Ricardo pointing to a tv screen with a side by side mouth comparision

Let me share a story about something that happened to me recently in Scottsdale.

I went to the gym with the intention of doing a 30-minute session on the treadmill at the Scottsdale Fairmont Princess resort next door to the Spear Campus, when the sun hit me on the face through the window and I realized it was going to be quite annoying. Suddenly, within seconds, the electric shades in front of me came down and I was good to go!

I turned around and I saw one of the gym instructors with the remote control for the shades in his hands. He looked at me and just said, “I anticipated your needs!”

This incident wowed me in many ways, but I guess the most remarkable aspect was how he seamlessly responded, as if it was part of his guiding principles, or perhaps the resort's guiding principles.

So, let’s reflect for a second about the concept of anticipation in the dental office, and single out different scenarios.

Anticipation during standard procedures

Perhaps the best example of anticipation from the world of sports, is the legendary Wayne Gretzky, whose unrivaled record as ice hockey’s all-time leading scorer was nothing else than the product of “foreseeing” where he had to be in the skating rink before his opponents.

This “simple fact” is extremely complex and can only be explained by:

  • “The Great One’s” advanced knowledge of the game
  • His ability to recognize patterns that would lead him to be in the exact position he needed to be to have an advantage

Keeping this in mind, the dental team should consider fostering the ability to identify risks and opportunities, and to determine protocols and actions to tackle them. An anticipatory mind requires that we are constantly aware of what may happen and being prepared to take appropriate action to provide a worthwhile experience for our patients.

As we review the day ahead and plan for a smooth outcome, our morning huddle needs to be conceived as the ultimate anticipation exercise. The photo above shows my team during our morning routine.

Anticipation allows us to:

  • 1. Be in control by remaining alert and on time
  • 2. Effectively plan, evaluate possible scenarios and consider alternate options
  • 3. Design contingency measures
  • 4. Improve communication with our team and patients

A good example of this is reviewing our patient schedule and anticipate which Patient Education videos we may play for them during their appointment. Ensuring the entire team is on board makes everything smoother.

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Anticipation during extraordinary situations

A few years ago, we had a pretty bad earthquake in Mexico City, where my practice is based. It happened during business hours, so we had five operatories working at full speed.

Mexico City is considered “earthquake prone,” so it is not unusual to hear the earthquake alarm, which theoretically means that there is time to evacuate the building in an orderly fashion.

At any rate, that morning in one of our operatories, Dr. Humberto Ciprian, one of our associates, was getting ready to do a ceramic try-in of an implant-supported, single-tooth maxillary central incisor restoration. Suddenly, we started feeling the earth shaking.

While some people are calmer than others during an evacuation, every person responds differently. This patient nearly jumped out of the chair in the middle of the procedure to make her way out of the office and building within seconds.

Since our office is on the third floor of a 10-story building, the street was rapidly flooded with people who evacuated from all the offices in the building, as well as the neighboring buildings.

Hundreds of people were there waiting on the street for things to calm down, to resume their business. Suddenly, Dr. Ciprian realized that our patient left after removing the screw-retained provisional, prior to trying implant restoration. He realized that not having her restoration in place would cause soft tissue collapse, not to mention that she would appear to be without a central incisor.

Ricardo pointing to a tv screen with a side by side mouth comparision

He immediately grabbed the provisional, along with a screwdriver, and rapidly left the building to begin looking for the patient among the large crowd on the street. He finally found her and proceeded to insert the provisional in front of everyone.

The patient was incredibly relieved, since she was still shaken from the earthquake-related anxiety. I cannot remember a time we saw a patient that was so grateful.

This was clearly an unexpected event that exemplifies not only the concept of thinking a step ahead of the game, but also knowing exactly what to do.

If you think about it, there are so many times where we can think of ways to address unforeseen situations, such as:

  • An overbooked schedule
  • A busy day in the practice when you are running behind schedule
  • A patient cancelation that leaves you with a large opening in the schedule
  • When the lab didn’t make it on time and the patient is already in the chair

Treatment contingency plans in case something goes wrong

As mentioned, the daily huddle allows us to review our flight plan. Nonetheless, on a normal day in practice, there will be unexpected situations related to scheduling, patients arriving late, emergencies, unforeseen outcomes during a procedure, or even earthquakes.

In this recent Spear Digest article, I make recommendations for contingency planning to avoid complications with implants and prostheses. As I noted then: “Considering contingency during treatment planning forces clinicians to create a solution for a problem they know will or may occur. It focuses on providing solutions to problems after the treatment develops the anticipated complications.”

Having the anticipation concept dialed in as part of our guiding principles, our brains and the brains of all members of our practice, helps everyone generate the best possible outcomes.

As we consider anticipation as a guiding principle in our offices, it would become natural to incorporate this as part of our growth mindset.

This begs an interesting question ...

Did Wayne Gretzky become the best hockey player ever as a result of his ability to anticipate situations? Or did he anticipate that he needed to develop this skill in order to become the best at what he did?

In another previous article, we discussed the challenges of communicating with patients in the Age of Information, such as avoiding “information overload” and addressing patients’ desire for immediate gratification with their dentistry. With the anticipation issue in mind, this should invite us to think about questions like:

  • Where do you see yourself in the future?
  • What type of dentistry do you envision doing?
  • What new trends in dentistry would you like to learn?

We certainly hope that Spear plays an important role in answering those questions and helping you tackle your own challenges with anticipation as you advance deeper into this rapidly shifting era of modern dentistry.

Ricardo Mitrani, D.D.S., M.S.D., is a member of Spear Resident Faculty.


Commenter's Profile Image Carl S.
July 24th, 2019
Great Article Ricardo While the ideas of preparation and anticipation are paramount to our success clinically, in our business and our personal life, not enough of us are prepared for what is to come. Some may argue Man plans God laughs but if you have no plan you probably are setting yourself us for failure . My team hears this message regularly and it will be the topic of our Team meeting next week. All the best, Carl
Commenter's Profile Image Ricardo M.
July 24th, 2019
Hi Carl, I agree with you 100%. We hardly think about it, and this is why I thought it was important to bring it up and hopefully start discussions among our teams. In fact we are filming a series of Team meeting on this specific theme very soon. Your feedback after your meeting next week will be super useful. Thanks so much. Cheers, Ricardo