By Edwin “Mac” McDonald DDS  

Change is inevitable, and dental practices often experience significant shifts. Whether it’s practice acquisitions, personnel changes, or technology updates, leaders must navigate these transitions effectively. Here are some key strategies: 

Clear Communication: Effective communication is crucial during change initiatives. Prioritize clear and frequent communication with your team. 

Recognize Transition Phases: Understand the different phases your team will go through during transitions. Recognizing these stages helps you address their needs appropriately. 

Feedback Matters: Despite its challenges, providing feedback is essential. Avoiding it can lead to decreased morale, reduced productivity, and increased stress among team members. 

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

Phase One: The Ending Zone 

In the first phase of change, you are saying goodbye to the old and how people either individually or as a whole identify with the familiarity of it. People may experience denial, numbness, or resistance. The way each person feels and copes is likely to vary. 

It might feel like a significant loss to someone, so it is important that the leader understands how many people are affected at varying degrees of uncertainty and resentment due to the “loss” of what is no longer. Uncertainty and resentment create an environment in which team members may expend energy but not get much done.  

Recognize that this will be a time of loss and grieving for most. The key element that has the biggest positive impact is communication. I have walked several practices through ownership changes. One of them was a privately owned practice that was being acquired by a very prominent corporation. The initial response and reactions from the team members ranged from denial and numbness to resistance. Some employees who had been there the longest felt betrayed. These reactions varied from day to day, and week to week. What helped was constant communication. 

Before a change starts to happen, before the team sees signs of a transition coming, it is important to start communicating why and the transition that is likely to occur. Making employees feel secure and hopeful will reduce uncertainty and resentment. The more certainty you can give them about what will transpire and the future benefits they can expect the easier everyone will move forward, being productive and carrying forward the positive relationships you have invested in over the years. 

Strategies for Managing this Phase 

1. Explain the rationale for the change and the benefits of it. If you are able, elaborate for each team member or department. There needs to be a venue to express concerns or gain support to bring about the closure. People need to know that you care about them as individuals. 

1. Be transparent. Describe in detail what will change and also what will remain the same. Transparency is vital to cultivate trust. 

1. Describe and celebrate the success and values of the previous ways of working and identify how they will be enhanced by the change. 

As long as we, the leaders, recognize their feelings, we have the opportunity to effectively help our team move to the next phase, so they do not stay in the ending zone too long. 

Laura S. Harkin, DMD 

I’m the owner of a third-generation dental practice. My father was a special person who cared for his patients as much as he did his dentistry. One important piece of advice that he gave was to make sure that my patient records were always complete and pristine. He said, “Anything that you are sending to the laboratory or to a specialist, even down to how you write your lab script or note, must be precise. And the reason is not only to minimize adjustment at the end but to also set an expectation for the same level of care returned by the lab or specialist.” 

As a team, we have spent time evaluating our models and photos to discuss how they can be improved and to recognize our highest standard. Recently, I became a little concerned about some of the radiographs we’d taken in the office. I encountered a few bitewings in which I was able to see the bone levels or the image wasn’t anterior enough to check the distal of the canine. So, as a team, we set aside time to review current x-rays and discuss the diagnostic qualities that we seek to achieve in each type.  

A team huddle provides built-in time and a safe place to do something like this. While reviewing the images, it became very clear that the team knew how to take vertical and horizontal bitewings. They also had a clear visual for how the images should look. Sometimes, however, a team member was shy about retaking an x-ray for they worried that a patient would be uncomfortable with the process. Other times, I imagine, they felt pressed for time and hurried to move down their checklist. 

Our review of images reinforced the level of care we collectively aim to achieve in all facets of our clinical day. Just as we strive for beautiful, mounted study casts, we take our x-rays with intention for our ourselves, our referral sources, and, above all, our patients. Consider taking a team meeting to share each other’s tips and tricks for taking x-rays in patients with difficult anatomy, a gag reflex, or missing teeth. Our own team members have a wealth of knowledge that sometimes doesn’t move from one treatment room to the next! 

By Pina Johnson, Professional Certified Coach, and Edwin (Mac) McDonald, DDS 

B.F. Skinner, a noted 20th century behavioral psychologist, conducted an intriguing and provocative experiment using laboratory mice. Using behavioral conditioning he was able to condition one group of mice to believe that through their actions they were able to determine their fate. Using the same methodology, he also succeeded in conditioning another group of mice to believe that there was nothing they could do to alter their fate. 

He then placed the first group of mice, the ones that believed their actions mattered, into a large tub filled with water. As anticipated, this group of mice, when placed in a life-threatening situation, acted instinctively and began to swim to the side of the large water-filled tub. Upon reaching the edge of the tub the mice were able to crawl out to safety. 

The second group of mice, the ones that believed that their actions were meaningless, when placed in the tub of water, simply sank to the bottom and drowned. Appropriately, the lack of responsiveness displayed by the second group of mice was termed “learned helplessness.” 

Culture Lifts or Sinks Ambition 

Belief that our actions and choices matter is essential to “making things happen.” 

According to Edgar Schein, an icon of modern leadership thought, the primary function of leadership is to create an organizational culture. The culture that we choose to create will influence every aspect of our organization and ultimately determine our dental practice’s success or failure. 

Value-based leaders understand the power to alter the course of the organization does not reside with a few; it is shared by many. Organizations with cultures based on shared beliefs and purpose are higher performing. Leaders of the highest performing organizations foster cultures rich in collaborative decision making and a profound belief that everyone has influence. 

Counter Learned Helplessness by Empowering Self-Confidence 

We have come to recognize that good-old “self-confidence” is a learned competency, and effective leaders create organizational cultures that promote and teach self-confidence to each individual team member. This is accomplished by empowering teams through collaborative decision making and ensuring each team member has been given the knowledge, skill, support, resources, and appropriate authority to accomplish each task required to meet the shared goal. 

Unleash Teamwork and Creativity 

In organizations with shared leadership cultures, human self-confidence is unleashed beyond saving oneself to act in the best interest of the organization. Knowing that our individual actions will have some effect on our organization’s future (and thus on our own future and the future of others we value) compels us to want to take actions that have positive benefit for everyone. This is “meaningful” for the individuals within the organization. This raises their engagement in the work and simultaneously generates a sense of wellbeing.  

In our dental practices, “We are serving others with empathy and care to ultimately improve their wellbeing.” This is a form of love. It begets appreciation and reciprocity. When the slings and arrows of daily life initiate negative thoughts of being out of control of a situation, remembering our purpose and prior successes enables us to see disappointments and frustrations as opportunities to create a new type of approach and carry on. 

The goal for effective leaders is to allow all of this to happen in a psychologically safe environment in which our staff need not fear repercussions for their well-intended actions even if the outcome of these actions is less than ideal. By creating organizational cultures that are psychologically safe, we draw out our organizational creativity which is often stifled by the psychological repression found in command-and-control cultures. 

Creative thinking is considered to be one our highest-level cognitive functions and has been found to be a distinguishing characteristic of exceptional organizations. The wise leader understands that their organization is best served through shared power, collaboration, and utilization of their organization’s collective creativity. 

Here’s how to become an instant leader.

A while back, I sat in on a Facebook Live interview with a dentist who was discussing practice management for young dentists. Like so many times, the interviewer asked the guests, “What’s the one piece of advice you would give to a dentist who is just starting out in his or her career?” And like so many “experts” the dentist replied, “Learn leadership.”

It was like asking for advice on how to live a long life and responding, “Keep breathing.”

Yes, leadership is the right answer, but have you ever looked at the number of books available on leadership? Today I looked on Amazon and found 60,000 leadership books.

Young dentists need better answers.

Young dentists need more practical answers—answers that allow them to apply what they know. Leadership comes in many styles and sizes. Leadership is a universal concept. Did the dentist mean the Leadership Lessons of Abe Lincoln…or the Navy Seals? There is a big difference.

A better question might have been: Where should I start regardless of style, personality or even mission?

What is the one thing that all leaders have in common?

The answer is followers. No one can be a leader without followers, and in a dental practice, followers are patients and staff. Not one of them will take one step forward if they don’t believe that you are the doctor that will take them where they want to go.

What is it that the followers in a dental practice want to know?

They have two silent questions in their mind. You must answer the two silent questions for them to trust you. And they must trust you to follow you.

The first question is: “Do you care about me?” So that is your starting point. Don’t take for granted that you are being perceived as someone who puts their patients and staff ahead of themselves. It takes lots of time to develop the mindset and habit set that leads to this perception. As a young dentist you need to start there and work on this.

The second question is: “Can you do the job?” or “Are you competent enough to do the job?” As a young dentist, understand that you are still in your apprenticeship stage of your career. That means there is plenty more to learn. In my career I remember taking many technical courses that were disconnected and I had to make sense of them. It was more like a self-directed apprenticeship.

Who can help you become a leader?

Mastering leadership, trust and technical dentistry is a combination you will find at The Pankey Institute. I tried numerous CE programs and read thousands, of books. But it was the inspiration and mentoring I received in the Pankey community, and the discipline of journaling (reflection) that I adopted mid-career that kept me on task towards mastery.

Today I would advise the young dentist to find a mentor or mentoring community, and when you find them, ask, “Do you care about me and can you do the job?”

That would be my advice to any young dentist looking to learn about leadership, trust and even mastery.