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720: 2 Questions to Know if You Are Doing the Right Thing – Debra Engelhardt-Nash

How do you know you're doing the right thing for your practice? There's an easy way to answer that, and it’s with two simple questions. To share what they are and how you can apply it to any dilemma you face, Kirk Behrendt brings back Debra Engelhardt-Nash, co-founder of The Nash Institute, with her expert advice for creating the best practice culture. Your practice is a Petri dish — so grow the culture you want! To learn how, listen to Episode 720 of The Best Practices Show!

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Main Takeaways:

  • An important question to ask is, is X good for my practice?
  • Another important question is, is X good for my patients?
  • If you answer no to either of those questions, don't do it.
  • Meet more with your team. Don't avoid conversations.
  • Verbal skills matter. One word can make a difference.
  • Change your beliefs to change your behaviors.

Quotes:

“[A dental office is a Petri dish] because there's stuff in there. There's good bacteria, and there's bad bacteria. If you think about a Petri dish, stuff grows in there. I mean, culture and attitudes grow in a dental practice. And sometimes, unbeknownst to the owner, sometimes unbeknownst to the doctor, culture has been growing. It's almost like when you find that little black darkness in the corner of your room and you say, ‘What is that?’ And you say, ‘Oh my gosh. Mold has been growing in here! Mushrooms have been growing in here!’ So, I think sometimes it's important to look at the Petri dish to see, what is growing in this culture? Is it the culture I wanted, or did it get infected? Did a virus get in? Did other bacteria get in there?” (10:23—11:19)

“I was roleplaying with a woman in the audience in Chicago [Midwinter]. I said, ‘So, tell me what would prevent [your hygienists from endorsing you].’ She looked at me and said, ‘You know, I have to be honest with you. I don't see my team taking the time to learn new skills. I don't see my team taking the time to change their behavior or taking the time to be trained. I think my team wouldn't go the extra mile and do this.’ . . . I said, ‘Wow. So, there has been a precedent that has been established in your practice that it's okay not to grow.’ And once again — Petri dish. Something is growing in there, but not what you want to grow.” (12:50—13:46)

“You need to meet more. The team needs to meet more. We don't want to avoid team meetings. We don't want to avoid conversations. We need to have them. And sometimes, conversations have to be critical. Sometimes, they have to be crucial.” (18:01—18:15)

“I also coached a doctor this morning. He’s got a team issue, and here’s what I coached him. I coached him because he really cares about this person. What he is getting ready to say to this person is, ‘I like you too much to let you perform this way.’” (19:17—19:32)

“You can be your own consultant, and here's how you can do that. Ask yourself these two questions . . . We can use the example of financial arrangements. Are these financial arrangements that we've designed for our patients good for the practice? The second question is, are these financial arrangements good for the patients? Or you can reverse them. So, an example might be, allowing your patients to make small payments over a long period of time in-office, is that good for them? Now, I would argue that it isn't. But a lot of times, my audience will say, ‘Yeah! Patients would love that.’ No. Okay, so let's suggest that we're going to say, yes, allowing your patients to make small payments over a long period of time in a dental office is good for the patient. Let's ask the second question. Is it good for the practice? No. So, it's not going to work. If you have to answer no to either question, then it's not going to work. It will eventually fail because it's got to be good for both the patient and the practice.” (20:03—21:19)

“We can have an outstanding team member. But if they create havoc, if they're not a great team player — let's say they're amazing, but people don't want to work with them. They create a problem. Every morning, they create a problem. So, the question is, is this team member good for the patient? Yeah, they're great producers, and they're great at the chair. But are they good for the practice? Or are they a detriment to the culture of who we are?” (21:33—22:10)

“We talked about the example of a great team member who was paid on commission and producing, but patients complained about how they felt while they were in their care. They felt rushed. The team members felt that they were being segregated because they didn't ask for any help because that would affect their commission and their pay structure. So, they became a non-team-player. And so, then you ask yourself, is that scenario good for the patient? It's not. Is it good for the practice? It's not. So, then we have to change the behavior. We have to change the system, or we have to change the behavior. If the behavior isn't good for the patients, it isn't good for the practice.” (22:24—23:12)

“You have a team member who is habitually late. So, you have to ask yourself, is it good for the practice that this team player is habitually late? No. Is it good for the patient? No. So, we've got to correct the behavior. It's a serious conversation. Or we have to change the person.” (23:14—23:39)

“[When a doctor wants to go from one-hour hygiene appointments to 30-minute appointments], let's go back to, is it good for the patient? Will we have an opportunity to have a conversation with the patient? Could we perform the muscular motions per minute in 30 minutes? Could we do radiographs? Let's say we could. Let's say we can do a prophy, we can do radiographs, we can do an oral cancer screening exam, and we can do periodontal probings. Let's say we can do the muscular motions. But can we have a conversation? No. Can we engage in relationship? Probably not.” (24:01—24:33)

“Why do you think that your patients have more allegiance to your hygienist than they have to you? It's because you're not spending enough time with them. And it goes back to, is it good for the practice that you're not reengaging them into you? So, going back to that 30-minute hygiene exam, is it good for the patient? No. Is it good for the practice? No. Don't do it. It's the wrong thing to do.” (27:04—27:29)

“It amazed me in Chicago when I asked people, ‘How many of you use text-to-pay?’ Few! I said, ‘Are you kidding? How many of you pay your bills online? How many of you book your airlines online? How many of you make dinner reservations online? You don't think your patients want to be able to pay their bill online?’ So, you need to review and say, are we still current with today's systems? Have we changed? Have we changed the way we schedule? Have we changed the way we talk to patients about scheduling? Have we really explored the current trends and what our patients, also known as consumers, want? And interestingly enough, when we talk about systems, a Harvard study [talked] about consumerism and the expectations of today's consumer. There are all kinds of statistics, but one of them is that consumers have a higher expectation of service than they ever have had before.” (28:38—29:47)

“One word can make a huge difference. One of them is, I like you [versus] I love you. That's huge. That's different. But if I go to dentistry, ‘It's just a cleaning,’ [versus], ‘It's an important cleaning.’ ‘I'm just calling to remind you,’ [versus], ‘This is an important reminder.’ That changes everything.” (32:22—32:47)

“[The word “just”] minimizes everything. It makes it insignificant. It's “just” a cleaning. It's “just” a little filling. I had a client one time. She didn't even realize — this is another piece. Forty-five percent of the time we spend in our lives is habitual. She had a habit of saying, ‘This is just a little filling. It's a little filling.’ She was mimicking the drill. ‘So, why am I paying $275 for a filling?’ She said, ‘I didn't even realize I was doing that.’ And so, when patients call to say, ‘I need to cancel my hygiene appointment. It was just a cleaning,’ who taught them to say it was just a cleaning? We did.” (33:04—33:56)

“You should always schedule a team meeting following a course at the Hinman, at Chicago Midwinter, or at the Greater New York. Even in a clinical course. If you're doing Spear or you're doing Kois — if you're doing anything — you need to go back to the team and say, ‘I need to debrief you. I need to fill you in on what I learned because I want you to be on board with me.’” (34:58—35:23)

“Don't become stagnant. Stagnant is like a pond — and you know what pond water smells like.” (36:20—36:25)

“If my team wants another $2-an-hour more increase . . . is it good for the practice to do that? Yes, it is. Because they're going to come back to work feeling valued, feeling important, feeling that they make a difference . . . Doctors, do not nickel-and-dime your team. If they're worth it, pay them. Pay them what they're worth. Sometimes, we can look at compensation, and it's outrageous. But I turn around and say, what's going to be my return on that compensation? Look at your team as an asset, not a liability, and what's going to be my return on that investment on my team?” (37:09—37:54)

“Always say things with the patient's best interest in heart. It's not “our policy”. It's, ‘This is what we found our patients prefer. This is what we found works best for our patients. This is what we found that makes our patients most comfortable,’ as opposed to, ‘Well, this is our policy.’ See — one word changes everything.” (39:07—39:23)

“If a doctor wants to get a point across, rather than feeling confrontive to the team, just ask the question, ‘Hey, before we do this, let me ask you this question. Is this going to be good for the patients? Is this going to be good for the practice? Help me understand the benefit to the patient and the benefit to the practice.’ And if you can answer yes, then it’s probably the right thing to do. But if we question — if we’re wondering whether or not it's going to be good for the patient, or we're wondering whether it's going to be good for the practice, let's rework it. Let's rethink it. So, a doctor can innocently ask the question, ‘Hey, before we do this, let's ask ourselves these two questions.’” (40:04—40:47)

“It's one thing to know how to do the dentistry. It's another thing to know how to talk about it and get your patients to understand and accept it.” (41:55—42:01)

“If I think patients don't want it, can't afford it, don't need it, I will find ways to prove that I am right. So, what happens is I will focus on that which I think is right. And then, what happens is I will create behaviors that will prove that my beliefs are accurate. And then, I'll get the results that I believed. So, if I think my patients don't want it, can't afford it, then I'm not going to present it. I'm going to become insurance focused. I'm going to be money focused. I'm going to create my policies, my protocols, and all of my behaviors towards the patient on what I believe, and it's going to perpetuate my premise that patients don't want it, can't afford it, don't need it. I've dug my own hole.” (42:52—43:39)

“[If I change my beliefs], I'm going to behave differently. I'm going to approach the patient differently . . . I'm going to ask different questions. I'm going to present dentistry in a different way. Because how many times do we say, ‘Well, we’d really like to do this for you, but your insurance isn't going to cover it. We'd like to do composite, but your insurance is only going to pay for amalgam.’ And then, we say, ‘You see? They were insurance driven.’ Really? Who drove them there? You did.” (43:54—44:23)

Snippets:

0:00 Introduction.

2:34 Debra’s background.

8:01 Why this is important.

10:11 A dental practice is like a Petri dish.

15:30 Does your team endorse you?

17:01 Meet with your team more.

18:33 Stop tolerating behaviors you don't like.

19:50 The two important questions to ask.

23:40 Is a 30-minute hygiene appointment a good idea?

27:30 Keep updating your systems.

30:49 Verbal skills are critical.

33:57 Always debrief your team after a course.

36:26 You get what you give.

36:59 Don't nickel-and-dime your team.

38:15 One word can change everything.

39:57 Use the two questions to get your point across.

40:49 About Debra’s courses.

42:02 The belief cycle, explained.

Debra Engelhardt-Nash Bio:

Debra is a trainer, author, presenter, and consultant. Having been in dentistry for over 30 years, she engages organizations and study groups nationally and internationally. She is a continual presenter for the American Dental Association, the American Academy of Cosmetic Dentistry, and the Chicago Dental Society Midwinter Meeting. 

Debra is a founding member of The Nash Institute and past president of the National Academy of Dental Management Consultants. She is an active member of the American Dental Assistants Association, the American Academy of Dental Practice Administration, and the Speakers Consulting Network. She has been repeatedly recognized by Dentistry Today as a leader in continuing dental education and as a leader in dental consulting. She is also a member of the American Dental Association’s Dental Practice Management Advisory Board, and recently became the president of the Academy for Private Dental Practice.

Debra is married to cosmetic dentist and dental educator, Dr. Ross Nash, of The Nash Institute for Dental Learning. She continues to work in his busy practice, doing exactly what she preaches. 
ACT Dental Team

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