be told by ourselves, by our care team, by our patients, and others. It’s ultimately up to us who will tell our story and what they will say. So, how do we go about telling our story? First, we must clarify our philosophy and vision to the point that they are “in our tissues” … to the point that we can’t NOT talk about them. Put your story out there with enthusiasm. The rest will follow.

The Least Understood Part of Dr. Pankey’s Cross

I’ve always thought that the least understood and least appreciated aspect of Dr. Pankey’s cross of life is the directive to “Know Yourself.” It seems more interesting and exciting to get into learning about your work and your patients. And applying that knowledge makes all the sense in the world. Many high achieving people are happy to dedicate themselves to a lifetime of learning about their work.

What about learning about ourselves? My experience is that it’s easier to believe we have “done that.” We take a psychological instrument and label ourselves as “Driver” or “Amiable.” Check! We survey our values and identify the top three. Check! We write a vision or mission statement. Check! How much more is there to learn?

I have come to understand that, over time, the self-discovery process of knowing yourself can be the most challenging and most rewarding aspect of your work. Knowing yourself is what makes you not only a better dentist, but a more effective leader, a more engaged family and community member, and a more fulfilled person. So, when I was asked to speak about that at the Pankey Institute’s Annual meeting I was both delighted and a bit intimidated. It is such a big topic!

“But, What about Self-Absorption?”

The idea of knowing yourself can have a connotation of self-absorption, a self-serving focus inward. This thought has arisen in our evening discussions at the Institute. We tend to think it is more appropriate to focus outward on our patients, our team, and our work. We want to facilitate their growth and their learning about how to become healthier. It can be difficult to see the value of that inner self-discovery focus. But Parker J. Palmer, whose writing has informed my work over many years wrote:

“. . . When I do not know myself, I cannot know who my students are. I will see them through a glass darkly, in the shadows of my unexamined life, and when I cannot see them clearly, I cannot teach them well.”

That lens through which we see others is an essential part of who we are. What I have learned so far is that my lens includes filters of impatience, and judgment, and assumptions about what I think I know. I have my blind spots. But my lens also includes compassion, and love, and understanding.

After 40 Years, Even New Discoveries

After 40 years in service of others, I am still learning about myself. As I learn to know myself, I am better able to take a step back and look at my filters, not just through them. I’m learning to question and understand where they fit and where they do not. I find it very interesting how on my best days I can see both the filter and the lens. With intention, I practice questioning my assumptions and suspending my judgment. Sometimes I can even laugh at the stories I make up about people and situations! And often I can also see the gifts I bring; the perspective, the compassion. Those are the times when I can bring all of myself to my work.

I serve better and I am better for knowing myself.

Mary will be presenting on Know Yourself at the Pankey 50th Anniversary Annual Meeting this year on Key Biscayne, Fl September 13,14.

Reactivity is hard-wired into all of us!

By definition reactivity is an autonomic function related to a perception of threat. When pressure and stress go up in a busy dental practice, reactivity tends to raise its ugly head.

Knowing Yourself is Hard Work.

From experience I know that seeing reactivity in others is usually easier than seeing it in myself, but I’ve learned to periodically focus on my emotional situation. I’ve learned that one of the best practices I can strive to embrace is to become a “step down transformer.” This means I focus on being someone who converts high-voltage, low-current power into low-voltage, high-current power. By taking in all of the energy and refocusing it in a positive and more relaxed direction, patients and team members are apt to feel better.

In the presence of ongoing stress—which easily produces an undercurrent of anxiety and reactivity, being less anxious will help others be calm. Stop and observe what is going on in your practice emotional system. Respond calmly and thoughtfully to allow time for others to reboot.

Your team and patients want you to be their guide.

As you work on yourself, you will see how much they appreciate the model of calmness you give them. By leading with calmness, you are creating an environment in which people can be their best and feel competent. Now, that’s leadership!

It’s critical to have discussions with team members about what behavioral influence entails.

Behavioral conversations are efforts with patients to encourage health. They involve discovering current perceptions and encouraging choices for improved health – especially dental health. Considering today’s understanding of the oral-systemic connection to overall well being, we owe it to our patients to continually offer them the opportunity for health.

Avoiding the BS Trap

As such, it is essential to consider that social conversation is not behavior conversation. I call it the BS trap. Yes, there is a social component to behavioral. Connecting on a personal level is critical.

As Robert Cialdini says in his book “Influence,” people like doing business with people they like. In a relationship-based practice, full engagement with patients is critical. Engagement increases the likelihood of being listened to and influencing healthy behavior.

AND, we must avoid the BS trap. Conversations need to be about them, not us. Conversations to influence values and behaviors need to be about patients. So, how do you know when social conversation has slipped into BS?

Encouraging Meaningful Discussion With Patients

The key is to realize when you are interjecting yourself into the conversation. Avoid personal words: I, me, my, mine, us, we, our, etc. It is not about us – our story – but about the patient, the patient’s story, the patient’s health values, and their objectives.

Avoid:

• “I went there …”
• “When I did that …”
• “My experience …”

How do you shift from social (the starting point in conversations) to behavioral? Have one or two powerful questions to shift the conversation:

• “How are you feeling about your health?” (Perhaps more powerful than: “What has changed in your health?”)
• “What are you doing to enhance your health?”
• “How are you taking good care of yourself?”

Then “Stay in the Question.” Continue to follow the thread they share. Remember …

Their first response is not the answer. It is their first response.

Questions are NOT the key. Listening is. Go below the surface.

• “What else?”
• “What do you feel?”
• “Say more about that.”
• “Do you have any ideas?”
• “Tell me more about …”
• “Yes, I understand.”
• “I’m glad to know that.”
• “Thank you for sharing that.”
• “Is there anything else?”
• “What is your suggestion?”

These questions work both ways. Teaching you to turn the focus onto the patient and teaching the patient to communicate their needs more clearly.

Have you read this article from team behavior expert Mary Osborne on understanding a hygienist’s true expertise?

It was August of 1995 when I walked through the doors of the Pankey Institute for the very first time.

I was attending a course specifically designed for hygienists and was literally in awe of every aspect of my experience there. Not only was the clinical information fresh and new from what I had been taught in hygiene school, I was also introduced first-hand to the philosophy that has since become the corner stone of my own personal and professional life.

The Power Of Development

Looking back over my shoulder at the past 24 years I realize that none of my learning or growth could have occurred if my “boss” had not invested in me. What I didn’t realize early on was that his investment was not just so that I could be a better hygienist. What happened was that I grew to become an incredibly high performing, deeply engaged, missionary and change agent for our practice. I learned that my thoughts, ideas, feelings, and questions were not only welcomed, but invited and encouraged each and every day. I become a perpetual student and my hunger for personal and professional development was fed and nurtured by the culture that we had intentionally created in our practice.

Today I have the opportunity to work with dental teams across the country, and my mission has evolved from being able to serve individual patients to supporting entire teams as they navigate their own growth and challenges. You see, my own experience as a team member was so powerful that I find it imperative to create my own version of Quid Pro Quo.   Yes, it’s rewarding to help practices learn and practice skills that can enhance every aspect of the patient experience, and even more rewarding to know I’m supporting each Dr and team member to be become the very best version of themselves.

What Does It Mean To Create A Healthy Culture?

Experience tells me it’s where each person is seen, heard, valued, recognized, and appreciated. Of course, it’s important to develop and implement systems, define clinical protocols and establish business operations. I ensure you that when team members feel a part of something bigger than themselves and connected to you and each other, a sense of accountability and responsibility to these standards increase exponentially…as does the presence of positive attitudes. And just in case you’re interested, I’ve also found that every single practice will ALWAYS have challenges, conflicts, and competing values to work out. The highest performing teams will be the ones who consistently push themselves to work ON their issues and work THROUGH their differences.

It was one of the greatest honors of my coaching career to be invited to work with the in-house team at the Pankey Institute last week. I left the building after our meeting filled with more pride than ever in the Institute’s commitment to excellence, and to their team. Your Pankey leadership team is continually helping each person find their voice, serve each participant, “walk the walk and talk the talk” of what it means to be in service and an agent for positive change.

Let me leave you with this question: What is the kind of culture that you want to have in your practice, and who are you willing to invest in to get there? I’m here to tell you, it’s worth the effort!

Once you want to be a leader and you know yourself well enough, you’re ready to move on to helping others effectively. We have already taken a look at the first two parts of Dr. Rich Green’s leadership definition:

“A leader is a person…

Willing and Able

To influence behavior;

Their OWN FIRST

Then others

To a preferred future.”

-Rich Green, DDS

Leading Others

Building on our willingness and ability to influence behavior (our own first), now we will talk about leading others. It is by leading ourselves well that we “earn the right” and have the highest capacity to lead others.

I’m going to use the four essential areas I discussed in the previous blog as a framework for discussing our leadership of others.

Let me start by saying that we can train someone to assist us or do a great job greeting our patients, or to do stellar financial arrangements, etc. But when we hire, what we really want to look for is someone who has similar values and is inspired by our vision and purpose.

If we are clear about our own values, vision, and purpose/mission, which means we have done our own work to get clear, we will know if our prospective employees are a good fit by asking questions.

If we already have employees and are in transition, meaning we are changing our practice and/or doing work to get more clear on our values (what the practice is about and where we’re headed), we have an opportunity to be in constant conversation with those around us.

The people around us – in this case our team, specialists, lab technicians, and patients – want to know what we believe in and what we stand for. People are hungry for connection on that level.  

Influencing Others

Now let’s look at the four areas I discussed previously and how they help us in our ability to influence others:

1. Our competency and skills.

What we are doing and how we are doing it models for our team what we expect and what we are about. When our team feels competent and skilled, they feel confident and pleased about the quality of their work.

Especially in a high level practice, taking our team to CE and taking the time to work with them on their technical skills as well as communication skills is vital to their success. Most of us know this and probably do this pretty well already.

2. Knowing how we are wired helps us understand how others are wired.

The patterns, beliefs, and behaviors are not the same, but knowing that we have all been programmed and that this is part of the human condition helps us have compassion and a deeper understanding of how people tick.

Remember, most of this programming we were either born with or was “installed” from 0-7. In some way, even if it doesn’t make sense, we all do what we do in order to feel safe, loved, competent, and a sense of belonging. Knowing this gives us compassion for why people do what they do. 

3. Emotions

Being able to be with our own emotions allows others to be with theirs. As we model this and help our team learn it, they will increase their capacity to be with their own emotions and those of others.

Empathy is one of the most important skills to have as a healthcare provider. We have the opportunity to be the leader of this in our practice and in our life. When we work with humans, we work with their emotions and experiences (whether we like it or not).

4. Knowing and owning our truth.

This is an empowered and empowering place to stand. When we own and are clear about our truth, our desires, what we stand for, and what we are about, we can lovingly set boundaries and make clear decisions.

This also helps us honor others as they stand for what they believe. Once we are clear about these things for ourselves, we have an opportunity to share them with our team so that we are all moving toward the same preferred future, which we’ll talk about in the next blog.

Stay tuned …  

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 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.