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August 2019--“Dentists have far more to do than they have the time,” says executive coach Don Khouri of Fortune Management. “But multi-tasking is an illusion.” What advice does Don Khouri give dentists?

 

The volume of requests originating from patients, team members, referring colleagues, external service providers, continuing education, and even organized dentistry exceeds the capacity of dentists to deal with them all. Delegating, deferring, juggling, and saying no are all tactics that can be used but two behaviors are key to high performance:

  • Focus on one task at a time.
  • Say no to requests that take you off track of achieving your goals.

High performance behaviors start with understanding your own goals, understanding that your priority is achieving your goals and not others’ goals, and that within your priorities there is a hierarchy of these at any time.

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Multi-Tasking Is an Illusion

Over two decades of research referenced by the American Psychological Association shows that, as we switch from one task to another, the transition is not a smooth one. There is lag time while your brain shifts attention from one task to another and multitasking (doing more than one thing at a time) takes as much as 40 percent more time than focusing on one task at a time. It takes a higher percentage of time depending on the higher complexity of the tasks. 

Stanford University research reported in 2018 demonstrated that multi-tasking on multiple media has become common place. At any moment in a dental office, team members may have incoming alerts from text and email, incoming phone calls, an open computer screen they are working in, and individuals walking up to get their personal attention. Chronic brain interruptions not only result in poor performance but also create biological stress and reduction in memory.

Only 21% of us are focusing on one thing at a time, and four out of five of us are multi-tasking. This isn’t a good thing. A great wealth of research over the last two decades has demonstrated that multi-taskers under perform. We can’t multitask plus have high memory recall or be highly productive.

Think about what demands were on you today. When did you feel elevated annoyance, frustration, or blood pressure? When did you feel overworked? How long did it take for those feelings to dissipate? With the added stress hormones and lack of focus, your busy and interrupted day cost your performance and may be contributing to eventual burnout.

 

Setting Priorities

Turning off our smart devices and closing the door to outside interruptions only goes so far. When people are pressing you to do something, you need options, and even the ability to say no.

A plausible scenario:

  1. Smith has a broken crown and doesn’t want to wait to see you. She is not in pain but so insistent that your Front Desk wants permission to schedule her for your lunch hour.
  2. Your hygienist wants your answer today about when to block out time on the calendar for her vacation because she must make a timely decision.
  3. You and your assistant are scheduled to review an order for implant components during your midday break, because the order needs to go in today to be ready for Mr. Garcia’s implant procedure next week. That will take 5 minutes if you stay focused.
  4. Your office administrator wants you to review and sign-off on proposed new software by the 30th of the month to take advantage of promotional cost savings. It’s now the 20th of the month, and you haven’t looked at it.
  5. Your insurance coordinator wants your approval to go in-network with a new plan and has requested your review of what she has documented so far.
  6. Your implant study club schedule indicates it’s your turn to make a presentation early next month. Two weeks leaves little time to prepare.
  7. You need to spend your Friday afternoon with your CPA to go over your tax returns because that was the only time that she had available.
  8. And what you really want is to have alone time to study your numbers ahead of the meeting with your CPA-business advisor, so you can also wisely discuss your business plan for the rest of the year, including investment in the new technology you want and an advanced implant continuum, which is something you really want to do.
  9. The Community Foundation in your county would like you to serve on their advisory board and fundraising committee. The first commitment would be for a minimum of two years, starting in two months. They need to know your answer by the end of the month. You know they will be calling you back any day now.

That’s a lot of requests that are not even the everyday clinical issues you face. So, now you need to reduce internal tension and return focus to your priorities. You have options to consider:

  • Which requests you can respond to quickly? Serving your patients’ urgent needs and maintaining a happy team is in alignment with your goals. Perhaps, your dental assistant can stay an hour later than usual, in which case, you can propose seeing Mrs. Smith at the end of the day, to maintain control over your schedule. With your midday break preserved, you can quickly review and approve the implant components order and have a few minutes to eat a sandwich, review messages, and try to relax a little.
  • Which requests should you delegate? Providing guidance and letting your team leaders take responsibility will enable you to focus on the things only you can do. For example, in the case of the new software, make your office administrator responsible for staying within budget. Grant her permission to demo and review the software with other team members, gather all the related costs for implementation, and then come back to you with a proposal for which she will be accountable for implementation. Have her explain the benefits of the change and challenges she anticipate. If she does the due diligence and is convinced this is the right move, then your life has been made simpler. Your hygienist’s vacation days can be scheduled with your office administrator, who has access to the schedule. All you want is knowledge about when she will be out and assurance that any patients that need rescheduling are managed by your hygienist or another team member. You can lead and guide without micromanaging.
  • Which requests can you easily defer? Make your insurance coordinator responsible for making best use of her time, doing the due diligence, and then reporting back to you and your office administrator. There is no deadline. You can meet about this next month.
  • With reflection, can you turn a request into something that will work to your advantage? What will I do about the implant study club presentation? Should I wing it? Can I find someone to swap with me at this short notice? Can I say no? Better yet, can I turn this into something beneficial to me? Perhaps, you have a potential implant patient for whom you are in the process of treatment planning and realize the case poses some special challenges. Presenting the case to the group and asking for how they would treatment plan it, could be the best use of your time and theirs, as you learn from each other’s experience.
  • Which requests are in alignment with your goals and should be your priority? Perhaps, you decide that you definitely want to block out Friday morning and Thursday evening to review your practice numbers ahead of meeting with your CPA. This will give you clarity and confidence as you make decisions to achieve your goal of expanding your implant practice.
  • Which requests can you say no to? There are different levels of no. Delegation to your admin team is one level of no. Proposing alternatives to your team to manage is another level of no. And then, there are times, when a request will take you so off track of your personal goals, you simply have to say a flat no. Perhaps, the Community Foundation request is something you would love to do in a few years, but now you are growing your practice. Knowing how to politely say no and getting it out of the way will shorten your list. Maybe this is a good email to write over your midday break. “I love giving back to the community and would like to help but I simply don’t have the bandwidth this year or next. I must decline your offer, even though I feel honored to be asked. Please keep me in mind to help in a brief, more limited way. I might have time for this type of commitment a few years from now.”

We Must Say No to Honor Our Yes

Psychology studies show we also have difficulty saying no to people who press us to do something, even if we know we don’t have time and the request is not in alignment with our own goals. Dentists and executives need to intentionally evaluate requests, be prepared to say no and mindfully respond based on reason instead of emotion. We must be prepared to say no in order to honor our yes.

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