by Sandy Roth
For the past two years, Sandy Roth has guided dentists and teams with her series, "Mastering the Art of Communication" and "Communication Skills for Successful Relationships." Beginning with this issue and every other month thereafter in 2002, Sandy's new series is constructed as a private-study workshop to help dentists learn the communication and behavioral skills that will help them be successful with their staff and their patients. We hope you enjoy the series.
If I asked a thousand randomly selected dentists to describe the most challenging part of their practices, only a few would express concerns about their clinical skills. Perhaps that is because dentists spend more time and resources pursuing clinical education than other areas. Ongoing clinical learning is essential in modern dentistry; fortunately, there are a plethora of opportunities for serious practitioners to learn techniques and concepts that will help them develop and maintain clinical competency.
Only a few more dentists would tell me that their business systems are the primary cause of their distress. A multitude of practice-management organizations and consultants exist who specialize in helping dentists learn how to manage the business aspects of their practices.
The overwhelming majority of dentists would raise their hands, however, should the issue of communicating with staff and patients be put to a vote. The fact that most dentists either feel (or are) inadequate at communicating is not surprising. After all, most dentists did not choose to become psychologists, human resource managers, or public speakers. The skills that are necessary to communicate effectively and form strong working relationships are not emphasized in the dental school curriculum.
In this year's series, Communications Workshop, I'll guide you through a process to help you become a more skilled communicator with both your staff and your patients. This issue's opening installment will address the most important fundamentals of working effectively with your staff. In the April 2002 chapter, I'll address the foundational concepts related to communicating with your patients. In each installment thereafter, we'll alternate applying those principles to staff and patients. Throughout the series, of course, I welcome your comments and questions.
A workshop, as opposed to a lecture, comprises several important components. First, a principle is established, followed by an explanation of that principle. Examples help people understand the principle in context. Finally, there is an assignment that allows each participant a chance to personalize the learning. I will use this format throughout the series to help you learn and apply some ideas that I hope will challenge your thinking and support you in your learning.
Communication is more about how you think than what you say. I always begin by emphasizing this fact so there will be no confusion. If you're not sure you believe this statement, simply recall the last fight you had with your brother or sister as a child. When your mother intervened, she likely made you apologize to one another. Although you might have uttered the words, "I'm sorry," you probably weren't; thus, the apology was worthless. Similarly, the mindset you maintain when working with others influences — more than your actual words — your behavior, and therefore, the outcome. No amount of communication training can overcome a bad attitude. A positive mindset creates a positive environment and will make a successful outcome more likely; a negative one does the opposite. A fearful, cynical, or mistrusting attitude will beget the worst in others and confirm the initial expectation. This is sometimes called a "world-view,' but I liken it more to your general beliefs about people. If you believe everyone is out to get you, you are probably right. Paradoxically, those who believe that others are basically good — and behave that way — tend to experience the best in others. The lenses in your glasses do, indeed, color what you see.
For example, I bet you can predict the difference between what you would observe in the practice of a dentist who considers his or her staff a necessary evil vs. one who sees them as an asset. The former might resent the efforts to hire, train, pay, and deal with employees and thus would be more likely to have less skilled, less satisfied, and less loyal staff members. The latter, on the other hand, finds investing time and energy in staff pays dividends that make the practice more successful. Similarly, a dentist who is deceptive, secretive, and untrusting will create a culture in which secrecy and conspiracy are more likely to thrive in return. These are the types of mindsets that will dominate the environment you create in your practice and determine whether your words are congruent and influential or as false as those you might have uttered to your brother as a child.
Your staff wants to do the right thing and make you happy. No one wants to do a lousy job, make mistakes, or annoy his employer. Virtually everyone works primarily to earn a living, but we all prefer a job from which we can derive a sense of accomplishment; we also want to know that we have performed well in the eyes of those who are important to us. The standards of performance you set and the feedback you deliver is vitally important to your staff's ability to do their jobs well. Of course, the question is whether staff members are receiving the complete report. Many complain that they don't know what their dentist expects. They regularly hear what is wrong but rarely get reports about what they are doing right. Again, your mindset is key. Some team members tell me that they see their dentist as crabby and generally unhappy, perfectionistic to an extreme, and a constant micro-manager. "He's always on our back, but since we now know we can never please him we've quit trying."
Once they are convinced they cannot make their dentist happy, many staff members will leave a position rather than endure failure and its repercussions. This is tragic when they have needed skills and could make a significant contribution to a practice's success. The costs of hiring, training, and investing in new staff are huge; dentists should actively avoid losing an employee for any reason other than incompetence or dishonesty.
While this principle makes common sense, many dentists fail to understand the role they play in helping their staff know what the "right thing" is. That leads us to the next principle.
Your staff must know what is on your mind. Dentists generally tend to be internal thinkers and processors. This means that they have many discussions in their heads that never pass their lips. Your employees are not mind readers, although they may try to figure out what they are missing by piecing together clues. "The last time we were in this situation, I did thus-and-such and got in trouble, so this time I'll do something different. I don't really know what is expected of me in times like this. It seems I'm darned if I do and darned if I don't." When team members complain about their dentist being inconsistent, this is often what they mean. While you may have a broad set of concepts and principles in your mind, your staff may only be witness to a single application and thus miss the big picture.
You must convey your clinical standard of care clearly. Your financial goals, business principles, and tolerance for risk must all be succinctly communicated to your employees; you must also give them solid guidelines for their performance. In addition to basic position descriptions, your staff will want to know when they can use their own judgment and when you want to be consulted. Moreover, they are vitally interested in knowing how you will define success — for them and the practice.
When you fail to clearly convey your expectations, others will fill in the gaps as they see fit. They will assume, guess, or suppose and are as likely to get it wrong as right. If you want to avoid incorrect assumptions, it's your job is to tell your staff what you need.
Your staff's agenda and priorities are different from yours. Even the most dedicated and long-term employees will have a different perspective on the practice. While practice success does impact both you and your staff, your position is and always will be influenced by the advantages of ownership and by your significantly greater earning power. While there are notable exceptions, dentistry's largely female labor force works outside the home mostly by necessity. Recent studies suggest that young mothers would prefer to devote more time to their children; they work primarily to supplement the family's income and/or provide a respite from home responsibilities. In fact, almost every female employee with young children will report feeling pulled between the obligations of child rearing, home keeping, and extended family. Dentists, especially males, seldom encounter this dilemma. This is why female staff may resist running over at the end of the day, attending continuing education on weekends, or participating in evening meetings. It is particularly unfair to use after-hours events as a litmus test for loyalty and dedication to the practice.
Dentists often bemoan the lack of "commitment" from their staffs, yet their expectations may be unrealistic. It is one thing to expect staff members to maintain a high level of performance during the hours of paid employment, and quite another to expect them to ponder practice issues at home or during leisure time. You may wish staff members would, for example, attend nonworkday events for the pure love of learning; however, it is always appropriate (and in some states legally required) to pay employees for their time in these pursuits. Asking to be paid for time spent at required meetings and events is not necessarily indicative of a bad attitude. It is a fair request that reflects an employee's personal priorities, and it should be treated as such.
Your staff wants to be understood and respected. People always function better when they believe they are respected by those who matter to them. I want to underscore the importance of truly understanding another person's perspective rather than feigning it. You may have said, "I understand, but," when you really didn't understand at all and merely used the opportunity to outline your own perspective. This is another example of our first principle — your mindset will be more important than the words you use. Conveying a feeling of understanding is important, but actually understanding one another is profound. It influences your behavior and communication in ways that can largely determine the success of the relationship as a whole.
This principle is complicated because we often confuse it with agreement. True understanding comes only from curiosity, by asking pertinent questions that invite others to convey their perspective, and listening without judgment. When you are curious enough about your staff to ask enough questions about what is important to them and really listen to what they have to say, you will allow yourself to understand their perspective, even if it is different from yours and even if you disagree.
Respect is vitally important when you wish to have an impact on others. Your staff will be more open to your influence when they believe you have taken their account in perspective and hold it in esteem. Consider how understanding and respect impacts you. How likely are you to follow the guidance of someone you believe does not understand your circumstances and/or does not respect your situation? You will likely reject this person's opinion and look elsewhere for support. Your team is no different, and it's in your best interest to invest time and energy in learning more about them.
Building blocks a guided practice
Your first assignment is to review each of these principles for their personal application. Begin by taking an inventory of the attitudes and beliefs you hold toward your staff. Ask yourself questions about the way you think: Are you trusting or untrusting? Cynical or balanced? Secretive or open? Do you believe staff members tend to be devious and dishonest? Do you believe people generally want to do the right thing?
The next step may be difficult and initially costly, but it will pay off handsomely in the long run. Hold a one-day team retreat during which you promise to reveal all. You may have to schedule this on a day you would normally see patients, so be prepared for that option. Open up and tell your staff what's on your mind, and make a list of issues you wish to address. To avoid turning this into a lecture, invite your staff to come prepared to interview you. What would they like to understand about you? As a part of this event, make some advance notes about what you would like to understand about them. Do they feel torn about home and family obligations? How does work fit into the rest of their life? Do they believe you are fair with them? This retreat may be the best investment you can make in the success of your team and practice. I believe a facilitator can be a major advantage in these meetings as well. If you would like more help in setting the agenda for such an event or securing a facilitator, please give me a call and I'd be delighted to help you personally.
Best wishes as you begin our 2002 Workshop series. I look forward to being with you again in April.
To learn more about how you can develop your communication skills, call Sandy Roth at (800) 848-8326 or send her e-mail at firstname.lastname@example.org for a catalog of learning resources.