Dr. Cooper thought this private message to his clients might be of interest to others.
Things are moving so fast that everything could change in an instant. Right now, I am working with you so you can intentionally drive your enterprises forward during these uncertain and chaotic times.
Sustaining a viable enterprise during the chaos with zero cashflows will demand you become a much more powerful leader. Leading through hard times is far more challenging than leading during good times. But steel gets forged in the fire.
There is now lots of good information available about how to bridge the gap in cash flow for the next few months; bridge loans, SBA loans, lines of credit, etc.
Since we are in chaos, defined as "complete disorder and confusion." I looked to the Chaos Theory for some answers. Chaos theory is the branch of mathematics that deals with complex systems whose behavior is highly sensitive to slight changes in conditions so that small alterations can give rise to strikingly enormous consequences. With "little things meaning a lot," we'll work on defining these "little things" on our coaching call.
Besides doing the little things, my coaching with clients now is focused on redesigning their practices to have patients and staff feel truly safe, and for patients to have unconditional trust you're doing what is right to keep them safe.
Context is decisive. When the context changes, everything changes within it. The context has shifted due to the pandemic. Although many think it will return to "normal" or the "way it was," this is simply not ever going to happen. When the context changes, it never goes back to the way it was. Easy example is smartphones.
When the context shifts, everything within the context takes on a different meaning and a different form. When the context alters, structures, procedures, and protocols adjust to the new context. Another example was 9/11 shifted the entire context of air travel. Now, getting to the gate is most often a lengthy and anxiety-producing process.
For your practice, I am recommending the following directives be considered immediately and implemented as soon as possible.
Keep in Frequent Communication with Staff
Most dental entities by now are shuttered or soon will be. Most have furloughed their staff except maybe two members – one answering the phone and the other assisting in emergencies. Given nearly all the staff has been furloughed, most have applied for unemployment.
Reopen dates that you have been told, more than likely, are pure fiction. Even New York has not spiked yet. This thing is going to last because without testing and without antiviral medication (vaccine, antibody detection, or drugs), along with the rapidly increasing morbidity rate, all made worse by the inability of the current healthcare system to handle the load, this event has will continue—the level of infection and morbidity not yet known.
As John Wooden said, "Failing to plan is planning to fail." Ultimately, the failure is and will continue because there is no real plan. A comprehensive plan is required but the likelihood of that occurring is slim or none. Plans that are cobbled together by many fragments as they are today rarely if ever, are sustainable. We need a "holistic" approach that our Federal government is incapable of delivering.
If (when) the pandemic is protracted, it could become a whole different story, for you and your staff. But at this time of uncertainty, what to do with staff, is to keep them connected – connected to you as the leader, to each other as teammates, and to the practice as something worthy of keeping alive.
Set up a Zoom account. With some or all staff is at home, set up consistent meetings at least once or twice a week. On the Zoom calls, stay connected. Check-in with each staff member. Time for real compassion and empathetic listening. Talk about what they are going through. They know each other and are closely related. Keep these relationships alive, and it will have an impact when and if you reopen.
At each meeting, ask some of these questions. Question number 6 needs only need to be asked infrequently, but the others can be asked much more frequently.
- How are you feeling? [Emotions unexpressed become self-saboteurs.]
- What are your most pressing concerns?
- What actions are you taking, or could you take to address these concerns?
- How can other team members or I support you?
- What are you learning about yourself during this time?
- When you picture what it will be like 5-years from now, what do you see are possible positive outcomes from this crisis?
Given most will be on unemployment and each state will have its own laws about part-time work, it won't be hard to figure out how to use staff when reopening is limited to "essential" procedures.
There will be many problems when you do reopen. Most of you will be at 50% productivity for a while, and hygiene will be very different. Every area of clinical dentistry will be touched and modified by Covid-19. So stay current with equipment changes such as spray control.
Staggard scheduling will be mandated for a while. People do not want to wait in the waiting room with other people. Staggering will force you to cut down on patient volume. Patients will be calling you from the parking lot, letting you know they are in the parking lot ready to come into the office. Learning to be precisely on time with a skinny crew will need to be mastered quickly.
There is now a ton of literature on how to increase sterility in the operatory, so start thinking about the changes you will need to make in terms of operatory management and patient flow.
Engage & Rally Your Community
This is something you can do right away and get your staff into action. Action decreases anxiety. It will also give your staff members a sense of purpose.
Your community consists of your existing and former patients, colleagues, neighboring businesses, and the local population. If you have your patients' e-mail addresses, consider informing them what you are doing as an office to make it more safe for them; updated policies and protocol, updated equipment to catch the spray, ultra air purifiers that won't allow viruses to enter, etc..
Patients need to see you are working hard on keeping them safe.
Safety and sterility are going to be primary marketing forces in the future. Designing a practice that feels really safe with the latest viral-control will go along way.
On some of your staff calls, ask the team how the office can best serve patients and others in the community in the current situation. Come up with projects to do. Then DO THEM.
A few offices I am working with have their furloughed employees calling patients just to see how they are doing and if they can be of service - if they need anything thing. For example, I have two offices that are delivering food to the elderly. Your team can invent how they'd like to contribute. And check in on their charitable activities every call.
This must be an all-volunteer initiative given in many states; to receive unemployment, you cannot work. This is about showing the community that your office cares.
The more you and the staff show empathy, caring, and leadership for your community, the more activities you have in serving others, the better will be the staff's psychology and well being, and yours as well. Higher levels of service, decrease anxiety and fear.
Organize Groups & Coordinate Activities
Generate a peer group that will work on this very complex dilemma, either physically or virtually. It seems virtual is the way to go. Put together an intimate group of colleagues – people you trust, respect, admire, who are in the same boat. Good leaders know that a group offers far more insight than they can have alone.
Five to seven people per group is recommended. For my clients, I've made the offer that I will join their first Zoom call with the group to help set up their group (at no charge). Then, the group is on its own - because no one has the right answer to their region, situation, or conditions.
Multiple views of the same problem always make the picture much clearer. And since this is a bottom-up effort, the best way to address it is with people in the same situation as yourself.
During this time in these groups, I strongly suggest you work on what you will do when you have to downsize to stay in business. When you reopen, expect you will be generating 50%, or at the most 60% of the business you had before. (Another thing we'll talk about on our coaching calls.)
After recommendations and solutions are available from the group interactions, institute them and on a series of followup calls with your group find out 1) what is working, 2) what can be improved, and 3) what's next.
Connect & Stay Top-of-Mind
It's true, "out of sight, out of mind." Stay in the minds of your patients. They are your greatest asset. Time to protect your assets. As stated above, have stay-at-home staff members personally call patients to check in on their health status, and ask some of the questions presented above.
Many patients will be at home for a while – especially at the epicenters and with the aggressive spread. Those staff members that are at home can call from home. That would be all active patients (2 years), and if you have the resources – go back another year or two. Bottom line – care about your patients' status and well being.
Send e-mails using platforms like Constant Constant Contact to your patients. You are a professional they trust, so they trust your information. There is always an update you can post. Keep it short. Show you care.
Worst Case Scenario
If the crisis continues to escalate, you may be ordered to become much more frontline providers –to become more integrated into the healthcare system. With 30% to 40% of the frontline providers getting the virus, local or Federal might demand dentists assistance where it is required. As licensed professionals with basic healthcare skills, you can be mandated to work near or even on the front lines. The Federal and state governments hold the trump card about your licenses. A kind of healthcare worker draft could occur.
And, the federal government might yet claim a Disaster Emergency, giving them enormous power, meaning they can claim eminent domain and use your operatories for medical purposes for hospitalizing of patients is they need greater capacity.
Make sure your next coaching call is set via my Web-calendar. There is no magic bullet. There is no magic wand. You need to figure this out yourself (with colleagues) and then make it happen. The only way out is through. I am here to be your partner in figuring out what you need to get done.