Tough Conversations with the Team – Is it Now or Never?

A Note from Spear resident faculty Dr. Ricardo Mitrani: Last week I wrote about the importance of psychological safety in the dental office and the value of empowering team members to share ideas openly. This article written by a Spear Customer Success Manager and the President of the Arizona Dental Hygienist Association highlights the team perspective on the value of speaking openly and honestly. Read on to learn why difficult conversations may be the key to team motivation and practice success.

“Look, this is not going to be comfortable for either one of us – but it's important we talk about this for your overall health.”

This is how I usually preface a difficult but necessary conversation with a patient. As a dental hygienist, it is my professional and ethical duty to help prevent and arrest disease in the oral cavity. This often means broaching the subject of poor hygiene, lifestyle choices and other uncomfortable topics so the patient can avoid more complex issues in the future.

Sometimes we need to “rip off the band-aid” to have meaningful conversations with patients – it's equally important to ask open-ended questions and practice active listening because it builds trust and helps us guide patients in making better decisions. This is especially true if what we have to say is difficult to hear.

As prevention specialists, hygienists are uniquely skilled in navigating fraught conversations – and this has only increased in the wake of the COVID-19 pandemic. In addition to a recent uptick in stress-related oral health conditions, patients are returning to dental practices with profound new fears about their finances and health – they have lost jobs, insurance, and loved ones due to the pandemic. And dental hygienists are often the first to hear about it.

In a recent LA Times article discussing the challenges facing hygiene teams in 2021, dental hygienist Jeannette Diaz highlighted why this is the case by saying, “Hygienists work in such close proximity and cover so many aspects of [a patient's] life in going over their medical history that grief, loss and depression come up as a topic of conversation.”¹

Importantly, hygienists are not just “tooth cleaners” – we are licensed dental professionals uniquely trained in our scope of practice and equally committed to patients' care. The amount of time we spend chairside with patients is an asset to any clinician because we can provide information about a patient that may not otherwise be made available.

For this reason, hygienists make the perfect partner in your practice when it comes to having tough conversations with our patients and our teams. We share your commitment to quality care and communication.

The lingering impact of COVID-19 – and the opportunity

“Many dental teams are ready to speak honestly about what they need from their practice owners – and vice versa.”

We are all emotionally and physically exhausted from the lingering trauma of the past 18 months. I've spoken to many hygienists, doctors and administrative staff who agree that things feel different in their offices today vs. before the pandemic.

First and foremost, there has been a notable uptick in certain oral health conditions related to skipped hygiene appointments, delayed treatment and stress. And much like their practice owners, new PPE requirements and rapid changes leave dental teams sweaty, dehydrated, physically and mentally fatigued, and riddled with aches and pains.

But dental office stressors like staff turnover, unmotivated team members and anxious patients are nothing new. What is new is how the pandemic exacerbated these issues and pushed many teams past their breaking point. Many dental teams are ready to speak honestly about what they need from their practice owners – and vice versa.

What do dental practice team members need from practice owners now? Based on my conversations with practice team members, they sound much like the needs of practice owners:

Breaks and balance

Practice teams need scheduled breaks and lunches to replenish and recharge. This can also reduce pain from repetitive motions and strain due to long days without a break.

Patient communication support

Hygienists and other clinical staff can provide enormous value in communicating with patients about oral health conditions and treatment. We need your support to implement patient education tools that help us communicate with patients consistently.

Feedback and open conversations

Practice teams need their doctors to ask how they can help – and be willing to give and receive difficult feedback. Simply asking for and being open to new ideas can make a big difference.

I believe these conversations will be difficult, but they'll be transformative when all parties can be open and honest with each other.

This isn't going to be comfortable for either one of us...

“...this grants doctors and teams the opportunity [...] to reset the tone of the practice by having honest conversations about pain points, struggles, and ideas for improvement.”

As Dr. Ricardo Mitrani noted in his recent article about psychological safety in the dental office, “Practice owners must highlight individual contributions, so everyone recognizes their impact on the bigger picture – but it's impossible for practice owners to highlight individual contributions if there aren't any contributions to highlight. This happens when team members fear being embarrassed or punished for speaking up.”

Dental practice team members don't want to come into work each day counting the minutes until they can go home. We want to be part of something bigger than ourselves by providing the best care to patients. Like you, many of us want to fall back in love with our professions and feel motivated to perform at our best every day.

Both the ADA and the ADHA have fought for years for dentistry to be recognized as essential in healthcare – and we are finally here. The question now is what dental practice teams will do with this new and long overdue title. In my view, this grants doctors and teams the opportunity to treat patients more holistically – to reset the tone of the practice by having honest conversations about pain points, struggles, and ideas for improvement.

Practice teams rely on doctors to start these conversations so they can show up ready to take care of patients. Psychological safety is crucial for high-performing teams², so these tough conversations are an important part of helping the practice grow. I challenge you to take a step back, put yourself in your team members shoes and begin to listen to their concerns without judgment or defenses.

As a final note - Your community here at Spear is strong and resilient, just like you. As a Spear Customer Success Manager, I always tell my doctors to lean on, lean in and support one another. Most importantly, to take care of yourself. If we are not physically and mentally well, we cannot be our best at treating and supporting our patients. Thank you for all you do.

Jeanette Lalli is a registered dental hygienist, a Spear Customer Success Manager and the President of the Arizona Dental Hygienists' Association.

References

1. Mendez A. We've skipped lots of dental care during COVID. Now hygienists are having a wild time. Los Angeles Times. https://www.latimes.com/business/story/2021-06-29/dental-hygienists-tooth-cleaning-covid. Published June 29, 2021. Accessed July 30, 2021.
2. Edmondson, A. Psychological Safety and Learning Behavior in Work Teams. Administrative Science Quarterly 1999; 44(2), 350-383. doi:10.2307/2666999https://rework.withgoogle.com/print/guides/5721312655835136/