Beyond Practice Management: The heart of caring

2013 03 12 14 45 43 994 Deems Don 70

In his book Money, Possessions and Eternity, Randy Alcorn writes, "Tolstoy said, 'The antagonism between life and conscience may be removed either by a change of life or by a change of conscience.' Many of us have elected to adjust our consciences rather than our lives. Our powers of rationalization are unlimited. They allow us to live in luxury and indifference while others, whom we could help if we chose to, starve and go to hell."

Don Deems, DDS, FAGD.Don Deems, DDS, FAGD.
Don Deems, DDS, FAGD.

This opening quote can certainly hit you in the gut, although my intention is to present you with an opportunity to look inside yourself in a way that you may not have done lately.

Have you changed your life or your conscience since you became a dentist? As Tolstoy said, we have unlimited powers of rationalization. Have we rationalized our practices, our profession, and even our lives into something we never imagined we would? Have we become focused on "the bottom line," fighting insurance companies, bad-mouthing corporate dentistry, looking for the next great product that will make us more money, trying a new marketing scheme for people to find us and become "new patients"? Where is our profession going? Where are our practices going? Where are we as people and as professionals going? A cynic might say we are small-business people, so what else can we do? What can you do?

Our recent ancestors in dentistry weren't focused on such things. They were focused on caring and providing dentistry the best way they could, with little thought to the many things that we allow to take our attention from us these days. Is the lack of caring a generational thing? Or have many of us just become crass and uncaring? Do we rationalize this and tell ourselves that these are just different days and times?

The core of caring

Yes, these are different days and times, but last time I checked we were still caring for people. Doing so in a team approach -- although necessary -- has even made it harder to demonstrate caring, as many patients are lost in the shuffle of the hurriedness of providing treatment and procedures. In reality, those patients we provide with exceptional dentistry and caring can still leave an office feeling uncared about by the rest of our team.

Defining caring is not a hard thing to do. Most of us would be able to come up with a reasonable definition with little or no effort because it is a word we are quite familiar with, encompassing emotions, effort, leadership, attention, and, yes, even love. Other important core attributes include relationship, action, attitude, and acceptance.

How do we go about showing we care for our patients? Free teeth whitening? A warm, moist towel at the end of treatment? A phone call in the evening to a patient who received treatment that day? Seeing a patient after hours? A birthday card, postcard, or email? Yes, each of these may indeed be a way we show we care, but is it the heart of caring?

As dental professionals, we care for people. We care for people in many ways, in ways that are oftentimes unique for the person we are caring for. It's not always easy to show we care and act in a caring way when we are stressed, troubled over matters unrelated to the person right in front of us, or when we're listening to someone complaining about something directed at us or our staff. Caring can be quite difficult, and it can challenge us to our core, even if we think of ourselves as caring individuals. Displaying caring is even more difficult in our practices these days for many reasons, and I am quite sure I don't need to tell you!

To get at the core of caring is an exercise not in rationalization but in action and attitude. Taking that path is not so easy; in reality, it's easier not to care -- just smile, say thank you, hand out a few empty compliments, and go on to the next patient.

Think of a situation in which you really felt cared for. What did it feel like? What did the person say or do that made you feel cared for? Was the situation in a healthcare setting? If not, have you experienced a feeling of real caring in a personal healthcare setting? If you have, you know how powerful it can be. If you haven't, I'm not surprised. Perhaps you were herded into an exam room for your last physical evaluation, your name having been announced to a full waiting room, then you waited for quite a while until your doctor appeared. Without looking at you, he or she might have asked a few cursory questions, then proceeded with taking your blood pressure (which you were sure happened way too fast and wasn't accurate), listened to your breathing, then checked off lab tests you "need," called the nurse in to take you to the lab, and there you were told to sit and wait again. Eventually your name was called and you did whatever you were told, then were given a bill for your exam and labs and told to "take it to the girl in the front" who collected your money.

Would you feel cared for in that situation? I doubt it, and hopefully that would be your last visit to that doctor.

5 values of caring

Implicit in this process is not just the caring attitude (or lack thereof) of the doctor, but also of the team. Team caring is just as important, as many patients leave practices because of uncaring attitudes of team members.

In the publication "Core Principles & Values of Effective Team-Based Health Care," published by the Institute of Medicine, the authors listed five personal values associated with caring:

  1. Honesty: There is a high value on effective communication within the team, including transparency about aims, decisions, uncertainty, and mistakes. Honesty is critical to continued improvement and for maintaining necessary mutual trust.

  2. Discipline: Each person carries out his or her roles and responsibilities with discipline, even when it seems inconvenient. At the same time, team members are disciplined in seeking out and sharing new information to improve individual and team functioning, even when doing so may be uncomfortable. Such discipline allows teams to develop and stick to their standards and protocols even as they seek ways to improve.

  3. Creativity: Team members are excited by the possibility of tackling new or emerging problems creatively. They see even errors and unanticipated bad outcomes as potential opportunities to learn and improve.

  4. Humility: Team members recognize differences in training but do not believe that one type of training or perspective is uniformly superior to the training of others. They also recognize that they are human and will make mistakes. Hence, a key value of working in a team is that fellow team members can rely on each other to help recognize and avert failures, regardless of where they are in the hierarchy. Effective teamwork is a practical response to the recognition that each of us is imperfect and "no matter whom you are, how experienced or smart, you will fail."

  5. Curiosity: Team members are dedicated to reflecting upon the lessons learned in the course of their daily activities and using those insights for continuous improvement of their own work and the functioning of the team.

Showing we truly care can be challenging but it is not impossible, and I would submit to you that if you are willing to look inside yourself and have open, honest discussions with your team about caring, you will make a huge difference in the lives of those who have chosen you and your team to care for them. It is a gift you have the extreme privilege of offering on a daily basis.

Even more, your efforts will not only affect the hundreds -- if not thousands -- of people who are touched by your caring, it will affect our profession ... our caring profession.

Dr. Deems is a professional personal and business coach and a practicing dentist. Since 2005, he has been annually named to Dentistry Today's Top Leaders list and is the author of several books, the most recent titled The Dentist's Coach: Build a Vibrant Practice and the Life You Want. He can be reached at He speaks regularly on topics of this nature both nationally and internationally.

The comments and observations expressed herein do not necessarily reflect the opinions of, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.

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