The triangle of respect

July 1, 2005
Have you ever walked into an office where the tension was so thick you could cut it with a knife? If your first instinct is to get the heck out of Dodge, you’re not alone.

Have you ever walked into an office where the tension was so thick you could cut it with a knife? If your first instinct is to get the heck out of Dodge, you’re not alone. Tense environments make people uncomfortable. They create suspicion, distrust, and poor communication. A stressful environment does not create an atmosphere where people want to linger, share thoughts, or spend time and money. Everyone’s energy becomes exhausted when the atmosphere is full of negative vibrations.

Doug Young coaches dental offices that want to go to a higher level. In his presentation, “Breakthrough Performance,” he discusses the effects of a toxic emotional environment. Doug has encountered teams full of animosity. Team members are convinced that patients don’t sense the discord. Doug disagrees, and explains how this negativity sucks people dry and results in team members simply going through the motions.

The term “team” seems like an oxymoron in a destructive environment. Perhaps I’m being optimistic, but “team” has a positive connotation to me. So if you’re practicing in a depressing, disapproving, unenthusiastic atmosphere, what can you do?

First, observe the little saying, “It all starts from the top.” It took me awhile to really appreciate the full significance of this statement. Most of us have a dentist/owner in our lives. There are some amazing dentists who create an atmosphere of joy, and there are others who are a considerable source of negativity. Sometimes, a seemingly benign employer delegates all of the unpleasant tasks to someone else. More blatant employers clearly infect the attitudes of everyone in the practice, from co-workers to patients.

Now before you stand up and shout, “Yes! My dentist or fellow employee is the true villain,” step back a little. If you will consider yourself a business, such as Hilary Hygienist, Inc., then you are also responsible for what happens at the top. So what is your attitude? Are you someone who people love to be around, or do your co-workers view you as a black cloud that shows up every day from nine to five, and just clocks in and clocks out?

Sure, each one of us has dark days and bad moods, but we are responsible for our own behavior. If you really examine your life in your heart of hearts, most dental hygienists have pretty good lives. I’ve never met a hygienist living on the streets. We have our teeth, and most of us have the capacity to earn a living wage. Lest you think I’m a Pollyanna, I know many hygienists who have faced serious life challenges, and the majority have survived.

Here is my point. If you are not happy where you are practicing, either fix your attitude or find another place. Patients deserve to be treated by someone who is happy to see them and who appreciates being their dental hygienist. I know there are a few patients in every practice who the entire staff wishes would forget the office address and phone number. But they are human beings who deserve our respect.

In 1994, I had a very unfortunate experience in a dental office where I worked. At that point in my life, money was a huge issue, so I readily agreed to see patients on Friday afternoons after regular office hours. One of the dentists was usually on site performing lab work, so it never occurred to me to worry. I work in a state with general supervision, needed the money, and patients were willing to schedule.

A good-looking 30ish male account executive was on my schedule for 3 p.m. About halfway through the appointment, his right hand landed on top of my leg. He rubbed the top of my thigh for the remainder of the appointment. I was stunned by his behavior, and then remembered there wasn’t a doctor in the office that afternoon.

I decided to ignore his harassment because I didn’t want to give him fuel for more aggressive behavior. But this was clearly a very uncomfortable and potentially dangerous situation.

When I relayed this incident to the doctor on Monday, he dismissed the patient’s behavior by saying he really didn’t mean anything. This was an amazing response, so I countered his reply with a question. Would he feel the same way if this had happened to his wife or teenage daughter? He said that was different. I left the practice within a short time.

Obviously there are cases where patients cross the line. Each case is different and requires a different remedy. The bottom line is respect. We need to respect our employers, co-workers, and patients. No one can work effectively if there is any break in this important triangle.

In contrast to that distressing episode, I recently had a wonderful patient experience. Jane is a 43-year-old patient who I first met when she was 12. I’ve been her hygienist for most of her life. Like so many young adults, Jane smoked.

Every time she came for an appointment I gently discussed smoking cessation with her. Even though I quit 28 years ago, I’ve got a vivid memory of quitting two and a half packs a day cold turkey. My heart goes out to smokers, but I know they have to be ready to quit. Until they internalize the seriousness of the situation, it’s like talking to a brick wall. But I also know it is my professional obligation to approach the subject.

I told Jane, as I tell every tobacco user, that one day she’d walk in and tell me she’d quit. It is critical that we be non-judgmental and ever affirming partners in the quest to quit tobacco. She quietly quit smoking on her birthday a month later. When Jane arrived for her hygiene appointment a few weeks later, she shared the great news with us. It was a thrilling appointment. The triangle of respect was stronger than ever between Jane and the dental professionals in my practice.

For those of you who are fortunate enough to be in an environment where you are respected and valued for what you have to offer professionally, keep on giving your best to the patients who place their trust in you. But if your only definition of respect is the title of a classic Aretha Franklin tune, take a serious look at your circumstances.

If the doctor and staff you work with deserve more respect, then start showing more appreciation for the team. If you determine that you’re not valued or respected, then look closely at your situation. Is the problem you or them? Only you are responsible for your thoughts, actions and behaviors. If you need to fix your attitude, do it. If not, then find a place where respect is at the top of your comfort zone list.

Anne Nugent Guignon, RDH, MPH, is an international speaker, has published numerous articles, and authored several textbook chapters. Her popular programs include ergonomics, patient comfort, burnout, and advanced diagnostics and therapeutics. Recipient of the 2004 Mentor of the Year Award, Anne is an ADHA member and has practiced clinical dental hygiene in Houston, Texas, since 1971. You can reach her at [email protected] or (713) 974-4540 and her Web site is