“Does anyone know what a paradigm is?” and with that Dr Mervyn Druian commenced his excellent talk to a group of dentists, dental students and friends on case presentation, practice profitability, and happiness in dentistry.
On a lovely balmy evening in August in leafy Belsize Park, 10 members of Young Alpha Omega gathered, armed with snacks, drinks and good company.
So…..many years ago, Swiss watches were the leaders in the market, then the non-winding/battery-operated watches arrived mostly from Japan… what happened? The bottom nearly fell out of the Swiss market until they had a paradigm shift and they started to develop these newer kinds of watches….and the lesson? ……..Things change!
Many years ago working in NHS dentistry was a privilege; we could focus on practising a high standard of dentistry. We could make a reasonable living and have control over our careers. Now it has changed and it’s a mess.
Around 40 years ago we were in the forefront of helping dentists to go into what is known as private practice but we preferred to call it Independent practice. Hundreds of dentists all over the UK were taught to develop business and verbal skills to leave the NHS… go into independent practice.. It didn’t have to be expensive but gave us much more control over our clinical practice as well as running our businesses.
"If we’re not paid what we’re worth we become worth what we’re paid”. (Dr Omar Reed). This has happened in NHS dentistry today, and we end up with GA’s for multiple extractions in children for example."
Dr Druian then continued with some observations and shared what he had learned over many years of life and practice:
"--Communication…charisma... Enthusiasm …..Bring it to your work and your interaction with your team and your patients and you will draw people towards you.
People don’t care how much you know until they see how much how care… for example: warming up the local anaesthetic before injecting and encouraging the nurse to gently put her hand on the patient’s shoulder when giving an injection to calm and reassure them.
Keep bearing in mind, that it’s not just about clinical expertise. Patients have faith and trust in us …it’s a huge responsibility…belief without proof, trust without reservation.
Learn to run a practice and create an atmosphere of excitement and care. My mentor Omar Reed advised: develop a personal philosophy/ vision which drives you and the team... It’s important to sit down with the team and set goals for yourselves and strategies for the practice.
After all, what do we want from life? Happiness, health, wealth, wisdom, peace of mind... That is everything we need in life.
Work should be fun! Patients come and hug me even though it may be politically incorrect! Everyone should feel it is a win-win... We need to work with honesty and integrity and contribute to the greater good.
Dr Viktor Frankl was a psychiatrist in Vienna and a holocaust survivor He developed a psychological approach called Logotherapy: Search for life's meaning as the central human motivational force.
He said: “Everything can be taken from a man but one thing: the last of the human freedoms—to choose one’s attitude in any given set of circumstances, to choose one’s way.” Quote from his book: Man's Search for Meaning
Patients can’t see our beautiful implants or fabulous root treatments etc…… we are selling the invisible… we are selling ourselves... the intangible.
Einstein had an interesting habit: once a day, he allowed himself the freedom to think and let his imagination run free. Why not take 5 -10 minutes to sit in the most comfortable chair in the practice i.e. the dental chair and let your imagination fly?
Winston Churchill once said:
We are under pressure all the time…. Learn to relax; Life isn’t perfect, just accept this!
Running a happy practice and making a profit
Don’t present your treatment plan to the patient from your own financial pressure requirements. You will never sell. Have the right mental outlook first.
For example, if a patient presents with acute toothache, deal with that first… address their basic needs and don’t start with a complex cosmetic treatment plan
Approach everything from a place of joy and giving.
This can give you an idea of how a man can progress in life and develop a life philosophy and a career.
Start with the Basic needs: food water warmth, safety, belonging to Groups, relationships, a continuing sense of accomplishment and finally…… to contribute and give back.
"f you have an irate patient, ensure you recognize who owns the problem. Is it yours or the patient’s?
For example: if a patient requests an urgent emergency appointment, but turns down several slots offered including the lunch break because it's inconvenient and becomes angry… who owns that problem? Certainly not the receptionist who is trying to help!
A fair fee is what a patient is prepared to pay and we are willing to receive without anyone losing out. For example, if you charge a crown at £500 and the lab fee is 300 plus expenses…you will lose… and become resentful for having underquoted. You need to know your expenses and outgoings and run the business with a logical head. Sadly, this is not taught at dental school.
A fair and reasonable price is the selling price for a service or goods that is fair to both the buyer and the seller, who are involved in the transaction.
You need to develop a business head. I ran a practice at a loss for years and learned the hard way.
Be present! Don’t be distracted or check your phone in the middle of a conversation. Seek first to understand before being understood … when you greet a patient in the surgery think about asking questions about family, general stuff, and social stuff so they can start to engage. It makes such a big difference to the relationship you can develop with your patients.
Working as a team
Let me tell you about geese behaviour.
Did you know that geese always fly in the shape of a ‘V’, as it allows at least 71 % greater flying range? When the goose in the lead gets tired, another goose takes over the position.
They have a strong affection for others in their group. If a goose gets sick or is wounded, a couple of other geese may drop out of formation to help and protect him.
They take turns being the leaders and support each other in difficult times.
We can learn from this. Work together as a team in practice, have a different person take the lead occasionally in practice meetings, and stand by each other in difficult times
More observations coming up!
4 types of patients will be coming to your practice:
Willing and able…terrific!
Willing and unable…work around it, do the work in stages say 6 months etc…and get it done slowly at a pace the patient can manage. Think about finance options if necessary
Unwilling and able… Use your skills and empathy to find the root cause. Sometimes it’s just a question of timing. Listen to the patient and don’t press
Unwilling and unable…It would be better for the patient to find somewhere else
Law of reciprocity: The more you give and help others the more you get what you need…law of abundance… I love that word!
You want to do your absolute best… there is lots to read and find, for example:
Napoleon Hill was an American self-help author. He is best known for his book Think and Grow Rich, which is among the best-selling self-help books of all time. Hill's works insisted that fervid expectations are essential to improving one's life….the book was published 100 years ago and it’s still in print
Work smarter, not harder...
Ensure you always have great records for better outcomes. Engage in the newer ways for instance with digital consent forms which are useful!
Omar Reed “Do the Right thing at the Right time in the Right place for the Right people”
Jim Rohn: "Miss a meal if you have to, but don't miss a book.” He also said: “Either you run the day or the day runs you” and “You don’t get paid for the hour. You get paid for the value you bring to that hour”
Carl Hammerschlag was a psychiatrist and healer who learned from the Navajo traditional healers and taught Psychoneuroimmunology.
He greeted each day with JOY. This is not incidental it’s VITAL
Hammerschlag said that living under chronic stress and stressful conditions eats away at balance and harmony. It causes people to only believe in the things that are in their heads instead of following what they believe is right in their hearts.
“There’s a cause-and-effect relationship with everything,” Hammerschlag said. “But for your consideration, there are some things that happen that we can’t explain. We tend in our culture to subordinate what it is we feel. When it comes to answering those unanswerable questions, what you feel is just as important as what you know.”
Dr Druian concluded his presentation with some heartfelt observations, especially to the students and young dentists:
You are on the path to a brilliant profession, and you can have total control of your career. We are so lucky. So few professions are like this one, even medicine,
When I think that I started with accountancy and did it for three weeks…. Oh my! I thought I was going to die! Then I got into Dental School, thank goodness. I hated dental school but I love the profession!
I love doing what I do… I usually can’t wait to get to the surgery every day!
When asked about the one thing that had made a difference for him Dr Druian emphasised that having a mentor changed everything. He said this profession is full of great teachers who are happy to help and share their experiences with you……. Learn from the mentors, they are everywhere!
Following the talk, there was a general discussion and there was a strong feeling of optimism in the room that the future holds so many possibilities and new modalities.
We were grateful to Dr Druian for giving up his time and sharing his experiences. He invited anyone who wished to contact him and come to the practice to spend a day observing and learning.
Dr Mervyn Druian BDS (RAND) DGDP (RCS) Past International President of the Alpha Omega Dental Society Fellow of the College of General Dentistry Fellow of the American Society of Dental Aesthetics Dentex Partner
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