Could ya do me a favor?

April 1, 2000
Case Profile: Anytown, USA, could be the locale of this very typical general practice, with one doctor, one-and-a-half dental assistants, one hygienist, and one business assistant.

Sally McKenzie, CMC

Case Profile: Anytown, USA, could be the locale of this very typical general practice, with one doctor, one-and-a-half dental assistants, one hygienist, and one business assistant.

Symptoms: "Ganging up" against the doctor is what this closely knit staff does best. Reluctant to revisit the recruiting/ hiring/training hassle, the doctor keeps his distress to himself and goes along.

Observations: During my lunch with the staff, I witnessed an all-out doctor-bashing. They showed no mercy, saying that Dr. Great Idea had gotten everybody excited about having a morning huddle every day, but then never followed through. Worse yet, they accused him of being a penny-pinching tightwad because he didn`t want to have Katie, the part-time dental assistant, go to full-time.

Back in the office, as the doctor was dashing between a crown prep and a hygiene exam, Debbie Dental Assistant stopped him, grumbling "Doctor, could ya do me a favor? There`s a light bulb out in the bathroom again." Two more times in the space of 15 minutes, Debbie stopped him again, complaining first that, "There`s just not enough time for me to order dental supplies when I`ve got all these instruments to take care of. Could ya do me a favor and give Katie more hours?" And the final in-transit comment that really got my goat, "By the way, I won`t be able to clean the X-ray developer before I leave on my trip, so could ya do me a favor and have Katie take care of it tomorrow and for the three weeks I`ll be away?" She`s got to be kidding!

Discussion: On the one hand, we`ve got a delegation-impaired doctor. On the other, we`ve got staff members who haven`t been made accountable for much, and who are so lame they`re all but comatose. And don`t look to the practice policy manual and job descriptions - especially in the clinical area - because there isn`t enough detail there to facilitate anything.

During the doctor-bashing, I had asked some pointed questions and discovered that the real reason morning huddles hadn`t been occurring was that front-desk Betty drops her son off at school in the morning and doesn`t get to the office in time for a huddle. So it`s not the doctor`s lack of follow-through after all! But, then again, if attendance at morning huddles was linked with stated job expectations as well as performance reviews, things might be entirely different. Until those ideas are in place, the doctor will keep taking a lot of "stuff" from his staff.

Treatment: Getting a grip on staff management needs to be the doctor`s first order of business. The key to establishing the right balance between the meeting of job expectations, accountability, and performance measurement is often found in employee empowerment - a controlled amount of "freedom" given to staff "to get the job done" within a specified period of time. Such empowerment is not only good for staff, but excellent for the doctor. One less thing to worry about here, one less there, and pretty soon some sanity has been restored to a crazy situation.

Next, those SOS messages delivered to the doctor in passing have to stop. Anything requiring the doctor`s skills or attention should be jotted down on a Post-It® note and placed on his desk calendar. For anything else, staff will have to start being self-reliant. Does the light bulb need changing? Just do it and leave the doctor alone.

As for Katie`s hours being extended, payroll expense is already at 26 percent - more than we recommend - and nobody on this staff is being overworked. We urged the doctor to consider the consequences of an employee shirking her responsibilities, with impunity, not to mention her being out of the office for a three-week vacation. That sends some message to the rest of the staff!

Sally Says: Are you afraid of recruitment, hiring, and training? Get over it and you`ll never need to put up with mediocrity again.

Sally McKenzie, a proponent of advanced education for dental professionals, has recently launched The Center for Dental Career Development, in La Jolla, Calif. A Certified Management Consultant, nationally known lecturer, and author with more than three decades in the dental profession, Sally is a consultant to the Council on Dental Practice of the ADA. McKenzie Management and Associates, Inc. provides in-office analysis of the business, clinical, and hygiene department; conducts on-site staff training; and offers a full line of educational management books, audiotapes, and videos. Call Sally toll-free at (877) 777-6151, e-mail: [email protected], or visit her Web site at: For information on The Center for Dental Career Development, call toll-free at (877) 900-5775 or visit the Web site at

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