Tuesday, February 14, 2017

Career Choices

My parents grew up during the Great Depression. My father, an exceptionally bright man, never went past grade 10 due to the financial pressures and costs associated with trying to keep him in school. He dreamt about being a lawyer but never became one; instead, he became a salesman in the men’s and boys’ fashion industry.

My parents grew up in a time with many others who were immigrants who had left behind professions and careers in other countries, only to do more manual labor and hold lower paying jobs in Canada due to their lack of English language capabilities. They instilled in their children the need to study hard and become a professional (a doctor, dentist, accountant, lawyer or engineer), and I grew up amongst peers who were driven to do just that.

Today, I continue to find the children of immigrants to be hardworking and driven to excel at school, in an effort to become a professional.

My children, however, are the progeny of the generation of people driven to excel in school. Our parenting style is more relaxed (I am generalizing here; of course, there are exceptions), as we live in a society that allows people to dream and offers them the opportunity to realize their dreams. Neither of my daughters have any interest in science, math and engineering (the so-called STEM subject: science, technology, engineering and math). One daughter would like to study art history and possibly curate a museum or art exhibit. The other would like to be an actress. Many of my younger patients now dream about becoming a chef. One cousin loves working with glass art. A nephew is an illustrator working on TV and movie productions.

We are incredibly fortunate to live in a society that has matured to the point where we now value art in all of its forms — visual, auditory, gustatory and tactile — and are willing to pay a reasonable fee to access it. Now, people can dream, work toward making that dream a career and anticipate they will be able to make a living wage pursuing those goals.

When I talk with my patients and learn about their careers, I am amazed at the variety of opportunities that are out there. We don’t learn in school how to do what most people do in their careers, and I think that is very cool.

One thing I am fairly certain, though, is that the pace of change is so rapid that I am starting to see people start in one career and, 15-plus years later, they need to go back to school and retrain to do something else completely different. I see the near future of people having two careers in their lifetime, without company pensions. The idea of retiring at 65, or another artificial number, will fall away as irrelevant. The focus seems to be turning toward staying healthy and productive, regardless of age.

And our success will be all based on the relationships we grow and cultivate. It is a fascinating time to be alive.

Larry Stanleigh, BSc, MSc, DDS, FADI, FICD, FACD, FPFA

Wednesday, February 8, 2017

Transform Your Life by Setting Goals

A goal often has been defined as the terminal point of a journey or a measurable and observable end result. When we think about setting goals, the first thing that usually comes to mind is making a new year’s resolution. If you are like me, then you probably have multiple goals for 2017 and beyond — goals that incorporate your business, family, health and finances and a yearning to serve others; goals that are derived through a type of self-awareness that incorporates your vision both near and far; and ideas, thoughts and dreams that provide clarity and meaning for the legacy you will someday leave behind. What are your goals in 2017, and where would you like to be in five years? 

More than 30 years ago, and prior to becoming a dentist, I was taught the importance of establishing goals and learning to focus on a vision. It was during this time and while working in the hospitality business that I discovered that goals originate out of a vision that begins with the end in mind.

Building hotels is a challenging and stressful business that requires tremendous coordination of architects, engineers, interior designers, general contractors, sub-contractors and the operating team all working to realize a vision for the grand opening. In many instances, the sales department has pre-booked the facilities 18 months in advance of the opening date, and there is little margin for error. Examples of this include pre-booking of major conventions, banquets, weddings or corporate meetings that may have upward of 3,000–5,000 attendees traveling from around the world.

It was during this time that I was mentored by great hoteliers and human beings who trained and empowered me to reach for the stars while learning to dream big. I learned that dreams (long-term goals) and vision are what inspire our heart and soul. I also learned that building beautiful hotels and setting schedules (goals) begins with a vision — a vision that leads to a blueprint and a blueprint that leads to a dream come true. As the founder of Hilton Hotels Corp., Conrad Hilton, once said: “To accomplish big things, you must first dream big dreams.”

Years later, and while completing my Master of Business Administration, I took the opportunity to research the key components of some of the most successful people in the world (Bill Gates, Steve Jobs, Martin Luther King Jr., Conrad Hilton, the Wright brothers, etc.). My conclusion was that they all had the ability to dream, visualize and create realistic goals. These visionaries all knew “why” they did what they did, and it was apparent that their dreams, goals and passion were at the core of their very existence.

There are numerous research projects that have been conducted to measure the outcomes of goal-setting. Two of the most common include an MBA Harvard Business School study and subsequent Virginia Tech study that support the assertion that setting goals are a key component to one’s success, both professionally and personally. The Harvard study revealed that the student who had goals, wrote them down and measured them on a regular basis earned 10 times as much as their classmate did. The Virginia Tech study revealed similar results.

In summary, being happy is a byproduct of realizing our dreams and achieving our goals. When we commit to written goals, we prioritize living our best lives. We also learn to accomplish meaningful tasks, improve our self-confidence, and foster spiritual and meaningful growth that ultimately provides us with a sense of accomplishment. If our goals are not documented, refined and monitored, then we are leaving everything up to chance. It is also worth noting they cost little or nothing to initialize. As they say, be careful of what you dream for, as you just might get it.


Thursday, February 2, 2017

What Defines a Successful Practice?

After a reading some blog posts focused on what it takes to have a successful practice, I started to ask myself about success. I started to ponder what a successful practice looks like. Of all the things I read, there was one aspect I wasn’t seeing being discussed — how to set up a practice in order to be happy, not just profitable. Somehow, we have always equated success with making money and the bottom line. This is what we all seem to be chasing after: profit. Look, this is what I have chased and am chasing after. But I can tell you that money does not buy happiness.

I know, I know, you are saying that you know that, but you would like to try it anyway. Does having a practice that makes good money make it a little bit easier to buy happy? Heck yeah. But once you have earned a certain amount of money, the amount you thought would put you on top so you could easily pay for all of the tuitions and the cars and the loans, you always want more.

American industrialist and philanthropist John D. Rockefeller was once asked: “How much money is enough money?” He answered: “Just a little bit more.”

Take it from me, and from Mr. Rockefeller, the amount of money you have never seems to be enough. When I made $100,000, I thought: If I ever made $150,000, that would be it. Then I made $150,000, and I was still living paycheck to paycheck. I needed to make $200,000. And so on and so on. 

Because here is what happens: Once you start making $100,000, you start living like you make $100,000. You buy a house, and you buy a car, and the kids are getting older, and they start kindergarten, and that’s costly. Then they join the T-ball team, which costs more money. You want to start them in an additional activity, and that costs money.

Then you make $150,000. You start to buy into the practice. Now your first kid is 10 years old, and now you have kid No. 2 and No. 3, and you have to pay tuition for two kids and daycare costs for kid No. 3. You buy a minivan. Then there is tutoring, baseball and football, and at that level, you have to have a special coach for a couple days a week. Your 5-year-old daughter is in dance class, and the studio wants $350 for the dress for the recital. You have moved into a bigger house because you have outgrown your first house.

At $200,000, you have bought 50 percent of the practice, and you are paying a big mortgage and three tuitions. Then there is baseball (Little League and travel team), football (Tuesdays and Wednesdays, with membership at a football agility-only gym), dance, driving school, drama and voice lessons. You buy the oldest his own car to get to all of his sports and SAT prep commitments. Oh, and now you think, I better start putting money away for retirement.

Are you getting it? It is never enough. No one ever wins the rat race — and we all are in the rat race. But here is my philosophy: I want to own my rat race. I want to make my rat race fun.

I want to be happy.

After 21 years, I think I have my ideal practice. I have the practice that I dreamed about. But guess what? It is small. I work 36 hours a week. I work out of two rooms (but could really do it out of one, 75 percent of the time). I love my staff, and I love coming to work every day. Doesn’t that sound successful?

In my next blog post, I will tell you about my practice and how I practice. It is probably going to look a lot different than you think.

John Gammichia, DMD, FAGD

Friday, January 27, 2017

Overcoming Challenges in Relationships

In December 2016, I completed a course with Dr. Paul Homoly about the craft of being a speaker. I have had a dream of being a keynote speaker for more than 20 years, and now, I am finally ready. 

I already have three speaking engagements booked, and two of the organizations are outside of dentistry. My first keynote speech is titled “Success Is All about Relationships,” with a secondary story about the people in our lives being a gift. With this topic in hand, and the holiday season having recently been upon us — which emphasizes positive family relationships and goodwill toward humankind — I started thinking about my relationships and how they have affected my families, both my biological family and my work family (team), as well as some problems that have occurred that are difficult to resolve. Allow me to tell you about some of the people in my life, the interactions with whom have taught me lessons over the past years.

My wife and I are both members of large families. My brother-in-law’s wife is not from a large family, and in her small family, she has managed to avoid certain relatives, including her mother and sister. After being involved in a small dispute with her, my family was not invited to their holiday celebration. My children were particularly hurt seeing their cousins posting pictures online; they did not understand why they were not invited. I don’t know how this will get resolved or even if it will get resolved. My wife’s close-knit family is slowly being divided by this one person.

I also have encountered problematic interactions with one of my employees in particular. I hired Freda* many years ago. She is a hard worker, a fast learner and had a successful career as a server in a busy restaurant chain in Calgary, Alberta, Canada. She understood teamwork, high levels of customer service and more. She was a great hire, but as time went on, she brought her personal issues to the office. She withdrew and stopped talking to people at lunchtime. She was banging drawers, rushing around and putting things away in haste, leaving the rest of the team scrambling to find things they needed — and not in a timely manner, which affected its ability to provide high levels of customer service to our patients.

Although Freda’s words stated she wanted to be a part of our team, her actions showed otherwise. To remedy this, we worked with Freda, providing her with coaching. We also provided team-based communications training for the whole office. Despite our best efforts, we ultimately found a way to help her find a different place to work. Over the course of the following six months, our productivity, production, collections and general happiness at work measurably improved.

These are just two examples I can share about dealing with challenging relationships — sometimes you can change them and sometimes you can’t. I have two families: my biological family and my work family (my team). We cannot change our biological family. We do not choose to whom we are related, nor who our family members marry. We can choose who the members of our work family will be. Success is dependent upon how we chose to navigate our relationships. The challenge is to overcome the difficult ones — or, if that is not possible, to focus instead on those relationships in your life that are positive and choose to build new ones.

May 2017 be a year of positive and fulfilling relationships for you all, in all of your families as we strive for success.

Larry Stanleigh, BSc, MSc, DDS, FADI, FICD, FACD, FPFA

*Name has been changed.

Tuesday, January 24, 2017

The Employee Review Conundrum

The blessing and curse of my group practice setting is having to relay/discuss/vote on decisions amongst my partners. At times, it’s a godsend — aka, those times when I have few if any ideas and I thusly appreciate the variety and breadth of opinions amongst my counterparts. Other times, though, it leads to disagreements and some heated discussions when opinions differ. 

One of the more recent discussions I can recall was around the idea of employee reviews. We’re a growing, multi-location practice with more than just a handful of employees now. Multiple doctors rotate locations on a daily basis. Although I’ve grown into having the confidence to be able to discuss a situation with a staff member in the moment, there are plenty of times in the midst of one of those days when I barely have time to check my email — not to mention discuss with my assistant the proper protocol for room restocking or CAD/CAM mill maintenance. It’s tough, and I’ll be the first to admit it.

I clearly recall a conversation with one of my assistants years ago about their previous boss who kept a Post-it® Note stack in his pocket on which he’d write down his employee’s issues, as well as potential teaching moments and growth opportunities. Although doing this would be tempting, I don’t care to be known as that boss. So sometimes, while it’s fresh in my brain, I calmly (err … not all the time) present growth opportunities to teammates. But often, instead, I’m on to the next thing — a DOL onlay prep, for example — and poof, there goes the idea to seize a teaching moment.

So what’s the solution? I’ve spent the past few weeks working on our operations manual, an organizational flowchart, etc. — the things any midsize or large corporation has to have in order to function effectively and efficiently. In section four of my ops manual is the page that covers employee reviews. We’ve never had ’em. Well, we did, and two team members quit.

So lies our conundrum. As owners, practitioners, Type Aers or simply just plain humans, we tend to focus our energy on the negative. Why?! This is just common nature, but it also is a poor quality to have, at best. Even when it comes to my best assistants, patient care coordinators or associates, I could list 20 things I wish they did better without any prep time. I’d honestly have to give thought to come up with the 20 things they do great — which is so unfortunate, because in piecing together the ops manual, they each did 200 things well! But for some reason, the growth opportunities that cross my mind on occasion are the ones that stick, the ones that I remember come review time.

So I am hesitant to begin the practice of scheduling such reviews, for fear of having the negatives outweigh the positives. I’m worried that scheduled reviews would simply turn into counseling sessions during which my teammates would “lay it all out there” — their disdain for another employee, for example. I would be careful not to anger the good/great employees with the little tweaks that would make sense in my head to outline at the time, but inevitably, I probably would just come off as nitpicky. The objective would be to be completely honest, so that my employees would actually grow and improve from them. Worst-case scenario, we would track legitimate data/records for the rare times when we would need to consult the human resources company to formulate a notice of unemployment form.

So, yes, there is clearly valuable information to be gained from reviews, but also hesitation and unease surrounding them. So how do you all handle reviews? Are they a regular (annual, biannual, quarterly) part of your practice? Do you have a magic method for focusing your energy on the positives? I’m interested to hear your thoughts.

I’d like to keep the reviews topic in my ops manual, and I’d like to eventually use scheduled review time as growth opportunities for my staff, but maybe more so for myself. I have to be a good leader, too, just as much as my employees must meet expectations, and part of that is actually leading: teaching, consulting, convening, instructing and communicating. It’s part of my job description.

Donald Murry III, DMD

Friday, January 20, 2017

The No. 1 Reason to Measure Your Patients’ Satisfaction

Recently, I had an interesting conversation with an owner colleague (Dr. Colleague) regarding the various means by which he and his staff solicit patient comments (via comment cards, website, text message, etc.). He was concerned about the number of patients who were moving their records (attrition; aka, churn rate) and figured it must be associated with insurance, patient relocation, changing jobs, big-box dental chains, competitor’s fees, etc. By the way, Dr. Colleague is a talented dentist with excellent clinical skills who has been practicing for more than 25 years. Suffice it to say, his office collections were more than $2,600,000 in 2016, and he is a popular doctor on the speaking circuit. 

Yes, I said, “collections,” not production. As a sidenote, in my opinion, production means almost nothing. It primarily serves as a benchmark from which to measure your collections and also as “bragging rights” for those of us who sit chairside at continuing education (CE) programs and tell our colleagues how successful our business is. Right or wrong, I believe this is where we get some of our satisfaction. After all, we are only human.

With regard to measuring patient satisfaction, a deeper dive into Dr. Colleague’s operation revealed that his team was trained (by a marketing firm who was selling their product) to be selective in seeking customer feedback. Unfortunately, Dr. Colleague’s team only solicits comments from customers who have displayed obvious satisfaction during their patient visit. Prior to dismissing the patient, the employees are incentivized ($1 per “positive” review) to implore the “satisfied” patient to write a review through a third party (marketing product) that is then uploaded into the dental business website.

By the way, I have no issue with team members and dentist asking for reviews or referrals. After all, I was trained in this highly internal marketing concept during my years at Hilton Hotels Corp. It is a powerful and effective way to build a patient base and is simply smart business etiquette. However, in Dr. Colleague’s case, employees were led to believe that positive reviews will offset negative reviews and that little attention should be paid to the poor reviews. This is simply wrong! There are no ifs, ands or buts about it, and no data to support their contention. Indeed, poor reviews can be vetted for the time being. However, is this any way to do business? Meta-analysis, please?

As clinicians with various levels of training and experience, we all have one thing in common. We know what it is like to experience failure (that sunken feeling) during a dental procedure and fall short of achieving the outcomes we expected. The patient or dental assistant may not detect our struggles, but we do. This built-in “feedback loop” has its advantages and serves to help us understand our limitations and/or the areas of clinical dentistry in which we may need CE or mentoring. After all, if we don’t meet the “Standard of Care,” we may have to deal with the U.S. Drug Enforcement Administration or State Dental Board. If a patient files a complaint, for any reason with any dental board in the United States, the dental board has a duty to investigate, and it will. So how does this relate to measuring patient satisfaction? We need to make sure we have a system that invites and allows every disgruntled patient to voice their opinion. Further, we need to acknowledge their frustration and concerns and take action to improve upon our deliverables, including the most important of all: five-star customer service. Without a conduit to voice their displeasure, it is only a matter of time until our patients will take to the “airwaves” (Yelp, Google, social media, etc.) and share their displeasure with the world.

With that said, there is one good thing that can come out of poor reviews. We learn to listen and improve upon everything we do. It won’t happen on its own. Make sure you have a system that invites and solicits comments from all patients — not just the satisfied. We have to know where we are failing in order to learn how to become successful.


Thursday, January 12, 2017

Vacations: Distant Childhood Memories

Last year, a good friend of mine confessed she had a dilemma: She was trying to figure out where to spend her remaining two weeks of vacation for the year. Wait … what? Remaining?! I asked how many weeks of vacation she had started with, and she casually replied, “Five.” At first, I was stunned. Then, I was jealous. Now, mind you, she has degrees in chemical and mechanical engineering and works for a top pharmaceutical company where important drugs are being developed to combat big diseases. But she doesn’t work on the weekends and doesn’t stay past 5 or 6 p.m. during any typical workday. And did I mention the five-week vacation?

I’m aware of how notorious Americans are for leaving unused vacation on the table, and recent research confirmed that we don’t seem to be thrilled about taking time off. In fact, we seem to applaud the all-work-and-no-play mindset. When I took my rare two-week vacation two years ago (after not taking any more than five days for several years), I received many astonished reactions. True, it’s about economics for many. But imagine if we were able to train our psyches to take a few days off in the midst of a long work streak. I would argue we would have more productive days following those days off, not to mention a more positive work atmosphere and better focus. In other words, we might actually reduce burnout and do our backs and hands a favor.

However, do those things really matter to us when we have packed schedules and can’t even afford to have our assistants call in sick because they have the flu, let alone a quick getaway? Besides, I wonder if my friend can empathize with dental practice owners or dentists with a solid patient base. Maybe she wouldn’t understand that even if we have a backup dentist to take care of our patients when we’re gone, we still keep those patients in the back of our minds regardless of how far away we travel. When I was staring at the Pacific Ocean during my holiday, I’ll admit I had thoughts of a bridge I had just delivered or a surgery I might have done before I left. “I hope the patient’s bite feels good and my stitches are intact …”

Besides, each day away from the office is a loss for the dental business. Practice owners can’t simply unplug from the office mentally and financially, as my friend in the drug industry may be able to.

As the holiday season came and went, I rolled up my sleeves and got to work as dental insurance benefits came to a close, while my dear friend browsed the travel section at the bookstore to plan her final fortnight of adventure for 2016. Lucky gal. 

Zeynep Barakat, DMD, FAGD


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