Dentistry Uncensored with Howard Farran

How to perform dentistry faster, easier, higher in quality and lower in cost. Subscribe to the podcast: https://podcasts.apple.com/us/podcast/dentistry-uncensored-with-howard-farran/id916907356

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• Judy Kay email address - JudyKay@PracticeSolutionsInc.net
            
• Practice Solutions Inc. - http://www.practicesolutionsinc.net/ 

Howard Farran:  It is an honor today to interview Judy Kay. We just lectured on the same meeting just like a month or two ago. It was in Tennessee.

Judy Kay:  Yes it was.

Howard Farran:  It was in Nashville, Tennessee and you jut crushed it. Everybody loved it and you speak about something that is just so important. Dentists go to school for eight years and they learn calculus and physics and geometry, then they do root canals, fillings and crowns and Judy Kay, I have to tell you that I’ve met probably all the wildly successful dentists. Every dentist that’s just crushing it in the last 20 years, I’ve probably met and the only thing they have in common, it’s not whether they do root canals or fillings or crowns, it’s not if they have digital x-rays or film of if they’re into CAD/CAM or any of that stuff, it’s when they walk into the room with a patients, it’s just charisma.

They walk in there and it’s a big smile and it’s ‘how are you’, and you just see the energy and they’re surrounded by staff that have been with them 10, 20, 30 years. It’s just this big happy family and the office is doing a million gazillion a year. And then you walk into the other 90% of the offices and the doctor looks at you and says well we’ve taken your x-ray and- the view box- here’s the cavity- it’s close to the nerve, you’re going to need a filling and then we’re going to do a root canal and- and then he’s trying to build his practice on Facebook and it’s just like I’m up the street from probably the first of the mega greatest, Omer Reed and I mean I follow him around. You know Omer?

Judy Kay:  I do.

Howard Farran:  I followed him around like a student. I was 24 years old, it was 1987 and my God, I used to wonder is he ever going to do the dentistry. I mean he’d walk in there and he’d grab these ladies hands and how are you doing? And he’d ask them about their wife and their kids and their mom and their dad and I’m sitting there like 15 minutes later- you’ve only got an hour schedules and you’ve got to do a crown, you’re wasting your time.

He wasn’t wasting his time, he was building the biggest dental practice in the world and it had nothing to do with dentistry. So I want to give you your first challenge and that is this: dentists sell the invisible.

When you go check into a hotel room, the maid put the slip of paper around the toilet seat because I didn’t see her clean it, she didn’t see me, neither of us will ever see each other and she’s selling that hey- this is clean. She puts a little cupboard, little cardboard thing over the glass so you know it’s not a dirty glass. When you order room service they leave an inch of paper on the straw to let you know it’s a new straw and when you go to a doctor and they say you need a root canal, well it’s like when I take my car in and they say I need to fix something in the engine. I mean I grew up with five sisters playing Barbie dolls until I was 12, I never changed the oil in a car. I’ve never seen a spark plug. I don’t know what my lifters are. But you look at this person and you think well I’m at the dealer and he’s in a uniform and he has a name tag and I’ve been dealing with the same guy for 10 years and I’ve always thought that the dentists that have the staff turnover, where every time you go in there it’s someone new, it’s a different receptionist or it’s a different assistant- well what happened to the hygienist that cleaned my teeth last time?

Oh she’s no longer here. Here’s the new girl. And what you focus on is the most important part, and that’s the part that the dentists don’t even think is ever relevant and that’s how do you make a happy staff, how do you make these people all get along and play nice? My core values for my dental office just real quick- I just have twelve: 1) create a fun, positive professional environment, 2) be passionate, enthusiastic, determined to make a difference, 3) be humble, 4) embrace and drive innovation, 5) follow the golden rule: treat other people like you want to be treated, 6) mistakes will be made. Be accepting and get over it, move forward. 7) Never stop learning. 8) Be honest and respectful, integrity is everything. 9) Balance life and work and be fully present in both, 10) strive to make everyone feel safe, valued and important, 11) be remarkably helpful. 12) Create opportunities that make our patients feel special.

So what I want you to do, is I want you to focus on this male dentist, I think the males are worse at it than the women dentists, the whole thing is the root canal and the bonding agent and he’s got staff turnover which I think breaks trust with the patient and they come in here and you’re telling me I need five crowns but everybody, it’s like a revolving door around this place. How do you get the dentist to focus on the staff and how do you do that? How do you make a happy, fun environment?

Judy Kay:  Well you’ve asked a lot of great questions and summed it up perfectly, thank you. First of all is getting the dentist to focus on the team is a huge chore. It is a feat because otherwise, many of these dentists would already be doing it. They don’t connect the dots of if I have a happy team I’m going to be successful. So it’s really about showing them the return on investment of making that difference of creating a happy team. It’s showing the connection of here’s why your patients have disbelief, it’s because you have to almost start out from the results and work backwards and show them where the problem is happening and connect it to, okay because your team member was confused.

You have something in your practice that makes all the difference in the world. You have a code of conduct. You have standards. You actually have standards for soft skills or what I call essential skills. Most offices don’t. There’s a presumed or an assumed that this is just how everyone should act but it’s never discussed, it’s never put in any writing anywhere or reviewed so that’s a huge thing. Starting because it gets rid of the confusion and the chaos of what they’re supposed to do. So just even having that in a part of your practice having a culture established by having a team meeting and creating what you want as a team together in your environment. I find that if you hand down the code of conduct to your team and you follow up, they don’t own it yet. If you have a team meeting or workshop and you include the team in defining what it is they want in their office culture, what they need as an individual personality- that creates a great code.

Howard Farran:  Do you have a code of conduct written for a dentist?

Judy Kay:  I don’t, I have to write them based on the personalities that they have in their practice because from your office Dr. Farran to another office there’s going to be very different team players. What their needs are going to be is very different so it’s really about customizing what’s important for this team to play well together and you mentioned a very key factor. You said there’s this revolving door of team members coming and going. Part of the problem is that they’ve never found out what was important to that individual team member to succeed nor were they aware of what it took to even be able to help support them to succeed.

So instantly they didn’t fit in in a very short time, and it’s like okay this doesn’t work here and we’re not going to invest the time or energy or passion in building this team member to belong in this team and understand how to be a great team member on this team.

Howard Farran:  So do you agree with the assumption when your average staff only stays with you for two or three years that it’s hard to build a big practice when your staff is a revolving door? Do you agree with that assumption?

Judy Kay:  Absolutely.

Howard Farran:  And I mean threads on Dentaltown in HR, I mean like some of the low hanging fruit that just kind of describes a dentist, like they’ll say things like well this assistant applied for a job and she was just fantastic but she had an earing in her nose and she had a tattoo I could see on her arm. First of all, I always see that as just décor. Like you have earrings on, I mean why do dentists get all crazy about a tattoo or an earring, isn’t it just like karma? If you meet someone and they make you smile ear to ear, do you really break it down to an object like well you have some ink on your arm or a piece of silver in your nose? Talk about that for a moment. Is it unprofessional to have a visible tattoo in a dental office?

Judy Kay:  I think that’s a personal thing. I personally don’t think so. I think that it depends, I’m not the what to wear lady here or how to dress, but what I can say because I have my own, and you’ve seen it, different style so it’s a style. I think it really depends on how you care for the patient. I think most importantly is that that person is warm and friendly and caring and that’s the energy that they’re sending out to the patient. I think dentists and administrators get lost in the hiring process of thinking they’re going to have this perfect little, almost Stepford wife type of employee that steps in and they’re going to look this way and act this way, and the scripting is going to be a certain way and I don’t buy into that. I think that comes off as very phony and fake and not as an actual connection to their patient. So I think it’s very much about the energy that we radiate out. I think if the patient feels we care about them, that’s the most important thing.

So whether they have a tattoo, I’ll use this example. My father is no more with us but at the end like 85, 86 year old retired, North Dakota, Catholic farmer, very tiny world as far as what as right and what was wrong and ended up going into a nursing home in the final year and ended up working with a lot of very different personalities than what he was used to. What I found for him is, the initial thought was he’s going to be uptight because everybody looked like him in his little farming community, he’s name was Clem and all of a sudden he’s here with all these people and he was great and what I saw the common denominator was the fact that they cared about him. That’s all that mattered. They were kind and caring to him and once he realized that they cared about him, he trusted them and it had nothing to do with looks or anything else. They could have had 100 tattoos, in fact I think some of them did. It didn’t matter. So I agree.

Howard Farran:  So is there any, what is the low hanging fruit? Go into how- dentistry is high stress. A lot of dentists say, about every three years we do an article on substance abuse because most all the states in order to renew your license you have to have three hours of continued education on substance abuse, but I look at the data and it says 18% of Americans will have a substance abuse issue and it’s 18% of dentists. Anesthesiologists is 30%. I’m proud to be Irish because Ireland, it’s actually 35% and only one country beats Ireland and that’s Russia at 40%. So that’s why I don’t like Russians because they beat us Irish in drinking and I think if the Irish just tried to drink a little more we could beat those Russians.

A lot of dentists, it’s stressful because if you work in a restaurant, they’re coming in and they’re all excited because they’re going to eat a bunch of food and butter and grease and chips and whatever. I remember taking my four boys to Disneyland and the kids were literally, they couldn’t even hold still they were like skipping in place. They were so excited and then people come to a dental office Judy and they’re like God, I couldn’t sleep last night and oh my God how much is this going to cost and I don’t have insurance, so it’s a little serves more the darker side of life’s experiences. When you go on a cruise ship, you can get a mani and a pedi but not a root canal for entertainment.

So how do you help this dentist create a happy environment in a stressful environment, because at the end of the day Judy it’s a stressful environment, no one likes the shot, the kid’s crying, we say it’s going to sting a little. If it’s in the roof of your mouth it’s going to sting a lot. How do you create a happy environment in a stressful environment? Does that question even make sense?

Judy Kay:  Well it’s about getting rid of the ongoing obstacles. Now if something happens once we survive it right? But if it’s ongoing, it’s kind of like you hit your finger with the hammer once, it hurts a bit but you’re okay, but you keep hitting it, it ends up being really painful and it will end up in a bigger problem. It’s the same with a dental team. What I find when I go and work with teams I’ll observe for a day or two and just watch the flow and see where their ongoing obstacles are and there’s certain things that they do that create obstacles for their patients as well so it might be a very difficult check-in procedure. It might be a very difficult financial arrangement protocol. Whatever it is that creates something that gets in the way for a patient wanting what they desire, or it gets in the way of a team member wanting what they desire creates an obstacle. So it’s really about how do we remove these obstacles? How do we get rid of the things we can see? As an outside observer that you can see when you walk in. I’m sure you’ve seen this time and time again. Why would you continue to do the same thing? It’s like you’re running into a wall. Why wouldn’t you change it and get rid of that stress?

People do it so often they don’t even realize that there’s an opportunity, that they have an option to change it. So it’s about getting rid of the obstacles that we know already exist and then when the other obstacles- if we take care of 85-95% of the things that we can count on that happen, then the 10% we can survive. You know we have a couple of patients that get more upset or have a little problem here and there, we can work through that. If every patient is upset or everything is high stress, then we get burned out. Then we can’t control it. So it’s really about getting rid of the majority of the obstacles that we know are going to happen and a lot of that has to do with having time in teem meetings, talking about what we run into. The pitfalls or the bottlenecks or the obstacles. It’s talking about how we would resolve it, how do we have a plan of attack before it happens.

You look at a major professional team, and I’m so bad at sports, I can’t believe I’m even talking about it but you look at- they have a plan of attack. If this play doesn’t work, they’re going to do this play and if this play doesn’t work, we’re going to do this play. So it’s really about giving people resources and options to fall back on because stuff is going to happen. I always laugh, I’ll ask a team how many of you have ever had the day actually go the way it was scheduled? How many days a year does that happen? Maybe two right? So why do we get stressed when it doesn’t go that way? That’s the norm!

It’s really about helping them get rid of the obstacles that we can get rid of upfront and then having the resource or plan of action of what we do. What do we do if Mrs. Jones comes in and she’s crying? What are some things we can do- so it’s already ingrained in us to know this is the next step- that gets rid of the stress and gets rid of the fear.

Stress comes from when we get into the flight or flight mode. That first 30 seconds we’re like oh my Gosh what do we do? And the whole prefrontal cortex shuts down and we can’t process so we hit more stress then we start spinning out of control. If we stop when whatever happens, doesn’t matter what it is and we take 30 seconds and breathe and just get back into our cognitive state, we’re going to be able to work through it and then having a backup plan of action we can pull from that and we can remember that and it becomes clear again and all of a sudden we’re okay again.

There is a way of removing stress. It’s really about understanding the obstacles and how to remove them.

Howard Farran:  In your experience, how long have you been doing this?

Judy Kay:  What part?

Howard Farran:  Well let me go this: I know it’s racist to say all Irish people love Vodka, when in fact it’s only 38% of us, but is there like an average dentist? When you look at 150 000 dentists, do we have any average mind set? If someone came to you that’s not in dentistry and was a psychologist, a counsellor or whatever and said Judy, describe a dentist for me. How would you describe that dentist and is that really the personality to coach and lead a team? So this average, introvert- if someone asked me to describe a dentist, I say well take a mathematician, a physicist and a chemist and an accountant and add them all up together and dentists, most dentists became a dentist because we didn’t have enough personality to become an engineer.

Is that really the personality to manage a happy team and because of that, should we have an office manager? If a dentist said to you, Judy Kay look, all assistants and hygienists and receptionists are bat shit crazy so I’m going to hire an office manager and her name is bat shit and she’s in charge of the crazy ones. Would you recommend the office manager approach? What would you tell that introvert, geek, mathematician dentist who is trying to lead five happy people in a stressful environment?

Judy Kay:  Well first of all I think that even an introvert, and I’m married to an engineer so I get that mentality, so I totally get it. You can teach, there are many different ways to lead and if they understand the concept and they have a goal and they’re clear on some things that they can do, I can teach them the skill sets to be able to lead.

The problem is that they don’t have the time. The reality is that you’re supposed to be in a room practicing dentistry and building relationships with your patients. How do you have time to run a business as well? So it’s really important and have the time to really have the conversations with the team. If you want a happy and engaged team it takes more than one meeting a year on your annual deal going hey, gee you’ve been swell all year long. That doesn’t create a connection, that doesn’t build a relationship at all. So I really, I do highly suggest a practice administrator or office manager.

I think it’s very important and that’s going to give them freedom to be able to practice more dentistry but saying that, that does not mean they’re hands off. They really need to have, I suggest weekly meetings with the practice administrator where there’s a connection of talking about any concerns or any successes with patients as well as team as well as goals for the practice as well as marketing, different things. All of those things so that they’re in tune with each other and they have a very synergistic message.

Often times I find doctors hire managers so they get to be the good guy and the manager is Guido, the bad guy and that’s a mistake because all that does is undermine the office manager and it doesn’t change the performance in the office at all because they’ll just go behind the office manager and go to the doctor so really they’re a part of that leadership team whether they want to be or not because they own the practice.

Howard Farran:  I want to stop you right there because it happens all the time. So you’re the assistant and you just come up to me and say Dr. Farran, the office manager said blah, blah, blah, that’s just not fair. What do I say?

Judy Kay:  Well you would tell her- alright. Thank you for sharing that. Please bring that back to the office manager. Take it to her, we’ll have our leadership meeting on Tuesday. We meet every Tuesday, we’ll discuss it. We’ll talk about- unless it’s a fire and it has to happen that day, we’ll discuss it on that day but I’ll discuss it with the office manager, I’ll get her feedback as well and we’ll make a decision, we’ll talk about that.

Howard Farran:  And what percent of the dentists do you think throw the office manager under the bus by changing her decisions? Where the staff runs around the office manager, comes to the dentist and the dentist changes it on the spot?

Judy Kay:  Well I would tell you that all of them that eventually hire me do initially before they hire me because that’s where the problem lies.

Howard Farran:  That’s a huge problem.

Judy Kay:  That’s why I have a lot of work.

Howard Farran:  And in the military, Judy Kay, going over your commander’s head, you better be right because if you’re not right you could end up in Leavenworth. If you disobey, if your commanding officer says you do that, and you say no and you don’t do it and you go over his head, if that guy over his head agrees with your commanding officer they’ll send you to Leavenworth. You cannot break the chain of command. In the military no one manages more than eight people- and it’s eight, one leader, eight one leader because they’re dealing with 4 500 nuclear bombs, I mean any one of those trident submarines could turn around and take out the whole country. We could lose every single- what is it 80% of all the air flights in America going to 30 airports? I mean one trident sub could take out that in five minutes so breaking the chain of command will not ever be tolerated in the military. You’ll go to Leavenworth if you do that and dentists do it all day long with their office manager.

I want to ask another thing, this is a question we get all the time: the wife working in the office as the office manager. Thoughts on that?

Judy Kay:  I think it depends on the personality. First of all I think it’s a very difficult position to be in as a wife because you’re expected to manage, you have different standards being the spouse. It’s not an easy position but I’ve seen it be very successful when there are clear standards. If it’s not their opinion but it’s based on okay these are the standards, this is what supports the standards. Tell me how if you have a disagreement with me, tell me how you feel what you would like to do supports the standards. So if they keep it away from the personal and they have the standards already defined, it’s a much easier position for them.

If however, they say well I think you should do this and on another day I think you should do this and there’s really not a decision strategy as well as clear standards, that’s when it gets into trouble and then if there’s a division, depends on how well the doctor and their spouse get along as well because if there’s some chafing there where the wife as the manager or the husband as the manager, I see that a lot now, tells the staff one thing and the doctor raises their eyebrows, there’s a problem.

Howard Farran:  What do you think would be worse for the dentist’s wife, to be the office manager or to actually have to sleep with the dentist at night?

Judy Kay:  It depends on the dentist.

Howard Farran:  Again it depends on the dentist. You’re not going to go any general. So Judy, do you prefer Judy or Judy Kay?

Judy Kay:  I’ll answer to anything.

Howard Farran:  You’ll answer to anything. What do you do, I think every dentist has had this experience, you’ve got just two phenomenal, great assistants. They’ve been with you 8-10 years and I swear to God, it seems like they just don’t get along and this one you just really love for surgery. She loves blood and guts. She’ll get in there and do any extraction, implant, she just loves blood and guts. This other one totally likes the cosmetics, the finishing, the veneers, the bleaching, they’re both great with patients. The patients love them both but in the central sterilization room they almost punch each other twice a week. What do you do with that because it’s not an easy decision to say oh I’ve got an easy decision, just flip a coin and fire one of them or hell fire them both- but you really want to keep these two ladies and they’ve been with you for 8-10 years but they jut don’t get along. Can you change that or is that just, you’re just not going to like some people?

Judy Kay:  I think you can in some cases, I think it’s about expectations. I think that so often times, we’re not taught conduct in school anymore. We’re not taught, I have a report card that I show in my PowerPoint slide that talks about conduct. You’re rated for that you observe authority, you respect authority, you are kind and courteous, you play well with others. For some reason we’ve stopped having that expectation of our students in school and of our employees at work. Part of the hiring process, and I think here’s where we drop the ball right at the beginning, is we don’t make clear expectations that part of their job is to get along well with others. It is not the doctor or the manager’s job to make sure everybody plays well together and that’s gotten shifted and all of a sudden team leaders go well you’ve got to make this where I get along with her. You’ve got to make her behave.

Well if she’s not supporting our standards that’s a different story but if she, the two of you just have a difference of personalities, that’s about the two of you learning to get along. So it’s really about and initially in that interview, it’s important if we’re going to hire you that you get along well with others. You may have a disagreement with someone, you may not believe in all the things that they do but as long as they’re supporting all the standards of the practice and the patients and what we have, we expect you to support that person. There is no opt out that you don’t help them because you don’t like them. That mentality, I don’t help her, I don’t check this person in or I don’t schedule that because I don’t like her, no you’re effecting the entire team so to be a part of this team right from the start, those behaviors are expected right from the start that you support each other regardless of whether you like each other. You don’t even have to be friends, you don’t have to like each other. You have to respect each other and treat each other with kindness. That’s the key. It’s about really clarifying that upfront.

Often times I come into practices where there’s been chafing for years, sometimes 20 years where these team members have been fighting and I’ll see, in front on the entire group, everybody’s eyes flicking around like oh we can’t say this in front of this person or that, and we have all these invisible elephants in the room. No, so I’ll say it feels like there’s some energy here, are we tired of fighting or worried about who is upset with who? Are there certain relationships where it looks like there’s an ongoing struggle? How frustrating is that for the rest of the team? I don’t think the two people usually involved in it realize how much the rest of the team gets frustrated and gets tired of it because everybody’s dancing around it.

It’s really about saying hey, as a doctors, as a practice administrator, if that were my role I would be saying to both employees, sit them down together and say look you guys, I think you’re both awesome. You’re phenomenal in surgery, you’re in there up to your elbows. You’re handing me instruments before I could even think of what I need. You’re fantastic, I can’t imagine running this practice without you. I would turn to the other one, and you’re so amazing with all the details, you make crowns look like artistry, you do all this fabulous work. I can’t imagine running this practice without you either. I need both of you. I need the two of you to figure out what it’s going to take to work this out because I want you both to be here. It would be a shame if you both had to go.

It’s all or none. When they start to realize that they can’t sabotage each other anymore, it’s like I need the two of you to work together so right now, here’s an opportunity. Let’s talk about what you need from her to be able to work in this environment and what do you need from, ask them, what do you need from each other? What do you actually need? What’s the bottom line? But the first question and I’ll retract- do you still want to work here? How important is it for you? Because sometimes the bottom is they don’t necessaRiley know if they want to work there anymore and we can’t want the employee more than they want their job.

Howard Farran:  That’s profound. We can’t want the employee more than they want their job. Kind of like a song, I can’t make you love me, or something like that.

Judy Kay:  That’s it, yes.

Howard Farran:  So I see this all the time and dentists on Dentaltown will say this all the time. I’ve got to admit, I’m a wet glove dentist, I still do dentistry. When I’m in there doing a root canal, it’s really like Stevie Wonder picking a lock. I mean you can’t see, it’s all by feel and there’s at least three canals or four and you’re in there for an hour and someone has come by the office and they’ll say something like- and you just oh yeah- you have no idea what they said and I used to agree just to get them out of there- oh okay. Because you’re just in there in the zone for an hour and then when you walk out of there I mean it’s like you just walked out of a cave, the light is bright and someone runs up to you and sticks a note, you don’t want to hear any of it and what the dentist does is then they go in their office and they shut the door and you opened up with a sport’s analogy, you said if this play doesn’t work, you do this play. You know during a football game or a basketball, there’s a coach out there with a plan and a play and they’re all coming to him- and as a dentist, when I do a root canal and I find out five minutes later I’m going to go into another one, I need five minutes to go to the bathroom or drink some water or eat a cookie or something and then you go in to do another one and I think the profound thing that you’re saying now is that, you don’t have time to be an office manager. You don’t have time to deal with all this stuff. You can’t go from a root canal to an implant to four filling in an hour and you need that five minute break in between, you just don’t have time for any of that.

There’s got to be a head coach walking around and you can’t undercut that person’s authority. You let them coach. Does that sum that up?

Judy Kay:  That’s right. And I think also it’s really- you’re so focused as a doctor on what you’re doing and that’s a good thing, we want you that way so it’s really important, I like to have a clinical person that’s really overseeing in the back as well, where you’re going, whose going to keep everybody informed so you’re not coming out of there going okay now where do I go? They’re your person, I love to have a clinical lead and that clinical lead can change from day to day. That way no one has this hierarchy of a position, it’s like people are like whoa, how did they get this? It’s more about saying okay, for today you’re responsible for the flow for the day. Tomorrow this person is, or they have a certain day of the week that they always have that role and it really helps the team step up. It also helps them be more accepting of the other person in that position because they know they’ve had to try to make it work out and then you get more help because your focus really needs to be on the patient and that’s why it’s so important for the doctor, or doctors if it’s a group practice to meet with that practice administrator at least once a week so it’s real time conversation so the team doesn’t bother them- and I don’t mean bother, I should say interrupt them in the middle of that day so they can take things and if they bring things to you Dr. Farran, you would just say please take that to Mary, take it to the office manager she’ll bring it to our conversation, our week team meeting. If they’re concerned that it’s not going to be portrayed in the way they want it, have them put it in a note, write it down and bring it to the table what’s for discussion, but nothing comes back on a knee jerk reaction response.

That’s what happens a lot of times because you’re just like okay, yes, let’s do this and then someone else asks you and they get a different answer and they go wait I was told this? Well no he told me this. Then you get this, the chafing. So it’s really better to have a little more time to think about it, think about the consequences, the benefits and having a second person that’s looking at it outside of the room as more of in between, looking at how will this effect the overall patients or practice, how will this effect as far as precedence, as far as practicality, is it something- a lot of doctors are more dreamers and visionaries and the practice administrator is the one that’s got to make it happen so she’s going to look at what’s realistic about this? How doable is it? So it’s really good to have that conversation and be able to sit down and have that conversation about making those decisions.

Howard Farran:  Now I’m going to ask you a very controversial question but it’s real. I always keep it real. One of the greatest HR speeches I ever listened to was by Pat Riley who was the coach of the LA Lakers and then he went on to Miami, wildly successful and he came and spoke to our dental association and I think most people went there out of stardom to see this very famous coach, and it was actually one of the best lectures I ever heard, he said now look and this is back in the day, this is ’87, you’ve got to remember Judy when I was a freshman in dental school the senior class had one woman and we called her man-woman because no one could really tell if she was a man or a woman, and now the classes are half women okay, so back in that day, ’87, the whole room was men and he says I know what you’re thinking. You’re thinking you’re a man and for some reason all your employees are women and you think you want to cry yourself a river, that’s a problem because look at me. He says in the NBA the coaches are all six foot, the players are all seven foot, we all get paid a million a year, they all get paid a gazillion a year, they can brutally kick our butt, he goes and with particular to intercity African-Americans, he goes most of them in the NBA didn’t have a father figure and so the female mom is the authority so if a man walks up to one of those players and says to them, they want to come out and go to fist, but if a woman comes out there they’ll just listen.

So they see the women as the authority, so here’s Pat Riley, a man who is little and isn’t on their level, so I want to ask you two questions: do you think if you’re a male dentist that there are some biologically inherent challenges in managing an all female staff and forward to that, I have heard at least 100 women dentists in the last 10 years say to me, you know it’s just not fair, I was an associate for a man dentist and he would say this to the staff and they would do that, and then he sold me the practice and left and I say the exact same thing and they all look at me like I’m crazy. Some of these little things, hey will you get me a cup of coffee, and they’ll say like what am I, your slave?

So you’re a woman, is there a difference between managing five women in a dental office as opposed to five men in the NBA?

Judy Kay:  Again, and I’m not trying to skirt but I think it depends on the personality. I see women dentists have the same problems in leadership as men dentists and I see men having the same, when it comes to not listening as women when it comes to that. I would tell you though that there is a natural inclination we have, how we respond. Women are more catty with women than they are with men, as a rule.

Howard Farran:  Define catty?

Judy Kay:  More judgmental, where we have a tendency to listen to a man maybe a little easier because of how we were brought up. I was brought up in a household where you never questioned dad, ever.

Howard Farran:  Same here.

Judy Kay:  And I started in dentistry in the mid 80’s, like ’84, ’85 was when I started as a receptionist and an administrator so I recall those days very much, it was all male. But I think in a very short time, I think initially there is a division. I think that there is a different when you’re male or female how people respond to you, I honestly do. But I think in a very short time as a leader it depends on how you lead. If you lead by example and that’s the biggest leadership principle I can teach. If you walk the walk, it’s very easy to get buy in from your team. Whether you’re male, female or whatever it’s about trust and respect that’s the bottom line and it doesn’t matter your sex at that point but initially we have a tendency- if a woman asks us to get coffee, we’re going to stand back a little bit. We’re like that’s subservient. If a man asks us to get them a cup of coffee, for those of us at least my age, we’re used to serving in some respect the male and I know that’s going to sound, that’s going to come back to haunt me big time.

Howard Farran:  Well I mean we all saw it as a kid, your dad will be sitting in the chair and say honey get me a beer and she’d run in the kitchen and come back with an Old Milwaukee.

Judy Kay:  Seriously, love you dad, he sat in the recliner and we had two channels, thank goodness we didn’t have 51, and the kids were the remote. Here, turn it to channel five. Turn it to channel twelve. Get up there- there was no question. He came in on the farm, mom helped farm just as much as dad outside, there were seven kids but she came in at night, he went in and sat in his recliner, she made dinner he came out and ate, he got up from the table and went back to his chair and she cleaned the dishes and did whatever and did some canning and that was it.

Howard Farran:  So seven kids on a farm in Iowa?

Judy Kay:  North Dakota.

Howard Farran:  North Dakota so were you guys Catholic or Catholic?

Judy Kay:  Catholic.

Howard Farran:  Oh my Gosh how did I guess. I was seven kids from Kansas and by the way, my oldest sister is a nun in your city, Minneapolis–Saint Paul in a suburb called Lake Elmo?

Judy Kay:  Oh yeah.

Howard Farran:  So whenever I want to visit my sister in the nunnery I would go visit 3M or Patterson for four hours and one minute and the whole trip would be- so I’d fly in there, go sit in Patterson or 3M from 08:00 to 12:01 and then go spend the rest of the day with my sister and fly home all IRS tax free. I swear to God Judy you’re not going to believe it but it’s like 80 degrees here and one time I left Phoenix to go visit my sister and the temperature was 100 degrees lower. I think I left here at 82 and got there and it was like 18 below or something, I was sitting there, I told Mary Kay I said I dropped 101 degrees to come and see you.

So I hope you’re not frozen to death right now. Are you warm enough to keep going?

Judy Kay:  Yeah we’re good.

Howard Farran:  You have a heater on there. So I want to ask you this, is a leader just born? I mean people who are great leaders, were they just born that way, just like some people are gifted in music? The happiest day of my life wasn’t the birth of any one of my four boys, it was the day my mom said I no longer had to take piano lessons. I just hated that. My teacher said I couldn’t carry a tune in a lunch pail. The only D I ever got in my life was in Spanish and the Spanish teacher, San Martine, told my mom I was linguistically retarded so obviously I wasn’t wired for music or sound or dialect. Is it the same with leadership? I remember in college, some people you would explain calculus to or physics one time and they’ve got it and other people you could just tell they never really got the concept. They just didn’t get it. So is leadership, you’re just born with it or you’re born without it, and if you’re born without it can you get better at it, or are you just kind of maybe the wife needs to come in and be the office manager or I should hire a manager, I’m just not a leader?

Judy Kay:  It depends on your desire, your level. We change when there’s enough in it for us to change. If I want you to become a better leader and you have no interest in it, you’re not going to become a better leader. If you want to become a better leader and you have enough desire and I usually weight it out like this: on a scale of 1 to 10, I’ll ask a doctor how important is it for you to become a better leader? If it’s less than an eight, chances are they’re not going to make a change, that’s the reality.

Because there’s pain in change. It’s uncomfortable. This is scary and I don’t know how it’s going to turn out so we go back to autopilot. There has to be enough desire, every one of us can change, every one of us can learn things differently, it’s the buy in, it’s the payoff at the end. If we don’t like what’s happening in our lives right now or we don’t like the results we’re getting and there’s enough pain or there’s enough benefits to changing, we’ll make the change. And that’s part of my conversation that I have with doctors upfront when I first speaking with them about coming and working with them and they want to know about leadership I’ll ask them: what are your goals for leadership? What do you want? What are your expectations and how important is it to you? Because if they really want to learn I will spend the time in working with them and they can become a very good leader. Will it be innate or second nature? No. But there are certain things that you can teach and you can learn that here’s certain things that I know if I do this all the time I will be a good leader. You’re not going to be perfect. No one’s perfect.

Howard Farran:  Judy, you can’t say that while you’re looking at me?

Judy Kay:  No!

Howard Farran:  Really? I’m nor perfect? Is that what you’re telling me? I’m just kidding. Judy I want to ask you this: they say in changing behavior, especially illegal stuff you know, what has to be your rock bottom? You’ve got a ticket for speeding, did you need to go to jail? Drinking, what’s going to make you stop? You lost your job, is it DUI, do you have to go to jail for running over someone? What is rock bottom for a dentist that calls your service? I mean when they call you, what just made them sit there and finally call you up? Did they have to fire both assistants, did the hygienist stab them with a scaler? What happened? What is the average reason dentists are calling you and then specifically, what are you doing for them?

Judy Kay:  I think it’s an awareness. I think the reason they finally call is they wake up one morning and they go, wait a minute, this wasn’t what I thought it was supposed to be. I went to school, I spent all this money, all this time, this energy, this is my practice and I hate it. It’s not where I want it to be at all. It’s not- It’s an accumulation. It’s like I don’t know if you remember this but we used to have this game, the straw that broke the camel’s back, it was this little plastic, maybe it was just a North Dakota thing but it was this little plastic camel and it had wheels on and you kept adding straws and all of a sudden the legs would split apart and the thing would fall over? Well that’s the same with the doctors who are calling me.

Things keep piling and they keep stacking until finally one day, and it could be little things so it’s not a specific thing, it’s an accumulation of things where all of a sudden they wake up and they go you know what? This is my practice and I’m sick of this. I want to be happy and I don’t want to come to work dreading this. I don’t want to deal with this anymore and that’s a hard conversation. I feel so bad for them because it’s a lot of time and energy and passion they put into this to have it turn out to be something that, it’s like oh my Gosh, this is horrible. This is an ugly step child that I never wanted.

So for me it’s really about taking it and saying okay so what is it that you do want? What makes you happy? So it’s more, it’s actually coaching it’s not consulting in essence. It’s very different. I don’t come in and say here’s what you’ve got to do Dr. Farran, you’ve got to do this, this and this and it’s like I’m going to ask you- what would make you happy when you came in here? What would be important? What would you like to see? What would you never like to see again? What do you want to do? What does your day look like? That kind of thing, so those are the questions I ask and then we start to say okay if you tell me what you want then we’ll look at different ways of how you can get that.

Howard Farran:  So do you go into the office or do you work with most dentists by phone?

Judy Kay:  I usually go in initially because what someone thinks is going on in their practice versus an observation can be to different things so I usually suggest if there’s a lot of problems, a lot of chaos, quarterly for a year. If it’s just a couple of, if it’s just a small area it might be just the one time observation workshop with some follow up advisory coaching calls or Skypes. It really depends on the level and it also depends on the amount of effort they’re willing to put in it themselves and how quickly they move it forward to.

Howard Farran:  And how do they contact you? What is your website? What do you give out, your website, email?

Judy Kay:  I give out my website and my email.

Howard Farran:  What are those?

Judy Kay:  Practice Solutions Inc.net and that’s plural- solutions. My email is JudyKay@PracticeSolutionsInc.net.

Howard Farran:  You nailed it on the head why they should call you. I think it’s just sad when a dentist just hates going to work. This has happened to me a lot of times. I took 500 hours of continued education a year my whole career on everything in dentistry and so many times the dentists sitting next to me, he’s telling me all the coursed, I’d say man you take a lot of CE and you know what the dentist would say? He goes, I hate my practice, I love getting in an airplane and flying out of my city because I hate my family and I hate my practice and I just try to take CE every weekend, and I always think wow, that’s just sad. I thought you just wanted to be a better dentist but- so if you hate going to your office, that’s a dark place and that could lead to dysfunctional behavior.

You might start trying to make yourself feel better by overeating, substance abuse, drinking, your environment can lead to dysfunction.

Judy Kay:  Well it also leads to very dysfunctional leadership because if you’re feeling that this is not what you wanted you have a tendency to take it out on the people that you work with the most because our filters come off around the people we spend the most time with, as a rule.

Howard Farran:  Say that again, our filters come off?

Judy Kay:  Our filters come off. It’s like family, you’ll say more to your family than you would to a stranger. You’ll be more direct. Team members, I hear this all the time, we can say that to each other because we’re like one big family. We tell each other. Until they overstep and then someone gets hurt feelings and then you’re no longer a family anymore. So to me it’s part of putting the filters back on. Just because we work with someone day in and day out doesn’t mean that we don’t still have to respect them and treat them with kindness. When you look at a dentist who is very unhappy coming to work, a lot of times there’s a passive aggressive behavior that happens with the team because they’re taking their anger out on the team and they don’t even realize it.

Howard Farran:  So what I’m hearing, I look back at my 28 years, I should only hire orphans. Single orphans with no children. That would be awesome. I’m going to start running all my ads: wanted, a single orphan with no children to be my dental assistant. That would get rid of half the problems on earth. It is really a dark place when you go to your office and you don’t want to be there and you hate it. So Judy when you’re talking to a dentist and they don’t like their office anymore. Do you think it’s more, the problem is financial overhead, insurance or do you think it’s more interpersonal team?

Judy Kay:  It’s definitely internal. It’s the personal, it’s the team. Here’s my philosophy in life and what I see time and time again, and it’s reality as well. It doesn’t matter what’s happening, it matters how we feel about what’s happening. Insurance isn’t good or bad, it depends on how we label it. It depends on how we learn to use it. Are there some negativities? Yes but there’s also some positives. There is a way out so it’s really about, you can have the exact same circumstances happen to the same two people in the exact same spot and they’re going to have a totally different outlook. Things aren’t good or bad, it’s how we perceive them in our mind. It’s how we think about them. So it’s really about helping, a lot of it is shifting the mind set on what we consider as positive or negative and I know that sounds out there a little bit.

Howard Farran:  So what I just heard you say is that one of my four boys could be good?

Judy Kay:  Yes.

Howard Farran:  There’s a chance if I reframed it in my mind, one of my four boys could be good. I’ll never forget when I got a divorce, I had four boys and one of them just wasn’t quite right in the head and I told my ex at the time, I said if you had an affair and that’s really not my kid, at this point I don’t care just tell me, and she said unfortunately that’s the only child that’s yours. No Judy, you have to be passionate as heck to write a book. A book is like having a child, that’s a year of your life. You’ve written two books and what I want to know is Rise and Shine- get out of your way and on your way to success, and Ta Dah!! Get Happy in Five Seconds, why did you write those two books and do you think dentists should read them? Do you think the office should read them? Would it be a good team exercise? Talk about your two books and what made you write them.

Judy Kay:  Number one I wrote the first book, Rise and Shine- get out of your way and on your way to success, because from coaching people are always blaming, well this didn’t happen if they didn’t do that. If I could have only done this then my life would be different and people were projecting and their actual failure or success was based on them, so it was about writing a book initially to help people get out of their way, because so many people are in their way and they don’t see it and they’re blaming the rest of the world. It’s everybody else’s fault. So that was the reason for the initial book.

The second book was just more working on the different things that happened when working with different teams and doctors and teaching them different ways on how to create a happier environment. One of the things that I teach, it’s called Ta Dah for a reason because I teach teams on how your physiology changes your psychology. So even in the most stressed moments, you can change how you mentally feel very quickly by changing your physiology. You can dance, you can sing, you can laugh, you can do Ta Dah. Ta Dah actually, you throw your arms up in the air and shout Ta Dah, you do this as a little kid but it can’t be just Ta Dah, it has to be Ta Dah! It’s got to be exciting, it’s got to be fun. Your body recognizes that as a positive body pattern and so it follows that. Ta Dah is a celebration pose. Runners run across the finish line and put their arms up in the air, it’s success, hey I did this, it’s awesome. Our body recognizes it so it changes what, if you’re stressed instead of stress hormones it doesn’t send you more stress hormones, it sends endorphins so we instantly feel better. Ta Dah was the title of that because I would teach that at the end and I would ask after spending three hours with me, what was your favorite thing of the presentation and they said Ta Dah, I’d say okay I could come in here and five seconds in I would have been done.

Howard Farran:  I still look back at my rat cage, my dental office, I always thought it was funny how a dentist will spend one third of their life asleep, one third in their office and one third in their home outside of the bedroom and the office will be 1000 square foot dungy place with paneling and then their home would be a 3000 square foot happy place and I always thought that was crazy. Why do you spend one third of your life, and when dentists are designing dental office, your husband is an engineer, they’re like well does it have to waste 10 feet wide? Couldn’t it be nine and a half or eight feet? And you’re like, dude do you want to spend one third of your life in an eight foot wide room?

What is wrong with you? And then you’ll go to a dentist who just loves it and he made a fourteen foot wide operatory and you’re in there seeing it after going out to a bar or whatever and the other three dentists say: why is it so wide? Isn’t this a waste of space? Dude, he’s going to spend a third of his life in here!

And going back to my rat cage, I put a pull up bar because I would come out of a root canal and you head is bent over, it’s a ten pound bowling ball, leaning over, jacking your neck, and I’ll jut come in and I’ll grab that bar and just do like five pull ups or six or seven and I feel like a million bucks after that. That was better than- so I want to ask you a favor. You know on these new smartphones, which by the way when I got out of school they didn’t exist and now we came out with a Dentaltown app and the Dentaltown app, the first month 25 000 dentists downloaded it. It’s really the only thing in dentistry like that and Judy on the app, we just added the podcast section so now you have these podcasts and the last one got listened to by 10 000 dentists downloaded it because it’s on iTunes and all that stuff, but we’re adding a book section and they’re asking me for an audiobook because I was 21 years old, I was born in ’62 so I was 21 when I saw my first ATM machine and I can still remember everyone laughing like that’s never going to take off because the computer was so small, every time you’d enter the next step the computer would take like two minutes and I mean you’d stand out there for half an hour and everyone would just laugh like that’s never going to go anywhere, but no one foresaw the computers getting bigger.

I never saw, when I was 21, that someday we’d have a phone in our hand that had emails and apps on it, but my team wants me to try to find someone to do our debut audiobook. I think the podcasts are taking off with dentists because they all say the same thing, they say Howard, when I come home or like Saturday, for me to do laundry and clean the dishes and do everything is going to take me about three hours every Saturday morning and I just put in my smartphone, my headphones and I listen to three. Dentists all the time are saying I do treadmill three nights a week for an hour and I just get on and do a podcast and as soon as you’re done, I get off the podcast and that’s why I’m still talking to keep you on the treadmill right now because if I stop this interview, you’re just going to get off the treadmill so I’m just going to keep dragging this thing out.

Amazon Jeff Bezos says that audiobooks are an explosion because of multitasking. It’s very boring to sit in a chair and read a book. It’s a lot more fun to listen to the book while you’re doing other stuff, multitasking. So I’m going to throw you under a bus on live podcast, you’ve got two books. Would you be interested in doing any of them on our first audiobook?

Judy Kay:  Yes.

Howard Farran:  You don’t have to answer but think about it because- well I’ve read your books, it was very visual so you probably want them to see the visual experience too right?

Judy Kay:  They’re pretty, yeah. There’s energy in the book but a lot of people I know, I’m going to throw my husband under the bus now: he doesn’t like to read. He would much rather listen. It’s just not his thing to do and I think a lot of people would be interested in that. I think it’s a great idea. I have to find the time but I think it’s a great idea.

Howard Farran:  Okay. So how would a dentist, what did you say your email was?

Judy Kay:  JudyKay@PracticeSolutionsInc.net .

Howard Farran:  Okay so if you no longer like dentistry, that’s a bad deal. If you don’t want to go in and play, I can’t make you be a better dentist and do better root canals, fillings and crowns if you hate your job. I mean if you love your job, you’re going to try hard and if you hate your job, you’re not really going to try and I’m telling you that to me this is very serious because I live in the fifth largest city in the United States, Phoenix Arizona. The metro is 4.7 million and about three dentists a year commit suicide since I’ve opened my practice in 1987. In 2014 there was another three, so when people say dentists have a high suicide rate, I can’t tell you how many dentists I know.

There’s been dentists in my front room that blew their head off and not just one. So this is serious shit. If you hate your job, you need to change your environment and Judy Kay, you are crushing it. Everything I hear about you is amazing. I loved seeing you in Nashville Tennessee and thank you so much for sharing an hour with me and I hope a dentist, I hope they don’t have to hit too rock bottom before they finally call you up and say I want to be happy because I know you could coach them to make them more happy about dentistry.

Judy Kay:  Thanks a lot Dr. Farran, and you know you said a magical thing, you said when we’re happier we try harder. I think that’s not just for the dentist, that’s for the entire team. So people say well the Kumbaya, the little we all stand around holding hands kind of thing- no! It’s not that, if we are happy with where we’re at, if we’re happy in the job we’re at, behind the scenes the work effort goes up. You’re going to see at least, on average, 20-21% increase in productivity just in being happier. It’s amazing.

Howard Farran:  So what I heard you say is divorce your wife and marry an orphan? Is that what you just said? Did I hear that right? Alright thank you for your time.

Judy Kay:  Thank you.

Howard Farran:  Okay bye-bye.