By David R. Rice, DDS 

Overcoming Initial Challenges 

Dr. Emily had always dreamed of owning her own dental practice. However, the path to achieving this goal was not without its challenges. After years of working as an associate dentist, she decided to purchase a practice from a retiring dentist in her community. 

Securing funding was one of the biggest hurdles she faced. She had to navigate the complex world of loans and financing, working with banks and lenders to secure the necessary capital. Once she had the funding in place, she faced the daunting task of transitioning the practice smoothly. 

Pleasing the existing patients was another priority. She knew that many of them had been loyal to the practice for years and were concerned about the changes that would come with a new owner. Dr. Emily worked hard to reassure patients and maintain continuity of care. She met with each patient personally, listened to their concerns, and assured them that she was committed to providing the same high-quality care they had come to expect. 

Working with the legacy team also presented its challenges. Some team members were resistant to change and unsure about the new direction of the practice. Dr. Emily recognized the importance of building trust and creating a positive work environment. She took the time to get to know each team member individually, understand their concerns, and address their needs. 

Building a Supportive Team Culture 

As Dr. Emily settled into her new practice, she quickly realized that building a strong and supportive team was not as easy as she had anticipated. Her initial team consisted of a few experienced dental assistants and a hygienist, but they seemed to be struggling to work together cohesively. There were frequent disagreements, low morale, and a lack of motivation. Dr. Emily knew that she needed to take action to address these issues and create a positive and productive work environment. 

She started by taking the time to get to know each team member individually. She learned about their strengths, weaknesses, and career goals. This helped her understand their unique perspectives and identify potential areas for growth. 

Dr. Emily also implemented several strategies to foster teamwork and improve communication. She held regular team meetings to discuss challenges, share ideas, and celebrate successes. She encouraged open and honest communication and created a safe space for team members to express their thoughts and concerns without fear of judgment. 

Addressing Conflict and Building Trust 

One of the biggest challenges Dr. Emily faced was managing conflict. She learned that it was important to address disagreements promptly and respectfully. She would often facilitate constructive conversations between team members, helping them to find common ground and resolve their differences. 

Building trust was also essential for creating a positive and supportive team environment. Dr. Emily demonstrated her commitment to her team by being transparent, honest, and supportive. She showed that she valued their contributions and was invested in their success. 

The Rewards of a Strong Team 

As Dr. Emily continued to invest time and effort into building a strong team, she began to see positive changes. Morale improved, productivity increased, and the overall atmosphere in the office became more positive. The team members started to work together more effectively and support one another. 

Dr. Emily realized that building a strong team was an ongoing process. It required constant effort, patience, and a commitment to creating a positive work environment. However, the rewards were well worth it. A strong and supportive team could help her achieve her practice goals, provide exceptional patient care, and create a fulfilling career. 

By Gary M. DeWood, DDS, MS 

As a dentist, our role in fostering a learning culture for our team is essential for their thriving success and that of the practice. When there is cultural alignment between the values and priorities, team satisfaction is significantly enhanced. By investing in our team’s growth, we reap numerous benefits, including: 

• Improved Patient Care: When team members are equipped with the latest techniques and information and understand why to use them, they can better help us diagnose and treat our patients. A well-trained and knowledgeable team, empowered with a deep understanding of their role in patient care, will lead to superior outcomes.  

• Increased Efficiency and Productivity: A learning culture can enhance problem-solving skills, improve decision-making, and foster a more efficient workflow. This leads to reduced errors, improved patient turnaround times, and increased productivity. 

• Enhanced Team Morale and Retention: When team members feel valued and supported in their professional development, they are more likely to be engaged and satisfied with their jobs. This leads to improved morale, reduced turnover, and a stronger sense of team cohesion. 

• Financial Benefits: Investing in your team’s development can have a positive impact on your practice’s bottom line. Improved care, increased efficiency, and enhanced team morale can all contribute to increasing revenue and reducing costs. Additionally, a strong learning culture will attract and retain top talent, ensuring the long-term success of your practice. 

Embracing a Learning Philosophy 

To establish a strong learning culture in your dental practice, it’s essential to define your values regarding learning and professional growth. Clearly articulate your commitment to continuous improvement and create a shared vision that inspires your team. Lead by example by demonstrating your own passion for learning.  

Attend conferences, stay updated on the latest dental research, and actively seek out new skills and techniques. This inspires your team to follow suit and prioritize their own professional development.  

Finally, create a supportive learning environment where team members feel comfortable asking questions, making mistakes, and learning from each other. Encourage open communication, provide constructive feedback, and celebrate successes to foster a positive and collaborative atmosphere. 

• Define. 

• Lead. 

• Create. 

Auditing Your Learning Culture 

To assess your practice’s learning culture, identify any barriers that may hinder learning, such as a lack of dedicated time, resources, or support. Prioritize professional development by blocking out time and allocating resources for training and development initiatives. Encourage a culture of knowledge sharing by creating opportunities for team members to share their expertise and learn from each other. This will help foster a supportive and collaborative environment that promotes continuous learning and growth. 

• Identify barriers. 

• Prioritize learning. 

• Encourage knowledge sharing. 

Empowering Your Team 

To foster a flexible and empowering learning environment, offer a variety of learning options to cater to different preferences and support individual development by encouraging team members to set their own goals. To address lack of time, prioritize learning by making it a strategic priority in employee growth interviews and allocating dedicated time for professional development. Then provide necessary resources, and empower them to make informed decisions about their learning paths so they can apply their knowledge in meaningful ways. 

• Offer diverse learning options. 

• Support individual development. 

• Empower self-direction. 

Fostering a Growth Mindset 

To foster a growth mindset, encourage a culture where mistakes are seen as opportunities for learning and growth. Provide supportive and actionable feedback to help team members improve, and recognize their achievements to motivate and inspire them. 

• Celebrate mistakes. 

• Provide constructive feedback. 

• Recognize achievements. 

Leveraging Technology 

To leverage technology for learning and development, explore software and tools that can enhance efficiency and create a library of online resources such as articles, videos, and webinars for team members to access at their convenience. Incorporate microlearning techniques, such as short online modules or podcasts, to fit learning into busy schedules. 

• Utilize dental technology.  

• Share online resources. 

Encouraging Collaboration and Peer Learning 

To foster collaboration and peer learning, facilitate the formation of study groups or learning circles where team members can collaborate and share insights. Additionally, establish mentorship programs to pair experienced team members with newer ones, providing guidance and support for their professional development. 

• Form study groups. 

• Create Mentorship programs. 

Remember 

Investing in your team’s development is a direct and powerful investment in the future of your practice. It takes energy to intentionally get the momentum rolling toward a place with a learning culture that extends beyond yourself. But once the momentum is rolling, these strategies become second nature, empowering your dental team to adapt to change, to enhance their skills, to deliver exceptional patient care, and to create a career for themselves and everyone around them.   

By Edwin A. McDonald, DDS 

Case Study 1 

Early in my practice I was introduced to a periodontist in Dallas. We began a close working relationship for many years. He was a great mentor to me. His work was superb, and his patients had great experiences. He got to know our patients so well he could guide them to the best treatment decisions.  

One day we met, and he told me that he was retiring. I told him that he couldn’t do that to me! His response was that he had found the perfect person to partner and transition with. He had.  

The most important thing that happened was my mentor took the time and made the effort to communicate with me about what was happening. It made me realize that I was important and significant in all of this. The incoming periodontist, Ron, was a young version of his predecessor with the same meticulous surgical technique, superb results, and great patient experiences. In fact, in many ways he became better.  

Years later, Ron’s office is in the same location, just beautifully remodeled and updated. The hygienists remained for many years as did most patients and almost all referral sources. Ron has been extraordinarily successful. That makes me happy. He makes me a better dentist. 

In this case, the two periodontists were philosophically aligned, clinically similar, consistent in their judgement, and had great ability to build high trust relationships. Those four components created a powerful foundation to move smoothly from the past to a great future. 

Case Study 2 

Unlike the first case study, most transitions have gaps between the old and the new. In addition, often the existing practice needs an infusion of energy, a new and expanded mindset, and a more powerful vision to move toward what is possible. 

I have a friend that bought a very traditional relationship-based practice with tons of potential. He is different than his predecessor in his management style, approach to relationships, and desire to grow his practice. He has more than doubled it in just a few years. He also has had a complete turnover in the team. In this case, he needed a team that fit how he wanted to practice. He hired individuals who were prepared to embrace a new approach to practice.  

My friend needed to become a more effective leader of his team and develop a deeper understanding of how important they are to his current and future success. That meant investing more time and energy into getting to know everyone, communicating his career goals and learning about their career goals as they together cast a vision of the future …a worthy destination that honored the past as it created an abundant future. That meant leaving behind some beliefs, assumptions, and patterns of thinking as he matured and as they matured. 

“All of the stakeholders around a practice transition will embrace the change if they see the incoming dentist and new team members living the values that have kept them connected to the practice for many years, there is clear and frequent communication, there are genuine efforts at building trust, and there is an expressed understanding of what is mutually beneficial to all parties.”
–Dr. Edwin A. McDonald (LineofSightCoaching.com) 

By Paul A. Henny, DDS 

Coping with Stress and Trauma 

If you hang around me long enough, the conversation will eventually turn toward the amazing work of Gabor Maté, MD. Maté is a Canadian of Hungarian decent. He is also Jewish, and barely survived the Nazi invasion of Budapest. He has spent his life studying the effects of trauma on the body, both physical and emotional, and he has authored several books. WHEN A BODY SAYS NO is a favorite of mine. 

All of Maté’s work has a common theme: how we individually cope with stress, and when it’s severe enough, trauma. He also advances the bold theory that most of our diseases and dysfunctions today are self-inflicted, even cancer and autoimmune disorders. They are self-Inflicted in the sense that our body does it to itself in its dysfunctional attempt to cope with chronic stress.  

Maté maintains that chronic stress, particularly in a young child, causes the child to dial back their sensitivity to the environment, to stop paying close attention, because it is or might be too painful. 

If you can follow this line of thought, then you will be led to better understand Mate’s theory regarding the common mental dysfunction ADHD, and even some of the milder forms of autism. Maté states that a stressed mother releases stress hormones into the placenta, and when chronically present, these can negatively influence brain development resulting in autism in some cases.* 

Note: Stress can also originate externally from toxins in the environment and food, and from working and living in toxic cultures. 

Today’s Toxic Culture and It’s Impact on Dental Practice 

Those of you who have heard me speak, have heard me say this before. We live in a very toxic culture today. We all try to cope with too much information, too many decisions, and too many stressful issues lingering in the back of our mind left unresolved. And the outcome is similar: we tend to dial back on our sensitivity to the environment. 

Consequently: 

• We start to think of others as being problems to be resolved instead of people. 

• We stop sensing other people’s feelings. 

• We stop paying attention to our gut and intuition. 

• We start blaming instead of understanding. 

• We start manipulating instead of listening. 

Combine all of these together, it isn’t hard to imagine the daily functioning of the average dental practice: 

• Detached 

• Unauthentic 

• Reductionistic 

• Money-centric 

• High stress 

Hence, lots of personal dissatisfaction occurs among staff and patients. 

Getting Back to Whole-Self, Whole-Person Dentistry 

Whole-person dentistry takes into consideration the whole person physically and emotionally. It requires us to be sensitive to our patients feelings, expectations, and experiences. It also requires us to be sensitive to our own feelings, because without them, we can’t sense others and the world around us accurately.  

Without sensitivity, we work through the day like an autistic child in a bubble, and then wonder why our patients don’t listen to us or take our advice. Thus, the road to true person-centered care must first run through us. And that needs to be a life-long pursuit —the process of getting back in touch with who we truly are inside and how we feel. THAT is what L. D. Pankey was trying to tell us when he said, “Know Yourself.” 

By Deborah Bush 

Imagine this: a valued member of your dental team walks in, resignation letter in hand. It’s a blow, not just to patient care, but to the overall morale of your practice. But what if you could have prevented it? Enter the “Stay Interview,” a powerful tool used by thriving dental practices to keep their top talent happy and engaged. 

Why Stay Interviews Matter 

Studies by Gallup and Pew Research show that money isn’t the only reason employees leave. Often, it’s a feeling of being undervalued, lacking growth opportunities, or simply not having a voice. A Stay Interview allows you to proactively address these concerns before it’s too late. 

Benefits of Stay Interviews for Dental Practices 

• Reduced Turnover: Replacing an employee costs a significant portion of their annual salary. Stay Interviews can help you identify and address issues that lead to departures, saving you time and money. 

• Improved Morale: When employees feel valued and heard, their morale soars. This translates into a more positive work environment for everyone, including patients. 

• Increased Productivity: Engaged employees are more productive. By identifying and addressing roadblocks, you can help your team work smarter, not harder. 

• Enhanced Patient Care: A happy, stable team provides better care for patients. Stay Interviews can help ensure your dental team feels supported and equipped to deliver top-notch service. 

Turning “Stay” into Action 

Here’s how to implement Stay Interviews in your dental practice: 

1. First, focus on high-performing team members, those critical to the practice and whose departure would be a major loss
2. Schedule private, dedicated time for the interview. Ensure a relaxed atmosphere. I recommend having a stay interview twice a year and strategically schedule one of the interviews before planned vacations. This way your valued team members have happy thoughts about their employment while gone and look forward to returning. If you are going through a practice transition, you may need to adjust when you do stay interviews to make sure you meet with each employee early in the transition to help them see the value of the transition for them. See Effective Strategies for Managing Transition in Your Dental Practice Part 3  – The Pankey Institute
3. •  Start and continue a conversation. Remember that “the relationship is the conversation.” Two-way listening and recognition are key. 
     • You might start the conversation with this question: “What do you enjoy most about working here?” 
     • Go deeper by asking: “What could make your job even more fulfilling?” “Have you considered leaving?”  
     • Trigger their professional drive by asking: “Do you feel challenged?” “Have I given you enough opportunities to grow professionally?” “What would you like to do more of?” 
     • Affirm their value. “I may not say it often enough, but I value you and recognize your contributions to the practice. In fact, recently….” “Would you consider leading on our next project to _______. It’s important to me that I have someone like you I can rely on to champion this and help make sure we make headway.” 
     • Ask: “What could we do to improve our office culture?” “Do you think I have been clear enough about the direction we are headed?” “Am I providing you with enough feedback?” “How do you like to get feedback?” See How Do You Like to Receive Feedback?  – The Pankey Institute. 
4. Actively listen and respond without becoming defensive.
5. Summarize the key points of the conversation and create a plan to address concerns.
6. Follow up with more conversations as needed. 

Remember, the key is to listen, respond, and act. Let Stay Interviews be the bridge to building a thriving dental team with happy smiles all around! 

About Deborah E. Bush: Deb is a contributing writer specializing in dentistry and a subject matter expert on the behavioral and technological changes occurring in dentistry. A graduate of the University of Michigan and a student of positive psychology, Deb has more than four decades of technical writing experience for medical and dental outlets and authorities. Before becoming a dental-focused freelance writer and analyst, Deborah served as the Communications Manager for The Pankey Institute for Advanced Dental Education and as Director of Communications for the Preeclampsia Foundation. Her work with leading dental brands includes Curve Dental, Patient Prism, and Alatus Solutions (which includes DentalPost, Illumitrac, and Amplify360). She has co-authored and ghostwritten books and articles for multiple dental authorities. 

By Edwin A. McDonald, DDS 

It is amazing to me to realize that I have practiced for more than 40 years in a relationship based, fee for service dental practice. Dentistry has become much more complex during that time. What has not changed is the need for human beings to be loved, accepted, significant, understood, and heard. Also, people who have a high value for their health seek high clinical competence and thoughtful patient management.  

Two years ago, I started looking for a partner to continue providing my patients with comprehensive, relationship-based care. (My hands, back, and body had been telling me that it was time to slow down.) My primary goal in this transition was to create a future where the culture of my practice would continue, and the practice would thrive and grow. 

I received a call 18 months ago from my good friend, Dr. Lynne Gerlach. She said: “Mac, I want you to meet Dr. Shawn Luck.” Lynne went on to say, “I interview young dentists every day and I rarely meet people like him.” 

Shawn and I met, and I immediately understood what she meant. After a few more meetings, several phone calls with colleagues that knew Shawn well, and a thorough financial analysis, it was time for “Team Mac” to meet Dr. Shawn.  

Team relationships are critical to a successful transition. Shawn was met with enthusiasm from my team. That meant we could move forward with a detailed agreement that included terms of employment and terms of practice purchase.  

Shawn’s well-grounded character, confidence, enthusiasm, and intelligence were the factors that guided my decision. We both needed what each other had. I needed Shawn’s character, youth, energy, ambition, and strong desire to own a practice. He needed my clinical training, experience, and commitment to be a focused, consistent, and relentless teacher. 

I began communicating the transition with my team and patients a few months before meeting with Shawn. I mailed a formal letter to my patients that said that I saw three to five years of clinical practice remaining for myself. The letter began and ended with a big thank you for their loyalty, trust, and support. It let them know that I was actively looking for a young dentist to partner with who would continue to take care of them. This letter was a huge success with a thank you from almost every patient. A few patients began to schedule pending treatment that had been on their mind. 

We sent a second letter four months later to announce Dr. Luck. We began communicating about his arrival in person with enthusiasm and emailed a digital copy. The main takeaway here is that the transition immediately benefitted from consistent, focused, and abundant communication with all practice stakeholders about what we were planning and hoping for.  

We are in the middle of year one and I am focusing on mentoring Dr. Luck. We are hoping to play the infinite game as we create and pass on opportunities to the next generation. 

My hope for my Pankey Institute colleagues is you will surround yourself with great people that make you better. Build partnerships with them. Build trust at a deep level. Build community. Serve one another. Seek opportunities to pass on the values of relationship-based practice to the next generation. If you invite young dentists into a relationship and repeat the mentoring you received, we can all play this forward. Dr. Shawn Luck has already captured the spirit of wanting to do just that. 

By Mary Osborne, RDH 

One way to involve patients in making choices about their health is to ask for an invitation to give information. Everyone on the team can look for ways to get permission before taking action. For example, if the dentist observes bleeding or plaque while doing an initial exam, the dentists often say, “The hygienist will help you with that.” That’s okay but getting an invitation for the hygienist is even more helpful. Instead of telling the patient what the hygienist will do, the dentist could ask for an invitation. “Would you like the hygienist to help you with that when you see her?” Patients typically say yes, and that sets the hygienist up for a different conversation when she sees that patient.  

When the hygienist sees a note that the patient wants some help removing deposits in a certain area, she has been invited to give information. The hygienist can say, “So, I understand from the doctor that you’d like to have some help with being more effective at removing the deposits that are around this tooth on the lower right.” 

In this circumstance, I might ask the patient, “What have you tried in cleaning that area?” I pause and allow the patient to think and speak. Perhaps they would demonstrate how they brush or floss in that area. If I do make a recommendation to a patient, I like to follow it with, “Is that something you’d like to try?” 

The dentist and hygienist are a team, and the patient is the third team member in partnering for health. In ideal practice, all clinical and front office team members are part of the collaboration and share their understanding of the patient with each other. Many times, especially with elderly patients, I find there is a family member who is a health partner, and we can invite them to participate in consultations. In dentistry, when we become trusted health advisors to our patients, we can also influence their choices in other areas of their health.  

When we listen well, we can filter our information through the lens of improving overall health. We can make connections between their perspective and our own. When we understand the patient as an individual with special circumstances, opinions, and emotions, we can help them get in touch with their own aspirations for health and help them move toward those goals.  

By John C. Cranham, DDS 

Every dentist finds it challenging to take time to train their team members.

Here are a couple of examples of how I’ve added time to my own day by advancing my team’s skills:

 I fired myself as the practice photographer. My goal was to have multiple people in my office who know our intraoral and extraoral image protocols and who can take the photos at the same high level of quality. To do this, I built “training time” in our schedule to teach photography. Now, while the patient is in the chair, I have the “photographer” show me the photos. We look at them quickly. Occasionally there is one that needs to be retaken, and I will explain why. The quality has become consistently high. By having multiple photographers in the office, my primary dental assistant can focus on something else when needed.  When I am working up a case, I often show them why I needed a specific photo. They take interest in their part of the process and the case. Engagement in their work rises. Always clearly share the why. 

I’ve also trained my team on how to fabricate deprogrammers. I’ve trained them all, checked their work, and explained the why behind our standard. We now have four people who can do that, too. This means we have a good product we offer patients and get it out in a timely manner when my primary assistant is busy.  When it comes to training your team, you will set a standard, and your team needs to know you are serious about it, but you can do this without being stern or making them feel bad. For example, in my office, if they take a bad photo or make an unacceptable deprogrammer, I explain why and ask them to retake the photo or remake the deprogrammer. As they redo something, they learn from their mistakes. I am patient with them. I tell them I made the same mistakes while I was learning. 

By Edwin “Mac” McDonald DDS  

Effective management during transitions directly impacts overall success. By implementing these strategies, you’ll lead your dental practice through change more smoothly. In Part 1 of this series, I described Phase One: The Ending Zone, the time during which a team is feeling the loss of the familiar and coping with uncertainty. In Part 2, I described Phase 2: The Neutral Zone, the time when a team is learning to embrace the change. Let’s look at what is likely to happen in Phase Three as a team continues to transition through change. 

Phase Three: New Beginnings  

During the third phase, the grieving is now passing or gone. This is when you and your team begin to identify yourselves (your culture) with “the new”—whether that be a practice ownership change, addition of more team members, merging with another dental practice, moving to a new office, updating your technology, adding a new niche service, dropping PPOs, or changing your operational systems (how you do things). The change is affecting their daily work and interactions with patients and each other. Adding to this burden is the tendency for patients to ask questions about the change. They also want to know about and feel connected to the change. Time and energy go into that additional communication. 

But, wonderfully, uncertainty is gone and things are clearer to the team members. Commitment becomes high again, and things start to feel “normal” again. People’s sense of competence is greater, they are able to easily identify the practice’s values to what is happening and how they are personally connected to them. When leaders and team members get to this stage, they can focus on the quality of the patient experience, and a new sense of commitment is felt. 

Strategies for Managing this Phase 

• Continue to talk with your team and individuals about how they are feeling about the change. 
• Acknowledge team members that have contributed to the changes. Doing this publicly cultivates trust and gives an example for others to follow. 
• Give individuals a part to play in sustaining the change and ensuring that it becomes the way of working or operating. People need to feel as though they are a part of it. Some leaders who have a hard time with delegating may need to practice letting go. 

Keep in Mind 

• Ultimately, the leader’s ability to communicate effectively will be the leading success factor in managing transition. 
• Approach other natural leaders in your practice – these are the people that others tend to follow or listen to , so get their buy-in early in the process. This will provide more support for you during the process. 
• Expect people’s performance to drop during the process and give grace to those that are not at their highest and best. Eventually, they will reach the other side and so will you! 

By Edwin “Mac” McDonald DDS  

Effective management during transitions directly impacts overall success. By implementing these strategies, you’ll lead your dental practice through change more smoothly. In Part 1 of this series, I described Phase One: The Ending Zone, the time during which your team is feeling the loss of the familiar and coping with uncertainty. In Part 1, I also listed communication strategies to help them cope. Let’s look at what is likely to happen as you and your team continue to transition through change. 

Phase Two: The Neutral Zone 

During this transition phase known as the “Neutral Zone” or “Chaos Zone,” team members grapple with the loss of the old ways and the unfamiliarity of the new. Competency levels vary, and individuals may feel consciously incompetent or consciously competent. What do I mean by that? 

Some may feel they now know what they didn’t about the change and understand the value of it. They are ready to navigate the change emotionally. Others may feel they are starting to “get it” and deal with it. And others have become champions of the change and model confident competence in making the transition. Others will still experience confusion, stress, doubt or skepticism. This is when leaders need to step up and put on an encourager and coaching hat. 

Strategies for Managing this Phase 

• Discuss Strengths Utilizations: Encourage team members to identify how the change allows them to use their strengths differently and explore new opportunities. 
• Open Conversations: Lead them in conversation and empower them to create solutions as issues of the transition arise. Foster teamwork and purpose as you converse with them, so they feel vital to the practice. Encourage them to talk among themselves and lean on one another as a team because you want to retain that team. Express your appreciation for them navigating and embracing the change. You can take them outside of the office for a social meal that does not feel formal and they can feel connected even outside the office.  
• Provide Support: They will feel the need for information in order to feel secure. Ensure communication networks are open. Bringing in a transitions coach helps. Consider what HR resources you can make available to support individuals during this challenging phase. 

Remember, effective management during transitions directly impacts overall success. By implementing these strategies, you’ll lead your dental practice through change more smoothly.