A Failure to Communicate

How to improve communication with your team

by Mike Farley

What a wonderful time to be a "treatment oriented-fee-for-service" dentist -- especially here in the Pacific Northwest where the population continues to grow while the number of practicing general dentists remains approximately the same as it has been for the past 20 years. With the technological advances in dentistry and a corresponding increase in the speed in which dental services can be delivered, the operating results of most general dentists are vastly exceeding anything I would have predicted just a few years ago.

Yet, this unprecedented success has been not been achieved without a cost. Most offices have substantially more patients in their practices than was the norm 10-15 years ago. This has forced dentists and their staffs to not only work smarter -- but, simply because of the volume, work harder, also. This excess of patients has created a situation whereby every available moment has been given over to production, thus creating the reality of tremendous financial success.

The Likely Victim

But, because no one has been able to increase the number of hours in a day, the large amount of time currently dedicated to production has, obviously, reduced the amount of time that previously was available to refine the other aspects of a practice that contributed to its overall success.

The most obvious victim -- sacrificed at the altar of production -- is that of communication between doctor and the staff. These people are so busy producing that the circumstances and situations which tend to cause stress, anxiety and frustration are being left unattended, and this is beginning to bring about major problems in many offices. The forums which allow for great communication -- staff meetings, departmental meetings, performance reviews, and the morning huddle -- are being reduced or, in some cases, eliminated so that more time is available for production. In fact, these "availabilities for communication" are now seen by some in the profession as restricting their potential for financial success.

My observation of this "limiting of communication" is that it is extremely short-sighted. More and more, Tyson and I are being called upon to referee or negotiate problems between doctor and team members. Problems that, for the most part, could have been prevented with a small amount of communication between the players. Recently, in many highly successful offices, we have seen tensions between team members reach such heights that it appears the "ship is about ready to sink." Yet when we review the actual issues that have caused these tensions we find that they are, for the most part, small items that have been allowed to grow to undue proportions. Molehills into mountains!

The Common Crime

As we all know, the "art of communication" is a major dilemma at all levels of society. Because each of us comes from a different background, we all communicate just a little bit differently. Consequently, these are some of the characteristics that appear frequently:

1. Poor presentation skills

2. Poor listening skills

3. Attacking

4. Withholding

5. Focusing only on ourselves

6. Not focusing on the office

as a whole

Also, many dentists profess to have an "open door" policy, and they are quite surprised when a staff mutiny appears on the horizon. My personal view is that the "open door" policy does not work when the staff perceives that:

1.Based on previous experiences, nothing will be done regarding the issue at hand.

2. They, or someone else on the team, will be punished for bringing up the issue.

3. The doctor's feelings will be hurt if the issue is presented.

These innate limitations, along with many others in personal communication skills, coupled with a planned reduction of time available for communication, set the stage for enormous frustrations on the part of various team members. Frustrations that, for the most part, cannot be offset by increased financial rewards.

Obviously, good communication does not just happen. But what's the big deal? Why is it so necessary for dental personnel to improve their communication with one another? To me it's simple -- good communication allows an issue to be handled while it is small, before anyone is upset. Poor communication allows a small issue to become a crisis item, with all the anxiety and upset that comes with it. How ridiculous is it to deal with an item after it has become a crisis (mountain), when it could have been handled in the normal course of events while it was a small issue (molehill.) All of us have been through a number of these emotionally traumatic experiences that, in fact, could have been prevented had it not been for a failure to communicate.

Isn't it interesting that we go to great lengths to improve our clinical and administrative skills, yet there is very little focus on improving our communication skills. Even if we have taken a "communication" course there is usually no follow-up to ensure that we implement what we have learned.

The Simple Solution

So, if I owned a Dental practice this is what I would do:

1. Increase my fees by 3-4% to cover the non-productive time my team will now be spending in meetings. Consequently, "lost production" will no longer be an issue. (Wasn't that simple!)

2. Schedule the following meetings:

Staff meetings:

3-4 hours per month. Commit to great agendas and follow-up.

Morning huddle:

15 minutes. This is the game plan for the day. Everyone should be there. Use a checklist.

Departmental meetings:

One every six weeks. 45 minutes. Clinical assistants; Administrative; Hygienists.

Annual performance reviews:

For each staff member: One per year (usually in January.) Use forms. Focus on growth.

Personal/Professional

interviews: One every four months with each staff member. How are they doing? What could be improved?

3. Commit to on-going training to improve each team member's communication skills.

4. Constantly focus on the fact that all of our office issues are business (not personal.)

5.By my actions, convince all team members that I am worthy of their trust.

A major component in working smarter rather than harder is our ability to improve the quality of our communication. Improved communication automatically reduces stress and tension within an office. The effort that is made to improve the communication skills of all team members will bring about a result for both patients and team members that was previously unreachable. Go for it! You'll love the result!