“Tales from the Troubleshooter #6”

Posted yesterday on Dentinal Tubules the latest instalment of Jimmy’s story.

Tales from The Troubleshooter – Case 1. Jimmy’s story.

Part 6. Environment – how do you really look?

The Seven Pillars of Dental Practice Management© are:

  • Vision
  • Financial Controls
  • Sales
  • Marketing
  • People,
  • Environment
  • Systems

Familiarity may possibly breed contempt. What it definitely can do is to make us immune to  the gradual changes that occur around us. Week after week, month after month the deterioration and acceptance of our surroundings is inevitable until one day something makes us wake up and take notice.

How many of us have thought that a wall was in acceptable state until we moved a picture and realised that we should have had the decorators in 12 months ago?

In the same way dentists who turn up day after day fail to see the gradual deterioration of their physical environment. How many of us make the effort to experience the patient journey from the patient’s point of view?

Jimmy’s practice had been established in the first couple of years of the new century. At the time there was a real “wow! – this is nice” feel about the place. There was comfortable, modern seating, music and great lighting. It set the pace for local practices. The operatories were bright with contemporary dental chairs and units.

As time passed the energy with which the business had been created gradually reduced and eventually disappeared. This was reflected in the decor which started to look faded and jaded. The team, lacking leadership, cared little for their surroundings and everything started to reflect the culture of the business, strangled by the unimaginative and incompetent middle management.

It was time to ask the questions:

  • What does the patient see?
  • What do they smell?
  • How does it feel to be a visitor to the practice?
  • What are the sounds they hear?

First task is to send the youngest or newest team member out of the building with a video or a digital camera and get them to take pictures of the area around the practice, the approaches to and the outside of the practice. This is something that I do whenever I visit a practice wearing my analyst’s hat. After the outside take views from every corner of every room, if possible take them from odd angles. Take a look at the view from the patient in the chair – including the dentist and nurse – to see ourselves as others see us.

Next, use the images or video as the basis of a staff meeting. Run through the show  with the team in silence ask them all to write down what they can see that is wrong, could be improved, changed or eliminated.

Then run the show again with everybody chipping in with their comments, take a look at the “fault areas” in the flesh and decide on what can be done to improve.

In Jimmy’s practice some of the changes that were made were:

  • Replace the “traditional” brass plates with modern acrylic name plates.
  • Give the outside and every public area a lick of paint.
  • Replace worn out seats.
  • Get rid of any and all patient notices that were held up with Blu Tack, it looks naff.
  • Removed the outdated telephone system so that patients were given proper messages and were able to deal with a human being.
  • Every team member was given responsibility for an area to monitor. Blown bulbs and tubes were replaced immediately when they failed.
  • Toilets were checked several times a day to ensure they stayed clean.
  • Magazines were replaced as soon as they became non-contemporary.
  • All the marketing material was renewed, refreshed and checked weekly.
  • Staff uniforms were changed and personalised.
  • The reception team adopted a zero-tolerance policy of paperwork on their desks.

I am sure that you can think of a dozen different things that you would do in such a position. The important thing is not the variety but the action itself of looking and being prepared to act.

In order to see how everyone else was “doing it” team members hand delivered letters to referring practices in pairs. They introduced themselves and compared notes of how the others looked, what the welcome was like and what could be learned. This also assisted the marketing drive and improved team morale as they got a change from their routines.

On the subject of team, a conscious effort was made to smile and make eye contact with every patient greeting, every time. It’s important for everyone to realise that the culture of the business is reflected in everything that they do. There  is no room for “bad-hair” days. Invitations for feedback were invited and were not just the “box-ticking, keep us compliant with CQC, do it and ignore it” variety. They were thought through and acted upon.

All the changes that Jimmy’s practice introduced were low cost when compared with dental equipment, they produced positive responses in both patients and team members and this was soon reflected in the bottom line.


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