December 2012 – Codiscovery

Know Yourself Worksheets & Thoughts By Bill Lockard, Jr. DDS

Posted on December 25, 2012

Know Yourself

Why – Why do you do what you do? What will be your sentence?

Self-Image – Who are you when you are at your best? What are your best qualities?

What areas of personality and behavior do you want to improve?

Material Things –What is your goal for financial success? How much is enough?

Home – How is your home life? Enough leisure time? What could make it better?

Health – What are you doing for health, fitness, and athletics – personal appearance? Do you

have a pleasant personality and positive mental attitude?

Relationships – Describe your relationship with friends, family and staff members? How does

your personality and behavior profile relate to others?

Work – Are you happy in your work? Are you a continual student? Are you doing what you

really want to do? Do you work with people you enjoy and respect? Do you produce

excellent comprehensive care? Do you work for people who appreciate you? If your answers are NO, how would you make changes?

Life Style – What are you doing to pursue an active life style? What do you want out of life?

What will it look like when you have it? How will your life be different when you have it? What are you willing to do to realize your dream?

Life Purpose –Your life has a unique purpose fulfilled through what you do your relationships and the way you live. Describe that purpose as a reflection of your aspirations.

Spiritual Health – Describe the spiritual influence in your life. How does your belief system

and values influence your behavior and spiritual health?

If you could have everything you desire, what does it bring you? How would your life change?

M. William Lockard, Jr. DDS

START not with WHY… but know HOW:

ü WHY do you want to create this dental practice – for what purpose?

ü HOW- is your Philosophy of values and principles – doing what is right. HOW and WHY give people in an organization a sense of values by which to work and live. It sets the standard for your character and integrity. How we do things manifests in the systems and processes within an organization and the culture.

ü WHAT- is your style of practice that you create; the dental procedures that you provide.

Have you developed a strategic plan, step-by-step, to achieve your dream?

ü Have you shared your Vision, your WHY and HOW with your team?

ü Is your office well organized? If not, why not?

ü Do you obtain professional financial, organizational, psychological and team management advice?

ü Describe your leadership style: visionary, directive, democratic, coaching or empowering.

ü What will the physical environment of this new practice look and feel like?

ü What are the characteristics and expectations for your team members? Are they clearly understood? Do you have a system to hire the right people first – then train them to your standard of excellence?

ü How will you and team members handle good and bad times?

ü How will this practice allow your personal life to flourish?

ü Do you have inner peace?

ü Have you established the Seven Systems that run your practice? Clearly defined with standard of excellence and responsibility assigned?

Financial Management Patient Retention

Exceptional Team New Patient Development

Technical Excellence Time Management

New Patient Experience

After you answer each question…..assume that you actually have what you want.

Ask yourself, “What would that bring me….how would my life change?”

The Power of Positive Attitude

Attitude is the all-important key to success and happiness. The winner’s edge is more than talent, education or money; it is a positive attitude, good self-image and likeability. We can’t capture success, nor can we buy it, or inherit it. We can only create it. And the only way to create it is by changing our thoughts and habits. We become what we think about most; our thoughts become our reality. Our only limits are our thoughts. Many times a positive attitude is more important than actual fact, regardless of how impossible the situation. Our attitude of confidence and passion for our ‘purpose’ will determine our capacity because it affects and releases our full potential.

It is our attitude that causes us to think, act and believe as we do. Our behavior is a result of our physical, mental and spiritual health. When we radiate a positive attitude of wellbeing and the confidence of a person who knows where he is going, good things will start to happen. Happiness and enthusiasm are contagious to everyone around us. Humor and joy are the ingredients with healing power that keep everything in proper perspective.

It is a positive attitude at the beginning of a task that affects a successful outcome. We get what we expect more often than not. All our actions, feelings, behavior and even our abilities are always consistent with our attitude and self-image. What we expect to see, in large part, we see. What we expect to have in our life, we have. What we focus on most expands. It is a cumulative process.

Our attitude toward others will determine their attitude toward us. The way we see, think or feel about people affects the way we treat them, and the way we treat them affects the way they respond. If you will treat everyone you meet for the next 30 days as the most important person on earth, you will do it for the rest of your life. The reward will be life changing – for you and them. Before a person can achieve the kind of life he wants, he must first become that kind of individual. He must think, look, and conduct himself as would the person he wishes to become.

We have been given the opportunity to assume the responsibility for the quality of our life. Accept the responsibility and develop the characteristics of honesty, integrity, empathy, sincerity and good humor. Thinking that you will make it happen and then doing it is the key. It is the defining characteristic of all successful people.

This life is yours.

Take the power to choose what you want to do, and do it well.

Take the power to love what you want in life, and love it honestly.

Take the power to walk in the forest, and be part of nature.

Take the power to control your own life;

No one else can do it for you.

Take the power to make your life happy.

-Susan Polis Schulz

Self-Knowledge, Happiness and Character in Relationships

Character and Predicting Happiness

Do you know what will make you happy? Many people live much of their lives saying, “If only I could really have the love of that person,” or ”have children,” or “get that job” or “that promotion,” or “live in that house,” or “win the lottery, then I could be happy.”

The study of happiness is a major new field of study in psychology. Dr. Martin Seligman and his colleagues have done a great deal of research on happiness. His research supports the argument that happy people are those who have developed their character and strive to be good people.

The psychologist Daniel Kahnemann won the Nobel Memorial Prize in Economic Sciences in 2002 for his research about how people choose and make decisions. His work shows that after getting the things that we think will make us happy, and after indeed experiencing a brief spurt in our level of happiness, which may last for as long as a year or two, we return to whatever level of happiness we had before we got the desired person or thing. Whatever positive feelings we do have are usually not as intense as we think they will be, and they don’t last as long as we expected.

We overestimate what the fulfillment of a wish will do for us, in part because we don’t realize what demands will be made as a result of having the wish fulfilled. Getting the things that we think will make us happy often requires us to change in some unexpected but significant ways. They come with requirements for us to adapt to new realities. Winning the lottery is one of the best examples of this.

Happiness is determined by who we are, the kind of people we are. It is a mistake to expect marriage or winning the lottery to make you happy if you were not happy with yourself and your life to begin with.

Aristotle said that happiness is first of all, about being a good person. He said being happy is inextricably tied in with virtue. He believed that successfully developing and strengthening our character would produce the most satisfaction in life. Those who have a weaker moral life are not as happy, no matter how successful they appear to be. They foolishly pursue wealth, status, security and material things as a way to feel better about self, and it does not work.

Self-Knowledge and Happiness

A basic attribute needed for becoming a better and happier person in life is self-knowledge. We all think we know ourselves, but that is a fallacy. It is not easy to know ourselves. It requires a great deal of objectivity. Self-knowledge, knowledge of others, and a correct understanding of the situation we are a part of or the context in which we live all go hand in hand. People of good character have a better grasp of these three areas than do others because their perceptions are more accurately based in reality.

Self-knowledge requires awareness of how we are behaving. The problem occurs when we allow our imagined picture of ourselves (what we want to believe about ourselves based on our subjectivity) to obscure any knowledge of our actual behavior.

M. William Lockard, Jr. DDS

COMMUNICATING QUALITY TO OUR PATIENTS

Posted on December 22, 2012

Robert
L. Cunningham, D.D.S. Contributing Writer

Helping our
patients/clients to value fine dentistry has everything to do with how we are with
the patient during their initial (and continuing care) visits to our
office. A close, ongoing examination of
how we structure and pace the New Patient/Co-diagnosis Experience is vital to our success in forming a trust bond with our
patients. What we do after the initial
visits will wither enhance or detract from that image.

Patients enter our
practice in basically three ways: 1. With a dental emergency or “urgency”; 2. Through a visit with the hygienist; and
3. When requesting an examination.

It is our stated
objective that the vast majority (about 80-90%) of our patients enter the
practice through the Co-diagnosis process.

THE “EMERGENCY” NEW PATIENT

Use the regular health history. Have the patient sign the consent for
treatment and the toothache questionnaire.
Treatment Coordinator or chairside assistant
conducts patient into the consultation room and reviews the health history and
toothache form with the patient, taking time to listen to their fears and
concerns.
The interviewer excuses them and gives the
doctor a synopsis of their emergency and the patient’s personality style.
The doctor and the assistant decide if it is
necessary for the doctor to interview the patient or have the assistant go
ahead with the necessary x-rays.
The patient is seated in a treatment room. If the doctor has not yet met the patient, he
is introduced by the assistant and takes a few minutes to establish rapport,
review the history and diagnostic information.
A diagnosis is made and the patient’s options
are quickly and precisely explained to the patient. The doctor or assistant discusses appropriate
fees.
Palliative relief is provided to the
patient. The patient’s comfort is
foremost. Appropriate anesthetic and/or
analgesic are administered slowly and painlessly.
Future needs are quickly discussed in general
terms. The assistant helps the patient
make and appointment with the appropriate doctor or specialist. The patient is strongly encouraged to appoint for a comprehensive exam.

THE HYGIENE NEW PATIENT

Patients are encouraged not
to enter the practice in this manner. It
puts the focus on the old adage that, “I only want my teeth cleaned and
checked.” It does not allow our practice
to be represented as favorably and comprehensively as we would like. The job of the person taking the incoming
call is to tactfully and assertively communicate this to the patient. If the patient still insists, they are
appointed to see the hygienist only.

The process is as
follows:

Welcome package is sent. If time does not permit the package to reach
the patient prior to the appointment, they are asked to come in at least ten
minutes prior to the scheduled appointment.
The hygienist
interviews the patient in the consultation room and takes about five minutes to
review the health history and establish rapport.
The doctor is introduced to the patient in the
consultation room after being de-briefed by the hygienist. Using the notes made on the health history
and Personal Patient Profile form, he focuses mainly on the medical portion of
the form and explains briefly what the IPT (Initial Periodontal Therapy)
appointment entails.
The doctor conducts the patient into the hygiene
room, where blood pressure, bacterial slide and complete periodontal charting
is performed by the hygienist. The slide
is viewed by the patient and the results are discussed by the hygienist. AAP periodontal typing is done with an
emphasis on the number and depth of pockets, bleeding points, and
recession. If a prophylaxis can be
completed at that appointment, the treatment is completed. If the patient needs periodontal therapy, the
doctor is brought in at that point to
make the diagnosis. (See materials on Periodontal Team Management
from JP Consultants.)
After the doctor leaves the room, fees are
discussed, financial arrangements are negotiated, and appointments are made in
the computer in the hygiene room.
The patient is encouraged by the hygienist and
assistant to reappoint for Co-diagnosis with the doctor.
Care,
comfort, concern and professionalism are the main concepts to be
communicated.

THE NEW PATIENT EXPERIENCE/CO-DIAGNOSIS

(85% OF New Patients)

Appointment
#1

Telephone information is taken and recorded on
the “Personal Patient Profile. A
convenient appointment is contracted with the patient. Welcome package is sent. Get patient’s permission to send a health
history. (If they are hesitant to fill
it our at home, we will interview them and fill out the form for the patient.)

When the patient arrives on the day of the appointment,
they are acknowledged by name and
told that the treatment coordinator will be right with them. Be sure to notice where they sit and notify
the T.C. Offer hospitality – coffee, tea, water and/or a magazine.

2.
Treatment Coordinator/Assistant Role.

A. Introduced
by the front desk. T.C. explains her
role.

B.
Patient is asked if they would like to see the
office. TOUR OF OFFICE. Stress our emphasis on their care and
comfort, especially sterilization and infection control.
C.
Interview in a private, preferably non-clinical
place. After a few minutes of social
chit-chat, start the interview by reviewing the health history, dental history
and the questions on the Personal Patient Profile. It is
not necessary to ask all of the questions on the Profile, just enough to get an
understanding of the patient’s issues and establish rapport. Record a healthy history synopsis on the
front of the “Examination Record”.
Highlight or underline any particularly important information.
D.
Key
Questions :

Be sure to ask the “expectations” question at
the bottom of the Profile. Record the
answer word-for-word.
Ask them, “Would it be helpful if I share with
you a little about us and what we are trying to achieve in our practice?” This is a good opportunity to share the
written “Practice Philosophy” and give them a copy.
In a spirit of self-disclosure and deep personal
sharing, let them know that we are in the health business, not the tooth
business, Share your own feelings abut
your experiences in health care and how our practice might be similar or
different. Write down their response.
If the patient has any cosmetic concerns, give
them a copy of our “Personal Smile Analysis” and ask them to complete it and
bring it with them on their next visit.
Review with the patient the value of full mouth
x-rays, study models, and photographs by using a set of generic records. Let them
know that the patient and the doctor will determine which records are
appropriate for them.
Review the medical and dental histories and make
notes on the form for the doctor. Excuse
yourself and debrief the doctor about
the patient’s history and personality style. Emphasis is placed on the patient’s pace and priority. The doctor
is taken into the consultation room and introduced to the patient. The T.C. stays with the doctor and patient
only as long it takes for the doctor and patient to establish an initial
rapport, then she excuses herself.
Doctor’s
role:

A. Social
graces – i.e. a conversation based on starting to establish a trust
bond relationship between the doctor and the patient. Focus on who referred then, who you may know
in common, family, sense of humor.
Listen intently!

B. Summarize
– Health histories and interview forms
(Personal Patient Profile and Personal Smile analysis). Use eye contact, feedback, acceptance, and
anchoring. Remember the axiom, “God gave
you two eyes, two ears, and one mouth.
Learn to use them in that proportion.” C. Contract
– Decide with the patient’s approval which diagnostic data will be used to do a
complete diagnosis and establish a treatment plan. For comprehensive restorative cases full
mouth periapical x-rays, mounted study models, and photographs will be
necessary before appointment #2.
It may be appropriate to make a separate “Records Appointment” to get
the necessary data.

D.
Screening exam – The purpose of the
screening exam is to determine which diagnostic records are necessary and to
get a get a general impression of the state of the patient’s mouth. Be sure
to emphasize to the patient that this is not a comprehensive exam. Let them know that during their next visit
you will have all of the diagnostic data and complete the exam and do a
consultation if that is appropriate. If
possible it is beneficial for the patient to have an initial visit with the
hygiene department (I.P.T.) prior to the diagnostic appointment, so that
pocket charting, bleeding points and AAP periodontal typing will be available
at the Co-Diagnosis 2 appointment.

Appointment
#2

1.
Treatment Coordinator/Assistant role.

A. The patient
is met in the reception room, greeted, and conducted into

exam room.

B.
Re-establish rapport with the patient. Ask them if any other questions or
considerations came up for them since their last visit. Answer the questions you feel confident in
and defer the others to the doctor.
C.
If the patient has completed a “Personal Smile
Analysis”, review their answers and mark areas of concern for the doctor. The doctor is notified that the patient is
ready and the doctor is privately debriefed on the attitude, issues and
concerns of the patient.

2.
Doctor’s role.

A. Doctor
takes a few minutes to “reconnect” with the patient, first socially then
picking up from the last visit as the Treatment Coordinator relays a summary of
her conversation with the patient.

B.
The doctor focuses on any questions or concerns
of the patient and is careful to write down anything that needs to be addressed
after the examination. It is helpful to
revisit their answers on the “Personal Patient Profile” and “Personal Smile
Analysis.”
C.
Helpful questions and discussions that may be used at this time:

How do you feel
so far?
Is there anything that you need to know about us
or our philosophy that we haven’t discussed.
You may share with them – this is what I would
want if I were a patient: 1).
Gentleness, and 2). A dentist who will
help me need him less.
The differences between emergency, urgency, short term, medium, and long term treatment
planning. Quality and timing.
Do you want to keep your teeth for a lifetime?

D.
Exam sequencing.
1. 1.
  The T.C./assistant charts missing teeth and
  existing restorations from the models and x-rays.
2. 2.
  On the back of the Examination Record two lists
  have to be made: 1). Diagnostic Issues. This is a 1, 2, 3, etc. list of major issues
  to be dealt with in their treatment plan.
  Examples of commonly used issues are missing
  teeth, malocclusion and shifting, periodontal condition, caries present,
  failing restorations, bruxism, oral hygiene, pathology, etc. 2).
  Diagnostic Options. These are treatment plan options in general
  terms with no fees attached.
  These options are usually broken down to mandibular and maxillary
  segments.
3. 3.
  Comprehensive oral exam. Including tooth diagnosis, occlusal analysis,
  oral pathology exam, periodontal exam (If not previously done by the
  hygienist.) and completion of the entire checklist on the front of the
  Examination Record.
4. 4.
  At this point the doctor conducts the patient
  and T.C. into the Consultation Room, where all of the diagnostic data is
  assembled on the counter to be discussed by the doctor and the patient. The T.C. usually stays in the room in the
  background as the doctor summarizes his findings and co-creates the treatment
  plan with the patient. The conversation
  may be specific with a patient who thoroughly understands their options and is
  able to make a decision then. This is
  particularly true of simple to moderately complex treatment plans.

At this
point a very important decision needs to be made. Depending upon the patient’s receptivity, pace (fast or slow) and
priority (relationships or things), the
doctor must sense whether to continue the process or to reappoint
for a separate consultation appointment.
Sometimes hygiene appointments, particularly a series of periodontal
root planings should be scheduled as a first phase of treatment before
major restorative fees are discussed.
This is because results of the root planing may alter treatment plan,
and having the patient in for a series of appointments with the nurturing
atmosphere of our team will made them feel more comfortable with who we are.

Appointment
#3

1.
The Doctor’s Role. (In a non-clinical setting.)

Ask the
following questions and record the answers:

How have you enjoyed your experience with us?
Have you decided how you want to see your teeth
in 10 years?
How may we help you with your plan?

The doctor listens,
responds, gets agreement on the patient’s plan of action, finalizes the treatment plan and quotes the fee, if appropriate at that time. The doctor asks the T.C. to discuss financial
arrangements and make appropriate appointments. Doctor exits.

2.
Treatment Coordinator/Assistant’s Role.

Asks
patient if there is anything that needs clarification at this time. Answers concerns.

Whatever
treatment has been agreed upon, the T.C. discusses               financial
arrangements, completes and has the patient sign a                  “Treatment
Estimate”, makes the next appointment and collects                          the down payment. The T.C. is responsible that all
financial                                    arrangements made by her be signed and dated
by the patient.

When the patient leaves, before going on to
another task, the T.C. puts the patient’s case in the computer for
tracking. If the treatment is to be
phased, multiple cases are used. The doctor is presented with an updated
tracking report every Monday morning.
The status of pending treatment is discussed and follow-up measures are
assigned.

It is important that all patients be kept
in the periodontal recare system so that pending treatment may also be tracked
and the video used in hygiene to revisit
their need for restorative.

THE
ENTIRE OFFICE IS COMMITTED MAINTAINING AN ONGOING, PERSONAL RELATIONSHIP WITH
THE PATIENT.

How to build an Exceptional Care Team

Posted on December 19, 2012

The “self-managed team” is essentially a philosophy based on shared values, trust, and unity of purpose, relationships, and a commitment to personal and professional growth. It begins, first and foremost, by hiring the right people and teaching the aptitude.

Self-management offers freedom and responsibility. It gives each person credibility and respect, and it satisfies the need for self-fulfillment. The prime responsibility of the doctor is to help team members discover, develop, and utilize their potential. In order for team members to grow requires the dentist must be willing to grow with them.

It requires team members who want to grow beyond skilled worker to ‘knowledge worker’ who knows what to do, when to do, how to do, and why to do the task.
It thrives on trust and self-accountability which requires honesty with one’s self. It requires a high tolerance for disagreement and ‘the right to be wrong.’
It thrives on a high tolerance for mistakes which permits calculated risk taking. It requires that all members of the team strive to live by the tenet, ‘Integrity is not only important; it is everything.’
It requires continuous growth of all persons involved.
It requires the discipline to set aside a half day
each week of non-patient work time for planning, learning, training, ‘how are we doing’ discussions and catch-up work.
It requires trust, openness, and willingness to risk asking the questions; “How am I doing?” “Do you have any suggestions for me?”

Essential Traits

Emotional Maturity
Courage of convictions – be responsible.
Admit mistakes –be accountable, honest, have integrity and keep promises.
Willing to adjust to new ideas, concepts, and approaches in the daily routine.
Ability to make decisions with confidence.
Reliable judgment.
Enjoy life and work. Respect the rights of others.
Self-directed – goal setter and self-starter.
Positive self-image – sets the boundaries of individual accomplishment.
Tolerant of disagreement – everyone has the right to be wrong.
Tolerance for ambiguity – they are flexible and not upset by unforeseen mishaps.

It is important that the attitudes, actions and activities of everyone in the office are congruent with the values, purpose and motivating spirit of the organization. Ultimately each dental team must develop its own unique style. The dentist and team must deal with their values, standards of excellence and the personal relationships required to exceed the patient’s expectations. We must continually work to align structure, systems, and processes with our shared values, vision and purpose. Shared values determine how people perceive problems, seek alternative solutions, and make decisions.

SHARED OWNERSHIP

No dream is beyond reach when you have a shared vision and
purpose with the right team.
Leaders must be willing to delegate power and control after clear goals, standards of excellence and expectations have been
established. Conflicting or ambiguous expectations are the cause of almost all relationship difficulties.
Everyone’s job, including the leader’s, must be open to examination and change.
All team members must be encouraged to make suggestions and be given real authority to act, to try things on the spot in the belief that failures are learning experiences.
Everyone must have easy access to all the information relevant to their work.
Everyone’s job security depends on their ability to provide solutions that exceed the patient’s expectation.
Teamwork must become a way of life. People working interdependently do not need job descriptions. Self-managed people with a
feeling of ownership work best knowing everyone’s area of responsibility. There are no departmental boundaries.
Everyone must make a commitment to personal and professional growth. Continuing education is not optional.

M. William Lockard, Jr. DDS

Practice

Health

Principles
of Team Membership

Always be willing to do more than your
share. A person with a high commitment to the success
of the team and practice will look for ways to contribute to the success of the
group to achieve the shared vision and purpose of the practice.
Never say uncomplimentary things about
another team member behind their back. Engage in positive confrontation of the
problem.
Confront your conflicts. Resolved conflicts strengthen
relationships. Unresolved conflicts do not go away, they accumulate and get
worse.
Accept reality – all team members are
not paid the same salary.
All do not have the same education, experience, duties, responsibilities,
abilities, attitudes and dependability.
Never be late or absent for trivial
reasons. One person absent can affect the quality of
care, the efficiency and effectiveness of the entire office.
Participate in team activities even
when inconvenient.
Electing not to participate may be seen as rejection by teammates. The more you
know about someone, the greater likelihood that you will care for them.
Be involved, concerned and active
regarding your personal growth. As a group of individuals who work
together become cohesive, caring and synergistic they are experiencing personal
growth.

Be
unselfish with your time and helping others.
Be
empathetic with patients and team members.
Confront
conflict with a positive attitude – see other point of view.
Accept
yourself and others – strengths and weakness – it’s OK to not be perfect.
Listen
to others more than you talk.
Be a
continual learner.
Accept
responsibility and be accountable for your actions.

Contribute
to personal growth of teammates when appropriate. Help is not help until it
is perceived and accepted as help by the recipient. The ideal relationship is
to have a friend who can act as a consultant where the level of trust,
understanding and caring is high enough so we can tell it like it is.

M. William
Lockard, Jr. DDS www.billlockarddds.com

Practice

Health

SELF ASSESSMENT
Complete
all the questions and discuss in round robin fashion with other team members.

List two valuable
abilities or qualities that you possess but are currently not using.

What is your
ideal picture of your job and your role in this team? How would your unused
abilities fit into this ideal picture?

What positive
contributions could you make to this team and practice by actualizing some
aspects of your ideal picture of your job?

What aspects of
your ideal picture of your job can you turn into reality? What specific steps
can you take? What are the obstacles to take these steps?

How can your team
members help you use your strengths and actualize your ideal

picture?
After
each team member answers all the questions the team works to take advantage of
each person’s strengths. This begins the process of working interdependently
and sharing responsibilities.
M William Lockard, JR DDS

The Five
Functions of Great Teams Patrick
Lencioni

Practice

Health

Teams with
trusting relationships:
Admit mistakes, weaknesses, and ask
for help
Accept questions and input about
their areas of responsibility
Give one another the benefit of the
doubt before a negative conclusion
Take risks in offering feedback and
assistance
Focus time and energy on important
issues, not politics
Offer and accept apologies without
hesitation
- Look forward to meetings and other
  opportunities to work as a group
Teams that engage in conflict:
Have lively, productive meetings
debating important issues
Ideas and opinions of all team
members are encouraged and considered
Discuss and resolve real problems
quickly
Minimize politics
Put critical topics on the table for
discussion
Teams that make commitments:
Create clarity around direction and
priorities
Align the entire team around common
objectives
Develop an ability to learn from
mistakes
Unite behind decisions and commit to
a clear course of action even when
complete agreement is impossible
Move forward and change direction
with confidence without hesitation
Teams that hold one another
accountable:
Ensure that poor performers feel
pressure to improve
Identify potential problems quickly
by questioning one another’s approaches
without hesitation
Clarify exactly what the team needs
to achieve, who needs to deliver what, and how
everyone must behave to succeed
Avoid excessive bureaucracy around
performance management and corrective action
Shift rewards from individual
performance to team achievement, there-by creating
a culture of accountability
Teams that focus on collective
results:
Retain achievement-oriented employees
Down play individual achievement in
favor of team performance
Enjoy success and suffer failure
acutely
Benefit from individuals who
subjugate their own goals/interests for the good of the team
Focus
on specific objectives, clearly defined outcomes and deadlines

Practice

Health

Dynamic Job Design and Performance
Appraisal
Clarification of expectations for each team member’s function,
responsibility, and performance.
Each team member writes:
Detailed
list of their job functions and responsibilities.
Standard
of excellence expected in detail.
Self-evaluation
of performance.
Doctor
writes list for each team member:
Job
functions and responsibilities.
Standard
of excellence expected.
Evaluation
of job performance.
Doctor meets with each team member to review and
compare:
Functions,
responsibilities, standard of excellence and performance.
Doctor
explains in detail any changes or improvement required.
A
composite evaluation and action plan with time table is agreed upon.
Recognize
that some departments in the practice may be at different stages of growth.
Team
members must understand how their actions may affect other team members and
their performance.
Praise
how each team member contributes to achieving the purpose and goals of the
practice.
M. William Lockard, Jr. DDS www.billlockarddds.com
When tensions are high and we seem to have lost our
positive attitude, I will sit with all the team members and ask these
questions. It is a positive way to get back on track. And they feel in charge
of the “Happy days are here again.”

Practice

Health

Appreciative Inquiry Change at the
speed of Imagination

Who are
you when you’re at your best?

___________________________________________________________________________

Think about a time when you were really engaged in
and excited about your work.

Tell me a story about that time. What was
happening? What were you feeling?
What made it a great moment?
What were others doing that contributed to this
being a great moment for you?
What did you contribute in creating this moment?
What would need to happen for you to have moments
like that more of the time?
________________________________________________________________________

When are we as a team at our very best?

What are we doing at those times?
How are we communicating?
How are we treating each other and others outside
of our circle at those times?
How can we be that way, and do those things more of
the time? _________________________________________________________________________________________________________________________________________________

If you had three wishes for our organization, what
would they be?
________________________________________________________________________

____________________________________________________________________________ _____________________________________________________________________
Philosophy ‘HOW’ Statement
Patients
We will help people feel
important, cared for, accepted and affirmed by all the team.
We will do only what is right
and put the patient’s interest first – sharing our values, beliefs and joy in
doing our WHY.
We will treat people
appropriate to their need, their understanding of the optimum treatment and
their ability to pay a fair fee.
We will accept people as they
are without passing judgment.
We will help people make
decisions based on their values and priorities. People will not be pressured to
accept treatment; they must choose treatment.
We will not provide treatment
that is inconsistent with our ethical standard.
We will inform people about
fees prior to beginning treatment.
We wish to receive a fair fee,
paid with gratitude and appreciation.
When people experience economic
hardship we will understand and be cooperative.
We wish to attract patients who
are fun and have values congruent with ours.
Exceptional
Team Members:
Develop integrated goals and
know that if the practice does well financially, they will do well financially.
Commit to the process of
personal mastery.
Grow in the process of
self-management, work interdependently, accept responsibility and be accountable
for their actions.
Are encouraged to voice their
opinion and then commit to team decisions.
Develop trusting relationships
and focus on collective results.
Establish clear expectations of
each other and the doctor.
Hold trust, honesty, integrity,
openness and respect as core values of this practice.
Let’s
make this office an incredible place where we have fun helping people improve
the quality of their life.
M.
William Lockard, Jr. DDS

Practice

Health

Occlusal Connection – Herb Blumenthal, DDS

Posted on December 10, 2012

Establishing wear patterns in the patient’s mouth is the best way to determine abnormal muscular involvement related to occlusal function. Do you see occlusal evidence of bruxing? When evaluating wear patterns, it is best and most accurate to have correctly mounted study casts with arc of closure registrations along with condylar guidance registration. The steepness of the condylar guidance helps determine the posterior tooth disclusion in lateral and protrusive movements. Prior orthodontic or iatrogenic grinding such as an occlusal equilibration, can influence visual evidence of wear. These factors need to be established before using wear patterns to determine muscle dysfunction.

Of course, the best articulator is the patient. There are limitations in using the patient, especially a patient in pain who will avoid areas of discomfort, which may give an inaccurate picture. This can be demonstrated in some patients who have posterior interferences that are mitigated by the use of an anterior deprogrammer. Limited lateral movements without the anterior deprogrammer are very restricted but will immediately free up with the placement of the anterior deprogrammer. Note any muscle trismus when the mandible is moved into a lateral or straight protrusive movement. This is an indicator that there may be interferences within the occlusal scheme that evoke a protective response from the muscles that function to allow this movement to take place.

If one single improper stimulus enters into this complex interdependent system, the entire mechanism is automatically restructured into an adaptive mode in an attempt to accommodate the stimulus. If this is a temporary stimulus, then the system will right itself after the stimulus is removed. The stimulus may be from the periodontal ligament receptors, a neuromuscular spindle cell in a muscle of mastication, iatrogenic tooth position, or muscles of the tongue or hyoid group. A change in the function of the mastication-hyoid complex changes the balancing requirements of the posterior cervical group of muscles.

In an attempt to balance the stomatognathic system, the labyrinthine reflexes can be affected. At times, stimulation of the proprioceptors in the periodontal ligament that fail to return to normal can have far reaching effects within this system. The chief complaint of the patient may not be the initiating factor in the observable response. This is where our powers of observation and knowledge of how the masticatory system works are invaluable in attempting to determine the cause and effect process.

Note the matching of wear patterns of the mandibular and maxillary teeth. When putting the patient in these positions, note any report of muscular pain. Remember the patient can put five to nine times more force on the teeth when bruxing as when consciously articulating the teeth together. There may be evidence of excursive interferences, especially after immediately leaving the rotational stage of condyle function. There may be evidence of hypo-occlusion on the same side or hyper-occlusion on the opposite side. Involvement of the deep masseter may be due to retrusive inclines and/or retrusive forces in lateral excursion.

On The Science of Influence

Posted on December 2, 2012

Know

Patient

Apply

Knowledge

Concepts from The Science of Influence Kevin Hogan, PSY. D.

Trust is essential to influence. People buy what they need from people who understand what they want. People are buying you and because of you, if they trust you. If they don’t, nothing has a chance to happen. Trust begins when credibility and reliability are established. You are the messenger; your likeability is the silver bullet. People are influenced by caring and empathetic people with similar values. When people sense genuine interest and concern for their welfare, they are likely to develop long-term relationships that will create win-win situations. Trust breeds loyalty. It is hard to switch from someone or something you trust completely. In fact, it’s almost impossible to change true loyalty because the stress of change would be enormous. Help the patient see you as someone who cares about them, and you will dramatically increase the probability of treatment plan acceptance.

Develop patient ownership of their problems and solutions early. There is greater ownership of the decision to accept treatment if the patient writes things down as he/she participates in the diagnosis and treatment plan process. Place something of yours into the hands of the patient, such as a diagnostic model of optimum treatment. When patients possess something, they perceive it to be more valuable than they did immediately prior to owning it. Once people own their actions or once people own something they value, their behavior and attitudes both begin to change.

Decisions are emotional, not just logical. Most people fail to influence others because they attempt to communicate with the sole intention of having the other person make a logical decision. They fail to realize that the unconscious brain (limbic brain) decides. The conscious mind, mostly composed of cortex, justifies the emotional decision to make that decision make sense. Take advantage of the brain’s organization and keep the client to your right when shaking hands, sitting and communicating. This accesses more of the left side of the brain for both of you, and allows you both to relax and perform more analytically.

First and last impressions matter. What happens first in some experience, event, or situation alters our perceptions of everything that follows. What happens last in some experience, event, or situation is extremely important in our perceptions and beliefs. People remember peak experiences and how the event ends, and then they generalize the ending back to the entire life of the experience. People want to have pleasant experiences. Make every effort to exceed their expectations.

Help people resolve their options quickly. Too many choices are confusing, and they don’t know which to choose. Be prepared to direct people to the optimum choice for them. People crave direction. Pointing out any negative aspects of your proposal makes you appear far more trustworthy, and it allows the patient to be set at ease as you are doing “their” job of finding the drawbacks of the proposal.

Compare expected results of action and non-action. People want to comply if they can see a way to not regret the action. They want to avoid making a bad (losing) decision. The best thing to do is look at what happens if they do and if they don’t comply. Looking at both sides increases the chance of compliance. The phobia of losing is tough to get past without at least acknowledging and examining the possible outcomes. The unknown is rarely a better option, in the mind of the patient, than the status quo, unless the status quo is enormously painful. When people are comfortable, there is little reason to change.

Create a realistic picture of what the patient will lose if they do not accept the treatment plan. Loss aversion is more pronounced for income than leisure. Losing the opportunity to travel is not as powerful as losing income. This means that money will have greater influence on a treatment decision than time. If you use the fear of losing money as a motivator for treatment, include a step-by-step set of instructions for compliance so the patient feels empowered to take action to avoid regret.

Help people go into the future and imagine in detail enjoying the benefits of their new oral health and attractive smile. Having people imagine the future is a powerful tool for gaining compliance. If you paint a realistic, positive future, there is an excellent chance that people will respond appropriately

Never let patients feel stupid about their past mistakes. People want leadership approval. All people need to feel wanted and part of a group. They want your appreciation and approval. Make sure they know that any intelligent person would have done the same thing if they were presented with a similar situation, for example, not knowing in the past about their real oral health circumstances. If you show even an unconscious body language cue that the person did make a foolish mistake, the natural tendency will be to feel defensive and that generates a “no” response.

Understand that at any moment, people are on the pendulum between the conscious mind response and their feelings, which are probably all over the map, trying to make sense of your proposal. There is ample evidence revealing that the closer one comes to a goal or an objective (in this case making a decision), the more likely one is to experience regret, which is the fear and anxiety of making the wrong decision. When people say, “I’ll think about it,” they don’t feel right in at least one way. They can’t quantify it because it is a feeling—but they are oscillating back and forth until it stops in the middle with “I don’t know” or “maybe.” Many times, a person’s conscious mind will analyze your proposal and make a rational decision to accept it, followed by a flood of anticipated regret. They say yes but feel no.

Ask the closing question after positive responses to three trial closing questions. Trial closing questions ask for a positive opinion. Closing questions ask for a decision. Do not offer someone a financial inducement to accept treatment (5% discount for cash).

When you get the decision you want from them, it is time to stop talking and move along. It is very important to always reassure the person that he/she made a wise decision. If you get a ‘no’ answer, understand that once someone passes on an opportunity, they are likely to decide that way in the future as well.

Trial Closing Questions: “Does that make sense to you?”

“Would you like to protect the back teeth so you can continue to eat popcorn?” “Is this how you want your smile to look?” “Would you like your lower denture to be comfortable and not fall out when you eat?”

Know Yourself Worksheets & Thoughts By Bill Lockard, Jr. DDS

Month: December 2012

Know Yourself Worksheets & Thoughts By Bill Lockard, Jr. DDS

Posted on December 25, 2012

COMMUNICATING QUALITY TO OUR PATIENTS

Posted on December 22, 2012

THE “EMERGENCY” NEW PATIENT

THE HYGIENE NEW PATIENT

How to build an Exceptional Care Team

Posted on December 19, 2012

Occlusal Connection – Herb Blumenthal, DDS

Posted on December 10, 2012

On The Science of Influence

Posted on December 2, 2012

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Know Yourself Worksheets & Thoughts By Bill Lockard, Jr. DDS

Posted on December 25, 2012

Posted on December 22, 2012

THE “EMERGENCY” NEW PATIENT

THE HYGIENE NEW PATIENT

Posted on December 19, 2012

Posted on December 10, 2012

Posted on December 2, 2012

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Great Forum

CODISCOVERY BLOG

Get Involved with theBob Barkley Study Club Now!

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Bob Barkley Study Club Now!