By October 8, 2007 1 Comments Read More →

My Visit with the Lean Dentist, Part 2

Last Thursday, I had such an enjoyable visit to Dr. Sami Bahri’s office. I was very impressed with the “Lean spirit” of Dr. Bahri and his employees. The culture there is pretty impressive.

Instead of just using Lean tools, it’s much more important to have a “Lean culture” and the Lean mindset in place, more so than the Lean tools. If you were to come in looking “have they 5s-ed everything?” you would be disappointed, and I think you’d be missing the point.

The office is focused on solving problems and preventing problems. Rather than implementing tools, I could tell the discussion is focused on making things better for the patient (reducing delays and inconvenience) and making work easier for the employees at all levels. That was impressive. I talked with many employees and they all talked about the same mindset, which was impressive. There is a drive to do things better. The employees (including Dr. Bahri) do not seem fixated on the press and the awards they have received.

“We’re not perfect, but it’s better than before. And we keep working at getting better.”

That seemed to be the mantra, everyone seemed to make that same comment. Continuous improvement, involving all employees, and eliminating waste. They have a very advanced Lean culture, compared to almost any workplace I have seen or been a part of.

Talking to Dr. Bahri in his personal office, I saw many books that I also have on my bookshelves. We’re both heavy readers. You would recognize many of the books, I’m sure. What is impressive to me is that Dr. Bahri (as you heard about in his Podcast) has gone to all of the original source texts — Ohno, Shingo, Deming, and he has distilled it to what matters for his dental practice business. He didn’t have anyone to copy, at least another dentist, so they had to figure it out for themselves.

“We start with the patient, not with the tools,” a front-desk employee said.

I also saw the break room, which also doubles as the daily team meeting space. Just looking at the whiteboard, there’s very neat evidence of the discussions that happen every day — part training, part problem solving. It might be the only dentist office breakroom where the whiteboard has scribbles about:

I saw examples of the Training Within Industry methodology, including a front desk assistant who showed me classic Job Breakdown Sheets that employees had been creating (and updating!). They focused on “what was important to document” rather than just documenting for the sake of documenting, which was nice to see.

Here’s something that you can’t teach, necessarily, and it’s hard to copy — you can tell Dr. Bahri cares about his employees very much. “Explaining why” is part of the culture, it’s something they work at (although there’s still room for improvement, which Dr. Bahri recognized when I pointed out a “warning” sign that didn’t explain why). That’s a key part of the “respect for people” principle.

Dr. Bahri and his office still have a lot of opportunities ahead, both in terms of implementing Lean methods and for their business, in general. The Lean improvements have freed up capacity that needs to be filled. So, if you know anyone who wants a new dentist in Jacksonville, Dr. Bahri’s office can take them on. There is a strong commitment to making sure that freed up capacity won’t translate into laid off employees.

In Part 3, I’ll come back to the Lean tools that I saw in place and I’ll also have some final comments about my visit.

You can also check out the Q&A’s with Dr. Bahri, Part 1 and Part 2.

Thanks again to Dr. Bahri and his team for letting me spend time in their “gemba.”


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Mark Graban's passion is creating a better, safer, more cost effective healthcare system for patients and better workplaces for all. Mark is a consultant, author, and speaker in the "Lean healthcare" methodology. He is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as The Executive Guide to Healthcare Kaizen. His most recent project is an eBook titled Practicing Lean that benefits the Louise H. Batz Patient Safety Foundation, where Mark is a board member. Mark is also the VP of Improvement & Innovation Services for the technology company KaiNexus.

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