Endo Mastery

BUSY DOCTOR SYNDROME

DEBRA MILLER | DIRECTOR OF COACHING

There’s an old saying about how, if you want to make sure something gets done, you should ask a busy person to do it. Busy people have to stay focused in order to get things done, and consequently they get many more things done than unfocused people. It’s a blessing and a curse. The curse is what drives Busy Doctor Syndrome.

 

Doctors caught up in the busy syndrome are resistant to anything that appears to make their life more complicated than it is now, even things that will eventually make it better. They have their nose to the grindstone and they are not looking up to even notice the opportunities around them. All they care about is checking off that daily list of things that need to be done.

 

The list gets populated by things that need to be done in the practice, and things that need to be done in life. Most people divide their time between work and life and many people talk about work/life balance. But what is generally true of the busy syndrome is that regardless of where you draw the line, a busy person tends to fill up the available time on both sides. It’s rare to find someone who is time-limited and overwhelmed at work while being relaxed and unstressed at home, and vice versa.

No one else can do it …

The problem is that busy people fall into the “no one else can do it” trap. They take on tasks and responsibilities because they feel they are the only person who can. In reality, “no one else can do it” is actually an abbreviation for:

This leads to some unusual anomalies in the choices of busy doctors. For example, consider a task that occurs over and over again every month that a team member could be trained to do very well. Every time the task comes up, the busy doctor has a choice to slow down and take the time to train a team member, or to do the task easily, quickly and correctly themselves. Because their mindset is predominantly shaped by the feeling and focus of being “too busy right now”, they endlessly put off the beneficial step of training and delegating.

Overcoming the busy syndrome

Not surprisingly, resistance to training and delegating is actually commonplace in endodontic practices. When Endo Mastery begins coaching with our clients, we analyze the doctor’s activities and daily flow. Almost as a rule, doctors are generally losing at least 2 hours of every day on tasks that could be delegated to team members. That’s a big chunk of time that could be better spent by the doctor to reduce their busy syndrome while delivering care to more patients with less stress.

 

If you’re feeling the busy syndrome in your life, start by asking what is the simplest thing you do all the time that you could train a team member to do. Nothing is too small, and small things are the easiest to train at first. Do one thing every week, and progressively move to more comprehensive tasks. It is a process for sure and one that is a lot easier with coaching because Endo Mastery does the training for you. But on your own, you can make a big dent on your time crunch as all the little delegated tasks add up.

OPTIONS FOR NEW ENDODONTISTS

DEBRA MILLER | DIRECTOR OF COACHING

Last week at the AAE meeting in Phoenix, I spoke to a lot of young endodontists about the challenges they are facing. Overwhelmingly, it is a financial precipice for these doctors, who are sitting on a mountain of debt as they try to get started in the profession. With 83% of the dental class of 2021 having student loans and the average debt load of over $301,000, young dentists are caught between the proverbial rock and hard place. Young endodontists have even more debt on average when you add in the financial burden of their residency.

 

Education is, of course, an investment in your future. But it is an investment that needs to begin producing a return right away after graduation. Servicing that debt is an immediate need, as well as supporting your cost of living. So, for new endodontists, they need to act quickly and, more importantly, in the right direction that sets up their entire professional future.

 

Most of the young doctors I spoke to have the goal to eventually own their own practice. However, their educational debt greatly affects their ability to get financing, and buying an “average” endodontic practice in every way (average productivity, referrals, staff and facility) is even out of range.

Start Ups and Associateships

Faced with this limit, there are really only two options. The first option is a cost-controlled start up consisting of an affordable location, minimized square footage, essential equipment and minimal staff. With a start up, you avoid paying for goodwill in a buyout, which means you’ll be starting with a zero referral base. Your life from day 1, will be about marketing, marketing, marketing to develop referral relationships.

 

A lot of doctors choosing the start up route make some pretty fundamental mistakes that cost them a lot of unnecessary expense and stress at the beginning. Real estate and leasing mistakes, over-equipping beyond the essentials, under-trained team members, poorly set up practice systems, and none of them obviously have any realistic experience in dental referral marketing. It can be a long row to plow without careful planning and support.

 

The second option when faced with financial limits is to associate in a practice, at least as a stepping stone while you pay down your debt and save money. The challenge with associating is determining what your income could be in the practice you join. You want to be in a practice that is ready to grow quickly by expanding clinical capacity. Otherwise, you could end up in a practice where you only complete two cases a day (or less!) on average, and you end up spending most of your time twiddling your thumbs (with your take-home pay reflecting that reality).

 

There are specific criteria that are helpful for associate doctors to determine if a practice is ready for them and can get them busy quickly. The first criteria is whether the practice is already successful at an above average level. If an “average” doctor completes only 3 to 4 cases per day, a truly associate-ready practice will have an owner doctor who is completing at least 50% more cases (5 to 6 cases per day).

 

Above average productivity is a sign of two important things that every associate wants to find in an employing practice. First, that the practice knows how to market and build referral relationships. Second, that the practice has figured out how to be efficient and productive clinically. That’s what will drive your income most as an associate, and that’s why associates in Endo Mastery-coached practice typically earn 2 to 3 times as much as associates in other practice environments.

 

Finally, I should mention the corporate vs. private practice landscape. Corporate entities are building their presence in the profession, and they are on a hiring spree for associates. I would suggest you use the same criteria to evaluate corporate positions. Focus on the specific practice you would work in, how truly associate-ready is it, how many cases will you complete daily, at what fee and collection ratio (since your compensation is percentage driven on collections). Also, keep in mind that working for these organizations adds another layer of management and oversight above you. Carefully consider whether the corporate culture is something you want to live with.

Your Career Start Options

There are a lot of questions about starting out and it’s hard to find clear answers. To help solve this problem, Endo Mastery has launched a free Career Start program for endodontic residents and new endodontists. This program features twice-monthly videos and a free one-day livestream seminar in June: “Pathway to Your Ideal Success in Endodontics”.

 

Whether your focus is new practice start up or associating, the Career Start program will give you some very practical information to make the best choices, plus crucial financial guidance to eliminate debt quickly and maximize your income. We’re really excited about this program. It’s something we’ve wanted to do for a long time, and we hope you join us!

THE ELEPHANT IN YOUR LIFE

DEBRA MILLER | DIRECTOR OF COACHING

I don’t know any more about elephants than the average person, but I am confident that taking care of an elephant requires specialized skills. If I were responsible for one, I would strive to be much better than the average elephant caregiver. I would want my elephant to be as happy and healthy as possible.

 

You are responsible for an elephant, in the form of your practice. Endodontists go to dental school, not business school, so most endodontists learn business ownership by necessity and by the seat of their pants. As a result, endodontic practice owners understand business ownership better than the general population. That much is true.

 

But what if my question was whether you understand business ownership better than your colleagues, who are also endodontic practice owners? Most doctors would answer that they are average, which actually means that they don’t know for sure. That’s a huge blindspot because you should know how well you are doing at making your practice “as happy and healthy as possible.”

Overcoming Your Blindspot

How does my practice appear to a referring doctor? How does my team appear to a referring An ancient elephant parable tells the story about how 6 blind men each touched different parts of the elephant to describe it. Depending on what part they touched, they formed different perspectives on what an elephant is. The tail is a rope, the side is a wall, the ear is a fan, the leg is a tree, the tusk is a spear, and the trunk is snake. None of them had the full picture.

 

Endodontists spend the vast majority of their time focused on treatment. That’s a great perspective on clinical care for the doctor. But heads-down in the operatory on a daily basis is a very limited perspective as a business owner, and it is the source of many blindspots and missed opportunities.

 

If clinical care is the heart of the practice, then viewing your practice from the position of a doctor in the operatory is akin to looking from the inside out. As a practice owner, you need to look at your practice from the outside in. Here are some perspective questions you should cultivate to overcome blindspots. Think about each one as a blind man touching just one part of your practice. What do they sense and what conclusions do they reach?

● How does my practice appear to a referring doctor? How does my team appear to a referring doctor’s team?

●   How do I compare with other endodontists in my area? What is unique or different about my practice compared to those practices? What do I or my team do better than other endodontists and their teams? Where are we deficient?

●   What perception do patients have when they speak to my practice on the phone? What first impressions are created by my facility and team when the patient arrives. What experience does the patient have during their appointment?

●   What is the experience of team members who work in my practice? Beyond clinical care, what would my team describe as my main priorities as a business leader?

●   What is my family’s perception of my practice, my responsibilities, and my work schedule?

●   If I was a different doctor who was buying my practice, what opportunities would I see that have not been taken? What deficiencies or limitations have been allowed to persist?

●   How do I feel as the owner of my practice? Have I achieved my vision?

●   How would an outside coach view my practice and opportunities?

The last question, obviously, relates very closely to Endo Mastery. It’s what we do. Most doctors have difficulty developing their “outside in” perspective for two reasons. The first reason, already mentioned, is that delivering clinical care is the heart of the practice. You can’t be everywhere else at the same time. Second, most doctors don’t have the broad-based knowledge across the whole profession to evaluate their practices objectively. As a result, most doctors vastly underestimate their opportunities for improvement and growth, and fail to act on those opportunities.

 

As coaches, we see this pattern everyday. Doctors are astounded by the level of growth they can achieve, how quickly they achieve it, and how blind they were to those possibilities before they started coaching. The light goes on once you shift your perspective and start asking the right questions.

SYMPTOM> CONCERN> PAIN> CRISIS

DEBRA MILLER | DIRECTOR OF COACHING

If you could magically reside in patients’ minds as endodontic conditions develop, you would see a pattern of behavior develop. On the balance, considering the general population of patients, when do most patients take action and seek out diagnosis and treatment?

●   In stage 1, patients might notice very mild initial symptoms: a twinge or something feels distinctly “off” at times. Most patients will be dismissive of initial symptoms unless they are exceptionally proactive and dentally educated.

 

●   In stage 2, symptoms progress to a steady concern: there is a growing discomfort that distracts them regularly. Some patients will seek out care, but many will “watch and wait”, and perhaps use OTC treatments to minimize symptoms or search the web for home remedies and advice.

 

●   In stage 3, discomfort escalates into pain: an ever-present throb and ache makes them unhappy and disturbs their sleep. Many patients will reluctantly realize that treatment is needed, although some cling to the false hope that the situation will resolve itself without effort, cost or intervention.

 

●   In stage 4, pain becomes severe and hard to bear: they are in crisis to find emergency relief as soon as possible. Patients make emergency calls to their GP, and their GP makes an emergency referral to the endodontist.

Considering how frequently we see emergency patients in endodontic practices, it’s a pretty clear sign that human nature is often biased towards waiting until pain is constant and the state of crisis is compelling.

Physician, heal thyself

At Endo Mastery, we see the same pattern in doctors with respect to their practices and lives. Some are proactive and vision-oriented, but many doctors are motivated to call us because symptoms in their practice and life are causing growing discomfort.

 

There are a wide range of symptoms that start out as a twinge but, as time passes, escalate to become greater concerns. Common ones include:

●   Stress around debt or cash flow

●   Decrease in energy or not having fun

●   Business or team management burdens

●   Team drama or poor team dynamics

●   Desire to work less without sacrificing income

●   Frustration from lack of growth, desire to grow

●   Loss of a key referrer or competitive pressures

●   Changing life goals and adapting the practice

●   Difficulty training the team

●   Desire to improve lifestyle and income

●   Feeling a lack of opportunities or resources

Waiting until you reach a point of crisis undermines everything you are working for. If something is needling you to the point where you are worried about it every day, carrying the stress around with you, and making it difficult to relax or sleep, then it’s clearly time to take action.

Visualizing Your Future

A great exercise is to think of what you want your practice and life to be like in 5 years. That is enough time to change literally everything and bring your practice and life into alignment with your ideal vision. But a lot of doctors don’t do this because they feel they don’t have enough opportunities, resources or control to achieve their desired outcome.

 

You don’t really know, however, until you dig in and start to take action leading to a solution. So, that is useful advice that we can learn from your patients: Don’t ignore the voice in your head until you’re in crisis.

WORK LESS AND EARN MORE IN ENDODONTICS

DEBRA MILLER | DIRECTOR OF COACHING

Given the chance, I think most doctors would enjoy being able to work less and earn more. Not only would work/life balance improve but rising income would add to your lifestyle spending power and overall net worth.


At the same time, a lot of doctors don’t believe it is possible for them to work less and earn more. In their minds, they have an equation that links how much work is required to earn a certain level of income. That equation tells them that to earn more, they need to work more. On the flipside, it also tells them that if they work less, they will earn less.


They also point out factors in the practice that seem to preclude the possibility of working less and earning more. Often, they believe their team as not ready or capable of rising to the challenge. Or they express doubts that their referral base could refer more cases.
More referred cases are the primary driver of higher income for endodontists. (A secondary driver is which insurance plans you participate in, which affects the reimbursement rate per procedure completed.)


So, for your income to rise, you need to complete more cases and there is no denying that sounds a lot like working more, not working less. In fact, completing more cases in the context of your current team structure, practice systems, and clinical workflow is probably more work. But it doesn’t have to be!

How More Cases Equals Less Work

In my mind, “work” has two meanings. The first is the “I’m going to work today” meaning, which is the time we spend away from our family to earn an income. The second meaning is “labor” … something that draws our physical and/or mental energy to accomplish tasks. Before I address the first one, let’s talk about the second one.


How much you feel the labor of anything depends on how much you love doing that task, and how much resistance you feel while doing it. Even when you love something, if you experience a great deal of resistance to achieving your goals, it can diminish the love significantly. Likewise, even an easy task that you hate to do feels like a huge burden.


Most endodontists have settled around a middle ground between what they love (delivering endodontic care to patients), the “labor” it takes on a daily basis, and the income it generates. But when you try to change the parameters, such as completing more cases to earn more income, the resistance scales up dramatically.


There are doctors who complete 4 cases a day and they feel stressed and labored. Other doctors complete 8 or 10 cases a day and feel effortless ease all day. The difference between the two is how you have optimized your team, systems, marketing and workflow. It’s no different than if you were a baker. The systems to bake and sell 100 loaves a day aren’t going to work for baking and selling 1000 loaves a day.


When doctors refine and improve their systems so that 8 cases per day are just as easy as 4 cases per day, what happens is that 8 cases actually become easier than 4 cases. It’s literally less work and more income on a per day basis! Professionalizing your practice to that level means purging out so much inefficiency, repeated effort and timewasters that were rampant at 4 cases per day (but allowed to persist). Suddenly, everything is in place for you to effortlessly complete more cases than you ever thought possible.

How Efficiency Drives Growth

What is common is that inefficient doctors and teams have difficulty believing they could complete twice as many cases during the same time. Their inefficiency is literally obscuring their opportunities for growth. Getting past the disbelief mindset is often the biggest challenge at the beginning.

 

The truth is that 90% of growth in an endodontic practice is driven by the team. When the team becomes focused on optimizing the doctor’s time, improving daily flow, and scheduling patients smartly so the doctor is never rushed nor ever idle, the value of the doctor’s time inside the practice can soar.

 

Value outside the practice soars too. If you have 50% overhead expenses to begin with, and you increase the number of cases you complete by 50%, then profits almost doubles! Wow!

Cases, Income and Work/Life Balance

It might be hard to visualize from where you are now, but this transformation of “work” is experienced by our clients over and over again as they grow. And it’s matched by a tremendous increase in income. For most doctors, going from 4 cases per day to 6 cases is enough to double their take-home. 8 cases per day can triple income!

 

Once you are successful at that income level, then you really have choices about how many days you are going to “go to work” … the first definition of work that I mentioned. For example, rather than 3 times the income, maybe choose 2 to 2.5 times the income while working one day less per week. Or, you can also keep your practice and income growing by integrating an associate, which opens up many short- and long-term options for amazing work/life balance.

 

There are so many possibilities and I always love to talk to doctors about their vision and how it can be achieved. I invite you to contact me anytime for a complimentary practice analysis and transformation conversation using the button below.

HOW DOCTOR EFFICIENCY DRIVES GROWTH

DEBRA MILLER | DIRECTOR OF COACHING

It’s your time that matters and what you should want (as a business owner, doctor and person) is to improve the value of your time spent in the practice, resulting in higher productivity and profitability. That, in turn, improves the value of your personal time – giving you a great life with the rewards that come from business success.

 

Endodontics is different than most other dental disciplines. In those disciplines, they have low and high value cases. For example, a GP practice can have cases that range from composite fillings for a couple of hundred dollars to full arch esthetic cases with fees of $15,000 or more. Once doctors reach a certain level of busyness, the only way they improve their value of time is by increasing the number of high value cases.

 

In contrast, endodontists deal with a stream of cases that all have relatively similar values. Therefore, the easiest way to measure the overall value of your time is the number of cases you complete. Whether you compare averages daily, weekly, monthly or annually, it’s a good assessment of how well you are using your time in the office.

 

Since endodontists can’t leverage their time through higher value cases, efficiently utilizing the doctor’s time is the primary driver of endodontic growth.

Two Types of Efficiency

Efficiency is the result of many factors in a team environment. In the endodontic practice, it’s useful to think about efficiency in two broad categories.

 

The first category is “clinical efficiency”, which is the time when the doctor is working in the patient’s mouth and providing treatment. This is the domain of the doctor, and it is their primary responsibility to develop the clinical skills to complete treatment effectively and efficiently.

 

Clinical efficiency is also affected by the assistant. A great assistant ensures the treatment room, instrumentation and supplies are prepared, so the doctor’s efficient workflow during treatment is never interrupted or delayed.

 

Today, most cases from bur-to-tooth to obturation can be completed by an experienced endodontist in less than an hour during a single patient visit. Given that endodontists are generally in the practice for 9 hours a day, that allows effortless completion of at least 6 to 8 cases per day.

 

Since most doctors complete only 3 to 4 cases per day, that turns attention to the other category of efficiency: “team efficiency”. At a very pure level of understanding, the primary role of the team is to improve the doctor’s efficiency.

 

The benchmark for assessing team efficiency is to start with the baseline of what the doctor is legally required to do. Aside from a few personal preferences the doctor may have, everything else should be delegated to a highly trained team.

 

In many practices, the doctor holds on to too many steps in the patient appointment that could be delegated to a well-organized and trained team. That leads to the doctor taking far more time than necessary and bouncing around between treatment rooms.

 

The schedule and flow become difficult to optimize in these situations. So, a doctor and team with low efficiency might only complete 2 cases in a morning, while a very efficient practice can double that. The impact on productivity and profitability (the value of the doctor’s time) is huge.

How Efficiency Drives Growth

What is common is that inefficient doctors and teams have difficulty believing they could complete twice as many cases during the same time. Their inefficiency is literally obscuring their opportunities for growth. Getting past the disbelief mindset is often the biggest challenge at the beginning.

 

The truth is that 90% of growth in an endodontic practice is driven by the team. When the team becomes focused on optimizing the doctor’s time, improving daily flow, and scheduling patients smartly so the doctor is never rushed nor ever idle, the value of the doctor’s time inside the practice can soar.

 

Value outside the practice soars too. If you have 50% overhead expenses to begin with, and you increase the number of cases you complete by 50%, then profits almost doubles! Wow!

THE TRUE COST OF AN UNPLANNED DAY OFF

DEBRA MILLER | DIRECTOR OF COACHING

Every doctor sometimes experiences the need to take off a day that would otherwise be dedicated to clinical care. It could be illness, a family emergency, or some kind of short-notice personal or professional need that results in the day being removed from the schedule. Estimating the cost of removing a day is easy from a production perspective. It’s simply your daily average production. However, the true cost is different than that, and it has a much greater impact. Because your fixed expenses do not change as a result of taking unplanned time off, almost the entire production amount is lost from your gross profitsConsider this example: If you are averaging $8,000 a day in production and working 160 days per year, the loss of one day as a percentage of production equals:
  • daily production lost / planned annual production
  • $8,000 / ($8,000 x 160)
  • $8,000 / $1,280,000
  • 625%

Now consider if your practice has a 50% expense overhead, with 42% of that fixed and 8% of that variable for supplies and other production-dependent costs. When you cancel a day, you don’t cancel any of those fixed costs and you only avoid the variable costs (8% of production).

 

That means 92% of the lost production comes directly from your year-end profits. The loss of one day (as a percentage) on your expected gross profits equals:

  • (daily production - variable costs) / planned gross profits
  • ($8,000 - $640) / ($1,280,000 - 50% overhead)
  • $7,360 / $640,000
  • 1.15%

So, in this example, the true cost of an unplanned day off has nearly two times the impact on the bottom line than it does on production. A couple of these days in a year and you may seem a little short on production compared to goal, but your take-home will significantly underperform your goal.

No one likes surprises at the end of the year. For this reason, it’s essential that any unplanned days off are made up for by adding days back into the schedule as soon as possible.

1 JOB OF THE ENDO OFFICE MANAGER

DEBRA MILLER | DIRECTOR OF COACHING

Most endodontic practices have an Office Manager, or at least a senior administrator who is charged with more overall responsibility. There can be a wide range of different tasks that the Office Manager is given, and these can vary significantly from practice to practice.

In some practices, the Office Manager may only oversee the administrative team’s tasks. In other offices, they are the right-hand of the doctor (management-wise) and may have a role in managing the entire team, handling confidential HR information and procedures, and the practice’s financial recordkeeping and accounting.

 

Often it is a question of trust, longevity and capability that determines how much the doctor delegates to the Office Manager. For practices with a more limited Office Manager role, Endo Mastery helps to expand their duties with training and accountability so that doctors can benefit more from a highly-trained team leader supporting them. For some doctors, this can dramatically simplify their day-to-day practice life.

Most Important Task

However, regardless of whether your Office Manager has a limited role or a fuller one, there is one vital task that every Office Manager must do on a daily basis. That task is to continually be aware and focused on optimizing the doctor’s schedule and productivity.

 

Ideally the doctor moves smoothly from patient to patient without being unnecessarily rushed or unnecessarily idle. A great day for the doctor is, as they finish one patient, the next patient is ready for them. The doctor is focused on what they are legally required to do in patient care, and they are surrounded by a highly trained team that handles everything else.

 

This opens the door for a high productivity schedule, but it requires thoughtful attention to the practice schedule. In Endo Mastery-coached practices, scheduling templates are carefully developed with the entire team choreographed around patients and the doctor. The Office Manager has primary responsibility to ensure the schedule is appointed with patients according to the template.

 

But that’s not everything that is involved. Endo has a high percentage of emergency patients that often need to be seen on the same day. Even when the template has times reserved for same-day emergencies, what happens if these are filled up and there is another emergency? The Office Manager, through continual communication between the administration and clinical team, is always prepared make adjustments on the fly when needed to squeeze in an emergency case. Maybe a patient can be asked to come a little earlier or a little later to open up space.

 

Likewise, the Office Manager pays attention to those days when the schedule template isn’t getting filled up. If there are openings, how do you get the day back on track? Can a patient scheduled tomorrow be brought in on short notice? It’s better to move someone and fill today’s schedule (buying 24 hours to fill in tomorrow’s schedule) than to let today fail to meet the practice’s goals for productivity and patient care.

Court Sense In the Moment

In basketball, they talk about a great player having court sense. In the middle of all the action, they intuitively know where everyone is, what openings can be created, and how to take advantage of opportunities. That’s your Office Manager … your MVP for offense and defense of the doctor’s schedule and productivity, everyday.

RAISING THE BAR FOR DENTAL ASSISTANTS

DEBRA MILLER | DIRECTOR OF COACHING

For endodontic practices, the doctor’s time is the most valuable asset. In very efficient and highly productive endodontic practices, the doctor and dental assistants work as a choreographed team to minimize the doctor’s time for each case. This allows the doctor to move smoothly from patient to patient, and to complete more cases per day without stress or idle time.

 

The baseline for establishing the choreography of your clinical team should be what the doctor is legally required to do in your state. Aside from a limited number of personal preferences for the doctor, dental assistants should be responsible for everything else that needs to be done in the clinical area during patient appointments.

Optimizing the Dental Assistant Role

Most endodontists learn marketing by trial and error when they first start to practice and have lots of time. After a few years of “hustling” to establish key referral relationships, they settle into the patterns of those relationships, occasionally adding a new referrer to the mix. Marketing often takes a backseat at this point.

 

At a certain point (and almost certainly when growth plateaus), you need a more disciplined and systematic marketing strategy. That includes a half-time marketing coordinator who prioritizes and nurtures referral relationships with regular meaningful contact.

 

When Endo Mastery begins to work with a coaching client, one of the first areas we look at is who is doing what during patient appointments. Here are some of the most common areas where doctors tend to under-utilize their assistants:

Assistants should be adept at establishing rapport with the patient and making them comfortable with what is going to happen during their appointment. They create value and appreciation for the doctor, so that the patient has confidence and trust. When the doctor enters the treatment room, they only need a few minutes to greet the patient and begin their diagnostic process.

Retraining isn’t about learning again how to do something; it’s about learning how to do something better. In that light, retraining is actually an ongoing process, because dental teams should always be striving to improve.

 

Every time something good happens, it challenges you to ask what can be done to keep the good times rolling. Every time something negative happens, it always challenges you to look for ways to improve so it doesn’t happen again.

 

But adapting to these challenging questions is a challenge in itself because often the answer isn’t definitive. Sometimes you are asking team members to be creative and try new things. That’s when you often experience resistance from your team … maybe not open disagreement, but the harder-to-detect “lack of genuine effort”. Team members get attached to doing things in a certain way, they become good at that, and they are often reluctant to step out on a limb when there is no clear benchmark for success.

 

In retraining, mindset matters more than anything. You have to create a culture that values learning and growth, accepts there are going to be bumps on the road to anything new, and rewards people who fully engage with the process. It’s groupthink, and progressive encouraging leadership that reinforces vision and goals is vital.

Assistants should complete CBCT scans and a prescribed set of radiographs. The CBCT image and supporting PAs should be manipulated to the doctor’s preferred screen view, so that everything is ready for the doctor when they enter the treatment room.

Assistants should deliver pre- and post-op instructions to the patient, and answer all their questions prior to the doctor arrival and after treatment is completed.

Assistants should ensure treatment room and trays are set up properly, with everything the doctor may need during treatment within reach without having to leave chairside. The lead clinical assistant should maintain a clinical manual for the practice and update it whenever there is a change or improvement identified by the doctor and team.

Assistants should prepare all treatment notes and reports to referring doctors according to a template established by the doctor. Doctors can quickly review and approve the notes and reports daily.

Like many business owners and healthcare providers, endodontists have a tendency to want to “do it all”. However, with systematic and careful training, a doctor can be confident and begin to trust in their team to take over more of the appointment process. In return, as assistants develop more comprehensive roles in the practice, daily flow and productivity can significantly improve while the stress of patient care is reduced.

UNTRAINING, RETRAINING AND CROSS-TRAINING

DEBRA MILLER | DIRECTOR OF COACHING

Keep the team running smoothly, performing at a high level, and helping the practice to grow requires a steady and focused approach to training. A team trained to the highest professional standards becomes your greatest asset and practice building. Teams that fall short of the mark can limit your success. Here’s some training tips that every practice can use:

Usually when you hire new people, you look for someone with previous dental (or preferably, endo) experience. You count on them coming with a set of skills that lets them integrate quickly and productively with your office.

 

What you don’t count on, and often overlook, is that they also come with the habits, values and mindsets of their previous practice. It can be a big gamble whether those things are aligned to your office. Many times, a new team member is thrown into the mix and it can be a big surprise down the road when you realize they’re in conflict with your goals.

 

Every new team member needs one-on-one training, which is often the responsibility of your office manager (for the administrative team) or your clinical lead (for dental assistants). Part of that training needs to be focused on finding the things that need to be untrained. Your team leader, when training and showing job responsibilities to the new team member, should be asking, “How is this different from the way you did it in your previous practice?”

 

By asking that question and highlighting differences, you create awareness for the new team member of the aspects of their job that they should not be relying on their “default” knowledge nor assuming your practice is the same.

Retraining isn’t about learning again how to do something; it’s about learning how to do something better. In that light, retraining is actually an ongoing process, because dental teams should always be striving to improve.

 

Every time something good happens, it challenges you to ask what can be done to keep the good times rolling. Every time something negative happens, it always challenges you to look for ways to improve so it doesn’t happen again.

 

But adapting to these challenging questions is a challenge in itself because often the answer isn’t definitive. Sometimes you are asking team members to be creative and try new things. That’s when you often experience resistance from your team … maybe not open disagreement, but the harder-to-detect “lack of genuine effort”. Team members get attached to doing things in a certain way, they become good at that, and they are often reluctant to step out on a limb when there is no clear benchmark for success.

 

In retraining, mindset matters more than anything. You have to create a culture that values learning and growth, accepts there are going to be bumps on the road to anything new, and rewards people who fully engage with the process. It’s groupthink, and progressive encouraging leadership that reinforces vision and goals is vital.

Everyone on the practice team plays a vital role. As long as everyone is there, in their lane and performing at a great level, every day can run smoothly. But what happens when something is out of place or goes wrong? A team member is absent, or an emergency (or more) needs to be scheduled into an already full day, or you have an equipment failure that slows everything down.

 

When these situations happen, it’s important that everyone who is on deck is capable of pitching in as much as possible to handle the flow. That’s where cross-training is so important.

 

There are certain tasks normally done by dental assistants that administrators can learn how to do. For example, turning over an operatory between appointments, or instrument sterilization. Be mindful of state regulations that may require licensure and a formal training program in infection control. Likewise, assistants should know how to cover certain tasks of the administrative team. For example, answering the phone, scheduling a patient, or processing a payment.

 

When you have team members who can adapt and be where they are most needed (even if it’s outside their normal role), you create a lot of flexibility. That gives you “court sense” on the fly to direct the team optimally as the schedule flow warrants.