Sunday, July 26, 2015


Years ago when I began working in a dental office, my assignment was to develop a patient education program to teach patients the basics of an oral hygiene regimen for themselves and their children.  The program included homecare instructions, facts about infant oral health for patients with young children, caries-preventive dietary information, an occasional explanation of proposed treatment to clarify a case presentation, and a good measure of schmoozing with patients to increase the sense of superb service and extra care they experienced at each visit.

The efforts paid off handsomely as the program evolved into an excellent marketing effort, raising the profile of the practice with which I worked.  I began to get requests from community agencies and organizations, health care facilities, schools, and even other dental offices to present programs focusing on education about oral health for children and adults, the specifics of dental hygiene, infant oral health, and dental needs of the elderly.  I was surprised to find that the seminars and training sessions were particularly well accepted at nursing homes and assisted living facilities.  Staff members at these facilities were trying diligently to meet their residents’ need for oral hygiene because many of the residents were infirm or had physical limitations that prevented self-care.  Additionally, many had a critical need for dental treatment.  As interest spread about care needed by this patient population, efforts to provide the care gradually increased.

Fast forward 15 to 20 years to the June 1, 2015 issue of our local newspaper which carries a syndicated series, DEAR ABBY, a personal advice column.  The title of that day’s column caught my eye---“Dental care in nursing homes can be difficult to arrange.”  A reader in West Virginia whose mother is an Alzheimer’s patient in a care facility wrote Abby to explain that although her mother cannot speak, she had indicated great pain from untreated dental disease by groaning and gnashing her teeth.  Upon inquiry the writer/daughter was told that it would be at least six weeks before a dentist would visit the home to provide treatment.  The daughter was horrified to think of the pain her mother will have to endure while waiting for treatment.

The writer wrote to urge readers with elderly relatives or friends in nursing homes to learn to help with daily oral hygiene tasks and to take the elderly person to a dental office for regular checkups and on-going care before dental problems progress to the point of chronic pain.  Abby’s response began, “As you noted, people are keeping their teeth longer.  We now know that a healthy mouth is important for good overall health, no matter what your age.”  Abby mentioned that in some states dental hygienists can provide hygiene services in nursing homes as well as in facilities housing special-needs patients, and they will refer a patient to a dentist for further treatment if necessary.  She continued by urging readers who have responsibility for a nursing or care facility resident to seek more information and follow the writer’s advice.

Think about the facilities housing elderly people and other compromised patients in your community.  How can you and your staff help these residents?  What can you do?  Upon asking himself that question, one long term dental client of mine decided that he and several staff members would volunteer to work one day quarterly in a nursing home or assisted living facility.  That’s just one example of community service that marks a practice committed to providing quality dental care regardless of a patient’s personal living conditions.  In addition to the sense of professional fulfillment a dentist and team members will reap from helping members of this population, the obvious “We care!” reputation community-wide will be a dynamic marketing tool for his/her practice---a sure-fire new patient generator.  Though not begun as a marketing program, such commitment to patient care results in practice growth.

Monday, July 20, 2015


Fewer words carry more credibility.  What?  Who says so?  Dr. Benjamin Franklin was one of our Founding Fathers who supported this maxim.  He once began a letter to a friend with an apology, paraphrased, “Please forgive the length of this letter.  If I had more time, it would be briefer.”  Franklin understood that verbosity can be a problem for both the reader or listener and the writer or speaker.  My point is that taking time to trim excess verbiage from your case presentations will assure that your words carry weight and clearly convey your diagnosis.  Wordiness can make listeners, your patients in this case, get so caught up in trying to decipher what you are saying that they simply stop listening.

Patients generally want to know three things during a case presentation:  (1) What’s wrong? (Explained in layman’s terms, please!): (2) Can you fix it? and (3) How much will it cost?”  Case present with these three questions in mind.  Elaborate only in answer to the patient’s questions.
Several years ago I heard an amusing lead-in for a speech at a Rotary club meeting.  The speaker began:  “A recent article stated the preamble to the Declaration of Independence contained 300 words, the Ten Commandments, 297 words, the Gettysburg Address, 267, and the Lord’s Prayer comes in at just under 100 words.  A federal government report on the price of cabbages in south Alabama allegedly contains 29,911 words.  So this morning, I will confine my remarks to somewhere between the Lord’s Prayer and the price of cabbages.”  I suggest you confine your case presentations to only the necessary number of words to clearly explain the diagnosis and necessary treatment.  Let an experienced staff member handle the “How much will it cost?” discussion.
In a case presentation, express your thoughts succinctly.  Patients’ acceptance of recommended treatment will increase as a result.

Monday, July 13, 2015


Staffing issues are often among the most arduous tasks the dentist/manager handles in his/her office.  The staff, the DENTAL TEAM, can be the core of success or one giant headache for the practitioner.  And, occasionally, they can be both in a single day. 

In my 35 years as a dental practice management consultant, my clients, seminar attendees, and readers have posed myriad questions and concerns about how to hire, train, evaluate, and work productively with team members.  In fact, this type of question is the most frequently asked.  I have come to think of personnel issues as the “soft or malleable side” of dental practice; whereas, the fiscal management, scheduling, recare system, treatment delivery, and other functioning systems are the “hard or fixed” side of practice.

Leadership of the dental team­--challenging, motivating, and inspiring them---is the dentist’s responsibility as surely as is the delivery of top-notch patient care and proper management of fixed systems in the office.  In short, the dentist must expertly juggle people systems and business systems in order to have a successful practice.

The next several letters in this series will address a variety of people-system topics.   Also, helpful information about personnel issues has been added to Practicon’s website in a series entitled Resources for Practice Management.  You will find six sub-headings of management topics pertinent to any practice---choose the one entitled "Interviewing, Hiring & Training" for more articles, forms, and data about staffing procedures.

Let’s begin our discussion with some rules of thumb about hiring team members:

When to hire?  Do not wait until crunch time to hire and train a new staff member.  At that point, the dentist and other team members are so desperate, they will often settle for a “warm body”. While over-staffing is not wise, sufficient, well-trained staff must be in place before significant growth and improved organization can occur.  The old adage, “Which comes first; the chicken or the egg?” translates into dentistry as “Which comes first; more staff or desired improvements?  Answer: well-trained, competent staff must come first before business systems can be enhanced.
Sources of applicants:

  • Dental auxiliary training programs
  • Dental supply sales people who visit many offices and may know auxiliaries who are looking for a new opportunity
  • Employment agencies specializing in healthcare positions
  • Your staff may know peers who are searching for a position.
  • Classified advertisements online or in print media
  • If the position can be filled with an on-the-job-trained person, notice  outstanding wait-staff, bank employees, or extra-friendly helpful, bright store clerks. Give such a person your business card and ask him/her to call to speak to your office coordinator about a job in your practice.

Applicant’s resume.  Appearance, grammar, and error-free composition count when looking at an applicant’s resume.  Read resumes critically, considering whether mistakes or poor grammar can be tolerated in the position for which you are hiring.  Notice duration of employment for each past job---frequent changes can indicate potential problems.

Telephone interview.  If a resume is acceptable and the person seems well qualified, a telephone interview is the next step.  Among other points, ask these three questions and listen carefully to the answers, making notes for recollection.

  • Tell me about the best job you’ve ever held. (Does skill and enthusiasm match  your need?) 
  • Tell me about the worst job you’ve ever held.  (Were problems with the job or with a person?  Can the applicant express feelings without vindictiveness or a display of bad attitude?)
  • Thinking five years from now, what would you like to be doing?  (I was once astounded when I asked this question of an applicant only to be told that she was looking for a job to make enough money to move to a city about 250 miles from the office location.)    

In-Office Interviews.  From the telephone interviews, choose several candidates to come for an in-person interview.  Two in-office interviews are recommended.  The first is with a senior team member.  If the person seems a likely candidate after the interview, he/she should meet other staff and the dentist(s).  Next, check references by telephoning the people the applicant listed.  Listen carefully for tone of voice, hesitations, and such as the reference speaks of the applicant.

Most applicants must consider the wage rate and benefit menu as they consider accepting a position.  If you prefer to postpone informing likely candidates about the compensation package until the second interview, tell him/her that compensation will be discussed as part of the second interview.  For the applicant who will be rejected after the first interview, no need to mention compensation at all.

The second in-office interview begins with a conversation with the dentist(s) followed by a paid two-to-three hour working interview.  See how the applicant functions; how interested he/she is; how quickly he/she understands office procedures; and evaluate his/her interaction with other team members.  If still being considered, the applicant should be told he/she will be called within a few days. 

While considering which applicant to hire, seek input from current staff.  Team members have a great deal to do with a new auxiliary’s success or failure on the job.  When an offer is made, ask the potential employee to respond within three days if he/she does not accept the offer when made.

Replacing a well-trained auxiliary can cost up to the equivalent of a year of his/her salary.  Once hired and trained, good people must be retained; and it is up to the dentist and senior team members to inspire loyalty and job satisfaction in the new person.  The following are just a few ideas about what keeps team members satisfied and motivated:

  • Be clear from day one about expectations for the job---no surprises for the newcomer.
  • Provide proper orientation to the office and training on the job.  (See Practicon’s website, Resources for Practice Management, and click on Interviewing, Hiring & Training for a Training Schedule for Business Team Members and Clinical Team Members.)
  • Delegate as much as possible as soon as possible to the new auxiliary.
  • Avoid micro-managing.  Once a new-hire is trained and displays competence, back off and show trust in his/her work unless problems arise.
  • Express appreciation often and sincerely.  This can be done verbally and/or in               small ways like a treat at the end of a particularly trying day or week. (Read the document Join Up Effort for New Employees.) 
  • Convince team members that they work WITH you rather than FOR you. 

Have fun together---whether with a pleasant ambiance in the office or at planned  events outside the office.  Fun can be such things as practical jokes within the group, sharing meals, social events, or community service. Engender enjoyment as part of your dental team’s interaction.  

Friday, July 10, 2015


“I know in my heart that man is good.  That what is right will eventually triumph.  And there is purpose and worth to each and every life.” - Frank Capra, movie producer in the 1930s and 40s. Born in Sicily;  loved the U.S. and claimed it as his country. Produced Mr. Smith Goes to Washington and other such classic films touting America’s greatness.

“Silence in the face of evil is itself evil.  Not to speak is to speak.  Not to act is to act.”
- Dietrich Bonhoeffer, 1906 – 1945.  German Lutheran Pastor and theologian.  Anti-Nazi dissident; murdered by the Nazis to quiet his criticism.

“Of all the dispositions and habits which lead to political prosperity, religion and morality are indispensable pillars.” - George Washington, First President of the U.S.A., Founding Father and hero of the Revolutionary War.

“If the foundations are destroyed, what can the righteous do?”

Psalm 11:3

Saturday, July 4, 2015


Want to convince your team members that being well-organized matters in the smooth operation of your office?  Or want to teach your teenage children that sloppiness is a bad habit to develop?  Or want to convince a spouse that being organized actually saves time?  Author Eric Metaxas gives you the facts to share with all three groups of important people in your life.  In his book, Miracles---What They Are, Why They Happen, and How They Can Change Your Life, Metaxas quotes one study that calculated people spend 3680 hours in their lifetime looking for lost items.  This significant amount of wasted time works out to 460 eight-hour days. 

Taken a step further and translated into the dental profession, one can surmise that since the average number of work days in a dental practice is 190 per year,  a dental practice can waste almost 2 ½ years of eight-hour work days looking for misplaced “stuff”.

Share that knock-your-socks-off fact at your next staff meeting to emphasize the incredible importance of organization in a dental office and in all aspects of life.  Incidentally, I highly recommend Metaxas’ book.  It’s an easy read full of thought-provoking data and personal life-altering stories of credible people whom Metaxas knows personally.