Getting to the Root of Practice Challenges

Leadership in dental practices often faces unexpected challenges, especially when dealing with negative patient feedback. By employing the Infinite Why system to analyze issues, leaders can uncover the roots of problems and foster a more constructive team environment focused on improving patient care.

• The emotional challenges of receiving negative reviews
• Understanding the importance of extreme ownership in practice management
• The Infinite Why system as a tool for deep analysis of issues
• Engaging in blame-free discussions for improvement
• The crucial role of leadership in guiding teams for better outcomes
• The importance of continuous training and communication within teams

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Chapters

• 0:02 Analyzing and Addressing Practice Issues
• 9:54 Leadership and Team Training for Success

Transcript

Paul Etchison: 0:02

We all go through periods of time in our offices in which it seems like the wheels are starting to come off. We get a one-star review, or maybe two, or the team continues to do things other than what you ask of them, or maybe a key team member resigns. Sometimes these are rare occurrences, but when things like this constantly seem to be going on, it might be time to look deeper at the issues. But how do we figure out what the true issues are? Today, I'm going to teach you a tool how to analyze every single issue that comes up at your practice so that you can get to the heart of the issue and continue to grow your practice and move forward. Stay tuned. You are listening to Dental Practice Heroes, where we help you create and scale your dental practice so that you are no longer tied to the chair. I'm Dr Paul Etcheson, author of two books on dental practice management, dental coach and owner of a $6 million group practice in the suburbs of Chicago. I want to teach you how to grow and systematize your dental practice so you can spend less time practicing and more time enjoying a life that you love. Let's get started. Time practicing and more time enjoying a life that you love, let's get started.

Paul Etchison: 1:13

So last September I remember sitting on my friend's driveway having some beers on a Wednesday afternoon and if you're wondering what we're doing drinking on a Wednesday, this is a friend of mine that works at Ford. He's often laid off I don't work on Wednesdays typically, so why the hell not? But it was like one of those days in the fall, that perfect time of year when you start to get that smell outside as the leaves start changing and the temperatures start cooling down. You know, beautiful, like light, breeze, sunshine on your face, clear skies. One of those first days that you start wearing pants but you're still in a t-shirt, but the weather feels absolutely perfect. And me and two of my friends were sitting out there in the driveway with two fold-out chairs, talking about all the things that are going on in our lives. We're talking about the Bears and why they suck and why the White Sox are like the worst team of all time in baseball right now the usual Chicago South side sort of stuff. But I remember this day not because of how great I was feeling on this beautiful fall day, but rather because how quickly the way I was feeling changed Now. In between conversations with my two friends.

Paul Etchison: 2:15

I looked out on my phone and I see that I have a notification for an email and the email is from Podium. Now, podium is the company that we use to do our review generation. So when I get an email from Podium Now Podium is the company that we use to do our review generation. So when I get an email from Podium, which is very often, it means we got a review. Now I look down and I see the notification and it says new one star review. Oh, you know that feeling. You go crap. What happened? So deep breath. What the frick is this? Let's examine. So I open up the email and I see this really long patient review and my first thought is like screw this, let's examine. So I open up the email and I see this really long patient review and my first thought is like screw this, I'm not reading this right now. I'm having such a good day. I'm not ruining my day. I will not give this patient review the power to ruin my perfect day I'm having now. So I shoved my phone back in my pocket and I forget about it. Easier said than done.

Paul Etchison: 3:02

After two minutes I remember my buddies telling me about something his brother just recently did. I can't even focus, I'm struggling to listen and I'm wondering what is that review about? What did it say? Surely it's got to be a crazy patient, right? I mean, only crazy patients leave reviews. It's got to be some sort of misunderstanding. We could fix it.

Paul Etchison: 3:20

And then I started going deeper, like why does my team consistently keep getting negative reviews lately? Why can't we just take care of the patient? Why can't I be present with my friends right now? So I read it, I read the whole thing and if it's true, you know this is just the patient's perspective, but if they, if what she says is true, then I'm ashamed to be associated with this office because it is bad. Now, on top of it, it's strangely similar to a one-star review that we just recently got, like two weeks ago. Now I'm starting to think about myself. I'm blowing it as a leader. I am sucking. The practice sucks. I should just retire completely from this practice because I have failed. I don't have what it takes to lead these people. How can I possibly sit on a podcast and pontificate about how you should be running your practice when I can't even keep the wheels on my own? And this is how I feel every time I get reviews like this. Now guess how I'm feeling right now as far as my life satisfaction, on a scale of one to 10. Before the review, 10. After the review 15. Negative, 10. Burn down the practice. So let me read part of both these reviews and you're going to see a similarity here. I'm going to pick parts of them because they're long reviews.

Paul Etchison: 4:35

All right, the first one says I was made to feel uncomfortable by an inappropriate staff member. Both people dismissed my concern. The hygienist, pam, instructed me that I should ask Santa for an electric toothbrush for Christmas, and this felt inappropriate and childish to me. Then Justine stated Justine's my office manager. Justine stated that she has known Pam for years and that I couldn't understand a joke. All right, that's the first review.

Paul Etchison: 5:02

Now here's part of the second review Gina, who is a hygienist at my office. Gina was in the room for less than 12 minutes before Justine, my office manager, came in and spoke at me. She said she has never had a patient complain about Gina and she was uncomfortable. So, truth be told, these are two very different situations. But did you hear that similarity? Both mentioned Justine and Justine expressing to the patient that she was surprised that they were complaining about that employee, and with good reason, because both of these people that they were complaining about Gina and Pam never get anyone complaining about them, so it is surprising. I mean she had a good reason to be doing that, but what the patient heard is you must be crazy. Nobody complains about this person. Right Now. The last line of the review just infuriates me. Person right Now. The last line of the review just infuriates me. This is what it says Stay clear of this place. This is the type of office where the office is always right and the patient never is.

Paul Etchison: 5:58

Now I'm asking myself why does my team lack the communication skills to adequately diffuse these patients? But the fact of the matter is this is really a sign of poor leadership on my part. Both of these situations started with a system failure. Both having to do with misquotes in insurance, are an error somewhere between the insurance verification and the treatment plan presentation. So really, who is to blame here? You guessed it, it's me.

Paul Etchison: 6:26

Often, as leaders, we're looking at issues and we wanna point the finger, but more times than not, these things are just signs that we're failing as leaders. We're looking at issues and we want to point the finger. But more times than not, these things are just signs that we're failing as leaders, and it doesn't mean that we're bad leaders or that our leads are bad leaders. Often it just means we've become too busy and we're not spending adequate time or energy in leading. So I want to teach you a tool to use whenever these situations appear at your practice, and you can do these in your head or you can do it with your team, because these things, when they happen, they don't just happen in a vacuum. They happen in a practice, with systems and culture and relationships between people and guidance from the leaders. All these things play into how our team behaves and how our team interacts with patients.

Paul Etchison: 7:12

So when you have a situation, pop up your practice. I want you to use the infinite why system. All right, what is this Infinite whys? You just keep asking why. Now you've got to ask why, at least five times. You can't stop before five. No matter what you do, you have to at least go five times. So let's look at this one situation why times? You can't stop before five. No matter what you do, you have to at least go five times.

Paul Etchison: 7:30

So let's look at this one situation why did this patient write the review? Well, because she was upset about her experience. Second, why? Why was the patient upset about her experience? Well, because we didn't meet her expectations and we didn't handle the complaint in the way that the patient wanted. Okay, why? Number three why didn't we meet her expectations and why didn't we handle the complaint in the way that she wanted? Well, because we communicated something wrong about her insurance and we gave her a surprise bill. And then we were frustrated by this person and the complaint and she was really difficult to deal with. Okay, number four why did we communicate something wrong and why were we frustrated? Well, because we skipped a step in the insurance verification process.

Paul Etchison: 8:13

And we're frustrated because things like this keep on happening. Why do things like this keep on happening? Because we're not being clear about the processes and holding people accountable, and that's leadership. Why are we not holding people accountable? Because the leaders are too busy doing other tasks other than leading their team. So they're. So we can play that infinite why? Game until we discover what's at the heart of the issue. And, just as a quality control check if you don't get all the way through this why system and figure out how, somehow it is your fault as the leader, extreme ownership. You need to keep asking.

Paul Etchison: 8:51

Now, after we discover the why, it's time to delve into the beautiful one-on-one that I love doing so much. Have an open conversation with your team without blaming. Never blame a team member, never point fingers. Just discuss the issue impartial. Don't take sides. It's not an us versus them. It's about why did this happen and what can we do so that it never happens again. In this specific situation. This is what we did.

Paul Etchison: 9:16

We ended up training the entire team on how to properly handle complaints, and I created a how to handle upset patients and complaints module. It's one hour long. If you want this training video for your team, sign up for the DPH Hero Collective. It's only $179 a month right now. And two, we went back to what is our checklist before we present a treatment plan at the front desk. What are the things that we have to check so we don't miss things like this? Because what this was was a weird, unusual plan in which the deductible is applied to preventative. So these don't happen so often, but they're not super rare. We do have them, but we missed it.

Paul Etchison: 9:54

Now these weren't just like two isolated incidents. At my practice, we were seeing a ton of issues happening like this in the fall, and the reason was is because there just wasn't a lot of leadership at the office right at that moment. My leads were too busy doing dentistry, seeing patients like working, because we were short staffed and we didn't have enough people. So they're covering for people and doing stuff like that. So they're too busy doing that rather than leading. And, truth be told, the leads leader, which is myself, is too busy drinking on a Wednesday at like 2 pm instead of being at the practice and helping. So it's my fault too, I will admit to that, but we need to be honest with ourselves if we're going to grow.

Paul Etchison: 10:38

So whenever you have an issue popping up at your office, I assure you it always comes down to leadership. You've got to inspire your team. You've got to give them a reason to do the things the right way other than just because they don't want to get in trouble. They have to do it for the patient. They have to do it for the team that they work with.

Paul Etchison: 10:58

We have to do it for the mission of the practice, and that all comes from having conversations about why we do things and why they're important, and it also comes with training and checking in and making sure that when there are frustrations with the team, you address it so that when you do get an upset patient, your team member doesn't get so frustrated with that patient that they piss them off so much they go write a one-star review.

Paul Etchison: 11:21

So look at the last two or three issues that have happened at your practice and do that infinite why game, keep asking why and figuring out why this happened and then why did that happen and why is it this way, until you get to the heart of it, so that you can address that situation and then learn from it and implement. And then, after you implement, make sure that you come back and check on it, to check in with the team, to make sure it's effective and also to reinforce the reasons why you were doing that way, so that it continues to be done that way, so you can stay consistent. And if you want more training like this for you and your team, check out the DPH Hero Collective at dentalpracticeheroes.