Minnie and Maxine.

I'm sure many of you are familiar with "Goofus and Gallant" from the popular magazine Highlights for Children. In dental offices I think we have similar characters, whom I will call "Minnie and Maxine" (my apologies to any real characters who just happen to have those names). Minnie just tries to get by with the least she can do, and has no team spirit. Maxine tries to do everything she can to get the job done, while helping others in the office as much as possible. She has a great team spirit. Doctors, hygienists, assistants (treatment coordinators), business administrators, hygiene coordinators, and any other auxiliary personnel, can be a Minnie or a Maxine. In fact, we all have some of both characters in us, but our goal should be to become more like Maxine and less like Minnie. That would make the office atmosphere better, the work would get done, the patients would get better care, and I think everyone would feel better about what was accomplished, knowing that we did it as a team.

Maxine truly believes that our motivation should be "to do the right thing for every patient." She also believes in the Guiding Principle of "Countless unseen details are often the only difference between the mediocre and the magnificent." Maxine understands that our purpose is to put patient care first! And to provide quality care and excellence in a caring professional atmosphere. She believes that she has a part in offering a supportive pleasant environment, and contributes to being very profitable and making a difference. She also understands that working together will create more profit to share, and will feel that she has truly earned her part. Minnie has heard all those things, but does not really understand the concepts and how she contributes to them. She wants to just come in and "do HER job" and collect her share of the profits.

Scenarios will be presented, showing how each of these characters would react to a given situation. Remember, we all have some of both, and even on different days and with different situations, may demonstrate Minnie or Maxine characteristics.

Minnie sees that both ultrasonic cleaners are full of instruments, but since some, or all, of the instruments are not hers, she decides to leave them for someone else, even though she has a little time in her schedule to spare. Maxine also notices that some, or all, of the instruments are not hers, but goes ahead and rinses the items in both cleaners, and prepares them for sterilization. She realizes that while she has time available, other staff members may not have that option at this time. Maxine also knows that getting those instruments out leaves room for the next batch, and perhaps helps speed someone else's preparation for their next patient.

Minnie sees that the sterilizer should be loaded and run, but again, leaves it for someone else, because, after all, not everything in there was used by her or her doctor. Maxine loads the sterilizer and gets it started, because she knows that some of the items will be needed again soon, in order to ensure quality care for the patients. Minnie brings her trash into the lab and piles it on top of the already full trash can, so that when Maxine removes the bag to replace it with a new one, she has to pick up all the trash that falls onto the floor when moving the trash can out.

Minnie is the one who leaves the empty paper towel holder, and the empty toilet tissue roll so that the next person does not have these much-needed items, but may not realize it until they reach out to where they should have been. Maxine replaces the paper towels and toilet paper before they are completely gone. She does not want another staff member to come up empty-handed. She also realizes that the next person to need that item may well be a patient.

Minnie notices that the stack of charts to be filed has become quite high, but decides that this is not her job; and anyway some of those are the "other doctor's files." Maxine has some time between patients, so she checks to see what she can do to help the office administrator. The administrator has been working hard all day taking care of patients' needs, but she has not had time to file the charts accumulating from the large number of patients who were seen.

Minnie puts X-rays in the developer, and then makes a personal call, while waiting for them to develop. While Maxine is putting her X-rays in, she notices that two of the hygienists have films that have already finished processing, so she mounts them and delivers them, remembering from the morning huddle that they had a very full schedule all day.

When Minnie gets to work in the morning, she does not even think about all the things that have to be done to get the office ready for patients that day. She just gets her charts and a cup of coffee and sits down. Maxine comes in, removes the items from the cold sterilization container, rinses and stores them. She knows that these items will be needed and that if contaminated items are placed in with those that have already been sterilized, the "clean items" are recontaminated and must remain the appropriate number of hours again to be sterile. In addition, to be ready to begin the day, Maxine sets up the ultrasonic unit as she knows this will assist everyone.

Maxine gets to work checking the X-ray, replenishing the X-ray solutions, turning on the processor to warm up for the first patient's film, running the quality assurance film to ensure that the equipment is working properly, and turning on the safelight to get the dark room ready to go. She realizes that all this is important: to reduce films that are not diagnostic, meaning that they have to be retaken, and also to ensure that a quality image is projected in all that is done for the patient. Maxine also checks to see if Minnie left the film supply empty or low, and goes to get additional film from the refrigerator, if needed.

When Minnie gets behind, she cuts corners on disinfection and sterilization procedures, because that is something no one but her will know about. And, "Dr. Minnie" doesn't really care or think it is necessary, because after all "no one ever catches an infectious disease in a dental office." Maxine tries to follow universal standards with each patient, because she realizes that each one has the potential to spread infectious diseases, such as hepatitis, to another patient, or to anyone on the staff. Maxine knows that if she were to have treatment of any kind, in the office of a dentist, an oral surgeon, or in a medical office, she would want the staff to take the same careful precautions on her behalf. She also feels that real "quality of care" includes those behind the scenes activities that are important, even if no one but her knows whether it is being done or not.

Maxine tries to find time during her day to remove sterile impression trays from the cold solution, and clean and place additional trays so that they will be ready when needed. Minnie doesn't worry about that, because if she needs a tray and it isn't sterile, she can always clean it and use it, justifying her actions with the thought that "somebody should have already done these trays, and then I would not have to compromise with this patient."

Minnie goes to the kitchen to have a snack, and when she gets through, leaves her dishes in the sink. This is not her day to clean up, and she doesn't care if the person assigned has to stay after normal working hours to do them. She has some personal things to take care of, and since her schedule is clear for now, this would be the perfect time. Maxine has her snack, and then cleans her dishes, as well as any others in the sink, because she realizes that not everyone has the time. It would not be fair for the assigned person to stay late, when she had some time open in her schedule, and could get it done during normal office hours.

Minnie looks at her column and sees she has some open time. She says, "Oh boy, I have a light day today, I can take care of some of those personal things I need to do, that I didn't have time to do over the weekend." Maxine sees the same schedule in her column, and thinks "If that time does not get filled, I can help the others who have a packed schedule. That way the patients get great quality care, and everyone can stay on time and get out for lunch and at the end of the day on time."

Maxine realizes that everything she does contributes to the office as a whole, gives the patients a better experience, quality care, and adds to the productivity of the practice. She understands that is what enables the practice to pay the salaries and benefits, and especially the bonuses that are based on the production of the whole office and not just her column or her doctor's column. Minnie does not consider herself as a part of the whole picture, while Maxine understands that without each piece working with the other, we can never complete a masterpiece.

I'm sure you all can immediately think of other scenarios where you have seen Minnie, Maxine, Dr. Minnie and Dr. Maxine, in action. If you'd like a helpful hint on how to help Minnie improve, read on.

Helping Minnie Improve

* Job descriptions are an excellent way to provide guidelines to employees, such as Minnie. That way they know exactly what is expected of them. These should be done in a way that indicates what that person's order of priorities is. Then it should be stressed that employees are expected to help each other whenever possible. Part of the job description should include the criteria on which the employee will be evaluated. If an employee knows what is important to the employer, he or she is more likely to exhibit that behavior.

* Employees should have job performance reviews, and these should be based on the quality of the job, as well as the team attitude portrayed.

* Tasks that are not direct patient care can be assigned several ways. A list can be made of all these, and divided evenly among the number of employees responsible for them. Another method would be to divide the tasks up and assign by a specific period of time (i.e., day of the week, Weekly, or monthly). The lists would be posted, so that everyone knew who was responsible for each task at any given time. If the task was not accomplished, or not done properly, the employer would know who to talk to about that specific item.

* Having job descriptions and posted tasks would result in employees feeling confident that they were doing what was expected of them. This would eliminate uncertainties, as well as avoid potential conflicts between employees. Reviews would be easily accomplished also, since the employer would continuously know who was performing as expected. Problems could be eliminated much sooner, and a positive environment maintained much easier.

By Anna Spaulding, CDA, RDA 

Anna Spaulding has worked in dentistry for 29 years, and has been a Certified Dental Assistant since 1982. She is a Registered Dental Assistant in Texas and has worked as a chairside assistant, performed business office procedures, and has taught dental assisting at Tarrant County College, Fort Worth, Texas. Ms. Spaulding has been a member of the ADAA since 1982, is a past president of the Texas Dental Assistants Association, and the Fort Worth District Dental Assistants Society. She is presently employed by Dr. Barry Stovall and Dr. Johnny Cheng in Fort Worth, Texas.