I don't have enough time

This week I have had lots of conversations and communications with members of dental practice team, all with a common theme – “We don’t have enough time.”

I am being told that there isn’t enough time to

• ·        Speak to patients
• ·        Discuss treatment plans
• ·        Spend time with the team
• ·        Train the team
• ·        Keep on top of compliance
• ·        Keep track of the numbers and KPI’s
• ·        Discuss adverse outcomes and near misses
• ·        Review and up-date processes and protocols
•          Learn, develop and train
• ·        Etc, etc, etc

What are you too short of time to do?

There are only 24 hours in any one day for any one and the knack is how you manage yourself to make best use of the time you have here are some simple tips that will help you have the time you require

·        Do less you can action this by either saying “no” and delegate more.

·       Allocate time. For the tasks and responsibilities that you are failing to do, calculate how much time they will take and schedule the time in your diary to complete them.

·       Recruit – if your team don’t have the time available to do the what they need to maintain and improve the quality of treatment and care you offer, you will need to recruit more members to the team or use external contractors

·        Automate Some of what you do manually could be completed by software, or machinery, if so, bite the bullet by the appropriate tools to free up some time.

·        Ultilize the time you do have. If you have a FTA rather than a cup of coffee and a casual chat use the time to do something constructive.

·        Eliminate distractions. If. Like many you don’t get your tasks done because of too many distractions and interruptions, create open door and closed-door times. During closed door times, you are not to be disturbed save for a medical or other emergency.

·        Walk away. This may seem counter intuitive to walk away when you have too much to do and many incomplete tasks. However, evidence and experience shows that when you work for too long the number of mistakes you make increases. Step away, nourish, hydrate exercise and sleep so that you can return renewed, revived and reinvigorated.

     Let me know which of these strategies you have used an what difference it has made

Which box are you in?

I often get contacted by practice owners or practice managers because they have a high turnover of staff and want to stop the rot. The never ending revolving doors of staff members in and out is stressful, expensive, demoralizing and extremely time consuming.

Not surprisingly there is more to solving this problem than can be addressed in on blog and let’s make a start.

Consider the people who have left your emplyment and their reasons for leaving, where do they fit on the matrix below?

What do the axes relate to?

The X axis relates to how challenging the role is. This does not necessary hard it is more a function of variety, opportunity to learn, develop, and grow and having personal responsibility for achieving goals and targets.

The y axis is engagement, how much time you and your time spend interacting this could be;

ü  Being genuinely interested in how they are personally and professional

ü Listening to feedback

ü Productive staff meetings

ü 3/12 staff achievement and planning reviews

ü Informal ‘water cooler’ conversations

ü Social events

ü Empathy and compassion

Quadrants 1 and 4 are great fun places to work, where the team interact and get on, their mantra is “communication is the key to success” The same cannot be said about quadrants 2 and 3. Where “knowledge is power” and information is never shared. When I visit practices with high engagement they are buzzing and communication is effective I am expected and all members of the team know who I am and why I am visiting and make me feel welcome as I am sure they do for all their patients who look forward to their visits. By, contrast, when I visit 2 and 3 practices, it is a surprise to the receptionist that I am expected, there is nothing in the appointment book and they have not been told and no one else knows except the principal who is generally hiding in the surgery. Often described as mushroom management, keeping everyone in the dark it - it doesn’t work   A common plea from team members in quadrants 2 and 3 is “All I want is for the dentist to say, good morning, good bye and a thank you would be nice”. The key to creating high engagement is prioritizing time for conversations.

“A Problem can only be present when a conversation is absent”

Low challenge practices 1 and 2 are generally bumbling along with very little engagement from the principal. The team make the day to day decision and the practice owner offers little if any guidance. The mantra for these practices is “This is the way we have always done it”. The danger is that practice is out of date with compliance or new clinical advances and because there is standing still in business these practices are going backwards as those around them develop and grow. “If your practice is not growing it is dying”

High challenge practices, embrace learning development and improvement, they not only stay up-to-date, they lead the way. For these practices, the mantra is “good is not good enough”

Consider the matrix for a moment which box do you think is the most sustainable from a business perspective, rewarding to work in and the one that patients want to be treated in?

Box 1

A nice place to work and no-one is using their gifts or fulfilling their potential. Conversations in this quadrant tend to be much more personal or social and far less about work, with little or any targets or accountability- Cozy and mediocre.

Box 2

Team members are less likely to want to come to work because there is little comradery and the work is not challenging. Team members are generally bored and looking forward to payday. Apathetic and boring

Box 3

This is toxic an environment with little communication and high demands. Commonly in this quadrant, practices are understaffed, under resourced and there is a dictatorial style of management, staff meetings, if they happen, are a list of what has been done wrong. Discouraged and stressful.

Box 4

Utopia a practice where there are productive conversations, share understanding and appreciation of one another. There will be a vision for the practice and program of growth and development tailored to each team members. Team members in this quadrant are loyal and stay for years and will generally only leave because of re-location of a partner. Empowered and Fulfilling.

Which box are you in?

If you recognize that your practice is quadrant 1,2 or 3 and you want to move to quadrant 4 call me on 07989 757 884 and I will show you simple and effective tools to make the transition.

If you are in box 4, you know there is still room for improvement, and I can support you in your continued growth. Call me on 0798 757 884.

I've just been blindsided

I was listening to an audible recording today and stopped in my tracks by the phase “Failure only occurs in someone who does not acknowledge their faults”

As I reflected on this I was remined about a recent conversation I had with a coaching client, who is currently taking their practice by the shirt-tails shaking it up and transforming it into what he wanted it to be when he first opened the doors. Over the years he had become busy being busy and lost sight of why he set the practice up and one day realized that it had drifted far from his original plan.

We spoke about Johari’s window, and how it describes what working with a coach can do.

For all of us we have areas that we know about ourselves that no one else knows, our strengths, weaknesses, passions, frustrations and fears etc.- This is called the hidden area. There are also things about us that others can see and we can’t, The blind area. There is an unknown area which neither our self and others know and also an open arena of information that you know about yourself and others also know. The model recognizes that the larger the open area is the more choices and control you have and therefore the more successful you will be. My client observed that my coaching was enabling him to increase his open area, discovering more about himself that he was able to share and learn more about his true self from / with others and this was making him a more respected, influential and empowering leader in his practice.  In his free flow reflection, he observed that the blind area in Johari’s window was very like the blind area on a lorry, that when you were in that location as a pedestrian or cyclist you were at risk of being killed.

He went on to reflect that the hardest and yet most rewarding aspect of coaching was that I had taken him from a place of unconscious incompetence, when he had no idea the mistakes he was making and the ramifications they were having to a place of conscious incompetence which he described as an “Oh my God moment”, when he looked into a metaphorical mirror and became aware of the costly errors he was making and the damage it was having on his family, his finances, his team and patients. My client expressed his gratitude that I then supported him giving him the information, support and space to think and decide, so he moved into a place of conscious competence.  And now he is reaping more benefits that he initially dreamed about as the coaching has moved him to a place of unconscious competence. Now he is excited about moving round the cycle again to discover more that he didn’t know that he didn’t know.

What he said about Transform you practice in 10 days.

 “Essential for anyone thinking about setting up a practice or having trouble running a practice  who is seeking ways to improve”

As soon as you are ready to take the first step and examine your practice, please feel free to use our free online tool, The BrilliantPractice Evaluation (BPE).  or use this in your browser  https://www.surveymonkey.co.uk/r/Briliant-Practice-Evaluation-BPE 

Many clients tell us that it helps them look at their practice honestly and unemotionally and others have found it an invaluable tool for creating and maintaining success.

So as I write this refection I am filled with enthusiasm for my next conversation with my coach so she can help me discover more of what is in my blind area.

This morning on R4, there was a discussion about the FA profits/losses and mention was made that their staffing costs are 70% of their income.

How do your staffing costs compare, and what would you expect from them if you if you were paying your team 70% of your income?

Would love to hear your thoughts Jane@IODB.co.uk

Resentment is like an allergy

Resentment is like an  allergy

If you or someone you know has a peanut sensitivity, each time peanut products are eaten peanut, your response will be more marked and more rapid and what started as a minor itch on contact with peanuts will escalate  o a risk of anaphylaxis.

Have you noticed how when someone does something that aggrieves you and makes you feel bad, angry or resentful on subsequent occasions if that same person makes even a minor mistake, or says something with an inappropriate tone or attitude towards you the feeling of annoyance is out of proportion to the trigger. Have you also noticed, that like the peanut allergy, subsequent events trigger negative feelings more rapidly that last longer and are felt more intensively? In a short period of time, you notice there is a deep sense of resentment being harboured and expectation that the person concerned is going to injure your feelings do something wrong on every occasion and you find yourself not only expecting the wrong doing, you are actually looking for it, to justify your righteous indignation.

"Resentment is like drinking poison and hoping it will kill your enemies.” Nelson Mandela

The success of your practice is entirely dependent on the sill. performance and cohesion of your team.

Consider now, are any members of your team harbouring resentment or animosity towards you or another colleague, and if so how is it impacting your practice, team, patients and bottom line?

"There are risks and costs to action. But they are far less than the long-range risks of comfortable inaction. " John F. Kennedy

Are you comfortably taking no action, ignoring any disharmony between team members? Or are you taking action to develop a culture of building and repairing forgiving, trustful healthy relationships?

"Leaders don't do what is easy they do what is right"

What difference would it make to your team, if by setting an example as soon you realized that you had upset a colleague you apologized, sought forgiveness and reconciliation? How could you create a culture and opportunities that your team are able to be safely honestly, truthfully express when they feel aggrieved so that forgiveness and reparation can achieved creating a strong harmonious team?

FIRST class -customer service

FIRST class customer service is what will build your practice reputation and do more to build your patient list and profitability than your clinical skills training. Yes, your clinical skills should be the best they can be and your customer service needs to be of a higher standard than what you can do with a handpiece. FIRST class customer service makes you proficient, popular and profitable.

Friendly. One of the first steps to awesome customer service is being friendly. It sounds so simple and yet I hear so many patients complain to me that their dentists and receptionists are unfriendly and it puts them off treatment or even returning to the practice. Your friendliness and that of your team will be impacting your bottom line. Unfortunately, the most unfriendly practices can be those with a high NHS commitment and with the focus on throughput, the first casualty is often customer care. How can you be more friendly to your patients? I am sure you know the answer to this, smile as you greet them, make eye contact, use matching and mirroring to increase rapport, show interest in them beyond their teeth, and listen. What else is on your list and how can you increase the friendliness across your whole team?

Informative. A complaint I hear from patients that undermines their trust with their dentist is when they are not told relevant information. You can massively increase your patient’s sense of loyalty to you and the practice by keeping them informed. Don’t just tell them about their dental health, show them, inspire, and encourage them so they take ownership and become part of the process and when they respond well praise them. Inform them of advantages, disadvantages, and what they can expect to experience between each appointment. Of course, you must inform your patients of the cost, and when you do what difference will it make to you and your patients when you go through the treatment plan, rather than it being generated at the reception desk. There is so much you can inform your patients about, and being mindful of information overload, you must give sufficient information to satisfy your patients, the GDC, your indemnity and to keep yourself safe. When you are providing information, make sure it is in a format that is intelligible and retainable. Do your patients need pictures, videos, sound recordings, written documents, demonstrations? Where, what and how can you give your patients sufficient information?

Responsive. Your patients love it when you are responsive to their wants needs and preferences, and customise the serve you offer to them. The more you know your patient demographics the more you can respond. Being responsive can be the tiny things such as having a padded coat hanger for them to hang their coat on rather than putting it over a chair or it could require a larger investment such as furniture appropriate to their conditions. It never ceases to amaze me how many practices and hospital have an elderly patient base and chairs that are so low the patients can’t get out of them. What can you do that ensures the customer service you offer is FIRST class, by becoming increasingly responsive to your patient’s current and future wants and needs?

Sincere. All your patients have amazingly sensitive and accurate, sincerity detectors, as soon as they sense that you are doing or saying something gout of process rather than because you mean it, it becomes highly counter-productive. Consider your emotional response when a check out assistant bids you farewell by saying “Have a nice day” and you know there is not an ounce of sincerity in their voice. Where are you and your team at risk of being insincere? Is it when you hand over your card and say “Call me any time over the week-end I am here to help”, or when your patient care co-ordinator  says “if you have any questions call me any time I am happy to answer any questions you may have”,  or when an patient rings with an emergency at 4:30 on a Friday and your receptionist says “Of course we are delighted to be able to fit you in this late on a Friday.” How can you and your team can increase their sincerity?

Timely. If there is one thing above all else that patients resent, is when they are kept waiting for their appointments. They report that they are not treated fairly, they can be refused treatment for attending 5 minutes late and often kept waiting for 45 minutes or more. Many patients have asked me to speak to their dentists about their time keeping particularly when patients book the first appointment in the session and are still kept waiting because their dentist has not turned up on time. Are your patient really being unreasonable when they object to being kept waiting? You can improve your time keeping by scheduling sufficient emergency slots only to be used on the day, allocating appointments that are long enough, ensuring you have enough equipment and an adequate decontamination process so you are not waiting for instruments, and being prepared. Yes, we do know that sometimes dentistry does not go according to plan and you may run late and having a way to manage this is essential to offer a FIRST class service. I would suggest that if you are running more than 10 minutes late more than once a week, you would benefit from looking at how your appointment book and surgery time is being run. What do you think you can do to increase the timeliness of your practice?

To summarise to offer a FIRST class service you must focus on FIRST things FIRST.

F = Friendly

I = Informative

R = Responsive

S = Sincere

T = Timely

Let me know what actions you have taken as a result of reading this article, and what impact it has head on your patients and practice.