Dr. Wayne D. Pernell, Pride Institute Consultant

	The new year brings many of us face to face with a daunting set of wish lists. We call them “resolutions” or even “goals.” We look at what we want to accomplish personally and professionally and-having written them down-proceed to ignore them and work in ways that manage to bring about somewhat opposite results.

	Powerful failures come from not truly having a plan. The resolutions made at the beginning of the year are mostly empty wishes with no clear vision of a desired outcome nor any sense of strategy for how to accomplish anything past the very first steps.

	So, dear leader-and if you’re not the dentist, then dear reader-to be successful, you need only to follow a few relatively simple steps and then, the difficult part: Follow through.

	Create a wish list. Call it that. It’s not a resolution, it’s a wish. What do you want this year? Do you want to lose 20 pounds? Do you want to take more time off? Do you want to buy a new digital radiography set-up? Do you want to outfit another operatory? Do you want to contribute more to your retirement fund?

	Don’t go overboard here. Jot down five or six possible things you believe you can focus on this year. Even though “winning the lottery” may be a wish, don’t write it on this list because there’s no real way to strategically achieve it with any certainty or reasonable Return On Investment (ROI). To reframe and recap, the first step toward powerful leadership is to create your list of desired outcomes that tie to your vision.

	For each of the items listed, determine the resources needed. Will the item cost you money? Will it require your time or someone else’s? Will you need help to get it done?

	Don’t just look at the list item and mumble something like “Oh, yeah, that’ll cost something.” By now you need to have started a five-column grid. Column one is the “to do” item. Column two is the notation of anticipated resources required-time/money/people. Don’t be vague here; be as specific as possible.

	Determine when you want the project completed. Remember, whether it’s losing 10 pounds or implementing a new digital radiography system, you need to have an end date in mind. Again, be specific.

	Also, in the five-column grid you’ve started, put the due date in the third column.

	More resource assessment: To whom can you delegate? You need to be able to be the CEO of your company and have various self-directed executives making decisions on your behalf. Who can oversee the project and report back to you?

	Letting go of every detail takes some getting used to, but remember, this is about new leadership in the new year. Practice delegating and fill in column four on your chart with the project manager’s name.

	The fifth column on the grid is for notes. Is there anything special you or the project manager needs to know along the way (e.g., report back dates or other requirements like cutting electricity or painting during non-patient hours).

	Build a communication plan. What needs to be said to whom, in what format, and by when? Your team members need to know what to expect so they can be in alignment with you moving forward. Remember you’re leading, not pushing. Tell the team where you’re heading!

	Do patients need to know anything? What about vendors? Also, consider the format for communication; will you discuss at a team meeting, post fliers, send letters, do an e-mail blast or engage in sky writing? Decide what you are going to say, to whom, and how it will be communicated.

	A leader needs to know that what has been hoped for and planned on is actually getting done.

	Assessing milestones along the way to final outcomes is essential to being able to course correct if you’re off track. A plane flies for thousands of miles and lands on a tiny strip of asphalt because it has corrected for deviations along the way. Make sure you land where you wanted to land by assessing your progress and keeping the outcome in mind. The question to keep in front of you:

	“Is what I’m doing right now getting me closer to or further from my goal?”
	Follow these six steps using the five-column grid, and you’ll be ready to turn your wishes into attainable goals as a new leader in this new year! 

Wayne Pernell, Ph.D., brings more than two decades of management, consultation and executive coaching experience to the Pride consulting and coaching team. Drawing on his background in clinical psychology, Dr. Pernell’s private practice evolved to focus on leading change in organizations.

Articles

 The new year brings many of us face to face with a daunting set of wish lists. We call them “resolutions” or even “goals.” We look at what we want to accomplish personally and professionally and-having written them down-proceed to ignore them and work in ways that manage to bring about somewhat opposite results.  How does that happen?

Make your resolution a reality

	“You’re wrong!”
	
	A patient complaint is as powerful as a slap in the face. The words sting and when they come from a patient it most certainly feels like a threat to your integrity. Most people are tempted to show how they cannot possibly be wrong. Most people want to prove not only that they are in the right, but that the other person-in this case, the patient-is wrong.
	
	It becomes a childish game of tug-of-war and putting any kind of effort or energy into making someone else wrong only causes a loss in the end; the cost of trying to make the other person see how right you are is significant. You could lose a patient, a family of patients, or worse, your own sense of honor. So if you’re not wrong can the other person be “not wrong” also? That is, can you allow for there to be two perspectives where both people are right?
	
	It’s unusual to think that way. It’s more customary to pick a side and then look for points that justify our stance. That’s called politics and thinking that way has no place in your practice. You got into the dental field to provide a service to other people, to help them get better in some way. So help them in this instance, too. Allow yourself to understand the other person’s point of view.
	
	

	Handling patient complaints starts with managing your responses to such assaults against you. Complaints are seldom personal. Think about the last one you heard. Think about the last one you gave – “This meal isn’t the way I ordered it.” That’s information, not a personal assault on the chef or the wait staff. A patient complaint about how you’ve run behind schedule or how a temporary looks or feels is not a personal slam. It’s information about the perception of the other person. Allow the information to be emotionally neutral. It is, after all, simply the other person’s perception.
	
	So how do you manage your responses? Begin by being grateful. The whole situation is likely to get significantly more calm if you approach it by being grateful that they brought the issue (their issue) to your attention. Stay curious, too. What is it about what they’re seeing that is an issue? What are you missing about what they’re saying? The most important thing to remember is that when a patient complains to you, they are giving you a valuable gift – the gift of information. Many people would simply, quietly, vote with their feet and abandon your practice. So be grateful when a patient is invested enough to tell you how he or she really feels.
	
	

Once you’ve adjusted your attitude, follow these steps:

	1) Apologize. There’s no tug-of-war if you refuse to pick up the rope. So, express your regret that the other person has had the experience that they have. (This step saves money! It’s true!! Sometimes the disgruntled will take a complaint to the point of lawsuit only because the other person didn’t apologize.) It doesn’t admit guilt and it doesn’t mean you’re at fault. Your apology is directed at their experience. If you’ve been accused of running late (again), try saying something like: “I’m so sorry that you’ve felt frustrated and delayed.”

	2) Inquire further. Sometimes people just want the opportunity to vent. Ask, “What else has happened in this practice that has disappointed you?” Patients will be surprised that you’re not on the defensive and that you’re actually taking an interest. It’s likely that you’ll get some further truth that you can use to help your practice get better. Honestly, wouldn’t you like to know that some elderly patients feel cold in the back? You could ignore that complaint because just about every office has trouble regulating the temperature from front to back. Or, you could take it as useful information and honor that patient’s experience. Perhaps your practice runs on time for most patients but by coincidence, this one patient has been made to wait the past few times he/she has had an appointment. Would you dismiss that information because you usually run on time or would you honor that information and acknowledge the patient’s experience?

	3) Are you getting the theme here? Honoring the patient’s experience is the key to maintaining a great, long-lasting relationship. Tell the patient how glad you are that they brought the information to you. Let them know that it’s really important that they feel comfortable in your office and tell them that you’re glad they’re invested in helping to make it better.

	4) Let them know that you’ll take action but don’t give away the store. It’s not uncommon to want to make everything right and then go overboard. Don’t offer 50% off of the next visit; that only trains the patient that you could have been offering deeper discounts along the way. Simply offer what’s appropriate to each situation. From the examples above, try something like, “Because you’ve said that you’re cold when you sit in the operatory, I’ll make a note in your chart to have a blanket ready for you. We’ll treat you like the VIP that you are.” Or perhaps, “We usually run on time but haven’t done so for you. To be able to treat you like the valued patient that you are, we’ll flag your next appointment, even making it at a slightly different hour so that we’re absolutely ready for you and you won’t be delayed.”

	5) Check with them that what you’ve offered is OK and find out if there’s anything else that they’d like to share with you.

	6) Follow-through. Do what you said you would do.

	Sometimes complaints are unwarranted. So, can’t patients be wrong, really? Yes, yes they can. The key here is to allow them to truly feel heard – listened to and heard. Then you enter from debate into the realm of dialogue and what they give you is simply information to be handled while you hold the emotion behind the words. Don’t dismiss it, hold it.
	
	The keys to your success can be found in your leadership and your ability to create positive relationships with your team members and with your patients. Successfully managing a patient complaint is the foundation for long-term partnership with each patient. Drawing a patient into the practice by allowing them to have opinions and acknowledging their emotions can result in the trust needed for positive referrals, greater case acceptance, and ultimately, the solid fiscal health of the practice.
	 

Dr. Wayne D. Pernell holds a doctorate in clinical psychology. He has been a full-time consultant with Pride Institute for over four years and boasts many successful clients across the country. Prior to joining Pride, Wayne provided management consultation and executive coaching services for leaders and their teams in companies such as Charles Schwab and Co., Whole Foods Market, and AAA. For more information on the Pride Institute, visit 

 or contact Dr Pernell directly by phone at (800) 925-2600 or by e-mail at 

 “You’re wrong!”  A patient complaint is as powerful as a slap in the face. The words sting and when they come from a patient it most certainly feels like a threat to your integrity. Most people are tempted to show how they cannot possibly be wrong. Most people want to prove not only that they are in the right, but that the other person-in this case, the patient-is wrong.

Handling the patient complaint

	What would happen if you could tell how a patient was feeling and could connect with that person instantly? What would the patient’s reaction be?

	The nature of the dental practice revolves around seeing people: people who come to you in pain, with fear or with potential excitement. Most certainly want something and don’t want something else. The key to serving them effectively is to enhance your role in the practice by remembering that each patient is human-vulnerable, excitable and emotional-no matter how they show it. And that information is essential if you desire value, commitment and accountability to ideal oral health.

	Being able to understand and respond to a patient’s emotional state is essential in building a relationship. Doing so, in itself, is the foundation for the partnerships with patients that make the practice stable and complete. Simply put, having rapport builds trust, and when you are trusted, your recommendations are more likely to be accepted. Rapport then leads to increases in efficiency, productivity and quality of care and service. In addition, people who trust you are more likely to say kind things about you outside the office and potentially refer friends and family members to experience that same level of care. Start with the focus on relationships and you will build a thriving practice.

	The key to building relationships is two-fold. First: Notice! Yep, just pay attention. Don’t get so caught up in being busy that you forget why you’re in the office in the first place. You’re there for your patients, so notice who each patient is and how he or she is really doing. The second part may seem counter intuitive and may take some practice. Don’t fix it.

	Most of us have a sense about how another person is doing. Sometimes we miss how other people are truly feeling because we’re busy formulating something to say instead of simply holding a space for that person. As stated earlier, the key is simply to notice. Okay, it’s slightly trickier than that because the art of “reading” a patient takes a bit of psychology.

	While volumes upon volumes have been written on this subject, below you’ll find some quick tips and reminders (since you do some of this naturally) for how to take a patient’s emotional temperature and then, how to respond (without fixing anything).

	Statistically speaking, somewhere between 70% and 93% of any communication is non-verbal or riddled with “meta-communication.” In all likelihood, meta-communication comes in at the higher end of that range which means that the words used in any verbal exchange account for only 7% of the message that’s conveyed by a patient.

	So up to 93% of a message delivered is not the words used!

	The rest of the message comes non-verbally, in the form of body language and the way the words are spoken. This may seem obvious, but sometimes we miss the obvious. So notice the way people stand, how fast they move and where their eyes go. Do they hold their heads up, keep eye contact and smile? Or are they slumping, breathing shallowly, and have their heads down with mouths slack?

	Besides listening to what is being said, deliberately notice the pace, pitch, tone and volume that is used. For example, people who know just what they want will stand very straight, hold direct eye contact and speak somewhat loudly and at a fairly quick rate. At the other extreme is someone who is fearful or perhaps slightly depressed. That person will keep his/her head lowered, hold limited eye contact, speak softly and breathe shallowly.

	Certainly there is a range of emotions in between. The key is to notice the other person as a person and not simply the next case of “broken cusp on 19.” Observe the patient behind the tooth number.

	You’ve noticed. Now what? The world of dentistry is one in which you’re trained to find a problem, focus on it and fix it. Here’s your challenge: Don’t fix anything-immediately.

	Practice “active observation.” By actively noticing how a people hold themselves, you’ll be able to ascertain their emotional state. For example, you might have a patient coming in for root canal therapy and a crown. Do not start with, “Lisa, you seem anxious about your visit today. Don’t worry because you won’t feel a thing.” Instead, start with, “Lisa, you seem a little hesitant about being here today.” Then just wait. That’s right… pause!

	Theorists in Gestalt psychology tell us that people rely on others as witnesses for their lives. Think about it. We tell other people stories about things that matter in our lives in order to get a reaction and to have shared a piece of ourselves. When someone notices something about us without us having to broadcast it, we feel cared for-usually.

	The way you deliver your message matters. You must match the patient’s emotional level with your own meta-communication in order to build rapport. If someone is feeling a little anxious and you come in booming loudly with a fast pace, there would be a terrible mismatch and the patient would feel judged and not heard. There would be no rapport and it’s likely you would lose the patient.

	Match the patient’s emotional state. If he or she is moving fast, head up and eyes making good contact, pick up the pace of your conversation. Match what you observe. If the patient is showing signs of fear or anxiety, slow your pace down, lower your voice and speak softly. Be deliberate and notice how the patient responds to you. The exercise of noticing gives you options for how your future conversations can be. And yes, sometimes conveying compassion has to be practiced.

	The whole focus of this topic is where you put your attention. Being able to observe the way another person shows up, determine his or her emotion and make a gentle comment that inspires additional conversation can and will enhance your relationships with your patients (and your team members).
	 

Dr. Wayne D. Pernell holds a doctorate in clinical psychology. He has been a full-time consultant with Pride Institute for five years and boasts many successful clients across the country. Prior to joining Pride, Wayne provided management consultation and executive coaching services for leaders and their teams in companies such as Charles Schwab and Co., Whole Foods Market and AAA. For more information about the Pride Institute, visit 

 What would happen if you could tell how a patient was feeling and could connect with that person instantly? What would the patient’s reaction be?