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Troublemaker on Your Team?
by Sally McKenzie, CEO
For some, all the world is a stage. For others, it’s a playground. And the adolescent behaviors, sophomoric attitudes, immature actions, and “mean girl” (and boy) tactics seem to never end. Worst of all, they can deride even the very best dental teams and practices.
Years ago, “personality conflicts” - as these behaviors were typically categorized, were shrugged off as silly little nuisances that were simply part of life in any workplace. And, certainly, we’ve all had to deal with someone who always seemed to be stirring the proverbial pot. But what happens when that person is an employee in your practice and it appears that very few can get along with him or her? In fact, a fair number of employees have even labeled the person a troublemaker, but most of those left. And from where you sit, this employee does good work, and truth be told, you would rather not get your hands dirty on these office squabbles. In fact, to you, it sounds like it’s mostly just idle gossip. Yet it is that “idle gossip” that can cost you and your practice a fortune.
Consider the case of Pam. She was a new hire in Dr. D’s office. She worked there a few months when the doctor invited her to attend a continuing education program that required out-of-state travel with the doctor. Pam was the third in a string of new personnel that had been hired to replace Sue, the doctor’s former assistant. The other two “didn’t work out.” Sue had been the doctor’s assistant for three years, but she left suddenly and with little explanation. The “old guard” wasn’t particularly welcoming of Pam. It seemed that whenever she walked in the room the conversation would stop. Although Pam came with extensive experience and a track record of success, her suggestions were greeted coolly at best. She was frequently left out of the communication loop. Jackie, the office manager, had a habit of overlooking Pam when it came to sharing details that would impact her performance, such as changes in the schedule, patient information, and so on.
But it was the day that Pam overheard Jackie talking in hushed tones to the other staff members that Pam decided this wasn’t the office for her. As Jackie quietly divulged to those gathered around the breakroom table over coffee and doughnuts, Pam would probably be the only one getting a raise this year after the special time she’d spent with the doctor on that “so-called continuing education trip.” Laughing it up, the group seemed to savor every morsel of the juicy gossip. Jackie went on to say that she was convinced that there must be something going on between them. When Pam confronted the doctor and asked him to address the matter, he defended Jackie and said she was just trying to be “funny.” Within six weeks, Pam found a new job. And once again Dr. D was left wondering why another good employee didn’t last even a year.
Innuendo, lies, rumors, and office gossip have long been part of the professional landscape. But the degree of viciousness has been turned up more than a notch or two in recent years. And when the rumor mill is shredding the reputation of your team, it’s time to step in and address the issue.
It is not uncommon for employees to engage in gossip if they are bored or don’t feel that they are informed about important issues. Human nature is such that when information is lacking, we fill in the blanks with what we perceive to be the truth. In an office in which sudden change occurs, such as an employee is let go, if the doctor does not immediately address the matter with the remaining staff, then they will talk amongst themselves and any gaps in the “official” communication chain will be filled in with their misperceptions and misinformation. It is the doctor who sets the tone. In Pam’s case, the character assassination would continue because the doctor abdicated his responsibility as the leader of the practice. In smaller businesses, such as dental practices, the best approach in dealing with office gossip is the direct route. Confront the offender. Make it clear that such behavior is unacceptable in your office. Even if the person denies being the source, you will have made your point. Most importantly, you will be setting a standard for the rest of the team to follow.
Sally McKenzie is CEO of McKenzie Management, a nationwide dental management, practice development and educational consulting firm. Working on-site with dentists since 1980, McKenzie Management provides knowledge, guidance and personalized solutions that have propelled thousands of general and specialty practices to realize their potential.
Interested in speaking to Sally about your practice concerns? Email her at sally@thedentistsnetwork.net or call 1.877.777.6151.
Interested in having Sally speak to your dental society or study club? Click here.
Hear Sally’s FREE podcasts at The Dentist’s Network - HERE
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Monitor Positioning
by Dr. Lorne Lavine, Dental Technology Consultants
As dentists transition towards a modern dental practice, many of them realize the value and benefits of placing computers in the operatory. A recent study seems to indicate that most offices have computers in the treatment room, and many practices are moving in this direction over the next 12-18 months. One of the issues that has created resistance is the confusion over proper positioning of the monitors. In this article, we will examine the decisions that must be made in positioning monitors for maximum benefit.
One Scoop or Two?
While the concept of having more than one monitor in the operatory was a foreign thought a few years ago, this is becoming more and more common today. The main benefit of two monitors is the ability to pick and choose what the patient sees and what they do not see. Most practices want the patient to be able to view intraoral camera images, digital camera images, digital radiography, patient education, and DVD or TV. However, in many cases, there is more HIPAA-sensitive information that is best not seen by the patient, such as the day’s schedule, financial statements, and other private information. In these situations, a dual monitor set up is ideal.
It’s important to differentiate between two monitors and a dual monitor display. Many offices already use two screens, such as a TV and a computer monitor. However, the TV is not connected to the computer and these are really two separate systems. In a dual-monitor display, both screens are connected to the computer. This requires the use of a dual-display video card. These cards can have outputs for both monitors (VGA or DVI) and TV (RCA or S-Video). By setting up the monitors in Windows, they are basically treated as two halves of one monitor: drag an image to the edge of one screen, and as you continue to drag, it appears on the leading edge of the other screen. Through this system, you can pick and choose what appears on each monitor.
Positioning
For the monitor being viewed by the patient, there are a number of options that are available. Many offices currently have TV monitors that are positioned in the upper left or right corner where the wall meets the ceiling. While adequate for watching TV, this position is not ideal for viewing digital images. The monitor should be positioned about 18” from the patient’s face, and this corner position is simply too far away. So, this narrows down the options to three: the ceiling, the wall, or the light pole.
For maximum flexibility, the ceiling is the best location. When connected to an articulating arm, such as those from ICW (www.icwdental.com) or Ergotron (www.ergotron.com), it allows the monitor to be viewed from both a sitting as well as a reclined position. Since many offices have drop ceilings, it is also easier to run the necessary cables (video, audio, and power) from the monitor back to the computer.
If viewing the monitor while the patient is reclined is important, then a pole mount is also a good option to consider. Many dental chairs have built-in options for a Radius-style monitor mount. The one limitation is the issue of the cables. If the floor is concrete slab and there are no conduits in place, then there is no easy way to run the cables from the monitor to the computer. Also, it makes sense to position the monitor as high as possible on the light pole, as the higher the monitor is positioned, the easier it is to view while reclined.
If viewing the monitor from a reclined position is not crucial, then a wall mount can be considered. These mounts come in many shapes and sizes. Dentists will have to decide if they need the monitor to extend out across the patient or just to the side, whether up-down motion is required, and whether they want a keyboard tray to be mounted to the monitor.
As practices add new technology systems, it is important for dentists to evaluate the different options available for positioning monitors. There are ergonomic and esthetic issues that must be considered, but with proper planning, the ideal result can be achieved.
Lorne Lavine, DMD is the Founder and President of Dental Technology Consultants. Dr. Lavine holds two prestigious certifications, the A+ Certified Technician designation and the Network+ Certified Professional. These designations demonstrate proficiency in computer repair, operating systems, network design and installation. Dental Technology Consultants provides dentists a full range of services relating to the implementation of technology.
Interested in having Dr. Lavine speak to your dental society or study club? Click here. Dr. Lavine can be reached at drlavine@thedentistsnetwork.net.
Hear Dr. Lavine’s FREE podcasts at The Dentist’s Network - HERE
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Outside The Box: Practice In A Small Town Or Rural Area
by Thomas L. Snyder, DMD, MBA
Director Transition Services The Snyder Group/Division of Henry Schein
The access to care problem in both medicine and dentistry has risen dramatically in the last ten years. In our dental profession, the number of Dental Health Shortage Areas (as defined as one dentist per 3,000 people) has grown from 1,853 shortage areas to 4,230 shortage areas in 2009. This is a 128% increase! So why are these areas growing so rapidly? From our experience, we have found that dentists who established their practices in small town or rural areas are having an increasingly difficult time finding associates or purchasers to buy their practices. Why so? The primary reason is that the majority of today’s dental graduates want to practice in urban or suburban areas. Granted these areas may provide more social and cultural opportunities than smaller towns or rural areas, but from a professional point of view, it may make good business sense for a young dentist to reconsider their strategy. Here are some points to consider:
Competition
It goes without saying that many young graduates are having a harder time finding associate buy-in opportunities in this tough economy in the suburban and urban areas. As many doctors have deferred their retirement plans for several years due to the economy, the opportunities in these areas for practice purchases has diminished, thus frustrating more and more associates who want to own their own practice. However, this is not the case in small towns and rural areas. Most dentists in these areas are doing quite well economically, as many communities do not have enough dentists, and consequently, patient demand is quite high. So less competition means more economic opportunity!
Accelerated Loan Forgiveness
Because of the dental shortage crisis, certain states are offering loan forgiveness programs based on the number of years a doctor practices in a shortage area. Practicing in these locales can accelerate your ability to retire your student loans. Moreover, if you decide to purchase a practice in a small town or rural area, chances are you will be able to purchase an excellent practice at a very attractive price due to the lack of demand of purchasers. Consequently, you’ll get a better return on investment in these areas than purchasing a comparable practice in an urban/suburban area.
High Net Profit
When valuing rural practices, we find that most practices rarely have overhead exceeding 50-55%. This is true for two primary reasons; cost of labor in small towns and rural areas is certainly a lot less than in urban and suburban areas. Secondly, so are the occupancy costs. Therefore, purchasing a professional building in these locales can be a tremendous financial investment for a doctor wishing to purchase a practice with the real estate. Even if you decide to rent instead, your facility expenses ratio will be significantly lower as well. So higher net profit can build your wealth more rapidly by having the cash flow to save more and retire debt more aggressively than your classmates will be able to do in urban and suburban areas.
Practice Start-Up or Practice Purchase?
In rural areas you’re faced with a worthwhile dilemma. You can move to a small town and either purchase a practice with a low multiple of gross receipts, or conversely, you may elect to start your own practice in the same area and be quite busy from the outset! We find that in many small towns and rural areas, practices are selling between 40-50% of last year’s gross and in some cases even lower than that. So, it is possible to buy an extremely successful dental practice for a relatively low price.
Life Style Changes
I have talked to some dentists who are tired of the “rat race,” competition and tough economy in the urban areas, and yearn to simplify their lives. So, for someone in practice who wishes to slow down the pace, increase income, and reduce stress, relocating to a small town or rural area may be the best solution.
Now for the few of you who understand the points we have just made in this article, think long and hard about considering a small town or rural area as the place to begin or end your career!
If you would like additional help, email Dr. Snyder at drsnyder@thedentistsnetwork.net.
Interested in having Dr. Snyder speak to your dental society or study club? Click here.
Hear Dr. Snyder’s FREE podcasts at The Dentist’s Network - HERE
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