Episode #381: The Reason Communication is Challenged in Your Office, with Katie Poulsen

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Just like on the playground, there is an in-group and out-group in your practice. And typically, the dentist is in the out-group. To explain why that is and what you can do to close the gap, Kirk Behrendt brings in Katie Poulsen from Dental Intel to share her research findings for why communication is so challenging in your office. There are many key elements to running a successful practice, and one of them is to keep your team happy! To find out how, listen to Episode 381 of The Best Practices Show!

Main Takeaways:

• In-groups and out-groups form because of conflict.
• Dentists are typically in the out-group of their practice.
• Communication breakdowns cause conflict.
• Not communicating expectations can cause conflict.
• Set a time for discussion so conflict can get resolved.
• Have consistent meetings, individually and as a group.
• Effective communication is learned, not inherent.

Quotes:

• “I wanted to study who was in the in-group in a dental practice, who was in the out-group, and why were they in the in-group or out-group, or does it even exist. And I had an idea, but I wanted to verify it. So, through a survey, and interviewing with multiple different roles in the practice, hygienists and dentists, different genders in each role — I didn't want there to be any gender bias — I found that, as you can imagine, dentists are in the out-group of their practice.” (8:38—9:16)
• “For a lot of dentists, [being in the out-group] happens for a lot of reasons. And what it all revolves around is conflict. For whatever reason — and this is a whole other thing that needs to be studied — most dentists, I don't know if they choose the profession because they don't like conflict, or the profession makes it so that you don't like conflict. Maybe they liked it before, and now they don't because they're in the profession. But it really does draw people who do not like conflict.” (10:04—10:39)
• “We can make a generalization that most humans don't love conflict. But for whatever reason, there are a lot of dentists who are conflict averse. And so, they want to do their job. They show up, they do their dentistry, and they let the office manager or somebody else in the office deal with all of the drama in the practice. Which, then they're like, ‘I'm the leader, and so I'm going to be over here. You guys work together. Let me know when you have a problem.’ Which, really, it makes for a huge chasm in the communication breakdown. It makes it so you don't get trusted by your employees. They don't go to you with problems because you're not approachable.” (10:40—11:27)
• “Dental hygienists do have overlapping responsibilities in the practice. I did a lot of anesthetics for the dentist. You can feel like your hands are tied a little bit with diagnosing periodontal disease. Like, you can see it, but you can't diagnose it. Or can we diagnose it? It’s being seen as a provider, even. I mean, there are a lot of practices where the dental hygienist is just treated like a member of the staff. And maybe they're okay with that. But that's the root of where all the problems exist. And it’s not just dentistry. It happens in any place where some of the tasks and expectations overlap between providers.” (13:15—14:01)
• “Add the fact that there's not time to have conflict in a busy dental practice. You can't approach [your team] over the patient, and the next patient is coming in the door. And by 5:00, everybody’s ready to get out of there. So, if you don't set time to discuss these things, then they don't ever get resolved.” (14:34—14:55)
• “When reviewing and surveying a bunch of these providers, hygienists and dentists, I was looking for common themes of why they were in the in-group and the out-group. And the first and most prominent theme that came about was expectations, setting expectations. And there were a lot of hygienists who felt like the line was always moving. And the same with the dentists. They feel like they go to a conference, and they bring this thing back, they bring Dental Intel back, they're going to get everybody on board. And then two weeks later, it all fizzles to the wayside because you've set the expectation maybe not so great. You want them to use it, but you haven't showed them how, or what to do with it, or how to implement it, or how you're going to measure if it’s successful. So, expectations are a really big common theme.” (15:19—16:24)
• “It’s not the fact that you are doing a bad job at setting expectations. It’s sometimes, you haven't even sat down to think what you want your expectation to be. You've got to take the time to step aside and see, ‘What do I really want? What are my goals?’ and line them in with your expectations.” (17:09—17:28)
• “In most practices, and this is a generalization, a lot of the leaders, the dentists, are men. The women are the staff. And even vice versa, I think having conflict brings — some people get emotional. They cry. Maybe they get defensive. And just having that trepidation of making someone feel bad is enough to avoid the conflict altogether. So, instead of saying, ‘I'm going to try to fix this problem,’ I'm just going to push it aside, and I'll deal with it, and I'll do everything myself. I've heard dentists say, ‘Sometimes, I wish I could fire all these people and do this job on my own,’ because that's conflict avoidance.” (18:29—19:15)
• “One of [the resolutions] that came up often as I was asking people, ‘How do you think that this could be fixed?’ a lot of them talked about having a morning huddle, or something like it, spending 15 minutes a day setting your expectations of what you expect to happen. And the other was consistent team meetings. And the third was meetings with your team members on a regular basis, individually, one on one.” (21:48—22:26)
• “You'd think that by holding [your team] accountable, it’s going to make them less happy. But it doesn't. It makes them feel like they know the plan, and they know where they're going, and know their expectations.” (22:52—23:00)
• “Every time I would listen to somebody talk about business in dentistry, it was always so money-driven and money-focused. And I kept thinking, if we could just focus on the staff, and make them a little bit happier and want to be at work, and motivate them, that second part would take care of itself.” (25:44—26:05)
• “Your team is not a set-it-and-forget-it kind of thing. It’s going to take work. And again, just like children, boundaries are important, and they're expected. And people do better in them. Your team members, they're not supposed to be spoiled toddlers. You're supposed to give them boundaries because everybody works better that way.” (27:08—27:29)
• “The role of the dentist is isolated. When they are the only person in the out-group and the whole team is in the in-group — I mean, if you feel, and you're a dentist, that you're isolated, you're not alone in that. It is an isolating position to be in, especially if you’ve put yourself in the out-group in your practice.” (28:23—28:47)
• “Communication is so, so imperative. And you don't automatically know how to communicate. Some people obviously are better communicators, naturally, but it’s something that’s learned. And so, if you feel like you struggle with communicating, if you see it in your treatment acceptance, if you feel like you're not able to set those expectations, or whatever, seek out people who do it well and ask them for advice. Ask them to help you.” (36:36—37:12)
• “Oftentimes, we assume that the way we talk to people is just inherent, ‘That's just who I am.’ But it can be changed, and it can be developed.” (37:18—37:26)

Snippets:

• 0:00 Introduction.
• 2:32 Katie’s background.
• 5:47 Why this is an important topic.
• 7:49 The in-group and out-group.
• 9:45 Why the dentist is in the out-group.
• 12:08 Dynamics and conflict between groups.  
• 15:05 Pitfalls of setting expectations.
• 17:48 Pitfalls of conflict avoidance.
• 19:16 How data was gathered for research.
• 20:55 Solutions.
• 23:26 Make your team happier.
• 26:31 Your team will do better with boundaries.
• 28:05 The role of the dentist is isolated.
• 29:53 Advice for dentists.
• 36:12 Last thoughts.  
• 37:27 Katie’s contact information.

Reach Out to Katie:

Katie’s email: [email protected] 

Katie’s Facebook: https://www.facebook.com/katie.c.poulsen

Katie’s social media: @katiesuepoulsen

Growth in Dentistry podcast: https://www.growthindentistry.com/

Katie Poulsen Bio:

Katie Poulsen is a Registered Dental Hygienist and has a master’s in professional communication from Weber State University in Ogden, Utah. She has been a clinical adjunct faculty member for Weber State's dental hygiene department and is a past-president of the Utah Dental Hygienists Association. Katie’s prior education guided her to study many aspects of communication within dentistry. Her primary research focused on dentist-dental hygienist communication dynamics and its effect on working relationships and patient satisfaction.

Katie now serves as the Director of Customer Marketing for Dental Intelligence, Inc.