Dawson Quicknotes

Measuring Success. Choosing a Life of Personal and Professional Balance

Measuring Success. A tale of two practices.

One of the more common errors that dentists make, which can have serious consequences in the long run, is believing that success is determined by the amount of money they make. In reality, financial security is certainly nice; however, it isn't the only yardstick for measuring success. In fact, one of the principal tenets of complete dentistry states that, in order to attain true success, dentists must maintain a proportionate balance between their personal and professional lives.

The following story by Dr. Dawson from The Dawson Academy's updated seminar, Predictable Dentistry-Predictable Success: Putting Your Practice in the Top Ten Percent, will provide you with a tale of two practices: one whose dentist is overwhelmed with a constantly growing roster of new patients—but no personal life—and another practice whose dentist is afforded the luxury of a life-work balance. Which practice is yours most like?

Download Measuring Success

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Creating a Vision for Your Practice

If you don't know where you're going,
how will you know when you get there?

As our country’s leaders have told us repeatedly, we are in uncharted territory.  Now, more than ever, it is essential to have a clear vision of who you are, where you’re going and how you want to get there. A focused vision, understood and shared by the entire team, will be your compass in these turbulent seas.

Times are tough.  It’s difficult to find anyone in our country who hasn’t been touched by the current economic condition.  Perhaps it is a family member, perhaps a neighbor, perhaps a patient, or perhaps you.  Have your retirement investments lost value?  Is your practice production down?  Are patients holding off on making treatment decisions because of the uncertainty portrayed daily in every newspaper, magazine and evening news report?

The following podcast is an excerpt from our Top Ten course where I talk about how to create a vision for your practice. To listen, simply click on the link below. To download, right click and select 'SAVE AS' to save this audio clip to your hard drive. You can play it in iTunes.

Download Practice Vision

 

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Creating a vision is just one of the many topics covered in our 2 day,
power packed lecture this year in Orlando:

Predictable Dentistry, Predictable Success - Putting Your Practice in the Top 10%

Give yourself – and your team – a needed shot in the arm.  Get the specific, practical, how-to’s used by thousands of dentists to achieve joy, fulfillment and financial success, in any economy.

We look forward to seeing you in Orlando!

-Joan Forrest

Records for Success

Organizing the New Patient Process

by John C. Cranham, DDS

At a recent faculty meeting at The Dawson Academy, one of the topics discussed was the apparent difficulty in getting our students to completely commit to the concept of doing a thorough examination. While almost everyone can admit to the value in conducting a complete exam on each new patient, they admittedly struggle with the logistics of doing so. Since so many offices are focused on hygiene, there simply isn't enough room in the schedule to make time for a thorough, complete examination. On the other hand, some offices are bringing in new patients to meet with the dentist, but not even the dentist has enough time to gather quality recrods for a proper evaluation. Unfortunately, no practice should operate without a complete exam and a complete set of records. The following will discuss ways for your practice to conduct a complete examination, ensuring that you obtain first-class, quality records for each of your patients.

Scheduling

These days, one of the difficulties that dentists most often encounter is the amount of information required to conduct a thorough, complete examination, which makes the need for an efficient, quality system to handle patients even more important. While this system will serve to make things easier for everyone in the dental practice, it will also impress patients with the office's efficacy. And since the patient experience is obviously an important detail, the importance of assigning one team member to be responsible for the management of the new patient appointment cannot be emphasized enough. In our office, for example, I work with a primary and secondary dental assistant. While the primary assistant generally assists during the larger cases, the secondary assistant, or treatment coordinator, works with doctor to gather the data during the new patient appointment, takes the records that can be delegated, and then organizes these records accordingly.

Keeping the new patient experience in mind, we also set aside one portion of each day to meet with new patients. In our office, we set aside 8:00–10:00 a.m. each day to see new patients, allowing the doctor to work with second assistant to conduct his part of the examination, as well as additional non-doctor time to gather any additional information needed by the staff. While this much time is not always needed, we've found it beneficial for both the staff and the patient to have too much time than not enough. A breakdown of a typical appointment is as follows:

8:00 a.m. — The patient arrives to the office, armed with a complete health history already filled out, since it was mailed in the new patient packet. The office administrator welcomes the patient to the practice and takes them on a tour of the facility. They will then proceed to a consultation area to discuss the upcoming appointment. Our main objective during this conversation is to get the patient comfortable with our office and form a connection with them.

8:10 a.m. — Next, the patient is taken to the clinical area to be introduced to the treatment coordinator. All pertinent information that the administrator has learned this far is relayed to the treatment coordinator. After some small talk, the process begins by taking digital photos. These 13 photos below are an extremely important part of the examination process, so make sure they are done properly and the patient understands the reason for the photos. You may explain by saying something like, "Mr. Jones, we are going to begin by taking a series of photos that will allow you to see what we see." We then save these photos to the computer and print the full face, smile, and occlusal shots on one sheet of quality photo paper.

                         

8:20–8:40 a.m. — The second dental assistant then introduces the new patient to the doctor. Following a bit of small talk with the patient still in the upright position, the doctor will then review the photos with the patient and ask a series of Future Focus Questions, which are designed to discover the patient's long-term dental goals. For example, we may ask the patient something like, "Mr. Jones, if I am going to be your dentist, I need to know about your long-term dental goals. I'd like you to review these photos and share with me how you would like your teeth to look." At this point, the doctor is listening to the patient's requests while the assistant writes down everything the patient says. This process will allow both you and your assistant to learn if the patient is more interested in cosmetics, function, overall health, or all of the above.

8:40–9:00 a.m. — After the long-term dental goals are clarified, the patient is set back in the chair, while the assistant works with the doctor to perform his part of the TMJ-Occlusal examination. The history, ROM, load testing, muscle palpitation, doppler, and centric bite registration is also done at this time. Charting for caries and faulty restorations is also done at this time. At the end of this examination, the doctor delegates the remaining records to the assistant and says goodbye to the patient. He also asks the assistant to have the hygienist stop by to do a periodontal evaluation.

9:00–9:10 a.m. — During the second hour of the inital exam, the hygienist will visit and conduct a full periodonatl probing with the dental assistant.

9:10–10:00 a.m. — While the dentist work the first assistant to start his monitoring, the second assistant will take an FMX, Panorex, Facebow, alginate impressions, and any additional records like JVA or a Ceph. This time can also be used to show the patient before and after photos of other patients who have undergone cosmetic changes, implant dentistry, or other advanced restorative procedures. When the assistant is finished, the patient will be scheduled for a follow-up consultation appointment within 3–5 days.

After the Appointment

Once the appointment is done, the second assistant has the responsibility to pour and mount the models, and organize them in a predetermined treatment planning area. In our office, the treatment planning area is a laboratory bench directly behind the dentist's desk in his private office. This work station is complete with a lab handpiece, air, and a computer. The second assistant's job is to put the mounted casts and photos in a dated lab pan, and place them in the dentist's station. That way, all of the items are conveniently available to the dentist when they begin the treatment planning process. If the office is not completely digitized, then the second assistant would place the models, photos, and charts in this treatment planning area. While many practices may not live by such standards for their own initial patient exams, we firmly believe that having the proper records and time to treatment plan properly is the single most important factor in radically changing the direction of your practice. Implementing a similarly structured process will surely provide you with the opportunity needed to diagnose and treat complex functional and esthetic problems. Most important, the message that will resonate throughout your practice is that you both you and your staff are thorough and excellent. In turn, patients that have complex problems will seek out your assistance in resolving their issues. After all, who doesn't want a knowledgeable dentist who is willing to spend the time needed to address their concerns? I can assure you that everyone does, and the process of convincing your patients that you are that dentist begins with a well-orchestrated new patient exam.

Treatment Planning Time

Dr. Glenn Dupont often says, "If it is important, schedule it." Dentists should keep a similar thought in mind when it comes to developing a treatment plan. In our office, the doctor arrives to the practice a little before 7:00 a.m., so he can work on case planning for the next hour. Since the records have been properly organized in the treatment planning area, the doctor is able to easily pull up all x-rays, probings, and photos on the computer, while also evaluating the mounted diagnostic models. The dentist is also able to use this time to conduct trial equilibrations and some basic diagnostic waxing. As Dr. Peter Dawson has said, "Never begin a case until you can visualize it." Treatment planning is about creating a visual picture that will help achieve the patient's long-term dental goals. Taking the time needed to develop these plans is critical to the success of your endeavors.

Conclusion

I hope this article has helped illuminate the importance for a thorough and organized new patient process. While you may find that the exact time table does not work for your practice, the important thing to understand is that you must come up with a system for handling new patients that works for you. Train the staff to have a specific role in what I believe is the most important feature of a thriving restorative practice. Create synergy among the team, so they take pride in getting to know the wants and problems of their patients, and get excited when new cases are accepted. Finally, having a specific time table will go a long way toward getting the consistency every dental office needs. I'm sure you will soon see the benefit of keeping these things in mind as you strive to get your practice to the next level.

John C. Cranham, D.D.S. has an aesthetic oriented practice in Chesapeake, Virginia where he resides with his wife and three children. An honors graduate of the Medical College of Virginia in 1988, Dr. Cranham maintains a strong relationship with his alma mater, as an Associate Clinical Professor, teaching in the AEGD program. Additionally he was appointed to serve for two years on the school's Board of Advisors.

Dr. Cranham is an internationally recognized speaker on the Esthetic Principles of Smile Design, Contemporary Occlusal Concepts, Laboratory Communication, and Happiness and Fulfillment in Dentistry. Dr. Cranham has founded PRE (Predictable Restorative Excellence) Seminars which provide a combination of lecture, mobile hands-on programs, and intensive 2-3 day hands-on experiences at his office in Chesapeake, Virginia. A published author, Dr. Cranham has a strong commitment to developing sound educational programs that exceed the needs of today's dental professional.

 

 

 

Clinical Assisting for Occlusal Equilibration

Step-by-Step Instructions for Preparing Your Staff to Assist With Occlusal Equilibration

by Peter E. Dawson, DDS

At The Dawson Academy, our number one goal is to educate dentists about the importance of occlusion, allowing them to provide their patients with a lifetime of optimal oral health care. We accomplish this goal by giving our students invaluable classroom lectures, hands-on coursework, and support. However, we also remind dentists that optimal oral health care cannot be achieved without the support of a knowledgeable staff who understands and practices the time-tested principles of occlusion, particularly equilibration. The following will provide you with detailed instructions for preparing your staff to understand and assist you with occlusal equilibration.

As mentioned above, our primary goal is for patients of complete dentistry to keep their natural teeth for a lifetime. While this statement is certainly easier said than done, we do know this: almost every breakdown of the teeth is caused by either bacteria or occlusal stress. Because of this, most patients know what happens if you don't brush your teeth or floss properly. What's more, they are also familiar with how to correct these problems—and most patients fear them without question! What most patients are not familiar with, however, is the damage—and subsequent treatment required by—from occlusal disease. It is a fact that excessive forces on the teeth can cause significant damage that requires even more extensive treatment to correct. That's why it's imperative for every member of your staff to have a thorough understand of occlusion. From the causes of occlusal disease to the need for treatment, a knowledgable staff will be able to answer patients' questions, affirm their decisions to proceed with their required treatment, and, perhaps most important, anticipate next steps during an occlusal procedure. With that being said, let's begin by reviewing some of the structures of the masticatory system to see how they function.

The Components of the Masticatory System

For the average patient, dentistry is all about teeth, so they spend an inordinate amount of time brushing, flossing, and rinsing—which is obviously a terrific first step toward maintaining healthy teeth. However, what the average patient is not aware of is that brushing, flossing, and rinsing are just a part of the process for maintaining healthy teeth. In reality, each and every component of the masticatory system, which consists of the anterior teeth, posterior teeth, muscles, and temporomandibular joints (TMJs), must also be maintained in good health. That's because each component of the masticatory system must function together. If any part of the system does not function properly, it will have a profound ripple effect on the remaining parts of the system, including muscle pain, worn teeth, headaches, and countless other problems. In order for your staff members to be aware of the importance of the masticatory system to complete dentistry, please review the following synopsis of both the masticatory system and its role in your patients' overall oral health with each of them. 

Teeth: The teeth are attached to the bone, and the bone of upper arch is fixed in the skill, meaning that all jaw movement is the result of movement of the lower arch or mandible.

Muscles: The muscles that move the mandible are called, as a group, the muscles of mastication.  

Jaw joints: The jaw joint is where a hinge in the mandible called the condyle fits into the socket. The jaw joint plays an extremely important role in the health of the masticatory system. The illustration to the right shows a cross section of the TMJ or jaw joint. The condyle fits into the fossa or the socket as shown. In between the condyle and the fossa is the disk, which is attached to the back of the condyle by a ligament called the posterior ligament. The front of the disk is then attached to the lateral pterygoid muscle. The joints fit when they are at their most superior position against the emenentia with the disk properly interposed. The reason we perform occlusal equilibration is to achieve a bite relationship where all biting force is equally distributed on the teeth without any interference to complete closure. In other words, we want to make sure the jaw joints don't have to displace when the teeth come together.

Let's take a moment to examine this relationship. By now, you've learned that the most important lesson you can share with your staff is that the relationship of the teeth, joints, and muscles is crucial to complete dentistry. In fact, if we are only concerned with how the teeth fit together and ignore the position of the joints, a patient's mouth may look like the illustration on the left. Notice how the teeth appear to be lined up at the midlines. What's more, notice how they fit together nicely along the entire arch. While this is certainly important, don't be fooled by its appearance. If you look at the position of the left condyle, you'll notice it has to displace when the teeth come together. When one or both TMJs must displace in order for the teeth to fit, there is a profound impact on the muscles that move the jaw.

For example, notice how the lateral pterygoid muscle has to actively pull the left condyle down and out of its socket every time the teeth come together. This process overworks all the muscles on that side, causing muscle fatigue, potential spasm, and pain in the masticatory muscles. When the doctor manipulates this patient's jaw to make the TMJ fit properly, the front view of the patient would look like the image on the right.  Notice that the teeth no longer fit together. In fact, the back teeth only close on one side now. This type of interference is called a posterior interference to centric relation. See how the midline has shifted when the joint is properly seated? When patients have occlusal interferences, the muscles constantly have to move the jaw to pull the jaw joint out of position in order to get the teeth together. As a result, the interfering teeth take a pounding, simply because they're in the way of where the muscles want the teeth to go. The ensuing damage on the teeth can include worn enamel, loose teeth, and possibly even misalignment. If the jaw has to slide around interfering teeth, it will often slide into other teeth, causing worn enamel and/or sore or loose teeth.

When patients do not have harmony between the teeth, muscles, and joints, the bite forces will then be unequal. The effects of an unequal bite can include loose, sensitive, and/or worn teeth, abfractions, cracked and broken teeth, recession, and bone loss. In addition, the constant pull of the muscle on the condyle pulling it out of its socket can lead to TMJ problems, including headaches and facial pain. 

Let's look again at the illustration of the TMJ. When the lateral pterygod muscle has to constantly pull the condyle down and out of position to geth the teeth together, the upper belly of the pterygoid muscle that controls the alignment of the disk can also become spastic, contributing to disk displacement. Some popping and clicking joints are the result of the ligaments being stretched so far that the lateral pole of the disk pops on and off of the condyle when the jaw opens and closes. 

Although the concepts discussed above may seem complicated, their importance cannot be emphasized enough—especially to your staff. The more your staff understands about occlusion, the harmony between the teeth, muscles, and the joints, the better prepared they will be to help you accomplish your goal of a lifetime of healthy teeth for each of your patients.  

      

 

Create a Thriving Dental Practice

by Peter E. Dawson, DDS

There is an almost magical triad of skills that, when learned and practiced, virtually guarantees the success of any dental practice. Excellent continuing education resources are readily available to any dentist who desires to become proficient in all three elements of this triad for success. The first two skills that are typically thought of as the keys to practice success are management skills and people skills.

While it is true that management skills and people skills are crucial factors to success, they can be lost without the third part of the triad, leading to frustration and overwork with minimum reward for efforts. The missing link in many offices and the part of the triad that is most important for fulfillment and practice success is the combination of skills that must be learned to produce clinical excellence. Concentration on clinical excellence can be particularly eye-opening for dentists who have been misled into believing that practice success can be assured by bringing large numbers of new patients into the practice each month. Certainly, new patients are essential to the success of any practice. However, trying to treat too many patients is counterproductive and unfair to your patients. What's more, too many patients is the most common obstacle to clinical excellence, which is the single most important factor that helps determine how successful a practice can become. Why this step is so often obscured by misconceptions about what really is meant by clinical excellence and how it affects every key monitor by which success is measured.

Why Clinical Excellence Pays Off

Clinical excellence is the best countermeasure for wasted time. Being busy does not equate with productivity, nor does "bigger" equate with better. If we look at the cost in time and dollars that are routinely wasted on remakes, reworks, adjustments, and , it would astound most dentists. Unfortunately, these time-wasters are so common that most dentists accept them as a normal part of practice. Understanding some of the basic clinical skills that are most commonly ignored can drastically reduce or eliminate many hours of wasted time and convert those hours to high productivity. Clinical excellence satisfies patient needs, which is the best way to build a practice. Today more than ever, patients expect quality. They seek out dentists who can make them look good and feel good. They put a high value on oral health and will most often be willing to pay for what they understand they need. The dentist who knows how to solve any masticatory system problem, and who does what is needed in a predictable time period at a fair fee will thrive.

What is Clinical Excellence

Clinical excellence cannot be explained in the limited context of teeth alone. Today's dentist must be physicians of the entire masticatory system, which in no way reduces the importance of teeth. In fact, it means we cannot isolate the teeth from the rest of the system. To be predictably successful, dental treatment must result in comfort, health, and equilibrium of all of the parts of the masticatory system. To reach that level of competence, dentists must understand and become proficient in the following skills: Diagnosis and treatment planning. The most important skills of all are typically shortchanged. The most successful dentists give a high priority to time spent on careful and complete examinations of the entire masticatory system. They know that a complete treatment plan must include whatever is needed to achieve optimum health of all the structures. They know it is also the blueprint for case presentation, effective scheduling, and increased production. Learning how to incorporate procedures for really thorough examinations is the first step to major practice improvement. Dentists are routinely amazed at how dramatically a complete exam policy can change a practice for the better. The incomplete exam probably is the most costly mistake a dentist can make. Any dentist can learn to become highly effective in presenting treatment plans, but this step depends on competence in the examination process so a comprehensive plan for treatment can be formulated. This is difficult to do unless the following clinical skills have been developed:

TMJ Analysis

Jaw relationships start with the temporomandibular joints (TMJs) because where the joints function determines how the lower teeth relate to the upper teeth. TMJ analysis has been confused by a variety of misconceptions, but if one understands the structural components and how they interrelate, there is no reason to be confused about the TMJs. Any dentist can be taught how to tell if the TMJs are healthy and can learn how to diagnose specific structural disorders. Occlusal treatment should never be started without examining TMJs first.

Occlusal Analysis

Almost every dental procedure has a direct or indirect effect on the occlusion, and occlusal disharmonies can be responsible for a wide range of complaints from sore teeth to headaches, wear, loose teeth, and many aspects of TMJ disorders. Yet, we find most dentists are so confused about occlusion that they do not even know how to evaluate or treat even the most common occlusal disorders. A tremendous amount of time is wasted and many problems are misdiagnosed if occlusal analysis and treatment are not understood. Occlusal concepts can all be taught on a structural basis that is so logical and learnable, dentists are typically upset that they had been practicing without this understanding.

Preliminary Mouth Preparation

The first goal of clinical excellence is to get the mouth healthy. Recognition of problems in the supporting structures is part of the complete exam, whichis too often shortchanged. Soft tissue management prior to restorative procedures is not only important, it is a practice-builder with many facets. A learnable program focused on getting mouths healthy invariably leads to an increase in total office productivity.

Esthetic Analysis

One of the major reasons patients seek dental care is because they want improved esthetics. It is appalling to see what is being so commonly passed off these days as cosmetic dentistry. The best esthetic dentistry is complete dentistry, which includes healthy tissues and beautiful teeth that are in equilibrium with all the other structures of the masticatory system. If tooth contour and position are related to total masticatory system harmony, it is exciting to see how predictably and beautifully esthetic results can be achieved. The concepts for doing this are so understandable that they eliminate the need for time-consuming guesswork or trial-and-error approaches.

Analysis of Anterior Teeth

The relationship of the anterior teeth is one of the most critical factors that affects not only the appearance, but also the stability of the entire dentition. Basic rules for determining correct relationships are very definitive and can eliminate the frustrating time waster of trying to talk patients into getting "used to" a result that does not quite feel right or look right. Problems of phonetics also can be prevented or predicted if concepts of anterior guidance and other determining factors are understood.

Quality Laboratory Work

Too often, dentists try to cut time or expense from the laboratory process and pay a premium in wasted adjustment time or compromised results. Quality laboratory work requires a very definite set of commitments. Most of these commitments take additional time up front, but save multiples of time at placement. A good doctor/technician relationship is one of the most beneficial factors a practice can have. It is dependent on precise communication of a number of technical guidelines for each laboratory case, but this communication method is easily learned and practically utilized.

Materials and Techniques

It is a tempting inclination to be the first one to use a new material or device, but it is a wiser approach to get independent factual information first. Staying accurately informed on new developments is expected of a quality dentist. A good rule of thumb is to always determine why a product is better before you use it.

Developing Clinical Excellence

While clinical excellence should be the first and most important priority, it is almost impossible to achieve in a disorganized office. And certainly enough new patients must be attracted to pay for the process. That is why the best approach is a combination of effort aimed at organizing the office team to help the dentist provide excellent care. But the doctor's definition of what is excellent care must be clarified first. Otherwise, time will not be reserved for adequate new patient exams and schedules will not be planned for optimum productivity.

The staff also must be trained to monitor and control the administrative process and develop the people skills for dealing effectively with patients. Fortunately, help is available for this kind of training, so the doctor can concentrate on improving the quality of care in the operatory, while the management skills are being developed or improved at the staff level.

I have had the opportunity to monitor a large number of dental practices from all parts of the country. Dentists who have committed to a high level of excellence reveal some consistent similarities, including the following:

1. They all made a conscious decision to practice superior quality dentistry.
2. Each one is a continuous student. They all take a large number of post-graduate courses in a variety of subjects.
3. Because they stay current, they reflect a high level of confidence when they examine or consult with patients.
4. They rarely advertise. It is unusual to find a Yellow Page Ad for a complete dentist. In fact, word of mouth from enthusiastic patients keeps their schedules full.
5. They see fewer patients, but produce more. Laboratory technicians verify that these dentists routinely produce several times the amount of restorative units compared with typical accounts at the lab.
6. Dentists that practice with a high level of competence work fewer hours, report lower stress levels, but have higher incomes.

If you make the decision for excellence, decide where you need the most help and start there. You must go for basics. Do not try to build a solid practice on fringe-type gadgetry or techniques. Be selective in your post-graduate course choices and do not block the process with self-limiting visions.

One thing is almost a certainty: The day you make the decision to have a truly superior practice focused on clinical excellence, your enjoyment of dentistry will go up. It will be a decision that only can be beneficial for both you and your patients.

Dr. Dawson is considered one of the most influential clinicians and teachers in the history of dentistry. Dr. Dawson is the founder of the Concept of Complete Dentistry^SM Series, as well as The Dawson Academy, which originated in 1979 ad the Dawson Center for Advanced Dental Study. In addition to numerous awards and special recognitions, Dr. Dawson is a past president and life member of the American Equilibration Society, and past president of the American Academy of Restorative Dentistry and the American Academy of Esthetic Dentistry.

 

 

Avoid Subprime Results in Your Practice

Measure What's Really Important and Accomplish What Really Matters

by Larry M. Guzzardo

In his groundbreaking book, Thriving on Chaos, Tom Peters proclaims, “What gets measured gets done.” He further explains, “Develop simple systems that encourage participation and understanding by everyone.” In other words, measure what’s important. Create measures of what is happening in your practice and empower staff to take action to achieve improvement. Keep what you track simple, paring it down to a few essential statistics that can capture the vitality of your practice at a glance. Anything you want to improve should be measured and monitored regularly.

 

Determine What is Important.

Determine what is important to the lifeblood of your practice, but don’t ignore non-financial measures, such as laboratory quality control, adherence to hygiene departmental protocol, or patient satisfaction. Ultimately, the staff will consider what you track as important. By not paying attention, you won’t be able to react until it is too late, keeping you from getting things done, making you appear indecisive, and preventing you from delivering on promises and commitments—which is certainly not the formula for a winning team. However, too many offices operate without any real direction, having a direct impact on employee development and practice progress. As a result, individual staff members may form cliques and resort to uncoordinated efforts to get things done.

 

Avoid Inaction.

So, what causes this inability for dentists to take action? Usually, the failure to put the right people in the right jobs leads to problems in the workforce. Oddly enough, doctors admit to knowing there are performance issues with certain staff members, but they choose to ignore it, hoping the employees can resolve it on their own. To make matters worse, the rest of the staff is aware of problematic employees, but the doctor usually does not seek their advice to address the matter. When a staff member is underperforming, ignoring the problem is bound to make it worse. Strong leaders encourage and stretch the abilities of talented staff.

Once the decision has been made to challenge your staff, you must commit to tracking their progress in detail through regularly scheduled review sessions that conclude with comprehensive constructive Actions Plans that outline the employee’s goals until the next review session (usually six months). Effective leaders begin by focusing on clear and specific goals. With clear goals, effective doctors implement them in a way that appears simple, but produces profound effects. At the end of every staff meeting or employee review, doctors should create an Action Plan. Note exactly what is supposed to be done by whom and by when. Then, discuss the steps that should be taken and how you will assist them. You can then review this agenda before you adjourn and make it the first thing you review the next time you meet. As simple as it may seem, this process is the first step in learning to get things done. It is the doctor who brings these habits into a practice where they did not exist before. Now under your renewed direction, the whole tone of the office changes as staff members prepare for meetings differently.

 

Embrace the Routine.

Sure, keeping track of assignments, following up on them, and evaluating progress seems boring, but it’s a routine you should learn to embrace. In underperforming practices, many dentists find no reward in continually improving systems and procedures. They rant, “Why can’t the staff just do this by themselves?” They’re afraid of being seen as too controlling. However, Dr. Dawson teaches us that where there are no controls, you will find control freaks. Ironic, but true, especially if there is no way to determine progress, meaning dentists must constantly check and recheck. This waste of time keeps the doctor from focusing on the staff and patient care. Time-efficient doctors who are engaged in what is happening in their practice are hungry for information, including information about daily and hourly production, collections, bad accounts, the schedule, incomplete treatment, hygiene therapy, supplies, equipment, and even the facility. They never want to be the last to know. They use meetings as an opportunity to have their staff bring data to them to be evaluated. By incorporating measures and tracking results, staff can self-monitor their progress and offer solutions to problems, facilitating their ability to understand the goals and vision of the practice. Developing measures and monitors saves time and allows the doctor to lead the practice and work toward fulfilling commitments and promises.

 

Larry M. Guzzardo who has co-authored two books, “Powerful Practice” and “Getting Things Done,” conducts in-office practice management consultations exclusively for dentists to enhance trust, create organization, increase profits, and develop patient relationships that last. Larry has presented numerous workshops, including “Winning Patient Acceptance,” “Business Communication Systems,” and “The Leadership Challenge.” Larry can be reached at 800-782-5770 or www.larrymguzzardo.com if you have further questions.