What is the Impact of Stress on Performance?

Man at computer and stress is impacting his performance.

Is there an impact of stress on performance? Yes; of course. You may think it is always a negative impact but that is not always the case. We actually need some stress in order to reach our ideal performance.

The stress we are talking about today is when it is too high and for too long. In that scenario, performance falls off.

How do we minimize the impact of too much pressure? First, we need to understand the correlation of stress to performance.

Inverted-U Model or Yerkes-Dodson Law

The Yerkes-Dodson Law correlates the impact of stress on performance. It illustrates there is an ideal amount of stress where the best output is achieved.

Without enough stress, boredom sets in and output is low. Conversely, with too much stress, anxiety sets in, and performance again is low.

Here is a fascinating thing, the inverted u-curve is not static. It is dynamic. We can help shift the curve for our teams with continued practice and mastery of skills.

What this means for us and our teams is that we can handle more stress before performance degrades. That is great news!

Skill Mastery and Margin

Another benefit of skill mastery is it provides margin for any “shrinkage” of performance. Let’s face it, sometimes we are in survival mode and barely keeping our head above water.

If we have expanded our skills and habits then should we have a temporary slip, there is margin to absorb it without negative impact on the customer experience.

Survival Mode Warning Signs – Watch Your Metrics

So how do you know if your team has been in survival mode too long? Watch your metrics and perk up your observation skills for the following warning indicators:

  • Increase in longer calls
  • More calls beginning with an immediate hold
  • Customers expressing increased frustration
  • Politeness and courteous tone dropping off

Take Action

Finally, do something! Ignoring the issue doesn’t make it go away. Some action steps you may need to take include:

Your team, customers, and your business will thank you!

3-Step Plan for Peak Performance

Coach watching practice with a playbook to obtain peak performance.

How seriously do you take the training of your team, ensuring your business excels in all scenarios? We need to take a lesson from sports teams as they are masters of this process. They follow 3P’s for peak performance. I appreciate Jack Daly providing the alliteration for the steps. The plan is to have a professional coach, practice regularly, and execute according to a playbook.

Professional Coach

Athletic teams would never consider entering the “fields of friendly strife” without having a coach. Think of athletes, top performers, and teams. Many times there are numerous coaches or trainers, each with their own specialty.

Your business teams are the same way. In a medical office, there are clinicians and administrative team members. They do not use the same skills to perform their duties. Different segments in your business have different needs. Liken this need to a football team having both offensive and defensive coaches.

So what does a coach do for your team? A coach/consultant provides accountability, guidance, and broader insights than your own.

Finally, a coach provides a neutral observation vantage point. They are not so close or emotionally sucked in and can extract themselves from internal bias.

The options are many, but to help you start thinking of the areas for your business, consider the following strategic segments:

  • Financial and business planning and development
  • Phone and in-person communication
  • Sales
  • Clinical efficiency
  • Patient insurance and finances
  • Human resources
  • Marketing


You know the saying, “Practice makes perfect.” Another is, “We do not rise to the occasion, we fall back on our training.”

Then why do we fail to schedule practice time? Do you think a sports team would go through a season only playing games? No way!

Practice consumes well over 90% of the athlete’s time. During the active season, an NBA player may have three games a week but have a 60-hour work week. The 3 hours of regulation time is a mere 5% of their work week.

I am not saying we need the same ratio of practice to game time, but what if we simply did the opposite proportion? What if we practiced 5% of the time? For a 40-hour work week that is a mere 2 hours. Break that down further and that is about 25 minutes per workday.

Schedule this time. Sharpen the saw. Run through scenarios. Never be caught off guard. Be intentional.


Professional athletes and teams have intentional habits, plays, and routines. Do you?

It is not enough to tell your team to, “Just do your best.” Shoot…that is leaving things to chance. We may as well be like the vultures from Disney’s Jungle Book…”Whatcha wanna do?” No plan at all.

Processes and systems are the building blocks of the playbooks for offices. With them, anyone can be trained efficiently and to a standard. It also keeps you from being out of luck when a person is out or moves on from the team.

A great way to document your playbook is to use a platform that not only serves as a repository of the systematic steps, but allows visibility and transparency into the execution of the process.

One such platform adapted for orthodontic offices is 360Matrix.

Plan for Peak Performance

Yes, you are busy. Sure, you may be a small business. Or, you may be a large business. But not taking action is simply an excuse.

Commit to ONE thing within this next week.

Maybe you need to determine your area of greatest need and explore your options for a coach/consultant. Another option is to take a first step of committing to a practice routine and put a team practice on the schedule — Or, consider one scenario, script, or process in your office that finally document it.

You decide, but START and DO ONE THING.

Stop saying what you will do and start doing what you say.

~Amy Demas

Finally remember, doing just one thing means you moved one step closer to peak performance and one step away from p**s poor performance.

No-Show Rates – Who’s Avoiding You?

Man waiting for someone while looking at watch.

First things first…no one likes to be stood up! But do you know who is avoiding you? Are those who no-show their appointments equally present across all types of customers, or is there a smaller segment of your customers impacting the metric?

Your No-Show Rates are an essential metric yielding clarity for your office. Let’s take a deeper look and see what we find.

Hate the Waste

Missed appointments within an office are more than a frustration. The opportunity cost of a no-show or late cancellation is the loss of productive work hours never to be regained.

Applying business acumen dictates a deeper dive into this metric for missed appointments or late-cancellations. But what should we explore? And how do we do this?

Listen in on how you can gain clarity on who is avoiding you.


Finally, dive deeply into root causes for your missed appointments. Understand it more fully by turning data points into actionable information. You can most easily do so by remembering a few essential tips:

  • Separate Active from New Patient appointments
  • Define what is considered “no-show”
  • Differentiate additional variables for New Patient appointments
  • Determine different goals for Active and New Patient No-Show Rates

Confirmation Call – “I’m confirming [beeeep]”

Bored woman listening to confirmation call

We have all experienced it, right? Thanks to Caller ID, we let the answering machine or our voicemail answer the call. It’s only a confirmation call. It serves to remind us to show up to an appointment or obligation. But the usual result is a quick [DELETE]…beeeeeeep.

The Ritualistic Confirmation Call

We have a love-hate relationship with such calls. On one side we appreciate a reminder of our upcoming appointment in case we did not write it down correctly. On the other hand, once we begin hearing the details, we hit “delete.” The usual confirmation call barely hovers above a level of mediocrity.

So why do we think we are doing something different by simply having a live voice instead of an automated voice do the same thing?

Change the Purpose – Connection Call

We want to be different than the usual confirmation call; let’s set out a plan.

Change the purpose from merely confirming and reminding to connecting and drawing upon the authority of our doctors. We can let the future patient know we are anticipating and preparing for their visit. This goal is easy to accomplish by referencing the status of their new patient forms.

Notice that by using this as an opportunity to thank or remind the caller about the forms we demonstrate we have taken an early initiative in preparing for their visit. It is not saying, “if” they haven’t filled it out to do so. It is actually knowing and personalizing it to them.

Thank or Remind Them

First, review the patient details to see if they have filled out their forms. If so, thank them. Conversely, if the items are not yet submitted, remind them. Either way, employ one of Cialdini’s principles of influence and draw upon the authority of the doctor.

Here are some examples:

(First, for completed forms)

“Good evening, this is Mary from Dr. Smile’s office. As Dr. Smile was reviewing your records he/she said you had completed your new patient forms and asked me to personally thank you for having completed them. Dr. Smile is looking forward to meeting everyone involved so he/she can answer everyone’s questions about his/her recommendations.

Again, this is Mary, and I will be at the front desk to meet you when you come in for your consultation tomorrow at 8 am. Should you have any questions before then, please call or text me at 555.555.5555. Again, that number is 555.555.5555. Have a great day.”

(Secondly, for incomplete forms)

“Good evening, this is Mary from Dr. Smile’s office. As Dr. Smile was reviewing your records, he/she noticed that the new patient forms were still not in our system and asked me to ensure you still had the appropriate link/email to those forms. After this call, I will email you the link. Additionally, the online forms are located on our website at www.communicateexcellence.com.

If you are unable to submit those tonight, Dr. Smile requests you arrive 15 minutes early, so you have time to complete those forms and ensure all the details are prepared in advance of your one-on-one time with the doctor. Dr. Smile is looking forward to meeting everyone involved so he/she can answer everyone’s questions about his/her recommendations.

Again, this is Mary, and I will be at the front desk to meet you when you come in for your consultation tomorrow at 8 am. Should you have any questions before then, please call or text me at 555.555.5555. Again, that number is 555.555.5555. Have a great day.”

Either example demonstrates you have taken the time to prepare and anticipate their visit. We want to sustain the great experience of the first call to validate we are unique. Be different…be excellent!

Try it out and watch how the small details add up to a better prepared new patient visit ready to say “yes” to your recommendations.