Laboratories: Getting it right

by Steve Anderson & Walter Hailey

What began as a leisurely afternoon drive with his recently turned 16-year-old daughter suddenly became a disaster for Dr. Johnny Bello. The young lady accidentally hit the gas peddle instead of the brake and launched the doctor’s new Acura Legend into the back wall of the garage. Without even leaving the car Dr. Bello knew the damage was extensive. For several moments he remained seated in silence. Collecting himself he turned to his daughter and calmly said, “That’s OK honey. We all make mistakes.”

When asked later what kept him from blowing his stack, his response was revealing. He said that as he sat in the silence of his damaged Acura he remembered a similar experience from his teenage years. Proceeding his daughter in what was now a Bello family tradition, he had wrecked his father’s car shortly after obtaining his license. He recalled his father’s understanding and knew it was the right thing to do when faced with the same situation.

But consider some of the behavior Dr. Bello learned by example and imitation in dental school. After spending hours waxing a tooth, with great exhilaration and anticipation he takes his work of art to his highly esteemed dental professor for approval. Following a close examination, that work of art, the product of hours of toil and tension, is mutilated and discarded by the professor. The accompanying comment is “I don’t know what you think you’re here for, but if you have any hope of becoming a dentist you’re going to have to try harder than that. Start over!”

As dental school continued, perfection and time were the watchwords of the day. Little if any positive affirmation of his clinical work ever took place for Dr. Bello. Rarely did he ever approach the professors for advice or help for fear of their response. Anonymity was safer than embarrassment.

If you think there is no correlation between how dentists were clinically instructed in dental school and how dentists treat their lab professionals, take our short quiz and see how much dental school may be impacting your behavior.

1.How many laboratories do you work with?

– 1 – 3

– 2 – 4 or more

2. When was the last time you switched labs?

– Within the last 12 months

– Within the last two years

– Within the last three years

– It’s been 4 years or more.

3.Why did you start working with the lab(s) you are currently using?

– My previous lab was doing lousy work so it was time to change.

– They had a better price than the lab I was using.

– They are local and close to my office.

– They came well referred by someone I trust and respect.

4.How often do you have to deal with lab work that is less than a good fit?

– Less than once a month

– Less than once a week

– Less than once a day

5.What do you normally do when you have to deal with work that doesn’t fit?

– I do whatever I have to do to make it fit.

– I just send it back to the lab and tell them to redo it.

– It is so rare, that when it does happen, we have a civil conversation about what the problem might be.

6. How would you characterize your relationship with your primary laboratory?

– When I send them work, they just do it and send it back.

– I only talk with them if there is a problem.

– We meet at least twice a year to discuss how we can mutually improve the quality of our work.

Assign the following points to the answer that you chose for each question:

Question 1:1.=20,2.=15,3.=10,4.=5

Question 2:A=0, B=5, C=10, D=15

Question 3: A=0, B=5, C=10, D=15

Question 4: A=15, B=5, C=0

Question 5: A=0, B=5, C=15

Question 6:A=0,B=5, C=20

How did you score?

— 90 to100 points: Put down this magazine, call your lab and celebrate. You are a great team!

— 80 to 89 points: You are well on your way to having one of the most effective dentist-lab relationships possible.

— 60 to 79 points: There are many areas that you could improve on.

— Less than 60: We need to talk!

We have worked extensively with dental teams throughout North America as well as with dental laboratories to improve their client retention and service. We know there is much that can be done on both sides to save time, money and stress. Through our experience we have found one critical underlying fact: the consistency and quality of the lab work you receive is directly related to the quality of the relationship and the communication you have with your lab professional. Great relationship…great results. Lousy relationship…lousy results.

Here are a couple of things to consider as you ponder your score and its relevance to your practice.

How many labs do you use? You may work with more than one lab because they specialize in different things. As a general rule the more lab relationships you try to maintain, the lower the quality of the work produced and the higher the level of your stress. The closer you move toward a single source supplier relationship that you can foster and build, the more consistent your work will become and the lower you will find your level of stress.

When was the last time you switched labs? If you find yourself switching labs often maybe it’s time to reconsider who has the problem. A good supplier relationship takes work just as does a good patient relationship. It doesn’t just happen. It takes both doctor and lab to make it work on a long- term basis.

Why did you start working with the lab(s) you are currently using? If you have ever changed labs because you said the work was lousy or that you could get a better price somewhere else, alarms should be going off everywhere. Price is the worst reason to change labs. There is always someone who will be cheaper. The question is what will they produce for the cheaper price? If you were not satisfied with the quality of the work, did you ever sit down and have a conversation about what you could mutually do to make things better? If not, you are likely to keep repeating the same experience with another lab… and another… and another.

How often do you have to deal with lab work that is less than a good fit? If remakes are a regular part of your life, there has to be a better way. It takes two parties to produce great results; a great dental team that is skilled at taking excellent impressions and communicating their expectations and a lab professional who understands that team and their objectives. If you don’t like the quality of the work, first start working on the quality of the communication.

What do you normally do when you have to deal with work that does not fit? How you handle things when they are not working correctly is critical. More importantly, how do you handle things when they do work? The blood pressure of the average lab professional goes through the roof when a call comes in from a doctor. Why? Because the majority of the doctor-lab communications are negative. If you want a better relationship with your lab and hence, better quality work, make sure they hear from you from time to time when things do work!

How would you characterize the relationship with your primary laboratory? We think there is only one acceptable answer to this question. The answer should be excellent. If this is not how you would describe your relationship we ask that you consider the following suggestions for getting back on track.

Since no one ever taught good lab relations in dental school, here are some suggestions to improve the quality of your lab work through the quality of the relationship you have with your lab professional:

Call your lab today and ask for a private meeting with the owner, account representative or the primary technician you use. You buy the lunch. They can’t refuse. If they do, check their vital signs! If they are too far away to have lunch, schedule a telephone appointment with them for at least 20 minutes.

The conversation should start with your explanation that you are totally dedicated to improving the quality of your work…constantly and forever. Tell them that you know it will take both of you working together to achieve this goal. With this objective in mind you want to discuss three things:

What things could you as the
dentist and your team be doing to help the lab produce the best quality product? (This might include everything from the quality of the impressions taken to the communication accompanying the work) Encourage them to be open and honest. Don’t be shocked if they don’t know what to say at first. It has probably been a long time since a dentist asked this question.

Would they be open to feedback from you regarding suggestions for improving the quality of both the end result and the relationship between both organizations? Be prepared to give them specifics. Don’t be afraid to ask for special service. Because you asked the question in the in #1 above and listened to the answer they will be much more willing to accommodate your most ambitious requests.

Would they be willing to have a similar conversation with you about the proceeding questions at least every six months? Schedule an on-site visit to your lab with your entire team if you have not done so within the last year. Take everyone on the team. Visit each department. Let your team see what happens at each stage of the process. Have the owner, account rep. and/or primary technician visit with your team so that you can create a two-way relationship of trust.

Schedule an on-site visit to your lab with your entire team if you have not done so within the last year. Take everyone on the team. Visit each department. Let your team see what happens at each stage of the process. Have the owner, account rep. and/or primary technician visit with your team so that you can create a two-way relationship of trust.

Fill out the feedback card that comes with your lab cases. Let your lab know when something is working. Appreciate them when things go right. Too often they only hear from dentists when things go wrong. (If you don’t get a feedback card with each case, suggest to your lab that they start doing that today.)

Make the commitment that you are going to view your relationship with your laboratory as a partnership, not “just a supplier.” You depend on them for the quality of work necessary to satisfy the needs of your patient. That consistently high level of quality can only be achieved through an excellent relationship and a mutual dedication to continual improvement.

To neglect the relationship you have with your lab is to neglect the quality of your clinical work. If you just do what comes naturally you are more likely than not to treat your lab professionals in the same way that you were treated in dental school; with something less than respect.

Just as Dr. Bello learned from his father, perhaps you can set the example for a new generation of dentists. Our challenge to you is to improve the quality of your practice by improving the relationship of trust and understanding with your laboratory. The payoff will surprise you… less stress, less chair time, more confidence in the quality of your clinical care, and a more satisfied patient. DPM

Steve Anderson and Walter Hailey are the founders of Dental Boot Kamp.