Quote of the Week

"You may be smarter than me, but your not as smart as my team." James Pride DDS

Integrity - Nothing works without it - Dental Practice Management

Nothing works without integrity. Nothing. When you drop your integrity, you lose power. When you lack integrity, you sabotage your satisfaction. When your integrity slumps, you directly undermine your peace of mind. It's invariant, without integrity nothings works.

"The truth of the matter is you always know the right thing to do. The hard part is doing it. "

- General Norman Schwartzkopf

Integrity is simple, but it is not easy. Integrity is "honoring your word as yourself." Most of us consider that we have integrity, but in actuality we have 'situational' integrity. There are times when we do and there are times when we don't.

The definition of integrity is "whole and complete with nothing left out." Whole and complete with nothing left out is not elastic, a sliding scale, or 'most' of the time. Integrity can't be fractional. You either do or you don't.

Integrity means absolute, unbending, all the time.

Under the strain of the current economic conditions, how many of us are absolute in our integrity? With our patients, with our staff, with our practice finances, and with ourselves?

Without integrity nothing works. So at this time, in the middle of the pressures of this recession, when there is much more difficulty in attracting and retaining new patients, when patients are saying "No" or "Not now" to your treatment recommendations, when cash flow is tight to teetering, when every day is a struggle to fill the book, where does your integrity stand now?

The majority of dentists have integrity as one of their top five core values. But the real test of a core value is to abide by it even if it means greater risk, loss of income, and greater distress.


"Integrity is the essence of everything successful."

- Buckminster Fuller

Are you doing dental procedures you are not fully trained to deliver (implants, endodontics, orthodontics, reconstructions)? Are you presenting treatment that isn't as necessary as you are making it out to be? Are you pressing patients to undergo treatment rather than having them choose the treatment? Are you operating with and inside integrity?

Are you managing your staff through domination or manipulation? Are you less than totally straight with them about the conditions of the practice or what they need to do to keep their jobs? Are you gossiping, playing one against another, not being truthful with them? Are you operating with and inside integrity?

Are you telling your spouse the undiluted truth? Are you painting a rosier picture so your spouse will not get concerned and interrogate you daily? Are you painting a sky-is-falling picture so you can get sympathy and get you off the hook from being responsible? In your communication with your spouse are you operating with and inside integrity?

Are you doing what is clearly required for your practice to remain viable? Or are you in denial, hoping things will soon get better and return to the way they were? Denial, hope, blame, fault, shame, drive you to reduce your commitment to integrity, but every time you sell out on your integrity, you will take a hit.

There is always a consequence to not being your word. There is always a price to pay when you justify why you operate without integrity. There is always a cost to telling white lies. Yes, the payoff might be immediate, but the costs are deep and long.

Sure, there are times when you make a promise and are unable to fulfill it. But when you have integrity, you are responsible and inform those involved that you can't deliver on your promise and renegotiate your promise.

No one is perfect. Promises will be made and broken. But when you're being your word, when you operate with and inside integrity, you own up to and make it right.

"In times like these men should utter nothing for which they would not be willingly responsible through time and in eternity."

- Abraham Lincoln

Reprinted with permission from Dr. Marc Cooper at The Mastery Company

Health Care Reform Guts Dentistry

Hidden in the hundreds of pages of the proposed US health reform legislation is a proposal to create "Mid Level Dental Providers". These will be individuals who are NOT dentists who will be giving local anesthetic, extracting teeth, doing fillings, sealants and cleanings. The idea is to place these providers into the poorer areas of the community and deliver dental care to those who can not afford it. What is the future of the typical famiily dentist? Will his patients flock to these "Super Hygienists" in order to get routine dental care at a discount? Assuming that this drastic change to the face of dentistry is coming, which I believe it is, what opportunities are there for the average dentist to embrace these changes and not only survive the paradigm shift, but to benefit from it?

Dr Marc Cooper of The Mastery Company, my business partner in the USA, has this to say in his recent newsletter, reprinted with his permission:

 MID-LEVEL DENTAL PROVIDERS AND YOU


The train has left the station. The horse is out of the barn. The soufflé cannot be put back in the oven. It's a done deal. With access to dental care now being pronounced a major public issue, dentistry will find itself painted into a corner. The profession has little power to stop the future from happening.

After years of neglect by the profession, having paid only lip-service to the issue of access, focusing primarily on practice growth through higher and more expensive utilization, the public and the Federal and State governments are declaring loudly that dental access is a major public problem. The ADA and all component dental societies are now scrambling to get ahead of this curve. As a practicing dentist in private practice, you need to get it - you can't stop it.

One outcome, which is already well in the works, is the creation of midlevel dental providers capable of doing simple extractions, fillings, sealants and giving anesthetic. Resistance by private practice dentists will be strong. The cries to "protect the integrity of the profession" will be shouted. The "death and ruination of all that is sacred" will be pleaded. Most private practitioners will perceive it as a threat to their survival. It won't matter. It's going to happen.

Already happening in Europe and now in full expression in Minnesota, with the new health care legislation in Congress, the midlevel dental provider is a "time that's come." You have a choice. You can get ahead of this curve or end up behind it. It's up to you.

Some will see this new expression as an entrepreneurial opportunity. I am beginning to work with a few select clients to carve out opportunities using this force of change. As my Native American buddy, Robert Mirabal, always tells me, "Ride the horse in the direction it is going." I see huge opportunities for dentists who know how to own, manage and lead a business and not just make money bending over the chair.

In order for these entrepreneurial dentists to win in this new future, they'll need to think about practice and practice management in a different way. They'll need to transform themselves as owners and visionary leaders. They'll need to become much more community and socially committed to make this work; larger organizational structures, much more effective management, more personnel, greater efficiencies.

For those dentists who have become accustomed to top tier fee-for-service only, high utilization, high-end of the market, they'll have to realize that their market will drastically shrink, leading to fierce competition for far fewer patients. For those entrepreneurial dentists who decide to change, it will be challenging to rethink how to deliver dentistry through others and make it work in this different context.

The healthcare reform bill introduced on the floor of the U.S. Senate proposes to extend dental care to millions of currently uninsured children, to set up new oral health surveillance programs and to train new dental professionals. Included in this category of "dental professionals" are midlevel dental providers along with their respective pilot programs. The bill also proposes to adjust and regulate many other aspects of oral healthcare in the U.S. as well, but these new regulations will be a topic for a future eNewsletter.

Contained in the Senate's 2,000+ page bill are far reaching provisions that require health insurance plans to be offered in "public exchanges" to provide dental insurance for children. These exchanges would be government run. People would be eligible to participate in the exchanges if they don't currently have health insurance through an employer or public plan such as Medicare. Employers with 50 or fewer workers could participate. For most of you, your patients are employed within these small businesses.

The shocker is the current Senate bill includes a mandate that prohibits plans in these exchanges from requiring co-payments or any other type of "cost sharing" for preventive services. Children could get services such as cleanings, exams, consultations, fluoride treatments, and sealants without their guardians having to pay anything above the exchanges (government) premiums.

Multimillion dollar grants are being proposed for midlevel dental health care providers demonstration projects. Job titles they are considering as midlevel providers include advance practice dental hygienists, independent dental hygienists, supervised dental hygienists, primary care physicians, dental therapists, dental health aides, in addition to some additional classifications. Midlevel providers would be assessed for their wherewithal to increase access to dental health care services in rural and underserved communities.

As I understand it, one of the big players in this is the CDC (U.S. Center for Disease Control and Prevention) who is being asked to formulate a five-year oral healthcare prevention campaign with an emphasis on community water fluoridation and dental sealants. The CDC would be the agency empowered to award demonstration grants to research methods of managing caries.

The current bill also includes provisions that place a tax on high-cost health insurance packages which would cause employers to strip the packages of their dental benefits. Now for many dentists who depend on 3rd parties for part or all of their revenues, this could spell real trouble.
Will the legislation pass? Who knows? Will the changes proposed in dentistry occur? Absolutely! These changes will happen and they will change the face of dentistry. Resistance, confrontation, struggle, will do little good. Did it do any good against HIPPA or OSHA?
I am clear that those dentists who are willing to change and who are willing to look beyond their past, beyond their local needs and agenda can get in front of this change and make it work as a powerful business expression. But it will take a basic transformation in how these dentists envision dental practice, how they redefine the purpose of dental practice and its mission, and stretch themselves to develop a breakthrough business model where midlevel providers fully participate.


The first step toward change is awareness. The second step is acceptance.

-Nathaniel Branden
Recommendation:

I suggest you send this blog post to your dental health care colleagues and get the word out. And as always, I am available for coaching any dental professional through the uncertanties of the future to come out on top and continute to be successful.

The Weekly Quote

"Leadership is getting people to want to do what you want them to do." - James Pride

Our Newest Video - The Mastery Program

Dental Solutions Europe and our American counterpart, The Mastery Company, are presenting several evening programs in the U.K. in January 2010. Those dates will be announced when they have been solidified. This is the video we put together to explain what our Dental Practice Management program is all about.

Learning to Love Complaints - Dental Practice Management

Most of us make little or no effort to know how our patients really feel about the dental care the entire dental team is delivering. We assume that no news is good news and this can give us a false sense of security. We go through our daily routine assuming all our patients are happy with our services when the reality is that things are probably not so. Most of your patients, whether they are happy or displeased with your services, will not say anything to you. If they are happy, they will return for future treatment. If they are not happy, however, they will probably leave your practice without a single word to you. By the time you realize that you haven’t seen these patients in a long time, they are already established with their new dentist and have forgotten all about you.

It can be very upsetting to everyone in the clinic when a patient actually makes the effort to complain to you about the “care” they received by you or one of your team. How do you feel when this happens? Believe it or not, you should be very happy when someone complains. A complaint is actually an act of genuine respect and that is how it should be treated. It tells you that the patient values you and your services enough that they are willing to create an uncomfortable situation in order to repair this professional relationship. They really don't want to just walk away because they are willing to confront you in order to help you fix a problem.

Instead of becoming defensive, invite the patient to sit down and discuss the matter. You might even offer them coffee. This might sound a little extreme but the point is to transform patient complaints into positive experiences. If this one patient is telling you about a situation they don’t like in your clinic, you can be sure there are many others that have thought the same thing, and didn’t tell you. In addition, it is said that people will tell one of their friends about a positive customer relationship experience they had but will tell 10 friends about a bad experience. How many of your silent but disappointed patients are telling their friends they are unhappy with you? Listed below are Dental Solution Europe’s 9 steps for handling patient complaints:

Make it easy for patients to state a complaint. Let them do the talking. Interrupting them and asking questions while they are telling you of their problem will just upset them more.

Don’t return the patient’s anger. Show genuine concern for them in both your tone of voice and body language.

Acknowledge that the person is upset, it shows respect. “I see that you area quite upset by this Sr. Santos. Please tell me more.” Look them in the eye and nod your head as they make their points.

Make a “Sad/Glad” statement. “I’m sorry you had a problem and I’m glad you are bringing it to my attention.”

Make a positive statement… “I will get something done about this problem.” Then make sure you do.

Settle the problem in a “hassle-free” manner. Don’t offer a solution that creates more of an inconvenience for them.

Do something extra when you have caused an inconvenience to a patient.

Share complaints and how they were handled with the team.

Never make or agree with a negative comment about a fellow team member or the doctor.

Patient complaints will become positive experiences if you view them not as indicators of poor service but opportunities to provide better patient care.



Dr. George McKee is co-founder of Dental Solutions Europe, a dental management and consulting firm based in Portugal. Dental Solutions Europe serves the global dental community as a business resource using proven information, tools and skills to assist dentists in making their practices grow and profit. For more information, visit http://www.dental-solutions-europe.com/uk/index.htm, or call +351 961 966 709

Patient Communications - Dental Practice Management

Communications and the New Patient Examination

 

The weakest activity in nearly every dental office is communication. Now more than ever, it is critical that the doctor create a strong trusting relationship with his patients and staff by mastering the skill of communication. One side effect of the current economic crisis is that it has destroyed the public’s trust in many things. No one trusts the banks. No one trusts the government and no one trusts that they will have their job next month. The timing of this could not be more relevant. With proper communication skills, dentists can instill a sense of trust between themselves and their patients which will manifest itself into more treatment acceptance and more referrals of new patients.

What principle competencies are necessary in terms of communication in the relation between the dentist and the patient? When dentists attempt to improve their communication skills, they usually are looking for just the right words to say that will influence the patient’s decisions. They want the magic phrases, the top ten list of things to say that will make their patients say “yes”. Dentists believe that in order to improve communications you need to become a better speaker. Well it doesn’t work that way. That is because there is one competency that must be mastered before any words come out of your mouth. What dentists don't realize is that the most critical and powerful aspect of communication is not speaking, but listening. That's right - listening! Listening is more powerful than speaking. Speaking is the listening spoken. Can you understand that? Listening, not only determines what is heard, but more importantly what is said after the hearing. Listening preempts speaking. Listening shapes speaking. The reasons we don’t listen effectively are that we already think we know what the other is going to say or we think that the other is trying to get something from us. We think that if we really listen that we will have to do something different about the matter, something unfamiliar. Once we start listening effectively and really understand the thoughts and concerns of our patients, then we generate a powerful relationship with our patients - a relationship that makes a mutual future possible. You provide a listening that allows for trust, kinship and commitment.

What are the dangers of not having empathy in this relationship? That is, if you don’t connect emotionally with the patient in visits with that patient? Along with possessing good listening skills, a good communicator is also attentive, open, sensitive, empathetic, and intentional. This is the emotional side of communication and is just as important if not more important than the medical, technical, factual and objective information we are educating our patients with. There is an old saying: “People don’t care how much you know until they know how much you care.” If good communication required only a transmission of facts and did not require an emotional component to it, then we wouldn’t need the human interaction to communicate. We could print all the pertinent information and hand it to the patient to read. Then the patient would sit back in your chair and let you start treatment. That sounds too mechanical and artificial doesn’t it? The more empathetic you are with you patients, the more successful you will be in your treatment of those patients. The less empathetic you are, the less your patients will trust you. This will eventually cost you your relationship with that patient. Therefore, lack of empathy costs you your future with that person. It costs you their loyalty, kinship, commitment to you and the team. People you don't listen to or empathize with don't stay around. They go somewhere where their emotional needs are met as well.

 During the first visit with your patient, what kind of “presence” should you assume with your patient? How should you be? This is a very good question. Most people would ask what additional things must they “do” to communicate effectively with a new patient. The success of a new patient interaction has more to do with who you are than what you do. Being and doing are very much different from one another. Doing is action. Being is where the action comes from. Being precedes doing. Good communicators tend to have certain core values or personality elements that are part of their “being”. If you integrate these qualities into your own being with discipline and high intention, you will become an effective communicator.

Maintain absolute integrity. Do whatever you say you are going to do. No compromises, no excuses and no reasons. 100% everytime.

Being truthful, candid and straightforward. Don’t brag, exaggerate or tell half truths. If you don’t know something, admit it, and then find out.

Be responsible.You are at all times responsible for everything that occurs in your dental practice, and that includes the outcome of your interaction with your new patients.

In relationship to language, the words you use, what does the dentist have to be careful of? With respect to the type of language you use with your patients, it’s very important to talk to the patient on their level of understanding. As dentists, we tend to talk in technical terms to our patients forgetting that they usually have no idea what we are talking about and forgetting that they will usually pretend to understand you, not wanting to look ignorant. Save the technical talk of enamel decalcification, crown to root ratio, implant integration and periodontal biological width for your colleagues, and instead, talk to your patients about keeping their teeth for a lifetime, improving their ability to chew, and giving them a beautiful straight white smile. Also, replace emotionally charged words and terms with accurate but more neutral ones. Use “procedure” instead of “surgery”. Instead of extracting a tooth, talk about removing it. Talking above a patient’s level of understanding gives the impression that you are talking down to the patient and are in a superior social position. You want your patient to feel as if you are talking as equals.

Using proper communication with the patient how does this affect treatment plan acceptance? By using proper communication techniques, your patients will know that you truly understand their dental problems along with all their fears of treatment and motivations to go ahead with that treatment. When you do this through the presence of your core values, your patients will trust that you will do what is in their best interests. The results of using proper communication skills is that you will see an increase in your treatment plan acceptance rate and an increase in the number of new patients that seek your services. Satisfied patients will tell their friends, and you will not find a marketing scheme on this planet that is more powerful than word of mouth advertising.

How do you know if you are communicating correctly with your patient? The only way you are going to know if you are communicating correctly with your patients is to measure the intended results. Start measuring each month the following statistics:

Number of new patients

Who referred the new patient to you?

The amount of treatment diagnosed on the new patient

The amount of that treatment that was accepted and initiated.

Compare each month with the one previous and you should see a steady increase in your performance. Don’t forget to thank any existing patient who refers a new patient to you with a handwritten letter of appreciation.