If you and I agree on everything, one of us is irrelevant.

There is a form of politeness and civility that wrecks relationships. I’m not talking about any liberty to vent or be mean. I’m talking about being so careful not to hurt someone’s feelings that we don’t say what needs to be said. True care for another’s best always involves honesty, even at the risk of being misunderstood.

As dentists and business people we have obligations and personal positions. To pretend to be totally altruistic in our actions is phoniness to the core. When others do this to us, we see through it in the same way we see the one guy who decides to go to the university football game, sit on the home side and wear the other team’s colors.

In a way, this gets back to my falling off the mountain. Because I was too polite, I permitted the problem of clashing skis to continue. I might have said, “I’m having trouble here, do you think you can help me?” Perhaps he thought the best way up the mountain was to lock our middle skis together. Who knows? We were too busy talking about other really non-essential things to have that important conversation.

I’ve gotten some push-back on the policy I wrote on appointment management. The best comments back (and they were in private, which is how it is usually best done) were the hardest to read, but they are the ones that make us think deeper about issues. Part of the difficulty was actually around who would be reading the policy and what the policy was for. So let me stake out a few positions here and then, by all means, feel free to respond, react, and push back some more. It is in this process we all have the opportunity to think deeper, sometimes about things we haven’t thought about or had to think about for a long time.

First, the creation of a policy is like a magic trick. The audience sees the trick, not how it was set up. It is like a beautiful painting – that started with some rough lines and sketches that were erased or covered over before the painting is displayed on the art gallery wall. The policy is part of the script the actors learn in order to perform the play. It is their task to memorize and personalize the script – to bring life to it. Therefore if someone says a policy is too cold or harsh or stark, it makes complete sense to me. I would much rather see a play than read one any day. I would much rather play Monopoly than read the rules of the game. However, when disputes arise, we can always fall back on the rules. So policies are important.

No, policies are vital, because they help us think through complicated problems as well the often difficult conversations that follow; and do all of it in ways that can build trust.

Policies are the floor, roof and walls of the building. They are the shelter that, when built correctly support the interpersonal relationships within. The policies are built to be silent and quiet but to have the strength necessary to empower those working in the business or clinic to serve patients with a personal touch. Well crafted policies also support patients and assure them that they will be treated in ways that respect them as the important people they are. The result is that policies enable care to move efficiently, easily and effectively. Another way to put this is, policies coordinate the actions of many people in order to move everyone toward mutually agreed goals.

Finally, all policies should have one assumption, if we are talking about People-Centered Dentistry. That is, the object of all actions and activities is for the betterment of the patient. The patient comes first. The patient is the VIP in the office, not the doctor.

Sadly, I know there are offices where this is not the case. It is either purely a cold lifeless business, focused on profit as the real bottom-line, or a soap opera centered on the ego of the star of the show (whoever this may be — and there may be more than one).

Because profit should not be the bottom-line, in no way is this to say that the best practices are not successful. In fact,I would argue the opposite is true. The most successful practices have it all. They are the best at caring for patients AND the best at working off policies that strengthen the relationships by seeing that everyone is treated fairly and with respect. Building a dental practice/business this way is a great deal of behind-the-scenes work, and pays off handsomely in the end — financially, emotionally, and spiritually. In addition, hopefully there are times away from the office for fun that improve physical health, and policies within the office that protect our backs, eyes, hands and all the rest.

So, in our discussions on policies, please understand that I am talking to you from the idea that we are behind the scenes. The play is in rehearsal mode as we discuss different aspects of patient care, with some of it being about those who provide the care and how we can best perform when we move into performance mode. Is this top secret? Not at all. You may be a patient reading this, so welcome to a behind-the-scenes technical discussion within dentistry. I hope you can find ways to apply it in your business and life that are helpful.

In the future, I will likely take sections of my first draft policy apart and discuss them in more detail. Also, in learning from many of you, I will try and write “policy statements” intended for patients and written in ways that enable them to see how the policy is a help to them. Finally, not all policies will work in all practice settings. Life is not vanilla here, but the more you can see and understand the nature of the dental environment in general, the more you can hopefully reflect and improve your own style of practice.