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Kristen Mott is the associate editor for Dental Products Report and Digital Esthetics.
It can be hard to find a voice in the busy workflow of a dental practice, but there are a variety of things that can help boost confidence in bringing new ideas forward.
Have you noticed a certain workflow within your dental practice can be improved to increase efficiency, but you’re afraid to speak up? Perhaps you’ve recently discovered a passion for graphic design, but you aren’t sure how to utilize this skill at the office.
For dental hygienists who are looking to take on the role of a leader but unsure how to assert their voice, these situations are all too common. The good news is you’re not alone. About half of employees across all industries regularly don’t speak their minds at work whether to colleagues or mangers, according to research from the Society for Human Resource Management.
“In dentistry, we’re taught to tell patients they have gum disease, but we’re rarely taught to sit down with the doctor or practice owner and have difficult conversations,” says Katrina Sanders, RDH, BSDH, M.Ed., RF.
There are numerous reasons as to why hygienists are afraid to voice their opinions at the office, including being shy, averse to conflict, worried about having their ideas shot down, or unsure how to start a conversation with the doctor. However, learning to speak up is critical not only when it comes to being a clinical leader but also advancing your hygiene career.
“We need to be our own voice and advocate for ourselves,” says Kelly Tanner, RDH, Ph.D. “Know what you bring to the table and lean into that.”
Here are 9 ways dental hygienists can learn to assert their voices and take on leadership roles within their practices.
Learn why past decisions were made
Whether a hygienist is shy or extroverted, it’s critical to understand why past decisions were made when voicing an opinion in a dental practice, Tanner says.
“If it’s purchasing new instruments or changing a protocol that has always been the same, I always recommend to people to try to understand the office and context at the time those decisions were made,” Tanner says.
For instance, during the heart of the COVID-19 pandemic, many instruments were on backorder. As a result, dental offices couldn’t necessarily purchase name-brand tools and were using different instruments than what they would normally order. Using context can help hygienists understand why certain decisions were made at the time and what went into the thought process for the doctor or practice owner.
When approaching a dentist with a new idea or a proposed change to an established process, Tanner says it’s helpful to tie the decision back to the patients. For example, instead of telling a doctor that you’d like to order better instruments, a hygienist can phrase it as, “I feel if we had better instruments or sharper instruments, it would help our patients and increase our efficiency.”
“Seek understanding first, and then make recommendations based on evidence with respect to the doctor,” Tanner says. “If you make it about the patients and the reason why we’re all here, you can usually get to a ‘yes.’”
Put yourself in the doctor’s shoes
Before sitting down with the doctor or practice owner to discuss your role in the practice, it’s important to first try to put yourself in their shoes and understand their perspective. Sanders notes most dentists don’t receive a lot of business training while in dental school. Additionally, their working knowledge of what a hygienist does isn’t very strong in many cases.
“Often doctors don’t understand skill sets and talents of hygienists and what a true specialist can bring to their practice,” Sanders says. “Keep that in mind when approaching the dentist from that mindset. They might not necessarily understand what you can bring to the practice.”
For individuals who are hesitant to meet with a dentist and assert their opinions, Tina Clarke RDH, M.Ed., recommends thinking about the impact on patients and future hygienists when deciding to speak up.
“You have to ask yourself, ‘If I don’t say anything and I leave the practice and it never gets addressed, then will the problem continue on for someone else, or do I have an opportunity to make a difference for someone else?’ If you can think about it as what you’re doing is helping someone else who may be in that future position, it kind of helps to relieve some of that pressure,” Clarke says.
Besides meeting with the doctor to discuss additional leadership roles that may be available within the practice, use this time as an educational opportunity. Be mindful of the verbiage you use when speaking to the dentist or practice owner as well.
“Remind yourself that these aren’t just the doctor’s patients; they’re your patients, too,” Sanders says. “I’ll say things like, ‘Our mutual patient,” or ‘This is our patient that we’re working on together.’ Take ownership over the role that you play as not only a clinician but as a patient advocate. Your voice becomes the voice for your patient.”
Find the right time to talk
If the doctor just spent the last two hours completing a complex root canal for a difficult patient, it’s probably not the best time to approach him about implementing new infection control processes in the office. Instead, schedule a specific time to meet that works for both of you.
“In private practices especially, people are typically just busy the whole day,” says Alyssa Aberle, RDH, BSDH, MBA. “Find time to sit down and talk because it doesn’t always happen naturally. Set that time aside so you know it can happen.”
Giving the doctor or practice owner an idea of what the conversation will be about ahead of time is also helpful.
“Give them some context about what you want to discuss. If they know what the meeting is about, they’ll be more receptive to what you have to say. Let them know you’re respecting their time.” Tanner says.
During the meeting, find out the doctor’s or practice owner’s concerns or opinions on the topic. That way, you’ll have a better understanding of the starting point and how to move forward. Be sure to also schedule a follow-up conversation.
“You can say the meeting was really productive and let’s circle back in two weeks. That way, you know there’s a follow-up that’s going to happen.” Aberle says.
Coming in with a working knowledge of the topic you’re presenting to the doctor or practice owner can pay off in a big way. Whether you’re wanting to purchase a new instrument, introduce a new procedure, or request more time per patient, having all of the pertinent information ready to go at your fingertips will help the conversation flow more smoothly.
“The more you have a working knowledge of the topic, the more confidence you’ll have behind yourself when you’re explaining it to the doctor.” Sanders says.
Aberle notes having confidence in a certain topic or area also makes people more willing to speak up. She recommends hygienists research the topic they’re interested in presenting and join social media groups to connect and engage in dialogue with like-minded people.
Trying out a skill on a smaller scale can also prove to be beneficial. For instance, if a hygienist is interested in infection control, Aberle recommends taking a course on infection control guidelines or connecting with someone who’s in charge of infection control procedures at their office.
“The more you learn about the different options out there, the more confident you’ll be to speak up and step into some of these roles. And when you approach the office manager or dentist, you’ll be more confident in your capabilities.” Aberle says.
Clarke agrees, adding that when hygienists take the opportunity to increase their knowledge and reinforce it through educational courses, it allows them to have more confidence when engaging in conversations with colleagues, patients and doctors.
“There are a lot of infection control changes going on right now. Throughout the pandemic, a lot of hygienists have been staying on top of the changes with the CDC and OSHA and sharing that with their office. What a great opportunity to become the point person on a piece of knowledge or skill set that the office needs to have.” Clarke says.
When presenting a new idea or proposed change, the doctor or practice owner will likely have follow-up questions. If you’ve already done your homework and planned for those potential questions, Sanders notes you’ll feel much more prepared to address any concerns.
While some doctors may be immediately open to receiving feedback on processes or modifying hygienists’ existing roles, others may be less receptive to these ideas. If you find that the dentist is pushing back against what you’re proposing, Aberle recommends sitting down and having a conversation about what their reservations are.
“Have a clear idea going in what you want to come out of the conversation,” she says. “Whether it’s to talk about roles that could be created or if you want to be in a specific role, have a clear idea of what your ideal outcome would be.”
Sanders stresses the importance of approaching any conversation from a level-headed, pragmatic standpoint. A lot of times there will be a rationale behind the doctor’s or practice owner’s views.
“Always listen to understand. Don’t fight to win,” she says.
Doctors and practice owners are all human beings, and Sanders notes many of them often feel isolated with all of the day-to-day business happenings falling on their shoulders. Asking a dentist to help you understand their rationale can often shed some light on why they have a certain perspective or immediate reaction to change.
“With a difficult doctor, they’ve likely become hardened over the years because they haven’t been able to trust other people,” Sanders says. “It’s a hard thing to do to trust other people and delegate tasks to others. Remind the doctor that you’re in this with them. Listen to understand first, and then ask questions.”
Unfortunately, there are still situations in which a difficult doctor refuses to budge. When it reaches that point, it’s up to the hygienist to decide what the best course of action is going to be moving forward professionally.
“If you’ve had conversations about changes that need to happen in the office or roles of different team members and it’s not going to go anywhere, that’s your point when you have to decide what’s worth it to you,” Aberle says. “If it’s something you’re really passionate about and you don’t feel like the place you’re at is going to give you that opportunity, then you have to consider if you look for another office to meet your needs for what you want to get out of your career.”
Before speaking with the doctor or practice owner about taking on new responsibilities within the practice, it’s critical to first do some self-reflection and discover where your passions lie. Do you have strong graphic design skills? If so, you may want to discuss taking on a marketing role within the office. Are you interested in managing people? In that case, you may want to attend a leadership or business course.
“A leadership role as a dental hygienist is going to look different for each person,” Sanders says. “For some people, it’s more of a clinical leadership role. For others, it’s in training or leadership within the practice. Use your own self-reflection and self-assessment to help guide what you’d like to see for your own career from a leadership standpoint, and then create a plan to present to the doctor and how they can be a part of it.”
Tanner says being self-aware can help hygienists develop a better understanding of why they’re looking to make a change. She also stresses the importance of understanding the skills that are required when taking on a new role or position. For instance, if a hygienist is interested in becoming a myofunctional therapist, reach out to individuals who are popular in that field to get a better grasp of the day-to-day requirements. Online courses and industry conferences can also prove to be beneficial.
“Know who you are and what your shortcomings are and what you need to work on,” Tanner says. “As you grow and build and move into your next position, there may be a different set of leadership skills that are required of you.”
Identifying where issues currently exist within your practice can also be helpful, Aberle says. Maybe the office can improve its perio therapy, or perhaps some infection control protocols need to be reworked. Most likely, other people in the practice have noticed the same issues, but they either haven’t spoken up or don’t want to deal with the extra work. Aberle notes this is a great opportunity to present a solution to the doctor or practice owner and offer to take on the responsibility.
“When you go to anybody and say, ‘We have a problem,’ there’s going to be resistance. If you say, ‘There’s a problem, here’s a solution I found and I’m willing to take on the work,’ they’re more likely to listen,” she says.
Improve your emotional intelligence
Emotional intelligence refers to the ability to perceive, control and evaluate emotions. In a professional setting, harnessing the power of your emotional intelligence can help you to better understand and connect with your supervisor. Not only will you be able to express and control your personal emotions, but you’ll also have the ability to understand and respond to the emotions of others.
Tanner, who is certified in the science of emotional intelligence, says a majority of communication issues and people issues have to deal with emotional intelligence.
“Be aware of how you’re being perceived, how the other person communicates with you and how you communicate with them. They may not want to get bogged down in the details of what you’re proposing. Some people are detail-oriented, while others care more about the overall picture,” she says.
Be in a curious mode whenever you’re meeting with the doctor or practice owner, Tanner says. Include them in the conversation, ask questions and seek understanding.
“When you’re curious, I think that’s when it opens up more room for exploration within the conversation,” she says. “Be open to what you’re going to hear.”
Within the office, be the person who listens more than they talk, Clarke says. For hygienists interested in taking on a leadership position, start by trying to be a helper to everyone on the team. Listen to their needs and see what you can do to support them.
“A truly great leader is going to hear the information, listen, and then be able to act accordingly and work with the individuals on the team and come to a solution that will work for everyone,” she says.
Some dental hygienists work solely in a private practice. For others, they might work on opposite days from a fellow hygienist. This can sometimes create a silo and prevent the open exchange of ideas and communication. To counteract this, networking is critical.
“You can connect with people and have that community to share ideas with,” Aberle says.
Thanks to the digital age we live in, unlimited information is available to hygienists online. Aberle suggests sorting through various channels to find helpful information. For example, if your practice does a lot of cosmetic dentistry and you’re interested in learning more about silver diamine fluoride, you can find groups of people online or discover podcasts that will be useful.
“You never know when opportunities will present themselves,” Aberle says. “Everything is at your fingertips in 2021. Find groups of people to connect with or make your own group if there’s not one out there.”
In conjunction with networking, coaching can be a viable option as well. Coaching is an investment in you, Sanders says, and it can come in many different forms.
“If you’re someone who struggles with leadership, communication, people hearing you the right way, or starting a dialogue, know that there are endless resources when it comes to coaching, whether that is self-coaching through guided journal and podcasts or true coaches where you can meet one-on-one with someone who can help you to build the skills that are necessary to communicate in the right way,” she says.
As owner of Next Level Dental Hygiene Leadership, Tanner helps supports dental hygienists by providing personalized support, coaching and educational tools to help strengthen and develop leadership. For her, creating a shared system of learning and helping transition hygienists into different roles is key.
“Your network is your net worth,” Tanner says. “Link up with people who are like-minded and be open to learning more. Reach out to who you know and always look for those growth opportunities.”
Consider switching practices
When you know you have specific skills or talents that you want to share with the community, but you don’t foresee them being a viable option at your current practice, share them anyways, Sanders says. She recalls discovering her writing talent and starting to share articles with her community, and her employer at the time began to notice and pay attention.
“Often we think the current situation is one in which the doctor or practice owner won’t appreciate those skills. Once they see it in action, it’s different. That’s important to understand,” she says.
For some hygienists, though, getting their skills noticed is an uphill battle. If you find yourself in a situation where your skills or talents aren’t being appreciated or utilized, it’s time to evaluate whether you’re being met with the level of challenge that you need on a daily basis.
“If you’ve brought something up to the doctor or practice owner enough times and it’s not in alignment with where they are, you have to be comfortable enough and believe in yourself and your future to say goodbye and find something else,” Sanders says.
Leaving an office can prove useful, Aberle says, because it gives hygienists a better sense of what they’re looking for in a practice. She also stresses the importance of asking questions during a job interview. For instance, ask the interviewer if you can view a copy of the office’s infection control procedure manual, or inquire about how the doctor treatment plans for a perio patient. By asking the right questions, hygienists can determine if a practice is a good fit for them.
“We’re used to the job interviewing us, but we’re also interviewing them,” Aberle says. “You want to know if they’re a good fit for you, and they want to know that, too. Every practice has different workflows.”
While it may seem difficult — and even scary — at times to speak up within your practice, doing so is key to advancing your professional career. By surrounding yourself with a strong support system, investing in yourself professionally, building confidence and acquiring skills that will help propel you forward, you’ll be able to take on more responsibilities and new leadership roles.
“You are your own limiting factor,” Sanders says. “The opportunities truly are endless now more than ever in dentistry.”