Episode 702: Calibrate New Docs and Hygienists Like a Boss

 Tiff and Dana are talking about a shift they’re seeing in a lot of practices these days: Practices adding providers! The best way to bring on new folks means making sure everyone is on the page, and Tiff and Dana dive into proper calibration for both new doctors and new hygienists.

On the hygienist side (which you need to add if you’re bringing on new docs), consider scheduling regular meetings and getting perio protocols in place. For new doctors, establish those monthly calibrations and how exam flow will work.

The most important note is having systems in place to allow new hires to come on as seamlessly as possible.

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Reach out to Tiff and Dana: [email protected] 

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Transcript:

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0:00:05.8 Kiera Dent: Hey everyone, welcome to the Dental A Team podcast. I'm your host Kiera Dent. And I had this crazy idea that maybe I could combine a doctor and a team member's perspective because let's face it, dentistry can be a challenging profession with those two perspectives. I've been a dental assistant, treatment coordinator, scheduler, filler, office manager, regional manager, practice owner, and I have a team of traveling consultants where we have traveled to over 165 different offices, coaching teams. Yep, we don't just understand you, we are you. Our mission is to positively impact the world of dental. And I believe that this podcast is the greatest way I can help elevate teams, grow VIP experiences, reduce stress, and create A teams. Welcome to the Dental A Team podcast. Hello, Dental A Team listeners, this is Kiera and you guys, you are in for the best treat of your life, consultant takeover. That's right. Get ready. They're dropping some dynamite. Our consulting team is incredible guys, and we are so blessed and so fortunate to have them sharing tips and tricks with you today. And as always, thanks for listening. I'll catch you next time on the Dental A Team podcast.

0:01:12.9 KD: I'm so excited to have you here with me today, Dana. I love recording with you. And I've got some really fun stuff today. I like to bring you a ton of things, I like to throw you for curve balls but today I really like to bring you things that center and focus around team training 'cause I think you're really fantastic at that. And also hygiene, 'cause I was not a hygienist, you were a hygienist and so it really, I think ties those things together for me. So I've got some of that for you today. How are you?

0:01:41.6 Dana: I'm doing good. Thanks for having me. Thanks for always keeping me on my toes and switching it up. I like it.

0:01:47.2 KD: You're so welcome. You're so welcome. So something that I've been seeing in practices and I know I'm in person in practice, but you are seeing even more practices virtually and you're talking to them all the time. And I'm seeing this really big need for like calibration because I feel like there's so many providers and I don't know about you, but a lot of my practices that I've been in lately or that I have been consulting virtually as well have been adding providers. I've got like office after office after office adding providers and I've got so many practice owners that I've been working really closely with to pull out of the practice. They're like, they wanna do dentistry and they wanna be a dentist, but they don't wanna do it five days a week. They don't wanna like break their backs doing the dentistry and so they're looking for ways to add in someone else, another provider, an associate that can do what they're doing without them having to do it.

0:02:44.7 KD: So I've been seeing that a ton and really working with practice owners to strategically create the systems and the planning to be able to allow something like that. But then on the flip side too, you add a provider, we add a doctor, we gotta add hygiene, we gotta make sure we've got enough hygiene, for both doctors. So have you been seeing that kind of shift, Dana, as you're doing your coaching calls and your, your video team trainings and things like that over the virtual scene? Have you been seeing that as well?

0:03:14.8 Dana: Oh Yeah, absolutely. And not only like bringing in new providers or adding new providers, right? There's always in every practice in every everything, right turnover too.

0:03:23.6 KD: Yeah, yeah, yeah.

0:03:25.2 Dana: And sometimes we have to pivot, right? Team members are out on vacation or they're out sick, and so we just have to pivot as team members that are in the practice do. So yeah, I think we see it so much in dentistry especially.

0:03:37.8 KD: Yeah. Yeah, I think so too. And just for all of those listeners and viewers, we do this by video, which is still super weird to me. But for all of you guys watching and listening like that is something that the Dental A team works really strongly with and really hard on with practices, is to ensure that you guys are prepared for whatever comes at you. Especially when it comes to hiring, onboarding new team members, making sure that they're ready to go, making sure that you have the systems and the protocols so that it's really easy. I think one thing that we do really well, Dana, is to ensure that that onboarding process is as seamless as possible so that you are not, the providers or the other team members aren't having to take away a ton of time from their days to train this person.

0:04:20.8 KD: Because I know, in dentistry our go-to is like, hey, this is the person I want you to mimic. So like, thrown to the wolves, like go do your thing. Especially our dental assistants, like I need a dental assistant, so I hired a dental assistant, so I need you to just be chairside, but it doesn't always work. So I know all the consultants work really hard with our practices to make sure that they're prepared for things like that. And one of the pieces that I think works the best that, that we've worked with, we've all worked with a ton of practices on, is really calibrating the procedures that they're doing. So I wanna speak on hygiene first because I don't think, I think a lot of doctors here like doctor calibration and we talk about it and we will talk about that, but I don't think that we consider the pareo calibration or the hygiene department calibration in a whole.

0:05:05.7 KD: And I think hygienists are just like in their own little silos in their rooms all day by themselves doing what they want to do, which is great because they for the most part are providing great services, right? But there's no, there's not a lot of sense of like team comradery because you guys are just stuck in your little hole all day. And then we're like, wait, why is this, why are you doing this differently than she's doing it? And it's like, well, because I do it my way. So Dana, is that, do you see that in your practices first of all? And then on the hygiene side, like you in practice, is that kind of, does that speak to how you might have felt?

0:05:45.7 Dana: Oh, absolutely yes. I for sure see it in the practices that I work with. And I know like as a hygienist, when I was in practice, I had to purposely, first of all, I was in the operatory all the way at the end of the hall.

0:05:57.2 KD: Of course.

0:05:57.8 Dana: So if I wanted any team member interaction, I had to be super purposeful about getting out of my hole. And even saying hello to some of these team members. So could I just be there in my silo doing my hygiene how I wanted to do it? Absolutely. So that's why I agree with you in that this calibration becomes really important because one, it becomes important as team members even like us speaking on hygiene specifically, right. To learn from each other. That's one of the benefits of being in a practice where there's more than one hygienist is you get the opportunity to learn from each other and calibration is a really great tool for that. And the other thing is too, like patient experience, right? And I'll use the practice that I go to personally, like I love them, the dentist is fantastic, but I know that if I want a rough super deep cleaning, I'm gonna go to one hygienist.

0:06:49.4 Dana: And if I want the general hygienist who isn't gonna bother me about my bleeding on eight and nine and seven and 10, like I know that I can go to her, right? So from a patient experience perspective, ideally we want no matter what hygienist you see, right? You get the same type of preventive treatment. That you're not going to see one hygienist and they're gonna say, hey, you need SRP, but then you see another hygienist and she's like, hey, you're kind of borderline, like we're still do a normal cleaning, right? That can very much affect patient experience and we also want to prevent that and calibration does that as well. So calibration kind of hits both sides of the coin, it helps steady and stable your team members and it helps up that patient experience.

0:07:33.0 KD: For sure. I love that you pointed, you pointed to that. There are a few things in there I think are huge to calibrate on, especially patient experience. I tell my practices all the time, and I just spent, I just spent the last two days this week with an incredible practice. They have two locations and honestly they're doing so many things really really well. Like, I went in and was like, what are we gonna do? 'Cause they're just killing it. They're doing so well and it was so cool. But then I think, what I noticed really quickly was they just have so many different doctors. They've got a lot of doctors, they've got a lot of hygienists and all of the providers and some of the assistants flip-flop offices. So every provider except for one doctor, and the hygiene are kind of like hygiene, kind of stay where they are, but not always.

0:08:25.5 KD: But the doctors are flipping and flopping back and forth between the practices hitting both of them. So I'm like, okay, there's, yesterday there was a little patient card, like our hygiene card, right? So the dental assistants in one of the practices have this little card and they jot down all of the important things that the doctor needs to know and they stick it right by the tray, doctor comes in and looks right at it. He only gets it at that one practice from his assistants. And I said, well, wouldn't it be fantastic if your hygienists were doing it at this practice too? 'Cause he said, I walk into hygiene and sometimes I don't remember the patient's name and they have the wrong chart up. And so I said, well, what's working in dental? Like what's working on your side that could work in hygiene?

0:09:06.1 KD: And then flip side to that, if you are used to something here at this practice and then you go to the other practice and you don't get it, you're gonna fail. Your fail safe is gone. And so any kind of habit that they're trying to create has been removed. And so it swings back to that patient experience, right? Because if the doctor or the hygiene's experience is different, the patient's experience is going to be different. So I think making sure that we're looking at those pieces, that one, the pieces that you implemented, making sure that they're actually getting used and they're being implemented. And then two, making sure that we're super consistent with anything that we do swings back around to that perio piece, right? I have so many hygienists in my practices all over the country that say, you know, I've been here for 19 years and I've been seeing these patients forever.

0:09:58.1 KD: How am I supposed to tell them that they have perio today? I'm like, well, they're 19 years older than they were when you started seeing them. So just time alone tells me that something could have changed even if they were consistent every six months. Like just time alone and age alone tells me that there's a lot of things changing here. And I heard a statistic not that long ago that said, I think it was every six years, I think it was six, don't quote me on that. Every six years your cells completely regenerate and become different than they were before. I'm like, well, just that alone I could, I could walk in and have perio. So it's just interesting to see that. And I think Dana, like what do you do with your hygienist that helps create that consistency? And especially when you've got a seasoned hygienist or you've got, I also have the flip side, right? Where newer hygienists are coming in where seasoned hygienists were and they're like, these patients probably should have had perio for years. Like how do you train on that? What is your suggestion for calibrating for them?

0:11:00.9 Dana: I think one, first of all, let's create the perio protocol. And this can differ office by office. So when we have several hygienists and they all have their different unique backgrounds, right? They're gonna default to what they know. So if you don't have a perio protocol in place for them to follow, they're just gonna default to either how it was done at their last office, how they learned in hygiene school, how they've always been doing it, right? So you're gonna get a mixture then of perio diagnosis coming from based, you know, vast variety of experiences. So truly coming up with the protocol in your office. So going down through each perio procedure, right? Do your, scaling in the presence of gingivitis, right? What does that look like? How many bleeding points is, because again, the definitions of these can sometimes be a little bit broad.

0:11:47.6 Dana: So generalized bleeding, what is that in your practice? Is it bleeding in all quadrants? Is it 20 or more bleeding points? What does that look like in your practice? And define it. Okay. And then define the process, right? If they're gonna have it, when do they come back? How often do we see them? Really outline when it is appropriate for a patient to have that service and then what that service looks like in your practice. And then go through all of them. Do your localized, do your generalized SRP, do your follow-ups for those, and then perio maintenance, right? And really establish what the protocols are in your office. Now some offices have a perio protocol and that's great. But again, calibrating on that, using it, right? So having your hygienist meet initially when you create it, I'd say at least monthly after that, maybe even revisiting it every quarter.

0:12:41.2 Dana: Pull out those FMXs, pull out that FMP and sit down as a hygiene team have everybody write down what they would recommend. Okay. See if it's different. Talk about why. Again, that's where you learn from each other. You're talking about why you picked one versus the other for this specific patient. And two, challenging yourself to no judgment, right? Looking at how did we treat the patient too. So if these are patients of record, how did we treat them the last time they were there? How did we treat them? And if it's different than what we said we would do now after establishing the perio protocol or reviewing it, have the conversations with each other. Role play them. Right? Figure out what you're going to say to those patients. If you're going to focus on, look, this is what you present with now. These are what the numbers are telling me today, right? Focusing on the present with the patient, but really role play. Because if you can't have those conversations with each other, you're certainly not gonna challenge yourself to have them with patients. So really digging in and making it so that it's easy then to use every day. 'Cause it's fine to have it in writing, but if we don't know how to use it and we don't know how to have those conversations, we're still not gonna be calibrated.

0:13:52.0 KD: I love it. I love it. And I think on those, I think calibrating, like you've gotta have a monthly meeting at least, right? For, especially for hygiene. And it's again, to review the protocols, make sure that, make sure that they're in place, that they're being used. And I think the verbiage is huge. And then I would say, and this goes for doctor calibration too, so we'll talk about that in a second. But I think with those hygiene calibration meetings and putting those things into place where you can do all of those things that you just mentioned, Dana. I think also looking at case acceptance, diagnosis, look at cases, because a lot of times I see associate dentists come to the owner doctor, right? Or a more seasoned dentist, associate dentist. And they'll say, hey, like, what, what's going on here? Like, this is what I thought, but like what do you see?

0:14:40.6 KD: But I never see hygienists go to another hygienist and be like, hey, this is what I, this is what I thought, or this is what I tried or what would you have done here? Like, rarely. I can't say never right? Never say never. I can't say never, but I rarely see that happen on the hygiene side. And I think it's because we forget that we can do that and we don't have it in place. We don't have these meetings and you're just siloed in this little corner all by yourself thinking you've gotta tackle the world and that everything's on your shoulders. And it's not like we've got a team behind everyone, especially in practices where there's multiple hygienists and when there's not multiple hygienists, I think the hygienists and the doctor need to have those conversations in that communication. So on the doctor calibration side, I think hygiene calibration is huge because of the perio.

0:15:28.0 KD: There's just so many inconsistencies and you, you hygienists are like, you are the, you're the piece that really holds the patient experience in my opinion. Like that is just the biggest piece of that, the experience. It's where it all, you know, culminates. So doctor calibration then is like the exams number one. So hygiene should be able to say to our doctors, like, hey, your exams are way different, right? Or if you're not getting a good co-diagnosis from your hygienist or refusal of co-diagnosis usually means that our doctors aren't super calibrated and they don't know what their doctor's going to say, from one doctor to the next, or the one doctor they have is like all over the place and they're not even calibrated themselves. So then hygienists and dental assistants shy away from that co-diagnosis. So with the doctors, they need to calibrate on diagnosis.

0:16:20.0 KD: Like what, what is what? What are you going to do in these situations? And treatment, like how are you going to do the treatment? What products are you gonna use? So what filling material? I get a new associate in and they've been using something, some prime bomb filler over here at this practice or at school, and they come in and they're like, I've never seen this flowable before in my life, what am I supposed to do with it? And we just expect, again, for people to just jump in and do it like we do. And then we wonder later, why is my associate schedule dead? Why is there, why can't we hit production Dana? Why? I give them all the new patients, right? I have a practice that said this to me and I worked with him really hard on tracking all of the diagnosis from his associate because he is like, I literally give him 40 new patients a month and his schedule is open tomorrow. I'm like, well he's not diagnosing. You've got to have calibration meetings. You've got to look back at, case studies and together really figure out what's the gap because there's a gap somewhere. And it doesn't mean that I need over-diagnosing or I want an over-diagnoser to be training an under-diagnoser. Like, you guys gotta come, just like we said with hygiene, you gotta come to the middle and figure out what that looks like. And Dana, what kind of frequency and kind of training do you typically see or do with your practices?

0:17:42.9 Dana: Yeah, I think kind of the same thing as far as hygiene. Like I think at least monthly, right? And I think that it is pulling FMXs, it's writing down what you would, what you would diagnose and then two, even further than that sometimes really it is having a steady exam flow, right? That we know that talking about these things in this order really, really work. Yes, all doctors are gonna have their own flare to that, their own like little spin on that and that's fine, but when things work right, let's stick with them and let's make sure that everybody is doing them consistently. So I would say first and foremost, just having those monthly touchpoints, start doing like start focusing on diagnosis in the beginning especially when you bring a new provider on just to make sure that you are calibrated in that.

0:18:32.0 Dana: Two, the other thing as far as calibration is often times, and I don't know why, but I see a lot of practices when we bring in a new doctor, give them your strongest assistant, right? Give them your assistant. [laughter] 'Cause oftentimes we bring in a new assistant for them who doesn't know, like, who isn't calibrated with our team either. So even another tip for that is put them with your strongest assistant or the assistant that is with you day in and day out. Because one, they can give you feedback on diagnosis, they can give you feedback on that calibration and they can kind of point you in the direction of like what's needed and stuff like that. So I think, that's a tip for that in figuring that out. But then I do think, yes, having those monthly meetings, pulling those FMXs, walking through the diagnosis together and then coming up with a protocol for your practice. Like, how, what do we treat? What do we do when we see x, y, or z on an x-ray? What do we do when a patient presents with, you know, a crack or whatever the situation is, really outlining the standard of care and the protocol for your practice.

0:19:38.3 KD: Yeah, I love that. That was really smart. So I think we'll pull out a couple action items because I think that there's some really easy action items that they can implement that will get this like ball rolling and then you guys can add onto that from there. So I'll start with the doctor side 'cause we just talked about that. So I think the pieces that I pulled out that seem to be the most important to me are making sure that you've got at least one time a month doctor calibration meetings where you guys are pulling case studies, you're looking at x-rays together, you're looking at diagnosis and case acceptance for sure. So we wanna make sure that they're, that everyone's diagnosing similarly, but that you guys don't have these gaping differences in the dollar amount that you have diagnosed, if you're seeing the similar number of patients, at least. So things to get started right away, schedule your doctor calibration meeting and let that first meeting be a review of a couple new patients, a handful of new patients that have been seen in the practice by each doctor, and then get your exam flow calibrated.

0:20:38.1 KD: I think that was brilliant. Make sure that your exam flow is the same because if your hygiene team, if your hygienist can count on that, they can lead you anywhere. They can lead and guide you anywhere. But when we've got doctors, I worked with a practice that had this, most of the doctors were like, you know, top to bottom we just, we go in a little circle, it's perfect. Upper, you know, upper right to lower right, like we just all the pieces. But then we had a doctor who would be like, oh wow, number two looks, you know, number two looks a little suspicious, remind me to come back to that. And then they'd be like, oh, number 28 is a little wild. And then 14 and then 27 and then, you know, and then 18 and then four, and the hygiene hygienist was like, I can't, it was so confusing that the hygiene team struggled to help direct and that doctor ended up not diagnosing anything.

0:21:30.4 KD: Everything kept being watches and it was because that doctor was jumping around so much. So that exam flow makes a huge difference. It takes some of the chaos out of your brain and then you can focus on what it is that you're trying to do. So if you are in this flow, in this routine, you've taken some of that thought process out and your diagnosis will automatically go up. You won't be missing things. So schedule that first calibration meeting with all of the practices doctors, get that exam flow going. And then I surely agree, I just had this conversation yesterday, with my practice that I was at and they said, we've got a new doctor onboarding, and we've got a couple new assistants and those are his assistants, and I said, awesome. And I'm talking to the lead assistant and I said, great.

0:22:17.0 KD: So you are gonna train the doctor when that doctor comes in. Or your next step, your right hand, because if you put these new assistants, even though they will have been there for a few weeks now, when he starts, you've got new training new and it's not gonna be the same. You're gonna lose all of the consistency. So your strongest assistant or their right hand should be the one that's training your doctors. And then they should be training the assistants and the doctors and then they can exit and then you're just calibrating from there to ensure that it's working. So schedule your doctor calibration, have that exam flow going, schedule them out and also schedule your hygiene calibrations. And on your next hygiene on that first meeting, I want you guys to do exactly what Dana said. Get that perio protocol in place.

0:23:05.5 KD: If you already have one review it. Does it need to be updated? Is everyone using it? Do we have a quick guide or a cheat sheet? And what does our case acceptance look like? So go bust those out you guys, those were some really great tips on how to calibrate your practice. And just keep in mind, something that just like, while I was in practice this week just kept coming up. So I know this is important for everybody to hear right now. Consistency is key. And if you're doing, if someone's doing something one way and someone else is doing that same thing a different way, if it's having to do with the patient experience, your exam, anything going on in the back office, that creates chaos. So make sure that everything, every system is consistent and that it's used every single time. Dana, anything you wanna add to that little snippet? That was a good one.

0:23:55.4 Dana: No, I think you wrapped it up perfectly. I think there's a ton of takeaway in there that I think teams run and go start it right away, but I think you wrapped it up perfectly.

0:24:03.7 KD: Awesome. Awesome guys, go have fun. Go get those calibrations done. Reach out to us, let us know what you think. We always like to hear from you guys at [email protected] shoot us over an email if you have questions on the calibration, but also when you win, tell us when you win those calibration meetings, and drop us a little five star review and let everyone know how good those calibration meetings go for you. Because they really are game changers and people really do read those. So if you've got tips and tricks add it in there, people are looking at them all the time. That's a wrap guys. Thank you so much.

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0:24:39.4 KD: And that wraps it up for another episode of the Dental A Team podcast. Thank you so much for listening and we'll talk to you next time.

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