Taking Problems to Your Boss’s Boss Fraught with Peril

Dealing directly with your boss’s boss can be hazardous to your workplace health, something I know from experience.  I used to work for a very large organization. The CEO was a whip-smart and affable guy. In my first few weeks on the job, I would banter with him on the elevator, but I did not have much direct contact with him. There were many layers of management between me and the CEO.

One day just before closing time, the CEO unexpectedly appeared in my Dilbert cubicle and sat down in front of me. Heads turned. Why was the CEO on this floor? Why was he talking to one of the new hires? Was he going to fire the new guy (me)?

It turned out that he wanted my advice on an issue. We had a five-minute discussion and he seemed pleased with my input. He gave me an assignment that would take me about two hours to complete. I told him I would have it done by the next morning. Always pleasant, the CEO stood up, thanked me, and walked away.

About thirty seconds after that impromptu meeting ended, my boss called me into her office. She was not amused. She gave me a dagger-like stare and demanded to know how I could have had the audacity to “go over her head.” I explained that the CEO had come to me; I had not initiated the meeting.

However, my boss did not believe me, instead implying that there was some conspiracy afoot. She suspected that I had been secretly speaking directly to the CEO for some time in an attempt to subvert her authority. I explained that there was no plot to overthrow her. I was just sitting at my desk when the CEO dropped by. While this explanation did not sound plausible, it happened to be true.

She must have subsequently talked to the CEO because her paranoia later subsided. However, I learned a valuable lesson: appearances count and one must always be keenly aware of the chain of command.

When there is an office manager in a dental practice, employees are often unaware this business etiquette. If they do not like the answer they get from their boss, the office manager, employees quite cavalierly go over that person’s head and ask the doctor the same question, hoping for a different response. The doctor is not an appellate judge who is standing by to overrule someone else’s decision. If the doctor reverses the office manager’s decision, then the office manager no longer has any authority.

To make the system work, employees need to know that going to one’s boss’s boss is not acceptable. The doctor has to back up the office manager almost all the time. When the office manager’s word means nothing, then the doctor has the worst of both worlds: paying an office manager who is not allowed to manage. If the office manager makes mistakes or handles situations inappropriately, the doctor has to coach the office manager to help that person grow, or, in some cases, replace that individual.

The good news is that many dental practices are substantial businesses. With good managers in place who keep the practice running and allow the doctor to take care of patients, the business can survive and thrive.

www.davidschwab.com

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Hey Dental Team, Who’s The Boss in the Dental Office?

I frequently ask dental team members a disarming question: “Who’s your boss?” Almost all the time I get this unfortunate answer: “the doctor.” It is probably the correct answer but still not a good answer, because in so many dental practices, the doctor wears too many hats: clinician, manager, and CEO. The manager hat has to go.

This problem is seldom seen in medical practices. When a surgeon is in the operating room, he or she is not likely to be interrupted by someone saying that another employee wants Tuesday off and that is not going to work; team members complaining that the workload is not fair; or pleas for help dealing with a patient who insists on coming in tomorrow even though there is just no room in the schedule.

In dental practices the multi-tasking doctor is always under siege. Team members stalk him or her in the hall, the private office, and sometimes the treatment room. Decisions need to be made and only the doctor has the authority.

It is revealing that the organizational chart of most dental practices consists of the doctor at the top, with a flat line listing of all employees below. Everyone other that the doctor is on the same level on the chart. In business parlance, this means that the doctor has many “direct reports”—a small army of employees who need to get the attention of the boss/doctor throughout the day.

The solution is for the doctor to designate a true office manager, someone with the authority—not just the responsibility—to manage the practice and make day-to-day decisions. The office manager reports directly to the doctor, who of course oversees decisions, but the rest of the team all report to the office manager. In this way, the doctor can focus on treating patients while the office manager handles administrative matters.

No practice is too large or too small for a manager. Whether the practice has four, forty, or four-hundred employees, there needs to be a designated office manager to rescue the doctor from most managerial tasks and ensure that the doctor is kept busy cranking out dentistry, which is the way the business generates revenue.

Too many management tasks sap production time and wear down the practice’s greatest asset—the doctor. Years ago, when the pace of life was slower, offices were not bulging with technology, and patients were not in such a hurry to get back to their over-scheduled lives, the doctor could run the business and treat the patients. Now, however, the practice of dentistry is becoming more complex by the day and the overhead monster is threatening to eat the profits. To ensure continued practice success, the doctor needs to concentrate on dentistry, while the office manager does the rest.

For many practices, particularly small ones, having an office manager is a change of culture, and I help often practices with this transition. When the organizational chart is redone and team members are trained in new roles and responsibilities , everyone benefits from a more logical distribution of duties.

Next week: The political clash that occurs when team members want to go around their boss (the office manager) to talk to the “real boss” (the doctor).

www.davidschwab.com

Seven Ways Practice Administrators Can Motivate the Dental Team

To motivate the dental team, use these seven suggestions:

1. Praise Good Behavior Regularly to Motivate Productive Team Members. It is easy to spot bad behavior, but most people in a dental office at any given time are doing a good job. When you are looking for problems, it is possible to overlook the people who are working in the trenches and keeping the place humming. Notice good behavior and comment on it. Recognition is a great motivator. Keep a log of how many times you praise individual performance. Chances are it is not enough to motivate the dental team.
2. Get the Doctor On board the Praise Train. Team meetings should not devolve into gripe sessions or a post mortem of yesterday’s challenges. Find ways to praise people in meetings and make sure the doctor takes an active part. When the doctor notices, everyone notices.
3. Shut Down Gossip. What would you do if a team member started smoking in your office? You would no doubt shut down that behavior right quick, as they say. You need to establish and enforce a no gossip zone. It is just as important as a no smoking zone because gossip is nasty habit that can destroy a practice.
4. Confront the Malcontents and Slackers. You can be diplomatic or direct, but you cannot let complaining and unproductive workers slide by without calling them out. They will either get the message and improve, leave the office, or be asked to leave. The morale of everyone else cannot be dragged down by one or two people. Like it or not, as a practice administrator, you are a cop. You need to lay down the law.
5. Put the Whiners to Work on Solutions. A great way to quell a whiner is to ask for a written list of suggestions. Ask them to include ideas for implementation, a timeline, and a budget if their suggestions will cost money. Discuss their proposal at a team meeting. If they have good ideas, then try to implement them. If not, then the whiner will get a fair hearing and it will be time to move on.
6. Reward the Team. People play slot machines for hours because they never know when the machine will pay off. “Random interval reinforcement” is a powerful motivator. Do the unexpected: everyone gets off an hour early one day; lunch is catered in one in a while courtesy of the practice; you have a party to celebrate a productive quarter, etc. You break up the routine and give everyone a reason to thank you and congratulate each other on a job well done.
7. Use the “Broken Window” Approach. There is a philosophy in law enforcement, too complex to explain fully in this space, that says that the police should respond to minor crimes (such as someone throwing rocks and breaking windows in an abandoned building) to prevent major crimes from happening later. In every dental office, there are customer service standards. When one small standard is not observed, the bar drops just a little lower. Over time, the practice is no longer distinguished by first-class service. If, for example, every new patient is supposed to receive a hand-written thank you note after the first appointment, then stay on top of that protocol, lest you go down the slippery slope and find more egregious problems later.

Practice administrators do a great job. These suggestions are another handy checklist to motivate the dental team.

www.davidschwab.com

Urgent Specialty Referrals: Clear Communication is Key

To gain insight into specialty referrals and the need for clear communication, it is instructive to consider a famous story from the aviation industry.  Some years ago a foreign airliner that was approaching a major airport in the United States crashed short of the runway. The pilots had advised Air Traffic Control that they were low on fuel. The controllers were giving the pilots instructions for a priority landing when the crash occurred. However, an investigation revealed that the pilots had only said that fuel was “low”; they did not declare “a fuel emergency.” The controllers later said that they would have cleared the plane to land immediately if they had known that the fuel situation was critical.

In dental offices, urgent referrals to specialists are sometimes made using ambiguous language. If the referring office asks, “How soon can you get this patient in?” the response may be, “Tomorrow.” In this case, the office manager at the specialty office may have every reason to believe that she is doing a great job. However, if the caller really meant to say, “Can you get this patient in today?” then we have a failure to communicate.

There are three parts to an urgent referral:

1. The referring office should ask if the patient can be seen in the specialist’s office today, as soon as possible. No ambiguity.
2. The reason for the urgency should be stated. “Dr. Smile would like Dr. Specialist to see the patient today because she is experiencing discomfort,” for example.
3. If it is an urgent matter, then the referring office should always make the call to the specialist’s office for the patient. Allowing the patient to make the call is not a good idea. It is courteous and efficient for the two offices to communicate with each other and secure the same-day appointment.

Communication between referring and specialty offices can be a challenge, but plain speaking can avoid misunderstandings and get an urgent case to the specialist’s office as soon as possible.

Case Acceptance: Telling Like It Is

When a patient presents with a mouthful of major dental problems but is reluctant to accept treatment, what can you do to encourage case acceptance?   You can co-diagnose and cajole. You can soft-pedal and sugarcoat and offer to phase and stage. You can empathize and sympathize. While you try to educate, the patient chooses to ruminate and procrastinate. Your team can trot out a low cost loan and still be met with a moan. When the patient leaves with no appointment, you can shake your head, roll your eyes, and throw up your hands, but you cannot foist a choice on a patient.

Here’s a solution that many young dentists are timid about using but that most experienced dentists have learned to employ: speak plainly; tell it like it is. Patients come to your office because you are a licensed professional, an expert in dentistry. They may not like what you have to say, but at some level they want what they are paying for—your professional opinion. Just as you have an ethical obligation to diagnose, you also have an duty to provide patients with the unvarnished truth.

When the diagnosis is alarmingly clear and serious, the consequences of no treatment are that a bad situation will only get worse. Informed consent means that patients must be made aware ahead of time of the risks of treatment, but they also need to know—and you should document your discussion in their chart—the consequences to their health of their decision to ignore your advice.

It is of course important that dentists continue the tradition of speaking to patients in a calm, professional, and respectful tone and showing compassion for the patient’s dental issues. However, part of the trust that develops between doctor and patient is an underlying foundation of honesty.

You can begin a difficult conversation by using these introductory phrases:

In my professional opinion . . .

 I have an obligation to tell you that delaying treatment is not advisable because . . .

 I know this is not what you want to hear, but as your dentist I feel that it is important to be completely honest with you . . .

 I wish I had better news, but your treatment needs are urgent because . . .

These comments can be tempered by telling patients that with proper professional care (and the patient’s cooperation by demonstrating conscientious home care), dental problems can be significantly alleviated.

The bottom line is that you have the ability to improve case acceptance and greatly help patients with major dental needs, but the patient must first face the reality of those needs if case acceptance is going to happen.

It all starts with telling it like it is.

Millennials Matter: Give Them a Reason to Talk About You

Why do millennials matter?  They are the largest demographic group in the U.S. (84 million). Born between 1980 and1999 the millennials are now, in 2016, 17-36 years old. According to Marketing to Millennials by Jeff Fromm and Christie Garton, for millennials, it’s all about the experience, and they are already talking about you on social media. Not only are the millennials digital natives who are avid users of social media, they are also influencing other groups such as the baby boomers who often emulate their behavior.

I recently did a search on amazon.com for an SD card for computer memory storage. One card had a list price of $8.47 and over 10,000 reviews. Think about that. Over 10,000 people have taken the time to give their opinion of an item that costs less then ten dollars. Using reviews to check out products or services prior to making a purchase has become part of our culture, and the millennials are leading the way on social media.

Millennials want to know what their friends think and they also want to know what groups of people are thinking so they can make an informed decision. They are likely to review your dental practice to add to the database and help others.

Because millennials value the experience, it is important that you use that word in your marketing. “Our goal is to give you a great experience!” Once you make good on your promise, offer to take a photo of the patient who has just completed a cosmetic procedure. The photo should be of the smiling, happy patient and the doctor. Immediately e-mail or text that photo to the patient and say, “We are so happy that you are pleased with your new smile. Feel free to share this photo.” Millennials will often oblige—and presto—the photo goes out through a millennial network.

The photo says it all because it shows a happy patient, great dentistry, and the doctor who made it all possible. It’s free publicity for your dental practice because you have a good relationship with a millennial who is inclined to share experiences with friends.  You set the stage by providing a great experience and value.  (For a discussion 10 Value Propositions, click here.)  Your patient has just become your greatest spokesperson.

Millennials matter.

 

 

Presenting Dental Implant Fees to Create Value

Presenting dental implant fees to create value is part of the patient education process.  In Part 2 of his interview with Dr. Neil Park of Glidewell, Dr. David Schwab explains how to use “fill-in-the-blank” dental marketing scripts to help team members communicate key dental implant benefits.

Also, Dr. Schwab discusses “marketing by the power of 10” and explains how team members need to be comfortable discussing relatively low fees and then use the same techniques to discuss more extensive treatment plans and financial arrangements.

There is also a discussion of the team approach to dental implant treatment from a marketing point of view and messages to be used when both the surgical and restorative phases of dental implant treatment is done in one practice.

Special thanks to Glidewell for granting permission to link to this interview:

Dr. David Schwab Glidewell interview Part 2:

https://youtu.be/k7rHNzZ5jKI

Part 1 of this interview deals with using the best analogies to explain the long-term value of dental implants.

In case you missed it, here is Part 1 of the interview.

Increasing Case Acceptance By Making a Great First Impression

As a way of increasing case acceptance by making a great first impression, the doctor should call the patient prior to the first appointment. This phone call impresses the patient and sets the stage for the patient to trust the doctor and be amenable to treatment.

Savvy dentists have found that this “pre-appointment phone call” is very effective, because patients do not expect it but they certainly appreciate the gesture.

It’s easier to do than you might think. Here are the steps.

1. New patient calls and makes an appointment.
2. Team member notes why the patient is calling, including any concerns the patient may have.
3. Doctor calls the patient a day or two in advance.
4. The script is simple: “Hello, Mrs. Jones. This is Doctor Smile calling. I see that we have an appointment on Wednesday at 10:00 a.m. I just wanted to call and personally welcome you and let you know that I am looking forward to meeting you. I will do a thorough examination and answer all your questions when I see you.” The patient will be pleasantly surprised and thank you for calling.
5. If you get voicemail, just use the same script as your message.

The patient will be impressed that you called. When is the last time a doctor called a patient in advance to welcome them to the practice? For most patients, this is the first time they have received such a call.

The new patient now has a first impression of you. Instead of anxiety about meeting a new dentist, the patient thinks of you as courteous and caring.

When you meet the patient, the ice has already been broken, so to speak. You have set the stage for a trusting relationship and the patient will be more likely to listen carefully to your treatment recommendations and accept treatment. When you increase case acceptance, you not only generate more production but you also create another happy patient who can offer a testimonial.

One of the reasons that this simply courtesy call works is that so few doctors do it. Get on board now before everyone does it.

10 Value Propositions to Increase Case Acceptance

How do you help patients understand the value propositions behind the dental services you provide in order to increase case acceptance? Your 10 value propositions in dentistry should include:

1. You use only the finest dental materials. Crowns, for example, are replacement body parts. You do not use discount parts but only the best materials because they are long-lasting and aesthetically pleasing.
2. You do not claim to be the lowest priced dentist, but your fees are an excellent value for the dollar. It is never cheaper to do it twice.
3. Your practice is patient-centered. That means that every decision, every recommendation is first seen through the prism of whether it is good for the patient.
4. You have the very best equipment that allows you to diagnose and treat patients using state-of-the-art dentistry.
5. You have been in the community for x years, and you plan to be there for many more years. Continuity of care is very important.
6. You are concerned about the patient’s overall heath. If you routinely take the patient’s blood pressure or do oral cancer screenings, explain the critical importance of these services.
7. You have exceptional diagnostic ability. The solution you propose will work in large part because you can accurately diagnose the problem in the first place.
8. You are an artist and a scientist. The treatment you provide in your office is unique. Patients can get similar treatment somewhere else, but they can only get your artistry in your office.
9. Dentistry is a customized service, not a commodity. People can buy mass produced items in a store or online and shop for the best price. However, a crown, for example, is a custom-made restoration for that fits one tooth in the mouth of only one of the 7 billion people on the planet.  Your dentistry is one of a kind!
10. You spend time with patients and get to know them. Patients are individuals, not numbers, and they are never rushed out of your office. You genuinely like your patients and they appreciate your gentle manner. In sum, patients can trust you to keep them comfortable and provide them with excellent dentistry.  Your loyal patients know that they get their money’s worth in your office.

These 10 value propositions are very powerful. While some patients want only the lowest price, no matter what, there are many good patients who are searching not for the lowest possible price, but the best possible value. That is what you deliver.

http://www.davidschwab.com

What’s Luck Got to Do with It: Creating Your Own Success

Are successful people just the beneficiaries of good luck or do they seize good fortune in the form of opportunities and also overcome adversity? President Barack Obama commented on this issue in a commencement speech at Howard University on May 7, 2016. “That’s a pet peeve of mine: People who have been successful and don’t realize they’ve been lucky. That God may have blessed them; it wasn’t nothing you did.” (The entire speech transcript can be found here: http://tinyurl.com/Obama-speech-Howard).

It is certainly true that some people are more blessed than others at birth. If your family is enormously wealthy, then you may feel that you were born on third base. If your family is desperately poor, you may feel that you are not even in the ballpark. However, the arc of life of the fortunate and the unfortunate is not predetermined.

Pick up any issue of People magazine to read about people whose God-given talents propelled them to fame and fortune—until they squandered it all due to poor choices they made in life.

The problem with ascribing success to luck alone is that it invites a corollary: failure is a result of bad luck and the unlucky among us are victims, not masters, of life. This “victim mentality” can be insidiously self-fulfilling if one wallows in self-pity.

However,there are many inspiring stories of people who overcame adversity to become highly successful. For example, there was a man who:

  • Failed in business at age 21.
  • Was defeated in a legislative race at age 22.
  • Failed again in business at age 24.
  • Overcome the death of his sweetheart at age 26.
  • Had a nervous breakdown at age 27.
  • Lost a congressional race at age 34.
  • Lost a congressional race at age 36.
  • Lost a senatorial race at age 45.
  • Failed in an effort to become vice-president at age 47.
  • Lost a senatorial race at age 47.
  • Was elected President of the United States at age 52.

His name was Abraham Lincoln. Many historians consider him the greatest U.S. President.

To be blessed with good fortune is one thing; to take advantage of good fortune and to persevere in the face of setbacks is quite another. Success is achieved not by talents bestowed but by using those talents wisely and well.