by Cathy Jameson, PhD
In Part 1 of this series, I outlined six principles of team development that form the very foundation of building a dream team. These six areas are:
1. Vision
2. Goal-setting
3. Surrounding yourself with superstars
4. Establishing position responsibilities
5. Putting your plans into action
6. Accountability
I hope that you have had some dynamic team meetings since you read that first article, and that you are working on refining each of those six principles. Upon review, you may have found that you were in excellent shape in these six areas. However, remember: Being on a path of continuous improvement is always good!
Now let's look at six more principles of team development, starting with number seven, communication — the bottom line to your success!
Communicate
Great communication equals great production! I always have believed that how we communicate is the bottom line to our success. Whether you are interacting with a patient, with a team member, or with a family member, your communicative ability can make or break the relationship. In fact, my doctoral research focused on the effect of communicative skill training on a dental team. I was able to prove through scientific research that communicative skill training resulted in improvements in the following five areas:
• Burnout and dropout were reduced
• Job satisfaction improved
• Personal relationships and teamwork were measurably better
• Stress was reduced
• Production showed significant improvement
If you and your team could realize these same benefits, would it be worth the time and effort to invest in continuous training in communication skills? Hopefully, you answered "yes."
In a dental practice, there are two very distinct but interrelated kinds of communication:
1. Interpersonal: The quality of your interpersonal communication is based on developing and nurturing open, honest, and trusting relationships. Your environment must be safe and secure. It must be a place where people can share their thoughts and ideas without fear of rejection or intimidation. You may disagree with one another, but disagree in a diplomatic manner — one that preserves the self-esteem and respect of each person.
2. Informational: Make sure that your paperwork provides the information needed to complete each transaction. The paperwork (or computer entries) must provide any information necessary to provide excellent care for your patients, check the patient in and out, reveal information about the patient (physically and personally), and provide accurate information related to the flow of patients, team members, and the day.
Ask yourselves, "Do all members of the team get the information they need to perform their jobs well and in a timely fashion?" If the answer is "no" in any area of the practice, sit down together and revise the information flow. Identify those areas that need refinement and do just that. Don't become comfortable with anything that is less than the best it can be.
Conflict resolution and problem-solving
Communication involves four skills: listening, speaking, reading, and writing. In both your interpersonal and information-based communications, these language skills are imperative.
When you are working with other people — especially in a close environment — these communication skills sometimes need to be used to resolve conflicts and/or to solve problems. That's OK. Successful people are not people who do not have problems. Everyone has problems. Successful people are those folks who have learned how to solve problems.
From this day forward, think of confrontation as a positive thing, not a negative thing to be avoided at all costs! If you have a problem or a conflict with another person, the relationship could be at great risk if the issue is not confronted and resolved in a caring and compassionate manner. The goal of excellent conflict resolution is to preserve the relationship and to be stronger and better on the other side.
Conflicts among dental team members will occur. Conflict is a normal, dynamic part of a forward- moving team. If your environment encourages people to express their opinions, then there will be differences. Most people, however, haven't been trained in the fine art of conflict resolution, so they mess things up unintentionally.
Learn to listen to one another, even if you don't always agree. Keep in mind that you are disagreeing with another person's opinion. You may not like what he or she is doing or thinking, but that doesn't necessarily mean that you don't like the person.
When you do enter into a problem-solving scenario, make sure that the needs of each party are clearly identified and that the solution you agree upon will meet everyone's needs. When you enter into a problem-solving discussion, use the five-step goal-accomplishment scenario to solidify your decision and to create a plan of action. Don't sit down to problem-solve unless you have the full intention of carrying out the solution.
Frequently, it is easier to walk away from a problem than it is to solve it. However, I encourage you not to take the easy way out. Be strong. Be courageous. Be empathetic. Be a communicator!
Decision-making
At the beginning of this article, I said that my definition of a great dental team is a group of leaders working cohesively toward a common set of goals. One of the characteristics of an outstanding leader is to be able and willing to make decisions — and to make those decisions quickly!
As you develop your team, consider the times and situations when members of the team can be actively involved with the decision-making. Some decisions will be made by the doctor who, ultimately, has veto power. Some decisions will be made by the office/business administrator or office manager. Hopefully, your systems are structured carefully and precisely and the members of your team are clear and confident about the administration of those systems. This will allow them to make excellent decisions without having to go to the doctor with too many detail-oriented questions.
Some decisions will be made by the team as a whole. Decisions that will affect everyone on the team are best discussed as a group. Some decisions will be unanimous. Others will be based on "majority rules." Be careful with this one. More than likely, someone will lose. If the latter is the case, there may be minimal acceptance and compliance. Still other decisions will be made by consensus, making it easy for the entire team to carry through with the decision.
Use a consensus agreement when:
• No definite answer can be determined.
• No particular team member has the expertise to solidify a decision.
• You must have commitment to achieve desirable results.
• You have plenty of time for a thorough discussion.
Discuss the pros and cons of each situation. Use the "good ol' Ben Franklin" approach. Discuss these pros and cons without criticizing each other. Remember, you may not like the idea, but make sure that you do not come across as not liking the person. Once you have come to a decision, analyze your response by choosing one of the following:
1. I can say "yes" to this decision without hesitation.
2. I find the decision acceptable.
3. I can live with this decision, but I am not crazy about the solution.
4. I don't like the decision, but I am not going to stand in the way of it.
5. I do not agree with the decision at all, and believe we should continue to seek other solutions.
If everyone chooses either one, two, three, or four, then you have a consensus and can move ahead. If anyone selects response five, then you had better go back to the drawing board.
Experts in the field of leadership have found that one of the reasons for failure — of a project, of a business, or of a leader — is that the leader doesn't make decisions well or doesn't make those decisions in a timely fashion. Don't fall into that category. Become a team of decision-makers. Not only will the members of the team feel a sense of empowerment and energy, but the practice will thrive. If you are truly a team of leaders, your decision-making processes are an integral part of your responsibilities.
Performance reviews
A performance review is a separate activity from a salary review. During a performance review, both the team member and the doctor (in some cases, an office manager) stop and sit together in an uninterrupted meeting to discuss the areas that are going well, the areas that could benefit from development, and the goals and aspirations of the team member being reviewed. Team members enjoy and look forward to this quality time with their doctor. Some doctors think that a performance review is a time to go over all the mistakes a team member made over the last year. Not so! If you have a challenge with a team member or with his or her performance, address that quickly and precisely. Do not, under any circumstances, "hoard" all the negative stuff and pour it all over a team member during a performance review. That is a sure way to destroy confidence, create fear and anxiety, and undermine a wonderful management opportunity — the performance review.
Hold a performance review at least once a week (daily is better) for a brand new team member. Ask him or her what is going well. Then, ask what challenges the team member is facing so that you can see to it that help is on its way.
For your established team members, hold performance reviews once or twice a year. Make sure that you have monitors in place that correlate to their position responsibility. These are the "flight dials" of their area of the practice. Remember: you cannot measure that which is not monitored. These monitors will be vital to a comprehensive review.
The team member should fill out a self-evaluation form at the same time the doctor does his or her evaluation. Then, go over these together at your scheduled (and honored) review time. Start with the positive — the things that are going well. Then discuss possible areas for development. Design a plan of action detailing how improvements will be made. What will the team member do? What will the doctor do?
Schedule a time for follow-up and make sure that you hold each other accountable for following through with the improvements.
You may want to have each member of the team do a performance review on the team as a whole. Each person should fill out a team review form separately. Then, set up a time for everyone to get together to go over this data during an upcoming team meeting. Having every member of the team evaluate the team as a whole can be very powerful and very productive.
Motivation
Each person is motivated in a unique way. During your performance reviews (or any time in between if you do not already know), find out what motivates the individual members of your team. Then, as you develop your compensation package and your system for rewards, you can be more confident that the type of compensation you provide is truly motivational.
Interesting research by Dr. Lawrence Lindahl shows that team members are motivated by appreciation far more than they are by money. However, most doctors think that money is the greatest motivator and that appreciation is "way down the line." Dr. Lindahl's study clearly shows how important it may be to have a discussion about the intricate aspects of team-building rewards.
Dr. Michael LeBoeuf, in his book, GMP: The Greatest Management Principle in the World, says, "That which is rewarded is repeated." His statement and his research support one of psychology's long-term truisms: human beings respond more effectively to positive reinforcement than to negative reinforcement.
Some doctors say to me, "Well, if I am not griping at her about something, she should know that what she's doing is OK." Well, that is not necessarily so! Not saying anything can be misconstrued to be something negative. Feedback is invaluable! Take the time to notice the work well done and acknowledge it. Your positive reinforcement — sincerely given — will go a long way toward solidifying a person's excellent performance and building his or her confidence.
Consider establishing goals together, as a team, and have a predetermined reward when the goal is achieved. Examples of an appropriate reward might be a trip, a dinner engagement, a monetary reward, time off, etc.
Consider having unexpected recognition for work well done. When someone goes the extra mile — or if the team exceeds goals — do something unexpected. For example, give everyone on the team a $100 bill and go to the mall for a 30-minute shopping spree. Everyone must show what they have purchased and must be willing to give back any money not spent. Team members must also spend this money on themselves.
There are thousands of ways to reward employees for an excellent performance, for going the extra mile, for handling a difficult situation with professionalism, etc. Be creative. Establish rewards for the accomplishment of predetermined goals. Establish recognition awards for achievement beyond expectation.
Finally, remember to "celebrate the small victories." When you take a step toward a goal, stop and recognize the excellent work done along the way to its achievement. Give "high fives." Celebrate each victory along the path. You will give each other the encouragement to go to the next level. Don't wait until the goal has been reached to provide rewards. You will need encouragement along the way. Celebrate.the victories.
Do not forget that appreciation is the most desired motivator of dental team members. A simple, but sincere "thanks," a note of appreciation, an acknowledgment at a team meeting, etc. — all go further than you can ever imagine! Be generous with your appreciation for one another. The doctor needs appreciation also! The world hands out plenty of negative criticism. Be a source of positive encouragement. Both you and your teammate will benefit.
Build a network of "resource" team members
This entire issue of team-building is enormous. There are so many aspects of building a solid and successful team that it may seem overwhelming, not just as you begin a practice, but throughout your entire career. Be a strong, confident leader. Reach out to the experts in the fields of communication, management, team development, and leadership to help you develop and improve these intricate and difficult skills. Do not be hard on yourself and think that you have to know it all. No one does! In addition, don't think that you — or anyone else — is a "born communicator" or a "born leader." That is simply not so! These roles require skillful training, development, and work. You weren't born a dentist, a hygienist, an assistant, or a business administrator. So why would you think that you could possess these other skills by osmosis?
Surround yourself with resource employees who will be "adjunct" team members — team members who will help you form a dynamic and successful team.
In these two articles, I have outlined 12 principles of team development that are foundational. They are imperative for excellent and productive teamwork to take place. There is no question that there are numerous other principles that could be a part of this series. Perhaps another series will follow. The subject is enormous and impacts each of us every day of our lives, making it a worthwhile continuing study.
Remember to continue your team meetings. Hopefully, you have gone over the six principles outlined in the first part of this series. Now it is time to go over these final six principles, asking yourselves what you are doing well. Keep on doing the things that are working for you and celebrate each victory — even the small ones! Plan for the ways you will celebrate (see box). Then, be honest with each other and discover places where improvements can be made. The efforts will be well worth your while.
It is very important that team members take the time and effort to reach around and pat themselves on the back. If you wait for others to recognize your work, you may wait for a very long time. Too often, others are quick to criticize, but slow to praise. So, when you've accomplished a goal, improved your processes, installed a new system, or put a new service into effect, celebrate the event. Congratulate yourselves, throw your own party, give out gifts, or simply bring in a pizza!
Many team members work behind the scenes. They aren't on the front lines getting immediate feedback from patients. They don't have the visibility and may not get the "kudos" they deserve. Yet, they keep the ship afloat by making sure that bills are paid on time, payroll is completed and checks go out, information is distributed accurately and in a timely fashion, etc. As the saying goes, no one ever calls to say, "Thanks for getting my check to me on time." It's just expected.
Think of examples of this in your own practice. How can you express appreciation for one another more effectively?
Consider celebrations when certain milestones are reached. But remember to express gratitude for the everyday activities that make it possible for you to perform excellently. You should also remember to be a role model, an example to your staff. If you pat others on the back, you set the tone for them to do the same thing.
To reiterate what I said at the beginning of the previous article, the success of your practice, your team — and your career — will be in direct proportion to the success of your systems. Your "system" of team development is the foundation of that success. Be forever in the business of developing yourself and your team. Be an asset to others. You will be strengthened each time you reach out to strengthen another.
Teamwork truly is the foundation of success for a thriving, forward-moving, fulfilling, enjoyable, and fun dental practice. Settle for nothing less!
Performance Review Form For the Dental Team
Your team review form might cover the following:
• Our communication lines are clear, open, and honest.
• Our practice environment is safe and secure.
• We know our "vision" and are working toward it in all that we do.
• Our goal-accomplishment protocol is in place, and we know our team and individual goals.
• All team members are clear about their own and each others's responsibilities.
• We all participate in decision-making when appropriate.
• We feel respected and valued.
• Our team meetings are productive, powerful, and fun.
• We face our conflicts and challenges head-on and move into problem-solving with confidence and a determination to find a solution.
• We are accountable for our actions.
• We all feel a sense of co-ownership of the practice.
Rate each of these statements from one to five, with one representing "strongly disagree" and five representing "strongly agree." Compare your notes; you may be surprised by how productive this time can be!
