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Howard Speaks: Doc, Are You a Monster? Howard Farran, DDS, MAGD, MBA, DICOI; Publisher, Dentaltown Magazine

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Doc, Are You a Monster?
by Howard Farran, DDS, MAGD, MBA, DICOI, Publisher, Dentaltown Magazine
The human brain is an extremely difficult thing to understand. Commercials for Zoloft, Abilify and other drugs that affect mood disorders are on TV all the time, which might lead people to think we're getting a pretty good grasp on figuring out the brain. We're nowhere near scratching the surface. In 100 years, scientists are going to look back at us and wonder, What were they thinking? Sure, we can build a rocket and put a man on the moon, but that was a simple rocket! Sure we can perform bypass surgery, but that's really just bypassing a clogged vein with a not-so-clogged vein. Yes it takes skill and knowledge to be able to effectively pull off these things, but if you think about them, building a rocket and performing a bypass surgery are rather simple when compared to decoding the brain. The brain is made up of a trillion neurons; we haven't even begun to understand it.

The reason I've prefaced this month's column with the above declaration is because some of us operate practices staffed with moody, unpredictable people; it's impossible to comprehend. There's no magic pill that's going to be able to change the chemistry and/or electricity of a person's brain to put them on a more even keel, so you're going to have to either find a way to manage or get rid of those on your team with "sloppy moods."

I recently read about "sloppy moods" in the book Love 'Em or Lose 'Em, by Beverly Kaye and Sharon Jordan-Evans (this book is my new HR bible by the way, and I highly suggest you pick up a copy for your office). The authors define "sloppy moods" as roller-coaster moods where someone is "up" one day, way "down" the next, and tend to have an overall negative affect on others. We all have ups and downs, but these peoples' sloppy moods run amok and spill over into other peoples' lives. With everything there are good sides and bad sides. On one hand, "sloppy moods" can be alright because when these people are riding their highs they take risks other people might not take or they might come up with amazing ideas that can change your business; but these moods are also horrible to manage because these people have a tendency to tear into others and can destroy the morale of your practice in a heartbeat. With these people, the tail is always wagging the dog and you never know what you're going to have to deal with.

I detest moodiness. You might have a team of five - four of whom you can wind your watch to their demeanor because it's always the same and you know what you're going to get when they come to work every day. But that other person might be all happiness and unicorns one day and the next they're belittling someone for a tiny mistake. That person always blames it on something going on at home or something hormonal or "just woke up on the wrong side of the bed." The four other people in this practice have bad days, too, but they never even think to spill their emotional baggage on others. That's dysfunctional and you don't need that. Ditch unpredictable, bad behavior. If that means getting someone professional help, great. If it means having to let someone go, so be it. You can't run a business and try to manage someone's sloppy mood at the same time.

Here's another scenario: When I'm out lecturing, typically dentists, assistants and hygienists will hang around afterward to chat or ask me a question. Sometimes an assistant will bring up a problem and I'll ask, "Well, what did your dentist say when you asked about this?" which elicits the usual response, I could never ask my doctor that. I'd get fired for sure!"

Locating and professionally dealing with moody dysfunction on your team is one thing, but doc, what if you're the monster?! What if you're the example of the jerk dentist on page 97 Love 'Em or Lose 'Em, whose assistant testified, "The dentist I worked for actually threw instruments at me when I wasn't fast enough in assisting him. Our patients were horrified, and many left our practice because of it." Is that you?

You could be the monster, doc! Call it Saddam Hussein Syndrome. When Iraq was prepping to go to war with the U.S., if any of Hussein's advisors said, "The Americans are going to mop the floor with us," he executed them. He surrounded himself with "Yes Men" who said, "Yeah, sure you can invade Kuwait and there's not a single thing America is going to do." When America did respond, it only took 100 hours to take down Hussein's army - and he was baffled. What happens when your assistant presents a differing viewpoint? At your practice is it only your way or the highway? Do you make every decision? Do you undermine everything your team does? Does everyone on your team have to ask you for permission for every little thing they do? Do you constantly threaten them with termination if they don't do things your way? Be honest, doc. Take a good look at yourself. If you're doing these things, it's time to change your ways.

Maybe you take really horrible impressions, but you have no idea that you do. Your staff can't tell this to you because you say you'll fire them, and your lab isn't saying anything because they're afraid you'll ditch them and go use another lab. So when the crown comes back and doesn't fit, you demand the lab redo it for free. Your lab is demoralized because you sent them a lousy impression in the first place, and they don't feel like they should do it for free. Dental labs eventually fire dentists because of disgusting behavior like this. If you think you're God's gift to dentistry, think again; maybe a really nervous middleschool student could take a better impression than you. What you ought to do is eat some humble pie, suck it up, call your lab and ask to spend the day with them to brush up on your impression-taking skills. What you ought to do is listen to your assistant when she says, "Doctor, I can't send this to the lab, it's a bad impression," and then take a new one. But you won't because, "I'm the doctor, and you're not," and that's why your practice sucks.

As much as everyone bemoans the corporate dentistry model, I look at Heartland Dental and think it really makes sense sometimes that the dentist is an employee and not the owner of the practice. Think about it… How dysfunctional would it be if Michael Vick owned the Philadelphia Eagles? He'd never have benched himself this season! If you're not going to keep yourself in check, nobody else will, and that's dangerous.

Your practice needs checks and balances! In the 1700s, philosopher John Toland looked at the hierarchy of the church and the monarchy and determined that there were no checks and balances and that there was zero transparency. And guess what? There was some really horrible stuff that was allowed to go on for hundreds of years. These days corporations are becoming more and more transparent so customers and the public can understand more of what's going on. Power corrupts and absolute power corrupts absolutely. You need to understand this, doctor. If you want your practice to move to the next level, you need your team to keep you in check, you need to stop terrorizing your team and frightening your patients with your disgusting behavior. No more sloppy moods. You need to accept your team standing up to you and there cannot be repercussions for anyone on your team presenting dissenting views. If you think you have a problem, you should consider getting professional help.

Another monster that lives in the office is one that I've talked about before, but one that nobody in dental practices will address until maybe it's too late: addiction. At least once a year, after I present one of my seminars, a dental staff will approach me and sadly tell me how their dentist overdosed - like the nitrous mask was over his face and they found him dead in the operatory because he suffocated on his own vomit, or they found him overdosed on Vicodin or Oxycodone at his desk. In many cases, his death could have been prevented if his staff didn't stand by and let it happen, even though they all knew what he was doing. I always hear, "We loved him so much! He was the best! He was so kind to us and his patients. We can't believe he's gone." Chances are they knew what he was doing, and they willingly overlooked it.

I can't help but feel bad for these teams when they tell me their stories, but they had the opportunity to do something about it before it was too late. If you ever listen to the talk-show doc, Dr. Drew Pinsky, he often says, "You're either part of the problem or part of the solution," and there's no other way around it. If you're looking the other way, you're part of the problem. Dental teams, this part is for you: If you know your dentist or someone else on your team is abusing dangerous and addictive drugs and you're looking the other way, you're an enabler! If you intervene, what's the worst that can happen? He might blow up at you? You might wake him up and save his life? What happens if you don't intervene? He could die. He could get arrested. He could lose his license and his practice and you could lose your job. It's a terrible situation to be in, but if you see this going on you need to step in and get help!

Doc, your practice cannot work in fear. It's time to address these monsters. It's time you create an atmosphere of acceptance, where your team can stand up to you and you can start having honest-to-goodness conversations rather than a fearful, barking dictatorship. Doc, the same skill it takes to keep your patients coming back is the same skill you use to keep your spouse and to hold onto your staff. If you're on your third spouse and the person who has been on your staff the longest has only been there for 19 months, you need to start realizing that the common denominator is you. It's time to take a good look at yourself and figure out what's wrong with you.

It's human nature to not want to hear bad news. People like to live in their fact-free bubbles and they hate it when someone bursts their bubble with an inconvenient fact. But you have to remember: no pain, no gain! Go pick up Love 'Em or Lose 'Em, open up to page 97 and take the Behavior Checklist (aka, the Jerk Test), OR take the test at the end of this column! Find out how you match up to the results. Be honest. If you want to get to the next level, it's time to kick the monsters out of your practice.

Dentaltown Magazine
September 2025
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