Say Goodbye to Weak Links on Your Team

Imagine the thrill of a same-day Invisalign start, only to be met with the crushing realization that no one in the office, not even the doctor, can perform the critical iTero scan. Join me, Dr. Paul Etchison, on Dental Practice Heroes as I unravel this cautionary tale from a coaching client, underscoring the chaos that ensues when key team members are unavailable and the vital importance of cross-training. This episode promises to arm you with the insights needed to fortify your team against the unpredictable nature of dental practice life.

Reflecting on my own early career, I share a humorous yet enlightening story of reliance on a single skilled assistant and the struggles that emerged when she went on maternity leave. From navigating frustrating daily operations to a memorable extraction fiasco, these stories aim to highlight the lessons learned in building a resilient and adaptable team. Whether you're a seasoned practitioner or just starting out, this episode offers valuable leadership lessons to ensure smooth, effective operations in your practice. Join the conversation and discover how to transform challenges into opportunities for growth and learning.

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Transcript

Paul Etchison: 0:02

Hello and welcome back to Dental Practice Heroes. I am your host, dr Paul Etcheson, and I am so happy that you are here learning how to better yourself as a leader and a dental practice owner. This is the show where we teach you how to practice less days without having to sacrifice patient care, work quality or profit. So earlier this week I was having a conversation with a coaching client of mine and he was sharing a story about something that has been frustrating him. So he's telling me that the other week he had an Invisalign start in which the patient had the consult, they went up to the front, they did all the finances and they put down their down payment and they're ready to get started. So you know that feeling right Like you just realized that you just added like four or $5,000 to your daily production in just like a moment, cause you got that patient to say yes on that same day Invisalign start. I mean, there aren't many better feelings than that. So he's all excited and he goes to find his assistant to do the iTero scan. But she's nowhere to be found because she's off on lunch right now. But he's like, okay, no big deal, I'll go get my hygienist that knows how to do it. But then at that moment he remembers that she's out on vacation this week. So he starts walking around the office looking for someone who knows how to do the scan. He's asking assistants, can you do an iTero scan? And he has this moment of realization there isn't a single person in the building that knows how to do one, including him as the doctor.

Paul Etchison: 1:35

I can relate to this because I've had moments like this as well. You know, earlier in my career I only had two or three assistants. This is way early and I would rely heavily on my main assistant, lauren. She was my assistant at my associateship. She was my assistant when I got out of school and she could do everything so highly skilled. We worked together great. Every time I needed something done, she was my go-to person. But this becomes an issue one day because eventually Lauren has a child and she goes away for a few months on maternity leave, which at that point forces me to work with my second assistant, jacqueline, and we got through the days, you know. We got through our patience, but it was just so frustrating Every single day that Lauren was gone. It was just more apparent to me each day that I hadn't spent any time training Jacqueline and I'd ask her to do something and she would ask, well, how? And I'd just be like, take this deep breath and just try not to show my frustration, try to breathe through it. But it was like a really difficult time and every single day I went into the practice like, oh gosh, this is going to be a nightmare. And then there's this one special moment that I would just will never forget.

Paul Etchison: 2:48

I was having trouble with an extraction. I was probably like 40 or so minutes in. You know like I'm sweating like crazy, like the sweat's dripping down on me. I'm so hot Taking the air water syringe and I'm blowing on my face because I'm just like burning up. And I'm saying to the patient over and over all right, I almost got it, okay, just about to get it. You know like when you're like you really in your mind you're in extraction and you think that you're like 10 seconds away from getting the tooth out, but you do that for like an hour straight, you're like 10 seconds away for an hour.

Paul Etchison: 3:18

It was one of those appointments. So there I am, I'm sweating. I have the hygienist. There's like two hygienists standing in the hallway behind me. They're waiting for their exams, my next two patients. They're already sat.

Paul Etchison: 3:29

And then I'm going through my head, I'm saying like, oh my God, I hate this job, I don't want to be a dentist anymore, I don't want to do this. And there's part of me that almost wants to blame my assistant, like if you could just suction better, I could see what I'm doing and then I could do this. But that wasn't the case. I mean, you know, but you feel like this, you're getting all emotional. So the patient's all strung out, they're exhausted, they're nervous, they're upset that we're still poking around in her mouth and we're trying to get this tooth out. And I hear the hygienist that keeps saying I need Dr Hutchison, I'm so sorry, I need this exam, the patient has to go.

Paul Etchison: 4:01

My next one's here, and finally I just go. Okay, I got to check hygiene and I asked Jacqueline. I say hey, can you get me a periosteal elevator? She looks confused. And I said a periosteal elevator and she still looks confused and her eyes are super wide and she shakes her head Like I don't know what that is. So now, like my blood is boiling, I take off my gloves and I kind of motion to her. I say like, kind of like meet me in the hallway. So she comes in the hallway. I'm so frustrated at this point and I lean into her ear. I'm like literally an inch away from a year and I whisper you've worked here for almost a year and you don't know what a fucking periosteal elevator is. And as those words left my mouth, I knew I done messed up. Her eyes got so wide and you could see just the damage I'd done on her face. She walked away and she did not come back. I had to grab another assistant. I finished the procedure, I got the tooth out and you're saying well, where did she go? Well, she went into the bathroom so she could cry.

Paul Etchison: 6:03

And this was likely one of my worst moments as a boss. I mean, I felt horrible, like just like deep shame. And as soon as I saw her I apologized, like I just gave her a hug. I said oh my gosh, I am so sorry. I totally let my emotions get the best of me. You didn't deserve that. That will never happen again. That was so wrong of me to do that. I was just deeply ashamed. She did forgive me, but that's not the point.

Paul Etchison: 6:32

The point is this you shouldn't wait until the moment when you need the skills to teach the skills you need to be training all of your people. So how do you do this? Well, it's pretty simple. You create 30, 60, 90 training checklists for every position. Okay, there's probably going to be three positions there's front desk, there's assistants and there's hygienists and you write down what concepts and skills you want each position to know for 30 days in, 60 days in and 90 days in. And then you meet with each new employee on those dates. You go through this checklist and you say how are you doing this? Do you know how to do this? And you make a plan to train with them. Okay, you have to make a plan. You can't just have the list. You've got to sit down with them and say, okay, we've got to make a plan, we're going to sit down this day, we're going to schedule it and we're going to teach you how to do this stuff. And really, to create this document it shouldn't take longer than like 15 or 20 minutes. It's not this like big, insurmountable task, but then, after you create it, all you got to do is use it. So, fast forward.

Paul Etchison: 7:32

My practice we have. I want to say eight, maybe nine, assistants. We'll say, eight assistants, and all eight know how to do an iTero scan and all eight know how to design, mill, adjust crowns, adjust contacts, adjust occlusion All eight. They know how to set up an assist for every single procedure. They know the concepts, like the principles of light. They know what the etch does and why it makes composites stick better. All eight of them are just absolutely amazing assistants. And any doctor that listening right now, if you had any of these eight assistants, you would be thanking the good Lord for them, because that's how good they are.

Paul Etchison: 8:09

But that comes from planning and executing during your onboarding with new people. So if you've never done this, it is time to do it Eventually, as your practice grows. You're going to delegate this to like all the training that's going to go to your leads. You're not going to have to do it anymore and you won't have to do a single thing to get your assistants trained other than just let your team follow the process. But for now, if you're not at that point, you don't have the documents and you don't have the people trained. You've got to do it, you've got to put in the time.

Paul Etchison: 8:37

Now I'm going to let you know Jacqueline, the assistant I was telling the story about that. I wasn't very nice to, and sometimes we still bring up the story and we can kind of laugh about it now, but we are still working together. She is my assistant. It's been 12 years, so she has forgiven me. She's a great friend. She is my clinical manager. She's a very important person in my practice. She's my assistant lead, somebody that I very, very much care about and, like I said, not only was that a bad moment for me, but that was probably, you know in my gosh, what you know 16 year career. At this point that was probably my very worst moment ever and it really wasn't fair to her. Now we often talk about this idea of extreme ownership and that is me owning everything at the practice. Now she had worked there for a year. She didn't know what a periosteal elevator was, but that wasn't her fault, that was my fault. I had no method or system for training and I had relied so heavily on my other assistant, lauren, that Jacqueline never got the opportunity to work at her full potential.

Paul Etchison: 9:42

So if you want an example of a 30-60-90, I will share with you my 30-60-90 checklist. It's in the show notes, you can download it. But if you want the other ones. You got to join the DPH Hero Collective. You want to get those training videos. You want to get all those other documents. It's all on the DPH Hero Collective at dphpodcom. Create those checklists, do it once, then you can use them for the rest of your career. And later this week we're going to explore what are the first things that you should do when you start creating hero practice, which is one in which you only practice as much as you want, even if that's not at all. So come back on Wednesday for that episode. Thank you so much for listening and I'll talk to you next time.