Change isn't easy for many people to wrap their arms around. We live in an ever-changing world where change is constant. When attempting to incorporate change into the working world, it is complicated by needing to empower employees to act. Just walk into any large bookstore and you'll notice the volumes of books on the subject, especially in the business management section.

Over the last 15 years, dentists have retained my services in the hope of making transformational change in their dental practices less painful and more bearable for the entire team and, ultimately, more fruitful. The top three areas of change that I address frequently are:

1. Getting from point 'A' to point 'B' in providing excellence in care-driven dentistry vs. insurance-driven dentistry;
2. Making sure that practices develop a distinctive, leading edge identity that may involve a practice image makeover, technology enhancement, and clinical advancements in key areas; and
3. Keeping practice profitability a reality in the life cycle of a dental practice.

In creating change in a practice today, it's important that we agree on the one common denominator in any business which is 'the people who make up the practice'. Dental practice leaders, departmental assistants, support personnel and dental hygienists are the key players in making a patient's visit a satisfactory one. It is the practice leader's relationship with each of these key players that is the catalyst for change. Whether a practice is interested in growth or distinction as a model for change, one thing is certain: both models have a common denominator and the common denominator is the PEOPLE WHO MAKE UP THE PRACTICE. Nothing will change in a practice unless the people you hire are empowered to act.

Growth Model    Acquisitions    Mergers    "Big Picture" Practice Mapping    Departmental Development

OR

Distinction Model    Technology Integration and/or expansion    Clinical Advancements    Customer Service    Leadership Development    H/R Management and Training

One of my favorite authors on leadership and change issues is John Kotter from the Harvard Business School. He is the owner of 11 business bestsellers and is best known for his eight step process of successful change. Besides Kotter's work on the dynamics of change as it relates to team participation, Kotter talks about pulling together a guiding team. In dental practices today, dentists and hygienists are the two most influential change agents. Successful change depends, in large part, on the dentist/hygienist relationship. Oftentimes, the dentist/hygienist provider team is the catalyst for successful practice change. These two providers have the greatest capacity to influence the practice 'culture' and it is through this culture medium that patients are served successfully or unsuccessfully.

I recently talked to Lynne Slim, a leading dental hygiene practice consultant and periodontal therapy columnist in RDH magazine about the dentist/hygienist relationship. Lynne embraces change and believes very strongly that dentists and hygienists need to establish a special relationship that leads the entire team in making change happen. According to Lynne,

Hygienists are looking for job satisfaction and career fulfillment and, as practice providers, they can make or break a hygiene department, particularly in the area of non-surgical periodontal therapy. Most hygiene departments are no longer conventional ones and the profitability of the hygiene department was not deemed to be very important in yesterday's private practices. Instead, the focus was on trying to get the hygienist to sell restorative dentistry.

Lynne also emphasized that today's hygienists are sometimes older and come prepared to join a dental practice with some business management skills that can be utilized in the dental hygiene portion of a dental practice. Even though the majority of hygienists are female, hygienists are spending more years in practices than before when women stayed home or worked part-time. Hygienists are looking for the right 'fit' in a job and they are passionate about health and wellness.

Here are some pointers in keeping your hygienists 'on board' and focused on changing and succeeding as practices transition:

1. Hygienists, in general, like being a team member, but remember that they are licensed health care providers who need to be respected as such. With respect comes open communication with the dentist(s), assistance when needed (just as the dentist needs assistance from the assisting team members), and they also need to be acknowledged for their expertise in any given area. If your hygienist is enthusiastic about non-surgical periodontal therapy, don't hesitate to support him/her in that effort and remove any barriers that get into the way of his/her vision for the hygiene department.
2. A hygienist has to believe that he/she can make a difference in her patients' lives. If she is not given adequate time for her patients, she will be very frustrated.
3. Since hygiene departments have become more profitable, hygienists love to assess and treat gingival and periodontal diseases non-surgically but they need adequate time to do so. They also need the right equipment to do their jobs well, and they should have a voice in determining what instruments and equipment are needed to do the job well. Good support from the assistants and front desk staff is also something they depend on to get the job done. Most consultants do not believe that hygienists should be rewarded with bonuses, but I think that hygienists who are functioning as periodontal therapists should be rewarded for their ongoing commitment and higher productivity compared to the conventional or traditional hygienist.
4. There's a big difference between a dental hygienist who Lynne calls a 'technician' (or what some call chat and polish hygienists) and those who are truly professional. It's easy for me to spot those hygienists who are just interested in 'chatting and polishing' and clocking in and out. Make sure that your hygienists are committed to your practice vision and include them in strategic planning sessions.

When you change your relationship with your hygienist(s) to one of mutual understanding and respect, the overall culture of your practice will change for the better. Clinical excellence will follow and replace old traditions and your patients' overall health and satisfaction will follow.

© 2006 Rhonda Mullins. All rights reserved.

Rhonda models leadership and executes real solutions for dentists and their teams as a national speaker and on-site consulting. Her objective: Transformation. She executes this through (3) three key areas: Strategic Practice/Business Development; Performance Based Leadership Coaching; and Human Resource Management. Her knowledge and instinctive business savvy in management and transition has increased net profits in practices nationwide.

As an author, she has penned her wisdom in numerous industry magazines such as Contemporary Esthetics, and more recently in Powerful Practice a recently released book by James Brookfield Publishers. This is a collaborative effort with the Academy of Dental Management Consultants. Also, in 2007 she will be a featured author on "Leadership in Dentistry" in Access, the National Dental Hygiene Associations publication.

She is a member of the National Speakers Association, Speaking Consulting Network, the Institute of Management Consultants, and the Academy of Dental Management Consultants. She has lectured for numerous Study Groups and National Dental Meetings such as: the Thomas P. Hinman Dental Society; Tennessee and Florida Dental Associations. Rhonda is one of the most influential Speakers/Consultants the Southeast. For more information on Rhonda Mullins, visit www.rhondamullins.com.