Sally McKenzie, CMC
Case Profile: This general practice in the heart of Wisconsin`s dairyland has one doctor, three operatories, a full-time hygienist, one chairside, and a receptionist.
Symptoms: Since the receptionist`s helper quit last month, staff resentment toward the doctor has been building, causing the doctor stomach cramps and frequent bouts of the "back-door trots." Ill-tempered staff = gastro distress = patient cancellations = more gastro distress, ad infinitum.
Observations: Introverted and "feeling" in his temperament type, Dr. Milktoast is easily undone by staff. Lou (short for Louise), the receptionist, is a rather disruptive force. Flaunting an attitude, she`s confrontational with the doctor and is an instigator with the staff. But, then she flashes patients her down-home smile, and all is forgiven.
Discussion: Without getting into heavy-duty psychodynamics, here`s my take on the situation. Lou, now 50, has been with the doctor for 12 years. She got married at 17, had seven children, and has never known anything but poverty. Being smack dab in the middle of dairy country makes it doubly hard to accept that you haven`t "got milk." Now imagine how it fuels Lou`s resentment to write payroll for a hygienist who`s making in excess of $25 an hour, when she, herself, is still only at $9 after so many years. Jealousy is like a bad toothache ... everything around it becomes tinged with pain. Lou always appeared to be really tight with her helper, (who quit before I got there), and with the chairside. Although "the girls" seemed to have a little clique, the truth is that Lou frequently managed to pit the helper and chairside against each other ... and ultimately against the doctor. For example, Lou would make sure that one knew when the other got a raise. Or if one got paid for personal time, Lou would rub it in when talking with the other. Petty politics finally forced the helper to quit after her request for a raise was denied and the chairside`s raise was granted. That`s when Dr. Milktoast`s cramps got even worse, and he called for help.
Considering the doctor`s personality type, the mood and spirit of the surroundings were in dire need of change, because the hostile environment obviously was making him physically ill. But even if his personality type had not been a factor, there`s simply no room in a dental practice for jealousy, envy, or manipulative behavior.
Treatment Plan: Step one - and this is going to sound familiar - is to take payroll out of the hands of the receptionist! I recommend that the doctor either give payroll over to an outside bookkeeper, or do it himself. Once salary information is out of Lou`s realm, she can no longer use it to manipulate staff. Furthermore, she`ll then have more time for scheduling to production goals and keeping up with recall ... without the need for a helper. Step two was to give Lou the choice of buying into the new way of doing things, and making a major attitude adjustment, or helping find and train her replacement. Since the doctor doesn`t have the stomach for such an ultimatum, I did it for him. To our delight, Lou was excited and motivated by the specifics of how to make her job better and how to become more valuable to the practice. Her enthusiasm was catching.
Sally Says: When you`re lucky enough to replace a bad attitude with enthusiasm, make sure you provide the proper guidelines. Enthusiasm without direction can be like a runaway horse.
Sally McKenzie is a Certified Management Consultant, nationally known lecturer, and author with more than 32 years in the dental profession. Her sole proprietorship, McKenzie Management and Associates, provides in-office systems` analysis of the business, clinical, and hygiene department; staff training; and offers a full line of educational-management books, audiotapes, and videos. McKenzie`s dental clients span 40 states over 20 years. She is a consultant to the Council on Dental Practice of the ADA. Call Sally at (877) 777-6151, e-mail to firstname.lastname@example.org or check out her Web site at www.mckenziemgmt.com.