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.

It’s important to consider your hygienists as autonomous skilled professionals independent from your management. Of course, as the leader you must provide guidance, but you should still defer to their training in their specific field.

A Hygienist’s Expertise

This is one of the hardest parts about managing a team – letting go of the reigns a little. But you don’t have to entertain a free for all to provide some freedom. If a hygienist has made it clear to you that they have both clinical and behavioral skills, then it’s your job to open up a dialogue.

You should discuss with them what you will individually bring to an exam. Find out what they feel comfortable recognizing and diagnosing, that way you can both be on the same page. Don’t rely on the antiquated belief that hygienists only know how to recognize. They are also fully capable of diagnostic techniques.

In hygiene school, they will have thoroughly reviewed the signs and symptoms of multiple conditions. But for them, their education tends toward directing them to call the problem to the dentist’s attention.

The key to all of this is to only offer advice in your area of expertise. That goes for both hygienists and dentists. As with most things, individuals vary. Dentists and hygienists will have different qualifications, therefore providing different perspectives in the practice. No matter our level, we must offer our opinions as opinions and be willing to listen to the thoughts of others.

Diagnosing versus recognizing comes down to semantics, while both are very different from the actual treatment planning designed by the clinician. It’s a hygienist’s responsibility to serve the patient’s needs to the best of their ability based on their skill level and judgement.

What do you consider a hygienist’s purview in the dental practice? We’d like to know what you think! 

How you help patients become healthier in your practice is a big question. That’s even more true when the role of your hygienists is unclear. The best method of serving patients well can become hazy due to procedural problems that have nothing much to do with care.

Hygienists in the Dental Practice

For example, there is some confusion over the relationship between the insurance company, dentist, and hygienist. Essentially, what level of care are hygienists allowed to handle and why? This brings up multiple concerns such as their ability to diagnose, who the patient wants to hear recommendations from, and how a periodic exam is charged.

The only way to figure out the right answers to these areas of interest is to take a hard look at your individual dental practice. There is no one perfect solution, no size fits all. You have to decide what is appropriate based on your relationship to hygienists on your team as well as their skill and knowledge levels.

Who Does What?

Clarity is a great motivator. When people understand their purpose, they are better able to carry it out well. The only way you can have clarity around the role of hygienists that will then seep over to them is to separate the expectations you feel bound by from what you actually think is best.

Taking the time to consider the big picture of your practice can go a long way. You can only maximize all the personnel resources at your disposal, including a hygienist’s communication skills, technical knowledge, personal perspective, and time, if you know why you’ve hired them in the first place.

First, determine where a hygienist’s value fits into your practice. What clinical service is your best and what behavioral service is your best? Most importantly: Who provides these services and why?

Where do hygienists fit into your dental practice? Give me a shout in the comments below!

Every successful dental case begins with a conversation. 

A Case of Great Dental Expectations

“So what should we do next?” my patient asked. I rolled my chair beside him, excited about the challenge of achieving his preferred future.

I looked him in the eye. “Do you really want to know?”

“Yes!” he said.

I responded, “I don’t know right at this moment. However, may I take some models, photographs, and study your mouth? Taking time to study your mouth with this information will allow me to develop viable options for you to decide what you would like to do next.”

This conversation came after my patient lost #12 and had an implant placed. He had never asked this question before and his past dental history was single tooth dentistry.

Once the records were gathered, I spent some time in my office lab opening up his vertical according to the principles that Mike Fling teaches in his worn dentition course as well as the Pankey restorative footprint and clinical sequence taught in our Essentials 3 curriculum.

From my patient’s diagnosis, I discovered that he had two options: ortho plus restorative treatment or restorative treatment without ortho. Space was needed and form and function would definitely improve with improved space. We met for a conversation.

We looked at photos and models, then discussed the options. He explained to me that he would prefer to do the restorative plan without the orthodontics. My team and I invited him to experience a mock-up of the potential outcome from a wax-up by our own John Lavicka of Dental Ceramics. The patient immediately replied, “Let’s do it!”

Even though the patient understood why I wanted to do the orthodontics, he wanted to attempt treatment without it. I was happy to move forward with a restorative-only treatment with one agreement: If it did not work, I could initiate orthodontics. He agreed.

To be continued …

Providing healthier mouths to patients and doing more fulfilling dentistry (and making more money as a result) are admirable goals most practices have. I have written a couple of times about techniques that help us improve case acceptance: creating curiosity and co-discovery, listening, the learning ladder, and more.

This brief overview is an attempt to see the process as a journey for the patient and to consider their perspective:

Patient’s Journey: Eighteen Inches at a Time

It Starts in the Head

Patients first listen to the facts about dental care, their need and wants, issues or diseases that they have, and potential treatment solutions. Sadly, facts are not enough.

Developing great listening skills, caring, and trust help patients come to see you as their health advisor. This requires an eighteen-inch ‘Journey to the Heart’! It is there that caring and trust live. The emotional connection is very important in case acceptance. To ignore it is to minimize your success. But that too is not enough.

The patient must schedule, keep appointments, and pay for recommended treatment. This ‘Journey to the Wallet’ is the next eighteen-inch trip the patient must take. It is the execution of the plan from their perspective.

Valuing dental care and oral health is demonstrated by their checkbook and what they spend time and money on. Still not done?

The next eighteen-inches take us to a knee. Appreciation helps fulfill us as caregivers. Most rewards are best when they are balanced, financial, and behavioral: money and warm fuzzies, you get the idea. Money alone does not buy happiness (but it does help you enjoy your misery in some mighty fine places!).

The final journey takes us eighteen inches to the patient’s feet. When patients tell others about your practice and refer their friends, you have come full circle. This trust display is the ultimate compliment to you and your team.

Keep the Patient’s Perspective in Mind

Ask yourself the following and seek answers with your team to enhance patient health, your fulfillment, and mutual rewards:

·       Have you helped nurture movement toward the heart?

·       Did the patient accept and schedule treatment? If not, why not?

·       Were they able to pay with gratitude and appreciation? (borrowed from Dr. Pankey)

·       Did you ask for and receive referrals of their friends and family?

Remember, it’s a journey, not a destination. Enjoy the trip and check the map along the way. You, your team, and your patients will all be the better for it.

A journey is best measured in friends, rather than miles. -Tim Cahill

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

Trust: Known and Unknown

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

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

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

A Relationship Strategy

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

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

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

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

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

Listening is a skill everyone likes to talk about but very few actually know how to enact. It’s more challenging than we might think to really shut our mouths and pay attention without constantly interrupting or adding our two cents.

In my last blog, I talked about offering an empty presence and letting the person finish their story. Here, I cover other important listening skills. We should all make the effort to speak less and hear more.

Become a Truly Great Listener

Listen for Their Heart

Listen for the feelings behind the words. Can you hear voice fluctuations? Can you read their eyes? Feelings of regret, fear, grief, hope, etc.

Using the balloon symbolism, I picture a red balloon filling with their emotions as I listen for feelings. There is no higher form of communication than heartfelt, empathetic listening. The balloon symbolism may feel silly, but it will help.

You cannot be heard until the patient’s emotional bubble is deflated through your quiet confidence and empathetic understanding.

Ask Permission to Go Forward

When you ask for and receive permission to offer advice, you are much more likely to be heard. This is truly one of the most intuitive questions you can ever ask and does wonders for building rapport: “May I give you some initial thoughts?”  or “May I have permission to consider what you have told me and study possible solutions?” 

Once a person has given you permission, they are more likely to become a partner in solutions. 

There is no greater gift of healing, expression of love and builder of self-esteem we can offer those special people we care about most, including our family, friends, patients, co-workers, and community, than listening. Everyone wants to be heard.

How do you practice listening skills? Let us know in the comments section below!

Dr. Pankey had an advantage most of us do not that made him a world-class listener. Often labeled a disability, Dr. Pankey was hard of hearing. Because of this, he had to learn how to listen intently to his patients.

Dr. Pankey learned to listen for feeling over content. Listening is a skill that can be developed and improved. It requires intention and attention. One must practice! Here are a few tips that help:

Actionable Skills to Become a World-Class Listener

Offer Your Empty Presence

Most important of all is the intent to be present. Be here, nowhere else. Never enter a room without taking a deep belly breath to quiet the sympathetic, judgmental lizard brain and enhance the empathetic brain.

Empty presence is being fully available for the patient with no agenda, no busy talk going on in your mind, no judgment about what is said, no mental correcting or explaining chatter going on in your head for when you get a chance to talk.

I like to imagine an empty white balloon completely devoid of anything. My objective is to simply let the person fill it with their own thoughts and feelings. Really focus on what they say and how they say it and especially the feelings behind it. You are a gatherer of their information, not an explainer, corrector, teacher, or judge.

Let the Person Finish Their Story Without Interruption

Take a deep belly breath again once they have gone silent. What they just told you is simply what they first told you. There is probably more. When a person has finished their story, the silent period is when they are understanding what they just said.

Silently offer your open heart with compassion, allowing them time to spill out everything they need to say. Silently count to 10 before speaking, then use simple encouragements: “Is there anything more,” “Yes, I understand,” “I’m glad to know that,”  “I’m sorry to hear that,” or “Tell me more.”

To be continued …

Do you want to develop an emotionally engaged, relationship-based practice where people choose you over the insurance-driven option? It is not going to be your technical knowledge that does this. It is in how you touch people’s hearts.

Trust or the lack of it can be built within seconds. How can we best emotionally engage people? Immediately as you greet a person, focus on them – each and every time. Give the S-O-F-T-E-N approach a try:

How to Develop Trust in Only 10 Seconds

Smile: A welcoming greeting in any language.

Open up: Open body language – relaxed, welcoming, arms open, palms up.

Forward body lean: Again, welcoming, not aggressive. A slight forward lean can demonstrate attention, interest, engagement.

Touch: Lightly when and where appropriate. Studies indicate people feel a warmth of endorphins with a light human touch. A gentle handshake with the left hand also touching lightly can work. A light touch on the shoulder or arm is effective too.

Eye contact: This is the most important thing you can do to gain immediate connection. Immediately look the person in their right eye. Not to stare. Especially while you are speaking to the person. Recent studies indicate eye contact has dropped to the 30-60% range in today’s digital smartphone era. That’s a huge drop into disengagement. It drops even more when one is speaking.

We are losing human connection to the soul, yet 60-70% eye contact is ideal. Practice glancing into their right eye consistently. Yes it feels awkward at first and yes it takes conscious intent. Why the right eye you ask? Mostly so you don’t stare at the bridge of the nose and look cross-eyed, but also the right eye engages a person’s creative, intuitive parts of the right brain more quickly.

Nod: A slight affirmative nod as the person is speaking is a strong indicator to continue. Studies indicate a person even accepts criticism and correction better if one nods slightly while presenting bad news. A nod tends to indicate support, not just agreement.  

Interestingly, the reverse is also true. A shake of the head while giving supportive news can create a sense of skepticism. Yes, I can look like a bobblehead at times. Emotionally engaged attention is becoming a lost art. But it is the greatest way to touch a person’s heart.

In dentistry we have a huge advantage. We have multiple interactions every day with good folks who trust us enough to do scary things in one of the most intimate parts of the body. We can grow that trust to emotional engagement one person at a time.

What is the result of an army of emotionally engaged dental missionaries? Lots of loving people who say: “You have to go see my dentist. They’re the best in the world!” Whose world? Theirs.

How can you achieve an emotionally engaged, relationship-based practice where people choose you over the insurance-driven route? Practice, practice, practice – on people, not just their teeth. Start with your family! And love the practice.

When a car breaks down, the way we choose to have it repaired says a lot about how much we value our vehicle. A similar phenomenon occurs with dental care. 

In part 2 of this series about how we see a fix versus a valued service-based relationship, Dr. Kelly dives back into an experience that made him reflect on the dental profession. Keep reading for the rest of his story:

A Car Service Analogy: Obligation, Expense, or Experience

Coincidently, many days I use the analogy of cars to taking care of teeth with my patients. We wear away the surfaces of our teeth similarly to how tires age. We pay for maintenance and parts with an equal financial obligation and expense.

When we have to start over and restore our vehicle (or get a new one), sometimes it costs the same as major treatment we could have done for our teeth. Sometimes the auto investment is inconvenient and urgent. Often, if we choose, it is predictable and pleases us. We find ways to pay for it.

Individuals always seem to find ways to pay for the things they value. We choose our own experiences whether we know it or not. I invite my patients to consider experiencing dental care in my practice similarly to the good experience I have had with reliable and well-maintained cars.

The business card for my practice has three tag words on it: Restorative, Comprehensive, and Esthetic. I’ve been told that the meaning of these descriptors is too obscure for new patients to understand. Why not be like the dentist down the street and just say “Cosmetic” or “Family Dentistry”?

I believe every opportunity I have to help patients experience each of these focused goals for our patient care enriches the dentistry I can provide them. So many in our patient family have learned through these experiences exactly what these words mean.

To be continued …