By Paul A. Henny, DDS 

Effective leadership in dentistry requires open-mindedness and empathy, while at the same time, assertiveness, consistency, adaptableness, and resilience.  

That’s a tall order! 

Many of us struggle to be assertive and empathetic at the same time, particularly when we are under pressure. All too often, we lean into our positional power and superior knowledge and don’t stop to ask ourselves: 

• How does the patient feel about my message? 

• Does the patient understand the long-term implications of the information I have presented? 

It’s important to remind ourselves that decision-making is a two-step process: 

Step 1: The recognition of accurate, relevant, timely, and important new information 

Step 2: Reasoning to make choices that align with values and goals 

Few people fully understand the nature of their problems, needs, and the complex processes necessary to realize their goals when they first come into our dental offices. Patients often behave dogmatically or too emotionally, which leads them to choices that result in more failure and frustration. 

Our ability to facilitate learning in others and lead them to decisions with predictably better outcomes can be developed. This is good news! With understanding, practice, and reinforcement through successful experiences, we can all learn how to become more effective leaders and develop a more successful practice. 

The 6 Key Steps to Effectively Guiding Our Patients 

1. Slow down and manage your time more strategically to spend more time with each patient.
2. Demonstrate empathy. Stay in conversation and ask questions to understand what they know and how they feel about the information you are giving them. 
3. Create a safe and effective environment for learning. This entails slowing down your delivery of information into the bite sizes that are appropriate for the patient and pausing often for their minds to catch up and for them to experience self-discoveries.  
4. Show deference for the fact that each person is the best expert regarding themselves, their feelings, values, and goals. Let them know you will support them in their process and invite them to learn more and weigh their new knowledge against their values, priorities, and long-term goals.
5. Give each person enough time to make complex decisions as well as work through the logistics necessary to make their decisions fit into their life.
6. 6. Remain clear and assertive about what is in the patient’s best health interests and consistent with your values. Only proceed with treatment decisions that are mutually agreed upon as appropriate.

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 David R. Rice, DDS 

I’m guessing your practice is a whole lot like mine. People can be challenging. Patients are people. Ergo, yes, patients often bring us challenges. With that and 29 years into dentistry, there are a few challenges I’m willing to admit and, like you, work to overcome.  

Our great patients get great dentistry.
Our challenging patients get our best effort.
Our job is to understand who each is, what each wants,
and how we do our best to deliver it. 

As you and I learn the best techniques and technology, we have to understand that many of our patients see the world differently. They see it differently than each other, and they see it differently than we do. At first glance, yes, this is an obstacle. But for those of us willing to spend time focusing on their views, this is a massive opportunity.  

About 20 years ago, the treatment planning and presentation mantra our team developed was: Pizza by the slice or the whole pie? 

 A talented and curious team with character, plus a well-defined process,
always equals complete care and profitable production. 

 Here are the four keys: 

1. Understanding who of our patients wants complete care—the whole pie right now. 

1. Knowing who of our patients isn’t ready for the whole pie today and needs us to serve that complete care one prioritized slice at a time. 

1. Recognizing that some patients love pepperoni, some love veggies, some are all NY and thin crust, some love that Chicago deep dish, and so on. 

1. Delivering each individual patient’s pizza the way they want it without yielding on our quality. 

All our patients come with a story. Some are ready for a whole pie. They want complete care and they want it now. Other patients are overwhelmed by the whole pie. Right or wrong, some past experience makes their yes to the complete care we know they need challenging. We can push them, or we can appreciate where they are and work with them one slice at a time. 

I’m not proposing we compromise our care. I’m offering us all an opportunity to elevate it. Whether you’re scanning and milling, 3D printing, injection molding, direct bonding, or prepping and temping long-term, the materials and technology we have at our fingertips today afford us an incredible ability to segment care. 

Complete-care case acceptance at 90%+ is a reality when we add great communication skills to the clinical skills we’ve worked so diligently to achieve. Today, I challenge you to assess, calibrate, and elevate your ability to deliver pizza by the slice…or the whole pie. 

In a conversation with a young dental practice owner, this doctor recited a long list of the things he would like to do. He also said he had colleagues, even mentors, giving him advice on how to run his practice. When I asked him questions to help him align his vision and values with the things he would like to do, we were able to narrow down the long list to three items that would be most impactful for his business. First, he was committed to being a great business owner, getting advice, and establishing an employee manual for his practice so that he could do the right things for the right reasons. Second, he wanted to create a brand for his practice, and that was going to involve marketing and training for his front office. Third, he was committed to getting advanced clinical training for himself and his clinical team.

As we started looking at courses for him and his front office and clinical teams to attend, I could feel his excitement rising. He blocked out time on the calendar for these courses. I could sense that he was crossing over from interest to commitment.

When you are “interested” – most often, it’s something that you approach at your convenience, while other things get in the way. What comes to mind are so many New Year’s resolutions for which people tend to be interested in losing weight, getting healthier, finding a new job, etc. but commitment is weak and it often wains after a few weeks.

When you truly want something to happen, you align other things, so it takes priority – you become “committed.” You take action, no matter what. In the case of the young practice owner, he blocked out his practice calendar and paid in advance for courses. That shows how committed he was.

When you’re thinking about goals for your practice, consider this: what goals will have the greatest impact on achieving your vision? Which ones are in true alignment with your values and will add to the practice culture you are building? Which should you prioritize? Then ask yourself, are you simply interested in doing them, or are you truly committed to doing them? If you’re committed, take action!

One definition of professionalism became the foundation of Dr. L. D. Pankey’s life and a thesis of his teachings. He wrote the definition himself!

“Professionalism is that quality of conduct, which accompanies the use of superior knowledge, skill, and judgment toward the benefit of another person or society prior to any consideration of self-interest.”

Throughout his life, he endeavored to make relevant connections with others, intentionally pay attention to others, share gratitude and appreciation, and offer compassion—even in the midst of reading another person’s lips!

As he was entering the last decade of his life, he remained continuously aware of and interested in others. Until the end, he was a continual student, eager to learn more. He encouraged other dentists to live and love their profession to its fullest at every opportunity.

The Story of Wilbur the Garage Mechanic

Dr. Pankey met Wilbur in the late 1970’s, when Dr. Pankey’s ’76 Fleetwood was not running as well as a relative’s ’72 Fleetwood. Dr. Pankey was able to observe Wilbur do his job and experience the ’76 Fleetwood move down the highway as if it were new. After a trip to Jacksonville and back, Dr. Pankey stopped again at Wilbur’s Garage to extend his gratitude and appreciation. He also wanted to listen to Wilbur’s own story again on a deeper level.

On reflection, Dr. Pankey wrote, “Like me, Wilbur got a few breaks. But of course, he helped make those breaks and took advantage of them by doing his job well and treating people right. Although he had never heard of the Philosophy as such, Wilbur was using it in his auto repair business just as I was using it in my practice.” Isn’t that interesting…

Dr. Pankey always had a smile on his face as he told Wilbur’s story in each Philosophy session he taught in the late ’70’s and well into the ’80’s. Let me encourage you to reread his personal story in the first section of A Philosophy of the Practice of Dentistry by L. D. Pankey and Bill Davis. Read that section of the book at least once or twice a decade. Reflect on your experiences; you just might become aware of new observations and connecting insights, during your decade-by-decade reflections. This exercise often puts a smile on our faces!

“That Quality of Conduct”

The quality of conduct on which Dr. Pankey founded his life’s work (his professional philosophy) not only embodied genuine interest in others as individuals (with uniquely compelling situations, needs, personas, and values). It also embodied genuine concern for others’ welfare ahead of his own. Intentionally sustaining his vision of practice, drove this professional philosophy deeper into his “tissues”—into his thoughts, behaviors, motivations, and emotions. His philosophy did not spring full grown out of his mind. It developed over time.

In my last blog, I wrote that as we look into our life’s mirror (over many decades for some of us), we gain a deeper understanding of ourselves. By reading again Dr. Pankey’s story, we discover a deeper understanding of how it relates to our personal stories and life’s work. Reflections on our own lives (and Dr. Pankey’s life) offer opportunities for new awareness, commitments, and actions. We develop over time, and the beat goes on!

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

On January 10th, 2020, The Wall Street Journal published an article on the changing patterns of retirement. It is worth a look. After 43 years in the world of dentistry, I have now survived three years as a “retiree” and have a few comments about preparing for and transitioning into this significant life event.  

Preparation Tips 

1. Before you “pull the plug” on work, start to figure out what you would like to do when you have more time. My unhappy retired friends generally failed to do this. I suggest you build on the things you like to do. Include personal time and together time with your spouse. Look forward to a new challenge such as learning a new language or trying your hand at gardening. If you are not now in a service club or a similar group, you will have the time to try that.  
2. With your spouse, discuss how you will manage money. Long before retirement, create your retirement budget and financial growth plan. The Pankey Institute curriculum will help you with this.  
3. Be genuinely interested in others. The happy retirees I have met talk much more about the new friends they have made than about themselves. They are outward-focused and active listeners.   

Transition Tips 

1. Create a schedule and stick to it. If you used to get up at 5:30 am and liked doing so, don’t change. Just get up and do something you did not have time to do in the past.  
2. Be committed to your plan. Intentionally stick to your financial and time management budgets.
3. Stay involved in dentistry if you love it. Keep your membership in organized dentistry and your study club. Be a mentor and continue to learn. If I am fortunate, I will help a few young dentists be more successful and avoid some of the errors I made. 
4. Meditate on L.D. Pankey’s Cross of Life. Be committed to spending social time with your family and friends, even volunteer for their causes. And don’t forget your spiritual life. I’ve been amazed at the nice folks we’ve met at church who are interested in us as people and not as what we did in our careers

Final Thoughts 

If you are 30 and have not started to think about retirement, it is time to start. The successful economics of retirement takes time and commitment. If you are nearing the years when you will retire from practice, start thinking about your future lifestyle now. Keep in mind that a life well lived is a happy one. Continue intentionally “giving back” after retirement, and you will continue to make memorable, good things happen for yourself and others.