Heather-Dawn:

Today, my guest is coming from the other side of the world, the UK. And that's not where she started. But I'll let her tell her tale. She is none other than Dr. Linda Greenwall. Good day Dr. Linda, how are you today?

Linda:

Love it! I'm good. Thank you.

Heather-Dawn:

Can you share with our guests just a little bit about who you are and what you bring to the world?

Linda:

Sure! Thank you so much. Thank you for the invitation to present on the podcast to chat with you. It's such an honor, really appreciate it. I was born in Cape Town in South Africa, and I trained in Johannesburg at Pitzer Dental School. My father and my grandfather were also dentists.

And so, when I was not qualified, I went back to work in the office; my father and my grandfather were just retiring. I saw how a well-run office was. I saw the amazing team that my father had. I saw the wonderful team atmosphere.

For example, here, they all stopped for tea at 10 o'clock in the morning. The whole practice wrote a brilliant idea and the whole team stopped. I thought that was just something fabulous. And then I came to London in 1985. I did my specialty training in prosthodontics and took various specialty exams; I took another 15 years of training. Then, I opened my own office in 1993. As I opened my office, I also had a baby that week; I finished my specialty on Monday, and on Tuesday I opened the office. On Sunday, I had baby number two, named Joseph. And that little boy Joseph grew up to become a dentist. Now on Wednesday, he's just graduating with his MBA as well. So, I brought him into the office and we started and as I was looking after him, I read this book, so I had no patience.

I read the book, Great Communication Equals Great Production by Cathy Jameson. I wrote to her and I said, I loved your book. She said, Linda, do you want me to come and teach you in London? I said, yes, please, please, please come and teach. We set up a collaboration. She's been training me for the last 28 years. Amazing. I am a good student; I listen to what she advises. And we go to the next step. But I've always regarded her not only as a great friend, mentor, and coach, but a wise woman, as well.

And so, we always have when we haven't caught up regularly. And, we implement, we do what she tells us to do. That makes a huge difference. And then I had another two babies. So, we have four big school babies. And the fourth - I have an amazing Receptionist or Practice Manager, Kristine, who's been with me since we started in 1990 - and we both had babies within two weeks of each other. We didn't plan it, we didn't know. Anyway, so she had her first baby. And I had my fourth baby. So, we got a "work nanny." We created a little nursery at work and the patients loved it because they wanted to come and see the two babies. That's how we helped her with childcare. We could both get back to work, so that's how we started.

I was lucky enough when I did my master's to research tooth whitening, and I wrote my dissertation on tooth whitening, which was back in 1990 to 92. I was one of the first in the UK to introduce whitening research to understand the whitening process of teeth. I've worked in that ever since and written three books about teeth whitening. So, I teach a lot about tooth whitening. I teach the team to be involved in tooth whitening and we still lobby the UK Government for changes in the law to allow more children to undertake teeth whitening because these days, children have this disease called MIH. It's a very severe disease. It's a global disease. Nobody dies from it but it's a very severe disease and one in six children globally has this problem. So, we still lobby to make changes in the world to help more children to be able to do this.

Then 11 years ago, I set up a charity called Dental Wellness Trust. I set up a branch in my hometown in Cape Town, to give back to Cape Town for the wonderful opportunities in education that they gave me and my family still living in Cape Town. In Cape Town, we now look after 15,000 children, and it all revolves around tooth brushing and oral health kits. We did research, we set up a group with a community of women called Toothbrush. And we have 18 Toothbrush mamas who are amazing, inspirational women, and leaders in their own community. They inspire me every single day. During COVID, we set up soup kitchens, we've served over 300,000 meals, these wonderful Toothbrush mamas; it's like a sisterhood of wise women. We train and we work with that. We set up the same programs in London, around England, doing the same thing. That's what we do on the side, as well as doing the dentistry. So that's a little bit about me.

Heather-Dawn:

That's a little bit? My brain is going wow, where does she fit all of this into a 24-hour day, but we have a friend in common who is Cathy Jameson. I can understand how she helped you to put systems in place so that the office runs smoothly, which would give you an opportunity to do some hard work, work that warms the soul as we serve and help other people. But drill down and tell us a little bit more about your collaboration with Dr.Cathy Jameson, you have another title. And that title is?

Linda:

Oh, we have a book together, which is called Success Strategies for the Aesthetic Dental Practice, published in 2011. I loved the information, and the teaching that Kathy was giving us and I thought we needed to write this all down. We need more people to know about this because they don't teach it in dental school. We worked on the scope for five years, so that we could produce these special gems that Kathy has a vast knowledge to share.

It gives us recipes for success strategies to run an effective practice.

We still refer to this book to this day when we have our team meetings, all kinds of things. It's our major reference book to help us day by day because as we know, dentistry is very stressful. There're so many different elements that are stressful. I think for a dentist, one of the most stressful things is not having a good, supportive team.

Things change a lot because life is different. We've had two years of COVID, post-COVID. Everybody getting ill. So what happened the first time, when we all found out about COVID, was that we sat down in a staff meeting and we read a report from the Wuhan dentists. This was Friday, the 13th of March. We sat down, we read this paper, and I said to my team, what I want to tell you all now is that I'm going to look after you guys, whatever happens.

The health of my team is the most important thing.

Whatever it takes, I'll give you my guarantee that I'm gonna look after you as best as we can because we don't know what the future holds. That's how it was in the beginning. A week later, the UK Government closed all the dental offices in the UK. There was no testing so we managed to get secret supplies of the PCR tests. We ran a program to test our own team regularly to keep them safe. My team was one of the key important aspects during the lockdown. We had meetings every week with our team to check in on everybody. How are you how you doing? Is everybody okay? We did a group Zoom so that, you know, we kept in contact all the time.

Heather-Dawn:

Well, that's one thing that you and I share a common understanding of the importance and value of our teams because we simply could not do it independently of them. I want to ask you a question. How would you describe the dream dental team? What are some must-haves for a dental team to be considered a Dream Team, such as the one that you have?

Dr. Linda Greenwall 

Read daily. Work on it to keep working with the team. Nothing, just nothing stays the same.

I think the first thing is that the dream team needs to have good leadership, a vision, and a mission.

We set the vision and the mission together with the team. Everybody needs to be on board. As Cathy teaches us, we all need to be on the bus together, in the right places on the bus, at the right time. Everybody needs to be going in the same direction; the bus needs to be going forward. So, you need to have the right team members. We need to work together as a team. 

A positive attitude is

one of the most important

things a team needs to be goal-focused.

We work together on our goals every week. Monday morning is a long meeting for an hour and a half, where we review what happened last week, what's happening this week, when there are plans, and we work very carefully. We all work on projects together. We all work cohesively. The team should feel comfortable, they should be less stressed. All the team members need to be working in a positive way.

There needs to be a trusting environment.

There also is a safeguarding environment. You know, a while ago, we had a situation with one of our dental nurses who was being abused by her partner. It was a complex issue, which we had to deal with to make sure that we could look after her in the best way possible. I wanted to have an open dialogue, so that our team, if they are having difficulties at home, can bring their problems. We don't want everyone to be massive cases. But the thing is, life happens. And so what happens at home affects how they perform at work. And so in a way, we can help them with that. Everybody needs to be on the team together helping each other, even if it's, "Can I get you a cup of tea?", but everybody needs to be there for each other in any way. If somebody's running late and the instruments haven't been done, the rest of the team members will step in to help. So, there needs to be mutual respect for each other mutual care team attitude that everybody's working together. The team needs to have focus and energy in a positive way.

Heather-Dawn:

Yeah, I think what I hear you saying is, teamwork makes the dream work. Everybody's sharing the same vision. Everybody goes beyond just what the job description is to caring for each other. Having the leadership that makes them feel comfortable to do that.

Linda:

They know the direction, they know the plans made. They know where we're heading because it's very clear. 

We do some fun things here, especially when we were out of lockdown. We did this thing where we did a group dance. We have a WhatsApp group for our team and during COVID there was, I don't know if you know this, it's called the Jerusalema dance. I sent them on WhatsApp the steps to practice during lockdown when we couldn't see each other. When we got together, we all did the dance together. It's a brilliant icebreaker and it's a fun thing to do. So, we do some fun things. We'll also have a practice song. Yes, on a Monday morning, if the team had a really wonderful weekend and everyone's a little bit quiet, or a little bit grumpy or sleepy, then the sleepiest team member will sing the practice song. We spoke about what should we have as a practice song. It's very funny; we all sing out of tune, but I think it's just a fun thing. And that, again, breaks the ice. When we have a meeting together we need to have some way of breaking the ice so that we can work together through humor or some team activity. It's a brilliant way to get our team focused.

Heather-Dawn:

I love that. Especially when you're speaking about coming together to set the tone for the week. Looking back at the wins and the not-so-much wins of last week. I won't call them fails because you always learn from things that didn't work well.

Linda:

If it doesn't go right then everything is smooth sailing.

Heather-Dawn:

I love that idea. I think the other thing that allows you to do is to go through and look at what needs to be done, what was done well. 

The word accountability comes to mind because in order for our team to work well, we have to be able to count on each other.

So we should have accountability for ourselves and for our team members. Do you agree with that?

Linda:

Absolutely. There needs to be accountability. Because a lot of that, for example, not only do we do sterilize instruments, and all that, they understand the policies and they, I don't know, if you use OSHA or understand our instrument policies. Everyone has policies on that, which is hard enough to do.

There's also the technology. No, because as we go digitally, there's more digital knowledge to bring. Each team member has a responsibility for the others in this field. We need to know we have trust delegated to this person. For example, we now have a fully digital system where we have a 3D printer in the office. We can print bite plates, we can print bleaching trays, we can print study models, and one of the team members is delegated to do that, whose accountability is that she does that. We know we delegate that to her. If there's a problem, she can come to us explain it, and work with the whole. The whole team is accountable to us and to each other. And again, to show respect for each other.

Also, I like to have an open-door policy that if they have difficulties, or if they notice a team member is not being held accountable or not, or if they are falling behind the team atmosphere, or not doing what they are supposed to do. I want to help to understand what happened; how did this happen? "What's the situation?", et cetera, so that we can become more accountable as a team.

It all comes back to communication, good communication.

Everybody on the team needs to have that. If there is a problem, I want them to come to me or to the practice manager, or the practice manager comes to me that I need to know. I told him I'm very nosy. I want to know everything so that I can problem solve, and we can problem solve together.

Heather-Dawn:

I find that sometimes people come into an environment, and they don't want to be the tattletale. Everybody's seeing it but nobody's saying anything. I'm not going to be the one to say anything. I find that to be so detrimental because everybody else is thinking the same thing. Everybody realizes it's costing us dearly, but nobody wants to speak up. When you have an environment where the dream team openly communicates, they realize that holding each other accountable is key to maintaining a level of excellence or distinctiveness that our patients will want and expect from our practice. When we are unable to do that, it pulls everybody down. So I'm happy that you have an open door policy, that it's not a judgmental one, people can just come and share. Sometimes it's very human-type challenges that are preventing. If we can help them to map it out, then it will make a big difference.

Linda:

That is an example that even transportation problems, for example. In London, it's a big city and they strike at a moment. So, that means they can't get into work. Two weeks ago, during our big meetings on Monday and Tuesday, the strikes were starting. Instead of our normal discussion, we did a logistics discussion. Who's coming in when? What are the difficulties? What are the challenges? Shall we move patients so that team can come in later? How can we work through this challenge together? What changes do we need to make because of this challenge that we're going to have? Also, checking that the patients will get in because they have the same problem, there's no public transport. How is the patient going to get in? We can anticipate this is going to be a problem.

Heather-Dawn:

So, what you're saying, Linda, is that problem-solving plays an integral role in the dental team's ability to function well. Right?

Linda:

And everybody's opinion is valuable. When you problem-solve, you need to think out of the box and you need everybody to contribute to solving the problem. Whatever their contribution is, it helps you to move, to think laterally so that you can actually think about the problem with the whole team. The team's advice is so valuable and so useful.

I expect my team to voice their opinions in a positive way. We don't want to hear negativity. But I need their opinions so we can formulate together the policy and the strategy based on the inputs. For example, during COVID we had to have 15 minutes to half an hour to change over the surgeries. In those days, we had to steam the whole room, and all that we had to acquire the equipment. Everybody needed to be working really well so we could move from room to room. Setting up the room, my team members would do that. The other team members would close down the room, sponge and steam it, you know all that stuff. That needs a whole discussion with everybody so that everybody can input, everybody can help and so we can go forward.

Heather-Dawn:

I always say to my team members, every one of us is a leader, everybody's point of view is valid and important. If we're talking about a specific challenge that we need to see, the business officers' perspective, the clinical assistants' perspective, the hygienist, my perspective, so we end up with a 360 view of the problem. Then, we can begin to address it. When you have an issue, sometimes what you think is obvious, that's not it at all. It's derived from somewhere else. 

Linda:

Exactly. This could be a simple problem but it multiplies if we don't communicate to understand what the problem is. And so we don't assume it is right to the root of the problem. What is the problem? How did it arise? How can we rectify it? And how can we move forward? I say to my team, don't come to me with the problem actually come to me with the solution. Let's say sterilizers are broken. Don't tell me the sterilizers are broken, tell me I've called the guy, he's on his way. That's the solution. When you're sitting with all these problems, you can’t move forward.

Heather-Dawn:

Love that. It allows each team member to process, work it through, then indicate what the challenge is, and bring forth solutions. Now, that may not be the final solution. But at least you're bringing something to the table that we can either grab onto and run with, or tweak a little bit. But everybody's weighing in. I love that, Linda. I love that. Now, I want to just drill down a little bit more about this aesthetic dentistry offering that we have. The golden question is what are successful strategies for the dental team to create a successful aesthetic dental practice?

Linda:

I love this question. I think first of all, that I like all my dental assistants to be brilliant communicators in their own right. I like them to establish a rapport and a relationship with the patients.

Number one, our patients fully trust our dental assistants.

They know they expect that the dental assistant is going to take care of them during the appointment, more than just suctioning that they are going to welcome them. Many patients may be fearful of the dentist. We try not to look too scary, with all the expectation to trust the dental assistant. They know that if they're going to have a good appointment, it's because the dental assistant is awesome and that makes them feel really, really much more relaxed and can build up trust.

I expect my assistants to be able to speak well to the patients. They always say to inform before you perform, no surprises. I expect for my dental assistants to go and fetch the patient from the waiting room to bring them into the treatment room and introduce themselves. "Hi, I'm Indra. Today, we're going to be working on the upper left side of your mouth. If you have any questions, this is a photo of how your teeth looked last time. This is what's going to happen." Explain that.

At the end of the appointment, I like the dental assistant to do post-op instructions really carefully with the patients. The patients develop this wonderful relationship at the end of the appointment. My dental assistants are so busy closing down the room and they're busy, busy busy, but the patients wait to make eye contact with a dental assistant to thank them for the appointment. In terms of Aesthetic Dentistry, a lot of what we do takes a very long time. You know, you need a three-hour highly concentrated time to be able to do this brilliant work. I call it creative, beautiful creation of smiles but the assistant is the key. The key element.

Then again, all our dental systems take photos, we do a lot of photography training with everybody, Everybody needs to be able to take a good photo. And before and after have this facility to be able to put on the television on screen next to them. The before photo, after photo, this is where you were, this is where you are, this is where we started. This is where you are now. And then you wait again and you leave a little bit of a minute for the patient to say is that me on the screen? Yes, that's you. That's how you were so you came in. Then they go wow. Then we say to encourage a patient. Do you want to take a photo on the screen? It's, you know, to show them on the journey. But that's all part of it.

When I do, for example, a new patient consults, I see the new patients in a different room, the team member prepares the room, they go through the health history, and everything is ready. So, I will see them on my own in the room. My question that I ask them is, "What would be your hopes and aspirations for your dentistry?" Sometimes they look at me. They go, actually, nobody's ever asked me this, but I'm going to tell you, and they give me what may be called the dental wishlist, you know, if they could wave a magic wand, this is what they would like. I write it all down. As I'm typing, I'm getting to know my patients.

My dental assistant who is in my treatment room is reading all the notes about the patient, and I'm writing on the screen so that she gets to know this patient. Then, we bring the patient in and the dental assistant will take the photographs. Again, just establishing the rapport to help the patient feel relaxed and comfortable in a trusting environment where they can talk about the issues and their concerns. And so, again, the dental assistant helps us on the journey.

One of my other assistants, our Treatment Coordinator, Rachel, she's been with me for 20 years. She would sit with me; we have a treatment planning session for the patients we are going to see. She comes into my office. We sit down and say what are our goals for this patient? Where are we going to go? What are we going to do? She prepares it all. I like my team to be very involved in all of these aspects so we can really work together to support and help our patients to achieve their smile goals. I want to see my patients achieve excellent oral health. I always want them to be on an upward journey of health and health sustainability. 

My hygienist has been with me for 25 years. This is the 25th anniversary of our practice. And she now lives in Manchester, which is quite far away. It's a two-hour train ride. She comes to work Monday, Tuesday, and Wednesday; she stays over, then she goes back home because she loves working on the team. She loves the way that, as a hygienist, they have full clinical freedom to do all the procedures that hygienists are taught. Not all hygienists are able to use all their wonderful skills, and I like them to use their skills.

Another really important aspect is that the team should come to me about any aspect that they're not concerned about or also give their opinion. Let's say we are very busy with an aesthetic case. And I think the side is too long; we do some composite bonding. I'll refer to my assistant and say what do you think? And I want an honest answer. So actually, I think that it's a little bit too long here. We need to do this. And her opinion is really important. A lot of our patients tell us when we are working together, it's like we are doing a dance or we're doing synchronized swimming, because the transfer of the instruments just flows, and she anticipates what I'm going to be using next or she'll say how about using this instrument for this procedure, etc., because she knows me. My head dental assistant has been with me for seven years. So, I like to keep our team for a very long time because we work together, a lot of loyalty. I do things to make sure that they can stay as long as possible and that we build that loyalty together.

Heather-Dawn:

Wow, Linda, you have given us so many nuggets today. I love this slogan:

Inform before you perform.

No surprises.

That means that our dental assistants have to have a great understanding of what is going to be done clinically. It also means that they have to build relationships with the patients so that they can reassure, they can underscore for us, and they can really make our patients feel at home and comfortable.

I know that if our assistants have confidence in the products that we are going to provide, it makes a big difference. So we, as dentists, need to show off. We need to show off the way we are promoting ourselves. So that if we say, this is who we are, then people don't have to question that. It makes the team feel comfortable and a little bit proud to be a part of this team.

I love the fact that the process in the dental chair is seen as teamwork. So the dentist knows what he or she is doing but the team member has such a great appreciation for what is being done that their response makes a big difference as well. That really makes our patients feel like they're at home with a team of folks who are qualified to do what I've come here to do. And by the way, they're so nice. Thank you. Thank you for all your gems today. I have a question for you. I always end my podcast with a quote. I wonder if you have a special quote that you'd like to share with us today, Linda?

Linda:

So, I think, first of all, all of us are leaders of ourselves and leaders in our community. Being in the healthcare profession, it's a meaningful, purposeful job. It's an important job and we all contribute to society for that. I say we want to make the world a better place. All of us think about how we can make the world a better place.

And how do we start?

We start step by step,

just one little tiny gift

and kindness to each other

will make the world a better place.

Heather-Dawn:

I love that. And I think you have made Cathy so proud. Well, I have a copy of your book and I've gone through it a couple of times. Cathy gifted it to me. It is amazing that we're in so many different places, but we're all in sync.

Linda:

We are all human beings and we all have the same problems. All of us. That's why the world should be more one. Because we are all similar. Even though wherever we practice, dentistry is the same. Because we're dealing with human beings. And we're giving ourselves, we're giving kindness ourselves. We're all there to help our patients to achieve a beautiful smile or get them out of pain, but we are in the healthcare profession. And so it's very similar wherever we practice in the world.

Heather-Dawn:

So thank you, Linda, for living so purposefully with your charitable work, with the wonderful dental care that you provide for your patients, for the wonderful leader that you are to your team, and for sharing with us in such an authentic way today. Blessings. We will talk again.

Linda:

So lovely to meet you and to have the opportunity to have such a lovely chat. Thank you so much. It's a great honor.

Heather-Dawn: 

Well, it doesn't matter if dental offices are around the corner from each other, or across oceans. We all treat patients in a similar fashion. And it means that we all organize ourselves and our teams in a similar way.

Dr. Greenwall reminded us of the importance of sharing a mission, vision, and goals so that the team is moving together on the same beat.

A positive attitude is so important. And the more trusting the environment, the better it is. Team members need to be there for each other and so there has to be mutual respect and care.

And you know what? Clear communication is imperative, especially if you're looking at problem-solving.

If people don't feel safe enough to share challenges, then they go noticed but unspoken.

And Dr. Greenwall also spoke about the importance of dental assistants being good communicators. They are the ones that truly develop deep relationships with our patients. And that is imperative if there is to be trust. And I leave you with her motto: “Inform before you perform. No surprises.”

Well, it's been another wonderful time with you guys. And if you enjoyed this session, please share. Please tell someone, please make sure if you haven't subscribed that you subscribe because you know that life is better when we live, learn, and grow together. See you the next time. Blessings.

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