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Coaching the Professions

Phantom of the Operatory

There are many similarities in the staging of a play and the performance of a dental office. In the magnificent musical Phantom of the Opera, the compelling phantom affects much of the performance by achieving his desired outcome from behind the scenes. Can we follow his lead and create an office experience that routinely exceeds our patient's expectations without us explicitly directing every scene? It certainly would lend itself to less management and more empowerment for our co-workers.

Let us then suspend our belief in dental teams and the all the accompanying sports analogies and enter the world of grease paint and foot lights.

Act I: Casting, Direction, Rehearsal

Act II: Script, Stagecraft, Musical score

Act III: Audience, Promotion, Reviews and Critics

Act I

Scene I Casting

Casting (hiring) is the key, there is not enough training and coaching that will rescue a person that is not suited to the part. Dental staff turnover rates approach 25% per year. The financial costs per lost employee and a new hire can exceed $30,000 to a practice. In a stage play 'the show must go on' so they keep understudies on the payroll. In a dental office the remaining staff pitches in until someone is found. Usually this is done too quickly under duress and the cycle of hiring begins again.

In theater, there is what is called a casting call (job interview). What is important to remember is that the casting director is looking for a person who has the aptitude to play the part. The applicant does not yet know all the lines and all the music but they do have the necessary potential to become that character in the performance.
Many times dental offices get overly focused on needing a highly skilled person for a particular position. Their skill level and experience (knowing the part) seem to out weigh the very important innate qualities of the individual that could potentially be more important in the long run. Select the best person that will compliment the other members of the cast. There will be time for them to learn their lines and grow into their part. A great cast has all the personalities and social styles that are witnessed outside of the theater. To create a great performance in our office celebrate the differences and cast them in a role in which they can be comfortable. There are parts for everybody somewhere, perhaps sometimes not in your office. It is in your and their best interest to help them find that role (position) where they can thrive.

As actors work together for a longer time, there is a magical phenomenon, they become an ensemble. They blend and harmonize with one another, while still keeping their individuality. This was witnessed on the small screen with shows such as: Seinfeld, Cheers, and Friends. It can also be witnessed back stage, where every one is dependent on one another to insure that the show goes off smoothly.

Scene II Direction

Who is the director in your dental office? It is the perception of many dentists that they must be the constant director (manager) of their dental office, or they must hire an office manager to free themselves of that role. The theater again offers a great opportunity to view this from a different angle.

Have you seen a performance lately? Did you notice the director?

As the curtain rises, the director's work is done. They have given their direction to all the players, musicians and stage hands and now it is literally out of their hands. The director communicates his or her vision of the play, and the actors interpret that vision and communicate it to the audience. As you can see, there is a great level of trust within a theater community. Are we providing that level trust in our dental offices? It is incumbent that the dentist communicates their unique vision with clarity. They must also trust and have confidence that their staff can and will articulate that vision not just in words, but in actions. How does the director insure that this happens? Let's go behind the curtain to Scene III

Scene III Rehearsal

When the correct cast is assembled, rehearsal begins. This process begins as a rather structured meeting. It is important that the cast knows what roles everyone else is playing and how they all intertwine to create an interesting and enjoyable production. In the beginning the actors learn their roles individually. However, if someone is familiar with a particular part they will help out any new cast member.

Unfortunately, in training dental staff, we are many times under such perceived time pressure that we skip rehearsal altogether and are in essence auditioning potential players during the actual performance. Staff education is paramount to get the best out of your people. As the play develops the cast is allowed to put their style into every scene. The performance becomes an evolving presentation that embraces the talents of all those involved.

During the run of a play, from time to time the director and the players get together to 'brush up' (office meeting) the performance. It is here that the actors and the director collaborate to refine and improve the performance so that it runs more smoothly and has the desired affect on the audience. The director may have to re-emphasize their vision. The players also contribute ideas, as they are the ones on stage that see best where improvements can be made. Because all the actors (staff and dentist) work so closely together these brush up meetings are not gripe sessions. Here the actors (employees) discuss not only how to best have the show elicit the intended affect on the audience but also have the show have a long and successful run.
Curtain

Next time in Act II we will discuss the script, the set and the musical score.

Act II

The Script

The use of the script analogy is not to encourage you to have a set script to be acted out by your staff. This has been attempted and has lead to results ranging from ineffective to disastrous. When a staff is scripted they lose their spontaneity and the ability to flex to their immediate audience. Also we do not have the help of a prompter; that partially, hidden person that has the script in hand and whispers the next line to the performer. Thankfully, for our co-workers, they do not have to memorize lines. When they have a through understanding of the office vision, they will be self- directed and comfortable in their role.

Let's think of this section as more extemporaneous or improvisation. The more the player (staff member) understands the desired outcome, they are able to utilize their own internal, natural acting ability (being themselves) to best impact their immediate audience (patient). It is our responsibility as the director to set the tone and the desired outcome. Then it is the entire ensemble's responsibility, dentist included, to be focused and creative to enhance the patient's experience.

'The play's the thing, wherein I'll catch the conscience of the king."

Hamlet. by William Shakespeare.

Our goal should be to catch the conscience or deep interest of our patients. This desired outcome is a well thought out and clear vision that is discussed and developed by the entire staff so that the message is consistent through out the patient's experience. It is a blending of acknowledging the patient's wants and needs with their circumstances, temperament and objectives. Then next, to create a dental treatment experience for them that will satisfy their dental health requirements of comfort, function and esthetics.

Stagecraft

All the world's a stage,
And all the men and women merely players:
They have their exits and their entrances;

As You Like It, by William Shakespeare.

As the curtain rises for your patients entering your practice, what feelings are experienced by your patrons? Does the set and ambiance match what they are about to experience? Do they feel a part of your practice?

Charles Garnier was the architect of the Paris opera house built in 1861. His genius was that he was the first designer that understood that the opera was both an occasion and performance. He created the ambiance that the spectators were part of the performance as they entered the building. By the use of grand staircases, promenades and mirrors he created a sense of occasion and inclusion that is deeply felt as you enter this Paris landmark. There is also a sense of spaciousness and cleanliness that was unique considering the mid 1800s, which when coupled with a logical floor plan was used to good effect in the opera. If you have yet to venture to Paris, the feel of the entrance is hinted at in the Masquerade scene in the performance of Phantom of the Opera.

How does your 'stage' measure up to your patient's expectations? How can you have the patient feel part of your office as they enter and travel through their experience? A key is that it is your office. We all develop a style, and philosophy of practice. Unfortunately, many times our office is inherited or professionally designed to some else's concept of what a dental office should look and feel like.

Garnier studied not only the opera but the theater attendees to create the blend that would make the experience congruent through out their opera experience. We do not have to build Paris opera houses or Taj Mahals to accomplish this. However, a thoughtful process of design and the accompanying ambience can create an environment that flows and blends with our practice philosophy. I would suggest that you and your staff enter your office with new eyes, and develop a plan to create your patient experience as they enter your practice.

Musical Score

This discussion is more about the subtle tone of your practice, rather than what genre of music is on your sound system or patient mp-3 player. What sets the tone of your practice? Are conversations readily available to be overheard? HIPPA concerns aside, is this experience you have envisioned for individualized care. Is it calming? Does it exude a quiet confidence? Is our focus continually on the patient?

Before and during a stage performance the rule of no distractions is always in place. Backstage is to be absolutely quiet. No peeking through the curtain to check out the house. During a performance the house lights are dimmed to aid in the focusing effect. This is an advantage we do not have in a dental office.

What we do have in common is the overture! The overture is the part of the musical score that gives a preview of the tone of the performance that is to follow. An overture in a dental practice begins when the patient's first contact with our practice. This in many offices begins with the initial contact on the phone. If a patient is immediately put on hold it is like beginning off key, many times an unforgettable experience for our, we now hope, future patient. Begin with a great overture and the patient will feel that they have already experienced of your practice.

The musical score must continue through out their visits to our office. People love great performances and tell their friends. Unfortunately, poor or inconsistent performances have had shows off Broadway in a hurry.

A closing thought as we discuss the consistent flowing of the musical score (tone) of our office. Both musicians and actors have bad nights brought on by the life that happens off stage. Professionals will help each other to insure that the performance goes off smoothly. Personal problems can be felt immediately by our patients. It is incumbent upon us as fellow troupers to help each other out to insure that the show (optimum patient experience) must go on.
Next time we go on to Act III.

Audience, Promotion, Reviews and Critics

Act III

Scene 1 The Audience

'Your audience gives you everything you need. They tell you. There is no director who can direct you like an audience.'

Fanny Brice 1891-1951

Never treat your audience as customers, always as partners.'

James (Jimmy) Stewart (1908-1997)

Backstage, as the murmur of the crowd begins to fill the hall, novice actors are tempted to peek through the curtain and check out 'the house' (audience). This is frowned upon by the veterans because to them any audience is a great audience. What are our expectations of our new patients and ourselves?

There is a maxim in show business that to be successful you have to learn to 'read the room'. Every audience is unique just as every patient has their own individuality that they bring to our office. It is our task to hone our interview and listening skills so that they are nearly practiced unconsciously. Accomplished actor's can sense when they are losing an audience. This loss of connection in the theater leads to a short running show. In the dental office, loss of connection results in a hesitancy and frustration and a constant need for large numbers of new patients. It is important to 'check in' with our patients when we sense that they are not entirely with us. A simple question such as;
Am I making sense to you? , can give of us a simple 'read of the room' that will let us know how effective we are with our communication.

One of the wonderful aspects of a well run dental office is that we are not in front of large groups of people at one time. In most dental offices it is an audience of one. This greatly alleviates the stress of 'reading the room' However, it also is unique in that if do not connect with that person our entire audience could leave at intermission.

Scene II Promotion

"Nobody counts the number of ads you run; they just remember the impression you make."
- William Bernbach

How did you hear about the last hit show that you wanted to attend? The most likely answer is hidden in the previous question. You probably heard about it.

To create a referral practice you must become one. I realize that this may sound backwards but is really the most direct and ethical way to become a close to 100% referral practice. Simply act like the practice you want to be. Let your patients know that you are or are becoming a referral practice and they will help you achieve that future. Ask patients new to your office how they heard about you. You will be surprised at the large percentage that was directly or indirectly referred to you due to word of mouth. This referral environment lends itself to the natural act of asking for referrals. When is it right time to ask for referrals? It is the right time when the patient perceives high value that is exceeding their expectations. This may be during the interview process, or anytime after, especially at a post treatment conference. There is time when an audience member leans over and says to their partner 'I can't wait to tell (friend, family etc.) about this show'. As the old vaudevillian said 'the secret to success is timing.' Recognize these opportune times in your patients experience and you will benefit from their referral. By encouraging the tradition of a referral practice, in a surprisingly short time, you will become that which you have acted.

Let's leave Broadway and venture to another famous New York City street... Madison Ave. This street has become synonymous with marketing and advertising. The goal of most advertising is to create a buzz over what you are providing your client. That buzz is people talking to people or word of mouth. Companies pay millions of dollars to create word of mouth. We have the ability in dentistry to create a word of mouth referral practice with out visiting Madison Avenue.

Scene III

Reviews and Critics

'Do what you feel in your heart to be right. You'll be criticized anyway.'

Eleanor Roosevelt.

At the end of the opening night performance, the producers and playwright wait in the lobby to catch the banter and response of the audience as they leave the building. This is the first and probably most accurate means of gathering critical information on how the performance was received. We have the same opportunity in our dental offices. This does, however, require the dentist to accompany the patient to the front desk. Because the dentist is in fact the producer and playwright in one, they are best suited to witness the patient's response. In simple terms, to witness two things: A smile on the patient's face and a payment. These two observations will tell you all you need to know about the health of your practice. It also gives you material for what you should celebrate or what you are going to work on in your next rehearsal and cast (staff) meeting. So many offices spend significant time and resources developing patient questionnaires. These lose their effectiveness as time slips by. There is nothing like being in the lobby with the audience.

In the past, a few critics writing about the previous night's performances had tremendous power in making or breaking a shows future. This has diminished some what because audience response is now most important to the theater. Much too much attention was given to a vocal few.

Most of us find that we spend the majority of our energy attempting to accommodate a few vocal patients that may not ever be satisfied. There comes a time when we must present a performance that we know is sound, valuable and attracts an audience that is comfortable with our staff, office and the dentistry they receive there.

I trust that you have enjoyed our stroll down Broadway. Have fun with this concept as it makes for lively staff meetings (cast parties).

Break a leg!

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