The Best Practices Show with Kirk Behrendt

650: Why Consensus is Horrible – Adriana Booth

You want everyone to agree and get along. But do you really? Agreement won’t solve all your problems, and Kirk Behrendt brings back Adriana Booth, one of ACT’s amazing coaches, to explain why alignment is more important for building a great practice. Consensus should never be your goal! To learn how to get leaders and team members to align, listen to Episode 650 of The Best Practices Show!

Episode Resources:

• Send Adriana an email
• Join Adriana on Facebook
• Follow Adriana on Instagram
• Subscribe to The Best Practices Show podcast
• Join ACT’s To The Top Study Club
• See ACT’s Live Events Schedule
• Get The Best Practices Magazine for free!
• Write a review on iTunes

Links Mentioned in This Episode:

Download ACT’s OGT Tool for free!

Get your Golden Ticket to ACT’s To The Top Study Club!

Read books by Patrick Lencioni

Read The 4 A’s of Leadership: What Does It Feel Like to Lead?

Main Takeaways:

Consensus is actually horrible.

You don't need agreement. You need alignment.

Schedule alignment time with your team consistently.

When leaders are aligned, you build trust and clear direction.

Building a great culture is a marathon. Be in it for the long haul.

Quotes:

“Consensus is horrible. Isn't that crazy to say? We all think, ‘Why? Consensus — we all just want to get along.’ But that isn't how it usually works. We all just agree on something quickly. It becomes an attempt to please everyone, and we're not having that really good, productive conflict that isn't fighting. It's really hashing it all out and coming to a really great decision, not just everyone nodding their heads saying yes.” (4:06—4:39)

“When our leadership team is aligned, your team will become more aligned. They will invest, naturally, more of their time, their talents, and their energy working toward exceeding the practice goals, not just meeting them. When we are misaligned at the top, it sends mixed messages, and your team loses faith. They lose trust. And it's not trust in you as a person, it's trust in you as a leader — and that can be really heavy-weighing on our leaders.” (6:35—7:13)

“[Misalignment is] like when you're a kid and you have the “good” parent, “bad” parent. You have the parent that might say yes to everything, and the parent that says no to everything. You go to the “yes” parent. It's the same in a practice and a leadership team. If they are not truly aligned, you're going to have your team members going to one person, going to this person, because they know what they want to get the answer to. I think that really speaks to, when our leaders are aligned, they will convey the consistent message to the team, and that gives direction to the entire organization. Consistency really is key.” (8:47—9:25)

“It sounds basic, and it really is. It just takes time and investing the time. The leadership team needs to be aligned on, where are we going? What is it going to look like when we get there? Hopefully, you have a visionary on your leadership team that has a little more of a creative brain, and they can picture what it would look like if we got to where we wanted to be. That is key in sharing with your team because it's, why do they come to work every day? They come to work because they know your vision and they’re there with you. They're right beside you doing the work. When you deliver the vision to your team, you have to remember that it is an ongoing process. It is not a, ‘Let's just show up once. I wrote it out. Here it is. Now, you know it.’ It is something that has to be in conversation regularly. It is not a one-time event. That is what leads most practices to get off, maybe going to the left a little bit. It's like, ‘Whoa, whoa, whoa. Here's the vision. Let's bring it back. Let's get on track.’ Because once your team is inspired by your vision, it's contagious energy. They're informed and they're aligned with the goals. There's no question of where we're going. ‘Okay. Let's hit the feet to the ground, and let's get there.’” (11:59—13:31)

“There are three parts to step number two. As we talked in vision, it's everybody be on the same page in leadership. And we have to be careful of the different styles of our leaders. There's danger in having all visionaries. There's also danger in having all drivers. We've got to have a happy balance. So, part of that, if you don't have that balance and it's not possible in your practice, then we have to turn internal and really work on our communication. Be open. Have vulnerability-based trust and accountability so that we can take whatever tools we have naturally and work together with them.” (15:36—16:23)

“Alignment will promote clear and open communication between your leaders. We have to be committed to the same cause, the vision. We have to be committed to open and vulnerable communication, knowing when to say, ‘Hey, I'm wrong. You're right,’ or, ‘I shouldn't have done this. I need help with this,’ and knowing you're not being judged for it. You're just being looked at as like, ‘Hey.’ Because naturally, and I know I've said this before on the podcast, at the core of most of us, we just want to help and we want to help others get to where we're going, whether you're a leader or a supporting team member.” (16:24—17:01)

“Vulnerability-based trust is something that Patrick Lencioni talks about a lot. It's being able to look at your fellow leaders and say you need help. Be open and honest about what you also want. It's the foundation of true, effective leadership. Because when our leaders are aligned, it's going to foster trust within the entire team, not just the leaders, and we can have better collaboration and teamwork.” (17:03—17:32)

“It's always nice when we're coaching a client who, they're already a really high-level clinician and they've got their ducks in a row, but what they want to work on is truly their leadership. And it doesn't matter at what point in their career. As soon as you feel like you need to work on it, jump in and start working on it.” (21:27—21:47)

“[The results are] really the by-product of working on the first two steps and being really committed. That's when the results start showing up. But also, we all know that that is really our goal in the end, is to see this stuff come to fruition. An aligned leadership team, one of the things that they are going to see when it comes to results is they can actually execute at a much higher level towards their strategic goals and towards their targets. We have a great tool for that, the OGT. When everyone is working together in alignment toward the same goals, like you said earlier, the magic starts happening and you're going to get there a lot faster. They also have a shared responsibility, at that point. The trust is built. They're going toward the same vision. They have the vulnerability-based trust with the hard conversations, with the great communication. They know what they're accountable for on our FAC, so they all have commitment to that end product, which are the results of their strategic goals.” (23:32—24:48)

“When we have a goal, our brain actually will start finding ways to get us there. One of the quotes in that same article that I read about all the neuroscience behind this was, ‘Whether you think you can, or whether you think you can't, you're right.’ So, we start with a positive attitude, ‘We can do this.’ Your brain gets on board and is like, ‘Okay, let's figure it out. We'll find out how to do it.’” (26:11—26:37)

“A healthy and aligned leadership team is really the catalyst for our practices being excellent — having a healthy culture, a healthy team, and being adaptable. This environment is ever-changing, so if we have all those things in place that we talked about today, you're golden. You're going for it.” (27:50—28:12)

Snippets:

0:00 Introduction.

1:42 Why this is an important topic.

3:51 Consensus is horrible.

4:40 You need to align, not agree.

7:25 Misalignment is felt by all.

9:35 The importance of vision and consistency.

15:30 Vulnerability-based trust and accountability.

20:45 Be in it for the long haul.

23:22 Alignment leads to results and bigger goals.

27:39 Last thoughts.

Adriana Booth, BS, RDH Bio:

Adriana Booth is a Lead Practice Coach who partners with dentists and their teams to cultivate leadership skills, build practice growth, and streamline business practices. After spending nearly two decades in the dental industry working with top-notch dental teams, Adriana came to ACT to share her passion for professional growth, high-level training, and systems creation with our clients.

As a dental hygienist with a love for continuing education and personal growth, helping a practice become successful is at the heart of her passion for dentistry.

Adriana has a B.S. in Dental Hygiene from West Liberty University/O’Hehir University. By being involved in several Columbus, Ohio, study clubs, Adriana maintains strong relationships within her local dental community. She enjoys a variety of fitness activities, family time, good books, and at the top of her list, her fur babies. 

The Restorative Diagnostic Practice

Episode #649 with Dr. Jim McKee

You're always busy — yet you make no money! Being a referral-based, fee-for-service, and diagnostic practice is the way to fix it, and Kirk Behrendt brings back Dr. Jim McKee, founder of Chicago Study Club, to share how to successfully build this type of practice. Enjoy dentistry while still making money! To learn how, listen to Episode 649 of The Best Practices Show!

Episode Resources:

• Send Dr. McKee an email
• Subscribe to The Best Practices Show podcast
• Join ACT’s To The Top Study Club
• See ACT’s Live Events Schedule
• Get The Best Practices Magazine for free!
• Write a review on iTunes

Links Mentioned in This Episode:

Register for Dr. McKee’s Advanced Occlusion course (February 29 - March 2, 2024)

Join Chicago Study Club

Main Takeaways:

Find something you enjoy doing and become an expert in it.

With dentistry becoming more complex, diagnostics is crucial.

Commit to training your staff. You can't build your practice alone.

In a referral-based practice, the caliber of patients you get is higher.

Quotes:

“When you have professional colleagues sending you patients, your patients are coming in at a different level. Having done traditional neighborhood dentistry for the first five, six, seven years of my career, I certainly know the difference. Patients come in more ready to say yes, and finances aren't as much of an issue. Not that there’s still not an issue, but they're a little more open to the discussion, and the first thing out of their mouth isn't, ‘Does insurance cover this?’” (5:30—5:56)

“The advantage of the in-network practice is you've got an unending number of new patients. I mean, it's awesome. You’ve got one new patient after the next. But the problem is you don't necessarily have enough time to work them up. You don't necessarily have enough time to develop a treatment plan and talk to them about it. And a lot of times, there's a mentality that, ‘I'm only going to do what insurance is going to cover,’ and that's okay because that's what they've been told. So, for that reason, I think it's the most challenging practice style out there today. The difficulty is, that's where a lot of young dentists end up out of school because they're paid well and it allows them to pay down some significant debt that they have. The problem is, you’ve got to get through those tough years until you go out and do something else, and you hope that you can make it through that.” (9:27—10:25)

“You’ve got to bring new patients in. And in order to bring them in, you need a specific skill set. If this is more of a generalized practice that just drills and fills teeth, these are the practices that are getting squeezed today because there's nothing to bring new patients into the office. Therefore, if a patient doesn't perceive a problem, they're going to go in-network because why would they pay more if they didn't have to?” (11:52—12:18)

“We always talk about profitability in dentistry. And it's interesting, most of the time when we talk about becoming more profitable, we're always talking about how to cut down on expenses to increase the profit level. The reality is, a lot of the times we have to look at the other end of the equation. Many times, we need to raise the revenue to be paid a little bit more appropriately for our services, which are then going to increase the profitability that we're able to do with those types of services. So, with this, there's going to be a higher cost to the patient. But here's the real key to the discussion. This practice absolutely demands a specific skill set, whether it's diagnosing joints, whether it's doing restorative dentistry, whether it's being an aesthetically trained dentist. No matter what it is, you have to have a specific skill set that brings people to you.” (12:51—13:56)

“Everyone talks about, ‘I want to get new patients referred to my practice.’ And that discussion is always talked about that, ‘I want patients to refer other patients to the practice.’ My advice is, if you can develop a practice where other dentists refer you patients, that is the most sustaining practice you will have, because it is not uncommon for a dentist to refer two to three patients a day to me, sometimes, depending upon who they see. That's not going to happen from a patient. And those dental-referred patients are already prescreened, so we basically know what they're coming in for. Those are patients that are more in my wheelhouse. It's more specifically designed for the skill set that we've been able to develop. And for that reason, I honestly think that's the most secure type of practice that's out there today. It insulates us from third-party issues. It provides a constant stream of new patients. It allows you to be profitable. It allows you to have time off to take continuing education to continue to build your skill set. It allows you to pay your staff more than they can get paid anywhere else in the community, which is going to promote long-term retention and decrease stress in the office. So, for me, that's the practice style. The problem is figuring out what you want your skill set to be.” (14:43—16:14)

“I remember back when the economy went south over the past 20 years. The few times it did, a lot of the aesthetic dentists sometimes took a little bit of a pounding because that was a discretionary-income-based need that the patient was filling. I was lucky, because if patients had growth problems, a patient had joint problems, if patients needed treatment planning issues worked out, those tended to not be as dependent upon the economy as some of the more discretionary items might be.” (17:34—18:13)

“I think the practice of the future is going to be a practice with multiple practitioners who can share specific skill sets. If you can develop a practice where you have three or four really good dentists that practice together and each emphasized a certain area, maybe one did joints and occlusion, one did airway, one did aesthetics, however you wanted to structure it, you can make that a specialty practice as well. The problem is, again, you have to keep a lot of people happy in that marriage.” (18:29—19:09)

“I've been talking to a dentist in the Chicagoland area about this concept of developing a multi-specialty practice for high-end dentistry. I think patients need it. You could imagine if you had one orthodontist, one periodontist, one oral surgeon, one restorative dentist, one joint dentist, and an airway dentist all under one roof who could collaborate, that would be a rocking practice.” (19:14—19:42)

“The practice that we're talking about, I think, gives you the best chance for a low overhead, because a lot of the dentists that we're talking to today, I'm sure you're hearing the same thing, they're saying they're too busy, they're too busy, they're too busy, they're too busy, and they're not profitable. But because they're having to write off fees because they're in-network — so, are you too busy, really? You're busy, but it's a case of working really hard for not maybe getting the financial reimbursement that you should be getting for working at that level. If you can develop this diagnostic practice, basically, you could do this having one front desk, two assistants, and a hygienist. You could probably have a four-person office if you were really clean about it. Five, maybe, if you wanted to have a lab tech and another help at the front desk. So, you don't have to have a big practice to do this. And that practice model can be modular where you could add on to that with another doctor, if you want. But I've got to be really clear. You don't have to do it. You could very easily make that a single-doctor practice and, I think, have a very sustaining practice if you were able to build that skill set and become more of a concierge type practice or a boutique type practice.” (20:51—22:28)

“There's definitely a practice within a practice. That's really how you build this practice. Your new patients could be the restorative practice. The diagnostic ones could be either new patients or patients who pull out of your own hygiene department. That's the beauty of this practice model. You've already got the patients there. You just need to bring them through in a different way so they're able to understand, a) the problem so, b) your solution makes sense. The biggest mistake I made is I provided solutions to patients who didn't understand they had a problem.” (25:03—25:38)

“There was an old saying, ‘Examination before diagnosis. Diagnosis before treatment planning.’ What we tend to do is jump right to treatment planning because we're looking to help people. And honestly, the exam gets cheated, and the diagnostics get cheated. Now, if all you're doing is filling teeth, you can probably get away with that. The problem is we're doing more today than just filling teeth. So, therefore, the exam really has to be at a different level than it's been before. We're not just looking to see if there are buccal caries on the lower first molar. We're looking at wear patterns, we're looking at joints, we're looking at gum tissue, we're looking at aesthetics, we're looking at airway, we're looking at facial development, all that stuff. And then, from there, what we have come to realize is that many of the patients that are coming to our practice have poorly developed mandibles and poorly developed maxillas. So, a lot of times, as restorative dentists, we have a foundation that hasn't developed very well. And then, all of a sudden, we're supposed to take not-great parts and create this masterpiece out of it where the teeth are exactly in the right place, and they look beautiful.” (26:17—27:41)

“The complexity of dentistry has changed. That's why I think, today, you can't get away from diagnosing, because most of the time we're not just putting fillings in teeth anymore. That's why the diagnosis part becomes critical. Because without that, your treatment plan — you don't know where to go with it.” (27:58—28:21)

“[Dentistry is] a whole different discussion today than it used to be even 10, 15 years ago. The ability to see MRIs, to see soft tissue and CT scans, to see heart tissue — it takes all the guesswork out of it. Which, honestly, you know what it does? It makes it fun. All of a sudden, the cases that used to make me nervous treatment planning, they're not there anymore because generally we understand what's happening at the back end of the system as well as the front end of the system, and we pretty much can give people answers. But not only can we give them answers, we can frame their expectations from a more realistic perspective. I used to promise the moon sometimes because I thought the only problem was muscle, and if I made a really good splint, they were going to get better. That's true if it's just a muscle problem. The reality is, there are more patients with structurally altered joints than we think. So, that's why if you're going to build a restorative diagnostic practice, my advice is to do it through the occlusion-joint or the occlusion-TMJ world because the need is so great, and there's no one out there answering the need.” (31:15—32:34)

“You have to be at a point in your career where you're ready to make a choice. For every dentist, that comes at different points in their career. I was fortunate to go into a small practice early, but I probably made my choice four, five, six years into it. When I talk to most young dentists, that's about the age where dentists start to realize, ‘I want to figure out where I want to spend my time in this profession.’ My advice is, find something you like and go after it. It doesn't matter what it is. Find something you like and become an expert at it. You're going to enjoy dentistry more. You'll attract people who have that need.” (32:51—33:40)

“If you really want to build this type of practice, you’ve got to commit to training your staff . . . Otherwise, it's too hard just for the dentist to pull the rope all by him or herself.” (33:42—33:59)

“Dentistry today, I think fee-for-service is alive and well. You have to be smart about it, and you have to choose something where there's a need, and where patients understand the need and are willing to pay for the need — but it's out there.” (34:06—34:20)

Snippets:

0:00 Introduction.

2:07 Dr. McKee’s background.

6:56 The three models of practice, explained.

16:38 Benefits of being a specialty practice.

20:33 You don't need a large practice for this to work.

22:45 You have a practice within your practice.

25:38 The diagnostic practice, explained.

28:23 About Dr. McKee’s course.

29:43 Occlusion, explained.

32:37 Last thoughts.

34:25 About Dr. McKee’s study club.

Dr. Jim McKee Bio:

Dr. Jim McKee is a member of the Spear Resident Faculty. He has maintained a private practice since 1984 in Downers Grove, Illinois, where he treats a wide variety of cases with a focus on predictable restorative dentistry. He is a member of the American Academy of Restorative Dentistry and former president of the American Equilibration Society. He has lectured both nationally and internationally for over 25 years and directs several study clubs. Dr. McKee graduated from the University of Notre Dame in 1980 and earned his dental degree from the University of Illinois College of Dentistry in 1984. 

Treating People, Not Patients

Episode #648 with Dr. Michael Sonick

Are you treating people, or just their teeth? To help you do both, Kirk Behrendt brings in Dr. Michael Sonick, author of Treating People, Not Patients, with ways to be hospitable, present, and empathetic for the people who choose your chair. Improve the way you connect with patients! To learn how to provide the Four Seasons experience in your dental office, listen to Episode 648 of The Best Practices Show!

Episode Resources:

• Send Dr. Sonick an email
• Join Dr. Sonick on Facebook
• Follow Dr. Sonick on Instagram
• Learn more on Dr. Sonick’s website
• Subscribe to The Best Practices Show podcast
• Join ACT’s To The Top Study Club
• See ACT’s Live Events Schedule
• Get The Best Practices Magazine for free!
• Write a review on iTunes

Links Mentioned in This Episode:

Register for Dr. Sonick’s course, The Art and Science of Exceptional Dentistry: Periodontal Mastery (November 1-3, 2023)

Read Blink by Malcolm Gladwell

Learn more about Culture Index

Main Takeaways:

Find mentors who can teach you “soft” skills.

Make patients feel safe and comfortable in your office.

Connect with the person in front of you — it doesn't take a lot.

Your patients are coming for great experiences, not great dentistry.

Quotes:

“Most dentists are not taught how to treat people in dental school. What are we taught? We're taught how to do crown lengthening, extractions, orthodontics, veneers, bonding. We even have requirements. You have to do 30 of these restorations. I had to make four dentures. I had to do six periodontal surgeries. I didn't have to be nice to anybody. I wasn't taught how to be nice to any of the people in my practice. They didn't teach us integrity. They didn't teach us transformational powers over patients. They didn't teach us neurolinguistic programming. They didn't teach us the most important thing that we can do for a patient — and that is to make them feel safe and comfortable in our environment.” (3:05—3:43)

“When a patient comes into a dental office, it's not the Four Seasons hotel. They come into our office, and we're not giving them a great experience. We're giving them an anesthetic. We're jabbing them. We have more knowledge than they do. We make them feel inferior. They already feel terrible because their mouths are in bad shape. They feel guilty. They come in with so much baggage and preconceived notions of what's going to happen to them when they're in our office. So, the first thing that I need to know about that patient is, what are they worried about? Let me take that away immediately. I try to find that out.” (4:38—5:09)

“For me, the restaurant became the model for running a good dental practice — except the restaurant is a little different. They don't serve dentistry, they serve food.” (7:03—7:11)

“You can't treat someone well just because you think they're worthy of being treated well.” (11:46—11:52)

“Have you ever been to a meeting, and you're there talking to someone, and they don't know who you are, and then, all of a sudden, they see somebody more “important” than you? They see George Bush behind you — I don't want to get political — or Arnold Schwarzenegger. They see him, and they go, ‘Let me talk to Arnold.’ The greats don't do that.” (11:54—12:11)

“There are plenty of restaurants that are beautiful, and they have good service — but the food isn't very good. You're not going back. So, the same with a dentist.” (14:25—14:33)

“It's hard for patients to assess our clinical skills, unless it's a single front tooth, or maybe even ortho. If their front six teeth are aligned — they don't know about the occlusion. How do they assess us? Were they nice? Did it hurt? What was the price? Those are easy ways to assess. But it really doesn't talk about the clinical skills.” (15:06—15:25)

“If you don't have the soft skills — and soft skills are the ability to relate to other human beings to get them to trust you, because it's really all about trust. If you don't get people to trust you, they're not going to buy from you. We're in a sales business. I don't think that's a dirty word anymore because we are in sales. We're professionals. What's the definition of professional? Someone who sells a skill.” (15:27—15:48)

“Everything that we did to become a dentist has nothing to do with soft skills. First of all, you had to get good grades in high school. Then, you had to get good board scores. Then, you had to join clubs. Then, you had to interview well. Then, you had to do well on your SATs. And then, you had to do well in dental school. But that doesn't really make you a good dentist. The process to become a dentist has nothing to do with being a good dentist, unfortunately. So, it's important to have those skills, but you have to know how to relate to other human beings and then make them feel comfortable.” (16:11—16:40)

“I think what's important for younger people is writing down a mission statement and figuring out where they want to go with their lives. Do you just want to do crowns all day long and make a lot of money? You can do that. Maybe you don't want to build your own private practice because you're going to have to have somebody to help you. I've worked with many dentists. I've had four or five partners over the course of my career, and most of the partners I've worked with don't really have that vision. They're great dentists and they are really smart. I try to encourage them to have that, but they don't feel it. So, can it be taught — which is an important thing. And I do think it can be.” (18:59—19:34)

“You're all unique in your own way. But there are certain skills that you can use to ameliorate the way you're practicing to get more patients to say yes to the treatment that you want to provide.” (19:57—20:06)

“I hope that you take away from [Treating People, Not Patients] the reason why you went to practice in the first place, and that's to help other people. In the book, it's 10 chapters, and each chapter has about 15 to 20 questions that you can use as a workbook. What you'll take away from the book is the importance of being there for patients, the importance of making a patient feel safe, the importance of creating a comfortable environment through décor, because people look at everything — as simple as fingernails. Do you have a written policy of what fingernails should look like? I mean, I don't want to talk to one of my female assistants and say, ‘Hey, you shouldn't have those long, pointy fingernails.’ But I can say that to them before I hire them so that there's an expectation.” (21:08—21:49)

“In my office, I don't get to see every patient. I don't get to have every interaction. I don't know how many interactions there are in a day. I'd say there are probably between 7,000 or 8,000 interactions in my office a day, between phone calls, emails, patients coming and going. Those are 7,000 or 8,000 opportunities for things to go wrong, so that whole team has to have the same philosophy built in. So, how do you create that team philosophy? I specifically show people how to create that in [Treating People, Not Patients].” (21:59—22:25)

“[The culture index] is my secret weapon. If I get somebody's culture, I know exactly who they are. My wife and I — they wouldn't fill them out, but I made all my family members fill them out. So, whenever I see their behavior, ‘Oh! Their culture index says they have a hard time making a decision, so they're having a hard time making a decision.’ So, I don't get upset with people for being who they are. And the culture index also shows us not who they are but who they're being in their job. What's cool is if someone comes in and they have a great culture index, but their job culture index shows them not happy, I tell them, ‘Oh, you're not happy at your job because you're forced to be not so social, and you have to be told to do something that you don't really want to do, and you're not very detailed, and you’ve got to make up for the creativity of your bosses because they don't have any.’ They go, ‘How did you know that?’ I go, ‘I looked at your seven dots.’ It's pretty cool. So, that's something that I love.” (28:09—29:04)

“There is turnover because people get married, people have babies, people leave for nine months, people have carpal tunnel. Things happen. I lost two of the best assistants I've ever had to the military because their husbands were restationed. So, we're always looking. The “bench” is really important. I always want to be overstaffed, not understaffed. Sometimes, one of my office managers will look and go, ‘They're standing around.’ I go, ‘I don't care. I don't care if they're standing around. We're getting the job done. We're meeting our production quotas. Everything is organized. If they want to stand around now, that's fine with me, because in about two hours they're going to be killing themselves. So, they can do that.’ So, I give my staff a tremendous amount of autonomy. But it is important to be overstaffed and to have that bench because you need it.” (29:46—30:30)

“It is slower growth if you're going to go fee-for-service. They're not going to say, ‘Oh, let me go down there because he doesn't take my insurance.’ You have to give them something that they're not going to get elsewhere, and that is a great experience because people are not coming for great dentistry. They're coming for great experiences. They're coming to be taken care of.” (33:54—34:11)

“There's nothing wrong with taking [insurance], and I realize that some people think you have to — but you don't.” (34:23—34:27)

“If you provide super high-quality care, give patients a lot of your time and attention, and spend an hour with every new patient, they're not going to get that anywhere else. And during that one hour, you get to give the patient choices so they can make the best decision. Now, my daughter is a dentist. She went to school in San Antonio, which is a good dental school. It's a procedure type school. A lot of procedures. So, she came out knowing a lot of procedures. As she was doing the procedures, and I've given this lecture to the residents at the perio program with Brian Mealey there, I said to her, ‘You have to give the patient choices, and then always let the patient say they can decide. And then, the first choice that you give them is to do nothing.’ ‘What do you mean?’ ‘You don't have to do anything. And the patient will say, what do you mean, not anything? And then, the decision gets shifted to the patient.’ It's amazing how many of my patients say, ‘No one has ever spent this much time.’ I don't even spend that much time with the patient. But I'm present, and I don't leave the room until they feel comfortable.” (34:46—35:43)

“I remember when I was in my teens, my father had to go see a dermatologist. He had some cancer on his face. Dr. Oestreicher — he's still practicing. He's like 80. He's in my town. He was by himself, and there were like 30 people in his waiting room. So, I went with my dad, and I walk into the room. Dr. Oestreicher walks in and starts the exam like that. I'm thinking like, ‘Hurry up, man. You’ve got 30 patients out there.’ I'm like 16. He's taking all the time in the world like there was nobody else. I wasn't like that when I first started. I thought I had to be busy all the time. I walk in a room with that new patient, or a patient of record, or a hygiene room, or whatever — that's the only person in front of me, and they feel that human connection. And it doesn't take a lot to connect. Just make some eye contact. Talk to them. It's amazing how patients will respond to that.” (35:43—36:37)

“My moonshot is to improve the way doctors and all healthcare providers interact with the people that they serve, and that is by being hospitable and by being present. Almost everybody I talk to does not have a good experience with their dentist, with their doctor, with their healthcare provider, even if they're seeing a PA or a nurse. And I'm a patient. We'll talk about that another time. I've had a lot of dental work done. I have 23 crowns. I've lost nine teeth. I've had two bad bike accidents. I've been on the other side, and I've gotten great care as an adult — not as a kid, but as an adult, I did — and it means a lot. So, I can relate to the patients.” (38:03—38:41)

“You can't tell your team like, ‘Let's treat patients better.’ That doesn't mean anything. You have to have some tools for it.” (39:07—39:11)

Snippets:

0:00 Introduction.

1:35 Dr. Sonick’s background.

5:14 Why Dr. Sonick wrote Treating People, Not Patients.

12:49 Why having soft skills is important.

20:48 Takeaways from his book.

23:00 Dr. Sonick’s hiring process.

29:10 It’s better to be overstaffed rather than understaffed.

30:41 Going fee-for-service.

37:23 Last thoughts.

39:42 More about Dr. Sonick’s courses.

Dr. Michael Sonick Bio:

Dr. Michael Sonick, DMD, is an internationally known, highly regarded authority in the field of Dental Implantology and Periodontology. He completed his undergraduate degree at Colgate University and received his DMD at the University of Connecticut School of Medicine and his certificate in Periodontology at Emory University. He received his implant training at Harvard University as well as the Brånemark Clinic in Gothenburg, Sweden. A full-time practicing periodontist in Fairfield, Connecticut, he is also a frequent guest lecturer in the international program at New York University School of Dentistry and the University of Connecticut School of Dental Medicine. Dr. Sonick is a diplomate of the American Board of Periodontology, a diplomate of the International Congress of Oral Implantology, a fellow of the International Team for Implantology, a fellow of the International Society of Periodontal Plastic Surgeons, and an Eagle Scout. His mission is to improve the quality of patients’ lives as well as the lives of everyone he meets. 

How to Say NO!

Episode #647 with Robyn Theisen

Saying no can be hard — but it’s not as hard as you think! If you have a hard time saying no, don't miss this episode. Kirk Behrendt brings back Robyn Theisen, one of ACT’s amazing coaches, to share how to have the conversation in a clear, effective, and non-emotional way. Start saying yes to saying no! To learn how, listen to Episode 647 of The Best Practices Show!

Episode Resources:

• Send Robyn an email
• Follow Robyn on ACT’s Instagram
• Subscribe to The Best Practices Show podcast
• Join ACT’s To The Top Study Club
• See ACT’s Live Events Schedule
• Get The Best Practices Magazine for free!
• Write a review on iTunes

Main Takeaways:

Say no to things you know you should say no to.

“No” can be a non-emotional conversation.

Set clear boundaries and expectations.

Saying no isn't as scary as you think.

Get good at being clear, not nice.

Quotes:

“I find, mostly, that people don't know how to have the conversation. That's the hardest part, is that people or leaders interpret [saying no] as it's going to have to be challenging or emotional or difficult. If you handle the conversations correctly and have the right pieces in place to be very clear about your expectations to begin with, I find they're easier to have.” (2:22—2:47) -Robyn

“You, as a dentist, have to get things going in your life, so you say yes to a lot of things. If you look at the early years of your practice, a yes was a good thing. Yes to patients, ‘Yes, I'll do this. Yes, I'll do that.’ Yes, yes, yes, yes. Well, the yes creates a lot of activity. And then, there's a certain point in your career where yes doesn't provide any more value. Yes just makes you more miserable. The new word that you have to use is “no”, because no keeps it all in a container. If you say yes to everything, you're never home, you have every PPO on the planet, you're seeing every patient, you're saying yes to every team member request, every patient request, and you take all these on as your own burdens, and you're miserable.” (3:34—4:14) -Kirk

“Expectations minus reality equals conflict. This is so true in the no versus yes. Are the expectations clear and allow you to either go down the yes or the no path based on the expectations that you've set up? That is one of the first things when I'm met with a challenge or something that I'm going to say no to, was I clear with how I set it up to begin with? And from a team member perspective, am I clear to everybody so that that expectation is set for everybody on the team?” (4:31—5:01) -Robyn

“When there's conflict, I always check myself. Was I clear from the beginning? Was there some room for gray area? Or as the leader, how could I have said this better or more clearly so that there isn't conflict, or the no doesn't have to necessarily come up? And so, I want to check myself with how that expectation was set to begin with.” (6:07—6:27) -Robyn

“When conflict is unresolved, it eventually becomes crisis. Whether it be perio, whether it be a relationship, whether it be money — you can't just live in conflict. Conflict has to have resolution, at some point. And so, having it fester, grow, and compound usually ends up in a relationship falling apart, or a health circumstance. So, you want to minimize it. It's okay to have conflict, but then we've got to resolve it and go back to it.” (6:36—7:04) -Kirk

“If there's a question that keeps coming up, there is that opportunity to go back and say, ‘Do I need to be more clear in my employee manual? Do I need to reset the expectations so that we're all on the same page?’ and be able to check yourself that way. The employee manual is the best way to start team members off with knowing what the expectations are and setting yourself up for success, both with them and for you.” (7:24—7:45) -Robyn

“In today's environment where everybody is so nervous about addressing or saying no to team members for fear of losing them, or just in the hiring market that we have, if you set this up clearly from the beginning and your new team members know exactly what the boundary is, there isn't room for there to be conflict, or there isn't room for them to misunderstand what your expectation is on how they arrive to work. What is the expectation about time off and how you request that? If we set them up from the very beginning, there isn't the conflict to feel nervous about saying no for fear that they're not going to be a part of the team, or they're going to be upset about it.” (8:30—9:04) -Robyn

“A healthy team doesn't experience entitled team members. Now, you might not want to hear that, but that's true. I don't find a healthy team where great team members are like, ‘No, I'm entitled to this.’ No — they are all built with the right behaviors, the right mental capacity, the right buy-in. And that is a function of leadership.” (9:34—9:56) -Kirk

“It's about knowing how to have the conversation. Things are going to come up, and so we avoid them. And by avoiding them, it makes matters worse. Like you were saying earlier, if there is some type of conflict there, it is going to put strain on the relationship until it comes to the head. And oftentimes, then it explodes. So, knowing how to have the conversation to begin with is an important part of it, and how to do it so it doesn't have to be emotion-filled. It's factual, and you're having a conversation to come to a resolution.” (10:42—11:11) -Robyn

“One of the most important pieces is to find some common ground when you're in disagreement. ‘Okay, can we both agree that we need to build a great team here and that we have to do X, Y, Z?’ You’ve got to start somewhere, because if you feel one way and I feel one way, it's going to become highly emotional and potentially explosive unless we can find some common ground about who we are as a group of people.” (11:12—11:37) -Kirk

“Having a set of core values is the most important thing you will ever do in a business because we can always trace back. And I'll tell you exactly how you use it. You use core values when it's positive, but you also use them when you get into potentially very difficult situations. I can say, at any point, ‘Listen, we are a team that believes all-in attitude. We give greater than get. Would you agree?’ Everybody that's here has to say yes — not because I'm making them say yes, but because they bought into that. So, we don't have to agree, but we do have to align on how we're going to support that value system.” (11:40—12:17) -Kirk

“It is really important to enter the conversation in a place where you are emotionally stable about it or not heated about it. [Otherwise], the conversation starts off on the wrong foot. So, if it takes you a minute to be able to collect your thoughts and cool down from it . . . I also think you have to go in it with the idea that you want to resolve this. We're asking questions in the conversation because the relationship is important, and we want to come to a resolution — not because we're mad about this, or we want to be right. We want to enter it in a place where I want to understand where the other person is coming from and be in the right emotional space to hear them and be able to work through for a resolution.” (12:50—13:28) -Robyn

“If we just want to be right, you're in a totally different emotional space when you are coming at this with trying to prove a point and asking questions for that reason rather than asking questions to understand or to clarify.” (13:30—13:43) -Robyn

“Dealing with somebody who has to be right is very difficult. I have been that person where I'm trying to be right. I always tell myself, ‘I don't want to be right.’ But there are times I do. And so, when Covey taught that principle, seek first to understand before being understood, those weren't just words. Those are actually really good practices. So, even when you're angry, and you're upset, and you're out of equity with somebody, and you have a lot of conflict going on inside, it's often best to ask a question and go, ‘Okay. Can someone help me understand what just happened here?’ because it'll take everybody from the emotional part of the brain to the thinking brain, and we can start to unpackage this because there are some things you may not see.” (13:49—14:34) -Robyn

“It could be that they have a totally different perspective on this. So, have your ears open to really listen. If you're going to ask the question, be prepared to listen and accept what they're telling you.” (14:37—14:47) -Robyn

“My dad gave me this advice: ‘Son, you're marrying a great woman, Sarah. You can be right, or you can be married — but you can't be both.’ I use that in my marriage, I use it at home, I use it with my team. And so, I'll say this to you as a dentist listening. There are going to be times where you're going to be like, ‘Okay. Do I want to be right, or do I want a team?’ It's a great question, because you can still eventually get the practice where you want it to be from a vision standpoint, but you don't have to lay down the hammer right now and tell everybody you're right because it's taking you further back than it is forward, in some respects.” (14:51—15:29) -Kirk

“[By listening], potentially, you learn something. Potentially, the way you wrote the employee manual or the way you intended it to be is not the way they interpret it. That goes back to the expectations piece. Do we need to change something there? If one person is having the questions, others potentially are. So, you learn something from it and can clarify it so that the issue doesn't arise again.” (15:30—15:51) -Robyn

“It’s better to be consistent than it is to be perfect or excellent all the time. I think if your behavior as a leader is consistent and you're calm, people can buy into that. They can go, ‘I know he's probably not going to like this, but he's going to be calm about it.’” (15:53—16:07) -Kirk

“Circle back when you make an agreement. If there is a, ‘We're going to follow back on this in 30 days,’ make sure that you do that. If it's important to you to resolve, make sure that you follow back with them. If you set the time to do it, be intentional about that and set the time to circle back.” (17:26—17:41) -Robyn

“It also is helpful, when that agreement gets violated, to be able to go back to the team member, or your partner, your kids, whoever that is, and be able to say, ‘So, my understanding of the agreement was this. Here's what happened. Help me to understand what happened there because this is what we agreed to.’ Again, it doesn't have to be an emotional thing. ‘We talked about this. This is what we both agreed to. In what I'm seeing here, this doesn't feel like what we agreed to.’ It gives you permission to be able to circle back and have expectations for what the outcome is.” (18:06—18:39) -Robyn

“The better you get at saying no, the more people will be okay on both sides. When you deliver the no, and then when they see the no, you go, ‘Wow, that didn't go so bad.’ People don't freak out as much as you think they will. And then, ultimately, what you want to create is team trust. Team trust knows that when they come to the bald guy, ‘I already know what he's going to say. He's going to say no, and that's okay.’ And so, it's one of those things that as you work on this in your family and in your business, you'll get so good at saying no to the things you know you have to say no to.” (18:44—19:17) -Kirk

“Another thing that we get very good at is there's one thing that happens, we avoid the conflict, and then these other behaviors start to stack up. So, then it adds more fuel to the fire. It is best to be timely if there's something that has gone off the rails or isn't right. Address it at the time. Don't allow it to stack and have more emotion go into it rather than addressing it head on, take care of it at this time, and go forward.” (19:35—20:01) -Robyn

“Classic in a dental office, you're in between patients, everything is busy, and it's like you're having these one-off conversations in the hall. Take the time to sit down and have a conversation that allows you to listen. I had a mentor one time tell me what these conversations are. Don't allow the other person to make you be unprofessional. Stay professional. Don't let their emotions get the best of you. Be well-thought-out. Have the time and place to sit down and stay professional in the way that you're delivering the message.” (20:04—20:32) -Robyn

“How these conversations happen is, ‘This is what you did. This is how you made me feel,’ all of these very blaming accusations. Instead, use “I” statements. ‘Here is what I saw.’ Be very specific. ‘Here is how I interpreted it,’ any of those “I” statements to take it back to you, and then ask them for clarification. ‘Is that how you intended? Am I correct in how I saw that? Am I correct in how I heard that?’ So, it is more of a conversation rather than a blame game of, ‘This is what you did. This is how you did it.’ People get very defensive about that, and that doesn't make for a conversation. It makes for a defensive argument.” (20:47—21:22) -Robyn

“The same mentor that told me to stay professional also said, ‘No one can make you feel a certain way. You are allowing yourself to do that.’ So, remove that from the way that you phrase it to them. Take responsibility for how you saw it, and give it from your perspective, not blaming somebody else for how they made you feel.” (21:41—21:59) -Robyn

“You can only feel bad if you let somebody else make you feel bad.” (22:08—22:11) -Kirk

“Being clear is kind. So, your expectations, setting those out. If you get the same question from several team members, I would encourage you to go back to yourself. Were your expectations set clear? If it's a common question, potentially, there is some more clarification that you need to put in there.” (22:22—22:39) -Robyn

“I encourage [teams] to eliminate the words “unfortunately,” “but”, and “however,” from their language and instead add “and”. It makes you change the way that you say the statement, and it changes the way that it's heard. So, you say you want to tell people what you can do, not what you can't. And you started the sentence by telling them what was negative. So, it started with, “unfortunately.” Which, after “unfortunately,” “but,” and “however,” anything that follows is a negative. That is how people and patients and your team interpret it. So, tell them what you can do. Insert “and” instead and remove those other three words.” (23:29—24:04) -Robyn

Snippets:

0:00 Introduction.

1:37 Why saying no is important.

3:27 E – R = C.

6:27 Create an employee manual.

7:48 Set clear boundaries.

9:04 Set clear expectations.

10:15 Know how to have the hard conversations.

12:27 Get out of the emotional zone.

14:48 You can be “right”, or you can have a team.

17:07 Follow up on your agreements.

18:39 Saying no isn't as bad as you think.

19:25 Address conflict in a timely, professional manner.

22:17 Clear is kind.

23:01 Eliminate these three words from your language.

Robyn Theisen Bio:

Robyn Theisen brings an entire life and legacy of dental experience to the team and every team with which she works as the daughter and sister of dentists. With almost 20 years of experience in dentistry, her roles ranged from practice management to operations at Patterson Dental to coaching teams. Robyn’s passion is empowering teams to realize that they can dramatically impact the lives of the people they serve by implementing skills and systems to remove barriers to life-changing dental treatment. She has done it for decades and does it every day with dental teams.

Outside of coaching, she enjoys time with her husband, Rob, and two daughters, Emerson and Ruby. She loves traveling, music, fitness, and cheering on the Michigan State Spartans. 

The 1 Key You Need to Get Started on a Better Practice and a Better Life

Episode #646 with Heather Crockett

If you're feeling stuck and want to change, now is the time to do it. To help you get started, Kirk Behrendt brings back Heather Crockett, one of ACT’s amazing coaches, with the number-one key to making change and progress in any part of your life. It’s time to stop sabotaging your success! To learn how to get out of your own way, listen to Episode 646 of The Best Practices Show!

Episode Resources:

• Send Heather an email
• Join Heather on Facebook
• Follow Heather on ACT’s Instagram
• Subscribe to The Best Practices Show podcast
• Join ACT’s To The Top Study Club
• See ACT’s Live Events Schedule
• Get The Best Practices Magazine for free!
• Write a review on iTunes

Links Mentioned in This Episode:

Schedule a call with Gina!

Main Takeaways:

Getting started is the hardest part of anything.

Stop getting in the way of your own success.

Find someone to help you be accountable.

Now is always the time for change.

Don't stay stuck!

Quotes:

“We oftentimes get in our own way of seeing that success of getting started. So many doctors, especially clients that I coach, tell me that they wish they would have started sooner. That's why this is important.” (2:29—2:43) -Heather

“People say, ‘Well, change takes time.’ No, it doesn't. Change takes a second. All you have to decide is, ‘Today is the day. I'm done. I'm changing. I'm signing up for a new program.’ Now, the key is, change has to be sustained.” (2:47—3:00) -Kirk

“One of my favorite coaches of all time, when I was in the toughest spot of all time in running ACT Dental, I reached out to him for help. I said, ‘I'm going to wait. I'm going to wait until next summer.’ He said, ‘Kirk, what's the benefit of waiting?’ I didn't have an answer. I remember exactly where I was. I was in the parking lot talking to him on the phone. He said, ‘There's no benefit. You're going to call me next summer, and you're going to be older, and these problems are going to be bigger. There's no benefit to waiting.’” (3:04—3:38) -Kirk

“What dentists often think is that they want their practice to be better. They want their life to be better — like you wanted your company to get better. But, ‘I'll wait for that perfect moment.’ When I was recently sitting in church, one of the speakers shared this with us. He said, ‘If not you, then who? And if not now, when?’ That really resonated with me. Of course, I'm thinking of things that pop into my own head, ideas that are coming to me for my own personal life. But I'm also thinking about my work life, and my clients, and their team members as well with this thought-provoking statement. This immediately brings those insightful thoughts to your brain, exactly like what you experienced, Kirk, with that coach. Why are we waiting? It causes us to step back for a minute and evaluate our current circumstances to say, ‘Okay, what is it exactly that we want to achieve, and how quickly do we want to achieve it?’” (3:50—4:47) -Heather

“Some of you think, ‘Well, I've got to start my own practice.’ The day you decided that was a beautiful day, and you found the resources. Some of you decided to move your practice to another location. All you have to do is start the search. And so, just the decision in your brain to take the initiative is really important.” (5:12—5:31) -Kirk

“Nobody controls you and what you do. Right? Taking that initiative has to be self-motivating. You have to be aware of the situation first, aware that your practice needs improving, aware that — for me, it's that I want to get back into yoga again. I used to be really good at that. For me, it's that self-awareness that, ‘Gosh, I haven't done yoga in so long. That's probably why my body is screaming at me half of the time.’ So, you have that awareness piece, but that self-management of taking initiative, that's the change that you were talking about. That's the first thing that you have to do, is say, ‘I'm going to make a change, and I'm going to make this happen.’ But you can't do it alone.” (6:08—6:50) -Heather

“The first step is just being aware. The more aware you are of your situation, the more you get annoyed with yourself because you want to see that change take place. So, taking that initiative and that first step.” (6:56—7:09) -Heather

“You'll naturally face two evils, and the two evils will be procrastination and perfection. You always want to, ‘I'm going to wait.’ And then, the second one is, ‘Well, I've got to get this perfect before I start.’” (7:19—7:33) -Kirk

“You've got to get moving. You've got to start somewhere. That's where “Get Mo” comes from. Start to move. Start to take some action and get moving on whatever it is that you're hoping to achieve.” (7:44—7:56) -Heather

“One of the concepts that I like that works for me is the 80% approach by Dan Sullivan. So, procrastination and perfection get in the way, for me, daily. Now, the important thing of getting anything to 80% is I'll draft it up, I'll look it up. Some ideas don't make it to implementation. But the fact is I drafted it, I looked at it, I had other people look at it, and we're just going to start it. And it can take an instant to do that.” (7:58—8:25) -Kirk

“Do you ever wait for the “perfect” moment to start something? For example, do you remember when Biggest Loser was really big on TV? I used to watch that all the time. There were so many contestants on there that would say, ‘Oh, I'll start Monday. I'll start Monday.’ So, ‘On Monday, then I will weigh myself. Then, I'll start counting calories. Then, I'll start exercising.’ But after 52 Mondays, you realize that you're a year older and you never started on Monday. We make these excuses, as humans, over and over and over. It's natural for us to make those excuses. We put barriers in our way because change is hard and uncomfortable.” (8:34—9:17) -Heather

“Change is hard. Complacency is easy. It's really easy to sit in front of the TV and eat some ice cream at night before I go to bed. It's really easy to do that. It's much harder to pick up and move, and do my yoga, or do a HIIT class, whatever it is that people are doing now. That's so much harder than sitting back and taking it easy. But that's what gets in our way, because we wait for the “perfect” moment. ‘Oh, I'll wait till Monday.’ What's wrong with right now?” (9:19—9:52) -Heather

“I don't know who said it, but 90% of success is just showing up. I have found that to be absolutely true. Whether it be a study club, whether it be a course, there are so many things I signed up for and I'm like, ‘I don't know . . . Oh, I'm glad I signed up for this! I had no idea.’ You show up, you meet somebody, and you're like, ‘I am so darn glad I'm here.’” (10:19—10:38) -Kirk

“I used to say this years ago when I went to a gym. The hardest part of any day is putting on those shoes, because as soon as I put the shoes on, I'm actually halfway to the gym. The old gym that my wife and I used to go to had a sign right above the door, ‘Congratulations. The hardest part of your day is over. You got here.’ And I'm like, bam — that's it. So, sometimes you’ve just got to get there.” (10:54—11:15) -Kirk

“Nobody, at any age, knows how many Mondays they have left. One of the questions that I ask a lot of my clients when we go through a brainstorming exercise to figure out what it is that they want, because sometimes even my clients are like, ‘I don't know what I want. I just want things to be better.’ So, I will ask them a series of questions. One of the questions I ask my clients is, ‘If you died in three years, what would you want to accomplish in those three years?’ It helps put things into perspective. What it does is it tells me what's the most important to them, and what we should take action on now.” (11:24—11:59) -Heather

“Human beings need other human beings to help them get out of their own way, because we stick back into that “complacency is easy” mode. It's easy. ‘Oh, I'm comfortable sitting on the couch in my jammies with ice cream.’ That's easy. I'm not as motivated. Now, if I know that I have to report back to someone, or someone's holding me accountable to doing those things, or my friend is expecting me at 6:00 a.m. to do yoga together, I'm going to actually show up and I'm going to do it.” (12:21—12:52) -Heather

“Other people are going to keep track of what you promised, and then give you deadlines so that you can actually accomplish those things within that time frame. They're going to ask you about it. They're going to give you the support that you need. We talked about Biggest Loser, and I'm going to talk about another TV show. I promise, I don't just watch TV, but lately I've been pulled into Shark Tank. And these entrepreneurs, they're looking for that accountability piece too. They're also looking for someone to help them to see things that they don't see. They want another perspective, and that's what these other human beings can do for us too. I can sit in a yoga class, and the yoga instructor can say, ‘Yes, that looks great. And if you twist this way, or stretch a little further this way,’ or your Peloton instructor, they push you a little bit further so that you do things that you didn't even realize you were capable of. That's that whole accountability piece. That's when that magic happens, when you involve other human beings in what it is that you're trying to achieve.” (14:19—15:19) -Heather

“If you ever said to yourself as a dentist, ‘I'll just build a business. I don't need anybody's help,’ that's silly or arrogant, one of the two, because you need the help of a great accountant. You need the help of a great consultant. I mean, you’ve got all these things that you cannot do yourself. And a great coach can say, ‘Don't do that. That's dumb.’ A great coach also doesn't work in your business, so they don't care. They don't have the emotional constraints that you and your team have about upsetting anybody. They're going to do it for the benefit of the practice. And my whole point in saying this is that you can lean into accountability. It's quite wonderful when you don't have to fill your brain with, ‘How do I figure this out?’ or, ‘How do I do this next?’” (15:57—16:41) -Kirk

“I often say this to my clients. You're getting in your own way . . . We get in our own way. We make excuses. We place blame. You can make excuses or progress, but you can't make both.” (19:01—19:15) -Heather

“You get in your own way. So, enlist the help of someone that will help you to get out of your way, and then take that first step.” (19:35—19:43) -Heather

“If you're stuck, don't stay stuck. There's nothing worse than being stuck — other than talking to yourself about being stuck. That makes it worse. And 80% of self-talk is usually negative, so you don't want to do that either. You need to start talking to somebody going, ‘Stop talking like that. That's not true. Let's get you out of the mud.’” (21:07—21:26) -Kirk

Snippets:

0:00 Introduction.

2:19 Why this is important for your practice.

4:49 Take initiative and have self-awareness.

7:56 If not now, when?

12:01 Find others to help you with accountability.

18:55 Last thoughts.

Heather Crockett Bio:

Heather Crockett is a Lead Practice Coach who finds joy in not only improving practices but improving the lives of those she coaches as well. With over 20 years of combined experience in assisting, office management, and clinical dental hygiene, her awareness supports many aspects of the practice setting.

Heather received her dental hygiene degree from the Utah College of Dental Hygiene in 2008. Networking in the dental community comes easy to her, and she loves to connect with like-minded colleagues on social media. Heather enjoys both attending and presenting continuing education to expand her knowledge and learn from her friends and colleagues.

She enjoys hanging out with her husband, three sons, and their dog, Moki, scrolling through social media, watching football, and traveling.

5 Signs You Have a Productive and Profitable Dental Admin Team

Episode #645 with Ariel Juday

Is your admin team unproductive? Before blaming them, look at the systems you have! To show you what a productive team looks like and how you can achieve it, Kirk Behrendt brings back Ariel Juday, one of ACT’s amazing coaches, with systems to help you support the backbone of your practice. To create processes and systems that everyone can understand and follow, listen to Episode 645 of The Best Practices Show!

Episode Resources:

• Send Ariel an email
• Follow Ariel on ACT’s Instagram
• Subscribe to The Best Practices Show podcast
• Join ACT’s To The Top Study Club
• See ACT’s Live Events Schedule
• Get The Best Practices Magazine for free!
• Write a review on iTunes

Links Mentioned in This Episode:

Get your free copy of ACT’s Managing an Accounts Receivable and Collections System

Main Takeaways:

Set clear expectations and processes that your entire team understands.

Have systems for insurance verification, billing, collections, and budgets.

Go above and beyond to create a review-worthy patient experience.

Have designated billers for insurance and for patient billing.

Keep your collections percentage at 98% — at minimum.

Create systems to keep a full schedule.

Quotes:

“The admin team are the ones that don't necessarily have the most training. They don't always have the most support. But really, they are the glue that holds the team together. If you can have a profitable and productive admin team, things will go so much smoother. The doctors and dentists, they need to know and understand how they can support their admin team and go off of the facts and not just the feelings.” (2:18—2:48)

“Let's look at our processes and our systems first before you go blame the team member.” (5:04—5:09)

“You need clear systems and processes, and you need to be able to see these. As a dentist, you don't need to be able to understand them. You don't need to be able to do every step. But you need to be able to ask them, what is the system? I would say a couple of the most important ones is a streamlined patient intake process. How is your admin team member getting patients their information on the phone? How are they getting them through the door? And then, taking it one step above, not only are we getting their new patient forms because, yes, everyone needs that, but once they get to that really productive level, are your admin team members tracking how long patients are waiting? Are they keeping an eye on those patients if they are waiting? Are they offering refreshments? Do they stand and greet them by name? So, not only are they getting them in and getting their paperwork, but how are they making them feel? And is that intake process — does everyone know the expectations?” (5:17—6:21)

“[Dentists are] like, ‘Oh, I'm on time.’ Great. Are you really? And then, let's say you're behind three minutes. In the grand scheme, three minutes isn't a really long time. But could you imagine if you and I stared at each other for three minutes? They're going to be like, ‘What’s going on?’ It would feel like an eternity, versus, we said, ‘Hey, we're going to take a three-minute moment of silence.’ Everyone knows they can look at their watch. And it's the same with patients. If you're running five minutes behind and we can tell them that when they walk in the door, then they are more willing, and it doesn't feel [as long]. But if they're just waiting, they're seeing other patients being taken back, and other patients are leaving, and now they're looking at their watch — it feels much longer when you don't know how long you're supposed to be waiting.” (7:11—8:06)

“[You] have to have a clear system and expectations of who does what, when, because you'll see that the insurance verification is one thing that really will sneak up on team members, and it can really hinder or enhance a patient's visit. Not because we tell the patients, but it's how prepared we can be by letting them know, ‘We were able to verify your dental insurance is active. This is your coverage.’ When you're going over their treatment estimates, you're able to bring in their personalized benefits. And so, we have to have that verified before the patients arrive — when possible. I know not every patient will give you the information. They don't even always know who they have, and that's okay. But when possible, have it before they arrive. And you want to know what information needs to be verified. Some practices will do a very detailed breakdown. Others will do a simplified version. It really depends on their practice and what the expectations are. And then, even take it one step further. Where do I put that information? Having it verified is one thing, but who needs to be able to have access to it? I would say this is an area of opportunity for most practices.” (8:54—10:22)

“If you're going to make one investment for your admin team members, online insurance verification is very helpful. It's definitely an investment, but it saves the team members so much time. Because, doctors, if you've never had to call an insurance company, be prepared to wait a minimum of 30 to 45 minutes before you get in contact with someone — and that's just hoping that that person will be able to answer your questions.” (10:55—11:27)

“Once you have a good insurance verification process, now you can have a better billing process. One thing I would say is, ask your team members when claims are being sent. If you're an admin team member listening to me, I would tell you this. There is no reason that claims should not be sent on a daily basis. They are electronic. It's a push of a button. Yes, you have to review. Yes, there are things. Yes, you have to do attachments. There is no reason that they should not be sent on a daily basis. Sure, maybe you miss one day here because, who knows what happened? But I would say claims should be sent the same day or next day. That's including with attachments, and that's including following up on denied claims. You have to have a clear billing process on, who sends the claims? Who creates the attachments? Where are the narratives coming from? Do we have the appropriate X-rays? Do we have the appropriate photos? Where is all that? So, when I say, yes, send your claims — yes, that's the easy part. It's the whole process in the system leading up to how claims get sent.” (12:07—13:21)

“You can't just say, ‘We collect at time of service.’ Great. I hope you do. And if you are, we can talk about some of the over-the-counter collections and that KPI to track. But what happens when a claim is paid, and insurance didn't pay what we were expecting? What is your collections process for a patient that comes in and someone on their account has a balance? You have to have a clear collections process. So, as soon as those claims are being paid and balances are being created, who makes a phone call? Who sends a statement? When do they make that phone call? When do they send the statement? If you have your billing person or your collections person and they say, ‘Oh, I send statements once a month,’ it's not enough. You have to be doing it more.” (13:43—14:35)

“I highly recommend your billings and your collections person be separate. Checks and balances. I don't ever like the same person following up on insurance claims and following up on patient balances. They go hand in hand, yes. But I think that's where you need two individuals as a team. It really helps with the checks and balances.” (14:38—15:02)

“I want to know that my patient is going to take care of that balance before going back and getting more treatment done — because they don't want to talk money. Patients don't want to. They know that's okay. However, it's a better dental appointment if they can get the collections out of the way and focus on their dental care. We've always said try to separate the appointment and the finances. Same thing with collections. No one likes to owe people money. So, if I can get it done and get it taken care of, they're not dreading that dental appointment. They're not dreading the end of it when they have to come and talk to me. I can get it taken care of ahead of time. I know that they're going to pay because they're not increasing. And yes, every now and then, you have the patient that says, ‘Oh, I didn't know,’ or, ‘I couldn't afford this,’ or, ‘I can't.’ Now, you can make the call of, ‘Okay. Should we reschedule this patient?’ Because you don't want to be doing dentistry for free without knowing it. That's what happens to teams. They let the patient go back, they get the treatment done, and then they come up. And what do you do? You're kind of handcuffed when the patient says, ‘Well, I can't afford that.’” (15:43—16:58)

“Over-the-counter collections — yes, literally over the counter. Let's not do anything under the counter. Over the counter on the same day as treatment. So, yes, they can come back two days later. However, in my mind, that's us being thankful that the patient was a good patient and a good person, coming back to pay their bill. There's no difference between me sending them a statement or giving them a phone call and taking that over the phone. And so, it's on the day of what I should be collecting. So, it's, ‘This is insurance. I'm estimating this is what insurance is going to cover.’ What is my patient investment? That's what I should be collecting on the day of service. Or if you're really good, at the time of scheduling.” (17:55—18:45)

“[If your over-the-counter collections is not growing], that means your team is doing a lot of work on the back end, and the strength of having the comfortable conversations of collections is not there. Your team is focused more on sending those texts to pay, focused more on sending those statements. So, just because your overall collections may be good — that means you actually have a good patient base that is loyal, and they pay their bills. If you have a good over-the-counter, that means you have a good system and process in place, and that your admin team are really taking care of business.” (19:06—19:44)

“If a dental admin team is highly productive and profitable, they understand the budget of, ‘When can I order specific supplies? When are the specific supplies that I need coming up on sale?’ and looking for deals. They're not just ordering a ream of paper here, a pack of highlighters, a pen. They have a process in place. I see this a lot with teams, is the supply budget is one of the ones that is the easiest to get out of hand, but it's also one of the easiest to control. Not that you have to pinch pennies all the time, but if your admin team knows every September is back-to-school, they can get some of those deals. And if they're looking out for your overhead, then it's going to return to them in the long run. That takes your admin team to a whole other level, is when they're looking at what goes above and beyond their job description or their day-to-day.” (21:22—22:31)

“Have designated billers for both insurance and patient billing, not only for checks and balances, but because one person, really — that would be a lot of time. If you want your patient billing and your insurance billing to be followed up on a regular basis, you need multiple people doing that. As we talked about, the length of getting an insurance verification, following up on unpaid claims, that's a lengthy process. Yes, you can see the status online. But most of the time, that does have to be done by phone call in order to see, what documents did you not receive? What do you need to do? Who can I send this to? Sometimes, you can get direct contact information and say, ‘If I fax it to this number, can it get processed today?’ And the same thing with patient billing, is you want one person working on it on a consistent basis. I would say at least have blocked out time, weekly. But really good, productive teams have a process that it's part of their daily process.” (22:41—23:49)

“We talk about block scheduling for the clinical side. Same thing with the admin team members. They need to have some kind of designated block scheduling. Because if you can imagine, you're trying to create a good patient experience, and you want to spend the time talking to them about where their balance is coming from. But you have patients coming in, checking in, checking out, and you're doing other things on the back end. The patient knows that, and they can feel that. And so, not necessarily that they will be able to step away, but maybe they know, during the lunch hour while doctor and the clinical team is on lunch, this is my hour that I can spend on following up on patient collections. Insurance, if I'm following up on insurance claims, you need to know what time of day you can call. Because if you're trying to call in the afternoons or evenings, you're not getting through. So, that's something that's like, first thing in the morning, I know I need to call to get in the queue early. They have to have that blocked time because if they're just going to work it in, we know — I mean, if I say, ‘I'll get it done today,’ it's not a priority. And this is something that needs to be a priority, just as much as taking care of the patients in the office.” (24:11—25:28)

“At a minimum, [your practice collections percentage should be] 98%. If you're at 98%, 99%, 100%, your team is doing what they're supposed to be doing. Anything lower, there's a breakdown in your systems. Your admin team is not as productive, or they're not as profitable as they can be. And like I said when we started this, don't blame the team member. Let's look at the system and the process first. It also might be a team member is uncomfortable with talking about collections and collecting. So, we need to know that. And then your AR, your accounts receivable, over 90 days should be 10% or less. And I will say our top performing teams that I see are five percent or less because they don't let the balances get that far. That's where they have the process.” (26:32—27:24)

“If you have a good process in place and you're calling [patients], you're sending their statements, their letters, they know about this balance. Now, if you have a bad process in place, and let's say it's 90 days, and they're just now receiving a statement, that's also very hard to collect because now you have to explain to them, ‘Why are you just now telling me about this? I planned for this months ago.’ And sometimes, yes, insurance — I know it takes a long time, and that's something that we can educate them on. But once you get a balance over 90 days, you're just gambling and you're honestly crossing your fingers, hoping that it's going to be collected. There's a good chance that it won't be.” (28:32—29:17)

“Not only are your admin team members getting people on the schedule, getting the confirmations done, but what you don't know — or maybe you do know and we just don't always acknowledge — is your admin team is working consistently on keeping that schedule full. So, yes, it's very easy to start out the day or start out the week with, ‘We're at 100% capacity.’ What does that day look like throughout the day? Are your admin team members following up on unscheduled treatment? Are they looking for same-day opportunities? If someone does fall off the schedule for whatever reason, how are they getting that appointment block filled? So, this is telling you, do they have good processes in place? Because if they just say, ‘Oh, we'll just fill it,’ but what's your system? What's your process?” (31:23—32:16)

“One of the fun parts being an admin team member is they find a lot of the same-day opportunities that the clinical team overlooks when they're presenting treatment. They know this person is running late. They know that this person got done early. So, they see it in a different way. I always tell the admin team members, ‘If you think we can do something today, go to the back, ask a clinical team member, hey, can we get this done?’ Especially nowadays with digital scanning, there's no reason we should ever treatment plan an occlusal guard and have them come back for that. We can say, ‘Hey, can you get this done today?’ ‘Give us five minutes and we'll figure it out,’ because it's a scan. It's easy. And I say that's where the admin team members can help, because they know the schedule like the back of their hand.” (32:19—33:11)

“If you think about it, the patient starts with your admin team, whether that be on the phone, or literally starting their appointment by walking in, and how they were greeted, and how they end their appointment. There's little that a clinical team can do to make the appointment so great and amazing, and the admin team member can easily derail that appointment. So, the patient retention, the good online reviews — are those coming because the patient had a good experience? I hate to say it, but a lot of the reviews come because they had a poor experience with their admin team members.” (36:40—37:22)

“One, you have to ask for [reviews]. But before you ask, you have to ensure that your patients are receiving an experience worth leaving their review. I know leaving reviews is not hard, and today we've made it super easy with QR codes, and text, and it goes straight-to. However, it still takes time from a patient's day, and they've already left their appointment. So, they've left their appointment. They've left your office. Maybe they're still in the parking lot. Are they still thinking about that visit though, or have they moved on to the next? A lot of us are busy. Our appointment is over, and we're moving on to the next. So, for the patients to write the review means that something happened that...

Oral Wellness to Overall Wellness

Episode #644 with Karese Laguerre

Just by looking in your patient’s mouth, you can help prevent and treat a myriad of health concerns. Many common issues can even be eliminated, and Kirk Behrendt brings in Karese Laguerre, founder of SPUR Dental Wellness, to explain how myofunctional therapy is the path to overall health and wellness. Help patients breathe, eat, speak, and sleep like never before! To learn how, listen to Episode 644 of The Best Practices Show!

Episode Resources:

• Join Karese on Facebook
• Follow Karese on Instagram
• Learn more on Karese’s website
• Subscribe to The Best Practices Show podcast
• Join ACT’s To The Top Study Club
• See ACT’s Live Events Schedule
• Get The Best Practices Magazine for free!
• Write a review on iTunes

Links Mentioned in This Episode:

Learn more at The Myo Spot

Learn more about SPUR Dental Wellness

Read Karese’s book, Accomplished

Main Takeaways:

Now is the time to offer myofunctional therapy for patients.

Myofunctional therapy will help differentiate your practice.

Consider elevating team members to be myo therapists.

Offer teletherapy options for better and easier access.

Your patients will want to do myofunctional therapy.

Quotes:

“It was a beautiful pediatric dentist that wound up shining the light for me that a lot of [my children’s issues were] all related to how they were using their orofacial muscles. That put me down into the hole, and I dove deep into that rabbit hole of myofunctional therapy and how oral function really does disrupt craniofacial growth and cognitive development. A lot of what's going on with our sleep is impacted by our breathing. And a lot of this stuff, yes, I caught it when my children were younger. But if it's not addressed — why is it so important, to get back to answering that question, is because all of this stuff compounds. It doesn't self-resolve. It's not that typical answer that's given by the pediatrician where, ‘They'll grow out of it.’ It actually compounds into different issues, and we wind up with adults that have obstructive sleep apnea, or that have TMD that is very difficult and painful for them, and they're in their young twenties. You're like, what's going on? We wind up with all these various issues that wind up compounding as they get older. And so, it's incredibly important to catch everything early. But if they're not caught early, it's important to start resolving it — because as you get older, it's going to turn into a number of things that we do not want to see in our dental chair.” (4:50—6:12)

“Myofunctional therapy, I like to compare it to personal training. I say that it's personal training of all the muscles below the eyes, but above the shoulders. We work with that wonderful orofacial and some of the oropharyngeal muscles to really help eliminate dysfunction that might be happening there. So, for a lot of our patients, that might be asymmetry. That might be overdevelopment of certain muscles. That might be underdevelopment of certain muscles. But essentially, we're going to be getting to the root of what's going on, why is there dysfunction, and then making those changes that are going to help. That way, we establish habituation of proper muscle function and proper oral rest posture, which I think not enough people talk about, especially in dentistry.” (7:17—8:05)

“There is a way for everything to sit at rest. Our tongue, at rest, should be lightly suctioned up against the roof of the mouth, from the incisive papilla all the way back to the soft palate — just a very light suction. It's not an active suction hold. Our teeth should be slightly apart, about two to three millimeters of freeway space. Our lips should be closed, and we should have predominant nasal breathing. That's the way that we should be most of the day when we're not eating or speaking.” (8:05—8:33)

“We know that our teeth are always in constant motion, or can be in motion, because the periodontal ligaments take certain force, and all the forces of occlusion, and so forth. So, our teeth are in motion. But that tongue and the force that it applies on the teeth creates an impact as to where those teeth are sitting in the oral cavity. When you have your tongue lightly suctioned up against the roof of the mouth, that palate is going to take those soft tissue pressures and forces, and it's going to grow and expand. When we have that tongue sitting down, floating in the middle of the mouth, now we have all of those pressures that would have been on the palate against the teeth. And so, that's going to alter the way the teeth are. Sometimes, it might be more where you have a Class II with a very prominent overjet, or it might be an open bite where the tongue has created its own space to rest in between those teeth. Or, then you have that tongue that might be lying down low and resting along that mandible, and that's going to really apply those same pressures outward on that mandible. That's where we get some of our Class III form and development. And so, it's always going to be the tongue [that wins]. It's always going to be the tongue. The tongue will win, but it's the counter forces between the tongue and the lips and having everything be balanced, and that's where your myofunctional therapy comes in. That really helps to retain those positions. That way, we're not constantly in this battle of shifting.” (9:56—11:27)

“There is nobody more primed and prepped for [myofunctional therapy] than a GP because, honestly, we are the only people really looking at the upper respiratory system in the same way that there would be any other competitive space. So, let's talk about medical. Nobody is looking in that area the way that we are. When we ask our patients to open up, we have a direct view, hopefully, into their oropharynx. If we cannot see their oropharynx, if that soft palate is low, you can't see that uvula, that tongue is up in a defensive posture, that's already — boom. You’ve found somebody who has an airway issue. When they open and you can't see their oropharynx, you know there's something going on. If you look at their palate, you're at the floor of their nasal cavity, because the roof of the mouth is the floor of the nose. And so, if you see a vaulted palate, if you see a narrow palate, what does that mean for the state of their nose? Well, that's going to be constricted space there. So, already, you as a GP looking at only two areas, can you see their throat? Can you visualize a nice, healthy, wide palate? If not, that's two strikes. Your third strike could be just looking at the mandible. Is the mandible recessed? The mandible is the anterior and lateral borders of the upper respiratory tract. So, if their mandible is recessed, what does that mean about their airway? You can take a glance, and you can get a good view of what might be going on with your patient in front of you. So, there is nobody more primed. That's the number-one reason why you should care, because you can make a big difference — just that one little glance.” (12:02—13:36)

“Things are evolving. We are evolving as people. If we're not evolving in dentistry to start servicing our patients at a higher level, to start providing more dynamic services, to start being able to give them these things that they're looking for — holistic solutions, more options — we can help them in different ways that help to, one, build trust, because 60% to 70% of people, it has been researched, do base trust as the main factor why they stay with a dentist. That's going to be a big thing that can help build trust. You're able to look at their airway, and you can tell them something that's going on. These are the things that help you to stand out, grow your practice, and help maintain your patient base. That way, you don't have to worry about any sort of marketing. Your marketing is actually your patients going out and spreading the word within your community that, ‘Oh my gosh, the doctor is offering us so much more than just scraping our teeth or just filling our teeth.’” (14:50—15:54)

“There are not enough myofunctional therapists. But there are so many different things that we can do about that to resolve that issue. One, it can be as simple as referring out to someone who sees people through teletherapy. Teletherapy is a phenomenal way to still address a lot of the issues without having to be in-person with patients. There are dozens upon dozens of myofunctional therapists who see people through teletherapy and telehealth services. You can also elevate a member of your staff. So, a member of your staff, like your registered dental hygienist on staff, would be able to go and get training, and then you can provide that as an in-office service. That is a beautiful way to now — not only are you screening in-office, but you can help to treat in-office. Amazing. Or you can use a service that does have the ability to provide you with teletherapy services for your patients in a membership format.” (16:37—17:41)

“It doesn't have to be, ‘If there's not [a myofunctional therapist] in my community, I can't help with any of these issues.’ It can be any number of ways that you can help your patients just by making a quick referral out, resourcing someone from your own team and helping them to maybe grow in their career in a different way that they may have been looking to that would help you with your staff retention, or implementing a system that's going to do it for you.” (17:48—18:16)

“One of the beautiful things about myofunctional therapy is that if I go back to that correlation that I made earlier with it being like personal training, it is very much where we're working on muscles. We have to get muscular strength and engagement. So, we do that through exercises and activities. These exercises and activities are very much instruction-based, so it's not as tactile, like physical manipulation, that we have to do. It's more visual cues and verbal cues to help patients do these instructions for these exercises. That's going to be where a patient, as long as they have internet access and a web camera and they're able to actually meet with the therapist virtually, they'll be able to get and achieve all the same results as somebody who is working in-person because it's an instruction-based therapy. So, they’re doing these exercises and performing them with the therapist, and then at home. In between sessions, they're doing two to three times a day. They're reviewing these exercises so that they can master them and gain that strength and awareness of those muscles.” (18:29—19:37)

“Your patients would not only do [myofunctional therapy exercises] — they would also love to do it. What we find, more often than not, is that it's really about how you explain these things. A...

The Total Health Dental Practice

Episode #643 with Dr. Susan Maples

People today are living longer — but lifespan doesn't always equal healthspan. Luckily, there is a way to extend health, and it can be done through dentistry. To share how, Kirk Behrendt brings in Dr. Susan Maples, author of BlabberMouth and Brave Parent, to explain total health dentistry, why it’s important for your practice, and how to implement it effectively. Put health and care back into healthcare! To learn more about the preventive care you can offer, listen to Episode 643 of The Best Practices Show!

Episode Resources:

• Join Dr. Maples on Facebook
• Follow Dr. Maples on Instagram
• Subscribe to The Best Practices Show podcast
• Join ACT’s To The Top Study Club
• See ACT’s Live Events Schedule
• Get The Best Practices Magazine for free!
• Write a review on iTunes

Links Mentioned in This Episode:

Read Brave Parent by Dr. Maples

Read BlabberMouth! by Dr. Maples

Learn more about Total Health Academy

Learn more about APDP

Learn more about AAOSH

Main Takeaways:

Total health dentistry will give you a competitive advantage.

Put the “health” and “care” in your healthcare as a dentist.

Do more than polishing teeth and looking at calculus.

Many diseases can be linked to oral health.

Quotes:

“Seventy-five percent of what we're spending on healthcare is preventable to begin with. But who is doing the prevention? We call ourselves a preventive visit, right? So, doing something weird inside that space that we call a six-month recall — stop polishing the teeth, and stop throwing toothbrushes in bags. Start helping people dig into what they want to become in life. It makes a huge difference in their life.” (6:05—6:31)

“If you are attracting patients who value health, they're much more likely to spend their money on their values, which means that they're not as insurance dependent. So, if you're looking for insurance independence and you're looking to have conversations with people about a comprehensive treatment plan where you could literally bring that to fruition, that's the target market — people who value health.” (7:37—8:04)

“I always say what's missing in healthcare today is health and care.” (10:43—10:47)

“Early on in my career, I learned that hiring had to be values-based hiring. If you think about any dual relationship, whether it's a breakup with a boyfriend, girlfriend, a divorce, or a parting of ways with a family member — anything — it's generally because we have this values rift. It's not because of anything else. We just value different things. And so, the idea that we would hire people based on values — which means you have to know your values. So, in our practice, we have a very distinct set of core values. You can see them on our website. There are six of them. When we interview people, we ask open-ended questions that get out what their values are. Not, ‘Do you like our values?’ but, ‘What are your values?’ We don't ask them that. We start to ask questions. For instance, if we like continual learning, we want to ask questions like, ‘Tell me what you've done for your own learning this year out of your own volition.’ And if they can't answer that, there's a pretty good chance they're probably not a continual learner. So, things like that. We tend to hire for values, which means that we end up with people who are not the same personality. They don't have the same credentials. We're all different that way, which is good because we serve a variety of people. We need to have different personalities. But our values are right on.” (13:45—15:13)

“If you're not getting along with someone on your team, generally, you can pick out the value that you have that is different from theirs. It's not right or wrong, it's just different.” (15:53—16:04)

“[Total health is] an individualized approach to care. So, in dentistry, we tend to do things by protocol. We bring our new patients in hygiene. We sit them down. We take a health history. We maybe take a blood pressure. We do an oral cancer screening. We look around with a perio probe. [In my practice], we don't do it that way. We start with a two-hour initial exam. This is for adults. This is the adult intake, a two-hour initial exam. We start out with an interview — the word interview comes from the word, “entre vous”, which means to see one another — in a library where there's not a dental environment, and we talk together. We have a facilitated conversation where we say, ‘Tell us about you.’ And then, we start to get into health. ‘What's most interesting to you about your own personal health or health challenges?’ And then, we stay in the question, as Mary Osborne teaches. We follow their lead, and we go where they go. When we've exhausted things like sleep and gut function, and you've done all of that — or if they start with dentistry, I'll start with dentistry. But then I'll say, ‘Tell me a little bit about your mouth and what it's been like for you to have been a dental patient all these years. What's going on there?’ So, we go through all that. We probably spend maybe 40 minutes, maybe an hour, before we ever get them in the clinical setting. And now, you've really made an investment in their life, and you're really putting together some pieces, discovering what they know about themselves. Then, I'm going to put that up against what I learn about them in the clinical setting. And then, we'll have a dialogue about what we can do to get them there. We're really wanting to help people become their best selves.” (16:29—18:22)

“When I first went into dentistry, my dad was an entrepreneur. He wanted to know, ‘How do you make money in dentistry?’ Because I bought a practice right out of school, 25 years old. I was trying to figure it out. I said, ‘Well, you charge by the surface. So, a filling is on the top of the tooth. It's one price. If it leaks over to the side, it's called a two-surface.’ I'm explaining this to someone who knows nothing about teeth. And he goes, ‘Oh my goodness, Sues. You are getting paid by the surface? You’ve got to shut up and work.’ He's like, ‘You need to be paid by the syllable.’ I thought, ‘Oh my gosh, I'm going to have to stop talking and really drill.’ I think that's kind of where dentistry has gone. But I have to tell you that, now, I'm getting paid by the syllable. And it's really, the more syllables that come out of the patient's mouth, the more they feel understood and trusting. The higher that treatment plan acceptance goes, the more we're able to do the dentistry the way we would like to do it. Giving the patient the lead is really a competitive advantage for treatment plan acceptance and for referrals. There is nowhere in healthcare that I know that people have as much time with the doctor as they have with me, and I'm able to help put all those pieces together. While all my friends are retiring, I feel like I'm having the best time, getting the hang of it, really helping people steer their life toward their best self yet.” (18:24—19:54)

“Seventy-five percent of what we're suffering from is preventable. But we're not doing any prevention in medicine. We're spending $1 out of $100 in prevention across the board, including dentistry . . . Dentistry has the last pillar of prevention left, and it's that hygiene visit. People are coming to you presumably healthy, and they're asking you to take care of a preventive visit. And we're doing all kinds of things in that visit that has no efficacy in the literature, like polishing teeth. We have to really break the mold and say we need to be individualized in our care. We need to help predict and preempt dental disease.” (20:44—21:37)

“Teeth should never dissolve. That's a pH problem. Why is that? Is it because there's acid coming up? Is it because we're consuming acidic foods? Is it because the sugar is feeding the strep mutans and it's producing acid? That's one disease. Periodontal disease is so multifaceted and so connected to everything else. I mean, look at the research on Alzheimer's. Most of these Alzheimer's patients have Treponema denticola and P. gingivalis in their brains. These leaky gums are creating problems, and everyone knows about it now. So, we need to look at this as a systemic problem with a host immune response that is horrific, and what do we need to do to help get that patient healthy? What about sleep? What about nutrient deficiencies? What about chemical sensitivities? What about addiction and alcoholism? What about depression where they stop caring for their teeth? Like, what are the pieces that we're missing where we can't seem to control this disease?” (21:37— 22:39)

“Right now, the health trajectory looks like people are going to be living a little less long. But we're already living long. The question is not lifespan, it's healthspan. The problem right now is that the last 30 years of our life are crappy years. I personally want to live like this and have one bad day. I'm approaching 64, so maybe I have another 40 years. I don't know. I'm thinking maybe 94, 104, something like that. I want to live a long, healthy life, and then die an unexpected death, maybe skiing or something. I don't know what I would be doing. But the point of the matter is, wouldn't it be cool if our healthspan could match our lifespan? It gives us a really new perspective on how we look at life, because I know I do not want multiple medications and all of the problems that come with that. None of us do. Right?” (23:11—24:08)

“I think that there is fear, and we live in a society that values money so much that people are always trying to give the worst-case scenario, ‘What if I try this and I fail? What if I don't make money at it?’ I think if you do the right thing,...

The Global Diagnosis Education Symposium Pre-Chat

Episode #642 with Dr. Josh Austin, Dr. Bill Robbins, & Dr. Jim Otten

Mentorship is lifelong. No matter what stage of your life or career, you will always need one — and study clubs are the best places to find them. To give you a taste of the people you will find, Kirk Behrendt brings back Dr. Josh Austin, Dr. Bill Robbins, and Dr. Jim Otten to share their experiences being involved with the Global Diagnosis Education Symposium and study club. Join GDE to change your life! To learn more about it and how to get started, listen to Episode 642 of The Best Practices Show!

Episode Resources:

• Send Dr. Austin an email
• Join Dr. Austin on Facebook
• Follow Dr. Austin on Instagram
• Send Dr. Robbins an email
• Join Dr. Robbins on Facebook
• Learn more on Dr. Robbins’s website
• Join Dr. Otten on Facebook
• Follow Dr. Otten on Instagram
• Subscribe to The Best Practices Show podcast
• Join ACT’s To The Top Study Club
• See ACT’s Live Events Schedule
• Get The Best Practices Magazine for free!
• Write a review on iTunes

Links Mentioned in This Episode:

Register for Global Diagnosis Education

Main Takeaways:

Your need for mentorship will continue throughout your career.

Seek out mentors. Don't wait for them to come to you.

Join study clubs like Global Diagnosis Education.

Failure is extremely important to growth.

Always create time for self-care.

Quotes:

“There is a desperate need for dentists and professionals to really be able to organize their thought process in an orderly way and be able to implement in their practice. Many very well-accomplished dentists, some who know far more about the detail of dentistry than we do, have trouble and struggle like we did in our own practices organizing and facilitating. We know they're looking for a safe space where they can be themselves, they can be authentic, and we can talk about our successes and failures. They look for guidance and community, and that community is Global Diagnosis, helping them to organize the process, but also standing with them and walking through the fire with them.” (6:51—7:39) -Dr. Otten

“We all naturally take the path of least resistance, so bringing something back to your practice is hard. It's hard to institute it. We think about it in our heads, and we turn it over, and turn it over. But at the end of the day, it's hard to then execute. And so, if you don't have that continuing thing, whether it be a study club that's in person, whether it be a study club online, whether it be a small community of local docs, whatever it is, you’ve got to have that thing that continues to push you to do it. For me, it was our chapter of the Seattle Study Club. That's really what fueled that, and there's been no organization that's more important to my career than that. Not everyone has the ability to do that. Now, we have technology that can bridge that gap. It just has to be a constant thing. It has to be the community around it that's pushing people to do it because, if not, we just go back to what's easy.” (8:12— 8:59) -Dr. Austin

“What we found in the feedback from our group is that what they appreciate most is the mentorship, that there's a consistent contact that helps them overcome all these cultural pieces that push against them. Because if you're doing interdisciplinary restorative dentistry at a high level of implementation, you're going to get pushback from a lot of the systems that are in place, and you've got to be able to overcome that. As a solo practitioner, I spend a lot of time staring in the mirror going, ‘Well, what the hell do I do now?’ But if I had people like Bill, which I have, and other people along the way that could help me through this and help me solve this problem, that takes you to the next step and takes you out of the default behavior that you've created that keeps you from moving to the next level. And failure is extremely important. Try it, fail at it, learn from it, and move on.” (9:04—9:55) -Dr. Otten

“Dental societies want to do these mentorship programs where they assign somebody to somebody. And that never — I mean, it's an arranged marriage. It rarely works. It has to come organically. That stuff has to come organically, but it has to come from — I like the word protege. I hate the word mentee. It is in the dictionary, but I feel like it was added later to annoy me. It's protege. The protege has to be the one that seeks it out. But when you use the word preceptorship — preceptorship, to me, is a defined period of time. You get preceptored for a certain period of time until you are competent, and then that relationship ends, and you are then off on your own. That never happens in dentistry. We need a mentor throughout our entire career, no matter what.” (10:30—11:17) -Dr. Austin

“That need [for mentorship] never goes away, no matter what stage your career is in.” (11:32—11:35) -Dr. Austin

“[Mentorship is] a lifelong relationship. It ends when you're dead.” (11:45—11:47) -Dr. Otten

“We all are familiar with a handful of amazing teaching institutes in the United States, and these teachers are some of the best on earth that are available to us in the United States. But the problem is that the implementation part of it is not managed very well. And so, people go and pay a lot of money and spend a lot of time learning this amazing information from the best teachers on earth. But then they go back, and on Monday morning, they still have got to face the dental assistant that says, ‘I'm pregnant and I'm going to be gone for four months,’ and the denture patients they hate. Implementing the stuff that they learned last week into the practice is so difficult to do. I think that is the gap that Global Diagnosis Education crosses over, and we become the implementation arm because we're familiar with what these institutes teach. We've been to most of them and taught in some of them. And so, we feel like we are the bridge for these people of implementing what they learned in these amazing centers into their practices.” (11:51—12:59) -Dr. Robbins

“I think you organically find a mentor when you're not looking for them. It's sort of like when you're looking for a girlfriend or a spouse — the more you try, the worse it gets. Trust me. Several tries at it, and it didn't work. But if you put yourself in these circumstances around people that have common values that you can trust and that are authentic, then the relationship emerges. And it's got to be a relationship that is genuine and values-based. That's how it lasts a lifetime.” (15:28—16:03) -Dr. Otten

“You can't progress unless you start doing cases that you're uncomfortable with. You need to get uncomfortable. But when you don't have the safety net of a community, you're tight-roping without a net underneath you. And that's what the community of GDE does. It gives people a safety net. They have a place every month that they can get together and say, ‘Hey, am I seeing this right? What am I not seeing? Am I on the right track?’ and having that support group that does that. It's an incredibly daunting thing to start that track without that help, without that feeling of support behind you. That's, I think, what a community like this does, and that's where we see the change. It starts there. And what starts small gets bigger and changes everything for people because — you never know. That one seed that you plant in one of the attendees here today turns into the next seed down the road for the next younger dentist, and the next seed down the road. And like you said, it just keeps going.” (17:13—18:06) -Dr. Austin

“Over the years, dentistry is a tough profession, not only on us physically, not only on us from a mental challenge standpoint, but from a mental health standpoint as well. It's one of the few professions — I don't know. If you're an accountant, do you really see failures? Maybe you miss a date on a file. I don't know. The accountants are going to send all kinds of crazy replies to us about us talking bad about it. But you don't see failures the way that we see failures. I think we're all trained that when there's a failure, we did something wrong. We wear that with us, and that weighs on us when we go home. And so, I started noticing what used to be an overall cheerful disposition had deteriorated over those 15 years.” (20:36—21:20) -Dr. Austin

“I've seen lectures from psychiatrists and psychologists, and it's fine. But they don't understand what our days are like. And so, I think the message [of my lecture] was, ‘Hey, this is coming from me as a dentist. This is just my journey. You may identify with all of this. You may identify with none of this. But this is the journey I've been on.’ And if you can pull some slices out of that that could be helpful for you going forward — I think, at the end of the day, the biggest problem is that dentists, in general, have really poor coping mechanisms. A lot of problems in dental lives come from that. Stress triggers these coping mechanisms that aren't healthy: alcohol, drug abuse, sex addiction, gambling — all these things that lead into other issues that permeate our lives. And it's because we're never taught very well how to cope, starting from our days in dental school, and then on from there.” (21:57—22:42) -Dr. Austin

“It used to just be, ‘What's the guy down the street doing?’ Now, with the internet and Instagram, I can compare my stuff with Dr. Michael Apa, who's prepping veneers on Jennifer Aniston at $5,000 a unit, and I'm looking at my case that I just did and thinking that I'm not good enough. Meanwhile, he's got a ceramicist looking over his shoulder while he's prepping. And like, of course I'm not going to be able to do that. And the other thing is, the problem with Instagram is that no one ever shows their failures. We don't learn anything from the things that go perfectly. But if you look at everyone's Instagram, everything we touch is the Midas touch. Everything is gorgeous.” (22:53—23:32) -Dr. Austin

“What you're talking about is what I heard Liv Boeree talk about the other day. She said it was a Moloch Trap. A Moloch Trap is something that causes us to leave our values to keep up with something else or in honor of something that's not real. For example, on Instagram, people all of a sudden now are modifying photographs. They're showing their best stuff, creating this culture. Whereas if they left the stuff alone, it would be a much more valuable learning lesson than if you're creating these things trying to outdo one another. So, you're sacrificing values, authenticity, honesty, and integrity to look good. And so, everybody starts to feel like they should look good. I think one of the examples she talks about in the Moloch Trap is when people go to a concert, and everybody is sitting down. And then, all of a sudden, the people in the front start standing up. Well, then everybody else has to stand up, and nobody can sit down. And no one has a better view now because they're standing up, and probably worse. But you can't get them to sit down. So, you're all trapped into this system. It's really an interesting concept, and I think that we are so affected by that in many ways.” (26:08—27:20) -Dr. Otten

“One of the things that sets gentlemen [like Frank Spear and John Kois] apart is that they always showcased what went wrong. That's where their principles come from. It's not just a slide show of beautiful case after beautiful case — it's what went wrong. I think that's why they are where they are, is because they're the ones that are willing to show, ‘I tried this. It didn't work. This is what we learned. Now, this is what we do.’” (27:39—28:03) -Dr. Austin

“Let's be open, let's be authentic, and let's be our real selves.” (29:41—29:46) -Dr. Austin

Snippets:

0:00 Introduction.

1:33 Dr. Austin, Dr. Robbins, and Dr. Otten’s backgrounds.

4:31 About Global Diagnosis Education.

7:40 Why study clubs and mentorships are important.

13:00 Highlights from their careers.

18:27 Topics at GDE.

29:26 Last thoughts.

Dr. Joshua Austin Bio: 

Dr. Joshua Austin, DDS, MAGD, FACD, is a native San Antonian. After attending San Antonio's Health Careers High School and the University of Texas at San Antonio as an undergrad student, Dr. Austin graduated from the University of Texas Health Science Center San Antonio Dental School. 

Dr. Austin is a member of the prestigious Seattle Study Club, which is a network of professional dental study groups dedicated to ideal comprehensive dental care. Dr. Austin's other professional memberships include the Academy of General Dentistry, the Texas Dental Association, American Dental Association, and the Rotary Club of San Antonio. 

Dr. Austin is a published author and lectures nationally on restorative dentistry and reputation management. He has a monthly column and weekly e-newsletter in Dental Economics, the most-read dental magazine in the world. 

In the past, Dr. Austin has served as a faculty member in the Department of Restorative Dentistry at UTHSCSA Dental School. Dr. Austin has received several awards during his dental career. In 2009, the Texas Dental Association honored Dr. Austin by naming him Young Dentist of the Year. In 2010, the Texas Academy of General Dentistry named him New Dentist of the Year, the most prestigious award it gives for dentists who have graduated in the previous seven years. Dr. Austin has earned a Fellowship and Mastership in the Academy of General Dentistry. In 2014, Dr. Austin was awarded with a Fellowship in the American College of Dentists for his outstanding commitment to ethics in patient care. 

Dr. Bill Robbins Bio:

Dr. J. William Robbins, D.D.S., M.A., practices part-time and is an Adjunct Clinical Professor in the Department of Comprehensive Dentistry at the University of Texas Health Science Center at San Antonio Dental School. He graduated from the University of Tennessee Dental School in 1973. He completed a rotating internship at the Veterans Administration Hospital in Leavenworth, Kansas, and a two-year General Practice Residency at the VA Hospital in San Diego, California. 

Dr. Robbins has published over 80 articles, abstracts, and chapters on a wide range of dental subjects and has lectured in the United States, Canada, Mexico, South America, Europe, the Middle East, and Africa. He co-authored a textbook, Fundamentals of Operative Dentistry – A Contemporary Approach, which is published by Quintessence, and is in its 4th edition. He recently co-authored a new textbook, Global Diagnosis – A New Vision of Dental Diagnosis and Treatment Planning, which is also published by Quintessence. 

Dr. Robbins has won several awards, including the Presidential Teaching Award at the University of Texas Health Science Center, the 2002 Texas Dentist of the Year Award, the 2003 Honorary Thaddeus V. Weclew Fellowship Award from the Academy of General Dentistry, the 2010 Saul Schluger Award given by the Seattle Study Club, the Southwest Academy of Restorative Dentistry 2015 President’s Award, and the 2016 Academy of Operative Dentistry Award of Excellence. He is a diplomate of the American Board of General Dentistry. He is past president of the American Board of General Dentistry, the Academy of Operative Dentistry, the Southwest Academy of Restorative Dentistry, and the American Academy of Restorative Dentistry. 

Dr. Jim Otten Bio: 

Dr. James F. Otten is a 1981 graduate of the University of Missouri-Kansas City School of Dentistry. He completed a one-year residency in hospital dentistry with emphasis on advanced restoration of teeth and oral surgery at the Veterans Administration Medical Center in Leavenworth, Kansas. He taught crown-and-bridge dentistry as an Associate Professor at UMKC before entering private practice in 1982, where he served as Chief of Staff of a large group practice in Fayetteville, Arkansas, before opening his practice in Lawrence, Kansas, in 1984. 

Dr. Otten has pursued rigorous post-graduate education since 1986, accumulating thousands of hours in advanced continuing education that he has intentionally applied to his practice in order to develop its personalized care philosophy. He has completed the rigorous curriculum at two prestigious institutions, The Pankey Institute for Advanced Dental Education, and the Dawson Center for Advanced Dental Education. He lectures nationally and internationally and has recently been asked to join the faculty at the Newport Coast Orofacial Institute in Newport Beach, California. 

Dr. Otten has been named a Fellow of The American College of Dentists and is an active member of The American Academy of Restorative Dentistry. In pursuit of excellence, Dr. Otten has gained a considerable reputation, both regionally and nationally, for...

Mastering Conflict: 2 Paths to Confident Communication

Episode #641 with Miranda Beeson

Your greatest challenge as a practice owner isn't the dentistry — it’s managing people. To help you overcome the inevitable conflict you will experience, Kirk Behrendt brings back Miranda Beeson, one of ACT’s amazing coaches, to share two frameworks for addressing challenges between leaders, team members, and patients. Don't let conflict become a crisis! To learn the best ways to resolve conflict in your practice and your life, listen to Episode 641 of The Best Practices Show!

Episode Resources:

• Send Miranda an email
• Follow Miranda on ACT’s Instagram
• Send Gina an email
• Subscribe to The Best Practices Show podcast
• Join ACT’s To The Top Study Club
• See ACT’s Live Events Schedule
• Get The Best Practices Magazine for free!
• Write a review on iTunes

Links Mentioned in This Episode:

Listen to Episode 529 of The Best Practices Show

Read books by Stephen Rollnick

Read Crucial Conversations by Al Switzler, Emily Gregory, Ron McMillan, Kerry Patterson, and Joseph Grenny

Main Takeaways:

Each person has a different background with conflict resolution.

Understand the difference between conflict and confrontation.

Master the use of “I” and “you” statements.

Let go of your need to be right.

Listen more, talk less.

Quotes:

“Everyone is coming from a different place and a different background around how they manage conflict. And right off the jump, I want to set apart — this isn't confrontation. Conflict and confrontation are two different things. Conflict is just a difference of opinion, in some capacity, between two people or two parties.” (3:55—4:14)

“Three percent of the population are D style personalities, which, D often stands for direct or dominant personality style. If only three percent of the population have a personality style that's willing to take on conflict directly, that means 97% of the world are not. So, anyone listening that's like, ‘That's me,’ it's okay because you're in the majority. That's why we're doing this podcast. So, mindset does matter. You have to be really intentional about wanting to improve the environment and grow as a team or as a leader around taking on conflict.” (6:14—6:53)

“Again, like we said, it's not confrontation. It's just, how can we decrease that gap between expectations and the reality that we're seeing. And we have to let go of our need to be right, or to go into it as if we have to win, or that our solution is the only way. And so, any time we approach conflict, it's important to be really, really open to new possibilities, to new ideas, and listen to the other person. That's a part of that conflict conversation. And then, also gently share our ideas so that we can have a conversation about it. The goal is that both parties end up satisfied, feeling heard, and having a mutual outcome that's going to benefit the practice and our future relationship.” (6:53—7:40)

“There's this thing called resisting your righting reflex, and it's one of my favorite aspects of the concept of motivational interviewing. It's so hard to do. Most of us, in any given situation, want to be right and want to be heard, and it's so important to resist that reflex to want to “right” the other person. ‘No, no, no. That's not how I see it. No, no, no.’ Your version of the truth is not the same as theirs, and so we just have to agree that we have different versions of the truth, and how can we get to a compromise and resist that reflex to “right” the other person.” (9:28—10:05)

“Resist your righting reflex. The example I use when I talk to dental professionals, especially hygienists . . . is when you have a patient who you've recommended periodontal care to, and they didn't move forward but they come in next time and they say like, ‘I'm so excited because I bought that gum detoxifying toothpaste. I saw the commercial. I can't wait for you to tell me it's going to look so good in there.’ And in my mind as a hygienist, I'm like, ‘I know darn well that that toothpaste didn't cure your periodontal infection.’ But I'm not going to immediately stop and “right” them and say like, ‘That doesn't work.’ I'm going to go, ‘Oh my gosh, I'm so glad that you heard what we were talking about last time that there were concerns there, and you went and took some action. Let's look at that together and see how you're doing.’ The reality is, they're not going to be doing any better than they were. But I'm not going to take advantage of that situation and “right” them in that moment. I'm going to resist my righting reflex, and then take it as an opportunity later to work on that problem together. They'll see it for themselves, eventually.” (10:14—11:18)

“The ARCH method, it's an acronym. A stands for acknowledge and agreement. R stands for request. C is confirm. H is hope . . . We’ll start with the A, acknowledge and agreement. What we want to do right off the jump to help ease any tensions around the conflict is acknowledge or agree to what we can about the issue. So, the other person has a point of view, and there's often a common place within the conflict, or within the situation, on which you can agree on something. If you can find one thing within this point of conflict that you can agree on, starting with an agreement or some acknowledgment of an agreement, that can be a really great starting point to immediately diffuse some of the tension within the conflict. So, if you're listening to gain resolution, there's usually something within their perspective that you can agree upon.” (11:56—12:57)

“Sometimes, we need to step away, regroup, and allow that frontal part of our brain to get into a more linear thinking fashion. And I say even write this down. Have a piece of paper that has ARCH, and you sit down and work through those thoughts for each one. Get it on paper. You can even use the piece of paper, if you need to, in guiding through the conversation. You can tell the other person like, ‘I'm really trying to do a better job of managing conflict conversations.’ There's a book called Crucial Conversations that I really love. ‘I'm trying to do better at managing these crucial conversations. I'm going to use this paper because I wrote down some thoughts because I want us to really end up in a good place with this.’ I mean, how cool would it be if you had someone coming to you with that much thought into how they're going to approach you to make sure this goes well, versus just coming at it emotionally flooded?” (14:43—15:39)

“First and foremost, stop. Instead of, ‘I want this person to understand where I'm coming from,’ it's, ‘Maybe I should take a minute to try to understand where they're coming from.’ That's responding versus reacting. And we've all done that with the text message. You type it out, and then you erase it, and then you type it out, and then you erase it. If you're doing that, just don't reply until tomorrow morning. Good rule of thumb.” (16:19—16:46)

“With acknowledge [in ARCH], a common occurrence within a dental practice is when somebody feels like they're the primary person managing sterilization — it comes up a lot. ‘Only so-and-so is in there. The other person is not.’ So, say you have two dental assistants and they're in conflict because one of them feels like they're carrying way more of the load around managing sterilization, and the other one is just seeing patients and not doing any of the extras. So, if we look at acknowledge, and you're being confronted by this person in this conflict way, again, easy. ‘I totally agree with you, Suzie. There are a lot of responsibilities that we're both responsible for, and we should share the load.’ So, Susie comes to me and says, ‘I don't think you're doing enough to help with sterilization. I'm in there all day long. I never see you come in there when I'm in there, and I'm just really frustrated.’ So, to acknowledge or create a place of agreement, I can say like, ‘Susie, you're exactly right. There are a lot of extra responsibilities outside of just seeing our patients. I think we should share the load.’ Now, that doesn't speak to why I'm not, and, ‘Yeah, but you did this last week,’ because we have to be moving forward in the conflict. But we can at least agree that there are a lot of extra responsibilities outside of patient care and we should share those responsibilities.” (17:19—18:44)

“Once we've reached that place of acknowledgement and agreement, the next piece, which is the R, is request. So, making a request, either for a solution for an idea from them to contribute, possibly to request bringing someone else into the conversation if we feel like it's elevated beyond what we can facilitate on our own. But the main thing is we want to keep the conversation moving forward. So, we start with an agreement piece. And now, to keep moving forward, we're going to make a request. So, in that same example, I might say like, ‘I really do try to help throughout the day. I just get so busy that I really can't find the time very often. Maybe you can share with me how you're working the time in. If you feel like you're in there throughout the day, maybe you can help me figure out what you're doing different than what I'm doing so that I can be in there more often.’ So, that's a request from that person to start moving into solving the situation.” (18:45—19:41)

“After we've made the request and we discuss what that looks like, so, Susie has shared with me, ‘Well, what I normally do is this. Maybe you could try doing that,’ or, ‘Hey, what if in the morning we look at the day, and I'm in there in the morning, and then you go in after lunch, and you're the one who primarily does it after lunch?’ ‘Okay, great.’ Now, we want to confirm what that solution is that we've discovered together after making our request. We want to make sure that once we've made an agreement, we confirm the details. Too many conversations go wrong, or the conflict repeats itself because we weren't clear. So, we might have discussed a solution, but we both heard that solution a little bit differently. If we actually verbalize and make a lot of clarity around what we've decided to do to help solve this, then we're all going to be really clear on the expectations. So, literally say out loud a summary of what you heard the conclusion to be and what that path forward is.” (19:48—20:46)

“Once you've confirmed what this solution is, what our path forward is, we now have this level playing field, this new expectation, that if we honor it and we do both move forward and honor this commitment we've made to each other, now you do have this elevated level of trust between each other where you're going to feel more comfortable next time going right into that conflict conversation because it was so successful the last time.” (22:23—22:48)

“We all know that sometimes it does work out where that person still doesn't go in after lunch to do their part of sterilization. But we've created this new, clear expectation where we can now go back to that conflict. This is where you and I say often, we can't argue with our own data. Someone can't argue with their own data. If you have verbalized this commitment to each other and you've set this clear expectation, if it doesn't happen, we can come back to this conversation using the same method and go back through our ARCH steps and say, ‘We made this commitment. Here's my request from you. And now, we're going to have to find a new path forward.’ So, what I really love is it does help to build that vulnerable based trust because the majority of the time, it ends up really solid. We all take action on that path that we agreed upon and we go, ‘Oh my gosh, I can have a conversation about a difference of opinion or something that's bothering me, and I can have a really positive outcome from that. How about that? Maybe I'll try it again sometime.’” (22:52—23:47)

“Hope is ending that conversation and that conflict conversation with positive gratitude around being able to take this on together, looking at the good of what's to come from it all. What is this better outcome that we're going to be moving into? Really communicate your optimism and hope for the future that's going to come from this new agreement. So, if we look at the example we were given, ‘I'm really glad, Susie, that we were able to talk about this. I really don't want you feeling like you carry my share all day as well. I hope that trying this new way where we split the day is going to lighten the load for both of us. This might be a better option than we ever would have come up with if we hadn't had this conflict.’ So, looking at the future and being really hopeful for what this decision and resolution that we came to together can really provide that's going to better our lives in the end.” (23:54—24:47)

“A lot...