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Connections of care

Feb. 1, 2005
It was a professional privilege and a personal pleasure and joy to speak to the Hawaii Dental Hygienists’ Association last November. As a speaker, it is always fun to speak in beautiful and exotic places.
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It was a professional privilege and a personal pleasure and joy to speak to the Hawaii Dental Hygienists’ Association last November. As a speaker, it is always fun to speak in beautiful and exotic places. From a personal standpoint, having lived in Hawaii for years, this speaking opportunity brought me back to my home of the heart. I knew that the theme of “honoring our professional ohana” (ohana means family) would be replete with implications of extended family meanings.

Hawaiians take the notion of ohana seriously, and their circles of “family friends” expand in direct proportion to their capacity for hospitality and generosity. If you are lucky enough to become included in their ohana, you immediately become an “auntie” or “uncle,” and are accepted with love as any blood relative. I’ll never forget the first local wedding my husband and I attended for our Hawaiian/Chinese friends. It was a family affair, with everyone contributing to the food, decor, and preparations - for a mere 2,000 people of the extended ohana!

Knowing what I know about the Hawaiian culture and their sacred ohana, I felt an obligation and an exciting challenge to customize my presentation, using family as a metaphor for expectations of the highest standards of professional health care. The seminar’s title, “All in the Family: Creating Connections of Care,” embraced the many connections we facilitate as health-care professionals, as in any extended family.

The introduction to my presentation mirrored my personal introduction to the legendary Hawaiian goddess, Madam Pele. Ancient Hawaiians had no written language, and mythology created strong symbolic metaphors for their ancient history. Passed down for centuries through storytelling and the unique and beautiful hula, these myths connected the common person to the powerful Hawaiian deities, and were often surprisingly congruent with scientific and horticultural fact.

Madam Pele, the infamous volcano goddess, earned her reputation creating the Hawaiian island chain through volcanic eruptions, all the islands being the tips of volcanoes. She still lives in the bowels of Kilauea Crater on the Big Island of Hawaii, which has been erupting for 22 years. She reveals herself to us as a flamingly beautiful young woman, as well as a haggard old woman. These visions are frequently apparent in the smoke patterns above fiery eruptions, and have even been captured on celluloid in published photographs.

The first time I saw Pele in action, I was a visitor to Hawaii. That started my love affair with the Hawaiian culture, and began my cultural connection with this magical place and mystical mythology. Twenty-two years later, speaking at the 2004 HDHA annual session, I found myself realizing a connection that has taken me across the Pacific Ocean many times and continues to bring me back to this source, connecting me to my many “families.”

As in the waves of the ocean, we never know where the extension of our influence begins and ends. We are all connected, yet the network of those connections exceeds even the wildest imagination. Consider the professional “families” that comprise your profession. Your first focus is, and must always be, your “family” of patients. Additionally, your “family” of team members warrants attention and care as well. Finally, the source of all of your professional “family” connections is you. It is paramount that you nurture yourself so that you can, in turn, nurture your professional ohana. The sidebar below offers some suggestions about your extended dental family.

Finally, take care of the family member who creates all these connections ... you.

As health-care professionals, we often become so focused on the care of others that we neglect ourselves. Here are some pointers to nurture yourself so that you can continue your connections of care.

• Get some exercise.
• Stretch in office and take minibreaks during the day.
• Do something outdoors.
• Eat low on the food chain and maintain a diet that supports your energy level all day.
• Practice ergonomic dentistry. Make sure your room is organized to maximize effective movement, comfort, and convenience. Utilize loupes, good lighting, supportive chairs or stools, slim-tip ultrasonics, and ergonomically designed hand instruments.
• Take a vacation.

Taking care of yourself will ensure that you’ll have the energy for others, and prevent professional and personal burnout. The Hawaiians were smart to honor their ohana families. By supporting our families, whether our biological families or our professional families, we support an interconnected system of comprehensive care that knows no bounds. Creating connections of care, like the ripple effect in an ocean, expands exponentially, creating new rewards in your practice, career, and profession.

Taking care of the ohana

Determining and maintaining the highest standard for your patients takes on new meaning when you think of your patients as part of your practice family. How would you treat this patient if he was your father or she was your sister?


• Would you perform a complete head and neck intra- and extraoral cancer screening at every appointment?

• Would you perform complete six-point probing to screen for periodontal disease?

• Would you provide preventive fluoride therapy?


• Would you preappoint each time to be sure you had a future “date” for comprehensive and preventive care?

• Would you call those long lost relatives/patients to welcome them back to their dental family for continual care?

• Would you become relentless about confirming their appointments, not just leaving messages and hoping they’d show up?

Hospitality (marketing)

• Wouldn’t you invite your family to invite their friends and relatives to become included in your family/practice activities (for example, internal marketing, asking for referrals)?

Accelerate your standard of care to the highest by asking yourself: “What would I do if this was my family?”

Your team is also your family. Typically, you spend more time in your office than at home, and staff becomes your family away from home. Like any family, there are ups and downs in relationships and daily itineraries based on individual agendas.

Take care of your team

• Praise all of your fellow team members in front of your patients. This is huge in terms of building team rapport, and it sends a clear message to your patients that you are a supportive team of winners. Everybody likes to be with the winners!

• Establish clear lines of communication. Do this through regularly scheduled meetings. Have staff meetings monthly and huddles daily. Hygienists should have bimonthly meetings with doctors for case review to maintain philosophical and diagnostic congruence.

• Establish team goals and agreements. Create strategies for conflict resolution. Agree to coach each other to uphold your goals. Create success scripts and then use them.

Your care connections of your team family extend out to your professional referral specialists also. This is your professional extended family. Do you know the periodontist to whom you refer patients? Make a point to become very well acquainted with your specialists, know their staff as well, and communicate with them on behalf of your patients. Let your patients know that “Dr. XYZ and his team are all a part of our dental family. They just happen to be in another building.” Then, make sure that you create with them those connections of care.

Janet Hagerman, RDH, BS, is a speaker, writer, and the director of dental hygiene for Coast Dental. She can be reached at [email protected].