Your Image

March 1, 1998
By establishing ground rules for your behavior, you can avoid `landmines` that shatter your reputation as a skilled professional.

By establishing ground rules for your behavior, you can avoid `landmines` that shatter your reputation as a skilled professional.

Cindy Quinn, RDH, BS

It sounds so simple: "Do unto others as you would have them do unto you." Yet the Golden Rule is far too simplistic for the dynamics of a dental office, because today`s dental practices function as a conglomeration of a kingdom and a corporation. When I began my dental hygiene career more than 20 years ago, most dental practices operated as a sole proprietorship - a kingdom with one dentist or a small dental group who had their "blood" in the business and made decisions from the top down without much input from others. The functions of a human resource department - such as company policies, employee manuals, or objective, third-party intervention during a dispute - were scarce.

Sadly enough, many dental offices still lack the sophistication of organized policies and defined job descriptions. With the advent of computers, acceptance of health-care marketing, and managed care philosophies, this monarchial perspective has become melded with the characteristics of corporations where planning and strategies are part of everyday operations. But it also yields destructive behaviors such as office politics, personal agendas hidden behind seemingly innocent behavior, and unspoken rules for particular situations.

Dental hygienists operate with an unusual challenge since they work with three very different audiences simultaneously - the office staff, employer, and their patients. Each "audience" has different needs and interests. Every patient seen throughout the day evaluates their hygienist up close and personal, using all five senses to form an opinion about care and competency. They can often tell when procedures are omitted or see bad habits or attitudes develop when the monotony of cleaning teeth weighs heavy. They casually mention these observations to the employer who uses these evaluations, as well as his own, to measure employee performance or his risk.

So how do hygienists put their best foot forward as highly-skilled dental hygiene professionals - without stepping on the various land mines that exist in every dental practice? The answer lies in developing a more professional image that is consistently exhibited to everyone while in the office. Seven general areas affect one`s professional image, and each will be discussed in detail. The objective is that everyone find an area which needs improvement in their own professional career. Remember, there is no such thing as becoming "too professional."

Some ground rules for behavior

Perhaps the best defense to avoid image-altering land mines lies in setting up personal "ground rules" in advance. These rules include fundamental behavior and demeanor that facilitate cooperation, and they are decided on well before situations arise. For example, anger, hostility, or back-biting should never be part of a true professional`s repertoire. Such behavior builds roadblocks to teamwork and problem-solving for both the employer and the patient. One should decide, early in a career, to eliminate these behaviors while in a professional environment. Similarly, when a problem exists, it should be confronted without attacking the people involved. Always criticize the behavior, not the person. If one makes a mistake, it should be corrected and an apology offered. Table 1 offers other suggestions for ground rules.

Accepting a position in a new dental office often creates a flood of uncertainty and anxiety. Despite a clear sense of ground rules, one must learn names, codes, policies, and procedures, as well as office dynamics. Author Michael Thomsett, in his book The Little Black Book of Business Etiquette, offers some suggestions for those entering an unfamiliar business environment. Because the unspoken rules from previous positions rarely apply, he offers guidelines that incrementally transition new hires into an accepted member of the office.

Thomsett encourages a low profile in which one asks lots of questions about procedures and the culture, without expressing judgements. The answers received and personal observations will formulate the dynamics between personalities and tasks in the office. For example, it will become apparent which employees need direction vs. those who work best with minimal supervision.

Once the procedures, unspoken rules, and culture are known, new employees should consolidate their position slowly, says Thomsett. It is best not to verbalize comparisons between new and former offices. Every business has intrinsic problems that stem from different sources, and comparative comments from a newcomer often cause alienation. When speaking out with suggestions, Thomsett recommends that the primary rule of behavior to follow when an issue arises is, "Don`t speak until you are absolutely certain about your position, or until you can back up what you say." Table 2 has other suggestions.

One would like to assume that subversive behaviors such as political manipulation and using influence for gain exist only in Top 500 corporations. However, it is universal because human nature creates conflicts and misconstrued communication. The real challenge is to identify the political land mines, be aware of the dangers, and decide how to act during political conflicts. During my career in corporations, I realized that achieving success in a position required a balance between our personal performance and our awareness of and reaction to the political realities that surround us. In fact, many high-level executives achieve their status because of their ability to "work the balance" rather than their skill or knowledge.

In the dental office, it is best to neutralize politics with specific behaviors. One should avoid using their influence to sway the actions of others because it often gets misdirected or misused. Similarly, one should talk directly with those they need to inform rather than ask someone to relay a message or, worse yet, use the underground grapevine. As in the children`s game, Telephone, the sender and receiver of the information interpret a message very differently. This could slow down progress, or cause misinterpretations and unnecessary conflicts. Probably the most difficult method for neutralizing politics in an office is to avoid worry over what others think or do. This thinking runs contrary to normal social behavior when opinions evolve from other`s actions and deeds, but it certainly provides a quick fix for animosity.

Of course, the manner in which the dental hygienist verbally communicates to the members of the dental team and patients create an instant impression in other`s minds. One should minimize slang, establish eye contact, avoid loudness or inappropriate laughter, and try not to interrupt another person in any professional dialogue.

But hygienists must also remember that patients do not respond well, nor appreciate, a condescending tone or lecture. The initial home-care questions asked by hygienists during an appointment have been compared to the tradition of Catholic confessionals more than once! Similarly, multisyllabic explanations of periodontal disease may demonstrate knowledge, but patients often listen politely and never really understand the severity of their oral conditions unless the material is presented methodically and in simple terms. It is often useful to listen to a patient summarize his oral health to you, after your explanation, to get a sense of his true understanding. This exercise has yielded many imaginative stories over the years, but has also clarified many concerns.

It seems obvious, but a word must be said about communicating to patients about the doctor or staff. Opinions about their personalities or capabilities are unwarranted, unless one acknowledges a co-worker`s good work publicly. Similarly, complaints about other patients or employees, however bona fide, reflect poorly on a trained professional. Should others complain in the office, it is best to suggest a potential solution to solve the problem rather than join the rank of the malcontents.

Up until now, verbal communication and emotional behavior appear to be the biggest culprits that undermine one`s professional image. However, nonverbal communication and specific, work-related actions also help shape one`s professional image. Many clinicians do not realize the impact their nonverbal communication, appearance and behavior have on patients and staff. For example, the legibility of written notes and spelling form judgements about an individual`s attention to detail, something that patients expect to see with hygienists.

Patients notice the overall appearance of those treating them, particularly because they have 45 minutes or so to study it from a supine position. As summarized by Ann Dow, "If the room looks sterile and hygienic, with the hygienist`s hair back, in gloves and mask, I trust the care I receive. I feel I`m in a hospital rather than the hairdresser`s."

Body language, nice-fitting attire, and well-groomed teeth, hair and skin say more for one`s professionalism than imaginable. Patients also notice the cleanliness and tidiness of the operatory. One glimpse of a dirty overhead light or lots of clutter makes people wonder about the cleanliness of every object used. Hygienists are particularly vulnerable in this regard because ultrasonics and prophy paste create a film on safety glasses, mirrors and lights so rapidly. Finally, the sense of smell greatly influences patients. Offensive odors such as onions, garlic, and cigarettes linger well beyond lunch time and should be avoided. Even perfume is subject to allergy or perceived as a pungent odor and is best left off.

Dental hygiene care provides an unique opportunity to get to know many people a bit deeper than the initial superficial impression. Successful dental practices are built with trusting relationships that include helpful gestures, good manners, and empathy for patients` concerns. Table 3 lists other suggestions that enhance one`s professional image merely by changing observable actions.

The over-used cliche, "actions speak louder than words," is certainly applicable when considering one`s professional image. When in management, I could sense whether new hires were the appropriate choice merely by watching their use of time and telephone conversations. Both sent a subtle message about their respect for others` time and communication skills.

Punctuality is an easily-achievable way to improve one`s professionalism, as is an apology to others if one runs late. Similarly, the length of lunch breaks is easily controlled. Consistently running late speaks volumes about one`s respect for others.

Telephone use in the dental office primarily focuses on listening skills and communication without facial expression or body language to help. Patients who call are often anxious about their problem or treatment, even though it may be common and of little concern to clinicians who recognize the problem. Dental hygienists may create a poor impression, unintentionally, because they are unaware how callous or confusing they sound on the phone. Sometimes the honest opinion of a trusted co-worker is helpful.

Telephone etiquette also reflects one`s professional image. A caller should never take priority over a patient that has an appointment, unless it`s an emergency. Once callers have been asked to wait, put them on hold so they aren`t listening to office conversations. At the same time, do not allow staff conversations to distract while on the phone. If a call must get transferred to another person in the office, explain the need for transfer as well as announce the call to the receiver. Abrupt encounters and interruptions demonstrate a careless regard for the situation and are not professional.

It takes work for dental hygienists to evaluate and improve their professional image. One needs to refine observation and listening skills, think about how messages are received, and set a positive example in a climate that may revolve around ulterior motives and poor communication. But contributions toward professionalism build our status as a whole in dentistry and provide leverage for recognition as trained clinicians rather than the Odoctor?s girl.O I certainly think it?s worth it.

Cindy Quinn, RDH, BS, is president of CreativAtions in Tucson, Ariz., which provides marketing services to dental manufacturers. Her 20-year career in dentistry includes seven years in corporate management.

Table 1: Ground Rules

- Respect the chain of command

- Evaluate situations in terms of office goals

- Communicate with everyone affected by a recent decision

- Avoid controversial topics

- Avoid choosing sides in petty disputes

- Avoid gossip or rumor

- Keep personal problems to yourself

- Maintain appropriate emotional demeanor

- Confront the problems, not the people involved

- Apologize if a mistake is made

Table 2: Entering a New Office

- Keep a low profile

- Consolidate your position slowly

- Ask lots of questions

- Learn the unspoken rules

- Suggest improvements but proceed cautiously

Table 3: Non-verbal Action and Deed

- Be well prepared for appointments and meetings

- Preserve the dignity of others

- Take initiative in a group effort

- Challenge the message, not the messenger, if one disagrees

- Don`t dwell on mistakes of others

- Keep promises

- Follow up when indicated

- Exercise good manners