The (Christmas) Party Is Over

I like to think that I have thrown some incredible Christmas parties for my staff over the years. Like many of you, I have thrown parties as a way to thank my staff. Over the years, I have treated staff to limousine rides, fine dining, open bars, disc jockeys, plays in Hollywood, private movie screenings, etc.

But now the party is over. Believe me, I wish the party could go on forever. How does the Prince song “1999” go? “But life is just a party, and parties weren’t meant to last.”

The reality of owning a small business is changing, and it is not for the better.

In California, businesses of all types are now required to provide their employees with three sick days per year. This sounds innocent enough, until you have to write the check. Let’s say you have four part-time hygienists; each one gets three days. That is 12 days of hygiene you pay for without any additional production for your office. Add to that the part-time assistants and front office staff, and now you are talking real money. You have to recoup this money from somewhere.

Also, the state of California suffered greatly during the Great Recession. So much so, in fact, that it had to borrow money from Washington, D.C., in order to pay the unemployment benefits for its residents. Now the bill is due, and California does not have the money to pay it back. Where does the state get the money? You’ve guessed it, from every single employer in the state.

So instead of thanking my staff during this Christmas season with a great party, I’ll thank them by helping California pay off its unemployment loan. I have no doubt that my staff will enjoy that just as much. I truly wish it did not have to be this way. I would rather patronize a restaurant and tip the staff. I am sure they could both use the business. That will not happen this year. I would rather take a nice ride in a limousine and tip the driver. That will not happen either. 

Tell me, am I the only one? Have dental office Christmas parties gone the way of the gold foil restoration?

Andy Alas, DDS 

Thanksgiving

Writer’s block! I’ve had it lately. I’ve been struggling with what I could share this time, and then it hit me. It’s going to be Thanksgiving! Duh. What better topic could there be for my blog post that comes out the day before Thanksgiving?

I certainly have a lot to be thankful for. I am very lucky that I figured out what I wanted to do as a career while I was in high school. I am thankful that I was able to work in the office of Phil Deal, DDS, orthodontist, as a junior in high school. He inspired me and gave me the confidence needed to “stay the course.” He passed away before I applied to dental school, but his wife, Jo, introduced me to some very good contacts for references. I am thankful for her help and for the dentists she introduced me to who provided me with good references based solely on faith in her and Dr. Deal’s reputation.

I’m also thankful for Betty Scott, the Texas A&M University Baylor College of Dentistry registrar at the time, who squeezed me into the interview schedule although I was one of those people low on the totem pole. This gave me the opportunity to express to the admissions committee my strong desire to become a dentist. Thankfully, they didn’t accept students on grades alone. I was accepted as an alternate and had to wait a year to start my training, but I “stayed the course.”

Most of all, I am thankful that my parents always gave me encouragement and helped me financially throughout my dental training. I did what most people recommend not doing and returned to my hometown, Fayetteville, Ark., to begin a practice with a very skilled general dentist, Ernest Stanberry Jr., DDS. In the three years I worked with him, he helped me improve my surgery and crown and bridge skills.

I have now practiced in my current office since 1980. I’m sure that seems like a long time; however, to me, it seems so very short. I am lucky to have started when I did because I have been able to experience the explosive changes in the technology of dental care. The past 10 years have been amazing to be a part of. I know I’m not ready to retire because I am really enjoying learning and being able to offer the best that dentistry has ever had to offer—computer-aided design and computer-aided manufacturing (CAD/CAM) digital restorations, 3-D cone beam diagnostics, implant placements, lasers, and new, predictable methods of bone generation and soft tissue reconstruction. These things all make practicing dentistry exciting. And, without a doubt, having the best staff ever makes these things possible.

Of course, I cannot leave out being thankful for having a wonderful, loving wife and a beautiful 18-year-old daughter.

During the Thanksgiving holiday season, I plan to rejoice in all the things I have to be thankful for.

Have a joyous Thanksgiving!

Terry G. Box, DDS, MAGD

The Holidays

This week officially is the beginning of the holiday season, and while you and your staff are trying to slow down, take it easy, and enjoy some family time, your patients probably are like, “Um, my benefits expire soon, so please see me for all that work you treatment planned back in February.” I propose that insurance companies change the benefits expiration date, but I suspect it is all planned out on purpose. 

I tend to especially become a perfectionist around Thanksgiving. I don’t know if it’s just my dentist personality taking over and wanting to do everything myself, but it is difficult for me to give up control. Last year, I was sleep deprived and taking care of an infant and let my mom do most of the work. This year, I’m ready to do (most of) it again. I must confess I am outsourcing the pies to a local bakery because pie crust…well, it’s just something I have learned not to mess around with from past experiences. Leave it to the professionals, I say. 

I am pretty grateful that my side of the family lives nearby and my in-laws are willing to make the trip here, which means I have zero holiday travel to deal with. The downside is everyone is in town for the weekend, and after a few days, I’m trying to find any excuse to get out of the house. And I do mean any excuse. I always wondered why the Greater New York Dental Meeting always began the weekend after Thanksgiving. Isn’t everyone at home hanging with their families, eating leftovers? But I get it now. Sometimes you just need a break from family time, and if you’re a dentist in the tristate area, you get a good excuse—if you need one, that is.

I hope everyone has a great Thanksgiving!

Lilya Horowitz, DDS, FAGD

3 Steps for Providing Effective Feedback to Your Team

Providing effective feedback to a dental team is critical to running a successful practice. Without clear communication, people can easily misunderstand or misinterpret your intentions. When you want to provide someone in your office with positive or negative feedback, you should remember that the goal is to provide that individual with constructive information to help them improve on some level.

For example, let’s say you just finished a difficult procedure that your assistant helped execute beautifully. At the end of day, you walk up to her and say, “Jane, you did an amazing job today!” She grins as you walk away, and you are so proud of yourself because you remembered to acknowledge her hard work…but what do you think she took away from that? Let’s change it around now and say, “Jane, you know that procedure we did for Ms. Smith? That went better than I thought it would, and it’s because of the way you retracted the tissue and had my field of vision absolutely clear. I could see everything because my mirror was dry, the cheek was tucked away, and your suction was in all the right places! That was perfect; please do that every time!” Which comment do you think will resonate more with Jane? Which one do you think she will remember and learn from?

Here are three steps that you can implement and easily teach your team to use daily:

1. Be specific with your example! If you want to provide constructive feedback, you must be clear on what it is that you want someone to continue to do, or what it is that you want them to change or improve on. 
2. Let them know how their action impacted the office. You may be surprised that many people are unaware of how their words, body language, and actions impact others. It is important for you to explain to them the outcome of their actions.
3. Be clear about your expectation. Let them know: If it’s good, keep it up! If it’s bad, teach them how to change.

Let’s look at an example of negative feedback. In this situation, one of the front desk staff, Lisa, keeps coming in with a messy uniform and looking completely disheveled. This is bothering you and the rest of your team.

Wrong way: “Wow, did you just pull your uniform out of the clothes pile and throw it on this morning?”

Better way: “Lisa, I’ve noticed lately that you are coming in with your uniform wrinkled and unwashed. The way you present yourself represents me, this team, and our office. I need you to come to work in a clean uniform, looking fresh and ready to go.”

In the second example, I was very specific with what I found to be a problem, how it was impacting the office, and my expectation of Lisa. It is never easy to give negative feedback; however, if you keep it professional and not personal, it’s easier to avoid hurting someone’s feelings.

Let’s face it: Being a leader is difficult at times. Communication is key, and what I suggested above is simple, but you have to practice it and get your team to practice with you. Try it, not just at the office but anywhere. The more you practice simple and clear communication, the easier it becomes to convey your message and your intention. It grows relationships based upon understanding, which in turn will surround you with people who truly understand you.

Pamela Marzban, DDS, FAGD

Don’t Skimp on the Help

We, as business owners, are constantly finding ways to improve the bottom line. It’s not that we are cheap or trying to cut corners. We run a business, one that allows us to feed our families, pay our mortgages, and go on those lavish trips to…err, I have a one-year-old. I’m not going anywhere at the moment!

With this, we’re always trying to find the best lab for the quality and cost, the best filling material for durability and cost, the best landscaper for greener grass and less money, and the best staff for the price.

Aaaaand here’s where I’m going to stop you….

In my six years out of school, if I’ve learned one golden rule, it is this: Don’t skimp on the help. Your daily schedule, patient experience, success, and livelihood depend directly on the staff you have around you. Our practice, for the majority of the time I’ve been out of school, has tried to keep our staff numbers to the minimum required level, and their salaries to a minimum as well. And it backfired. There were times when I was so unhappy to show up to work. And darn if it took me this long to realize it was 95 percent team related. One (or three) bad apple spoils the batch. They’re a chink in your otherwise strong armor. And they spread their bad attitudes like wildfire.

We have figured this out. The bad apples are out, staff numbers are at a more appropriate level for the speed and efficiency at which we like to work, and salaries are up. By golly, if morale isn’t at an all-time high. And imagine this—production and collections are up to a level that negates any increased cost in staffing.

I’m sure I’m talking to an audience who has already figured this out. But for those of you who were like me for so long, take a step back and evaluate your staff as a whole. Get rid of the bad apples—you’ll find better staff members. Trust me. Give that dedicated assistant or care coordinator a raise. Take them out on a fun social outing. Make it a regular thing. After all, these are the individuals who determine if you go home happy and reinvigorated at the end of the day or show up at home tired, angry, and ready for a beer. The former is so much more fun.

There are many ways to help out your bottom line in the new year, but don’t make staff one of them. Don’t skimp on the help!

Donald Murray III, DMD

I Found Myself

Recently, I traveled to Yosemite National Park in California to see a dentist who shaped the guy who you know today.

His name is Ray Bertoloti, DDS. He is the original bondodontist. I saw him a couple times a year in the late ‘90s as he traveled around the country. But now he only speaks in Yosemite, Hawaii, and Japan. So Yosemite seemed to be the closest.

My wife and I went out there together. I have three words for this part of the country: A MAZE ZING!

I am from Central Florida (I grew up there as well). I have been to pretty parts of the country, but this is another level of beauty. We flew into San Francisco and visited some friends who live in Marin County. Then, we took the 4 ½ hour drive out to Yosemite. The drive alone was worth going out there.

From the mountains to the Sierra Nevada, to the giant windmills in the fields, you move into the Yosemite part of the drive, and it is just breathtaking. There are pullover spots where you can stop and take photos, but if you stopped every time there was an awesome view, you would never get to your destination. 

 

It is a national park, and once you pay and enter, you can’t just drive; you have to ooh and aah and take photos…and then, stop and take more photos. Huge sequoias line the streets, and there are granite mountains and glaciers behind the trees. You kind of forget you are there for a dental course. 

There are only two hotels on the property. The Ahwahnee Hotel is the old hotel with the huge living room with the fireplace and nice restaurant. (There were postings near the fireplace that said something to the effect of, “If you find yourself falling asleep, please get up and go somewhere else.”)

The Ahwahnee was booked, so we stayed at the Yosemite Lodge at the Falls, which was “right across the street.” Funny story, when us city folk say “across the street,” we mean “across the street.” So we go down a street and, if you go right, you go to The Ahwahnee Hotel. If you go left, it is the Yosemite Lodge...this is what they mean by “across the street.” The hotel and the lodge are about 2 miles apart.

We got ourselves checked in, and I went straight to the lecture. Have you ever been to a lecture and halfway through it, you ask “Why do I waste my money on all the other lectures?” You know right then that this lecture is the place to be. Well, this lecture was definitely one of them.

Ed McLaren, DDS, led the first day of lecture to a small group of us. There were about 45 people in a small room. There was a question time built into his lecture, so he would answer a question that would lead to 10 more fairly intelligent questions.

I was as relaxed as I have ever been in a course. This was a group that knew their stuff, as far as adhesives and materials. The lecturers were definitely challenged by the group; they all were pretty bright and could handle this group.

I write all this to say, I think I am figuring out who I am dentist-wise. I am 46 years old, and I have found myself. I know the type of lecturer I like to see, and I know the dentists I like to hang around. I am starting to understand how I get jazzed in this profession.

I am a biomimetic adhesive operative dentist.

I love being a general dentist. I love working on all types of patients. I love all ages. I love doing esthetic stuff, including posterior esthetics, too. I like doing all of this, but with a minimalistic approach, and I want to know that what I put on teeth is going to last and look great.

So when I fly for six hours, then get in a car and drive for four and a half more hours to get to a lecture where, an hour in, I say to myself, “This was so worth it,” it is pretty fulfilling.

I felt the same way when I flew to Chicago to attend the 2009 Academy of Operative Dentistry Annual Meeting. Every lecturer spoke my language. It seemed that everyone, every other dentist I talked to, spoke my language.

Now I have figured out why I don’t feel that at my local study club—there are about 10 types of dentist there. Not that we can’t like each other, but it is just different. I know there are a couple of guys just like me at those study clubs, and I tend to gravitate toward them, but it is not the same as being in a room full of dentists just like me.

As a young dentist, I didn’t know this. I thought when I went to a course, if I didn’t love it, it must be me. As a young dentist, I tried to learn it all, so much so that I learned very little.
I would learn a lot, then go back to the office and practice the way I practice.

Instead of trying to do what everyone else seemed to be doing, I started trying to find lectures that teach what I like. How many times do you go to a three-day course that costs a lot of money and continue to say, “Yeah, right,” or “This is out of my league”? And then you hear the guy sitting next to you get exasperated, because he is thinking the same thing: “This is great for the one person I get to see a year who needs X.”

I know I am rambling, but it took me 20 years to figure out who I am. I want you to find out earlier than I did. I saw Dr. Bertoloti when I was just out of school. Then I went on a 20-year journey that led right back to him again.

Do you know who you are? Do you feel like you are alone in a room of dentists? Are you on your journey?

Let me know. Thanks for listening.
John Gammichia, DMD, FAGD

#AGDProud

If you have ever written on a regular basis, you will understand what I mean when I say I had a completely different blog post prepared, but after this weekend I ditched that story for this. Recently, AGD President Mark Donald, DMD, MAGD, challenged us to share with our friends and colleagues why we are both proud and loyal. 

I recently returned from the AGD 2015 Fall Joint Council Meeting on Oct. 30 to Oct. 31 in Chicago. It was, as I anticipated, an amazing weekend to collaborate and network with other AGD members. My journey to this aspect of my AGD service, at the national level, began last year after attending the 2014 AGD Leadership Development Symposium on Nov. 21 and 22 in Chicago. This most recent experience is just one of the many reasons I am #AGDProud: 

• I am #AGDProud that I have the opportunity to serve as a volunteer at the national level, working with my fellow council members to contribute ideas and concepts to share with other members.
• I am #AGDProud that our organization is passionate about our members.
• I am #AGDProud to share the excitement of becoming a Fellow with other members and help them with their journey to become a Fellow if they desire.
• I am #AGDProud of the AGD and the work being done to advocate on behalf of general dentists.
• I am #AGDProud to serve at the state level, working to ensure our members have the best benefits any organization can offer.
• I am #AGDProud to educate nonmembers about the benefits that the AGD provides.

How do you share your pride? We can all meet the challenge that Dr. Donald has asked of us.  

What do you think of when someone says they are loyal? Are you #AGDLoyal?

I think of a person, who, despite being presented with a conflict or challenge, continues to move forward in a positive way. I think of a person who is reliable and trustworthy. 

·         I am #AGDLoyal in that I am dedicated to our organization to serve in my appointed position.

·         I am #AGDLoyal to my colleagues who stand with me in our unified endeavor to create the best constituent we can be.

·         I am #AGDLoyal to my patients, and I continue to push myself to learn as much as I can in order to provide them with the exemplary care they deserve.   

I hope that you can share your excitement as an AGD member with your dental team, patients, and friends. Get the buzz going and push yourself to be #AGDProud.

Colleen B. DeLacy, DDS, FAGD

Things I Never Say to Patients

There are certain things I never say to a patient. As you can imagine, I’ve learned each of these the hard way. Allow me to save you from some pain.

'Nice to meet you.'

You believe you are being polite. In fact, you may actually mean it—you are pleased to meet them. The problem is they have brought in their husband, sons, and daughters to your office for treatment. Sure, it is the first time they are actually your patient, but they have spent hours in your waiting room. They know all of your staff by first name. Now here you come along and say, “Nice to meet you.” Nice going, you’ve just made them feel real special. Instead, I say, “Nice to see you!” Notice the difference? You may or may not have seen them before but either way the statement rings true: It is nice to see them.

'Who missed that cavity?'

Any guesses as to who actually missed that cavity six months ago? Who looked at those radiographs and missed that obvious carious lesion? You guessed it. You did. Corollaries to this include: “Who did that lousy root canal?” “Who did that ugly crown?” Avoid such statements. We all know the answers to these questions.

'I agree; your previous dentist sucked.'

My feeling on this: Just as you are saying this, someone is saying this about you. You’ve heard it in dental school and you’ve heard it while attending continuing education (CE) courses. Don’t criticize others’ dentistry since you were not there under the same circumstances. I know, this sounds obvious to you. However, you’d be surprised by the number of dentists who missed this lesson in dental school and in CE courses. Seriously, you’d be surprised.

'Yes, your insurance covers this.' 

What you meant was that the patient’s insurance will pay 50 to 80 percent of the treatment plan. What they heard is that the treatment is covered 100 percent—as in, it’s free. Can you spot any potential misunderstanding here? What I usually answer is, “I don’t know. Let’s ask Lisa.”

BONUS! I’ll offer this one for our wonderful staff members who answer our telephones:

'Have you been here before?'

Never say this. Sure, I’ve been here before. I just sent you a big fat check, is what your caller is thinking, so instead say, “When was the last time you visited us?” If they’ve never been to your office, they’ll say something like, “Oh no, this is my first visit.” Now you know whether they need a new patient appointment.

How about you? What are your cringeworthy moments? What things have you learned not to say to patients?

Andy Alas, DDS

Operation Rendezvous

It was a chilly October morning. The roads were washboard rough. A-10 Warthogs flew overhead in forward air control. Hueys were in the back, bringing troops and supplies forward. CF-18s were screaming by at low altitude, startling all of us, enormously loud and scary. You could hear the bombs and gunfire in the near distance.

We maneuvered our mobile dental clinics in the six-wheel-drive trucks towing 10 kW generators as close to the front lines as we were allowed. Arriving at our designated spot, the ground was uneven. We quickly dug a trench and backed the truck into it, and used the hydraulic lifts to finish leveling out the operatory. Firing up the generator, we had the clinic up and running in minutes.

At first, we saw trauma. My general practitioner training and knowledge were put to full use. As things quieted down, we did more routine dentistry including endo, perio, and restorative dentistry. Welcome to Operation Rendezvous 1989.

The mobile dental clinics operated by the Canadian Armed Forces were modern, fully equipped, functional dental operatories capable of completing comprehensive dentistry in a mobile field setting. As the commander of the dental field unit for the Allied Command Europe (ACE) Mobile Force, I had the opportunity to mix with colleagues from many of our allies, and our clinics were the envy of them all.

My family is about to undertake some renovations to our basement and in cleaning up some old files, my daughter, Isabel, found the certificate of appreciation I received for participating in Operation Rendezvous from our government. This was something she was surprised to see and very proud to have learned about. This was the first of three field operation exercises I participated in. The second was in Northern British Columbia in January 1990 and the final was in North Norway (Bardufoss, near Tromso) in February 1990. It was the highlight of my service to our country prior to my release at the end of my contract, where I settled in Calgary, Alberta.

The Royal Canadian Dental Corps, formerly called the Canadian Forces Dental Services, is celebrating its 100th anniversary this year (www.cda-adc.ca/en/about/forces/). It was founded to support the Field Ambulance in the First World War and was so successful the British copied the Canadian model.

At the 11th hour of the 11th day of the 11th month, we remember those who gave their lives for our freedom on Remembrance Day in Canada (Veterans Day in the U.S.).

I don’t talk much about my time in service of my country to my children. It was a big part of my past but not my present. But I am proud of that service and I find it humbling and satisfying that my daughters feel pride in my service as well. As a result, they accompany my wife and me to Remembrance Day ceremonies each year without complaint. And I am finding a growing number of young people doing the same thing…remembering and participating in remembrance.

And that is a good thing. By remembering we may be able to avoid the tragedy of the past.

Warm regards,

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