Every dental office has a unique current that runs through it, like a river. It has a temperature and a movement that can be felt as you first wade into the flow. A river’s current is the energy force that guides every drop of water, just as the office spirit of camaraderie creates an aura for the actions of every single staff member. The energy field in the office also determines the satisfaction level and the sense of security for every patient. The current of supportive enthusiasm is established by the dentist and can be multiplied by every staff member at every moment of patient contact.
A healthy office current cannot be forced onto a group of people by a benevolent dentist. Neither can it be conjured up by everyone taking a course or reading a book. Nor can it be easily altered once the flow is moving. It develops its own momentum as it moves through the day: new patterns and behaviors take a long time to be nurtured and become a smooth part of the flow.
Your patients can feel the unique current when they walk through your front door. They sense the pace and energy in the reception room, in the hygienist’s chair, when you come in to provide the clinical exam, and when they take out their checkbook to pay for their care. They respond to the diagnosis and recommendations in your office according to a subconscious sense of trust, quality, and energy in the office. Patients can feel tension: they can be intuitively aware of hidden agendas, and they will express their reaction by delaying treatment, saying “no,” or even taking their records to another office. Some of their judgment is based on your new equipment and your clinical expertise, but their excitement to act now is based on a sixth sense of comfort and peace that comes from the feeling of ownership and security exhibited by the team of people that had an impact on them. It is critically important that you grow and motivate the team you have selected.
Practice success is not just about fixing teeth. Teeth do not have emotions, people do. Teeth are easy.
How do you create a healthy, patient-focused aura in a dental office? It begins with the dentist defining personal success very clearly and moves on to building a team of dedicated, motivated professionals who carry that energy and commitment into everything you do as a dental professional. Every successful dental team needs to learn, grow, bond, share, and support your mission as a dentist.
Whether you see three patients a day or thirty, whether you have four or twenty-four individuals working in the same building, you need staff meetings. In fact, the busier you are, the more patients you see, the greater is your need to regularly stop, sit down, look into the eyes of your work friends, and learn how to define mission, collaborate, and build the daily energy necessary for prolonged success.
You can attempt to teach or will this motivation onto your staff. You can buy some allegiance with bonuses or force dedication, for a time, with sheer willpower. But, if you are to raise the ceiling on patients wanting extraordinary quality services and if you are to grow your monthly production, you have only two choices: you can either work faster or you can empower your team.
You do not develop a team just because the king rules the kingdom. If a commitment to serve the patient is not enlivened by your team members, you do not have a team. Unless they understand the vision, believe in the dedication required, and are willing to hold each other accountable for defined outcomes, you do not have a team. Staff meetings are foundational to the success of a team. Remember, effective staff meetings are absolutely essential both to the success of the team and your dental practice. Figure 19.1 captures a moment in a meeting in the staff lounge of a dental practice.
Dental team: A group of people with different background skills and abilities working together toward a common goal for which they hold themselves accountable, and for which they are held accountable as a group.
It is not instinctive for a young dentist to regularly set aside productive chair time in order to gather everyone together to share and learn. In many average and below average dental offices, staff meetings are not held at all or are regularly postponed in favor of more important things. In some cases, staff meetings are grudgingly held and barely tolerated by the dentist or the staff in the practice. “I do not have the time for staff meetings,” “I have never experienced one really valuable staff meeting in my life,” “I have enough trouble getting the work done now, why would I want to call a meeting and waste valuable time?”
Dentists often believe success is a matter of knowing the technical material, learning the business skills, and surrounding themselves with an honest, diligent staff. It is true that you need technical and business expertise. Equally valid is the necessity for a talented, devoted support team, but it does not stop there. To be successful, day after day, year after year, you need to continuously motivate, train, reward, and challenge your team to understand and value your devotion to your patient’s oral health and your team-shared vision of quality service.
The difference between average and excellent in any organization is the difference between common knowledge and daily application at every moment of public contact. Being successful every day absolutely requires focused, productive, and regular gatherings of your work group.
You will do more to improve your happiness and success as a professional by regular, focused team meetings than you will by taking a full week of the best dental education course in the country! Let me tell you why that is true.
You know your stuff. You graduated from a good dental school and have passed your boards. You have your license in hand, and now you have a dental practice. You have a setting to work your gifts in the public arena and actually get paid for it. All the patients in your community do not realize yet how good you are, but that will happen soon enough. You assume the key to your success as a dentist is literally in your hands.
But success is NOT in your two hands. Contentment at night when you are in bed waiting to fall asleep is not about your technical skills. Being able to do the dentistry is just the beginning. Contentment is found in knowing the patient with an old loose bridge who called today can fit in the schedule tomorrow morning without upsetting your other patients or your dental assistant. Contentment is found in knowing this: when the local school principal is first told she needs four quadrants of scaling and root planning, she does not get angry and ask why no one ever told her she had periodontal disease before today. Contentment is found in knowing this: when you leave the operatory and the patient quietly asks your assistant why root canals cost so much, your assistant has practiced an answer that builds confidence and security in the patient’s decision to have this service provided today. That is the contentment that allows you to fall asleep with a smile on your face as you look forward to your professional decision to work every day to help people keep their teeth for a lifetime of health.
How do you get a group of unique, gifted, and dedicated people to rise above their differences?
How do you motivate these individuals to work as a team? How do you encourage them to value service to the patient the way you do?
How do you build a sense of responsibility within a group of people who each came from different life experiences, with different personalities and different personal needs?
What types of meetings are necessary for a successful office?
- One to start each day and establish congruency of focus.
- One to share personal successes and celebrate victories.
- One to share basic business information of the office.
- One to bring new staff members into the family and experience your office philosophy.
- One to learn of changes in dental techniques, materials, and office systems on a regular schedule.
This can all be productively accomplished with just two meetings: a morning huddle before the start of each day and a team meeting once a month for a few hours. The total time required might vary from 3 to 5 hours a month, which is carefully devoted to allowing each person to understand, connect, and contribute to his or her own success and the success of the dental office.
Successful meetings: How would you know if you had one?
If we use these points as criteria for success, imagine what has to be in place to accomplish our goals. First, we have to agree on what makes a group of people a team. There are many settings where a group of people get together and act but no one would confuse the group with a team. There are established restaurants where it feels like the staff members do not talk to each other. Questions are repeated and you are left alone at the table for long periods. You sense that no one is in charge, and you have either been ignored or, if served, concluded that they really do not care if you come back for a second visit.
Sometimes it seems as if the waitstaffs in some restaurants do not even like each other. Very quickly the service falters and next your perception of the quality of the food diminishes and you wonder why you came here in the first place. It does not take long to decide you are not coming back. Have you ever experienced a dental office like this?
Conversely, you have also been in restaurants where everything is seamless. The greeter tells you who your waitperson will be and he or she arrives quickly. Everyone seems devoted to making sure you have whatever you need. They actually look for ways to be responsive to your questions and desires. They can tailor the menu to meet your dietary needs, and they smile as they ask if there is anything else they can do to be helpful. And, no surprise, the food is terrific also.
What makes the difference? How does a group of people, each with a different background and experience, become an integrated unit that is capable of meeting the needs of a single customer, a couple on a date, a family with children, or a large group celebrating a wedding anniversary? Each visitor has a unique expectation and a unique perception of that particular restaurant. A successful restaurant finds that people return again and again because the experience was predictably warm and responsive. The food was well prepared, but food alone would not make this a return experience. Quality food is important, but quality food is not enough.
Quality dentistry is important, very important, but it is not enough to make a successful dental practice.
Agree on Success—Order without Control
Definition of success for the team: the entire staff enjoys, participates, takes away lessons, and improves service to the patient and to each other. Definition of success for the dentist: you develop rapport, educate, challenge, affirm, and grow a team of people to expand your ability to help patients make better choices about oral health.
You have an orderly pattern to your office systems without having to control or dictate the daily patient encounters in the delivery of oral health services in your office. Involve your entire staff in the process of patient service. Their confidence and authority to act comes from shared goals and common expectations for success. You can focus on direct patient care while your team demonstrates the attentiveness and service you would want if you were a patient in a dental office.
Team meetings must be:
Regular but team-driven
Focused but flexible
Fun but productive
In order to become regular, team meetings need to be scheduled at a definite time with no opportunity to change the date or shorten the length of the meeting. The staff should know this time is as indispensable as lunch and the day the paychecks arrive. Everyone, including part-time team members, should make a dedicated effort to be present for the entire meeting, every time. Staff members are paid for the full time of the meeting, and any food or incidental costs are paid for by the dentist.
Just as the daily schedule is the itinerary for the day, morning huddle is the GPS device to get you there efficiently. Huddle is held 15 minutes before the start of each day. The goal of the huddle is to indelibly connect the daily expectations of each person in the office. It is an opportunity to share information that is usually known only by one team member but for which whole-team awareness is important to establish congruency in delivery of service. Figure 19.2 portrays the activity of a morning huddle. The dentist needs to know there is a difficult patient who needs anesthesia coming into hygiene at midmorning, and the assistant needs to know that the front office staff will call the one o’clock patient to be sure she has taken the required prophylactic antibiotic that was forgotten last time. The person handling financial arrangements wants the hygienist to have the mother of both children this afternoon stop at the desk to make the insurance co-payment. The dentist may want the receptionist to ask the guardian to stay in the office at 4 o’clock to approve the necessary care for a special needs child.
This daily exchange of unique information makes the day start to flow harmoniously for everyone. It is part of how the patient begins to perceive the office energy currents that intuitively inform them that this office is well managed. Patients reflect the confidence, warmth, and assurance they witness within the office.
Each person must come to morning huddle prepared. Some staff members may come to the office 20 minutes early that morning to prepare, and some may stay a little late on the day before. If you have a hygienist who starts at 9:00 a.m. every day, s/he would need to prepare the afternoon before and give the information to someone else to report for her/him. If each person expects to participate three or four times at different points in the fixed agenda, a great deal can be accomplished in just 15 minutes.
The business office comes with information about overnight schedule changes, patients having financial arrangements to make, or payments due today. They may also have information about special insurance requirements for a patient or have knowledge about the family of a new patient coming in today. They may know of a patient who must be seen exactly on time this morning because of a previous scheduling problem. The hygienist will know who needs x-rays, who has pending dental treatment as yet unscheduled, which patients need dental exams, and who in today’s schedule might need a treatment plan/plan of care, or a new comprehensive exam. The dental assistant will know which patients need special precautions, what set-ups will be needed for each patient, and which rooms will be used. The dentist is responsible for knowing which patients may need special care and which ones may have recently completed treatment by a specialist. The dentist must also help the scheduling coordinator know which time in the day is appropriate to see an emergency patient if someone should call and need to be seen today.
Every team member is also encouraged to bring news of special happenings they have learned about patients. Who, on today’s schedule, has recently been in the newspaper, had an anniversary, been in the hospital, or graduated from school. Huddle is also the time when anyone can offer news about any patient of record who has had a significant milestone such as a wedding or birth of a baby. These patients might get a congratulatory card, with sentiments from multiple team members. Huddle is the time when a specific person would put a congratulatory card on the staff table so it can be signed during the day and mailed that evening.
Huddle is one more way you can create the expectation that each individual is responsible for the success of every other team member. Each person has an opportunity to be the one who satisfies the expectations of the patients visiting your office today. The quality of this meeting sets the tone and pace for the day. This allows patients to routinely leave the office glowing with praise for the congruency and professionalism of your office.
When everyone comes to this huddle prepared, you can begin to develop today’s current of energy with a motivated, healthy team of individuals each possessing a desire to contribute to the whole. There must be a routine list of business office, hygiene, assistant, and dentist responsibilities that is used each day. If you do not start with common information and shared expectations, you will not feel linked throughout the day when the inevitable emergency call comes in or the important patient arrives twenty minutes late. Morning huddle starts promptly 15 minutes before the start of the day and can be completed in 10–12 minutes.
Start by 7:45 a.m., end by 7:55 a.m.
Table 19.1 provides details for a huddle agenda.
The entire office gathers monthly on a firm date and at a known time, no excuses. These meetings should eventually be off-site so there will be no interruptions and so it is obvious to the team that you are making an independent commitment to time and space for focused discussion and personal connections to enhance your daily work. There is a safe narrative that will lead to an orderly, patient-focused, and emotionally satisfying gathering that every person will look forward to every single month.
Early in a dentist’s career staff meetings are called only when there is a crisis. They are seen as a time to fix what is wrong. The topics are often critical issues that require urgent action, and there is little discussion about long-range issues that impact your practice harmony. When dentists have greater experience, there is more planning and more time allowed for issues at a staff meeting. Still, staff meetings often remain a negative, complaint time controlled by whomever has the biggest problem or the loudest voice. This is not an experience anyone is willing to have a second time.
Start time:__________, end by__________
Rewarding experiences—personal and professional
Six parts to predictably successful team meetings:
Table 19.2 provides the basic organizational structure for a team meeting.
During the rewarding experiences portion of the meeting, everyone will share at least one personal and at least one professional experience that has occurred in the last month.
This time is devoted to a leisurely sharing of experiences by each person clockwise around the room. After one person starts, the sharing moves calmly around the circle giving each person an opportunity to tell his or her story. This allows a friendly, relaxed, and unhurried opportunity for people to demonstrate through words who they are both personally and professionally. They can first tell the group what brings them satisfaction and reward outside of the office environment. Some dental colleagues find it not only easy but necessary to share home experiences. Some team members would have shared these personal highlights even if it meant bringing a photo or a personal memory to work during a busy day. Other team members will be less open about their lives outside of work, and that is fine. This process is not about revealing confidences. However, everyone must have a couple things that have />