Choices: The Road Not Taken

In Diagnostics, Print Issues by Patti DiGangi

Many of us have heard the poem “The Road Not Taken” by Robert Frost. Though this poem paints a beautiful picture of choices and roads to follow, in my experience, as for many entrepreneurs reading this, roads are an illusory dream. There are not well-defined roads to choose from. Our choices create the road.

It Isn’t Luck

Many years ago, I had a mantra on my luck. I thought that I was lucky to be offered a job in our family dental practice that lead me to dental hygiene school. I was lucky about this and that. Finally, I had a brother-in-law who looked at me and said, “BS!” I was shocked. Not by the language but rather by the interruption of my well-practiced litany. I was just average, nothing special. He said my words and beliefs were wrong because each day we are faced with choices. How we choose is what decides the future.

It’s taken me years to truly understand the depth of meaning to his words. Often we can understand our life by looking backwards. I can see how my choices led me to my current life. At the same time, I am a futurist, looking beyond the now to decide how I can create my path. If I don’t know where I am going, how can I find/ create the way?

Choosing How to React

I am a leader and have been for a long time. My previous history was to be a leader of complainers. How many times have you sat in a meeting or had an opportunity to share your thoughts and opinions and said nothing? Then later, you talked to friends and family about how you felt, particularly when you felt wronged or had a better idea?

A very progressive practice I worked in (we were paperless and chartless in 1992!) had both monthly all-day staff meetings as well as morning huddles. What a lucky choice to work there… not! The dentist would ask our opinions and ideas. The silence was deafening. Yet, in the parking lot, I would show my leadership skills leading the negative comments. As a matter of fact, I was so good that even if the other person wasn’t feeling negative, I could and would talk them into it. That was a then-undiscovered and not-so-impressive leadership skill.

My experience and previous role models in life had demonstrated this behavior pattern over and over. I didn’t realize at the time how well it had imprinted on me. Yet it is not the fault of those role models; I chose my behavior, even though I didn’t like it much. I didn’t feel motivated or excited about what I was doing.

This dental practice also offered amazing opportunities for learning. I participated in several different practice management coaching programs. We traveled to several, taking as much as 4-6 weeks out of the office and on the road. The programs weren’t all wonderful. Yet, I was eating a different diet of role models. It was an amazing opportunity that I embraced. This was not the choice of others who only found fault and complained.

Windows and Doors

These learning opportunities opened new windows for me. I understand our opportunities as windows now. My old model said people open doors for you…if you are lucky. My experience is windows can be opened/unshuttered to see new possibilities. Then the individual needs to find the window, open it, go through it and then do something on the other side of it, taking many steps with varying choices along the way.

When I figured out the window idea was when I began to be a better mentor. Prior to that, I was not a mentor; I was a co-dependent enabler. That is the model seen frequently in dentistry. Services offered become obligations on our part that we follow without much question. An example is pre-scheduling hygiene care. It is a service a practice provides that we say is for the convenience of the patient. Yet, is it really? Isn’t it also for our convenience? Without questioning that part, we fall into the seeming requirements of reminder systems, confirmation, and more. We take the responsibility and are surprised when the patients don’t.

Enabler or Helper?

An enabler is someone who helps negate the consequences brought on by someone else’s behavior.  Enablers are people who are in a relationship with someone suffering from an addiction; however, instead of helping the addicted person, they allow them to continue their behavior.

Many of us in healthcare have helper personalities. There is a big difference between a  helper and an enabler. The biggest difference is the fact that a  helper knows what her actions will do to help the individual. A  helper  does not always say, “Yes.”  A healthy helper does not take the responsibility for the outcomes for the people we help.

Helping is a choice we make or a series of choices. We need to be careful not to slip into an enabling role because ultimately that helps no one.

Procedure Codes for our Services

Another example is the provision of a toothbrush and floss, not unlike a 6-year-old’s birthday party goody bag. This is another service dentistry provides often without question. This service has a CDT procedure code, D1330, that isn’t even documented. And to many, the idea of charging a fee is abhorrent.

We have created an addiction for our patients. We have trained our patients to expect this no-fee service. They think the products don’t cost the practice anything. This is wrong on many levels as we all know. The value of the service is not the provision of the product; it’s the personalized instruction.

Oral hygiene instruction is the core of the services provided by hygienists, and often it takes a great deal of time. There is another CDT procedure code when this instruction takes more time. D9920 behavior management, by report definition: May be reported in addition to treatment provided. Should be reported in 15minute increments. Our time is a valuable commodity, and one we can’t get more of. We need to make the choice to value our time and expertise. If we don’t, neither will the patients or anyone else.

Accurate Procedure Code Metrics

I seem to see life through my procedure codes filter. This was my choice when I coined the name of my company DentalCodeology – the study of dental procedure codes.

I have chosen to embrace their importance for more than 3rd-party reimbursement. Accurate and complete use of procedure codes provides important metrics. Metrics that can give us the power to quickly arrive at data-driven decisions that can improve outcomes and performance, drive cost savings, and enhance patient quality of care and satisfaction.

Current Road

The journey continues. The newest road I am creating called for new choices. “Beyond Oral Health” better describes this leg of my journey. Using the term “dentistry” is the well-taken road and narrows our focus to teeth. The oral environment is 80% NOT teeth. We can cure, not just manage, periodontal disease, have a world with no oral cancer, and have a caries-free world. These deeply held beliefs create the direction of my choices.

We know what we do goes so much beyond oral health. The continued emphasis on teeth is not the road I want to take. It is my choice by traveling/creating a different road that, as Mr. Frost says, will make “all the difference.” I welcome you to make the choice and join me.