The productivity paradox

I'm going to share with you something amazing that I've discovered called "The productivity paradox".It's the exact opposite of all that you'd expect. It surprised me when I first discovered it and yet it has been consistently validated in over 20 practices that I've visited.When you see it I hope that you say "Why didn't I realise that before?"It's far easier to produce $8,000 of dentistry per day than to produce $2,000.Now, I bet you're saying "How could it possibly be easier to do 4 times as much work? It must be harder to produce more work."Therein lies the paradox.Let's look first at a practice where the dentist produces $2,000 per day.Basically it's a shambles.The treatment rooms are a mess. Instruments and materials are laid out in pretty much random fashion. Setting up for procedures takes ages. For example, it took 16 minutes to set up for a root filling in the worst practice I've seen.The team is clueless. They just sit and await instructions. They are not pro-active. They neither listen to what the dentist is saying nor anticipate what's needed next. The dentist has to carry out many tasks that the team can and should do. In addition, the dentist must constantly watch the team, tell them what to do and correct their mistakes. The team are forever asking the dentist questions. In really hopeless practices the dentist must search for the nurse because she often just disappears. She's usually found chatting in the sterilisation area or at the front desk.For the dentist, it's exhausting and stressful. Working in an office like this is like trying to run through quick sand. By 5.00pm the dentist feels like a rung out dish mop.Now contrast that with the $8,000 per day practice.At this level of productivity the systems are streamlined. Setting up for any procedure takes just a few moments.The team's alert and proactive. The dentist only has to treat patients - nothing else. Instead of the dentist watching the team, the team watches the dentist. They make sure everything he needs is ready the moment he needs it. If he forgets something they gently remind him. They virtually never need to ask him questions.The systems in a practice like this have all been perfected. Nothing is random. There's no wasted time or wasted movement. The instruments and materials are the fewest and fastest that are required to achieve each procedure. While working on a patient the dentist never has to break his concentration. He never has to look up or ask or wait. Working in this environment is total relaxation and focus.The experience for the dentist in such a practice is like being in a cocoon. Everything just happens magically around him. He's almost like a spectator.At this level you just go with the flow. You find yourself standing in the hallway and a team member says to you: "Surgery 2, Mrs Mary Jones, VMK crowns 14, 15." You salute and off you go. When you enter the room everything is ready and the team is waiting. You just sit down and start.The trouble is that many $2,000 a day dentists will argue vehemently that they don't want to produce $8,000 per day because they don't want to work that hard.If only they knew...