7 ways to painlessly introduce change in the dental practice


For dentists who are seeking to grow, change is required. So, how does a practice implement change without striking fear, and resistance, from the team? Simply start small.

For more than 30 years I’ve been coaching practices, big and small. I’ve found many dental teams have metathesiophobia. Please, don’t worry. You can’t catch it. And, it’s actually pretty simple to cure. Metathesiophobia is the fear of change.

There are a variety of reasons why people fear change. Some people like the comfort and consistency of status quo. They do not like to deviate from an established routine. Others fear the negative consequences of change and believe the cost of change will outweigh the benefits. But dental teams cannot do the same thing and expect different results – more new patients, increased treatment acceptance or reduced account receivables. These things don’t “just happen.” They are the result of doing things differently. For dentists who are seeking to grow, change is required. So, how does a practice implement change without striking fear, and resistance, from the team? Simply start small.

In Japan, they have a word for the continual, gradual and incremental approach to change and improvements. That word is “kaizen” and many American companies have integrated kaizen into their business and manufacturing processes. The psychology behind kaizen is to implement change in way that is sustainable and consistent, but at a threshold low enough to not trigger people’s fear-of-change reaction. In other words, the best way to implement change is to be slow and steady. The first thing to do is understand what the practice’s current systems are producing by measuring key metrics.

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Identify the starting point

A team should never want to just change for change sake. Instead, they would want to change to improve, which logically requires they have complete understanding of their current situation – or the starting point. They also would want to have a definitive goal – an ending point. In a dental practice there are key metrics that must be measured, monitored and managed that will indicate if the changes implemented are having a positive and sustainable effect.

Non-emergency new patient acquisition.

Patients who seek a practice’s services to fix an emergency problem may-or may not-be long-term patient opportunities, so they should not be counted as a new patient to the practice. Therefore, the goal should be 25 to 40 non-emergency new patients a month.

Preventive hygiene conversion.

This is the percent of non-emergency new patients who appoint and commit to regular hygiene. A practice’s conversion goal should be 80 percent, measured at a three-year interval.

Case completion.

Most practices have very high case acceptance, which is when the patient says “yes” to the doctor. But somewhere in between the treatment and fee discussion, the “yes” turns into a “maybe” or a “some, not all.” Case completion is the percent of treatment that is actually accepted, scheduled and completed. (In my experience, this averages a very low 50 percent, when it could and should be 80 percent.)

Once the starting and ending points, or goals, have been established, it’s time to implement small changes and measure their impact against the identified benchmarks.

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Make small changes become habits

Challenge me and I’m certainly able to give up sweets for a week. Almost anyone can make a change if it’s short term. But creating new habits – which are long-term changes - is much more complex. Why?  Because anything new can be uncomfortable when it’s first implemented. So, let’s start small with four simple changes that are easily integrated into the team’s daily habits.

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Start the morning with a huddle.

I recommend changing facilitators on a weekly basis, so everyone on the team has the opportunity to lead the morning huddle. This improves team accountability and engagement. During this short five to 15-minute meeting, the team should review the patient schedule, acknowledge “good deeds” and make sure everyone has the information they need to make the day a success.

Wherever you are, be there.

When the flag goes up in the morning and the patients begin to arrive, the doctor’s office is “off limits” until the last patient of the day is out of the operatory. When I’ve challenged dentists to ban their office during the day, they are almost always surprised at how often they are in the space and surprised by how much more productive the entire team is when everyone is present and engaged.

Have the assistants run the back office.

As the most productive producer on the floor, the doctor should be almost solely focused on patients’ clinical needs for the day, not on scheduling or managing the team’s dynamics or day. The assistants should be choreographing the doctor’s and team’s movements throughout the day.

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Let patients choose how they want to pay.

 It’s important to have defined financial payment options. But, it’s equally as important to let patients choose the one they prefer from all options available and not reserve some, like third-party financing, for specific treatment types or amounts. Simply ask all patients, “We accept cash, credit cards and have flexible financing available. Which of those would you prefer?” When a practices limits options; they may limit their case completion.

These changes are small, but significant. Each should be implemented the kaizen way: individually and gradually to achieve sustainable change and to avoid an outbreak of metathesiophobia. Remember, every remarkable journey is merely a series of small, consistent steps. 

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