Article from RMI DentalSuccess Letter ()
June 27, 2002
Printer Friendly Version Issue 5
   Art Anderson gets a little Tipsy...       

Regulating What You Put In Your Brain
 
In today’s world, the consequences of careless thinking can have disastrous results.  So how do you improve the filter through which you run everything you read and hear?”   Here are some suggestions:
 
1. Know your biases. We tend to be influenced by our backgrounds and the beliefs we have grown up with.  Because of this we tend to admit into our thinking only the evidence that supports our preconceptions. Knowing this, it’s important to keep an open mind.
 
2. Listen and learn from everyone.  This doesn’t mean you accept everyone’s opinions.  But if you don’t listen to them all, you will have a limited basis on which to decide what you believe.  Read the writings of newspaper columnists, philosophers and religious leaders. Give special attention to those whose beliefs disagree with your own. 
 
3. Be skeptical. Writers know that one way to get attention is to attack the status quo.  That’s why you see articles titled, “Stay Fat and Stay Fit,” or “Grow Up but Don’t Grow Old.” Maybe the status quo needs changing, but remember it didn’t get that way without reason.
 
4. Consider the source.  Ask yourself who is providing the information, what is the evidence and what is merely opinion or hearsay.  When you have considered all of these things, you can compare new opinion with existing knowledge and see if you should alter your thinking.
 
5. Try new ideas out on your friends.  Especially try new ideas out on those you know will be of the opposite opinion.  That will give you additional perspective.
 
6. Keep an open mind.  “What goes up must come down” was valid until we discovered how to overcome gravity and get into space.  One of the exciting things about life is that the more you know, the more you realize there is more yet to learn.


 
Greg Sneyd, Director of DentalSuccess Financial, talks about...

Free Credit Card Collection Training Tools From EDR
 
Many of our readers have already enrolled in our new credit card processing program with Electronic Data Resources. They are finding that they can save every month on their credit card processing and can also take advantage of many free training tools that EDR provides as part of their service.
 
Here are some of the free training materials that everyone on your team  involved with accounts receivable and collections should be aware of: 
  • Cutting Your Collection Time – This resource guide provides comprehensive guidance from top management and finance professionals. It covers drafting an effective collection policy, speeding up collection times and cutting collection costs.  
  • Tools For Patient Payment – This video shows your team how to improve receivables management by demonstrating many of the procedures and techniques for collecting payment with credit cards.  
  • How to Collect at Time of Service – This 30 minute video offers useful tips on a variety of interpersonal skills and techniques that help prompt for patient payment and present payment options in a variety of circumstances.  
  • Financial Management Textbook – This in-depth booklet discusses everything from managing receivables and collections to balancing outstanding claims.
Your practice should not be without these free training tools.
 
If you would like to have EDR contact you to get your free training materials and also get a free analysis of your credit card processing costs and show you how you can save on credit card processing costs every month, simply send an email to gregs@dentalsuccess.net (type EDR in the Subject line).
 
Or print this page and fax it to 801-293-8524.
 
Yes! I would like to be contacted by EDR to get my free training materials and my free analysis to show me how to save money every month on credit card processing.
 
 
Name: _________________________________________________________
 
Phone: ________________________________________________________
 
 
Fax to 801-293-8524

  Steve Anderson and Walter Hailey share...

Special Dental Report - Mind Your Words

Are you chasing clients away with your language?


WORDS that can KILLyour case acceptance

by Steve Anderson & Walter Hailey

f your slip were showing or your tie were crooked, would you want someone you trust to alert you to what you couldn’t see for yourself? If you will let us take it a little closer into your intimacy zone, what if you had bad breath? How else would you ever find out about something potentially offensive to others as a funky case of halitosis if not for someone stepping up and letting you know? Similarly, although you are the dental health professional who can cure your patients’ bad breath, you may be saying things in your case presentation that turn your patients off to saying YES to treatment. These 25 words can be as infectious as the worst periodontal condition you will ever treat.
 
Take the Case of Acceptance Verbal IQ
 
We all know that how you talk about your patients’ health has a lot to do with what they will agree to do regarding the treatment you prescribe. So take our little quiz. Rather than be guilty about confusing your patients with unclear images, limiting terms and approval-addicted-based ambiguities, we invite you to be honest. These poor choices in words may make you feel clever but they just puzzle your patients. To paraphrase Hippocrates, we challenge you to “heal thyself” by fixing what comes OUT of your mouth in order to better fix what’s going on IN the mouths of your patients. If you think of dentistry as a lifelong learning journey, then think of us as your key to smoothing out the road along the way. We have identified the potholes, dead ends, roadblocks and detours that can send your case presentations careening off the road. Get these 25 injurious and unsafe words, marked in bold type, out of your vocabulary for a more smoothly paved path to full treatment plan acceptance.

Irresponsible Pronouns
 
 
Let’s start small. There’s nothing smaller than a pronoun, but its incorrect usage reveals the root of a much bigger problem. For example, “Well, Mr. Haven’t-Seen-Ya-In-Five-Years, we have a little infection here.”
 
The truth is that the patient, as his name implies, has not been back to see you in such a long time that blood and pus now characterize the activities in his mouth. It’s a swamp of deep pockets in every quadrant. We don’t mean to imply that he needs a scolding. On the contrary, he needs to be informed of what is really going on in his mouth. That doesn’t include your mouth. Therefore, WE is the worst word you could ever use. It lessens the importance—and the urgency—of his condition. He’s already failed to show a great interest in a disease he has had for too long a time, a disease that only gets more dramatic without treatment! So if WE are sharing the problem, then HE won’t have to deal with trying to find a solution. Someone else will, and he’s very likely thinking: “Don’t bother ME with this now.” Okay, you say we is a minor thing, so we’ll agree. But combine it with:
 
Limiting Adjectives
 
So the patient has successfully avoided the real deal about his or her oral health needs. Let’s revisit that apparently innocuous remark: “We have a little infection here.”
 
Well, King Kong is little, too, when he stands next to Godzilla, but he’s a pretty scary sight atop the Empire State Building! Once you put Fay Wray in the palm of one of those giant hands, you add the perspective that makes us want to DO something like call in the airplanes and save the day.
 
The entire art and science of dentistry takes place within an incredibly small portion of the human organism, but that doesn’t lessen its importance. And we all know from our earliest lessons in grammar that adjectives are designed to describe things, but they are at their best when they create a context.
 
To create a context that patients can actually understand and respond to effectively, pay attention to the three forms of limiting your language: to describe the severity of a condition, avoid saying little—or any of these “accomplice synonyms” like minor, kind of, sort of, insignificant, tiny, a touch of, inconsequential; to describe the frequency of trouble, avoid saying sometimes—or the other usual suspects like maybe, on occasion, from time to time, once in a while or the ever unclear not infrequently; to describe what action patients should take, avoid saying Perhaps you should think about or equally wishy-washy phrases like Maybe we need to look at this some more next year or Let’s just wait and see.
 
We don’t wish to insult you. We would never say that you are lying to your patients when you use such limiting terminology, but the result of these words comes to the same thing: patients decide NOT to accept full treatment. If their disease isn’t that bad, why should they?
 
How much different is that from supervised neglect? Chances are your patients have not been to dental school. Which brings up: 
 
Incomprehensible Nouns
  
We would like to get personal for a minute. If you’ve ever been to our Dental Boot Kamps or heard us speak at conferences, you know that we are in the business of helping our clients enjoy their own business more—and help them get more business for their business.
 
We know all kinds of business terminology, but we pride ourselves on speaking plainly.  We like to keep it simple. And as direct and clear as we try to be, sometimes people refuse our recommendations. It’s tough watching people, we like and want to help, lose money or their marriage or make monstrously ill-advised decisions in practice management. But we long ago discovered you can’t be everything to everyone. We know how valuable we have been to so many because they tell us every day by phone and fax and e-mail and at dental meetings. But we understand the power of rejection. If we were afraid of getting shot as the messenger of bad news every time we looked into someone’s mouth, we would get defensive, too. 
 
Looking Smart Versus Being Smart  

We know that one of the dumbest, knee-jerk ways for one to save face in the face of rejection is to retreat into the rarefied air of the high fallutin’. Using all those big fancy words form dental school may make you feel like a genius, but they may make your patient feel less than intelligent. Here’s a tip from our business school: looking smart is not as important as being smart. And the smartest professionals are the ones who make their patients feel smart. That’s the key to case acceptance.


We invite you to drop all those incomprehensible nouns of Latin and Greek derivation from your treatment case vocabulary. Though occlusal disharmony may accurately describe your patient’s bite, we think the language is a bad fit. In fact, using such words is akin to putting your foot in your mouth.
 
Take a term as commonplace in dentistry as periodontal disease. During a conversation with a very well educated business associate of ours, we were explaining the ever expanding market for dental services in North America. In an unthinking moment we told him that  “half the people do not see the dentist on a regular basis and 80% of them have some type of periodontal disease.” His immediate response was, “That’s nice, guys, but what do dentists have to do with feet?”
 
It may come as a shock to you, but not everyone gets up in the morning thinking about their periodontal condition! Our friend is very smart—in his area of expertise—but in the area of dentistry, his level of education is still at an elementary level. That doesn’t make him dumb. It just makes him normal, like most of the dental patients you see every day. So, if you expect them to understand what you say, you must talk with them at the level they can understand. 
 
“I Wish I Would Have Said” 
 
How many times have you said that to yourself long after the case presentation is over and the patient has left the office without accepting treatment? Wouldn’t it be nice to eliminate “I wish I would have said that” and replace it with “I’m glad I said that.”
 
Start by planning ahead and thinking about what you will say BEFORE you meet your next patient. Let’s face it: it’s not as if you are going to make a recommendation that you’ve never made before, so start replacing every “I’m-smart/you’re not” phrase in your diagnosis and treatment with emotional word pictures that communicate a powerful imagery to your patients and fit their belief window so that they want the procedure you recommend. Here are a couple of examples of more words not to use: 

  • Probing: you don’t really expect a patient to show much excitement for such a term! Who do you know who wants to be probed? It sounds invasive. Dr. Jeff Gray, one of our Dental Boot Kamp faculty and a master communicator, says, “I’m going to use this ‘ruler’ to measure the pockets or turtlenecks around your teeth which are like fence posts in the ground. If you lose the dirt, the fence gets loose just as your tooth does if the bone dissolves from the infection. So what I’m doing in puttering around your gums is a lot like golf—the lower the score, the better. You are playing on a par 3 course.”
 Notice that now the patient not only knows what you are doing, but can “play along.” When it’s time to make a treatment recommendation, you can be sure that the patient is more qualified and less resistant to say YES. 
  • Root Canal: Yikes! This has got to be the most over-rated procedure in dentistry. It has been anchored in everyone’s mind as the most awful thing you can experience.  Out loud it’s as scary and as life-threatening as gum surgery! For procedures this severe to the ear, it’s awfully tough to get anyone who’s not a masochist to say yes to the treatment. Instead of making the procedure sound terrifying, make the condition sound terrifying and the solution or procedure seem easy.
For example, you might say, “You have a serious infection that’s eating a hole in your jawbone and it’s really pretty simple to take care of. All I am going to do is make an opening in the tooth similar to doing a filling and then I’ll rinse and clean out the space where the infection is growing. That space is like the space in a sprinkler line where the water flows. We simply seal up that space so nothing comes in or out and you’ll be able to eat and chew comfortably again.”
 
If you are concerned that you might be perceived as not being totally up front with the patient, then feel free to say, “You may have heard this referred to as a root canal in the past.” As least this way they will understand what’s happening before you use a term that is negatively associated with the opposite emotional response that you want. 
 
Here are a couple more examples of word pictures:
  • Excess wear on teeth: It is a lot like an M & M—the enamel is the candy coating and the dentin is the chocolate. 
  • An expanded filling: It’s like a crack in the cement. When water freezes in it, it expands and breaks up what surrounds it.
Our Challenge to You  

We trust by now that you get the idea. Present the condition for what it is, namely, serious. Then present the treatment that will be performed in a comfortable, non-threatening way. In addition, make sure that the words you use have meaning for the person you are saying them to, not just to yourself. We invite you to go back through the article and write down the 25 words in bold case on a piece of paper and eliminate them from your treatment case vocabulary forever.
 
No matter how good your intentions are, sometimes a change in the way you express yourself can have a dramatic impact upon your patients and their responses to your suggestions.
 
Before your next team meeting, give your team the following homework assignment. Come up with the most compelling description you can for each of the dental health conditions and treatment procedures you encounter every day, such as:
  • Scaling and root planning: Ouch! You might as well say, “You’re gonna get plucked and skinned!” 
  • Implants: is this about breasts? Agreeably one of the greatest innovation in dentistry, it is unfortunately a trigger word that is directly associated with leakage, illness, disaster and lawsuits. 
  • Bonding: This is either too intimate or some 007 technique. What about crowns, indirect only/inlay, direct composite, occlusion? Let your imagination have free rein.
Where to Next? Take it to Third Graders  

Here is our can’t-go-wrong action plan:

 
Get your entire team involved in helping you use language that is clear, imagistic, patient-centered and communicative. Let them give you—and one another—feedback so that everyone in the practice speaks effectively?
 
How do you know when you are being effective?
 
Go to your local school and do a presentation about dentistry to a class of third graders. If these children can follow what you are saying, then you know your patients will. Most adults you will meet have little more than third grade education in dentistry anyway. By raising your own case presentation verbal IQ, you automatically raise your community’s dental IQ. We wish you continued success in dentistry.
 

 
Walter Hailey and Steve Anderson are the founders of Dental Boot Kamp, North America’s leading course in case presentation and the people-skills sided of dentistry. For more information and dates of their upcoming seminars or to order your free “Leadership and the Dental Practice,” call toll free 1-800-460-3838 x106 or email
gregs@dentalsuccess.net. (type DBK in the Subject line)

  Suzanne Black – Coaching Director Talks About...

Strengthening Relationships Through Having Tough Conversatioins

 
How many times have we ruined our weekend by stewing over a conversation we needed to have on Monday when we got back to work?  If you are like me, that pit in your stomach is unmistakable.  Although we try to avoid it, there is no getting around the fact that something needs to get communicated, discussed and resolved.
 
While most of us do not relish this challenge, there are positive outcomes available.  What if you could approach this conversation opportunity with the possibility of actually strengthening your relationship?  What must the conversation include in order to leave both parties satisfied and progressing with their work? How will you handle it if the conversation gets heated?
 
First, however, what is your current style?
 
Are you:
 
RoboCop – Mowing down anyone who gets in your way.  Obviously the only way to handle this is with a direct hit!
 
Scarlett O’Hara – “Oh we’ll think about that tomorrow!”  putting off those conversations hoping it will get better without having to address it.
 
Henry Kissenger – Well once we have weighed all of the pro’s and con’s it looks like you will need to change and stop doing the thing you’re doing that bugs me to death.
 
Mom – Just give them a dirty look and that will convey the message.
 
Clint Eastwood – Make my day …  Start the communication peacefully enough and then when any resistance comes up – mow it down.  (closely related to Robocop.)
 
Having applied the above approaches, you undoubtedly will be avoiding any tough conversations in the future.
 
Is it a tough conversation or a person that’s tough to talk to?  

Sometimes the person that you need to speak to is someone you don’t feel comfortable with.   What makes a conversation tough is the fear of the reaction and whether that reaction will hurt us in some way.  If you can minimize the reaction – you’ll develop more confidence in having the conversation.
 
Preparing yourself for a tough conversation can help you raise your confidence and your openness to having the interchange. 
  1. Disentangle your feelings from the facts.  Get clear on your behavioral requests.  Hurt feelings can make you be retaliatory vs straight with your partner.  
  2. Try to imagine the situation from their point of view.  Attempt to take on the point of view that if you were in their shoes at this time in your life you would see things the same way.  
  3. Plan your opening and be willing to stay in the conversation until it’s complete.  
  4. Breathe, lighten up and include some humor, especially about yourself.  If you don’t take yourself so seriously there is less to find issue with.  
  5. If you don’t come to a resolution, acknowledge the understanding that the dialogue has allowed and see what each of you think is the next step 
  6. Do not gossip about the person with which you had the conversation.  The gossip damages any safe environment you may have created.  It also diminishes the possibility that you can work effectively with the challenging person since you have demeaned them through gossip.
Breaking the Ice  

In the Dental Boot Kamp, we teach a couple of ways to begin to break the ice on a tough conversation.
  1. I need your help.  All of us want to be helpful in someway – even those of us who may be crustier on the outside.  Asking for a person’s help gets you started off on the right foot.    For example – “I need your help.  At the end of the day, we get really backed up on instruments and if you could take care of ops 3 & 4 and I take care of 1 & 2 we’d have it handled.  How does that sound to you?”
  2. Asking permission.  “Would it be ok if we spent a few minutes talking about a challenge that I/we have?”  
  3. Apology.  “I must apologize.  Obviously I misunderstood your comment to me.  I know you want this to work out well for both of us.  Did I do something to cause you to be upset with me.”
I learned from Walter Hailey that a great way to have a conversation is on a walk.  During the walk we are both looking forward so that it is less confrontational, we are breathing deeply which allows for more endorphins to feed our sense of well being.  In fact,  Walter had a tough conversation with me on a long walk.  I’ll never forget it.  He was making some pretty tough statements about how I was leading in the organization.  At the end of the walk, I knew he cared and I knew I needed to make some changes. 
 
The most important aspect of having a tough conversation is to do it the NIKE way -  Just do it!  The withholding and suppression of the conversation can lead to reducing your confidence around the person, causing health concerns and eventually losing that person as a partner.
 
The human mechanism is to justify ourselves and find fault with another when we have withheld communication.  
 
Setting the Practice Up for Healthy Communication
 
In a busy practice it may seem like it’s not a priority to take time for communication. But not communicating with the team can exact a heavy price.  A communications gap doesn’t only undermine morale and performance, it can ultimately impact the bottom line:
 
·        Over a five-year period, companies with higher scores on information sharing had a higher return on investment and higher return on sales than companies with low scores, according to a University of Michigan survey.
 
·        An analysis of data from employee attitude surveys at Hewlett-Packard and GE found a strong correlation between improved two-way employee/supervisor communication and increased productivity and employee retention.
 
·        At Sears, analysts found that a five-point improvement in employee attitudes – a factor often tied to information sharing – will drive an increase in customer satisfaction and improvement in revenue growth, according to  “The Employee-Customer-Profit Chain at Sears” – Harvard Business Review, January 1998.
 
In the dental practice, we all know the toll it takes on patient relations, case presentation and team work when either the dentist is dissatisfied with an employee’s performance or team members are at odds. 
 
In one very successful practice we instituted regular team meetings during office time.  Productivity increased by 35% in less time.  I have seen this time and again.  Take the time to communicate – the time invested will pay off.
 
Setting up a Safe Environment
 
In your team meetings, establish a safe environment by asking each person use the team meetings:
  • To communicate fully.
  • To communicate honestly and respectfully.
  • To promise that there will be no retaliation as a result of what is said in the meeting. 
  • Once every six months have one on one time for every team member with each other.  15 minutes each is sufficient.  In that time ask 3 questions:  What could I do to improve my performance?; What  would I like from you to have things  work better?;  What I want to thank you for is_____? 
 For more information about our Coaching program simply send an email to gregs@dentalsuccess.net (type Coaching in the Subject Line) or call Greg Sneyd at 800-460-3838 x106

  Cynthia McKane Wagester talks about …

The Case of the Missing Manual

When I received the email from my old friend, a dentist who has been practicing for 14 years, I was floored. “Cindy, I’m not running a practice, I’m running a zoo. I don’t have a dental team, I have five well-educated hissing wildcats who snap at each other and at patients, who break things and lose things, and whose idea of cooperation means telling me what somebody else has screwed up. I’ve tried being kind and being rotten, but things have just gone from bad to worse. The hygienist who has been with me for 11 years, quit two months ago. The new hire doesn’t seem to know if she’s coming or going. Last week I almost fired my front desk gal because she thinks my office phone is for personal calls.  SOS.”

I couldn’t believe what I was seeing. None of this made sense. Dr. Mallard was a great dentist and a great guy with great people skills, but he was describing a place where nobody knew what was what. A place where the boss was Attila the Hun on Tuesday and Mother Teresa on Wednesday. A place with no fixed rules and no clear agendas. A place where morale was getting worse every day because everyone was thinking “I don’t know what is really expected of me. I never know what is going to happen here.”  When I called to set up an appointment, my first question was “Do you have an office manual?” I already knew what the answer would be.

I made two proposals. “Send me a list of everything you don’t like about how your team does things and set up an in-service day so that we can all sit down and work on this.

I arrived at the practice on the appointed day, distributed fat legal pads and pens, and we got to work. I explained that an office manual was a guidebook for making things work – a road map for figuring out where everyone was and where everyone should be going. I introduced Dr. Mallard’s needs and expectations, and encouraged everyone to list their own. Then I added points I had not heard anyone else mention.
 
At 9:00 a.m., management was nervous and team members were surly and silent. By 10:00 everyone was talking loudly and hurling accusations. By 10:25 people were starting to understand why there was a problem and everyone started to move away from the blame-game and towards solutions. We addressed records and responsibilities, education and vacation, snow and seniority, parking and purple hair, flex-time and down-time, benefits and bonuses, and a host of other items that needed to be clarified and committed to paper. When we broke for lunch, the mood was electric.
 
By 2:00 p.m., we had nailed down the nuts and bolts and were ready to venture into  more complex issues -- relationships and communication. By 3:15, all team members were suggesting parameters for professional conduct and performance evaluations, meetings and mentoring, incentives and grievances, safety and morale.

It was almost 6:00 p.m. when someone noticed that it was too late to continue that day. I collected the legal pads. The notes would be collated and typed up by my staff and returned to the team members for further review and approval. No one objected to scheduling a follow-up in-service day for this purpose.  Before we broke for the night, I asked everyone to thank someone or compliment someone for contributing to the project. They were surprised, but they complied with enthusiasm.

Two months later, UPS delivered a beautifully bound and illustrated manual. A month after that I got a batch of notes from the practice. “I finally feel I am valued here.” “This is now a good place to be.”  “I like my job and the people I work with.”  “I’m in charge of updating the manual in December and everyone is already giving me good ideas.”

The doctor wrote,  “ My people are helping each other, joking with one another and taking care of business. It’s a miracle.”

I emailed back. “No. It’s a manual.”
 
The article is authored by Cynthia McKane-Wagester, who is President / Founder of McKane & Associates, a full-service management company servicing health care practices. Her company’s expertise is in developing excellence in staffing systems, working philosophy, and in ensuring that all team members, whether proven or inexperienced, adapt their skills to meet the ever-changing workplace. She can be reached at her offices in Maryland at 1-800-341-1244 or  cmandassoc@aol.com .


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