Dr David Dornfeld talks about COVID, keeping your immune system strong, and living well.
Dr David Dornfeld talks about COVID, keeping your immune system strong, and living well.
Trainer Don Benjamin shows us things we can do at home to stay fit, healthy, and sane in challenging times.
IMPORTANT: IF YOU HAVE ANY INJURY, MEDICAL OR OTHER CONDITION, DOUBT ABOUT YOUR ABILITY, LACK OF RECENT EXERCISE, OR EXPERIENCE PAIN , PLEASE CONSULT YOUR PHYSICIAN, CHIROPRACTOR, PHYSICAL THERAPIST, OR OTHER APPROPRIATE HEALTH PROFESSIONAL BEFORE DOING ANY OF THESE.
A wellness conversation with Stacey Rose, LCSW. Better and Stronger Together.
Clinical psychologist Dr Anthony Pantaleno discusses the psychological challenges of COVID-19 and how we can deal with them.
I recently saw a blog post from a colleague about an experience we all encounter. How would YOU handle this one?
I just fired my worst patient. She came to me from another dentist, bad mouthing him. First red flag. Long story short, she questioned everything. Wanting me to explain in great detail. No problem… I’m patient, I love educating my patients. She has since taken 5 hours of my life explaining dentistry… she then applies her “logic” and comes up with her own answers. All incorrect.
Last visit I tell her, if she cannot
trust me, I cannot treat her. Today she starts in… she has a 2.5 hour
cerec appt.. I just go, “nope, you’re the most difficult thing my life and
you’re not worth it” she tells me how she needs this done. I say” I
am escorting you out, now. I’ll send you a check for all you’ve spent here, you
are not welcome”
Pearl, if someone makes you hate the work you love, GET RID OF THEM.
No matter what business model you’re in, whether it’s a DSO, Charity Care, or High Touch, Low volume, it is risky business to do any dental treatment without first establishing a positive, nurturing mutually respectful and supportive rapport. It’s risky for your peace of mind, it’s risky for your health; it’s risky for your outcomes; it’s risky for your cash flow; and it’s risky for the people you serve. If we are constantly at odds with those whose trust we must have, there is neither joy nor success in anything we do with them.
And I’ll go a step further. At our 2019 Speaking Consulting Network conference, we heard from Todd Williams, an executive who helped develop the culture of the Four Seasons Hotel Chain and who currently serves Centura Health as Vice President of Culture Development. Mr Williams talked extensively about the importance of love in any relationship, and that includes business- yes, I said business!!!!
Who hasn’t experienced the tear-your-hair -out aggravation of calling a business to whom you pay lots of money , encountering what seems like 10 minutes of prompts, only to encounter a voicemail box or a call center operated by someone reading from a script with no clue of who you are, what you need, or how urgent your problem may be (think cable provider , insurance company )? Who hasn’t agreed with a friend who’s posted “I hate xyz cable company or abc insurance” ? And who has been fortunate enough to stay at a four or five star hotel or dine at a nice restaurant, where our feelings are every bit as important as the quality of the room or the food?
In a digital, transactional economy, just about every issue we face is almost expected to be reduced to a one-size-fits-all solution solved with a keystroke by a remotely located clerk reading a scripted set of questions. And when this happens, struggle, conflict, and disappointment are almost inevitable.
Love. Empathy. Shared values. Outward mindset. Quid Pro Quo. Where have they gone? And what opportunities do they offer those of us who understand their real value today and always.
Most dentistry is elective. It involves an exquisitely sensitive part of the body. Its success depends on so many factors, not the least of which is the informed approval and active maintenance by the receiver of the care. At bare minimum, it requires the physical, mental, and financial cooperation of the person receiving services. Ideally, we want to have that person in a relationship of active collaboration, where everyone is in agreement on what is in the best interest of the person receiving care. Once that agreement is established, those receiving our care are more relaxed. They feel good about being in our company and receiving our best care. They are more likely to follow up on maintenance. And life becomes easier, outcomes are better, and any issues which could arise during or after treatment are easily resolvable.
I love (and need to) get paid a fair fee for my services. What I love even more are the hugs I get from grateful people and the referrals to people who call my office saying that their friend said our office is just wonderful. Our office. Not our work, which is very good, of course, but our office. That means the experience they get every moment they interact with us and the feelings they have long after they leave.
Which brings us back to our colleague who fired her confrontational patient.
Some seemingly tough people are merely expressing fear and can be won over with a little love and generous listening. I’ll take those people into my life with enthusiasm. But there are people who do not want love and empathy, and that’s fine. There are people who, for reasons beyond our control, have to fight over everything. That’s OK, too, but not in my personal or professional life. That’s my choice. And it’s yours, too!
Establish a culture of heartfelt care and concern by your entire team for all who enter your office. It doesn’t take long, and it’s so much fun. Ask probing questions. Express empathy. See how your dentistry can improve their lives. Connect as a competent person who likes people, nurture and maintain that connection, and watch the material and intangible rewards follow. .
The lesson learned by our esteemed colleague at the beginning of this piece is that we cannot be all things to all people. Whether you view dentistry as a business or a professional practice, your team, the people you serve, and you are so much better off when love is what differentiates yourself from everyone else. I’m not sure that The Beatles were right when they said “Love is All You Need”. We need clinical and business skills for sure, but love is a critical component if we are to thrive in any aspect of life, and yes, that includes business!
Three Reasons Why You Should Have Already talked to your Accountant this Year
As the days grow shorter, temperature cools and leaves start to change – it’s easy to forget about the importance of talking with your accountant about 2018’s potential tax bill. Let’s be honest, talking with your accountant does not usually rise to the top of your list. However, as I have found through personal experience, you need to chat with your accountant regularly and early in the year. If you haven’t spoken yet with them yet, please read my three reasons why you need to setup a meeting now!
In early 2015 as I entered into the first full year of helping my wife manage her dental practice – I asked my accoutnant when we would be meeting to talk about tax strategies Their response was “we don’t usually discuss those things until late November or most likely in December?”
When I discussed this with our financial adviser, he immediately referred me to a new accountant!
I met with the new accountant and was so impressed I decided to move my business to them right away. Soon after, we reviewed numbers, the accountant created projections of our tax liability and helped us create strategies to minimize our burden. Luckily, we were at a point in the year where we could still make relatively easy changes to payroll deductions, 401(k) and HSA contributions, capital purchases, etc.
Here are three keys to managing your accountant and approach to taxes:
#1 – Your Advisors Work for You
If your advisor is not giving you what you need, then why keep them? Breaking off relationships, even business ones, can be very uneasy. Since many dentists are juggling so many aspects of owning a practice, – it’s important to get the answers you need when you need them. Thankfully, I had a financial advisor who encouraged me to make a change to our support team!
#2 Build a Team that Works Together
Whether this means taking your advisors up on their referrals or interviewing them beforehand and asking of their willingness and ability to work with others that you may hire – having a team is key. Team members should obviously be an accountant and a financial advisor, but may also include a lawyer, and insurance agent, and maybe even a banker. My financial advisor is known to have follow-up conversations with my accountant on my behalf, and then report back on the high points of their discussion. Think of it as interdisciplinary care for your finances.
#3 – Good Decisions are Never Made in a Time Crunch
There is a great video I saw on LinkedIn post showing someone drawing over the course of 10 seconds, 1 minute, and 10 minutes. The point of the post was to show how different a result you will get when you spend more time on a task. Making decisions and moving money at the last minute is never ideal. Just like patients make far better decisions on their dentistry when they’re not burdened with a toothache, you will be way better off if you plan and revisit your financial goals throughout the year!
Now that you know the importance of planning for taxes, you need to act!
A little bit of planning will go a long way to minimizing your tax burden and maximizing your wealth
Adam Heim is a life-long learner, enthusiastic supporter of small business and hopeful entrepreneur. He has spent nearly a decade in banking and has a background in product pricing, commercial real estate, demographics and financial modeling. Adam created FirstTimeDentist.com in response to his perceived ‘gap’ in quality information, when he assisted his wife buy her dental practice in 2014.
Curiosity and the Complaint
Sally has been a patient for over 15 years. Her visits to us have been successful, productive, and delightful. We are very fond of each other.
At her last visit, with no warning, Sally laced into me, saying that I had deliberately placed a defective piece of dentistry that’s been trapping food for the last 6 months. She went on to say that I must have thought that she wasn’t going to live much longer and it didn’t matter to me that she had a problem.
Now if that doesn’t get your heart racing and activate your fight- or- flight reaction, nothing will!
I took a deep breath and coolly asked Sally to allow me to see the problem determine its cause. I discovered that Sally had fractured some porcelain off a screw retained crown over an implant which we had done for her a few years ago. Very calmly (and, of course, without reminding her that I had expressed concern about her bruxism several times in the past), I assured Sally that I can easily correct the problem. “I don’t want to go through any more drilling!”, Sally said belligerently, “and all this will be at YOUR expense!” Nonchalantly (while my insides quietly boiled) I assured her that there will neither be any drilling nor cost to her.
I realized that Sally’s confrontation was a professional make-or-break moment for us and had to be resolved. Here’s what I did:
I removed Sally’s crown, sent it to my lab for repair, and re-inserted it. Over the two appointments, I focused on the task at hand and maintained our usual connectedness. Once the crown was re-inserted, I asked Sally to come into my office for a few minutes. With body language, facial expression and vocal tone that expressed concern and curiosity, I asked Sally whether I was correct in my having heard her assertion that I intentionally placed a bad piece of dentistry in her mouth. Sally quickly responded “yes, that’s what I thought, but then I realized that, although you are a professional, you are also human. “I thanked Sally, but I went a bit further and asked, “You know, we’ve been through so much and accomplished a lot together. I’m wondering if anything else was troubling you a few weeks ago, because the comment didn’t seem to be consistent with what we really think about each other”. Sally quickly warmed up, we had a lovely talk, and we ended with a hug.
In Conversational Intelligence, author Judith Glazer discusses neurochemical changes that occur during confrontation, which lead our minds to a defensive, fearful mode. In a dental situation, this is a recipe for disaster. The patient accuses, the dentist either gets overly defensive or needlessly appeasing, and the result is a winner and a loser, with one or both parties feeling badly about themselves and the practice.
The best antidote to this state of fear is trust. When someone shows us empathy, our brain chemistry changes, bringing connectedness, composure and constructive thought. My intentional actions and verbiage changing the nature of our discussion from You vs me into we transformed potential disaster into a strengthened relationship.
1- If Sally had maintained an air of distrust and hostility, I was prepared to very compassionately tell her that perhaps I am no longer the right dentist for her.
2- Shortly after this episode, Sally lost a very close relative, devastating her and her family. Events leading up to this tragedy could very well have been what was causing Sally to have acted so strangely
3- Although no technique of communication will work 100% of the time, always act with kindness, empathy, and curiosity. Bond with people in your life in good and challenging times. Everyone is going through something. You have the power to heal. Use it well and use it often.
An Inconvenient Truth We All Know :
Wellness is not an entitlement. It is both a behavioral choice and a responsibility, subject, of course, to some genetic and congenital limitations. The repair of the damages made by bad will cause us to suffer significant consequences and also bankrupt ourselves and our country.
The Challenge We Face:
To meaningfully connect with every human being we encounter to show them a better, healthier way to live
The Big QUESTION:
How can YOU combine your care, skill, judgment with an outward mindset to help someone get healthier today AND to differentiate yourself and your practice?
Here’s a Real Life Example
My wife and I went out to dinner with our friends, one of whom is a brilliant, highly accomplished nephrologist who is about to phase out of medicine and into retirement over the next few years. Alan and I were both residents at the same hospital and have remained friends for thirty- plus years. He’s an outstanding physician who has worked extremely hard, going from hospital to office to dialysis centers, often working well over 10 hours a day, not to mention the nights he is on call for life and death emergencies. Naturally, our conversation turned to our work. Alan deals with very, very sick people, whose kidneys are malfunctioning and/ or whose blood pressure is dangerously high. “we spend more money on dialysis patients who don’t show up”, Alan told me, to my astonishment, “ Non-compliant people cost us a fortune”
What Alan told me is that the dialysis world is filled with the same “no-show” issue that plagues many of our dental practices. Even as I’m writing this, I’m thinking, “are you kidding me? People put their lives at risk and won’t go out of their way for life sustaining treatment?!!”
If I can take a moment to state a fact in a politically incorrect manner, health is not an entitlement. It is both a behavioral choice and a responsibility, subject, of course, to some genetic and congenital limitations. If we make choices that are deleterious to our health and if we expect the repair of the damages made by those choices to be an entitlement, we will suffer significant consequences and also bankrupt ourselves and our country.
In our world, periodontal and dental health are attainable. It’s easy. Practice good hygiene habits, eat properly, correct issues before they take a toll, get checked periodically, and keep it all simple. Our challenge, my friends, is to get the message to people. We need to come together and battle the “gee Doc, it doesn’t hurt, so I really don’t want to fix the tooth, floss my teeth, correct my bite, etc.” We need to create new practice models to enhance wellness and discourage disease.
We have a huge opportunity to use our relationship based practices to influence people and show them that behavior is the key to health and wellness. My friend Alan’s frustration is the result of a population that is conditioned to think that they can do anything they want and the doctor will be there to fix it.
The same inconvenient truth holds together for ourselves- we, too, need to keep our own bodies in shape. Let’s cut down on the bad eating, let’s exercise to keep our muscle mass up and our body fat down. Let’s stay intellectually engaged to fend off the risk of soul-robbing dementia. And let’s stay socially engaged because that, too, is the key to quality longevity.
Forty- plus years after his tragic passing, Dr Bob Barkley’s words are resonating loud and clear. We have work to do, folks, for ourselves, for those we serve, and for our country. The political implications of this are way beyond our capacity to deal with; however, we can begin to fix the world, one dentist and one person at a time.
“How Soon should I do this, Doc?”
That was the question I heard last week from Sam, a very successful entrepreneur and business consultant whose open proximal contact between a large, wide and fractured composite restoration and a healthy tooth was causing chronic irritation to his periodontium. The tooth is clearly in need of a full coverage crown.
Now, we’ve all heard that line a million times in our practices. Back in the 80s, gurus and consultants told us to give patients a sense of urgency to do their dentistry. “Get em to commit right then and there, while you have ‘em in the chair”, they’d say. “That way they can’t back out. And you know they need the treatment” When I heard this in the beginning of my career, I became agitated. And I still get agitated when a speaker, writer , or one of my colleagues talks about getting a commitment from a hesitant or nervous person on extensive treatment during a brief chairside conversation.
I’ve always been uncomfortable with this blanket, one-size-fits-all strategy for profitability. You see, wellness is elective. And, whether we like it or not, sometimes life throws other urgencies at people. Having teeth is elective. And maybe, just maybe, that seemingly successful person who lives in the great neighborhood may have more serious priorities in their lives, whether we think so or not!
If we are to have a meaningful, healing , nurturing relationship with people, we have to keep it real. Dr Pankey’s first rule was know your patient. In an era when people formerly known as patients have become consumers and we dentists are motivated to make their lives better, it is absolutely critical that we behave in an open honest, nurturing manner and make them feel safe in expressing their concerns in the same way (yes, those we serve can nurture us every bit as well as we can nurture them).
Instead of establishing urgency to dental treatment, why not take a moment with that person and explore how it fits into their lives. Lead them to make THEIR best decision on that crown, that implant, that full mouth rehab that we are chomping at the bit to do. Because when the receiver of the service is in control of how and when they receive the treatment, we all benefit.
And if and when that person comes into your office with a condition that absolutely cannot wait, like early endodontic pain that’s about to become a full blown abscess, your sense of urgency will be quite real and credible.
It turns out that the company Sam is consulting is in a bit of trouble, but will be paying him a huge sum of money next month. So he asked if he could call us in a few weeks to schedule his work without any financial anxiety. We listened, we understood, Sam appreciated it, and the work will get done at a time that makes sense for him. After all, it’s HIS life we’re looking to make better.
There are times when the power of science is so seductive that we may come to feel that all that is required to serve others is to get our science right, our diagnosis, our treatment. But science can never serve unless it is first translated by people into a work of the heart”
Rachel Remen from My Grandfather’s Blessings
No one can disagree that the technological and scientific advances of the last 50 – 60 years have improved the lives of countless people. And no one can argue that the pace of our advancement is accelerating faster than ever. Let us not forget, however, that compassion and care of another human being can easily get lost in the maze of technological advancements, both inside and outside of our dental world.
A few months ago, I found out that my social security account had been breached. With a sense of urgency, I moved a few patients in my schedule and went to my local Social Security office. What I encountered was nothing less than dehumanizing and nauseating. After a nearly two- hour wait, I encountered a clerk who took my complaint, looked at the co worker sitting next to her and said “we got another one” and proceeded to process my information at a snail’s pace. Not once did she express concern for my well being. Not once did she address me by name, or even “sir”. She even scolded me for politely asking how long the process would take, only responding when I firmly told her that I am a practicing dentist , had been waiting for two hours and that a patient in pain was in my office waiting for emergency help. Civil service is a good thing. Heartless, unaccountable arrogance in any service is not. The clerk failed to realize – or had been conditioned not to even bother thinking of- each human being is a story of hope, fear, happiness, and sorrow. Empathy is clearly not in her job description. But shouldn’t empathy be in ALL of our interactions?
I am reminded of the debut of over-the- counter home tooth whitening products back in the 1990s. A salesman came to my office and touted the wonders of his product , telling me, among other things, that patients will not get the level of whitening from his product that they can get from a dentist and that they will seek additional whitening services once they try the OTC products that we should recommend. He also told me that patients would want to replace their anterior crowns and composites once their teeth become whiter. This phenomenon is an example of Dr Remen’s point. How heartless is it to manipulate a person to do something that could begin a cascade of overtreatment? How can we justify applying the latest and greatest technique or technology without understanding the needs, the wants, the lives of the people who are trusting us AND helping them understand how these technologies can impact their lives both positively and potentially negatively?
As we enter the very exciting digital era of dentistry, huge opportunities are unfolding before us. Scanning, digital smile design, digital recording of Centric Relation, and 3-D printing are here. But how will we use it all? Will we apply the latest technology each time a human being walks into our offices before a thorough evaluation? Will Third Party Payers, Electronic Health Records and algorithms supersede the care, skill, and judgment that only a human being can give?
My team and I are reviewing our core values in the process of updating our Mission Statement to reflect our uniqueness, what we value, and what we have to offer to people with our skills and with our hearts Practicing from the heart brings joy, fulfillment and prosperity to us and gives the people we serve a unique and valuable service unavailable in many other aspects of their lives. Let us never forget to keep this important element in our practices and, I dare say, in as many of our human interactions as possible.
Better, Richer, Stronger - Dr. Alan G. Stern / The Life Coach for Dentists
804 West Park Ave. Ocean, NJ 07712 / (732) 493-8030
April 19th 2020
Dr David Dornfeld talks about COVID, keeping your immune system strong, and living well. https://youtu.be/0pxTFuEomjY
April 12th 2020
Trainer Don Benjamin shows us things we can do at home to stay fit, healthy, and sane in challenging times. IMPORTANT: IF YOU HAVE ANY INJURY, MEDICAL OR OTHER CONDITION, DOUBT ABOUT YOUR ABILITY, LACK OF RECENT EXERCISE, OR EXPERIENCE...
April 2nd 2020
A wellness conversation with Stacey Rose, LCSW. Better and Stronger Together. https://youtu.be/6lebp1o20_w