It Takes A Team

Since 2007, I have been voted by Portland Monthly Magazine as a Top Dentist in the specialty of Oral and Maxillofacial Surgery. The magazine sends out a survey to my peer group each year asking, “If you or your family member needed oral and maxillofacial surgery, who would you go to?”  Voting clinicians are asked to take into consideration years of experience, continuing education, manner with patients, use of new technologies, and physical results. Once survey results are finalized, the nominated oral and maxillofacial surgeons are then checked to ensure that they are in good standing with the Oregon Board of Dentistry.

I am incredibly flattered to have been selected for the past twelve years by dentists, hygienists and physicians in Oregon as a provider of excellent surgical care in my field. Each year I am given a beautiful plaque to place in my office. But even though the award has my name on it, the recognition and credit for excellent care doesn’t entirely belong to me.

Recent publications have shown how surgeons who are more experienced have better outcomes, and my previous blog post discussed how several studies have demonstrated that female surgeons have better outcomes as compared to male surgeons. But, a new set of studies published by Forbes magazine this week have shown that if that surgeon begins working with a new team, patient outcomes often drop.

Teamwork determines the best care for surgical patients according to new studies and therefore drives surgical outcomes.

The researchers of this study looked at other teams and found similar results: no matter what type of team (graphic design, Navy SEALs, surgery), shared experience trumps individual experience and talent – and the longer a team is together, the higher they tend to perform.

Studies have shown that it takes on average five years for a surgical team to reach peak performance. Peak performance in surgery means that patient safety is a top priority and the team works to ensure this. This critical support allows the surgeon to focus on what she does best–operate.

For a team to reach excellence, three things need to be present: belonging, bonding and believing.

Belonging is the state where every team member has a voice and feels free to express themselves. This work culture creates safe connections between team members and allows for every member to have a voice. This is particularly important in surgery as bonding helps to prevent errors such as wrong tooth extractions and errors in medication administration. To foster an environment of belonging, I ask my team to run our safe surgery checklist prior to each procedure for each patient. My surgical assistant and anesthesia assistant have the voice to notify and stop the team if they have a concern prior, during or after a surgery.

Bonding refers to creating an environment where vulnerability is allowed. Humility is fostered for all of the team members which allows the team to examine errors and discuss near misses in patient care. We bond at GeislerOMS each morning as we huddle to discuss each patient prior to the day beginning. We also hold monthly medical emergency drills which allow us to train together and make errors together in non-critical settings. The process of making errors in training allows for us to make improvements in patient care in order to keep patients safe. We also conduct our annual Advanced Cardiac and Pediatric Life Support certifications in our facility rather than in a classroom. We invite our local first responders (Lake Oswego Police and Lake Oswego Fire) on site in order to make sure our facility is in top working order and to learn how we can best interact with them in the event of an emergency. New technologies, procedures, and techniques are often incorporated into our routine from these round-robin training sessions.

Believing is the act of striving for something other than bettering one’s own situation. It involves identifying a shared purpose and focusing one’s energy on that shared goal. At GeislerOMS, we believe that we are here to serve patients with compassion, surgical excellence and integrity. We believe that each patient we treat is precious and deserves all the best that we can provide for them. Our patients come first, period.

Any success that I have achieved as Oregon’s first female oral and maxillofacial surgeon, I proudly share with the members of my team who work with me both in the operating room and in my private practice in Lake Oswego. I am incredibly blessed to have PJ, KD, Aurora, and Sarah to help me. They make my job a pure joy. And the next time you visit GeislerOMS, know that there is a competent, highly skilled team waiting to care for you.