Mastering the art of communication

Nov. 1, 2000
3M Dental is proud to sponsor the Dental Economics year-long "Mastering the Art of Communication" series.

Part 11

The Art of Communicating With Your Staff

3M Dental is proud to sponsor the Dental Economics year-long "Mastering the Art of Communication" series.

Sandy Roth

"Two different worlds -

We live in two different worlds ..."

Don Rondo

The anonymous female voice said, "Sandy, will you write something to doctors about how to communicate with staff? Dentists need to understand how important staff is to their success and that it`s difficult to go through the day not feeling valued, appreciated, and respected."

I had heard this plea before, and I will no doubt hear it again. Many dentists are not naturally equipped to communicate effectively with their employees. Even dentists who are comfortable conversing with patients often struggle with day-to-day dialogue with staff members. In many cases, dentists tend to process internally; those around them may not have the advantage of participating in a discussion about what the dentist is thinking and how his or her perspective is changing. Staff members may observe changes in behavior, but have no clue what brought about those changes or what lies ahead.

In reality, dentists have a lot on their plates - some of which cannot be shared. Because most dentists work in isolation, they must focus fully on clinical examination, patient medical conditions, diagnosis, prognosis, treatment planning, and, of course, the execution of selected dentistry. In addition, clinical dentistry is a form of microsurgery, practiced for many hours each day. If the dentist is to accomplish these obligations well, his or her focus must be riveted on minutia and details that nondentists often fail to appreciate. Adding to this are hefty ownership and leadership responsibilities for a small business that forms the livelihood for several families. It`s enough to boggle almost any brain. It`s asking a lot of dentists to add awareness of and attention to staff needs to this slate of obligations. Indifference, however, is not an option.

Hiring competent personnel with the skills to perform the role is the crucial first step. But you must also appreciate that high achieving staff members want to be part of a team. Paul Homoly states that "the term `teamwork` has been used so much dentists and staff don`t hear it anymore, let alone practice it." People often incorrectly think of a team as a group of people who help each other when they are behind. A more appropriate definition of a team is: "A deliberately assembled group of fully functioning individuals who come together with complimentary attitudes and abilities to accomplish a shared purpose that none of them could achieve alone." Thus, dentists must ask themselves the following questions about their staff or candidates for positions on the team:

"What does this person bring that we want or need?"

"How can this person help us achieve what we can`t achieve on our own?"

Asking these questions enables the dentist to hire someone he or she can value, appreciate, and respect. Competent people will insist on knowing what is expected, where the practice is going, what is changing, and how that will impact their positions.

In many cases, staff members are unappreciated because the dentist either doesn`t believe or doesn`t know how their attitudes and abilities contribute to the shared purpose. Was the staff member selected simply the best of the pool of applicants - or someone who was deliberately selected based upon unique gifts and talents? If you do not value someone`s work or opinion, you are not likely to communicate regularly. Thus, the relationship deteriorates until someon gives up and the employee leaves.

In many ways, the underlying issue is a lack of trust. How does one develop a trusting relationship? Is trust earned? Is it given? Is it assumed? Trust isn`t blind or foolish faith lacking in foundation. Rather, trust is comprised of three easily understood and concrete elements. The quality of each relationship, and the effectiveness of communication within the relationship, can be tested by the degree to which these elements are present.

Competence (Skills): You are not likely to trust someone you perceive to be lacking the skills required for the task. Be it a brain surgeon who lacks medical competence, or a housekeeper too disorganized to clean properly, there can be no trust without skills. The individual may be motivated and have a strong work ethic, but without the necessary skills, confidence will be compromised.

Skills do matter. Although it is important to hire for attitude and train for skills (you cannot train someone`s attitude), it is essential that each of your employees have a skill set that contributes to the purpose and goals of the business. Too often, dentists who are overwhelmed and ineffective managers delegate tasks to people who are not ready to handle them. Failure under these circumstances is almost guaranteed.

Motive: Alignment is the degree of partnership between the dentist and staff, especially regarding similarity of perspective and goals in the organization. If a group is to function as a team, each person must not only row skillfully, but in tandem to the finish line. Partnership forms a team; a team cannot exist without a specific partnership agreement between all members. It is significantly easier to communicate in a partnership than in disarray.

Dentists often feel conflicted when they don`t trust their staffs` motives. In fact, distrust of motive is the most significant factor in most rocky relationships. Addressing mistrust is paradoxical, because it requires communication to explore people`s motives. The real challenge in understanding motive is to discuss initial assumptions.

Trust develops when people perceive one another to be in alignment with the practice`s core values and purpose. Underdeveloped skills are tolerated or even overlooked if there is alignment. Dentists are more tolerant of a less than ideally skilled employee when they are on the same page. A highly skilled person who has a different agenda, however, will not likely have the same level of support and commitment from others.

Willingness: The third leg of this stool is important, but often overlooked: Energy. Enthusiasm. Effort. Work ethic. The plain fact is that when people don`t show up - either literally or figuratively - they aren`t reliable. An employee with a poor work ethic kills trust. An individual whose values align with the organization - and who possesses skills and a strong work ethic - will make a powerful impact. Those without the energy to get the job done are ineffective. Lackluster performance deprives the practice of the necessary results for a successful business.

Symptoms of poor work ethic include tardiness, rushing out of the door at the stroke of the hour, daydreaming, lack of participation in meetings, lack of interest in continuing education opportunities, slovenly movements and habits, strict adherence to job descriptions, a "union" mentality, and a reluctance to participate in problem-solving.

The equation adds up:

Poor skills + aligned motive + willingness = low trust

Good skills + out of kilter motive + a strong work ethic = low trust

Good skills + aligned motive + lack of effort = low trust

Every combination and permutation results in the same low trust if any one of the three elements is missing. (If you would like to receive a Staff Profile Worksheet, please send your name and address to Sandy Roth at ProSynergy Dental Communications, 1721 Ferry Avenue, SW, Seattle, WA, 98116. You can also request it by e-mail at [email protected].)

These three elements relate to what the employee brings to the relationship. There are, of course, elements that the dentist brings. Sometimes, these elements contribute positively to the relationship and create an environment where more open communication can prevail. Sometimes, however, what the dentist brings is destructive. Consider the following:

Mixed messages. Employees need leaders who are congruent and consistent. That doesn`t mean that you must always be completely certain. If you are confused, say so. Your staff`s reactions are dependent upon knowing how you think and feel. Their ability to perform is often linked to your consistency.

Avoid playing the role of the agreeable nice guy/gal if you consistently find yourself disgruntled about your sacrifices. If you need time to consider a request, say so. Don`t agree to something without thinking it through, particularly if you are likely to regret it later.

Bringing your personal issues to work. Nobody enjoys listening to the problems or personal issues of others for very long. A true leader must not allow personal problems to overflow into the practice. Personal issues consume time and energy which might be more appropriately devoted to patient care.

It isn`t necessary to be so secretive that no one knows anything about you. However, there is a distinction between simply identifying personal issues (an aging parent, a successful child, a difficult time in a marriage, an unreliable car) and making those issues an ongoing topic of discussion with patients and staff.

I like to envision that the door to the practice is lined with one of those blue-bug zapper lights. When you pass through the portal, your personal stuff is zapped and left at the door.

Practice owners are leaders and therefore role models. When you show a healthy respect for these boundaries, you earn the right to hold your team accountable to the same standards.

Resent paying your staff. Let`s face it: The salary gap between the average dentist and the average employee is huge. Of course, you own the business. Of course, you are the investor. Of course, you spent many years in advanced education. Yet, your staff is entitled to a reasonable, commensurate wage paid without resentment. If you don`t feel an employee is worth the salary, release him or her and hire someone who will make you happier. The job market is particularly tight right now and good employees are hard to find - and harder to keep. Get used to the idea of paying an appropriate wage for the stellar staff you want. Pay them gladly.

Playing favorites. Everyone is entitled to be treated fairly, though not everyone has to be treated the same. If Susan`s mature and cool-headed thinking leads you to rely on her in tough patient situations, that isn`t playing favorites - that`s smart management. Let her and others know your perspective. If someone`s performance displeases you, on the other hand, you must let him or her know that you expect change. "Playing favorites" is often a euphemism for ignoring or mistreating others. Give clear feedback rather than punish by withholding favor. Be straight and clear with your staff and you will encourage the behavior you admire.

Making - then changing - the rules. Many dentists will outline a financial policy for the staff to follow with patients, yet alter the approach for self-serving reasons. The team is likely to feel angry and abandoned when this happens. If you have difficulty quoting fees, stay out of it and let your staff handle these situations. Be careful about giving discounts to your golfing buddies or relatives when you have told your staff that there will be no exceptions. The team working to meet financial goals will feel undermined when they see you bartering dentistry for house painting or discounting the fee for social reasons. Set reasonable fees and expectations and hold yourself accountable as well.

Moodiness. If you want to alienate your staff, moodiness will do it every time. You can`t afford to become a victim of your own unbridled emotions. You are probably a better dentist than an actor, so don`t fool yourself into believing that you can hide your feelings. It may require professional help to overcome this pattern. It is too much work for people to walk around on eggshells every day, so deal with these issues in a healthy way.

Failure to give feedback and conflict avoidance. A closed book cannot be read. Your patients and staff must be actively involved in everything that impacts them. You must lead the charge. Giving appropriate, honest, and timely feedback is essential to improving performance. If conflict is difficult for you, get some help in learning how to force yourself to address it sooner rather than later. Conflict is inevitable, so build your skills and address it before it becomes a major problem.

"The buck stops here." You cannot do it all yourself. You must involve your staff in appropriate levels of decision-making and allow them to learn how to become responsible and productive. You will need strong, confident, and competent people around you to carry the load. Authority comes from shared goals, not only from you.

"Solve it yourself." You can`t divorce yourself from events in your practice any more than you can handle them all yourself. Once a problem becomes public knowledge, it belongs to the entire group, including you. Your leadership will initially provide the forum and process for problem-solving until the group learns how to initiate this on its own.

Problem avoidance. Letting problems build until they reach nuclear proportions is a costly error. You cannot afford to overlook problems. You may not have the best perspective on the practice, so you must keep your eyes and ears open to the tune of the times. This is where asking questions, the most important communication skill you can master, will serve you well. Pay attention to the culture in your practice and catch problems early when they are easier to solve. That is part of your business.

Vague answers. Short or cryptic responses to quesions confuses your employees. Reveal, reveal, reveal! Employees need explanations, guidance, and training. You can`t use verbal shorthand and expect your staff to understand everything that is important. Be available, and be expansive when communicating with employees.

Kudos

The ability to give positive, reinforcing feedback to members of the team is a skill many dentists lack. One frustration team members express is that they rarely get strokes, positive feedback, or "warm fuzzies" from their dentist. "All I hear is what I`m doing wrong," or "It seems like I can`t do anything right," are regular comments. Here are a few guidelines for giving effective feedback:

Feedback must be genuine. Don`t make up nice things to say just to placate an employee. Feedback must be true and reinforcing in a meaningful way. "You look nice today," is not a kudo. "That was a great insight you had about Mrs. Jones," is.

Now is always better than later. Let an employee know early and often what you admire and that you want him or her to do more of it. Immediate feedback has a greater impact. Dentists are furiously busy, yet a simple comment like "Great job on that, Susan" or "Thanks for the question," takes almost no time at all. It only takes awareness and intent.

Show some enthusiasm. If you don`t watch "ER," make a point to do so as part of your continuing education in this area. The character played by Eriq LaSalle, Dr. Peter Benton, is a prototypical example of an arrogant, self-centered, insecure, insensitive manager. He seldom gives positive feedback unless forced to do so, and always with a deadpan voice and sour face. Dr. John Carter is most often the object of his disapproval. When Benton does give positive feedback, he does so reluctantly, and Carter knows it: "Yeah, yeah, nice job Carter. And don`t be late for rounds."

Forget Oreo cookies. An old fashioned strategy for giving feedback is to sandwich a zinger between two positive statements. The chocolate cookies made of positive sounding statements surround the creme filling which might be hard to take otherwise. Forget that strategy. It is artificial and people are onto it pretty quickly. Just give good, honest, consistent feedback and you won`t have to play those games.

Give feedback individually and publicly. Make sure to acknowledge good works in front of the entire team. OI want to let all of you know how pleased I was when Julie helped de-escalate a potentially confrontational situation with Mrs. Berkshire. Julie, why don?t you tell everyone what happened.O After Julie has shared her success with the group, you can add your spin. OThis is a great example of what I meant by putting yourself at risk. Thanks again, Julie.O

Don?t forget that when you give kudos in front of patients, they develop an awareness of the broad skills of your team. They like to know when they have strong, competent people serving them.

Collective kudos lack the impact of individual ones. Yes, there are times when a round of Oatta girls/boysO makes sense, but just saying OEveryone is working hard, thanks,O isn?t enough to generate the positive reinforcment you want. When the efforts of the individual get lost in the crowd, people feel that they are being overlooked.

OAndO works better than OBut.O Of course, there are times when you want to call attention to something that needs improvement. OThanks for giving it a go with that temporary and I think with a little more practice you?ll get it down pat,O is very different than, O ... but you need more practice.O Pay attention to where your feedback goes. Up is better than down.

Don?t link reinforcement to instruction. Restrain your inclination to dilute your praise with additional comments such as, O... but next time, do it this way.O Anything that suggests what the person should have or could have done erases the praise that came before it. Advice, teaching, instruction are all legitimate, but save them for a time dedicated to that purpose.