Bucket Power: are you a grumpy dentist?

By Dana C. Ackley, Ph.D. Originally published by ACT Dental.

Which is deadlier, psychological or physical torture? Surprisingly, it may be psychological torture. Consider this study: 38% of prisoners of war held by North Korea during the Korean War died; the highest rate of death among prisoners of war in U.S. military history. The North Koreans engaged in a relatively low rate of prisoner physical abuse. Instead, they systematically undermined prisoners' self regard, poisoned relationships among prisoners and in other ways undermined their social supports.

The outcome was what prisoners called "give-up-itis." Prisoners would literally give up participating in their own survival. When they did, they typically died within two days. Psychological torture created a sense of hopeless despair. Physical torture usually makes prisoners angry. Anger generates energy needed to survive.

You may be thinking: "This is interesting but what it is got to do with dentistry?" A lot. This study is cited in a new book , How Full Is Your Bucket?: Positive Strategies for Work and Life, by Don Clifton, Ph.D., and Tom Rath. They cite evidence that the psychological atmosphere in your practice plays a critical role in the physical health of your employees, your patients, and you. It also has a pronounced impact on the financial health of your practice.

Here's the quick and dirty summary of the author's thesis: Imagine a bucket inside of you. Every interaction that you have with another person helps to either fill or empty your bucket. We also have a dipper. What we say and do with others helps to fill or empty their buckets, just as their dippers fill and empty ours. "When our bucket is full, we feel great. When it's empty, we feel awful . . . a full bucket gives us a positive outlook and renewed energy . . . an empty bucket poisons our outlook, saps our energy and undermines our will (p. 15)."

The North Koreans were masters at emptying buckets. People literally died. Is it that serious in the workplace? A study of healthcare workers found that employees who worked for a boss whom they disliked (who regularly emptied their buckets) had significantly higher blood pressure. It was estimated that hypertension, caused by their boss, increased the risk of heart disease by one-sixth and stroke by one-third. Thus, if you have allowed yourself to be a grump, your employees may be paying a price with their health. (The smart ones probably go find a new job, giving you more positions to fill. The number one reason that employees leave a job is that they don't feel appreciated.) Additionally, your bucket probably is not doing so well either. Folks don't get too busy filling the buckets of grumps.

Grumpy dentists, or a grumpy staff member, can easily drive your business into trouble. Imagine the difference in response of patients whose bucket gets filled during a visit to your office versus the patients whose buckets get emptied. Consider this study from the customer service sector.

The study was done with 4583 employees in call centers, the kind of place that you might contact when you have a problem with your credit card or a product. You know that when you have a bad experience with a company's call center, the chances are good that you will never do business with that company again. You also may tell your story to others, driving even more business away. Alternatively, when you have a good experience, you become a highly loyal customer, and you may tell that story to your friends.

Some call center representatives scared off every customer with whom they talked. Those customers never came back. Other representatives retained and engaged every one of the customers with whom they spoke. They helped their business prosper.

The implication for your practice is clear. If you want to retain patients, you and your staff need to help fill their buckets. Otherwise, they are likely to leave. It is expensive, in terms of money, time, and energy to recruit new patients to fill the slots emptied by fleeing patients (who discourage everyone they know from using you as their dentist).

The Up Side: Clifton, a psychologist, was the chairman of the polling organization Gallup until his recent death. He made a career of studying "positive psychology," i.e., looking at what is right with people. It was this emphasis of focus that led him to develop the bucket and dipper theory.

In addition to polling, Gallup engages in intensive research on leadership in the workplace. One study examined 4 million employees in 10,000 business units across 30 industries, a huge study. They found that workers whose buckets were more consistently filled by regular recognition and praise:

  • had higher productivity

  • had higher levels of engagement with fellow employees, i.e., people got along and communicated better

  • are more likely to stay with their employer

  • were rated higher by customers (read patients) with regard to satisfaction

  • had better safety records and fewer on the job accidents

What to do: Do these research outcomes sound like characteristics that you would like your employees to have? Of course. Fortunately, there are some things that you can do to help make this come true.

First, assess how you and your team members treat each other. Don't settle for superficial answers that team members may be motivated to give you to keep you from looking too carefully. Try to get a feeling for whether people's buckets are getting emptied or filled. You can depend on the fact that your patients are experiencing the same degree of filling/emptying that is going on among you and your staff. A truism is that front line employees treat customers as they experience themselves being treated in the organization.

Sometimes it is hard to study one's organization and come up with an objective, balanced view. If you think that this might be true in your practice, or if you just want to be sure that this assessment is accurate, I will be glad to help you assess the psychological atmosphere of your practice.

Sometimes, one person can set the tone for empty buckets. Emotions are contagious. If you have a sourball-in-chief, they can poison the entire atmosphere. Their bucket dipping encourages others to do the same. Usually such people are extremely competent in their jobs, or they intimidate other people in the organization, or both. You get the feeling that you can't do without them. You can. One negative person, no matter how skilled, can disrupt an entire organization.

On the other hand, beware the temptation to let someone become a scapegoat. It is more common that everyone has gotten into bad habits, bad habits that can be changed, especially with modeling and support from the leader. If you erroneously identify the primary source of bucket dipping as one person, you will not be in a position to take the necessary steps to solve the problem.

If your assessment indicates more empty buckets instead of filled ones, it is time to act. If you do have a chief sourball, you will have to make a decision about whether that person can learn to behave differently or if they will have to be let go. Some people can learn to change and accept opportunities to do so. Others do not choose to change. Of course, if you are the chief sourball, your only choice is to seek ways to learn to fill buckets.

How to Learn to Fill Buckets: Clifton and Rath offer some ideas about how to fill buckets. Some people may find their suggestions to be enough. Most people will find that the authors' ideas feed the intellectual side but may not be enough to create sustained change. This is because intellectual input alone rarely is enough to eliminate one's emotional barriers to change. Most dentists, and their teams, can profit from having a coach who is knowledgeable about how to change behavior. I would be happy to follow up on my assessment of your office by coaching you and the team in the art of filling the buckets held by yourself, your team members and your patients.

Dana C. Ackley, Ph.D. is a psychologist who provides coaching and consultation to dentists and their staffs. He has been a guest lecturer at the Pankey Institute for Advanced Dental Education and writes frequently for Dentistry Today. He can be reached at dana.ackley@eqleader.net , or 540-774-1927, or EQ Leader, Inc., 2840 Electric Rd, Suite 208, Roanoke, Virginia 24018.

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