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A Great Day in Dental Practice

February 19, 2014

Filed under: Uncategorized — Barry @ 1:15 PM

 

stop-and-smell-the-rosesI don’t usually write posts like this one.  Usually I start off with a point I want to make…but today I just wanted to stay in the moment to describe how I feel about a great day in dentistry.

My goal I guess is for you to stop and appreciate what dentistry can do for you…because we don’t usually do that…but at the stage I am at in my career, I can sit back and smell the roses.

Yesterday my hygiene schedule was filled with patients who have been in my practice for over thirty years.

One of them, Tom, travels up from North Carolina three times a year for his maintenance.  He never misses.  Sometimes he flies in and combines the trip with seeing friends and relatives.  Other times he goes on to New York to visit his son.  Obviously Tom is more than a patient…he’s a friend, a member of our family.

I remember when he first came to us.  He was overcome with fear from a lifetime of bad dental experiences.  Slowly, over time we restored him.  He gradually accepted more complex treatment including implants which were fairly new at the time.  Tom’s dentistry has held up…because of his care and appreciation.  That’s what makes me feel good.

My next patient was a woman I restored fifteen years ago.  Same story.  Although she lives a lot closer, she never misses her hygiene appointments.  On random occasions she stops in and brings us wine or fruit platters.

She speaks very little English…but we communicate.  I commented to her how beautiful her smile has remained and that the dentistry appeared as if I had placed it yesterday.  Even I was amazed how well she took care of it.

Upon leaving, she stood up and gave me a hug just uttering the words, “Good Doctor, beautiful work.”  At that point I was consumed by what this profession can bring…pure joy.

I am fond of using a quote:  “One thousand compliment + 1 insult = 1 insult”

Knowing that…many times during a day or week when that one bad patient comes in, I still carry that patient home with me.  I am human, after all.

But on this day I enjoyed one of those moments when I know why I practice dentistry.

 

Art of Case Presentation – Interview

October 3, 2013

Filed under: Uncategorized — Barry @ 10:57 PM

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Well it’s finally here.  The Art of Case Presentation is now out and available in both its soft cover version and digital version.  I presented the book at the Pankey Alumni Meeting on September 18.  You can order the soft cover format by calling 856 795 1121.  Watch this blog and CasePresenter.com for online ordering as well.

In the meantime the e-book version is available at Amazon.com, the iBook store and the Nook store.

This morning I was interviewed by Shirley Gutkowski at Blogradio.com.  I discussed the book and some of the ideas that I wrote about.

I spoke about some of my favorite topics like:

  • The paradox of duty and desire.
  • MEGO–Mine Eyes Glaze Over
  • The Biology of Presentation-Dopamine and the Promise of Happiness
  • Visual Storytelling an
  • The Story Structure

Of course the book goes into much more detail, but you can listen to the interview by clicking here:

 

Take a listen and tell me what you think.

I Love Adam Levine

May 30, 2013

Filed under: Philosophy,Uncategorized — Tags: — Barry @ 10:56 AM

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Let me start this post by saying I don’t watch The Voice.  I’m ambivalent about it.  But I couldn’t help notice the brouhaha that judge Adam Levine started when he was overheard saying “I hate this country.”  He was frustrated because one of the members of his team was voted off of the show by a public vote.

It seems that the person who was voted off was so obviously the best that he was stunned.  People I asked said the same thing.  So why did the public act so irrationally?  Or was this just his opinion?  Or do I have to go back and read Freakonomics and Predictably Irrational?

In other words why do people behave  so irrationally when the truth is so obvious?  Like I said I don’t have much stake in The Voice, but I do have a stake in this country’s health care system.

People who read this blog are a mixed group.  Many dentists read this blog and will understand where I am coming from…let me tell you a story that has been developing through the years:

This morning I had a patient come in to tell me she was leaving my practice after 15 years.  She was taking her family too, and she felt so bad because she loved our office,

But her insurance was changing, and “she had to go where they told her.”  She had tears in her eyes.

There was no convincing her.  She felt as if she was being forced beyond her will.  Irrational?  I know dentists think so.  But what about the lay people reading this blog?  How do you feel?  You see, this is why, as a dentist I support Adam Levine’s outcry.  Do I hate this country?  I can tell you that it gets pretty frustrating when we watch people confirm a system that will not work to provide the best care for them and their families.

It’s frustrating to watch the public vote for a system that breeds mediocrity.  It’s frustrating to watch the public en masse support a system that has no room for dentists to grow into excellence.

Dentistry may be just a small portion of the health care system.  But it is part of the system, like the mouth and teeth are part of every person’s health system.  Dentistry is a microcosm of what is going on economically and politically in this country.  And health care professionals are watching the public just confirm exactly what they don’t want — they are voting to walk over the cliff.

That’s what frustrated Adam Levine— he said it and retracted it.  I don’t think he hates this country and I don’t either – but it can sure get frustrating sometimes. We need more people to step up and support their true feelings—Adam knows talent…health professionals know health care.

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Dentistry Looked Bad–Sorry I was There

May 8, 2013

Filed under: Uncategorized — Barry @ 9:33 PM

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Did you ever wonder why dentistry rarely gets a fair shake in the media (and I include Hollywood in there too).  The Gallup pollsters have been reporting for years that dentistry is one of the most respected and trusted professions.  Yet, that’s just not newsworthy…there’s no story there.

Tonight I participated in a panel discussion on HuffPost, the live streaming video of The Huffington Post.  I thought long and hard how I wanted to represent dentistry.  The moderator used leading questions and controlled the discussion.  In my defense, I thought I did a pretty good job.  As a forty year veteran of the profession I think I have seen dentistry from all sides.

Joining me on the panel were two disgruntled and distrusting patients who had bad experiences, a reporter who was on the team that brought us Dentistry for Dollars, produced by Frontline in June, 2012, and an insurance fraud expert.  Obviously, the two patients told their tales.  One was a “my dentist hurt me tale,” that most of us have heard before…and will probably hear again at the next wedding you attend.  The other was a “he said I had 5 cavities when I never had a cavity before or since.”  Okay…if I really wanted to make the profession look bad I am sure there are some pretty ugly stories out there, like the graft that failed, or I went in for a simple filling and left with a root canal.

George Kennedy said it best in Cool Hand Luke: “What we have here is a failure to communicate.”

The guy who really bothered me was the insurance fraud guy…I don’t know how many times he used the phrase “crooked dentists,”  but I really started to take offense.

Dentists (as the Gallup Polls tell us) are really good, honest people.  We are trying to do the same thing as everyone else—make an honest living and serve their patients as best they can.  I believe that.  I’ve met most of you at continuing education courses through the years.  I’ve stayed up late discussing how best to treat your patients.  I’ve seen you worry much more than many of my friends and neighbors who go to work at their jobs everyday.

http://live.huffingtonpost.com/r/segment/bad-dentist-practices/5182ac222b8c2a153d000299.

 

Are there crooked dentists?  Sure.  Are there poor service stories? Sure.

Dentistry needs allies.  We need groups and organizations that make us look a lot better than the way we are portrayed.

Here is a link to the HuffPost stream.   http://live.huffingtonpost.com/r/segment/bad-dentist-practices/5182ac222b8c2a153d000299

I would really like to hear from you…get mad…get loud…express yourself.

 

 

Charismatic Dentist

Filed under: Uncategorized — Barry @ 11:12 AM

Bill Clinton

 

Recently a colleague referred to me as being a voice for the non-technical side of our profession.  I don’t know how to take that.  Through my forty years of practice I certainly worked hard to learn and apply the technical skills.  It’s just that the soft skills came more naturally to me and I really had to struggle with becoming a better technical dentist.  Through it all I came to realize that there aren’t two separate parts.  The technical and non-technical aspects of dentistry are joined at the hip.  The competent dentist must be skilled in both areas in order to succeed.

Sociologist Max Weber described charisma as a gift that few people truly possess.  Think Bill Clinton…quite a charismatic guy, wouldn’t you agree.  Weber defined charismatic authority as “resting on devotion to the exceptional sanctity, heroism or exemplary character of an individual person.  But what are the traits of charisma?

Olivia Fox Cabane in her bestseller The Charisma Myth tells us that charisma consists of two distinct traits…warmth and presence.  Sort of like Bill Clinton.  It has been said that when he greets people in a crowd, he makes them feel like they are the only one in the room.  And what about his presence?  Powerful, or what?

Charisma is certainly a trait any leader would covet.  That is why Max Weber called it a gift.

But warmth and presence sounds a lot like soft and hard…the same blend of skills and traits I feel make up the successful dentist.  Kind of like the ying and the yang of dentistry.

All of that is quite easy to digest…harder to apply but certainly easy to understand.

And while we’re talking about parallel traits, how about Stephen Covey’s description of trust as being a blend of care and competence.  Now all of these elements can work together but many of us are predisposed to one or the other.  A trustworthy, charismatic leader would probably get a lot of “likes” on Facebook.

But there is a problem with all of these elements says Harvard Business School Professor Amy Cuddy, “people view warmth and competence as inversely related.”

In simple terms it means if you are very nice you’re probably not as smart as your colleague.  Cuddy tells us that’s not very good for female executives who are culturally trained to be, extremely warm.

In a study of Wall Street law firms, “technical competence was more heavily weighted in men’s numerical weightings as compared to interpersonal warmth for the female attorneys.”  And these technical skills were coveted more when it came time for promotions.

So what does all of this tell us?  Well, that the complete dentist is a blend of both types of skills, the soft and hard, the warm and technical, the caring and the competent.  But our culture views these traits as competitive (but they are not).  That being said, our culture favors one over the other many times.  I feel that dentistry, and dental schools have always weighted the technical over the softer interpersonal skills.  Maybe because we have been a male dominated profession for so long.

If you are the charismatic dentist…you probably are doing well.  If not, you will have to fill in your weak areas.  In the future the dentists who focused solely on technical skills will probably be working in a corporate environment where the warm and soft stuff will be handled by staff.  And those dentists who are only good at the soft stuff…well, they always had a tough time competing.

This isn’t a secret in dentistry.  Dr. L.D. Pankey, on his famous Cross of Dentistry held a place for Know Your Work.  A closer look shows an appendage off of that arm which further describes work as technical and behavioral.  That was Pankey’s way of describing the hard and soft skills, the warmth and the presence and the ying and the yang.  But the profession only saw the technical.

Dental schools, continuing education programs and consultants must teach dentists to become more charismatic.  Look where paternalism has taken the profession.  By not training dentists in interpersonal skills we have left a giant void in the profession.

 

 

 

 

 

 

The Key to Trustbuilding

April 22, 2013

Filed under: Uncategorized — Barry @ 6:50 PM
20130422-102409.jpgThe full locust pose, aka poorna – salabhasana in Bikram yoga, has many benefits. Besides firming the abdominal wall and upper thighs, it increases the size and elasticity of the rib cage and improves flexibility and strength of the lower spine.
In my class it has one more benefit…it builds trust.
When I first began doing Yoga I found the people to be a little cold and distant. Lately, I found that to be just the opposite. I asked others and they reported similar feelings. The room has really warmed up—and I don’t mean physically.
People smile more. People talk more. They share stories. There seems to be more trust.
Trust doesn’t come automatically. It must be developed.
It’s interesting to note that my teacher Leo, who has a really great rap, always takes the opportunity to tell us to touch our neighbor when we do the full locust pose. Notice in the picture how the arms are extended.
He tells us to “touch our neighbor for good luck,” and then tells us how much the Power Ball is this week.
One morning he said something very interesting, “You people have a better shot at winning the lottery than actually touching your neighbor.”
After that it seemed, things opened up…people were reaching out to touch each other a bit more. And then smiling a bit more.
Touching does wonderful things…maybe even building trust.
Animals know this…what’s with all the grooming? How do you feel when you pet your dog, or hug your child?
Positive psychologist Chris Peterson in his book Pursuing the Good Life: 100 Reflections on Positive Psychology informs us that teams that touched each other more, in terms of head slaps, chest and fist bumps, high fives and other variations of touching…built more trust and won more championships.
I now watch my favorite teams to notice how true this is.
The title of this blog is TAO—trust, appreciation and ownership. I have been writing a lot about trust lately because when discussed, no one ever tells us how to build it. How to develop; it…they just give us the platitudes without any reasons…how motivating is that?
Well, here’s some advice with some science behind it — hug your neighbor, touch your partner…not only is it fun…it builds trust.
Thanks Leo.

 

How to Teach so That it Sticks

April 15, 2013

Filed under: Philosophy,Uncategorized — Tags: , , , — Barry @ 7:33 PM

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I asked a hygiene patient if he was flossing.  He immediately said that, yes, he was.  So I asked him why there was so much blood on his face.  He shrugged.

How many times do we give patients instructions only to find they are not doing the task correctly?  This problem isn’t restricted to oral hygiene.  Medical offices see similar issues.

Some of the things we ask patients to do require instruction…then feedback.  It also requires the patient to practice until it becomes a habit.  But if they do it wrong…they will always do it wrong.

That is why we have to check for mastery.

This message was hammered home to me during a recent Yoga class.  My teacher pointed out how if we do a posture wrong, we will continue to do it wrong…forever.  The technique must be corrected early…then the practice begins.

That’s why they call it practice.  Dentists rarely practice.  For them it’s always game time.  Back in school we practiced our preps and we practiced suturing…but later on we take it right to the stage.  If we get it wrong we rarely get better…in order to get better it takes a lot of desire, humility and vulnerability.

Remember the saying, “Feedback is the breakfast of champions?”

I digress.

Let’s get back to patients.  I gave my hygiene patient the floss dispenser.  He grabbed six inches and then it was all elbows.  We took the time to show him…and next week we’ll check him…check him for mastery.

Later on that morning I saw an elderly patient who had a lower partial denture made one week prior.  I asked her how it felt…she said fine.

I asked her to put it in (wondering why it wasn’t in), and she took it out of her bag…and then those elbows started to go to work.  I had to stop her because the frustration was too much to bear.

Once again I thought of how many partials and appliances are inserted without thoroughly going over things we take for granted.  How many meds are given?  How many wounds are dressed?  How many catheters placed?

Teaching takes time…learning takes more time.  It was John Wooden who said, “You haven’t taught it until they have learned it.”

I have been writing and speaking about relationship based dentistry for years—this is another example why I feel it’s the only way to practice.  Dental practices that value people over production get this.

 

 

 

 

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Take Advantage of Luck

February 25, 2013

Filed under: Philosophy,Uncategorized — Tags: , , — Barry @ 9:30 AM

 

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I took the courses, bought the newest technology and signed up for the latest marketing program, then why don’t I have the same success as everyone else who is doing it?

Have you ever asked yourself that question?

In frustration asked yourself, “What more do I have to do? 

I meet dentists all the time who invest fortunes in continuing education and new tools like lasers, Cad-Cam, digital impression systems, CT scans and every new shiny object that comes along, in hope of finding success.  Yes, there are plenty of examples of successful dentists who have achieved success but generally not because of a course, a product, a service and even (heaven help me) a mentor.

Many years ago I traveled a great distance to an over-the-shoulder course to watch a “famous” dentist practice.  I learned a lot during those two days.  Most of the dentists were taking notes on the materials and the equipment he was using.  But I paid more attention to his demeanor and his habits.  Some I liked, some I did not, but I sensed that his success in dentistry and life was more due to his personal habits than anything else.

Since then I have tried to constantly reinvent myself.

At first it was tough going.

I tried to copy him.  Everything about him…from his approach to staff and patients to what he ate for lunch.

It took me some years to realize that it was only a good start…so many things that worked for him, did not work for me.  Success was elusive.

Until I remembered one of America’s own great philosophers – Popeye, who said, “I am what I am.”

You are unique.  Role models are nice, but you have to develop -YOU- you must have a strategy for YOU.

Success is elusive—copying someone else’s business plan rarely works.  Most success comes from randomness, serendipity and luck, as described by Frans Johansson in his book Click Moments.

Of course, always remember what Louis Pasteur said, “Chance favors the prepared mind.”  By that I mean that most of the success we experience in our life comes at random moments and it seems that all of the plans we make don’t directly lead to success.

But when we work hard, create good habits, practice discipline then we are prepared when those moments come.  So if your strategy is to copy someone else’s secret sauce for success, you may be better of preparing your daily rituals to be better prepared when good fortune comes your way.

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What Happy Dentists Know

February 12, 2013

Filed under: ARTICLES,Business of Dentistry,Philosophy,Uncategorized — Tags: , , — Barry @ 10:00 AM

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I have a pet peeve.  It bothers me when dentists look at the very best people in the field and believe they will never achieve that level of success, because they don’t have the “hands” or the technical skills necessary to do great work.  This problem isn’t restricted to dentistry...artists and writers look at great works and judge only the result rather than looking at the process that the person went through to achieve the result.

No matter how many times I hear the story about what Michelangelo told an admirer when she called him a genius, he said,   “If you knew how much work went into it, you wouldn’t call it genius, ” and I truly get it…so many of us turn to the beautiful photography on Facebook or the work displayed by dentistry’s masters, and say we can never do that because they are “genius’s”  and I just don’t have the hands or the skills to do that work.

The other day a dentist commented on some work I did, saying it wasn’t up to the “Pankey” standard.  He expected that every piece of work would be perfect if done by a Pankey dentist.  Well we’re all on the same journey.  When starting out our work can be just plain shitty.  Then after a few years it just sucks.  But eventually it gets good with the potential of becoming great.  The problem is that most people expect great every time.  Maybe the masters can do that and I certainly shoot for that, but the reality is we do our best and grow to be better and better.

And that’s all we can do.

But there is a problem… (more…)

How to Get Clear

January 28, 2013

Starts with Vision

In my long career in dentistry I notice one trait that dentists seem to have.  They seem to get in there are “do” things.  Most of the time they acquire the knowledge and then they “do.”  It’s not only dentists.  Bookstores are filled with titles that fall into the “how to” category.  The self-help genre sells millions of titles promising people how to do anything.  We all want to achieve…it comes with our software.  So we believe that the key skills for success are knowing and doing.

I would like to add one more key skill to the mix.  Maybe the most important skill of all, the one that every leader must possess to be effective.

That skill is vision.  Seeing clearly where you are going, or the “where” you are taking your patient.

We have all heard it before—Covey said, “Begin with the end in mind.”  He called it a habit, but it is really a skill. And it requires practice and developing a style.

Think about writing…even this blog post began with a vision.  There are two types of writers.  Those that just write by the seat of their pants and those that use outlines.  Some use “jot” outlines and others use a very elaborate outlining process.  But all three have some ideas where their writing is going.

And so it goes with treatment and life planning.

I recently read a quote from Dr. Peter Dawson,

“This is why I have such great disdain for the hurry up…exam.  Unfortunately, this is typical ‘usual and customary’ dentistry.  It is what most patients expect, but it certainly sets aside any competent dentist who goes beyond these expectations.”

Disdain?

A strong word, but I agree.  Why do dentists do a hurry up exam.  They just don’t take the time.  Most know what to do.  Most can do it.  But most don’t have a style or process of visualizing the future.  The real shame is they don’t take the time to clarify their future.

Everything starts with the examination process…a dental exam or a self exam, it doesn’t matter.  In order to find problems we must take the time, and then discover new places to go to.  Get as clear as possible.

I call the skill of vision, getting clear.

It may be the most worthwhile skill you develop.  It will turn you from a dentist to a leader.

 

 

 

 

 

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