September 2, 2022
by Julian Perez, Chief Legal Officer at dentalcorp
The concept of mise en place (everything in its place), a modus operandi conceived and perfected in gourmet restaurants, could significantly improve the quality and consistency of the treatment and patient experience provided in dental offices. Those who recognize mise en place as a process and method of preparing high-quality meals in restaurant kitchens might wonder, “How is a line cook’s modus operandi relevant to the practice of dentistry?”
To answer that, consider a brief passage from Kitchen Confidential, Anthony Bourdain’s best-selling memoir in which the chef and journalist described mise en place as “the religion of all good line cooks.” Note that I have substituted the word “cook” with the word “dentist” to demonstrate the universal applicability of this concept.
As a [dentist], your station, and its condition, its state of readiness, is an extension of your nervous system… The universe is in order when your station is set up the way you like it: you know where to find everything with your eyes closed, everything you need during the course of the shift is at the ready at arm’s reach… If you let your mise en place run down, get dirty and disorganized, you’ll quickly find yourself spinning in place and calling for backup.”1
In a dental office, the “chef” or boss is the principal dentist. For a dentist, the physical “meeze” may involve a dental chair, patient, surgical kit, and handpieces. “Meeze,” however, has now evolved to something far more than the physical setup; it is a way of approaching any complex task. It is an organizing principle for life.
A 2014 Harvard Business Review article by Ron Friedman noted that the concept of mise en place has much to offer us all. He says, “The value of applying a similar approach and deliberately taking time out to plan before we begin is arguably greater” for those outside the kitchen. As an approach to masterfully executing a difficult task, mise en place comprises three core principles:
Preparation: planning the day ahead to set yourself up for success;
Process: constantly striving to find better, more efficient, and more satisfying ways to accomplish an objective; and
Presence: minimizing unproductive distractions so that you can be focused on the task at hand, centred, and in the zone.
In his 2016 book, Everything In Its Place: The Power of Mise-En-Place to Organize Your Life, Work, and Mind, Dan Charnas argues that by studying and incorporating some of the mise en place practices of master chefs, one can become more effective in their daily activities.
Charnas advises to set aside 30 minutes for a daily “meeze”. Just like chefs use their “meeze” to plan a dinner service, dentists can apply the same process to prepare for the patients they will see and the treatments they will provide the following day.
Charnas recommends a 30-minute-session at the end of the day with three objectives:
1) Cleaning your physical and virtual spaces,
2) Clearing your mind of the past day’s clutter, and
3) Mapping out the following day. A 30-minute daily “meeze” will save time, restore peace of mind, and result in a more enjoyable and profitable endeavor.
Here is how to create your own daily “meeze”:2
The ABC of mise en place is “always be cleaning”. The chef cleans as they go, and so should an expert clinician (and their team). The daily “meeze” is an opportunity to catch up on cleaning that could not happen in the moment. Start the “meeze” by organizing all the things you have accumulated during the day and place any items you used back in their proper places.
As oral health care providers, dentists should decide what actions to prioritize the following morning. This will help set the tone for an efficient and effective day. Steven Covey identified “Putting first things first” as one of the keys to success in his iconic book 7 Habits of Highly Effective People. Putting first things first is an essential element of the “meeze” and is about prioritizing effectively to avoid wasting time. Before leaving the office, clinicians should identify the instruments, information, or other resources needed the following day, and confirm they will be ready when and where required.
Successful clinicians have much to do outside the operatory. In contrast to the patient appointment, non-clinical time likely will not be scheduled by a treatment coordinator, however, it is just as critical. Mise en place will also help dentists maximize their time before, between, and after patients. Organized dentists will figure out how much time they have “free” on their schedule and place the above-identified actions into the unscheduled parts of their day. When one rushes, one ends up doing things twice and takes twice as long. As Abraham Lincoln said, “Give me six hours to chop down a tree and I will spend the first four sharpening the axe.” This is an efficient way to spend your “downtime” efficiently.
Getting ready for the next day means printing and/or reviewing your schedule and setting up the operatory for the first patients. Dentists will have team members assist with this task, but if an instrument is missing or is out of place, there is nobody else to blame. A line cook lays out the items in their station in the order they will be used. Dry items are placed behind liquid items, so they don’t get wet when liquid items pass over them. The same process should be applied in the operatory. Mise en place would help ensure the team knows what the clinician needs, and if they do not, take some time to explain things. When dentists create their own daily “meeze,” they can truly leave work behind at the end of the day while feeling confident and ready for the next day.
About the Author
Julian Perez is Chief Legal Officer at dentalcorp, where he oversees legal, regulatory compliance, corporate governance and enterprise risk functions to support practices in the delivery of optimal patient care. He earned his bachelor’s degree from Yale University and a JD from Columbia University’s School of Law.