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Inside Dentistry
February 2010
Volume 6, Issue 2

Confronting Challenges

How to create a true sense of urgency!

Amy Morgan

Raise your hand if you have experienced any sense of anxiety, fear, or stress as a result of all the bad news about the economy. When the negative news keeps coming at you 24/7, it’s hard to believe you can steer a positive course for you and your team or your patients. But you can and you must. The key is to keep everyone moving in a positive direction by creating a sense of urgency to move and act now.

One of my favorite authorities on change management is John Kotter, whose latest book, a sense of urgency, is perfect for this challenging economy. Kotter says the first step in creating a true sense of urgency is to fully understand the opposites: complacency and false urgency.

Let’s start with understanding what false urgency is, because as consultants this is what we see the most of in dental practices. False urgency is created through intense pressure, threats, or feelings of failure (both present and future) being applied to a situation. Let’s say you are a general practice where your average production runs $70,000 to $80,000 a month. Normally, the practice attracts 10 to 12 new patients a month (referral only) and production has steadily increased 3% to 5% per year pretty much in alignment with fee increases. But you watch the news every night, and you’re sure your patients are feeling the pinch. You walk in on the first day of the new month and discover your schedule is wide open and hygiene has more holes than usual. You panic, call a staff meeting, and threaten job cuts if the problem isn’t fixed. But no one does an analysis of the situation or tries to come up with a specific plan to address the problem. Instead, the team is now just as stressed as you are. This scenario creates a tremendous amount of false urgency—your team is running around, calling anybody they can, blaming different departments, and working themselves into a frenzy of defensiveness, blame, and frustration.

Compare this to a complacent team. Kotter defines complacency as “a feeling of contentment or self satisfaction, especially when coupled with an unawareness of danger or trouble.” Even if the team does acknowledge problems in the practice, if they don’t see the connection between their own actions and the challenges in the practice, they will maintain the status quo. The scary thing is that complacent teams very rarely know they are complacent, because they think they are doing what is successful and right. For example, let’s highlight another practice that prides itself on being an effective team with many referring general practices because of its long-term relationship-building efforts. It also has had very specific marketing plans including lunch-and-learns, CE opportunities, and going the extra mile to acknowledge its top referring practices. As a result of the team’s marketing strategies, last year the practice did more implants than any previous year and is goaled to do even more in 2010. But the team has heard some rumblings from other specialists indicating that general practices may be referring less because of the economy. The team has noticed less implant consults but is not worried because of all the marketing tactics it has in place. The team blames the slowdown on the other offices and console themselves with the belief that eventually things will pick up.

Neither the false urgency nor the complacency will lead our two example practices to better success in a very challenging environment. The only solution is to create a true sense of urgency—where there is not only buy-in to the logic that “there seem to be real problems and we need to fix them,” but also a set of feelings that creates “a compulsive determination to move, and win, now.” There are four key strategies to creating true urgency to address a problem.

Give your team the important facts. In the first example, the doctor had his “facts” wrong. Based on just one day’s worth of production, he immediately concluded the practice was failing and called a “reign of terror” staff meeting. Managing by judgment is never the right answer. What is needed before reacting are facts that unemotionally identify strengths and challenges. If our panicked doctor had reviewed his statistics with his team, he may have discovered a different story. He may have started the new month scheduled below production goal, but what’s the big picture? Where is the practice year to date (production and collections)? Where is the practice in terms of last year’s successes? Are new patient numbers increasing or decreasing? Are patients of record still saying “yes” to significant treatment and if not, what’s the primary objection? These are the facts that can lead to focused, proactive strategies that will stop a downward trend with no blame, shame, or regret.

Win the hearts and minds of your team. The doctor in our second example needs to engage her self-directed team to want to improve their own processes. To start, she needs the team to agree that the facts are pointing toward a problem. This involves analyzing and acknowledging what truly is working in the practice here and now, as well as challenging the team to grow beyond their previous success. To engage the heart, a leader cannot use threats or strictly negative consequences such as, “We won’t have raises this year if we keep losing implant consults.” It needs to sound more like, “How can we help our struggling community so that we can take our relationships to an even higher level of loyalty and succeed in any economy?” This demonstrates that the doctor trusts and believes in her team. By focusing on involving the team and fully utilizing their skills and talents, they become engaged in addressing the challenges of the present and future.

Commit to solving one problem at a time. Once both of our dentists have analyzed the right facts and engaged their teams, it’s time to do something different to get a different result. The biggest issue we see when practices attempt to solve problems is the impulse to fix everything at once. If the top problem is making dentistry affordable for the patient, then the action plan must be focused on that. Do you offer deeper courtesy adjustments for patients willing to pay in full? Do you investigate more external financing options? Do you provide internal financing for patients of record, and for longer periods of time? And if so, how do you make sure that patients remain accountable to their financial arrangement? The last thing that should be added to the action plan are marketing steps, treatment presentation tweaks, and scheduling upgrades, as this will guarantee split focus and lack of results.

Celebrate success along the way. Let’s face the truth: dentists tend toward negativity even in the best of times. If you wait for the end of a perfect year to celebrate your team’s commitment and achievement of all the benchmarks that contributed to that year, you will have a very under-acknowledged and under-appreciated team. People instinctively need to have a feeling that they are moving in a positive direction, especially when the goals are daunting and out of reach (in the moment). The best leaders genuinely praise progress by catching his or her team doing something right (or almost right) and acknowledging that achievement. If our doctor in the first example works with his team and adds an additional $10,000 to the schedule in the first week of a difficult month, he had better call a meeting to praise the team and discuss how it was accomplished, identify what skills need to be reinforced, and, most importantly, emphasize how the highlighted, new behaviors will contribute to continued success.

Make no mistake, creating true urgency takes time, thought, and effort. It requires collaboration, good communication, great analysis, and strategic thinking. To a dentist struggling to stay afloat, this may sound like fiddling while Rome is burning. But the bottom line is if you want your patients and your team to positively move forward with you during challenging times, this is the answer. Now, go create some true urgency.

About the Author

Ms. Morgan is the chief executive officer of Pride Institute, a dental practice management consulting firm located in Novato, California. She can be reached at

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