Oral Health Group

The Total Team Concept: Doctor – Technician Relationships

September 1, 2004
by Damon C. Adams, DDS

Due to the growth in demand for sophisticated dental laboratory products, combined with this potential decrease in the number of experienced dental technicians, things are about to change in a big way! The time is coming when many dentists will most likely find themselves scrambling to locate, and then be accepted by, a higher-end dental lab capable of producing the esthetic and functional results they have been properly taught to seek. In fact, exceptionally trained dental labs are already choosing the doctors with whom they would like to partner, in order to serve the patient at the highest level possible.

Esthetic demands by the public, being driven by aggressive international marketing coupled with dramatic advances in technology, ignited this revolution in care that will most certainly continue to grow at a rapid pace. The public is becoming more and more aware of the possibilities available at the higher end of the dental spectrum. This is putting increasing pressure on all doctors and support teams, including their dental laboratories, to increase their knowledge and abilities to deliver a higher-end product along with exceptional service.


Our business vision should drive our practice engine

We must gather the knowledge and skills to be able to create a vision and practice (business) philosophy that will accommodate these new challenges. Hard work is needed in relationship-building skills, communication skills, teamwork, and inter-business networking skills. This will be paramount to any long-term business success for the well-run dental practice. These skills will also be vital to our business relationship with the dental laboratory. This is especially true if we are to take full advantage of any of the more functionally and esthetically sophisticated materials readily available to the patient-centered practice.

Is your practice on the same page as your dental laboratory?

As Dr. Bill Blatchford eloquently stated in the Journal of the American Academy of Cosmetic Dentistry (1998), “A strong vision demonstrates itself in every move you make as a dentist. Your actions speak your vision.”

Can you articulate a vision that will inspire you and your staff as your practice grows? That is the first accomplishment that must be achieved in order to have “actions that speak your vision.” Other team members should be considered in our overall plans as well. What is the vision of your dental laboratory? Is your practice vision compatible with your laboratory’s vision? Or, is the laboratory’s vision in conflict with, or maybe even diametrically opposed to whatever you see as your practice vision? The vision statement should be supported by an underlying practice philosophy that is realistic and inclusive of the kind of care that we wish to deliver. This vision should be parallel and symbiotic with the vision and business philosophy of our choice in a dental laboratory if we are to collaborate at the highest levels. Then we can put our collective vision into action and our businesses will become a synergistic firestorm of growth and ideas.

Is your business philosophy and methods for implementation of that philosophy consistent with the dental laboratory that you have chosen to do your work? Do you both believe in open and honest communication to improve the functional and esthetic end result? Are the doctor-technician ego barriers and prejudices that stem from past experiences put aside to allow a healthy flow of constructive, two-way criticism? Do you share a common goal of wanting to reduce stress and loss of profits by decreasing the incidence of re-makes through co-investigation and meaningful responses, regardless of who is at fault? Can you have an agreement to discuss what went wrong with a case and to be willing to share or accept the responsibility? Do you have a common goal of motivating all your team members with specific positive feedback when things go splendidly?

Can my office be on roller skates while my laboratory is on a luxury cruise?

Many doctors profess to practice in (what they believe to be) a fee-for-service based practice. Without realizing it, many of these same doctors, like their laboratories, are actually deeply engrained in a fee-for-commodity business philosophy. They are often hopelessly bogged down in an “all-my-patients-are-insurance-dependent” world. They feel they are on a no way out, dead-end professional ride. Does this have to be the case?

Frankly, this all boils down to some tough leadership choices in operating our businesses. How can we afford to get work from a high-end dental laboratory that puts the quality of its people and work first, above its production numbers? This is the kind of laboratory many like-minded doctors are now searching for in the hopes of achieving a marketing edge in providing superior restorations. Many of the teachers in well-known centres for continuing education are encouraging their attendees to select only the very best dental laboratories and to adjust the fees to their patients accordingly. It has been said that insurance or government determined fees are not compatible with a high-end, patient-centered, high-service oriented practice. As the CEO (leader) of our business we must sometimes make the tough decisions that will allow us the financial freedom to choose the absolute best team possible.

Our collective actions often speak louder than words or intentions. Let’s look at our professional dental meetings as a prime example. How many dental meetings have you attended in your career where the dental technicians are present in any significant numbers to exchange ideas and to help make an impact on the profession? (This assumes that they were officially invited and encouraged to attend mutually relevant meetings.) Of course, like some of our colleagues, there may be those who would not attend for any other reason than to fulfill minimum CE requirements. There may also be various barriers such as a bit of professional uncertainty or possibly even a negative inter-professional experience(s) in their background.

For many years now, the dental technicians have been meeting in Chicago at a separate location from their dentist colleagues. Meanwhile, the doctors and ‘all’ their staff members have been building their relationships and learning together as ‘a team’ at the Chicago Dental Society’s Midwinter Meeting. Can you begin to see what is wrong with this picture? What kind of message does this send to our valuable dental technician team members? Ideally, leaders in dentistry should be looking out for all the team members involved in the process of serving their patients. Maybe we have all been waiting for someone else to invite our dental technicians to join us? Perhaps, until now, we have not given it much thought. Leadership is about knowing when and how to empower all of our team members to become all that they can be.

United we stand, divided we all work harder!

Let’s look closer to home, in our own practices. Do you view the dental practice and dental laboratory as two separate business entities or do you see them as being on the same team? Instead of sending carefully prepared cases to a technician or the laboratory, I often encourage my colleagues to view their dental technicians as their extended staff. Even though the technical work is usually accomplished under two different roofs, and in distinctly different work cultures, the goal should be to identify and develop that which is most vital for our mutual success. It will be evident in the delivery of superior work for the patient. How can these moves toward a joint effort begin to take shape within your practice? Are you working with a laboratory that is truly compatible with your business goals? Is it even possible to be on the same page (vision and practice philosophy) with your current dental laboratory? How do we, as leaders in our business, reach out to our dental technicians?

Look in the mirror! What do you see?

Begin with an exercise that requires a little self-reflection to gauge current personal feelings and posi
tions on some important doctor-technician issues. Read the following questions and answer each of them “True” or “False”:

— I expect my laboratory to do work for me that meets or exceeds my expectations.

— I want my laboratory technicians to understand my needs, to appreciate and respect me as a caring dental health professional.

— I truly appreciate, respect, and value the relationship that I have with my technicians or laboratory owner.

— I have visited my laboratory at least once and have met all the technicians that work on my cases.

— I visit my laboratory occasionally to discuss a complex or an esthetic case and to build our working relationship.

— I have routinely taken, or at least invited, my technician(s) to attend relevant dental, management, marketing, or communication continuing education courses with the rest of my office team.

If you are like most doctors, the first two questions are no-brainers. It should have been easy to answer “True” to both. However, and more importantly, how did you answer the rest? Statements like, “I really care about my dental technician.” or “I deeply respect my dental laboratory.” seem to ring quite hollow if we cannot answer, “True” to all of the above. Please do not get discouraged as a result of this exercise nor the challenges contained in the many questions in this article. You are not alone. Nearly all of us have been through similar experiences related to our relationships with our dental technicians. I know that we would never be intentionally unappreciative of our laboratory colleagues. Let’s simply take the first steps at putting our revelations from this exercise into a perspective for growth. That is the total team concept! DPM

Dr. Damon Adams is from Traverse City, MI. He is an Assistant Professor, Department of Otolaryngology, at Medical College of Ohio. Dr. Adams is an internationally recognized speaker who has lectured and consulted for many dental organizations and laboratories including the Shaw Group of Dental Laboratories headquartered in Toronto. Dr. Adams is listed in Dentistry Today’s Leaders in Continuing Education.

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