'Captain, permission to come aboard' -- getting the team on-board with OSA therapy

"I prefer to sail in a bad ship with a good captain, rather than sail in a good ship with a bad captain." -- Mehmet Murat Ildan, Turkish playwright/author

You have been to the weekend sleep course and are now inspired. Over the past six months, you have picked up on every opportunity to learn more about treating obstructive sleep apnea patients in your practice. You now sit down at your monthly team meeting and eloquently deliver your best, most passionate "Save the World" speech on how together the entire team can make a difference in the lives of your patients. And their reaction?

Crickets. Blank stares. Did someone mutter, "… here we go again …"?

How do we get the team on-board with a new idea such as OSA therapy that can make a difference in the lives of our patients? How do we steer our ship in the right direction and gain buy-in from our crew?

With nearly 40 million Americans suspected to have sleep apnea, less than 10% are ever diagnosed and less than 2% are treated effectively. Building off our last three sleep articles that addressed creating awareness, implementation, and marketing, this month we continue the series with getting the team on-board with dental sleep medicine.

Now, let's return to the captain and crew analogy. The New Zealand Coastguard has rules for safety at sea that can be summarized into five basic principles:

1. It's a wide-open space, but there is still a right place to be. Know where that is, and why it is.

The field of dental sleep medicine is still a wide-open space. You may be a master clinician and master marketer, but proper integration with the team is essential in sleep dentistry success. Start by sitting down with the team and creating a vision statement for integrating sleep dentistry into your practice. It need only be a half to a full page. Use sentences that start with "We believe …" and be specific. By crafting a vision statement with the team, you will achieve buy-in early. They will know that their voice, opinions, and concerns matter. Expect some pushback from the team when integrating a new clinical vertical such as sleep dentistry in your practice. Make certain you all have a clear, documented understanding of how this new discipline will impact scheduling, your current clinical offerings, and the procedural flow in the office. Remember back when you first implemented cosmetic dentistry in the practice? One of the best ways to get the team on-board was to perform these procedures on team members or their relatives so that they can witness and believe in the real-life results. Consider doing the same thing with sleep dentistry. If one out of eight people are walking around with OSA, that means at least one team member or spouse may suffer from this condition. Treat them and get your team on-board.

2. Know who gives way to whom, and what your responsibilities are.

Integrating sleep dentistry will often impact one team member more than others. Typically, this means a dental assistant may need to expand his or her role in the office. Position this as an opportunity for this team member to grow. Offer to have this person attend the CE courses with you. Encourage him or her to become involved with the AADSM.org and/or the ACSDD.org. Allow the team member to help champion the idea in the office, and if this is the right person for the job, consider having him or her own this entire strategy. Be sure to change the written job description to reflect this new role. Consider crafting a bonus program in the office to reward the team member for helping the sleep side of the practice grow. By designating a sleep champion on your crew, other team members will feel less threatened by this change. Empower the team with information so that they know who is in charge and who is responsible for each step of the sleep patient experience inside the office. Clarity in expectation breeds motivation. Remember, you can't hire motivation, but you can foster it.

Fig. 1 -- Everett M. Rogers' Diffusion of Innovations

3. You must keep a good lookout at all times.

Odds are if you are considering sleep dentistry for your practice, you are an early adopter or in the early majority on the Rodgers Innovation Adoption Lifecycle. This means you still have ample opportunity to position yourself and your team as the sleep dentistry experts in your community. However, many of your team members may find themselves at different points on the bell curve below. Just because you might be an early adopter, many of your team members may be more comfortable being in the late majority category. This "comfort disparity" may be a direct result of the last time you tried to implement a new product or discipline in the office and how well or how poorly you executed it. Sit down with the team and have them plot on the graph below their comfort level with integrating sleep dentistry in the practice. Take time to listen to them and come to a consensus. You might be the visionary (or "lookout") of the practice, but without the team on-board steering and maintaining the ship, you risk damage -- or worse, mutiny.

4. All boats must travel at a safe speed.

Take caution in not turning the boat too quickly or you risk capsizing your vessel. When implementing change in the office, there are three main steps:

1. Craft the vision together.
2. Plot the path forward with goals and champions.
3. Set realistic timelines for the change to occur.

Sleep dentistry can be profitable and will positively impact patients, but it is not an overnight cure for a practice plagued with broken systems. Be strategic, methodical, and integrate sleep into your practice at a safe speed.

5. When things go wrong and the approaching boat does not appear to be giving way, the stand on boat must take action.

When getting the team onboard with sleep dentistry, you might be faced with occasional setbacks. When you sense that the team is losing momentum with developing this service, take action with effective team meetings to reignite the passion. Effective team meetings must:

1. Start/end on time.
2. Follow an agenda.
3. Oftentimes include pre- and postwork.
4. Allow time to listen to each attendee.
5. Strive for a win-win collaboration, not just consensus or compromise.
6. Plot actionable next steps and who owns those steps.

By taking a proactive and intentional team approach when things go wrong, most minor squalls never evolve into full-fledged storms.Want to be an effective captain of your ship? Consider these five rules for effectively getting the team onboard with sleep dentistry. Best of luck and smooth sailing!

References available upon request.

Brad Guyton, DDS, MBA, MPH, serves as the dean of dentist development at Pacific Dental Services and as an associate professor at the University of Colorado School of Dental Medicine. He practices dentistry with Dr. Radz in Denver, Colo., and can be reached at [email protected].

Gary M. Radz, DDS, maintains a private practice in Denver, Colo. He holds a faculty position at the University of Colorado School of Dental Medicine. Dr. Radz is a founding member of the Catapult Group and is currently working toward his diplomate in the Academy of Clinical Sleep Disorders Disciplines. He can be reached by email at [email protected].