Habit upon Habit

Calendar with colored blocks

Recently I came across a social media post with a great image having the months of the year written in a block font and broken into how many days in each month (see photo above). Immediately I knew I wanted to pull that into my personal resources to help master my habits. I am fully aware each day is an opportunity to build a habit upon habit.

As I began to fill in the days I began to call it my “patchwork of progress”. It hits so well upon the science of habit loops.

Habit Loops

James Clear, in Atomic Habits, and Charles Duhigg, in The Power of Habit, speak of habit loops. They describe a 3-part cycle of a habit loop. The cycle is started with a trigger or cue, which then causes a response or habit, resulting in a reward. The item I appreciate James Clear speaking more of is how craving is a part of the loop. The craving for the reward is what puts us in action and solidifies the loop into a habit. I like to think of craving as a catalyst fanning the flame of action.

Habit Loop - Cue, Response, Reward

My Habit Loop

Allow me to tell you how I took the coloring page into my own habit loop.

The cue for me are seeing the calendar sheet. It reminds me of my “why” of the desired habit and the end state I desire, but it also triggers a craving for me. I LOVE “done” and want to continue the streak of coloring in each day. So getting to color in a shape or checking off a block motivates me. But I know in order to be able to get the reward I must take action (response/habit). And then once I do, I get the reward of coloring in the daily block.

This cycle works well for me because I love to color but rarely take the time to do so. This means my reward is very desirable for me. And since I have this reward so closely coupled with a cue/craving it is very effective.

But How Many?

This year I picked three core habits I wanted to work on. I picked one for my heart, one for my mind, and one for my spirit.

I also give myself “partial credit”…just like I encourage my students to do. Allow me to explain.

One of my three is to step on my scale. I have a long hard history and battle with my scale. The numbers it displays sometimes seem to taunt me or yell at me causing me to want to avoid it and give up on my ultimate goal of good health.

I am working on changing its meaning as I work on my health. So every day I set my intention and awareness of a health-focused day by stepping on. Yes, I want a downward trend and am working on that, but more importantly, I step on…notate it…and color in a block. But on days I travel, I have no scale to stand on so I mentally set my intention. If I do that, upon my return I don’t fully color in the block for that day but I hashmark it. Grace…grace…grace.


Awareness is the first step to change.

I teach this to my students from their very first coaching session by providing a sheet of blocks to chart their wins. And I encourage them to give themselves credit in multiple ways. If they fully execute the habit we are working on, they are to “x” the block, like a “strike” in bowling. If they don’t execute on the habit but immediately think of it afterward…you know that “D’oh” moment…then I instruct them to give themselves a “/” in the block, like a “spare” in bowling. Awareness is the first step to change.

Little by Little

Bit by bit I see my habits changing and I like it. Little by little I see incredible changes as I work with teams!

So what two to three things will you and your team choose to work on? Dont’ even stress about two or three…pick ONE. Master that one habit/process and move to another.

Remember…habit upon habit…process upon process.

Contact Communicate Excellence for a systemized habit-upon-habit approach to the success of your team.

New Year Intentions. New Possibilities…But Are They Probable?

Turn new year intentions into a possibility.

There is something special about a new year with its new beginnings, new intentions, new possibilities, new calendars, and new planners. All seems fresh and the possibilities are endless.

But if it is possible, does it necessarily mean is it probable?

Our family enjoys going to CiCi’s Pizza. “Welcome to CiCi’s!”

On one particular instance, prominently displayed at the front door was a sign offering a $250 prize for anyone who could meet “The Challenge”. The rules included eating a 28-inch pizza and drinking a large soda, without ice, in 60 minutes. No standing, no throwing up.

Now is this possible? Yes—according to the sign, one person had succeeded.

Is this probable? No—so far only one had succeeded while over 40 people had accepted the challenge.

Possible vs Probable

So what is the difference between possible and probable?

The dictionary says that possible means, “capable of happening, existing, or being true without contradicting proven facts, laws, or circumstances—capable of occurring or being done”. Common words—”it could happen”.

The dictionary says that probable means, “likely to happen or to be true”. Common words—more than likely, “it will happen”

New Year Intentions

This is the time of the year when we make resolutions or add things to our “bucket list”. Each of these things falls into the category of possible or probable. Some things that determine where they fall include your expectations and effort.

When we walked into CiCi’s, we saw the challenge and determined that it was something we could possibly do, (we like pizza and how hard could it be?) — but probably would not do because we did not expect to win and were not willing to make the effort to win, and so far, only one had succeeded.

Your List – Your Choice

Think about the resolutions you have made for yourself and your team. Then categorize them into Possible and Probable. Finally, see how many you can transition from Possible (it could happen) to Probable (it will happen) by providing the correct expectation, effort, or resources.

Remember, it’s your list—it’s your choice. You can turn “possibility” into “probability” with the plan and effort it takes to meet your expectations.

And what would that look like? Success!

Set Yourself Up for Probable Success

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Learn how to improve EVERY communication and call!

From making a great first impression to proper communication for scheduling and handling difficult patients, [Amy Demas] shows how to dramatically improve conversion rates, build your practice, and create raving fans in the process. Implementing her time-tested methods will help build teamwork and reap big profits for your practice!

John McGill

Learn from the communication expert, Amy Demas, as she shares her insights after evaluating over 10,000 calls EACH year. Then consider…

If you don’t have time to do it right, when will you have time to do it over?

Coach John Wooden

Find Communicate Excellence: A Guide to Authentic, Positive, Consistent Front Desk Communication wherever books are sold. For $19.99 it is a resource you cannot afford to pass up.

Three Ways to Respond to Change

Resistance, Running Away, and Curiosity are ways to respond to change

The Greek philosopher, Heraclitus, is attributed as saying, “Change is the only constant in life.” And since we would all agree that is true, how do you and which way do you respond to change?

My long-time life and career coach, Nicole Greer, and I have had many talks on this topic. Most of these discussions are in coaching sessions when…you guessed it…there is a change in my life and in my circumstances and I am struggling. She reminds me of the 3 energies I can apply to the changing circumstance.

The three energetic responses are:

  • Over/Against
  • Retreat
  • Toward

Let’s look at all three and see how they may show up for you and for your team.


The first response is Over/Against. The illustration of tug-of-war is perfect for this type of energetic response. Some change is thrust upon you and resistance sets in. You or your team begins to dig in. The trenches are established and we settle in for the long haul. Sabotage is even in the playbook of this response.

As a leader, how often have you been excited about a new process, new protocol, or a new way to build up your team yet, when you arrive on Monday morning you receive the eye rolls, crossed arms, and shaking heads?

They dig in as a fortification surrounding a city under siege. They know you can only hold out for maybe a day, a week or a month…at most. Then they know it will be business as usual.

Or maybe you are facing the change. It could be a competitor opening up down the street, a new direct-to-consumer business model encroaching on your potential clientele, or even a child making a decision you do not like.

Your blood boils, your mind swirls, your stomach turns into a knot. You might even be like the boy below…”I’ll show you!”

The sad part about the resistance is that everyone digs in and no one is cooperating to make the circumstance, or change, better.


Run away! Ignore it!

Retreating is yet another way to respond to change. The thought being if we refuse to face the circumstance before us, it is as if it really does not exist.

This response is the opposite of Over/Against. It is to ignore it as if it will vanish like an early morning mist. But in reality, it only puts off the inevitable. And the inevitable may become more intense when not addressed.

Think of your team. Sometimes we all know someone needs to be “promoted out of the company”. One poor team member can ruin the entire culture. Not only does it create tension and awkwardness for the team, but it destroys the team’s confidence in your ability to lead.

You may hate the thought of firing the employee because you hate such a crucial confrontation. Or maybe the thought of finding a replacement scares you. Either way, putting off the best decision by retreating from it does not make it better or go away.

Don’t ignore a needed change. Face it.


Finally, we have a “Toward” response.

Let’s face it. Change isn’t always easy. Change may not feel good. But if we can ease movement toward it and remain curious, the transition will be easier.

For a personal change. Take one small, repeatable habit at a time. Secure that habit then add another. This keeps us from overhaul resolutions that rarely last.

Within your business, instead of returning from an event and thrusting broad and sweeping changes, start with casting a vision for what you desire. Then start with one change at a time. This will allow your team to more easily draw upon “toward” energy instead of “against” or “retreat” energy.

Draw them in. Help your team moving toward the goal.


As Norman Vincent Peale says, “Change your thoughts and you change your world.”

Pay attention. Notice your responses. Observe your team’s responses. Are you taking note as to how you and your team respond to change?

It may be time for some change in your office to ensure you are keeping up with the industry trends. Set you and your team up for success. Watch out for “Against” and “Retreat” attitudes. Foster how you and your team to take on the inevitable change with an attitude and energy of “toward”.

“Slow and steady wins the race.”


Dare We Talk of Money?

Talk of Money and Piggy bank with dollars

The question of how we talk of money on the phone has been around for years. How do you approach it?

Do we take an absolute stance to never talk about cost on the phones? Should we claim ignorance? What about quoting a range? And how about speaking of payment arrangements?

Setting the Scene

When a potential customer calls asking for a quote or cost range for treatment we immediately feel perspiration beading up on our foreheads. The verbal tap dance begins and many feign ignorance of what anything could cost.

More likely than not the majority of callers have a general idea of cost. They have Googled it, asked around, or have already had a quote provided.

So then…what’s the big deal with the question and this talk of money? What is the question behind the question? That is what we should be asking ourselves and addressing.

Invariably this is a way to ask if you are affordable. Don’t miss this! By not addressing the actual question you risk the provided opportunity to demystify how you can work with them making your services possible in light of their monthly budget. You have not removed a critical barrier to entry for them.

Let’s discuss the various strategies that get used when the talk of money and cost invades the initial call.

Free Ranging

While “free ranging” is a good idea when shopping for eggs and meats, it is not a wise option to the cost question on the first phone call.

When I hear a free-ranging reply it is always with cost ranges way to broad as to CYA. It tends to sound like: “Well…it can be anywhere from $2000 to $8000 for braces.”

Oh my! In an effort to cover any option possible the free-ranging team member has done a great job of scaring away those who don’t have a lot of funds set aside. Conversely, the deal maker will be upset with a final quote anywhere above the low-ball $2000.

Don’t put yourself in this spot.


Oh, the affliction of amnesia…how sad it is…especially when it is not genuine. Unfortunately, this is the way our front desk teams are taught to act out. But this does not evoke trust.

The tap dance of acting as if you do not know the typical costs for treatment come across as just that…acting. The caller knows you know and to pretend otherwise does not foster trust inn the relationship.

One form of this is palatable. It is when you do not dodge the question but rather inform the caller: “There are various factors that impact the cost of treatment and during your free consultation the doctor reviews your case we will provide you all the information about any recommended treatment. Let’s go ahead and get you scheduled for your complimentary exam.”


Ah, this is what we want. We want someone to see beyond the verbal question and validate the unspoken question…the issue of affordability.

In this instance, we still mention there are various factors impacting the total investment of treatment, but also add, “what I can tell you is that we are very successful in working with so many families to get down payments as low as $xxx and monthlies as low as $xxx. Would that work for you?”

Then guide the caller to make the appointment.

You have now removed a barrier to entry. And you have also provided social proof of helping other families.


Do not let the talk of money cause anxiety. Also, remember we do not want to be quoting fee ranges or pretending we have no idea what our offices charges. Neither approach addresses the real concern of the caller, which is affordability.

Answer the unspoken affordability question. Discuss what dollar amounts will be used by the team. Then you can let the inquisitive caller know you have been very successful working with many families to get down payments as low as $xxx and monthlies as low as $xxx. The other details will be covered in the complimentary exam so go ahead an get them scheduled to come on in.

5 Categories of Questions

5 Categories of Questions and question marks

There are several categories of questions from which we can draw. In our businesses and our lives, we must realize there is more than one way to ask a question. We need to know which type is most effective. Today we will elaborate on five categories of questions.

The five categories of questions are:

  • Permission
  • Clarifying
  • Discovery
  • Leading
  • Wishing

“If you do not know how to ask the right question, you discover nothing.”

W Edwards Deming


We use permission questions at the beginning of our customer interactions. A common one is: “How may I help you?”

Other times we use permission questions are when we need to place a caller on hold (“May I place you on a brief hold?”) or begin a series of questions (“May I ask you a few questions?”).

Notice the use of, “May I”. Politeness is a key component of these type of questions.


Clarifying questions are used predominantly as we exchange information. They help ensure understanding and accuracy.

A common use is when repeating back hear information and adding on, “Did I get that correct?”

Or, if we want to validate our listener captured the essence of our message we may ask, “Do you have any questions about what we discussed?”

Understanding and validation are the goals of these questions.


While we use discovery questions throughout interactions with our team and customers, they are used heavily on inquiry calls. The challenge is obtaining a proper ratio of close-ended versus open-ended questions.

Close-ended questions saturate most inquiry calls. This staccato and ping-pong effect of question-answer, question-reply is why many calls sound as if we are going down a list or tabbing through computer screens. (Oh, please tell me you aren’t taking these crucial calls on the computer!)

But by adding strategically placed open-ended questions throughout the inquiry call you create space to uncover valuable information. It also fosters the relationship by demonstrating a greater curiosity about them. Finally, it sure feels better offering information than having it extracted.

Think about it…would you rather answer the typical, “Name? DOB? Address? Phone number? Who referred you?”…or experience a greater free-flow and exchange of information with the following inserted throughout a call, “What prompted you to give us a call today?” and “Is there anything else we can do to make your first visit more comfortable?”


A well-crafted leading question helps guide the respondent to the intended reply and desired answer. This is a form of influence…or persuasion.

There are times this in not appropriate and why judges call out attorneys for “leading the witness”. But for our offices there are times we need to guide and influence our customers into the options we provide.

Using a leading question is most effective in our offices when needing to schedule customer appointments. After offering two choices, we ask, “Which one works best for you?” The use of “which one” implies a limited resource and option. Compare this to asking, “Do either one work?” as if the provided options emerged from a limitless pool of possibilities.


Wishing is a type of question, but it is heading down the slippery slope toward pleading. That is not where we want to go.

Wishing tends to end with, “Ok?” and a near sing-song lilt.

This pattern can slip into our questions and it then devalues our position. Do you know where this is so commonly heard?

child on playground

You’ve got it…the playground!

Have you heard the wishing parent? “Johnny, we are going to go soon. Ok?” Can’t you see the scrunched face and hunched shoulders and hear the wishful lilt in the voice?

It is so easy to change the wish to a clarification. Try this: “Johnny, we are going to go in 5 minutes. Do you understand?”

We must do the same and even elevate it to a leading question. Instead of asking, “Mrs. Jones, when do you want to come in?” change it to, “Mrs. Jones, the doctor has [Option A or B]. Which one works best for you?”


Be intentional with your questions. Empower your teams by teaching them about these five categories of questions and provide examples. Finally, practice and provide constructive feedback on the effective selection and use of the questions.

“If you want the answer – ask the question.”

Lorii Myers

But let’s add to the quotation…ask the right type of question.

“It’s too…(hard, busy…)”

Picture of cheese as a play on cheese with a complaining whine.

Do you need some cheese with that “whine”? We have likely heard this play on the phrase “wine and cheese” when someone is whining. Our team members are not immune to it…and neither are we.

But let’s face it, phrases that start with, “It’s too…[hard, busy, new, different]” usually equate to one thing…a whine or EXCUSE.

Where there’s a will, there’s a way

Willingness is a key component of change and growth. Without it, even the most capable person wallows in mediocrity or stagnates their progress.

In order to overcome a challenge or obstacle, we must apply willingness. When I see stories in the news or posts on Facebook of individuals overcoming impossible odds, such as Nick Vujicic, Aldo Amenta, or Anna Sarol, our willingness seems pale by comparison.

“In order to accomplish something, you must be willing to do whatever it takes to accomplish it.”

Mike Hernacki

Now I’m not saying this is to do anything illegal but let’s take it to where the rubber meets the road in our offices with two examples of what we can do to foster success.

“It’s too hard to remember.”

Really? I know the change of a habit is not easy but we can prepare in advance.

An example of this is when I hear some individuals needing to exchange one word in their greeting. The culprit is the word “can” instead of “may.” The last part of our introduction should be, “How may I help you?”

And why do we say “may”? “May” is a permission word and “can” is an ability word. You may remember this from your grade school days when you asked your teacher to leave the room to go to the bathroom. You may have said, “Can I go to the bathroom?” to which your teacher sarcastically responded, “I don’t know…CAN you?”

Then you would make the exchange to use the correct word and repeat yourself by saying, “May I go to the bathroom?” Then your teacher would grant you permission.

The same happens on the phone. We have teachers and English majors calling our offices and though they may not say the sarcastic response out loud, I can guarantee they are saying it in their head. So, exchange the word and remove an unnecessary hurdle. Say it correctly and demonstrate you take care of even the little details to get them accurate.

What can you do? Create a reminder…a sticky note to be placed at your phone. That way we set ourselves up for success as we exchange one habit for another. (For more on exchanging habits, refer to Charles Duhigg’s book, The Power of Habit.)

“We’re too busy to take an inquiry call on paper first.”

Here is another one. When I hear this whine or excuse, it cries the need for a checklist. Checklists are invaluable as a safety net ensuring nothing is missed, and they serve as a communication and trust tool allowing anyone to notice, at a glance, the status of the process.

It is said best in The Checklist Manifesto that checklists:

…provide a kind of cognitive net. They catch mental flaws inherent in all of us – flaws of memory and attention and thoroughness.

Atul Gawande

The debate over taking an initial call directly into the computer versus on paper doesn’t seem to go away. A summary of the debate can be obtained here.

But that is not the point here. We want to apply willingness to create the best first call experience while not forgetting to input the details into our system. So what do we need to ensure we do what it takes to make it excellent and without error? A checklist!

Create a checklist and stick to it. Not only will your callers have a better experience, but you can then move some of the tasks on the list to a quieter time of the day, allowing for level loading of work capacity. Checklists are critical to your office’s playbook of success.


Watch out for when a whine or excuse bubbles up in your office. A key indicator of them is hearing phrases start with, “It’s too…”

Finally, apply true willingness to overcome the obstacle. Do what it takes! A couple of examples are reminders and checklists. Do so and you will set the environment for excellence!

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