Shaping Our Communities of Practice

By embracing change and incorporating humanism into the oral health care delivery system, dental professionals have the power to positively impact the future of dentistry.

By Lucinda J. Lyon, RDH, DDS, EdD On Oct 1, 2015 0

The dental profession is at a crossroads. Some of the most significant trends affecting dentistry include the realities that total dental spending has been flat since 2008; utilization of care by working age adults is declining; and dental care utilization for children is increasing.¹ In addition, health disparities remain ongoing in spite of scientific advances and pressure from payers to increase care delivery value and reduce costs.^2,3 Reports from the Institute of Medicine support improved oral health through increased focus on chronic disease management; new and different delivery systems; and value vs volume compensation (ie, payment for increased wellness vs procedures).⁴ These challenges, while perhaps anxiety provoking, should also be galvanizing. Pressure to reduce costs will drive innovation, exploration of alternative delivery models, re-examination of the role of oral care providers within the health care system, and increased coordination of care. The outcome will result in greater opportunity to bridge the gap between oral and general health. Our professional futures will, no doubt, look very different. Each of us has unique motivators, personality profiles, operational styles, and even regional tendencies that impact our reaction to change.^5–7 How do we shape our communities of practice to bring out the distinctive best in all of us?⁸

HUMANISTIC PRACTICE

Perhaps there are ways to more purposefully shape our communities of practice in the oral health profession. Humanism, or humanistic practice, a concept embraced by medicine and education, may provide a start. In education, humanism traces its roots to the 1960 teachings of psychologist Carl Rogers, who believed that “for a person to grow, he or she needs an environment that provides genuineness (openness and self-disclosure), acceptance (being seen with unconditional positive regard), and empathy (being listened to and understood).”^9,10 Medicine confirms that patients have greater satisfaction and better health outcomes when they perceive their care provider to be more humanistic.¹⁰ The Gold Foundation’s goal is to “work with health care professionals in training and in practice to instill a culture of respect, dignity, and compassion for patients and professionals.”¹¹ They describe the humanistic professional as one who demonstrates the following traits:

Integrity: congruence between expressed values and behavior
Excellence: clinical expertise
Compassion: awareness and acknowledgement of the suffering of another and the desire to relieve it
Altruism: capacity to put the needs and interests of another before your own
Respect: regard for the autonomy and values of another person
Empathy: ability to put oneself in another’s situation
Service: sharing one’s talent, time, and resources with those in need; giving beyond what is required¹¹

Humanistic values are equally important to organizational development and are defined as: providing opportunities for the organization and individual stakeholders to develop to their full potential; seeking to increase the effectiveness of the organization; creating an environment in which it’s possible to find exciting, challenging work; providing opportunities for people to influence the way they relate to work, the organization, and the environment; and treating individuals as people with complex needs—all of which are important to their personal and professional lives.¹²

Reflecting on humanism and how it might serve our patients, our colleagues, and our practices will be increasingly important in the changing dental landscape. Building strong communities of practice that help us strengthen our culture of humanistic professional care may be a first step. Culture shapes actions and practices. Mankins¹³ notes that the strongest performing organizations share many of the following performance attributes: honest, performance-focused, accountable, collaborative, agile and able to adapt, innovative, and dedicated to excellence.

If we agree on a shared culture of practice and operationalize some of the above values, working toward agreed upon goals should be easier. Each of us has an opportunity to model what Edmonson¹⁴ describes as a culture of “teaming.” You don’t have to be the positional leader to prompt change. Teaming can be initiated and fueled from the top, bottom, or middle of an organization by authentically demonstrating curiosity, passion, and empathy, defined in the following ways:

Curiosity drives people to find out what others know, what they bring to the table, and what they can add
Passion fuels enthusiasm and effort, makes people care enough to stretch, to go all out
Empathy is the ability to see another’s perspective, which is absolutely critical to effective collaboration under pressure¹⁴

CONCLUSION

Change and transition are challenging. We’re asked to let go of some of our ways of accomplishing tasks that have made us successful. Transition requires authentic reorientation to feel like we “own” our change. Bridges and Mitchell¹⁵ suggest a strategy to help your team find and embrace new ways. They recommend asking about: purpose—why are we making this change; picture—what will it look like when we reach our goal; plan—how will we get there; and part—what can I do to help. Constructive conflict may be part of the process. Weiss and Hughes¹⁶ remind us: “Disagreements sparked by differences in perspective, competencies, access to information, and strategic focus may generate value from collaboration.” And that “Clashes between parties are the crucibles in which creative solutions are developed and wise trade-offs among competing objectives are made.”¹⁶ They urge that the goal of managing conflict should not be compromise but rather newly innovated options and solutions.¹⁶ The American Dental Hygienists’ Association report “Dental Hygiene at the Crossroads of Change” reminds us that the evolving oral health landscape calls on a more collaborative style of leadership—one that is interconnected and interdependent; one that engages colleagues toward common goals; and one that draws commitment from passion, empathy, innovation, and accountability.² Shared goals of excellence, respect, dignity and compassion for patients and colleagues alike will be crucial to building exciting, innovative, humanistic communities of practice as we move into the future. Together, we are responsible for the continued service and success of the profession, and each of us has the ability to initiate changes that will shape our communities of practice. In the spirit of the oft-quoted words of Mahatma Gandhi, “Be the change that you wish to see.”

REFERENCES

American Dental Association. A Profession in Transition: Key Forces Reshaping the Dental Landscape. Available at: ada.org/~/media/ADA/Member%20Center/FIles/Escan2013_ADA_Full.ashx. Accessed September 25, 2015
Rhea M, Bettles C. Dental Hygiene at the Crossroads of Change: Environmental Scan 2011-2021. Available at: adha.org/sites/default/files/7117_ADHA_Environmental_Scan.pdf. Accessed September 25, 2014.
Glassman P, Harrington M, Mertz E, Namakian M. The virtual dental home: Implications for policy and strategy. J Calif Dent Assoc. 2012;40:605–611.
Institute of Medicine. Advancing Oral Health in America and Improving Access to Oral Care for Vulnerable and Underserved Populations. Available at: iom.nationalacademies.org/Global/Search.aspx?q=oral&output=xml_no_dtd&client=iom_frontend&site=iom&proxyreload=1. Accessed September 25, 2015.
Myers Briggs Foundation. MTBI Basics. Available at: myersbriggs.org/my-mbti-personality-type/mbti-basics/. Accessed September 25, 2015.
DISC personality profile. Available at: discprofile.com/what-is-disc/overview/. Accessed September 25, 2015.
Rentfrow PJ. Toward a psychological geography of the United States. Am Psychol. 2010;65:548–558.
Simply Psychology. Carl Rogers. Available at: simplypsychology.org/carl-rogers.html. Accessed September 25, 2015.
Infed. Carl Rogers and Informal Education. Available at: infed.org/mobi/carl-rogers-core-conditions-and-education. Accessed September 25, 2015.
Weissmann PF, Branch WT, Gracey CF, Haidet P, Frankel RM. Role modeling humanistic behavior: learning bedside manner from the experts. Acad Med. 2006;81:661–667.
The Arnold Gold Foundation. What is humanism in health care? Available at: humanism-in-medicine.org/about-us/faqs. Accessed September 25, 2015.
Margulies N. Organizational Development: Values, Process, and Technology. New York: McGraw-Hill Book; 1972.
Mankin M. The defining elements of a winning culture. Available at: hbr.org/2013/12/the-definitive-elements-of-a-winning-culture. Accessed September 25, 2015.
Edmonson A. The three pillars of teaming culture. Available at: hbr.org/2013/12/the-three-pillars-of-a-teaming-culture. Accessed September 25, 2015.
Bridges W, Mitchell S. Leading transition: A new model for change. Available at: consultpivotal.com/leading_transition.htm. Accessed September 25, 2015.
Weiss J, Hughes J. Want collaboration. Accept and actively manage conflict. Harv Bus Rev. 2005;83:93–101.

From Perspectives on the Midlevel Practitioner, a supplement to Dimensions of Dental Hygiene. October 2015;12(10):50–51.