June 2017 – Codiscovery

Know Your Patient

Posted on June 29, 2017

We all want to get along and be liked. We also want to make good decisions, so when we make decisions regarding issues that we know little about, we often use a cognitive-social approach by asking our friends for advice, observing other people’s behavior, or seeking out and reading testimonials.

In the world of the social sciences, this cognitive-social approach, is known as “social proof” or “informational social influence”.

Psychologists tell us that we make assumptions about most things via a rather incomplete fact-gathering process often tainted with bias. And sometimes this process may even be completely devoid of facts.

We see this phenomenon frequently in dentistry, as patients enter our practices with all kinds of preconceived notions picked up from their social environment, or through experience – and how much of it is true is unique to the individual.

Some patients function off of ‘survivorship bias’, which is based on our tendency to assume marketplace “winners” are those who are most visible. In other words, in the popularity contest of life, less visible and better options are often not even considered. A current example of this is the growing public assumption that every “all on four” case is successful long-term, and every patient is happy with the outcome. This distorted perception has been created by some very clever and persistent marketing which conveniently skips past potential down-sides.

As a marketing executive friend of mine once told me, “If you are not in the top three of top-of-mind, you may as well not exist.” This marketing truth can open the door to all kinds of moral arguments regarding marketing, and about which our profession has struggled with for over fourty years. I will leave the probing of this issue for another day, but suffice it to say that the “marketing issue” is full of moral fog, and if marketing is not done in a principle-centered fashion, it can lead to some very undesirable outcomes for patients and consequently the reputation of dentistry as a profession.

Our patients also have a tendency for what psychologists call “loss aversion”, which refers to our tendency to strongly prefer avoiding losses over acquiring gains. In other words, we have a psychological tendency to seek out bargains instead of quality, unless a strongly assertive argument and expectation is established for the later. Consequently, the “race to the bottom” with regard to viewing dentistry as a price-sensitive commodity by the public is real, and it is rooted in loss aversion. Hence, establishing a brand expectation for quality is a challenging but essential step for health-centered / relationship-based dentists.

Our patients are also influenced by what is known as the ‘availability heuristic’, which is a little mental glitch in our heads which causes us to assume that the first things which come to our minds are the most relevant to us. For instance, when people think of Delta Dental they think of saving money, and not that the policy is limited to $1000.00 a year, is highly restricted, or that dental “insurance” is really a defined benefit plan which has nothing to do with their overall dental health.

And finally, many of our patients often come to us with a ‘confirmation bias’, which refers to their tendency to search for -and favor- information which confirms their beliefs, while simultaneously ignoring or devaluing information that contradicts those beliefs. An example of this is seen when a patient comes to us believing that all dentists will hurt them, or that any dentist who is not on their insurance plan will take advantage of them financially.

You can easily see from this brief discussion, that the psycho-social nature of our relationships with patients before, during, and after treatment is complex and potentially full of cognitive distortions which can lead to undesirable behavior and poor decision-making. Consequently, successful helping relationships emerge only when we are aware of where potential distortions may lie and tactfully manage our patient’s expectations toward more successful treatment outcomes through collaborative relationship-building, and co-discovery.

L.D. Pankey put it another way, “Know your patient”, because it is the only pathway to health-centered outcomes in patients with complex needs.

Paul A Henny, DDS

Read more at www.codiscovery.com

Can Health-centered Dentistry be “unit-based”?

Posted on June 27, 2017

The concept of unit-based dentistry is based upon the sickness-centered medical model and a by-product of the industrialization of health care delivery. As such, it begs a question: Are people simply the sum total of their body parts? And if so, when someone is missing a few of their body parts, are they therefore less of a person as a result?

Obviously, we are much more than a sophisticated aggregation of symbiotically functioning parts. Why then are we seduced into treating our patients as if this were not the case?

Another question: Would an artist ever consider charging per color when creating a painting? If the medical model of reimbursement were true, universal, and appropriate, why wouldn’t the value of a painting simply be based upon the sum total of the cost of the paint and the time it takes to apply it?

Is a masterful painter more or less of an artist than a masterful dentist designing and creating sophisticated solutions which take into consideration -at extremely high levels – biology, physiology, biomechanics, neurology, form, function, esthetics, and dare I say…feelings?

My point here is that unit-based thinking is mechanistic , reductionistic, and puts us at great risk of completely separating our thinking and treatment strategies apart from our patient’s complex and fascinating humanness.

Unit – based thinking is an immediate solution-centered concept fostered by historical insurance reimbursement patterns. It completely disregards the complexity of our work -on and with humans – and the fact that we are much more than an accumulation of teeth, bone, and gingiva attached to jaw joints.

The challenge remains for many dentists to figure out how to treat their patients more holistically when they are only being reimbursed by third parties for parts repair, servicing, and replacement.

Dentists who aspire to treat their patients as “whole people” with feelings, goals, and uniquely challenging physical circumstances must separate themselves from the needs and the demands of the insurance industry as much as possible if they are to be successful.

Dentistry is an art and a science. It is also extensively about care, skill and judgment. In that context, a crown is not just a crown applied universally like a 3/4 inch stainless steel bolt, an exam is not an exam when goals differ, and a treatment plan is not the same for every patient with the same code-worthy disability.

Clearly getting paid by the unit simply fails to acknowledge this fundamental truth.

Paul A. Henny, DDS

Vision Matters

Posted on June 22, 2017

Don was a 13-year-old paperboy when he read the headline that Buddy Holly had been killed in a tragic plane crash. The news left him devastated and empty inside, particularly when his friends responded with “So what?”.

Later Don McLean become a struggling solo act artist rambling through Canada and playing Buddy Holly songs 13 years after Buddy’s death, and when Holly’s legacy of ‘Peggy Sue’, ‘That’ll be the day’, and ‘Not Fade Away’, were largely forgotten.

But Don McLean had a vision rolling around in his head, a vision of a song which was true as ‘American Pie’ and that revealed his deep feeling of loss.

When the song was finally written following a flurry of inspiration, the recording took months to complete. Don’s former record label had collapsed into bankruptcy; and the session musicians kept telling him what was wrong with it.

McLean persisted, and the song hit #1 for four weeks and quickly propelled the album to gold status, making Don a millionaire along the way. He recently sold a copy of the original manuscript for 1.2 million dollars.

I am sharing this story today, because this is precisely how a vision works. Visions are deep on purpose, inspiration, and tenacity, and they face many obstacles which must be overcome before they are ever shared and generate prosperity.

These same principles apply to the creation of a relationship-based practice. It requires a clear vision, insight, readiness, and a deep determination to overcome every obstacle. And just like Don McLean’s experience, the rewards of execution are greater than ever imagined in the beginning.

Paul A Henny DDS

Read more at www.codiscovery.com

How True Teams Behave

Posted on June 21, 2017

Watch a competitive athlete make an honest error in a game and observe how quickly his or her teammate’s gather around to offer encouragement and support.

Now, compare that observation to what happens in your practice. How are errors or honest mistakes perceived and handled? And are they perceived and handled differently for different people?

The bottom line: What is the emotional cost of learning in your practice?

High performance Care Teams view honest mistakes by capable* team members as a part of the learning process. They move forward, by recognizing that the making of few mistakes may imply that not enough risks are being taken – that not enough intellectual and creative stretching is occurring to advance the practice mission to the next level and better support the Purpose.

Consequently, always “playing it safe” by definition fails to move a practice forward toward peak performance. Great practice leaders intuitively know this – that stumbling precedes walking and that walking precedes running. They offer support and encouragement just at the right moments to keep facilitating growth and expanding upon what is possible each and every day.

Paul A. Henny, DDS

*As with any great sports team, there are moments when new members do not seem to fit the practice culture or mission, and there are other members who have moved past their prime and their current performance is now hindering the vital growth and development process. An essential – and difficult- part of leadership includes identifying these individuals and respectfully moving them out of the team ( or perhaps to a different place within it ) so that new potential can be actualized through more purpose-aligned members.

Read more at www.codiscovery.com

How True Teams Behave

Posted on June 21, 2017

Watch a competitive athlete make an honest error in a game and observe how quickly his or her teammate’s gather around to offer encouragement and support.

Now, compare that observation to what happens in your practice. How are errors or honest mistakes perceived and handled? And are they perceived and handled differently for different people?

The bottom line: What is the emotional cost of learning in your practice?

Paul A. Henny, DDS

Read more at www.codiscovery.com

Think Like a Sailor

Posted on June 15, 2017

Imagine your brain is a computer, and at the beginning of each day you have 100% of available memory. And as you proceed through each day, bits and pieces of that memory become preoccupied with focusing upon tasks and responsibilities which must be accomplished that day or in the near future.

This memory is much like the RAM – random access memory- on your computer, which is fragile and lost if the power goes out… and the larger the number and frequency of obligations we are confronted with each day, the less capacity we have left for creative problem solving – the only pathway to potentially making tomorrow a more effective day than today, and a day more in alignment with what we want to see happen long-term…our “preferred future”.

In other words, our here-and-now obligations and distractions easily become barriers to our long range goals and vision.

So how do we get around our natural tendency to over-focus on immediate needs at the expense of critical long range goals in our ever-more swamped schedule?

Strategic Planning and curating – curating out of our schedule low priority items and keeping our strategic plan top-of-mind.

AND THEN setting aside time each day to focus and steer our practice and life in the direction of our long-term vision.

The key point here is making the DAILY commitment to doing this. The DAILY re-focusing and the DAILY adjustments demanded by current conditions.

You see, our brain functions much like a computer on some levels, but our life never follows the plan created by our objective thinking. On this, Dwight Eisenhower accurately said, “Planning is essential, but plans are useless”, because navigating our life is more like sailing than programming a guided missile.

A good sailor has both destination and current conditions in mind, and they are constantly re-assessing, while making course corrections and resource utilization adjustments to insure the port of choice is reached.

So too then, we must manage the direction of our practice. Because without doing so, the prevailing economic winds, tides, and weather will easily throw our dreams upon the rocks.

Paul A Henny, DDS

First Principles

Posted on June 13, 2017

First Prin·ci·ples, noun: the fundamental concepts or assumptions on which a theory, system, or method is based.
……..

Elon Musk is perhaps the boldest entrepreneur on our planet. After founding PayPal and revolutionizing the way the world made on-line payments, he started Tesla, SpaceX, and Solar City, and is now revolutionizing automobiles, rocketry, and solar panels.

Musk attributes his creative successes to First Principle thinking. He said, “I think it is important to reason from First Principles rather than by analogy…First Principles is kind of a physics way of looking at the world. You boil things down to the most fundamental truths and say, ‘What are we sure is true?’ … and reason up from there.”

As health-centered, relationship-driven dentists, we can learn a lot from Elon Musk. And that is because reasoning from First Principles is the ONLY way to create an authentic practice experience for our patients.

What do I mean by “authentic”?

I mean the creation of a practice which represents a true reflection of who you are as a person and Care Team; a reflection of your quality and caring that is so obvious it can go unspoken – as just observed and felt is quite enough.

And authenticity must start with First Principles, which are like lighthouses, showing the way even in the fog and storms of daily living in a complex and ever-changing world.

Boiling things down to First Principles allows us to then build upon them flexible and congruent mental models which are unique, powerful, effective, and deeply satisfying.

And building resilient Principle-centered mental models also help us avoid defaulting to the way everyone else does things…often in lock step with ever-changing insurance industry demands … following the money AND AWAY FROM UNIQUENESS AND AUTHENTICITY.

If people are going to choose your practice over many other options, they need to have a rock solid reason. And if people are going to pay an appropriate fee for the receipt of your finest care, skill, and judgment, they need a rock solid reason.

And that reason needs to be the brand called the authentic, principle-centered YOU – as nothing less will do.

Paul A. Henny, DDS

How Our Memories Shape Our Decisions

Posted on June 8, 2017

We accurately remember only 20 percent of what we hear, and remember only 30 percent of what we see and hear. However, we can recall 70 percent of what WE say and write down, and 90 percent of what WE say and what WE participate in exploring after we have heard it from someone else.

This is another way of saying that we misunderstand people all the time, and they misunderstand us right back, unless we make a concerted effort to minimize misunderstandings.

As humans, we are very biased in our first impression of others. Psychologists call this bias “primary effect”, where in essence, our brains are designed to make quick assessments which then help us to determine if we are safe and therefore what to do next.

As we age and become more educated, we add more layers and complexities to this process. As dentists, and dental team members, we like to add: “They are not a cooperative person”. “They don’t know which end of a toothbrush to use”. “They never follow my directions.” “They have a low dental IQ!”

But in truth, upon first meeting someone, we know far too little about the them to draw many accurate conclusions. And we have all experienced this, as the best dressed person with the finest car, can sometimes be the most difficult to work with – and completely unreliable. Conversely, the fellow with the beat-up pickup truck and dirty work boots can be so reliable and good-for-his-word, that you can plan your whole day around him right down to the last minute.

Our minds naturally want to make quick assessments of others, and then find ways to think which are consistent with what we already believe about them.

Then, laid on top of this is our tendency to use our positional authority figure power to leverage an outcome WE desire.

And perhaps worse, we confuse this leveraging with leadership, when in truth it is a subtle form of manipulation, and when successful at gaining compliance often creates co-dependency relationships which then bare bad fruit later on down the road.

So how do we get around our natural tendency to misunderstand others and consequently, trip ourselves up and undermine our well-intended purpose?

Bob Barkley answered that question fifty years ago. He told us that to build successful relationships which render out problem ownership, compliance, and ultimately a higher degree of health, we must create an experiential learning environment for our new patients, one in which they can experience the meaning of what they are learning (co-discovery), and then participate in planning for a more preferred future (co-diagnosis / co-planning).

And in so doing, we hit the 90% retention rate, and when that true and transformational knowledge matches up with their values and priorities, we hear the word “YES!”

Paul A Henny, DDS

The Multi-tasking Myth

Posted on June 7, 2017

Linguists tell us that the word ‘priority’ came into the English language in the 1400’s. And at that time, there was no plural version…there was no such thing as “priorities”.

Only in the faster-paced world of the 1900’s did the word ‘priorities’ enter our lexicon, with the implication that we can do two or more things just as well -and at the same time.

But it’s a lie.

Neuroscience now tells us that it is neurologically impossible to concentrate on multiple tasks simultaneously, much-the-less do them all well.

So, what happens in reality is that the brain is forced to switch back and forth very quickly from one task to the next. And that there is a price for doing so.

Have you ever met a fine artist, musician, or master furniture maker who was juggling five different tasks at the same time?

I didn’t think so.

Multitasking forces the brain to pay a psychological toll every time it interrupts one task to focus attention on another task. Neuroscientists call this toll the “switching cost”, and it is paid in the denominations of stress and degraded outcomes.

An interesting study in the International Journal of Information Management found that the average person checks email once every five minutes, and that it takes 64 seconds on average to fully resume focus on the previous task.

Relate this truth to a dentist performing multiple hygiene checks while jumping between two active treatment rooms.

Easy disorientation…

Leading to more technical and judgement errors…

Leading to more unhappy patients,

And ultimately, to more and more stress.

It also means that we waste a lot of opportunities for right brain creative time, as switching forces us to stay in an analytical left brain mode.

And we wonder why we are less happy!

All this attempted multitasking didn’t hit the mainstream until the 1970’s, when computers -promising to simplify our lives – entered the workplace. Before that, no one claimed that they were “good multi-taskers”.

Today, people wear the term like a badge of honor. But its a rationalization, not reality. What it really means, is that they have a high stress tolerance and can get a lot of things done at a “good enough” level quickly.

Comprehensive, health-centered, relationship-based dentistry is complex. It takes uninterrupted focus, and extended right-brain functioning. Consequently, “switching cost” is the enemy. And “switching cost” is what high-volume multi-op insurance-centered dentistry is all about.

So we have a choice, to pursue the volume, and accept the toll of distraction, stress, lower quality outcomes, and less happiness.

Or, we can pursue truly helping relationships with our patients, and enjoy our profession more and provide more and better health-oriented care to a smaller group of more appreciative people.

The choice is ours to make as long as we remain independent, and mission-centered.

Paul A. Henny, DDS

Key Care Team Attributes

Posted on June 6, 2017

Most of us have heard the behavioral truism, “You can’t take others to a place you have never been to yourself.” And this truth applies doubly to the functioning of patient-centered / relationship-based practices.

A central theme within this practice model is personal growth. And by this I mean progressively greater understanding and application of new knowledge in the lives of the dental team and patients as well. The former is critical because it influences the later…team members influence patients toward greater understanding and better choice-making.

Consequently, there are certain essential attributes which must be present in team members for this practice model to function optimally. Here are eight* of them:

1. Optimistic -In spite of the craziness of today’s world, they maintain a hopeful and positive attitude toward adversity and people.

2. Involved – They actively pursue problem identification and resolution. Additionally, they are caring, and committed.

3. High Self-Regard – Not to be confused with high self-esteem, they feel competent, capable, and worthy of success. They believe that their lives make a positive difference in this world and demonstrate it every day.

4. Mission -They have a transcendent commitment to living personal values which are very clear to them. This commitment goes far beyond immediacy, and beyond themselves. They see their life as an integral part of a greater whole and which is congruent with the mission of the practice.

5. Energetic – They are stimulated by their curiosity of people, things, and challenges. Consequently, their positive energy is contagious, and problem-solving ability high.

6. Resilient – They are flexible and adapt in a healthy, functional way to stress. Consequently, they do not avoid conflict, rather they approach it maturely with an intent to positively resolve it and move on.

7. Self Control – They know who they are. They know where they are. They know where they want to go. They know what they are doing – or are in the process of finding out. In other words, they are effective self-leaders.

8. Relationship-oriented – They prosper in long term intimate (open and honest without hidden agendas) relationships, and consequently they are able to seek out and effectively propagate opportunities for commitment in others through those relationships.

Paul A Henny, DDS

Know Your Patient

Month: June 2017

Know Your Patient

Posted on June 29, 2017

Can Health-centered Dentistry be “unit-based”?

Posted on June 27, 2017

Vision Matters

Posted on June 22, 2017

How True Teams Behave

Posted on June 21, 2017

How True Teams Behave

Posted on June 21, 2017

Think Like a Sailor

Posted on June 15, 2017

First Principles

Posted on June 13, 2017

How Our Memories Shape Our Decisions

Posted on June 8, 2017

The Multi-tasking Myth

Posted on June 7, 2017

Key Care Team Attributes

Posted on June 6, 2017

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