The Starting Point for Practice Reform

Every dental practice has a Wish List, but none has a Fairy Godmother. Most wish for phenomenal practice growth, some want more personal fulfillment for their hours of labor, and a few just wish team members would stop complaining. For wishes to come true, the magic wand must be loaded with effective communication skills.

What is effective communication? Most don’t define it completely. It is the exchange of ideas, verbal or written, in which the Sender gives information to the Receiver, where it is processed. The Receiver should understand the information so well that it could be not only repeated but explained as well. They then send a response back to the Sender, and that person acknowledges hearing it. It forms a cycle. If the cycle is clear and precise, there is less chance for undesirable results.

A dental office communicates with many different audiences daily, whether it is with the patients, insurance companies or fellow team members. Their method of communication is either a liability or asset to the practice. For instance, vague, staccato-like generalizations or mean-spirited blasts of frustration are always liabilities. But so is a string of complicated dental terminology thrown over a patient’s head. No one learns anything positive and the practice cannot thrive. Team members become jaded and dentists dread the next personnel nightmare. In contrast, when communication focuses on benefit-driven words, delivered in a concerned fashion, one creates an asset. That’s not to say that the office environs resemble the Fairy Godmother’s castle, but the overall spirit for daily interactions takes on a positive spin which promotes productivity.

Think back to dental school. Everyone has probably had a grunting professor who clearly considered questions a nuisance, but the rigors of study were made tolerable by the other instructors (I know well, as a former professor for 21 years). These people valued the thought and energy put into the details of crown preparations. Many of them understood the value of clear communication and that required an understanding of others. It’s normal. Personal growth or the lack thereof, comes from the analysis of discussions held deep within. This form of communication factors in experiences of the past, and hopes for the future, into the present situation. Self-communication, a powerful phenomenon, has a greater impact than ever imagined on infiltrating the sub-conscious mind.

Self-Communication for Practice Growth

Effective communication within one’s mind leads to personal growth. It is the starting point for practice reform. To be successful, a dental practitioner must develop a winner’s image in his or her mind. That requires harnessing the power of the sub-conscious mind. Everyone has assigned themselves a value, based on their self-image, which either restricts or expands their potential for success? The key is in creating an image of perfection, writing it down in a statement with precise details and clarity that others can also understand, and repeat. This message revolves around what is desired, from a far-reaching, long-term perspective, not what exists or may occur within a month. It takes about 4-5 sentences to summarize and should fit in a wallet or briefcase, available for review. For example, one could dream about the number of new patients that call because the marketing efforts work so well. Or one could calculate the amount of revenue that the practice receives when case acceptance improves. Formulate a clear, crisp picture of the image. Make it feel so real that it is projected in personal behavior. To do this, one must ignore their present results. It is so difficult to do! Likewise, one must force themselves to stop talking about their losses or disappointing practice results. It corrupts the self-image and prevents progress. Rather, focus on long-term images of a perfect practice and become the Sender of these messages through the communication cycle. Talk about it enough, and watch the conscious mind transform the sub-conscious mind to controlled positive thinking. This allows effective leadership of the team because a dentist’s positive behavior becomes contagious to others. There is no room for mediocrity or dishonesty. Only after this attitude becomes second-nature can one take the next step to improve communication within the practice.

Remember that most Wish Lists include practice growth? A dental practice will only grow if team members believe that they are an integral part of the office success, respected and valued for their contributions. To do this, dentists must clearly communicate a clear direction and determined focus. Each practice should abide by a well-thought mission statement, a written document that is constructed and agreed to by the team. Different team members are selected to read the mission aloud in the daily morning huddle. They also need to establish clear objectives for growth and focus on these as the foundation for daily decisions. Team members think “does this contribute to the objectives of the office?” as a benchmark for their actions. As a group, they should meet weekly to discuss the results achieved against targets that had been set and communally discuss adjustments. When this system is in place, the individual dentist is free to assume the true role of a “doctor”, processing patients’ care and sharing the profits with the team members without having to think about the operational details.

As has been touted, team members’ behavior reflects the general tone of the office. They communicate by their actions as well as their words. Individual team members must serve in a position that best suit their strengths, usually indicated by the type of work they like to do. When someone is hired to do something they enjoy, they are more productive and less inclined to make mistakes or complain. When allowed to use their strengths, the weaknesses eventually disappear from view. They also exude a cheery disposition to those around them, making it possible to deliver consistent customer service and a positive attitude.

Think about “attitude” for a minute. How is it created? Once again, self-communication is the key. Attitude is a result of a three-step process; a situation creates thoughts, which lead to feelings, and this generates actions accordingly. For example, running one mile may create produce bad thoughts about tedium, especially when shin splints result, so one’s action may be to stop running forever. This same mile could create exhilaration from endorphins and one adds running to their daily routine. That is the power of self-communication. A similar analogy exists with less-than-favorite patients. One can allow them to ruin the day, or they can view the situation as an opportunity to help or win someone over. Dentists have the power to control their thoughts and attitudes. They can either jump in the river of positive thought and travel with the current, or swim upstream with negative thoughts which require more energy and produces limited results.

Patients are actually the dental offices’ employers. If the dental team performs their job adequately, patients will keep them busy and generate the revenue necessary to pay the bills. What is on their Wish List? What are they really buying? Besides pain avoidance, patients want to trust the dentist to provide the best care possible which maintains or restores their health. But it is no longer merely dental health – it is long-term, systemic health and lifelong function of the dentition. They might make an appointment to just fix a problematic tooth, but that stems from the human propensity to think short-term. With the appropriate information, guidance, and powerful messages, patients will evaluate long-term solutions. Remember to use analogies or stories related to others’ experience to help patients view the need for treatment in a more objective light as well. For optimal practice growth, dentists need to clearly communicate difficult-to-face problems with patients, giving strong recommendations and logical explanations that back them up. They need to overcome the fear of rejection when an extensive case needs presentation, and discuss each patient’s priorities. Rejection may mean that the patient is not ready to proceed now, but will call back later. If not, ponder if a mistake was made and thus, a lesson learned. Then let it go, for good. Though many dentists don’t feel comfortable about it, a discussion of fees and financing options is also essential. No one enjoys the surprise of a large bill, or the liability of one that goes unpaid.

Aside from the issues involved in diagnosis and arranging optimal treatment, communication also involves genuine care and concern for people. Those who have had difficult dental procedures during the day deserve a personal call from the dentist. The occasional feisty patient deserves to express his feelings, without interruption, and find the office amenable to a solution. Ask the patient for the solution and the response may be surprising! New patients deserve an initial visit with the dentist to establish a foundation for thorough communication from the onset. Reaching a diagnosis, and mapping out steps for treatment in an understandable manner, must precede care by other team members. A fully-informed patient keeps appointments. That approach also makes clear the need for comprehensive dental hygiene procedures prior to restorative care.

Communication with the dental lab is either an asset or liability as well. Too often, design intricacies are briefly noted or the impression is marginally inadequate. There’s no phrase more appropriate than “garbage in, garbage out” for this level of sloppiness. The dental practice must focus on the needs of lab technicians and work on an equitable solution if errors occur.

Likewise, consider all the professionals flanking the practice, such as the accountant or attorney, as on-call advisers for opportunities and watchdogs for liability. These individuals are trained to help a practice thrive. Communicate changes and seek opinions on a regular basis, establishing a long-term relationship with each one. Let them know the weaknesses and priorities, and expect their assistance in the growth of the practice. Do not merely view business operations professionals as the means to an end but, rather, as highly-trained resources with good counsel. Because these professionals recognize the implications of changes in the law, at the state and federal level, they react with action much faster than dentists who focus on patient care. The final component for practice growth involves marketing. No matter what opinions are held on the topic, one must recognize that dentists all market their practices daily even though it may be inadvertent. Actions and attitudes communicate enough material to attract or retain patients, generate referrals, or lose an entire extended family. Building trust is a tricky business. It is best to view marketing as attracting attention to the office and its services to inform everyone that their dental solutions lie within. That requires a strategy, not simply a cluttered Yellow Pages ad. One should not waste time merely recruiting bodies with discounted services and monthly specials. They must communicate a clear message with different media, offering solutions rather than services. The current esthetic revolution provides proof that people will happily pay for model-straight, white teeth to fend off aging or increase their sex appeal. It offers a quick solution, far more apparent than routine dental care.

Team Communication for Professional Growth

It is easy to assume that, once one has re-directed their self-communication and achieved tangible gains in practice growth, everyone should live happily ever after. But it’s not like that. To create a fully-functioning team, one must also focus on continuing professional growth. Dentists should view their role as a communicator as one part motivator, mentor, and monitor for team members. Most people like responsibility, when given guidelines, and they flourish when rewarded, as well as sincerely appreciated, for taking initiative. They enjoy feeling like an inter-related participant for success and will adopt a perspective of ownership in the practice, when properly cultivated. A weekly group discussion of the team flushes out office decisions, problems, and opportunities and helps create that perspective. A judgmental attitude or verbal punishment for mistakes will squash it. Consider assuming that a mistake must have been made because someone misunderstood or took a chance, but failed. Rather than find fault, work toward solutions and move farther along the learning curve. Replace “You shouldn’t” statements with “I would like you to —“and spend energy on drawing out someone’s good qualities rather than wasting time on fixing the bad ones. However, if a team member chronically demonstrates errors and poor judgment, it is a sign that they are in the wrong position suited for their talents and termination or job reassignment is indicated.

The more dentists harness the power of self-communication, and communicate their vision of a perfect practice with team members, the more progress will be seen in the growth of a dental practice. Eventually, the content of one’s communication becomes a habit. Examples of people who have developed a bad habit include constant complainers or boisterous braggers at social gatherings. Habit is a choice. Let inner thoughts create a good habit and watch it reform the dental practice. Who needs a Fairy Godmother when the power to improve personal, practice, and professional growth sits right on one’s shoulders?

For 30 years, Dr. Anil Agarwal has lectured both nationally and internationally on implants, adult reconstruction and dental practice management. He was an Associate Professor at Northwestern University for 21 years. He earned both Fellowship and Diplomat status in the International Congress of Oral Implantologists, as well as Fellowships for the Academy of General Dentistry and the American College of Osseointegration. He has completed over 1500 hours of continuing education in dental and management-related topics, earning many certifications in personal growth and finance-related topics. Author can be reached at


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