{"id":4624,"date":"2010-09-09T06:42:26","date_gmt":"2010-09-09T13:42:26","guid":{"rendered":"https:\/\/staging.opexlearning.com\/resources\/?p=4624"},"modified":"2021-11-14T22:45:44","modified_gmt":"2021-11-15T03:45:44","slug":"book-review-follow-the-learner-the-role-of-a-leader-in-creating-a-lean-culture","status":"publish","type":"post","link":"https:\/\/staging.opexlearning.com\/resources\/book-review-follow-the-learner-the-role-of-a-leader-in-creating-a-lean-culture\/4624\/","title":{"rendered":"The Lean Dentist: Book Review of Follow the Learner"},"content":{"rendered":"<div class=\"a296a24fa2fc69ef5487857f02f111e8\" data-index=\"9\" style=\"float: none; margin:10px 0 10px 0; text-align:center;\">\n<script async src=\"\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- Single Post readerboard -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:inline-block;width:728px;height:90px\"\r\n     data-ad-client=\"ca-pub-8207522353004717\"\r\n     data-ad-slot=\"1144967431\"><\/ins>\r\n<script>\r\n(adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>Several months ago I finished Dr. Sami Bahri&#8217;s (The Lean Dentist) book <a title=\"sami bahri, lean dentist\" href=\"https:\/\/www.amazon.com\/gp\/product\/193410924X?ie=UTF8&#038;ref_=sr_1_1&#038;s=books&#038;qid=1283967843&#038;sr=1-1&#038;linkCode=shr&#038;camp=213733&#038;creative=393173&#038;tag=sixsigma09-20\" target=\"_blank\" rel=\"noopener\">Follow the Learner: The Role of a Leader in Creating a Lean Culture<\/a>. I&#8217;m grateful to the Lean Enterprise Institute (LEI) for providing me with a free copy (as well as several other books they&#8217;ve sent me).<\/p>\n<div align=\"center\">\r\n<table border=\"1\" cellpadding=\"5\">\r\n<tbody>\r\n<tr>\r\n<td style=\"text-align: center;\" colspan=\"2\"><strong>Other Book Reviews You Might Enjoy<\/strong><\/td>\r\n<\/tr>\r\n<tr>\r\n<td>\r\n<ul>\r\n\t<li><a title=\"toyota mindset, taiichi ohno book review\" href=\"https:\/\/staging.opexlearning.com\/resources\/toyota-mindset-commandments-taiichi-ohno\/7715\/\">The Toyota Mindset<\/a><\/li>\r\n\t<li><a title=\"A visual factory, book review on lean\" href=\"https:\/\/staging.opexlearning.com\/resources\/book-review-the-visual-factory\/4352\/\">A Visual Factory<\/a><\/li>\r\n\t<li><a title=\"follow the learner, book review on lean\" href=\"https:\/\/staging.opexlearning.com\/resources\/book-review-follow-the-learner-the-role-of-a-leader-in-creating-a-lean-culture\/4624\/\">Follow the Learner<\/a><\/li>\r\n\t<li><a title=\"kaizen and the art of creative thinking, book review\" href=\"https:\/\/staging.opexlearning.com\/resources\/book-review-kaizen-and-the-art-of-creative-thinking\/4617\/\">Kaizen and the Art of Creative Thinking<\/a><\/li>\r\n\t<li><a title=\"whaddaya mean i gotta be lean book review\" href=\"https:\/\/staging.opexlearning.com\/resources\/book-review-whaddaya-mean-i-gotta-be-lean\/3813\/\">Whaddaya Mean I Gotta Be Lean<\/a><\/li>\r\n\t<li><a title=\"5s for healthcare book review\" href=\"https:\/\/staging.opexlearning.com\/resources\/book-review-clinical-5s-for-healthcare\/3452\/\">Clinical 5S for Healthcare<\/a><\/li>\r\n\t<li><a title=\"inmates are running the asylum book review\" href=\"https:\/\/staging.opexlearning.com\/resources\/simplify-your-product-design\/290\/\">The Inmates Are Running the Asylum<\/a><\/li>\r\n\t<li><a title=\"33 strategies of war book review\" href=\"https:\/\/staging.opexlearning.com\/resources\/book-review-the-33-strategies-of-war\/220\/\">33 Strategies of War<\/a><\/li>\r\n<\/ul>\r\n<\/td>\r\n<td>\r\n<ul>\r\n\t<li><a title=\"lean manufacturing a plant floor guide, book review\" href=\"https:\/\/staging.opexlearning.com\/resources\/book-review-lean-manufacturing-a-plant-floor-guide\/4864\/\">Lean Manufacturing: A Plant Floor Guide<\/a><\/li>\r\n\t<li><a title=\"book review on best service is no service\" href=\"https:\/\/staging.opexlearning.com\/resources\/book-review-the-best-service-is-no-service\/4347\/\">Best Service is No Service<\/a><\/li>\r\n\t<li><a title=\"lean six sigma logistics book review\" href=\"https:\/\/staging.opexlearning.com\/resources\/book-review-lean-six-sigma-logistics\/4379\/\">Lean Six Sigma Logistics<\/a><\/li>\r\n\t<li><a title=\"implementing six sigma book review\" href=\"https:\/\/staging.opexlearning.com\/resources\/book-review-implementing-six-sigma\/4372\/\">Implementing Six Sigma<\/a><\/li>\r\n\t<li><a title=\"steve blank, four steps to the epiphany book review\" href=\"https:\/\/staging.opexlearning.com\/resources\/the-lean-startup-and-customer-development\/3428\/\">Four Steps to the Epiphany<\/a><\/li>\r\n\t<li><a title=\"five dysfunctions of a team, excellent book review\" href=\"https:\/\/staging.opexlearning.com\/resources\/chime-in-comes-before-buy-in\/389\/\">5 Dysfunctions of a Team<\/a><\/li>\r\n\t<li><a title=\"venture capital and private equity, book review\" href=\"https:\/\/staging.opexlearning.com\/resources\/book-review-11252006\/261\/\">Venture Capital and Private Equity<\/a><\/li>\r\n\t<li><a title=\"book review of implementing lean software development\" href=\"https:\/\/staging.opexlearning.com\/resources\/12-questions-with-mary-poppendieck\/183\/\">Implementing Lean Software Development<\/a><\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<\/div>\r\n&nbsp;\n<p>This post is my review of the book.<\/p>\n<h2>Leadership, Not Just Dentistry<\/h2>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright wp-image-4643 size-medium\" title=\"lean dentist office layout\" src=\"https:\/\/staging.opexlearning.com\/resources\/wp-content\/uploads\/2010\/09\/lean-dentist-lean-office-layout-300x286.jpg\" alt=\"the lean dentist, lean in a dental office\" width=\"300\" height=\"286\" srcset=\"https:\/\/staging.opexlearning.com\/resources\/wp-content\/uploads\/2010\/09\/lean-dentist-lean-office-layout-300x286.jpg 300w, https:\/\/staging.opexlearning.com\/resources\/wp-content\/uploads\/2010\/09\/lean-dentist-lean-office-layout.jpg 466w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/>Dr. Sami Bahri is a dentist, with a practice in Florida. His history goes back to the early 90&#8217;s where he quickly became frustrated with the current state of dental practice &#8211; for him, it seemed inefficient and patients deserved better. He quickly read all he could on the current management fads at the time, then in 1996, while listening to Lean Thinking on tape, he received the answers he needed to transform his dental practice into one that encouraged and supported flow and enabled him to create a better patient experience <sup class='footnote'><a href='#fn-4624-1' id='fnref-4624-1' onclick='return fdfootnote_show(4624)'>1<\/a><\/sup>.<\/p>\n<p>In his words,<\/p>\n<blockquote><p>&#8220;When the patient gets in the chair, we don&#8217;t want to waste any time,&#8221; Bahri said. &#8220;I look at it from the patient point of view.&#8221;<\/p><\/blockquote>\n<h2>Dentistry as Job Shop<\/h2>\n<p><a href=\"https:\/\/www.amazon.com\/gp\/product\/193410924X?ie=UTF8&#038;ref_=sr_1_1&#038;s=books&#038;qid=1283967843&#038;sr=1-1&#038;linkCode=shr&#038;camp=213733&#038;creative=393173&#038;tag=sixsigma09-20\" target=\"_blank\" rel=\"noopener\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-4625  aligncenter\" title=\"follow-the-learner-sami-bahri-lean-dentist\" src=\"https:\/\/staging.opexlearning.com\/resources\/wp-content\/uploads\/2010\/09\/follow-the-learner-sami-bahri-lean-dentist.jpg\" alt=\"lean dentist\" width=\"480\" height=\"167\" srcset=\"https:\/\/staging.opexlearning.com\/resources\/wp-content\/uploads\/2010\/09\/follow-the-learner-sami-bahri-lean-dentist.jpg 533w, https:\/\/staging.opexlearning.com\/resources\/wp-content\/uploads\/2010\/09\/follow-the-learner-sami-bahri-lean-dentist-300x104.jpg 300w\" sizes=\"(max-width: 480px) 100vw, 480px\" \/><\/a><\/p>\n<p>In dentistry, conventional training told dental students to schedule patients by batching like procedures to avoid setups.<\/p>\n<blockquote><p>When I made your appointment I would see how many fillings you had and I scheduled them together. I had a different setup for crowns so the next time you came, I would do the crowns. Most of the time, dentists tried not to switch from one type of procedure to another in the same appointment because of the time that it takes to do setups.\u009d<\/p><\/blockquote>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-medium wp-image-4641\" style=\"margin: 3px;\" title=\"lean-dentist-standard-equipment-set-up\" src=\"https:\/\/staging.opexlearning.com\/resources\/wp-content\/uploads\/2010\/09\/lean-dentist-standard-equipment-set-up-163x300.jpg\" alt=\"\" width=\"163\" height=\"300\" srcset=\"https:\/\/staging.opexlearning.com\/resources\/wp-content\/uploads\/2010\/09\/lean-dentist-standard-equipment-set-up-163x300.jpg 163w, https:\/\/staging.opexlearning.com\/resources\/wp-content\/uploads\/2010\/09\/lean-dentist-standard-equipment-set-up.jpg 304w\" sizes=\"(max-width: 163px) 100vw, 163px\" \/>He estimated the typical dental setup of preparing tools and materials takes about 15 to 20 minutes. Thus, a patient needing a root canal and crown even if they are for the same tooth will need a separate visit for each procedure.<\/p>\n<blockquote><p>The problem is that in your mouth, you need crowns, fillings, root canals, veneers, etc.,\u009d Bahri said. So when you come to me, I should have the flexibility to go from one to the other nonstop. That puts the mouth at the center of the process.\u009d<\/p><\/blockquote>\n<p>Batching dental procedures avoids setups but leads to other wastes. For example, if you arrive for a dental appointment needing a procedure other than the one scheduled (like a root canal instead of a filling) the tools and materials for the scheduled procedure must be removed while tools and materials for the new procedure are set up.<\/p>\n<p>Even if the appointment goes according to plan, traditional scheduling extends treatment time. For example, if you need a root canal, two fillings, and four veneers, you&#8217;ll need at least three appointments. That means three roundtrip drives to the dentist, three periods away from work or leisure, and three times the chance that at least one appointment will have to be rescheduled.<\/p>\n<blockquote><p>It was organized like mass production. I wanted to change that. I don&#8217;t think healthcare professionals realize\u00a0how much their offices are influenced by mass production assembly lines. By removing these wasteful activities, a lean\u00a0transformation gives healthcare professionals more time and resources to spend on personal patient\u00a0care.\u009d<\/p><\/blockquote>\n<h2>How Long to do a Cleaning?<\/h2>\n<p>Here is his explanation for what dental procedure was performed most often and how he arrived at a takt time for that specific procedure:<\/p>\n<blockquote><p><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-medium wp-image-4640\" title=\"lean-dentist-takt-time\" src=\"https:\/\/staging.opexlearning.com\/resources\/wp-content\/uploads\/2010\/09\/lean-dentist-takt-time-300x281.jpg\" alt=\"\" width=\"300\" height=\"281\" srcset=\"https:\/\/staging.opexlearning.com\/resources\/wp-content\/uploads\/2010\/09\/lean-dentist-takt-time-300x281.jpg 300w, https:\/\/staging.opexlearning.com\/resources\/wp-content\/uploads\/2010\/09\/lean-dentist-takt-time.jpg 349w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/>Bahri analyzed an annual history of procedures performed in his\u00a0office to determine what was done most often. Cleanings at 3,985 were the runaway winner. Dividing by this\u00a0number the available work time of 104,160 min., the time the office is open during a year, gave him a takt time\u00a0of 26.13 minutes. Every 26.13 minutes we had a cleaning ordered,\u009d he said. Despite this stable average rate,\u00a0the workload of hygienists varied greatly day-to-day. Some days the two office hygienists didn&#8217;t have enough\u00a0work to keep them busy; other days Bahri had to bring in a third hygienists to help.<\/p>\n<p>The next question was, &#8220;How long did it take to do a cleaning? \u009d Bahri said. Using takt time and cycle time data, Bahri could calculate the number of hygienists actually needed to meet the rate of demand for cleanings (the takt time) instead of applying the traditional dental management formula of having one or two hygienists per dentist. He also would be able to distribute cleanings evenly throughout the schedule, eliminating the peaks\u009d and valleys\u009d of too much or too little work for hygienists to do.<\/p>\n<p>Equipped with a stopwatch, pencil, and paper, Marisa Young, an office flow manager, studied hygienists working. She and Bahri discovered that a cleaning could be done in 20 minutes, six minutes less than the takt time, after nonvalue adding activities, such as walking to dentists&#8217; cubicles and cleaning up between patients, were eliminated. Dental assistants and two flow managers\u009d took over the hygienists&#8217; jobs of cleanups, collecting payments, presenting treatment plans, and making appointments.<\/p>\n<p>Every 26 minutes a cleaning was ordered so hygienists had six minutes of free time in between cleanings, which is okay with me,\u009d Bahri said. It can&#8217;t follow the same drumbeat as an industrial process. And at that time, I was allocating an hour for cleanings, so I had cut it by half.\u009d<\/p><\/blockquote>\n<h2>The Results &#8211; Applying Lean to Dentistry<\/h2>\n<p>Below are the results of his application of Lean Thinking to dentistry:<\/p>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-4639 aligncenter\" title=\"lean-dentist-before-after-benefits\" src=\"https:\/\/staging.opexlearning.com\/resources\/wp-content\/uploads\/2010\/09\/lean-dentist-before-after-benefits.jpg\" alt=\"\" width=\"491\" height=\"171\" srcset=\"https:\/\/staging.opexlearning.com\/resources\/wp-content\/uploads\/2010\/09\/lean-dentist-before-after-benefits.jpg 491w, https:\/\/staging.opexlearning.com\/resources\/wp-content\/uploads\/2010\/09\/lean-dentist-before-after-benefits-300x104.jpg 300w\" sizes=\"(max-width: 491px) 100vw, 491px\" \/><\/p>\n<p>Mark Graban, at Leanblog, held a Q&amp;A with Dr. Sami Bahri regarding his application of <a title=\"lean for dentistry, lean dentist\" href=\"https:\/\/www.leanblog.org\/2007\/10\/q-with-lean-dentist-part-1\/\">Lean for a dental practice<\/a>. Please go there too to read more.<\/p>\n<p>Below are two videos of Dr. Sami Bahri, the lean dentist &#8211; these videos are worth watching.<\/p>\n<p>&nbsp;<\/p>\n<p><a href=\"https:\/\/www.amazon.com\/gp\/product\/193410924X?ie=UTF8&#038;ref_=sr_1_1&#038;s=books&#038;qid=1283967843&#038;sr=1-1&#038;linkCode=shr&#038;camp=213733&#038;creative=393173&#038;tag=sixsigma09-20\" target=\"_blank\" rel=\"noopener\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-4625  aligncenter\" title=\"follow-the-learner-sami-bahri-lean-dentist\" src=\"https:\/\/staging.opexlearning.com\/resources\/wp-content\/uploads\/2010\/09\/follow-the-learner-sami-bahri-lean-dentist.jpg\" alt=\"lean dentist\" width=\"480\" height=\"167\" srcset=\"https:\/\/staging.opexlearning.com\/resources\/wp-content\/uploads\/2010\/09\/follow-the-learner-sami-bahri-lean-dentist.jpg 533w, https:\/\/staging.opexlearning.com\/resources\/wp-content\/uploads\/2010\/09\/follow-the-learner-sami-bahri-lean-dentist-300x104.jpg 300w\" sizes=\"(max-width: 480px) 100vw, 480px\" \/><\/a><object width=\"520\" height=\"415\" classid=\"clsid:d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http:\/\/download.macromedia.com\/pub\/shockwave\/cabs\/flash\/swflash.cab#version=6,0,40,0\"><param name=\"allowFullScreen\" value=\"true\" \/><param name=\"allowscriptaccess\" value=\"always\" \/><param name=\"src\" value=\"http:\/\/www.youtube.com\/v\/uqX_edFvefs?fs=1&amp;hl=en_US&amp;rel=0&amp;color1=0x2b405b&amp;color2=0x6b8ab6\" \/><param name=\"allowfullscreen\" value=\"true\" \/><embed type=\"application\/x-shockwave-flash\" width=\"520\" height=\"415\" src=\"http:\/\/www.youtube.com\/v\/uqX_edFvefs?fs=1&amp;hl=en_US&amp;rel=0&amp;color1=0x2b405b&amp;color2=0x6b8ab6\" allowscriptaccess=\"always\" allowfullscreen=\"allowfullscreen\" \/><\/object><\/p>\n<div class='footnotes' id='footnotes-4624'>\n<div class='footnotedivider'><\/div>\n<ol>\n<li id='fn-4624-1'> source: kaizensensei.org\/medical.html <span class='footnotereverse'><a href='#fnref-4624-1'>&#8617;<\/a><\/span><\/li>\n<\/ol>\n<\/div>\n<!--CusAds0-->\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Several months ago I finished Dr. Sami Bahri&#8217;s (The Lean Dentist) book Follow the Learner: The Role of a Leader in Creating a Lean Culture. I&#8217;m grateful to the Lean Enterprise Institute (LEI) for providing me with a free copy (as well as several other books they&#8217;ve sent me). This post is my review of [&hellip;]<\/p>\n","protected":false},"author":12327,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[382],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>The Lean Dentist - Book Review of Follow the Learner<\/title>\n<meta name=\"description\" content=\"Dr. Sami Bahri, the Lean Dentist, book review on &quot;Follow the Learner: Role of a Leader in Creating a Lean Culture&quot;\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The Lean Dentist - Book Review of Follow the Learner\" \/>\n<meta property=\"og:description\" content=\"Dr. Sami Bahri, the Lean Dentist, book review on &quot;Follow the Learner: Role of a Leader in Creating a Lean Culture&quot;\" \/>\n<meta property=\"og:url\" content=\"https:\/\/staging.opexlearning.com\/resources\/book-review-follow-the-learner-the-role-of-a-leader-in-creating-a-lean-culture\/4624\/\" \/>\n<meta property=\"og:site_name\" content=\"OpEx Learning\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/get.shmula\" \/>\n<meta property=\"article:published_time\" content=\"2010-09-09T13:42:26+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2021-11-15T03:45:44+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/staging.opexlearning.com\/resources\/wp-content\/uploads\/2010\/09\/lean-dentist-lean-office-layout-300x286.jpg\" \/>\n<meta name=\"author\" content=\"Uday Kawar\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@shmula\" \/>\n<meta name=\"twitter:site\" content=\"@shmula\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Uday Kawar\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/staging.opexlearning.com\/resources\/book-review-follow-the-learner-the-role-of-a-leader-in-creating-a-lean-culture\/4624\/\",\"url\":\"https:\/\/staging.opexlearning.com\/resources\/book-review-follow-the-learner-the-role-of-a-leader-in-creating-a-lean-culture\/4624\/\",\"name\":\"The Lean Dentist - 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