According to a recent survey released by the John Templeton Foundation, people are less likely to feel or express gratitude at work than any other place. And their feeling of appreciation toward their current jobs, ranked dead last on their list of things they are most grateful for.

Oddly, this outcome isn’t because people don’t crave receiving gratitude at work. Ninety-three percent of those surveyed agreed that their bosses are more likely to succeed if they expressed gratitude more often, and only 18 percent thought that expressing gratitude made their bosses “weak,” or hurt the organization. Additionally, the majority surveyed reported that hearing “thank you” from others at work made them feel better about themselves and more motivated.

So, What Gives?

Why is something which is so obviously appreciated and helpful so frequently withheld? Why do Americans actively suppress gratitude at work, even to the point of robbing themselves of happiness and all its benefits?

The answer lies within the nature of our “reptilian” brain which lies buried underneath or logical neocortex. Our brainstem, midbrain, and limbic system are constantly surveying the environment to determine if we are safe as well as where we are within our tribe social status-wise, as well as how our tribe ranks relative to other tribes.

As a result, we are slow to give support and appreciation to others because it might change the organization of our social structure in such a way that we might personally lose out. Another way of saying this is that we are all built on a neurobiological level to be inherently selfish.

Overcoming Our Silence

The role of gratitude in dental practice should be a positive, intentional one that makes every single care team member feel values. When they feel good about themselves and their contributions, performance will rise. To this end, we must consciously work at overcoming our tendency to remain silent and ignore other people’s contributions and exceptional performances. And how can we do this?

1. Make gratitude part of your practice culture from the top down. One of the biggest takeaways from research on workplace gratitude is that your care team needs to hear “thank you” from the doctor regularly. This is because it’s up to the people with the most social, political, and financial power to clearly, consistently, and authentically thank, in both public and private settings, those who have helped their status. In other words, we need to lift everyone else around us. Rising tides should lift all boats.
2. Gratitude should also be built into your performance reviews and staff meetings, where time can be allocated for each person to say “thanks” to others on the team for being thoughtful and pitching-in at critical moments.
3. Thank those who seem to never get thanked. Thanking those who do important, but easy-to-take-for-granted work is key. Your office cleaning crew, your UPS delivery person, the mailman, your accountant… You get the picture. These simple gestures improve morale and increase trust, and therefore increase performance.
4. Aim for quality thankfulness, not quantity. Forcing your team to be grateful to one another won’t work if they’re harboring resentment and other unresolved issues which remain untouched. Hence, forcing gratefulness as a strategy is not “cultural,” its superficial and doesn’t work. Instead, it can feed upon the power imbalances which undermine gratitude in the first place, and therefore make expressions of gratitude feel inauthentic.

The key is to create times and spaces that foster the voluntary, spontaneous expression of gratitude such as morning huddles and regular team development meetings.

Many of you are already doing these things, but are you doing them frequently enough and with the right intentions?

In times of disruption, small changes can have a large impact. Follow the 5 P’s and see where Proper Planning to Prevent Poor Performance leads you.

Those of you who experienced the joys of boot camp may remember the 5P’s: Proper Planning Prevents Poor Performance. Since we are all stuck waiting to get back to the office, now is a great time to work on plans for a preferred future.

Although we will be opening in a disrupted world and the market we left has been transformed by forces outside our control, good business principles and practices remain valid. Here are some key performance indicators adapted from Roger Levin’s 2019 article about the KPI’s every dentist should know.

Production, Collections and Profit

Review your production, collections and profit for the last 12 months. Levin points out that the trend on each of these items should be up. Sounds simple but it is not. Dig in and analyze deeper. Start with monthly figures and look for trends, then weekly and daily. What are your most productive procedures, days, time of days? When was your last fee increase? Analyze your outstanding accounts. You should be collecting 98% with only a small percentage over 60 days outstanding. How much are you writing off due to insurance mandates? How profitable are you? Have you set any goals? Understand that any item in your practice that is not true overhead is profit. Now you are ready to start working “on” your business.

What percentage of your active patients is currently scheduled? Nobody should every leave your office without another appointment. Your goal should be 98% of active patients are scheduled for some form of care. What is your case acceptance rate? Are you tracking patients with planned treatment that is not scheduled? What is your average production per patient? What is your average production per new patient? It should be at least two times greater than existing patients. What is your hygiene cancellation rate? If you are not happy with what you are learning, now is the time to be planning for better outcomes.

Overhead

Now is the time to carefully assess every item included in your overhead. If you have a practice generating a million dollars, a 2% decrease in overhead is $20,000 directly to profit. Levin Group tells us that general dental practices should have overhead at 59%. Very few practices meet that goal. It is very likely that new mandates from the government will be coming for PPE and testing. Now is the time to get lean and mean in this area.

Patients

Are you tracking your monthly new patient growth and your patient attrition? With all the media attention to aerosol spreading of Covid-19, it is likely there will be resistance to treatment and dentistry in general. Knowing your current situation is important. It is imperative that you use every means available to help your current and new clients understand that you are concerned for their health and safety as well as to emphasize that deferring treatment will only lead to future more difficult and expensive problems.

Staff Costs

The elephant in the room…staff costs in a general dental practice should be 25% of collected production. Your team members are the most expensive and most important part of your business. You may want to share your homework with your team – or even involve your team in the exercises above.