Are We Having Fun Yet?

By: Joan Garbo

Joan GarboDo you remember your first day on the job? If you are the doctor, do you recall the excitement of walking into “your” practice for the first time? Do you still feel that tingle of excitement whenever you walk through the door? If not, when did your work become a job; when did it become “ordinary” and routine?

While becoming accustomed to one’s environment and repetitive actions can improve efficiency and lead one to mastery of a given task, “routine” can also have a deleterious effect on customer/patient service. Some of the simplest actions determine the experience of excellence in service, such as eye contact and a smile! Yet if people operate automatically, or “on cruise control,” these simple acts are dropped out, and the patient’s experience becomes “nothing special.”


To better deal with what devolves into complacency at work, it would be useful to understand a thermodynamic law of physics: entropy. In layman’s terms, it is the natural tendency of substances to move from a state of concentration to one of dissolution (e.g., ice melting into pools of water).

The only thing that intervenes with entropy is a conscious being! So in the example cited, to maintain ice, someone must make sure the temperature of the ice stays below 32 degrees Fahrenheit. It is also important to note that since entropy is a natural/normal occurrence, there is no element of blame in the dissolution process.

The principle of entropy occurs in relationships as well. Most marriages go through “the honeymoon phase” in which all is well, and the experience of love is in the air. After some time, the experience of “being in love” begins to fade, even when the couple will say they still love each other. There seem to be some unique couples who are able to keep the love fires burning… and it is not an accident or because of the “right chemistry” between them. Rather, it is because at least one, and more often both people, makes conscious efforts to keep the fire burning… that is, a conscious being intervening in the natural devolution of the relationship. They do more than doing things to keep romance alive; they also stay focused on mutual goals and encourage each other in the achievement of the goals. Most important, they communicate openly and effectively when disagreements and problems arise.

In an orthodontic practice, there is an excitement and even a sense of euphoria for some when the practice first opens, when new staff is hired, when a satellite office is opened, and so on. As time goes on, the newness disappears and the practice moves to a phase of “business as usual.” This is entropy in action and it is a natural occurrence. However, a conscious being can intervene with entropy.


There are operating principles that, when followed, will keep people focused on their real jobs of providing excellence in service regardless of their actual job descriptions.

Following these principles will open up numerous actions that will maintain an atmosphere that attracts new patients and inspires referrals to your practice. One is the power of focus. Whatever you focus on will grow. So, if your attention is on what’s wrong, you will find a multitude of problems. As my mother used to say, “put the acCENT on the right sylLABle!”

The most important thing to focus on is your vision and mission.

Especially in times of a slow economy, one can be easily distracted by the bad news. Start looking for what is working. Focus on the patients who are in the practice and make sure you excel in attending to them. Create staff games wherein they “count how many people you made smile today,” or “how many complements did you receive,” or “who found out something new about a patient today.” These games keep everyone focused on making sure the patients feel connected to the practice.

Remember, “the attitude of gratitude determines your altitude.”  At your morning huddle, have everyone write on a flip chart  what they are grateful for, and don’t have any repetitions for the whole week. Create a “mailbox” for doctor and staff acknowledgement/appreciation notes, and deliver them at the end of the day before the weekend.

These are just a few things you can do to keep your economy distinct from the economy. When you bring joy to work with you, joy will be with you to take home at the end of the day.

About the Author

Equipping all levels—from the novice to the seasoned professional—with the best tools of the trade, Joan Garbo has been a national consultant, trainer, and public speaker since 1978. She has applied her extensive training and experience in language development to communication and relationships in the workplace. For the past 25 years, Joan has specialized in consulting and training business owners and their employees in effective communication skills, team-building, executive coaching, and how these impact customer service. Joan is dedicated to supporting professionals in creating work environments that are nurturing, productive, and prosperous to management, employees, and clients. Joan can be reached by by e-mail at, phone at (631) 608-2979. Joan Garbo Consultants, 19 Glen Lane, Copiague NY 11726.

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