Ep #22: Creating the Culture for Success with Dr. Joel Small

Welcome to Practicing with the Masters for dentists with your host, Dr. Allison Watts. Allison believes that there are four pillars for a successful, fulfilling dental practice: clear leadership, sound business principles, well-developed communication skills, and clinical excellence. Allison enjoys helping dentists and teams excel in all of these areas. Each episode she brings you an inspiring conversation with another leading expert. If you desire to learn and grow and in the process take your practice to the next level, then this is the show for you. Now, here’s your host, Dr. Allison Watts.

Allison:       Welcome to Practicing with the Masters podcast. I’m your host, Allison Watts, and I’m dedicated to bringing you masters in the field of dentistry, leadership, and practice management to help you have a more fulfilling and successful practice and life.

For those of you that don’t know Joel, I met him years ago, but I actually didn’t know he taught leadership until I had a man email me, oh, I’d say several weeks ago now. He was talking to me about leadership and how many courses he’d been to and that one of the best lectures he’d been to was Dr. Joel Small. I just thought, “Oh my gosh, I didn’t even know that you were doing that.” We used to be in a study club together.

Joel is a fantastic endodontist. I get a feeling that you have a pretty neat practice from reading your book, Joel. I know you’re an endodontist, a speaker, a writer, and an entrepreneur. You’re a cofounder of the North Texas Endodontic Associates in Plano, Texas. And that you have 30+ years as an endodontist. How many years have you been in practice, Joel?

Joel:           I’m in my 36^th year.

Allison:       Okay. All of those have been in private practice?

Joel:           They have. That’s correct.

Allison:       Okay. You have your post graduate training in endodontics at University of Texas Dental Branch in Houston. Received your master of business administration degree—wow, that was brilliant—with an emphasis in healthcare management from Texas Tech University in Lubbock.

Throughout your career, you’ve remained committed to your profession. He has served the American Association of Endodontists as a member of numerous committees, including his service as a trustee of the research and education foundation. He’s also served the AAE as one of their national spokespersons. He’s past president of the Southwest Society of Endodontists.

He speaks nationally on topics of leadership, practice management, and specialty practice transition. He and his partners in North Texas Endodontics Associates have published numerous clinical research articles in various general and specialty dental journals throughout the United States and abroad.

He is the co-owner also of Phase II Associates, which is a dental practice brokerage firm in Dallas, Texas, that deals exclusively—which I just learned it’s not exclusive anymore—but he has been doing exclusively practice transitions for specialists.

Most recently, Dr. Small has written a newly released book, Face to Face: A Leadership Guide for Health Care Professionals and Entrepreneurs. I just learned that you are expanding your brokerage firm to start helping general dentists but only in the Dallas area. Is that what you said?

Joel:           Well, north Texas, we’ll be throughout north Texas.

Allison:       Okay.

Joel:           Yeah.

Allison:       Yeah, you have a friend of mine, going to join you doing that. That’s great.

Joel:           Good. We’re very excited to have Lynne on board. That’s wonderful. She’s a wonderful person.

Allison:       She is. So we’re so excited to have you here, Joel. I’ve respected you for a long time. I appreciate you spending your evening with us. I just wanted to start, I read your whole book and I really enjoyed it.

Joel:           Thank you.

Allison:       If you could just maybe start by I think most of the book is centered around what we would call values-based leadership or the values-based practice. Can you tell us about that style of practice versus the other style of practice that you mention in there is results-based?

Joel:           Right, right.

Allison:       And the difference between those two? And how we get to a values-based practice?

Joel:           Well, I’d love to—by the way—anybody that wants to ask questions, please feel free. I was saying before most of you got on that it’s always a little bit intimidating doing a phone lecture because you can’t see your audience, you can’t look them in the eyes. You don’t know if you’re connecting with them. So if there’s anything that I’m saying that you need further confirmation or explanation of, please feel free to chime in.

Allison, I’m going to back up just a little bit from where you wanted to start and say that I’m living proof that people can change because everything I write in my book and everything I talk about I learned because I did it wrong initially and I learned how to do it right eventually.

So please understand that I’m not here to lecture to anybody, I’m here to share information and let you know how my life was transformed through values-based leadership and how it’s transformed my practice. That’s not to say I’m an expert because I don’t think there’s anybody that’s in the field that’s a true expert in leadership because there’s so many facets of it.

After 27 years of endodontic practice, I finally went back to school, which is something I’d always wanted to do. I got my MBA at Texas Tech University. Among all the different topics that we discussed was this section on leadership. I became so mesmerized by the topic because in studying leadership, I saw why things I did in the past didn’t work and why certain things did work.

I started to develop a crystal clear view of how we can change and transform our practices through values-based leadership. You mentioned results-based. Results-based leadership has nothing to do with transformation. It’s a transactional relationship. There’s a difference between transformation and transaction. Transaction is a quid pro quo which the Pankey people understand very well because I think that’s in your motto. But quid pro quo is basically tit for tat. You do something for me, I do something for you.

So in essence, in a practice, if you have a results-based practice, you have a quid pro quo or transactional-based business in which people work for a salary. If they don’t work, they don’t get paid. If they don’t get paid, they don’t work. In a transformational relationship, everybody benefits. Everybody is made better as a result of the synergy of the group.

Unfortunately, and I say this because I experience the same thing, dentists do not understand leadership. It’s not our fault. It’s that we’ve never had training in it. We’ve never had the opportunity to study leadership and to appreciate it.

Understand that leadership is now a 12 billion dollar a year industry in the United States and growing rapidly every year. It is the single largest expenditure of corporations in the United States for staff training, is in leadership. So there’s something that business understands that dentistry is just now starting to see. It’s very significant. Anyway, that’s the differences between those two types of cultures.

Allison:       I’m curious…

Joel:           Go ahead.

Allison:       I’m curious if you have a thought about, I’ve kind of come to see and I know that Mac and I were going to try to get Brian DesRoches to come down and do a thing. I know you know Brian but I remember Mac saying, he said, “When I am having a clinical thing, a clinical meeting, or course, or something, seminar. I can send out, let’s say I send out 500 invitations and I’ll end up with 50 people in the class.”

Joel:           Right.

Allison:       “When I’m having something about leadership or soft skills or something that’s not clinical, I have to send out say 5,000.” It was a lot more things he had to send out to get the same amount of people because percentage-wise there aren’t as many people that are interested in these skills. Why do we as dentists think we can just—I mean, I did it too when I first came out. I just thought that if I just build it they will come. If I do great clinical dentistry I’ll be successful.

Joel:           Sure, and that’s a very excellent question. I wrote about this in my book. This is what I believe anyway. Whether you believe it or not, listening, I’d be interested in your comments.

I truly think that dentists are systems-based people. What did all of you do that are dentists when you got out of school and you started your practice? You called people up and you said, okay, I need to know what do I do here, what do I do there. Or you called a consultant that came in and they setup systems for you. So you manage systems. We become very adept at managing systems in our business.

Then the consultants that we hired, and I hope there’s no consultants on the call here because what I’m going to say, I’m going to temper it in just a minute, but consultants basically teach management and managing systems and tell you you’re leading your practice when nothing could be further from the truth. The fact of the matter is that management and leadership are very unique skills, almost exclusive as far as the skillsets required to become a manager versus a leader.

We think we’re leading because we’re managing our systems. You know, we’re managing accounts receivable, we’re managing this system, we’re managing that system. But we’re not letting the people underneath us do the work. We’re managing it for them. If you read the book called E-Myth, it’s written by Michael Gerber, has anybody on the call read that book?

Allison:       I have.

Joel:           Okay.

Allison:       They can’t—unless they raise their hand. Y’all could raise your hand if you’ve read it.

Joel:           Well in the E-Myth he makes a very good point, he talks about entrepreneurism and that’s really what we are, entrepreneurs. We are small businesses. We are small service-oriented businesses and we’re entrepreneurs.

An entrepreneur many times is a technician that doesn’t have entrepreneurial skills. What that person does is they start to acquire all these systems: accounts receivable, accounts payable, marketing, scheduling, everything else. But they don’t have the people underneath and they haven’t developed the people underneath them to run the systems.

So basically what you’re doing is you’re juggling all these balls in the air. The more you add to it, the more balls you’re juggling in the air. Then eventually, one of those balls is going to start to fall and the whole thing starts to crumble.

There’s a point in every practice, in every business, where you realize something’s not right. I’m doing too much. I’m burning out. We’re not being as productive as we can be. I need some help. So then is when a lot of people call in the consultants and honestly, I don’t think they’re a huge help to us because they’re still teaching us to manage a system.

Allison:       Yeah, that’s been my experience as well. I think some of the consultants now are starting to talk a little more about leadership. But I know back when I first started, I didn’t get much of that. I agree. I’ve never heard that point made, that’s great. I think that’s right. That was my experience as well.

Joel:           Right.

Allison:       I felt like I needed to have all my systems in place. I would go, I don’t know where I went, to get all those things. But I needed them all written out and I needed to tell everybody what they were supposed to do. [Laughs]

Joel:           Right.

Allison:       Instead of empowering them to…

Joel:           There’s a great book that just came out by the way. If you all want to write it down, it’s called Multipliers. I think the author’s name is Liz Wiseman.

Allison:       Okay.

Joel:           In the book, she talks about leadership. Leaders should become multipliers. What they do is they multiply the knowledge and the skill of their business. As opposed to someone in the book that they refer to as a diminisher, which is somebody that diminishes the knowledge and the skill of the business. Some of the issues we’re going to talk about tonight directly impact whether you become a diminisher or a multiplier.

A multiplier has a culture that’s very collaborative. It’s a different type of culture. Whereas a diminisher is a micromanager and is overseeing everything and not allowing their people to stretch their knowledge. In fact, studies will show that diminishers are only getting 20 to 25 percent of their people’s potential. Now imagine if you were a diminisher you could become a multiplier and you can go from 25 percent to say 90 percent of your staff’s capability. What that would mean to you? What would that mean to…

Allison:       Oh my goodness.

Joel:           I know. What would that mean to you as far as not having to micromanage everything? To have people underneath you that are not only committed to your culture, they’re very skilled, they know what to do on their own. It allows you to move beyond the management of people to the management of process, which is a much more creative mindset for the business owner or the practice owner. Then you get to do the creative things.

But how can you do creative things when you’re constantly being pulled down in the muck and the mire by issues like staff tardiness, poor attitudes, people not showing up on time. Those are the kind of things that keep you from becoming that multiplier, becoming the kind of leader you need to be.

Allison:       Yeah. So let’s talk about that. Those are real things that we deal with, the tardiness and all that. Are you saying that having this type of practice, which we’ll get into here, right? Because we’re going to talk about the values-based practice and you’re saying that that becoming a multiplier and having a values-based practice basically gets rid of that?

Joel:           I think that in order to be a multiplier, you have to identify your values.

Allison:       Okay.

Joel:           That was one thing I know we were going to talk about, we call the core ideology, which is your purpose and your values. Those two things together become your anchor. Your core ideology, which is your purpose and your values, they’re vital reference points for us as human beings and as professionals. When the wind is blowing everybody off course, if you have good values and a defined purpose, you’re going to stay the course because you can always go back to those. That’s always your number one position and your fallback position.

So it’s important that we define those things. Allison, you and I were talking yesterday, that’s probably the hardest thing any of us can do is to really define who we are because we tend to go on our reputation which is defined by others. Because you’re a great dentist, you do great work, you’re a great endodontist and all of a sudden, okay, then that’s my identity. I’m a great endodontist. I can do this and I can do that.

But that’s not the real you. The real you is your character which is internally defined. In order to find that out, it’s a very introspective process and sometimes it’s not a fun one because we see some things about ourselves that we wish were different.

Allison:       Yeah.

Joel:           And we have to be willing to change that.

Allison:       And that process, we talked a little bit about that yesterday. I noticed for me, you know, I had people tell me that I needed to do my vision, and my mission, and all of that. I did do that, to a certain extent, but it’s ever-changing, right?

Joel:           Absolutely.

Allison:       So it’s not, for one thing, it’s not stagnant. It’s not something you do once and then you’re done. A process, you said.

Joel:           Well your values and your purpose really don’t change. Those are the two things that are immutable. In fact, there’s a book, it’s called The Living Business. The author’s name is Arie de Geus, D-E-G-E-U-S.

Allison:       How do you spell Arie? A-R-I?

Joel:           A-R-I-E.

Allison:       Okay.

Joel:           Phenomenal book. He actually worked for Shell Oil Company overseas and was hired to research why certain companies lasted through generations and generations and others failed and floundered. He actually found a company in Scandinavia. It was a family-owned company that was 500 years old—500 years. You can imagine how many political and geopolitical changes took place in 500 years and that company was still owned by the same people.

Allison:       Wow.

Joel:           Now, they started out as a ship building company but as time changed and that wasn’t profitable, they went into forestry and then as time changed, they went into blah blah blah. They must have changed four or five times, but they still kept the same principles and they kept the same values and the same purpose for the whole 500 years.

His thesis was, is that companies that maintain those types of cultures in which the values and the purpose are immutable, are the ones that are sustainable. Those are the sustainable businesses. It’s a fascinating book if you—oh gosh, I’ll look it up while we’re talking but I’ll give you the name of it. But the author is Arie de Geus. It’s a great book.

Allison:       So that process then that I experienced was more of a process of uncovering my true values.

Joel:           Right.

Allison:       Not so much that they changed, even though that’s what it felt like.

Joel:           Right.

Allison:       Okay.

Joel:           Yeah, we all have the store window values that we think everybody wants to see when they’re shopping. We also have the ones that are the true us. In our practice, we have kind of a unique group. I’m from Texas, I have an Irishman and I have an Australian, both of which were here on green cards as partners. So we have come from varied backgrounds so when we did think like this, it was really interesting.

One of the values we came up with was freedom. Everybody said, well that’s kind of strange because you know, most of the values are kindness, integrity, and that type of stuff. The reason we chose freedom is we always want to be able to do and become the people that we want to become irrespective of what was going on in our business.

So we’ve lived together for now, David’s been with me 15 years, and John 10 years. We always support one another. David just got his masters of fine arts and I just got my MBA and John is a photographer and a cook, a gourmet cook. So we always are supportive of one another. But that for us, that was important. So values don’t have to be what other people think they should be. For us, the thought of freedom was very important so we included that in our values statement.

Allison:       Cool. So one of the things I thought was really exciting in your book was that you said that, for me, I love the whole conversation about self-awareness.

You said that when 75 members of Stanford Graduate School, this came out of a book called True North, when the 75 members of Stanford Graduate School of Business’s Advisory Council were asked to recommend the most important capability for leaders to develop, their answer was nearly unanimous self-awareness.

I thought that was really interesting, it wasn’t like decisiveness or—but it makes sense, because if you don’t know who you are, if you don’t have the self-awareness to know who you are then you’re not aligned with your own…

Joel:           Also, I think, at least in my opinion, one of the true characteristics of an effective leader is authenticity. In order to be authentic, you have to be self-aware. How can you be authentic if you don’t know who you are? Where’s your authenticity?

Authenticity, it diffuses issues. When people know that they can trust you, that you have their back, you speak from the heart, there’s no duplicity, there’s no agenda there. They know that what they hear is true. Self-awareness is the key to authenticity.

Allison:       Okay. Then because you just brought up the thing about trust. You said also, and I think this is part of authenticity, is that our team not only needs to know what our values are but they need to see us living in alignment with our own values. There’s a whole piece about some of the practices that you’ve worked with where they say one thing and then they’re doing another.

Joel:           Exactly.

Allison:       They don’t even realize it.

Joel:           Let me back up here because I think there’s a whole segment that would be worth discussing here. How many—you can raise your hand—how many people here have always wondered how you find the right people for your staff? How do we find the right people to fill the slots in our practice? I think all of us have really thought through that. All of us have made mistakes and hired people out of necessity or because we need to plug a warm body.

Allison:       [Laughs] Lisa raised her hand. I don’t think she really has a question.

Joel:           Hey, we all do it. You know, I’m not saying you don’t. I’m saying I do it. We’ve all done it in the past, and isn’t that a regretful situation because it always seems to fail on you? I think the more you’re self-aware, the more you’re authentic, the more you have a collaborative culture, the more you actually define who you are, then you become a mirror. People can look in your mirror.

And you know what? We talked about this yesterday, Allison, we think that people follow us because we’re such great leaders. I don’t agree with that. I think people follow us because they see something about themselves in us. The clearer we know who we are, and we understand our values and our purpose, and the clearer reflection we can give to them of who we truly are, they can look in our mirror and see themselves.

Then they choose whether they want to align with us or not. They can either go their own way, which I would prefer they did if they’re not aligned with what I believe in. Or they can choose to align with us. I think there are cultures out there that are so strong that people that come into them that are not aligned with the culture stick out so badly that they cannot last a week. They’re gone.

Allison:       Right.

Joel:           Because it’s so obvious because everyone else is so committed and so aligned to the culture that you’ve created, or you collaboratively have collaborated, that an outsider that doesn’t align with that just can’t make it. It’s impossible.

Allison:       Right, yeah. I’ve had that experience. I think mine is really just getting to that point after 18 years but it seems like it’s getting clearer and clearer to us as a team what we really want. It’s getting clearer and clearer to the people when they—if they do come to work there they don’t last very long if they don’t fit.

Joel:           You know what else is interesting? When you get to that point, when you reach that pinnacle where you have that kind of staff and all of a sudden, you become a magnet for the really good people out there. No longer do you have to hire people to fill a warm body in an empty slot. Now you have all the good people coming to you because they want to work for you. They know that the turnover rate is not very high number one so when an opportunity becomes available, you get calls from all over town from people who want to come and work for you.

Allison:       Yeah. This is the part that, Jill, when we were earlier talking and Jill was saying something about marketing the practice and new patients. I think it also, when you have a really strong culture, your patients experience that. Then you attract the patients that appreciate that kind of service or whatever it is that your values are, it also affects your patients.

Joel:           Well, you know, that goes directly into the discussion of your brand too. As I said in the book and I’ve written a couple of articles on this, we’re in a different kind of industry. We’re in the service industry. So I kind of compare and contrast us to someone like Nike. Nike can make a shoe and you may love their shoe. You may be brand loyal to that Nike shoe. In other words, you can go into the sporting goods store and walk by the Asics and the Brooks and all of them that may be right up front, more accessible, less expensive, but you’re going to go right to that Nike shoe and you’re going to buy it.

But here’s the thing, you may like the shoe but what does that tell you about the culture of Nike? That tells you nothing. For all you know or don’t know, that shoe could have been made in a sweatshop overseas by underage children. You don’t know that. But when you walk into a dental office, we don’t have a product we manufacture. We don’t really sell anything except our culture.

When people walk into our office, the very first thing they see is your staff. Your staff is a manifestation of your culture. When they communicate with these people, they are actually experiencing your culture. So in reality, in a service industry, a small enterprise, a service industry like a microenterprise, which is ten employees or less, which defines most dental practices, your culture is actually your brand. There’s no distinction between culture and brand in our business.

So people say well I need to have… my stationary needs to match, my colors… it doesn’t matter. It doesn’t matter. Your culture is your people. You have to develop your people to brand yourself. That is your brand. Your people are your brand. That’s the one thing that no one else can reproduce.

I have a cone beam. Do any of you want a cone beam? You can have it. I’ll give you the number. For $80,000 you can have a cone beam. I mean, that’s the thing. There’s nothing that I know or I have that you can’t know or have, except my culture. You cannot have my culture. That is the one distinguishing factor that is the competitive advantage.

[Allison and Joel speaking at the same time]

It’s a sustainable competitive advantage. That is the only sustainable competitive advantage that we have in dentistry is our culture. That’s it.

Allison:       I love that. Yeah, you said twice in the book something like this or maybe this, I may have written it down exactly like this: It’s not what the customer receives but how they receive it.

Joel:           That’s right.

Allison:       Because they can receive a root canal from me or a root canal from you, but how are they treated? And how are they cared for? How are they followed up with? Right? That’s what you mean by that.

Joel:           Exactly. It’s not what you’re giving, it’s how you’re giving it. That’s becoming more and more obvious. There’s so much information coming through our heads every day, on the radio, on the news, on our iPhones, everything. I think we have a sense to block things out.

I don’t think advertising means much anymore like it used to. There’s just so much of it. It’s almost like it’s white noise in the background anymore. I don’t know how much of it really really sticks with us. But an experience of a service does stick with us. We’ll remember that. We’ll come back to that. That means something to us.

Allison:       True. Do you mind—I don’t know if this is even appropriate and I don’t know if I brought it up with you last night. I kind of liked your idea of the touch points, the exercise that you do?

Joel:           You mean the one where I added up all the time spent?

Allison:       Yeah and I don’t know, whatever you think would be valuable for people but I do think it would be—I think one of the ways that we can actually take this phone call back to our practices, this is my idea and if you have a better idea of an exercise. I was just thinking to take this information back and maybe start to make some of the changes in our practice, to our culture, or something. That maybe a way to do that may be to start looking at obviously the values and the purpose but also maybe look at what experience are we giving our patients?

Joel:           Exactly.

Allison:       What experience, I don’t know I was just trying to think of maybe an exercise and that was one that popped into my head.

Joel:           I think that’s a great exercise, particularly for the people that are on the staffs that are on this call. I mean, it wouldn’t be a bad idea to start keeping track of touch points. A touch point is really any communication, even on the phone, between you and the patient. So what I did is I added up touch points. The staff’s touch points and my touch points with patients.

Overwhelmingly, the staff spent more time with my patients than I did. I think you’ll find that to be true in your offices too. They answer the phones, they book the appointments, they greet the patients, they take the x-rays, they do the pulp testing that we do. When I’m done, I say goodbye and I review the file, films, and explain to them what we’ve done. The staff helps them get out. They’ll make calls to the referring offices and that type.

If you look at it, the staff spends an inordinate amount of time with the patient. The doctor spends, I spent about half the time that my staff spends with a patient. If the experience is the culture and the culture is the brand, then your staff becomes a very significant part of the brand. It’s incumbent upon us to make sure that the staff not only commits to the culture we have. But we have to give them the permission to do what they do and the resources to be successful at it.

So that was the whole purpose I think of the touch point example. It’s not a bad thing to do in your own practices because you’ll realize once you do it, the doctor has—you know, I would love to think all of my patients come to me because of me but the reality of it is they love my staff.

Allison:       Yeah. I had a patient one time tell me that if my hygienist left that she was going to follow her wherever she went.

Joel:           Absolutely. I tell all the perio residents that I talk to, especially residents, I say, “Do not go into a practice and run that hygienist off.” That would be a big mistake. Basically what we’re talking about is the culture. I want everybody to think within and understand like I’ve learned what does it take to have the kind of culture in which people hold nothing back? In which your staff is not afraid to take things upon themselves?

Then you provide them with the psychological safety that they can go out there and make choices. Even if the choice is bad and even if they mistake, as long as they can explain to me that number one, what they thought they were doing adhered to our core ideology. Number two, that what they thought they were doing was in the patient’s best interest. Then they did not make a mistake in spite of the fact that the outcome may not been favorable. They have to have that kind of freedom to be able to do those kind of things.

We have to get away from micromanaging people. Micromanagement is one of the worst things that we as practice owners do. It de-energizes, it disenfranchises, we have to create cultures that are collaborative, that people feel like they’re relevant and we have to be vulnerable enough to trust them to do what we know they are capable of doing. We have to be multipliers and multiply their capabilities by giving them the resources to be successful.

Allison:       I love what you’re saying. I am going to make myself a big star because we have a question and I want to come to that, Joel.

Joel:           Sure.

Allison:       I think it’s Kate. Let me unmute you, Kate. Is that you that has a question?

Kate:          Yes, well it’s not a question. I’m really enjoying what you as dentists are saying. This is honestly the first dentist-related course I’ve been let in on as a hygienist. You know, I’m trying to do more collaborative hygiene work and bring patients into dental practices and actually be proactive about dental offices succeeding, even on my own time.

I’m just really really excited about what you guys are saying because I think there’s a ton of dentists that could really benefit from this course. I just was going to offer up that I read a lot of reviews about dental offices, even before I go help them out. One thing I think that is super beneficial is besides even your website reviews, is to do a Google search on your name on practice reviews because one thing hygienists often, and assistants, and front office will hear the real story without the dentist in the room.

Often when I’m reading these online, you can have let’s say a so-so dentist or a good dentist and if you have good staff, the patients will stay. But if you have a so-so dentist and a good dentist with one bad experience, one bad overbearing staff member, one that’s diagnosing as a front office manager and shouldn’t be, and giving estimates based on a diagnosis or anything like that, a patient in these reviews will leave.

So I find it really telling when patients are writing online. It’s much more like therapy. You can see in real time what they really thought and one little straw that broke their back. So I just wanted to offer that up.

Joel:           Sure, absolutely. Yeah, we check our media, we’re on Angie’s List and all, we look at that all the time. You’re absolutely right. Some of the write-ups are pretty telling. Fortunately, most of them are good. We have had a couple bad ones. I think everybody gets one or two of those occasionally for whatever reason. It’s important to monitor those, absolutely. That’s a good point.

Allison:       Thanks. Anything else, Kate? Oh, I think she muted herself already.

Kate:          I muted myself.

[Laughter]

Allison:       Okay, I’ll mute you too. If you have another question, raise your hand again. Thanks. Or comment, yeah. I’ve also seen kind of a similar thing but I’ve seen not very good dentists who have a great practice, very successful practice, because of their, I would say culture. Just the personality of the dentist, the team is fun, the team takes good care of the patients. Then you see some really good dentists who don’t get to do their really good dentistry because they’re just not as appealing as far as relationships and personality and being able to really connect with people.

Joel:           Yeah.

Allison:       Right?

Joel:           Absolutely true.

Allison:       I want to talk more about the vulnerability and trust piece. I thought something that you said was really interesting in the book. I mentioned it to you already but can you talk a little bit about, you said something about giving trust before you expect to get trust. Like just to get to trust your team before you expect them to trust you. Or instead of making them prove to you to trust them, right?

Joel:           Right. Well, I think that goes back to the fact, I’m sure that I’m not saying anything here that people don’t already know. If you’re going to lead people, you have to lead by example. No one’s going to follow a leader that doesn’t follow his own words. Your deeds have to follow your words.

If you make trust—which I think everybody would want to do—and make trust a part of their culture, then you have to be the first one. You have to be front and center when it comes to trust. There will be times when your trust will be violated so to speak.

In the book, I talked about shrinking within ourselves and not wanting to come out of our shell after something like that happens. But you know, I think what really teaches the staff something is for them to see this develop. To see the whole picture in front of themselves. To see their doctor’s trust violated and to see how the doctor handles it.

I think that is such a powerful message to your staff to see someone that they know because they know other staff members and they always know, believe me, the staff knows what happens. If you think the staff doesn’t know what happens, I would disagree with you. They know what happens.

They know when something’s happened. They know when your trust has been violated by another staff member. Or even another person for that matter. When they see how you react and you turn right around and come back and trust again and give that trust, then that tells them that you’re the real deal.

It’s important to be able to give trust. Now, there are certain times when trust has to be doled out, little by little, you don’t just open everything up to people necessarily, but the concept of trust, you have to lead the way. There’s no question about it. You have to lead the way. If you don’t trust, then they’re not going to trust. If you don’t have trust in the relationship—I trust, as all of you do, I’m sure. You wouldn’t have people around you. We trust the people that work for us. We should. If you don’t, you need to get rid of them.

There’s never an issue then—if something goes wrong in our office, I never even think about it being a matter of somebody violating my trust. I always look for a different explanation and usually that’s when I find.

Allison:       Yeah, okay. Thank you for that. I think this is Jill.

Darvy:         Actually it’s me, Darvy.

Allison:       Oh that’s Darvy. It’s Darvy. Okay. Hi, Darvy.

Darvy:         The question I have for the speaker is that you know we can control our practice culture but now we’re talking about interdisciplinary or multidisciplinary dentistry. We have talented teams where some of the cultures within their practices are not as high level as others.

So being that he’s a specialist, how does he manage it? Because we don’t want to over function for our interdisciplinary team. So how does he handle that?

Joel:           You said we don’t want to over function?

Darvy:         Well, you know, when a patient goes to all the different practices when we’re doing the interdisciplinary case. Some people’s cultures are great and other doctor’s cultures, are not. How do you manage that? Because obviously some of your referrals don’t have a good culture.

Joel:           No, some of them don’t. You know, we talk to them a lot of times about—I had lunch with one of our good referrers and who is also a Pankey and Dawson and Spear dentist. He kept losing patients. I mean, patients would come into me and say, “Please send me somewhere else.”

Being a specialist, we get to work with so many offices. If you’re attuned to the culture-type issues, you see very clearly why these offices are floundering. It becomes really obvious to you. This was a particular office that the staff turnover was, you know, it’s like a revolving door. The doctor had some personality issues and stuff.

So I went and talked to him. I said, “I don’t know how to tell you this. I hope you take it the right way. But I’m having a significant number of patients coming to my office that want me to send them elsewhere. I’m having to do it because they’re insisting. I don’t want to do that because I know you’re a very good” and is, a very good dentist. But doesn’t have a very good culture.

In having done that, have things changed? No. They haven’t. I still have patients coming and wanting me to send them elsewhere. I’m still doing it because I have no choice. All we can do in that situation is do our part and feel good that we did everything that we could do to help that person out. I talked to him about his staff. I talked to him about issues. But obviously, he didn’t want to change it.

Now, would I not accept a patient from him? No. Because it’s not the patient’s fault that they’re seeing a doctor that has a poor culture. If they choose to go somewhere else, I’ll get them there but I’m certainly not going to quit working with the doctor because I think I owe that to his patients. Did I answer that? Did I answer that or not?

Darvy:         Yeah, you did. Well, you did from the specialist referral. Like from a general dentist office, we’re the one who’s creating the team.

Joel:           Right.

Darvy:         So as the culture gets worse, sometimes we have to sit there and search out a different specialist that has a different culture. But sometimes the cultures are great for a long time and then something happens and it goes downhill. That’s what I’m experiencing right now.

Joel:           Let me ask you this, would you be comfortable talking to that doctor? Having lunch with him and telling him what the issues are?

Darvy:         You know, I think the doctor has to be willing to listen.

Joel:           Well, that’s true. But you know, you don’t know that until you do it. Then even if they’re not willing to listen, then you go back to your office saying, “I feel good about what I did because I did the right thing.” If he chooses not to listen, then that’s his prerogative. With somebody you’ve worked with a long time and that happens, I would honor them by having that discussion with them.

Darvy:         I agree.

Joel:           Because they deserve that. If they choose not to change it, then you can move away and never think twice about it. You did what you should have done.

Darvy:         That’s true. Thank you.

Joel:           Yeah, absolutely.

Allison:       Thanks, Darvy. All right, I muted you again, Mark Darvy. So if you want to say something else, just raise your hand again. Is there anything else you want to say, Joel? Because I’m going to kind of change the subject.

Joel:           Well, no. We were going to talk about communication of course. If you had Brian DesRoches on, actually Brian DesRoches is the one I got the part about being 100 percent responsible for our communications. That’s really Brian’s stuff. I’m a big fan of Brian’s. I’ve studied with Brian.

I think this is something that if none of you were on that call, that might be worth repeating because I see it so often in dental practices, specialists, generalists, otherwise. That is that we never accept, or I shouldn’t say never, but we often do not accept responsibility for the communication.

When I say that, I mean this: it’s not only important that we understand what we said, which believe it or not, some people don’t. But it’s also important that we are perfectly clear that the person receive the message as we intended it to be received.

What happens many times is we—and I’ll tell you a perfect example. My son, when he was younger, my wife would come to me and say, “You said this and this to Zach.” I would say, “No, I didn’t.” She said, “Yes, you did.” I learned from Brian that it didn’t matter what I thought I was saying. What really mattered was what he was hearing from me.

So we have to be responsible with our staff and our patients that not only do we say what we want to say and feel comfortable that we’ve said it properly, but we also have to be responsible for making sure that they heard it as intended.

If you think about it, in many of your practices, that’s where communication breaks down because the message we’re trying to deliver is not being heard by them, particularly in an endodontic practice where people come in in pain. They’re probably not hearing anything you have to say. Following up on that communication to make sure that it was heard properly can become critical and it can become a very important issue in your office.

Allison:       So you’re just saying ask a question?

Joel:           Yes, absolutely.

Allison:       Just ask.

Joel:           Absolutely, yes. You say, “Let me just be clear. I want to make sure you heard this correctly from me.” Then you go ahead and say, “Please repeat back to me.” Or, “Tell me what you heard me say.” Make sure that everybody is on board.

Allison:       Okay.

Joel:           But I’m not taking credit, that’s strictly Brian DesRoches stuff.

Allison:       Well and I liked also when you were talking to, maybe right before you were talking to Darvy you said, you were telling the story of meeting with a dentist friend and the way you started out the conversation was something like, “This is a hard thing to say. I hope you take this the right way.”

Joel:           Right.

Allison:       You sort of managed their expectations by saying, “This is a hard conversation.”

Joel:           Sure, of course.

Allison:       “And I hope you understand my intentions when I say this.” Like you’re speaking from love, you know?

Joel:           Yes. Anybody that would be in their right mind would know that when their endodontists come to talk to them about something like that, they’re doing it out of concern.

Allison:       Yeah.

Joel:           No one’s going to do that just for the fun of doing it.

[Laughter]

Allison:       Absolutely, not.

Joel:           Yeah, absolutely.

Allison:       I think we have a question. I think this time it is Jill. Is that you, Jill?

Jill:              Yes, it is.

Allison:       Okay.

Jill:              Could you spell Brian’s last name for me?

Joel:           It’s D-e-s-R-o-c-h-e-s.

Jill:              Okay. What was the name of the book again?

Joel:           My book?

Jill:              Oh, I thought it was his book.

Joel:           No, well, Brian does have some books. I can’t remember the names of them but you can go on his website.

Allison:       Jill, also if you want, and Kate, I think you too probably because you guys just signed up. If you guys want me to send you a copy, I think what Joel is referring to is I’m going to send him a copy also of the link. I had a call with Brian.

Jill:              Okay.

Joel:           Yeah, that was what I was referring to.

Allison:       He has three books. I know one is called Your Boss is Not Your Mother.

Joel:           Yeah, that’s right. There was one like that.

Allison:       He has a new one that sounds really good and I can’t remember the name of it but I don’t even think it’s been released yet. But anyway, I can help you with that. Just email me or something and I’ll email you the recorded call so you can listen to him. He’s really fantastic.

Joel:           Yeah. Brian is a clinical psychologist and he works a lot with dentists. He does some leadership workshops that I’ve taken. I know Mac McDonald has taking them, a lot of us have taken them here. It’s really exceptional. I would recommend it to anybody because it tells you so much about yourself.

Jill:              Thank you.

Joel:           You bet, absolutely.

Allison:       You’re welcome. Do you feel complete, Jill?

Jill:              Yes, I do.

Allison:       Okay. Thanks. I’m going to re-mute you. Okay. What I wanted to ask you about next was, this is the thing I was saying I don’t really hear anybody talking about in dentistry. I mostly hear it sort of in spiritual conversations. It’s the abundance mindset.

Joel:           Right.

Allison:       I’d love to hear what you have to say about that. I think that’s really neat.

Joel:           Well, I’ll tell you how it applies to us and our practice. I tell my partners almost on a daily basis that it’s in our best interests that each of us be successful. That’s kind of a buzz word around here. That each of us gains and grows by everyone else’s success. We try and do that with our staff as well. We have some staff members that are taking college courses, trying to become MBAs and so forth and we’re helping them along the way.

We just believe that we all, it’s like doing well by doing good was a famous statement. It’s attributed maybe to Benjamin Franklin and I’m a true believer. There’s a book out by the way, that I think is a really really good book. It’s call Give and Take. It’s a new book, hang on, I’ll tell you who wrote it.

Allison:       You like to read, huh, Joel?

Joel:           I read a lot.

[Laughter]

I’m an avid reader. The name of the book, it’s newly published. It’s Give and Take. It’s written, I’ve got it here on my computer by Adam Grant. It really proves to you that good folks can finish first. They don’t always finish last. So I think there’s something about abundance versus scarcity. There’s a scarcity mentality. The difference is that the person that’s abundant sees their glass as being half full. The person that’s scarce, sees scarcity, sees into their glass as being half empty.

The difference in the cultures they create is so significant. One would ultimately become a culture of commitment. That would be the person that believes in abundance, where people can buy-in because you’re working as hard to make them successful as they’re working to make you successful. Everybody transforms themselves by the synergy of that relationship. Then in the other, the scarcity mentality, everybody covets everything. If I had a pizza and you ate a piece of it, then there’s less for me.

So what happens, that becomes a compliant culture because everybody is guarding themselves. They’re guarding their treasure so to speak. They don’t want to be collaborative. So rather than have commitment, you have compliance. The difference between commitment and compliance, I could do a whole hour on just that. It’s just phenomenal the difference between a compliant and a committed culture.

Allison:       Well, I know what abundance means to me, but it’s not about the money. It’s really about just believing that you can give and you can grow. It’s sort of an unlimited possibilities kind of a thing. You said it’s not a philosophy, it’s a lifestyle.

Joel:           I did.

Allison:       What do you mean by that?

Joel:           Well I think you either live a life of abundance or you don’t. It’s in everything you do. It’s not just what you do at church. It’s not what you do in your practice. It’s woven into the fiber of your being. To be an abundant person is part of who you are. To have a scarcity mentality I think that that has the same definition. It becomes part of who you are. I just believe that you either live an abundant life or you don’t. It’s just part of who you are.

Allison:       Okay. We can develop that, right?

Joel:           Well, yes. In answer to your question, you can develop it. But it’s not an easy thing to do because if you think about, and you take it all the way back to even your childhood, it started even back then. Were you willing to share your toys with others?

When I talk to these doctors and I talk about associateships and partnerships, the first thing I say is, “Disregard everything that you’ve heard. Here’s the crux. Here’s the crux of the matter. Do you play well with others?” I mean, do you play well with others. That’s basically it. If you’re going to have a partner, if you’re going to have an associate, you have to answer that question, do you play well with others. If the answer is no, it’s not for you.

Playing well with others kind of embodies the thought of abundance. That’s believing that we each gain from each other’s success.

Allison:       Like that whole thing is something that’s sort of intangible a little bit, right?

Joel:           Well, yes and no. Because if you look at all the great minds in leadership today, Zinger, Jim Collins, all the great thinkers today, they will, no matter what metric they use, no matter what they were trying to measure, they always found out that cultures that were qualitative versus quantitative, in other words, the stressed life, the better life, the collaboration, the psychologically-safe environment, those were always, no matter what metric you used, more successful in the end than qualitative cultures.

Allison:       Than quantitative…

Joel:           Than quantitative, yes.

Allison:       Okay.

Joel:           If you’re looking at financially, they were more successful. If you’re looking at staff satisfaction, they were infinitely more successful. Every metric you can use to measure between those two was skewed to the abundant culture.

Allison:       Okay. That encompasses a lot, that abundance culture thing.

Joel:           Absolutely.

Allison:       Okay. One of the things that you talked about that I could wrap my head around was that piece about focusing on strengths instead of weaknesses. I think that’s a really cool thing. How did you do that in your practice? Did you do strength finders or any of that kind of stuff?

Joel:           No. I’ll tell you, just to give you an example. We have two—well, one lady is working on her MBA right now. She’s doing it in marketing. So we just gave her our Facebook and our e-newsletter. She has just done a bang-up job with it. We just knew that she was the kind of person that would really flourish. She has really flourished as a person by doing that. I mean, it’s really been something special for her.

You have to look at the strengths, some people are better up front. You know, people people, others are little worker bees, and so forth. You’ve got to figure out what they’re good at and what they enjoy doing. It’s like Jim Collins said, “You’ve got to get the right people on the bus.” He wrote Good to Great. Get the right people on the bus. He said that’s number one but number two is to make sure the people are in the right seats. That’s what you’re referring to as strengths.

What’s interesting, this is just an observation that I’ve made. I’d love to hear if everybody else has ever experienced this. The more you play to people’s strengths, the more they grow and gain from achieving things through their strengths, the more you’ll see their deficiencies disappear.

Because I think a lot of deficiencies we see are because people don’t give it their all. They’re afraid to do it. If you can empower them by addressing their strengths and giving them the resources to do what they need to do and they start to gain confidence, a lot of times, the deficiencies just spontaneously disappear.

Allison:       I love that.

Joel:           Yeah.

Allison:       I bet that’s true. Also you’re not focusing on them. What you focus on grows.

Joel:           Right, exactly.

Allison:       If you starve the weaknesses by giving them no attention whatsoever, then that’s cool. I like that.

Joel:           Yeah.

Allison:       Okay. Well I know we’re getting to close to the end of time so I don’t want to start another question. Is there anything you want to sort of wrap with, Joel? Then I can open the lines and let everybody say goodbye.

Joel:           Sure.

Allison:       Or if anybody has any questions.

Joel:           All in all, and as I’ve said from the get go, I’m not here to lecture. I guess I did. I guess that was the format for tonight. But I love conversations more than lecturing and I’m just trying to hit some high points with all of you. Just understand I’ve been there. I’ve done that. I know how hard it is to truly become a leader. It’s a journey that I haven’t succeeded in completely and am still working on and studying. But it’s a journey worth taking.

The end result is not only—and I think the important thing to understand is that the more you develop yourself as a leader, the more your practices will benefit. But even more importantly, the more you’ll benefit personally. It transforms your life and not just your business. It’s a journey that’s very definitely worth taking.

Allison:       I’m going to say this because I know we have some people on here that are—I mean, actually more people on here today are not dentists than are dentists today.

Joel:           Okay.

Allison:       So you’re speaking to everybody. Not just the dentists. You’re saying every single person in the practice.

Joel:           Absolutely.

Allison:       Okay.

Joel:           Yeah, I think it’s universal. Just very quickly, we had a lady here in our office that had a very bad marriage. Husband had some drug problems, spent all their money and so forth and so on. She was really struggling to make ends meet. She was depressed and so forth. We just worked with her and we gave her the nurturing, the care, we were very understanding of her issues.

Over time, really through the culture, because we were the only decent culture she had experience in. She developed a very strong personality and developed her own self confidence and ended up separating, segregating her funds from her husband’s funds and just retired not long ago because now she owns four or five rent homes in town. She’s making enough money that she doesn’t have to work anymore.

You just saw her grow throughout that. So this is something that’s important to everybody. Her values and her purpose were defined, I think more here than anywhere. Because of the strength that she had, she was able to pull herself out of that situation and we were very proud of her. We hated to lose her but we thought that was a wonderful story.

Allison:       That is a wonderful story. Awesome, thank you, Joel, so much.

Joel:           Thank you.

Allison:       For sharing your time with us.

Joel: I enjoyed it, visiting with all of you.

Thanks for listening to Practicing with the Masters for dentists, with your host, Dr. Allison Watts. For more about how Allison Watts and Transformational Practices can help you create a successful and fulfilling practice and life, visit transformationalpractices.com.