Beyond Practice Management: Creating the perfect day

2009 08 19 10 27 14 220 Don Deems 70

"It's been another one of those days," John lamented.

"So, what happened?" I asked.

"Well, we had two people leave messages on our answering machine last night cancelling their appointments for today, then the exterminator showed up to spray for bugs in our office during the middle of the day, making it nearly unbearable to work because of the smell -- not to mention how it affected the patients.

Then the bridge on Mrs. Jones wasn't the right shade, so it had to go back to the lab, and then the lab called needing a new final impression on another patient because there was a pull on the margin of the prep they didn't feel comfortable with. My primary chairside assistant had to go home at midday because her son got sick at school, and then of all things an endodontic file separated in a canal and it took me over 30 minutes to retrieve it, throwing me way behind schedule. On that same patient I found out we had no final impression material; our team member forgot to place the order last week. To top it all off, another patient came in to tell me she decided the veneers I placed on her teeth weren't to her liking.

I left the office not wanting to come back, and all I could think about on the way home was a cold martini -- maybe two or three."

Why "another one of those days"? They don't have to happen, so why do they? Each of these issues could have been avoided, and different measures could have been taken throughout the day -- and the preceding days -- to create different outcomes.

If you dissected each of John's lamentations, you would probably be able to solve them individually in a number of different ways, but that wouldn't change things much for John in the long run. The issues are much deeper than that, which is where professional coaching comes in.

Take a different look at your practice management: different than being reactive instead of responsive; different than solving problems and enabling team members to continue with bad habits; and different than dealing with complaints and mistakes after the fact.

Focus on the following 10 "beyond practice management" elements to create a perfect day at the office. Make the necessary plans and take the actions needed to make it a reality, and you'll be well on your way to greater satisfaction, fulfillment, and enjoyment. Remember, knowledge without action is useless.

1. Stop all interruptions to your day.

An unorganized workday will leave you frustrated, fatigued, and unsatisfied by the end of it. When you take charge of your environment and stop putting up with the things that hold you back from your goals, you will give yourself more time to accomplish what you wanted.

How can you stop interruptions? Start by having your team screen your calls. No one gets through unless your team knows you are expecting a call or it's a family emergency. Use voice mail or written notes to facilitate returning calls when it's convenient to you.

Quit checking your email so much. Save surfing the Web for down time. Internet and email are the biggest daily interrupters for most people.

Teach, train, and empower team members to handle every situation that arises that really doesn't need your "doctor" attention. If you're a control freak, it will be harder for you to let go of what you've been hovering over for so long, so start with small items. Good coaching will help you with the rest.

2. Plan your schedule, taking into consideration your high-energy time each day.

Do you like doing molar endodontic procedures starting at 4:30 PM? If you do, more power to you. Yes, there are times when it can't be helped. But if you had a choice, would you prefer to start complicated, draining procedures that late in the day when your energy is probably the lowest?

Chart which times of the day you would prefer to do certain procedures. Block out those times on your schedule and have your team schedule those types of appointments during those time slots. Any procedures that need to be scheduled outside of that require your approval. Have your dental hygienist(s) do the same. They don't like starting scaling and root planning at 4:30 p.m., either. Many dental software programs will allow you to program this into your schedule to act as a visual reminder of what appointments get scheduled where or to set up rules that restrict when you can or can't schedule an appointment.

3. Schedule your activities, including your own tasks, travel time, quiet time, extra time for breaks and emergencies, and appointments with others.

If you're not using a planner, you're not getting the most out of your day. Day Timer makes several planner options; Franklin-Covey also has planners that help remind you what is really important to you and to plan your activities around that. Many software programs, handheld PDAs, Pocket PCs, smartphones, netbooks, iPads, etc. all have scheduling capabilities. Use one!

By not planning your daily schedule, your time will always somehow get used up and you'll be left wondering at the end of the day where all your time went. In addition, failing to leave time in your schedule won't allow you to respond to life's little (and sometimes big) unexpected events and you'll be stressed to the max because you don't have the time to deal with it. Picture a piece of paper that has a blank left margin and the rest of the page filled with writing: That left-hand, open margin represents when you can deal with the things that come up in your life. If you have no margin, you have no time to respond.

4. Group similar activities into their own time blocks.

To make your day at the office run smoother, schedule like procedures together. Your assistant will thank you for not having to get out a bunch of different equipment all day long, and you'll get "in a groove" for completing treatment more efficiently.

At home, plan your day with necessary projects to not have interruptions, and make sure you have everything you'll need before you start -- even gas for the mower that you could pick up on your way home from work.

5. Select the biggest, most important job and do it first.

The simplest example here is to use Stephen Covey's method of placing items in one of four quadrants: Important and Urgent, Important and Not Urgent, Not Important and Urgent, and Not Important and Not Urgent.

The first two quadrants are the ones you should be living and working in daily. The last two can be delegated or are just a plain waste of your time and energy.

6. Break up large projects into manageable chunks. At the end of each chunk of time, stop and do something different.

It's easy to feel overwhelmed at a large project. You know what to do: Take one step at a time. It's been said many times, "The journey of a thousand miles starts with one step." This is certainly true of the myriad issues I pointed out in John's lamentations at the beginning of the article.

Let's take this a step further. When you've reached a certain stopping point, do something different, then go back to the larger project. You'll find setting something aside will provide time for you to reflect on how the project is going, as well as what ways you might make better use of the time you are spending on the project. And you'll get the energy release and break from your concentration efforts.

7. Make adjustments to your schedule as required. Be flexible.

One of my favorite phrases is "Be rigidly flexible." Be flexible when necessary but only when necessary. Your daily schedule must have time planned into it to handle unexpected problems. Otherwise, you'll be pressured to squeeze somebody into a busy schedule, which short-changes everyone else (especially the person who scheduled time in advance), stresses everyone out (including you), and often results in the provision of low-quality care to all involved.

In addition, communication always gets short-changed when conversations are rushed, leading to misunderstandings, and on and on. By blocking your schedule at least once each day for unexpected needs, you'll be able to respond to the needs of your clients, which will work wonders for you and your practice. Mistakes decrease and life becomes more enjoyable.

The same goes for your home schedule. A too-busy home schedule doesn't allow you to respond to family and relationship matters that really need your devoted and loving attention.

8. Delegate tasks.

Delegate everything you can. Then delegate even more. Go ahead -- make those moves! Take ownership of whatever needs to be done by making sure that the person you delegated the task to has the necessary tools and directions, but then get out of their way. Have them report back to you when the task is completed if necessary. You'll be amazed at how this helps you.

9. Find something complimentary to say to everyone who speaks to you and move on quickly.

You cannot say "thank you" too much. Acknowledge people's efforts sincerely, say something nice about them, and find a way to reinforce their strengths. Make it a point to have "an attitude of gratitude" each and every day for everyone and everything in your life.

10. At the end of the day, clean off your desk, update the next day's plan, and take no projects (or problems) home.

That doesn't mean you have to complete each and every project. Sometimes things just don't work out, or there's more to do than could possibly be completed in one day -- no matter how well you planned it. Cleaning off your desk will give you a feeling of completion and focus, you'll go home not trying to remember this and that, and you'll gain a better perspective on how you can make tomorrow a perfect day.

Dr. Deems is a professional personal and business coach to dentists and their teams and is a practicing dentist. Since 2005, he has been named to Dentistry Today's Top Leaders in Continuing Education 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, or at (501) 413-1101.

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