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The Key To The Most Productive And Profitable Practice

by John Meis

I am often asked, what is the one KEY to improving the profitability and production in a dental practice. And I wish I could say that there was just one key, but there are a quite a few and they tend to work together symbiotically in all the best practices. If I had to answer that with just one key, I would point to the morning huddle. I have studied the most profitable and the most productive practices in the country and the one thing they all have in common is that they start their days with a productive morning huddle.

Let’s start with the purpose of the morning huddle because I think sometimes people get a little confused about what you should be trying to do when you conduct a morning huddle. You should be aiming for under 15 minutes. This isn’t meant to be a long-drawn out meeting that everyone dreads attending.

These are the four things that we’re trying to do during the morning huddle;

1. Create a connection between each other as teammates and human beings

2. Celebrate the things that are going very, very well

3. Prepare and motivate for the day

4. Team education

So, what does that looks like?

First, we create a connection: First goal was a connection between team members and we do that by starting out with a positive check-in. When we were small, everyone could give their positive check-in each day and as we grew, we took turns and everyone had an opportunity once per week. The question to ask is, “What is one good thing or win in your personal or professional life?” This allowed us to start the meeting off on a positive note.

Then we would look at the schedule and see what opportunities existed to create a connection with our patients. Are there are any patient notes we should celebrate, recognize, or empathize with? Were there any weddings, birthdays, or celebrations that occurred recently? Or would someone be coming in who lost their spouse since the last time they were in? We want the entire team to know what is happening so that everyone can create a connection with the patient and everyone would be ready to respond.

Then we add celebration. What I like to do is talk about yesterday’s highlights. In our meeting room, we had the walls covered with numbers (because that which is measured and managed improves.) So at the end of every shift, each team member was responsible for updating their KPI’s. The numbers would be in red if they were under goal, in black if they were on goal and in green if they were above goal. This way, the next morning it was easy to see at a glance where we stood. The following morning, it was easy for me to recognize the green numbers. I purposely did not call out the numbers in red, everyone could see those, and I could follow the trends and work with those that might need extra coaching if their numbers remained red for multiple days or weeks.

The key here, was that I didn’t focus on the numbers – but instead focused on exceptional service moments and what the numbers meant in terms of the patients that were served and the teeth that were protected. I would point out the people that went above and beyond, people that dealt with a very difficult patient or difficult situation. If we were able to work in emergency situations, I made sure to point that out and thank those. If we did same-day dentistry, I would recognize the people that were involved in making that happen and use the opportunity to recognize them for their exceptional service and mention why we continue to provide that level of service.

The two numbers that we do review are production and collection. Since they are also on our board, we don’t have to spend a lot of time on them, but they are the big drivers, so we look at them every morning and we look at where we stand in relation to our goal for the month.

Next thing is preparation: The most productive people in the world, spend a good deal of time preparing so that they can be productive. Abraham Lincoln was quoted as saying “Give me six hours to chop down a tree and I will spend the first four sharpening the ax.” That is what our morning huddle allows us to do, this is where the profits come out of the morning huddle process. So many people complain about issues with cancellations and failures with appointments, this is your opportunity to turn those into production in your practice.

Each hygienist comes to the meeting prepared. They have reviewed the schedule and they know if there’s any restorative treatment that has been diagnosed and not completed with their patients. Assistants are going through their schedule and they are looking to see if there’s anybody on their schedule that is overdue in hygiene. I am constantly looking at where treatment is available that can be done today that wasn’t scheduled.

This is something that I very rarely see in practices, looking for opportunities with what’s coming in today instead of feeling powerless because of what is not happening today. Those who are prepared and nimble and able to make changes quickly are succeeding.

Next is motivation. I think it’s important to announce any bonuses earned. So, at the Team Training Institute, we teach a bonus system that has a whole team bonus so that if the practice does well, everybody does well. We also have individual bonuses, that if someone is a super performer or goes above and beyond, they get certain bonuses. If a team member earned a bonus, I want everyone to know about it because I’m focusing on the positive and I’m focusing on the people that are going the extra mile. I always want to focus on that. We all want to conform with what the people around us are doing. That’s why I always want to show the hyper-performers, I want to make sure that they’re the ones that get a lot of attention because that’s what I want to instill in everybody. I want everybody to conform to that. If I don’t pay attention to it, if I don’t recognize it, it’s not going to happen. Most people focus their time and attention on those that are lagging or what isn’t working and wonder why they lose the good team members. Focus on the hyper performers and you will get hyper performers.

The next thing that I suggest you fit into a huddle is something fun. It can be a short video or story or cartoon to share with the group. We nominate one person in charge for the week, and it rotated, they focused on finding something fun to share and we called it Wacky Wednesdays (if you follow Team Training Institute on Wednesday’s we post the Wacky Wednesday cartoon.) Continuing the fun theme we would have; Tuesdays Treat Day. You could have Monday Motivation, and Throw-back Thursday. We just tried to do something to keep it light.

Remember, this is a morning meeting, not a morning beating. We’re not talking about the things that didn’t go right (we need to fix those as they happen, not saving up for the meeting.)

I was recently contacted by an office manager at a practice who is just starting this process, and she said the doctor came in and basically yelled at the team for the entire morning huddle because they were behind goal for the month. I can tell you that fear is useful in motivation for a very short term. Then, the motivational effect of it goes away, so why do that? Why not use the positive? Why don’t you use the time to build people up? I promise they will follow you further and faster if they feel appreciated and a part of the team. They will do the opposite if they are afraid or feel beaten.

The last piece is education. One thing to do for education is to review your practice values. A great practice I know, calls this “how we roll.” Each morning they read off one of their values and either tell a story about somebody who has done that in the office or they’ll ask the team what’s one way that you can live this value at an even higher level today?

Next is to review treatment planning. I recently did a 2-day workshop with our top members and one area that we focused on – one area that has the biggest impact on your case acceptance is the importance of the entire team being able to have a very close idea of what you’re going to diagnose before you diagnose it. During the education part of the morning huddle you can help your team understand what we call your diagnostic assertiveness. When the entire team is on the same page with treatment planning you will find your treatment acceptance goes up. You can do this every day. You can throw up a film or a situation so that people understand how you’re going to treatment plan it. That way, they can pre-assess and pre-heat the patients.

The last thing for education is to review language. When we talk about situations in the patient’s mouths, I like to use the framework of problem, consequence, solution, benefit. So, problem is what’s wrong, consequence is what happens if you don’t do anything, solution is how we fix it, and benefit, why that’s good for them. This is another factor that effects case acceptance. I see patients making decisions that they probably would make differently if they understood the consequence of what happens if they don’t treat it. I think that this should be scripted, I think that everyone should be using the same words. When we talk about the problem, how Dr. Jones describes it, how Dr. Smith describes it, how Suzy and Sally describe it should be very similar and use the same words. And none of those words should be words that you learned in dental school. This is when we review and practice the language.

The real outcome of the morning huddle is to make sure people leave prepped and emotionally energized to have an amazing day.

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