What you see in this picture is a small but important ceremony that takes place each week in The Winter Lab in Laguna. That is a samurai figurine there in the middle being passed from one team member to another.

In Japan, the samurai exemplified the traditions of honor and self-discipline. The samurai were warriors who believed in respectful, ethical behaviors. The samurai held themselves to exceptionally high standards as examples to others.

And in The Winter Lab, the samurai figurine represents the best of what we can be. It is given each week to a team member who has done something to honor the traditions and ethics and standards of the lab in an exceptional way.

What I love about this is how inspirational this award has become among the team, how meaningful it is for them to have that samurai sitting in their workspace for the week. And that’s a lesson for anyone who leads a team.

Incentives can take many forms. Some, like the passing of the samurai, are simple recognition awards with no financial component. Others are purely economic incentives. Whether to implement a rewards system and what form it should take are contentious issues among dentists. I’d like to see what your responses are to the following questions:

 Loading ...

 Loading ...

 Loading ...

 Loading ...

What is your feeling on reward strategies in general? Are they a great way to keep the team motivated, or are they more trouble than they’re worth? Do they get “tired” and lose their incentive value over time, or do you find you’re able to keep it fresh and energized so that it retains it incentive power? Share your thoughts below.

When restaurant owners think about maximizing profitability, they focus on two questions: how many customer sittings can we “turn over” within the available hours, and how can we get them ordering the right things? Too many “appetizer-only, no-alcohol” diners lingering for too long can put a restaurant out of business. Of course, the right atmosphere and quality food and service are what drive results, and the results they are driving toward are simple: more customers, making more of the right menu selections – the kind of selections that allow the restaurant to get a profitable return while showcasing their finest creations.

Similarly, the items on your “menu” of services also represent a range of value and sophistication, even more so. When you compare a single filling to a full-mouth reconstruction, it’s obvious that not all hours are created equally. So for the dentist who wants to grow the business, the focus shouldn’t just be on getting more patient “sittings” in the chair, it should also be about getting as comprehensive as possible with each patient. (And just like the restaurant, you drive those results by being sound on the fundamentals, which in your case means providing the right patient experience, supported by outstanding clinical and value creation skills.) It may seem obvious, but the need to “go deep” is something that some dentists tend to lose sight of in the quest to acquire and serve more patients. It’s not just how many people are coming in, it’s what they’re ordering.

And this brings me to the most important point: the “revenue versus expenses” factor. Your overhead rate is an important indicator, but it’s worth keeping in mind that overhead is actually always 100% until you break even, after which you’re just paying variable expenses such as lab and supplies. That’s when you start to see the big gains on the bottom line. And having more higher-value appointments each day gets you to that point of optimal profitability that much faster.

 Loading ...

Yesterday, Cheryl’s Buick told her to pull over and turn off the engine. She did. Cheryl has always listened to those with more information than her and she had no reason to doubt her Buick. The radiator reservoir was empty and new vehicles have a sensor in there that interprets empty as really bad – WHEN IT IS SAFE, PULL OVER AND TURN OFF THE ENGINE bad. So it was off to the dealer for an examination and treatment plan. They don’t allow parents to go back with their Buicks (for “safety” reasons according to the sign) but they told us the water pump was leaking and needed replacement. We left the Buick and headed home.

I kept thinking about whether or not the Buick really needed a water pump, it only has 60,000 miles on it, isn’t that the usual thing they say when the radiator system is involved? Maybe we’re being taken for a ride (lots of places to go with that one when we’re talking about Buicks, right?) because that’s what I’ve heard those car places do. I grew up in a gas station! Like Frank, my dad owned a service station and I have a lifetime spent working on cars. Wouldn’t I KNOW if Cheryl’s Buick needed a water pump? By the way, I really do trust our service at this particular dealer.

SHOW ME
I NEED to SEE it and experience it even when there is trust already there. It’s too hard to battle the influence of the horror stories I’ve heard.

The parallel to what we do our patients everyday was powerful for me, “That tooth needs a crown.” They say OK, they smile and go up front, they LOVE and TRUST me! They go home and somewhere inside that little voice says “I wonder if I REALLY need a crown, I’ve heard they always say that, and besides, wouldn’t I KNOW if I needed a crown? I’ve had teeth my whole life and my parents had teeth and I don’t think every tooth needs to …”

You get the idea. They need to see it, to experience it, to ask for it, EVEN WHEN THEY LOVE US. Help them ask.

I know the Buick will be better and I know the Buick is at the right place. I hope they have the old water pump to show me when we pick her up.

If the response to my last couple of blog posts is any indication, it seems that dental insurance and the limitations around it (including self-imposed limitations) continues to be a hot-button issue among dentists. And not just among dentists—but I’ll get to that shortly.

At the end of my post about patients’ insurance mindsets, I asked for your help in a poll. I found the results to be predictable, dismaying and inspiring all at the same time.

The great majority of you – 76 percent of respondents as of today – said that the insurance mindset was “a big factor” in your practice that you are always working to overcome it. That was predictable, because for years I have been seeing how dentists have had to battle against insurance-based preconceptions in their quest to provide ideal care. And it’s dismaying because it means that the majority of patients out there are still not valuing dentistry in the right way, and that three-quarters of the dentists responding to that question feel they are in an uphill fight every day they go to work.

But it’s also inspiring because it reminds us that we are in a fight – a fight to preserve the independence and integrity of your diagnoses. The solidarity you display on this issue tells us something (believe me, it’s hard to get 76 percent of dentists to agree on anything). An issue this important that affects this many dentists and patients deserves considered attention and real strategies. It’s not just a fight against insurance companies. It’s also a fight against our own tendencies to play into the insurance game.

And that brings me to another response I want to note – a comment on my last post about how dentists have to resist the impulse to self-censor when presenting treatment. What makes this comment extraordinary is that it comes from a patient.

This is a patient who suffered significant dental trauma as a teenager and went through a number of dentists before becoming a featured case study for Dr. Frank Spear. You can read her whole comment on the blog page, but here’s an important excerpt:

“I went through a dozen highly recommended dentists. During that time, I went from 1 to 20 provisional crowns. No dentist stood up and said “you won’t like this, but…”

Every dentist assumed I’d say no. They self-censored.”

Until she saw Frank. Any notions of what she may or may not be able to afford never entered into his thinking. He listened to what she wanted to achieve and he told her what it would take to achieve it. And of course, he had the clinical mastery to deliver on that plan.

In my last post I said that the introduction of dental insurance has led to a mindset in many patients – the “Anything That’s Covered” (ATC) mindset – that has become a barrier to ideal care. But that patient mindset has, in many cases, also led to a clinician mindset – one that feeds off of and plays into this kind of thinking.

It’s a natural human reaction. You hear the “no” repeatedly from “ATC” patients, so you begin to anticipate it. And because you don’t want to keep hearing it (nobody enjoys rejection, after all) you begin to alter your presentations to accommodate what you think patients want to hear. You start self-censoring based on the perceptions you have of what they think their needs are, and what you think they will accept. And when you do that, you’re both playing a self-defeating game.

Even when you do present the absolute best treatment plan for them, you still often end up playing the game. “There’s no way I can do all of that, doctor,” the patient says. “What should I do first?” What they’re really asking is: “Which part of this treatment plan is not really necessary?” They want to divide it into the “needs” and the “wants” and the “wants” usually end up losing to other more exciting priorities. And they want you to help them prioritize; they want you to tell them which part of their treatment it’s ok to say “no” to.

If you want proof that allowing yourself to be pre-programmed by the “no” is self-defeating, you don’t have to look any further than the surprises. There are the patients who you know very well can afford it but who unexpectedly refuse even basic treatment. But there are also the good surprises – the ones you thought could never afford it but ended up saying yes. That’s not to mention the ones who ask you for treatment you didn’t even present.

These patients are living evidence that it does not pay to make assumptions. This is why you need to fight the impulse to play into the limiting mindset. You have to immunize yourself against the “no” reflex and make the commitment to “go in fresh” every time. A “no” today just means you fulfilled your obligation to present to the fullness of your ability. It’s just another opportunity to build the relationship further tomorrow. Stay committed to that purity of purpose and, over time, there will be more pleasant surprises in store.

Great dentistry is what it is, and being a great dentist means standing by that commitment to always say what you see, to educate, and to take patients on a journey towards valuing quality care.