Leading the patient-centric practice

Oct. 15, 2014
Unlike dentists, corporate leaders in many professions are well prepared for running businesses.

By Roger P. Levin, DDS

Unlike dentists, corporate leaders in many professions are well prepared for running businesses. Most have formal management training, mentors to provide inspiration and guidance, and hands-on experience as they move up the ladder to high-level executive positions.

Dentists receive little or no business training in dental school. Even if they serve as associates before running practices of their own, they rarely gain valuable business knowledge or experience. Unfortunately, this lack of preparation holds back many doctors in the new, more challenging, postrecession dental economy - as evidenced by the fact that 75% of practices have seen their production levels decline in the last four to five years.

Today, practice owners must learn to be practice leaders if they want to achieve true financial success while staying focused on doing what they love - practicing dentistry.

What it means to be a leader

Before becoming leaders, dentists must learn what that really means and what it does not mean. Leadership does not mean barking orders at everyone, running meetings, or making philosophical pronouncements. There are many different ways to define it, including this one, which has always guided me well as the CEO of my company;A leader makes it possible for other people to be successful.

In a dental practice, those "other people" are the staff members. Obviously, if they are succeeding, the practice leader will also do well. Note that this definition emphasizes giving, not taking, and contains no words like "control" or "power." It reflects the understanding that a true leader inspires and encourages employees, rather than making demands.

Over the past 30 years, countless dentists have confided in me about their lack of leadership ability... and I have had the pleasure of seeing their relief and excitement when I explain what practice leadership really means. It is so much more attainable than most dentists realize.

What excellent practice leaders do

Before defining the activities that constitute practice leadership, I want to briefly explain what effective leaders do not do. They do not manage - or micromanage - daily operations in the practice. They do not spend more than 2% of their time dealing with administrative issues, financial matters, or clerical tasks. They delegate all of these essential yet nonclinical tasks to staff members, freeing themselves to practice dentistry and perform the following leadership roles:

1. Create and share the practice vision - The first requirement for the practice leader is to answer, where do I want the practice to be in three years? By answering this question in writing, the dentist can present it to the practice team and communicate it to them regularly, reminding them about what the practice is trying to achieve. The vision gives staff a greater sense of belonging and purpose. It enables them to feel that what they have is not "just a job." They have a role in achieving something exceptional in a specified period of time.

Why three years? Deadlines create a sense of urgency and motivate action. Also, situations and perspectives change over time. When the practice fulfills its vision in three years, the practice leader can then reevaluate the possibilities and create the next three-year vision statement.

2. Set at least 10 goals based on the vision - Now the practice leader and team address the question, how will we achieve our vision in three years? Goals are the answer. Though not typically measurable like performance targets, goals are nevertheless very specific (e.g., add a chair, upgrade all management systems, increase the range of cosmetic services). Team involvement in goal setting makes sense not only because they contribute signficantly to the process, but also because they will be responsible for helping achieve the goals. In effect, they will own the goals just like the practice leader does.

Establish at least 10 goals for each of the three years leading to vision fulfillment. When the practice reaches the first year's goals, those for the second year can be set. These will reflect progress made as well as what it will take to position the practice for the third-year push.

To keep everyone focused on reaching the practice's goals, there should be a progress report at every Monthly Business Review. This will reinforce team members' feeling that they are part of something greater than themselves. If it becomes clear in these meetings that progress toward a goal is lagging, the team can brainstorm ways to move forward in that area.

3. Lead by example - I once read that leaders either cast a long shadow that their employees try to emulate or a dark shadow that demoralizes staff and inhibits progress. In dental offices, team members look to the practice leader for cues about how to behave. They constantly observe the dentist's work ethic, demeanor, actions, and attitudes, and this means that the leader must always be "on," demonstrating the behavior expected of the staff. An enthusiastic, upbeat dentist will usually have an enthusiastic, upbeat team. Staff members will make the effort to give exceptional customer service to patients when they see the doctor doing so. In general, practice leaders should display a positive attitude, high energy level, enthusiasm, recognition of others, humility, and other qualities that make the work environment more pleasant and productive.

4. Inspire the team to excel - In the spirit of making it possible for other people to succeed, the practice leader should give team members efficient management systems to work with, sufficient training in the use of those systems, and targets to drive performance. One more component of team success is inspiration. By actively encouraging excellence, acknowledging achievements, and taking setbacks or stress in stride, the dentist will build a strong team. Outstanding practice teams are not hired; they are inspired.

How leadership works in a patient-centric culture

Envision this example: The dentist wakes up late and has to skip breakfast, gets caught in a traffic jam, and barely arrives at the office on time, only to discover that the first patient of the day just cancelled. This is clearly a bad day in the making, yet every staff member and every patient they see that day believes that the dentist is in a great mood.

This is not fantasy. It's the reality in offices with dentists who understand how to be excellent practice leaders. Doctors have bad days, but if they let every problem affect their behavior, the team will reflect it, and their patients will have a less-than-positive experience. Everyone will lose.

The well-led practice always has a patient-centric culture, which means that every decision and every action is based on the answer to, how will this affect patients? Not the doctor, not the staff, and certainly not the bottom line. All that matters is the patient.

In a patient-centric culture, decisions are easy as long as what will benefit the patient is clear. However, this does not mean that the practice will suffer. There may be a temporary setback, or extra effort may be required on the part of the dentist or a member of the staff. But a happy patient is a loyal patient and a good source of referrals.

By consistently focusing on the welfare of patients, the practice leader inspires staff members to do the same. This gives them a sense of purpose, which in turn motivates them to improve both their own and the team's performance. Even minor tasks get major attention when seen through the lens of a patient-centric culture.


Several years ago, I attended a course at the Harvard Business School taught by Bill George, former chairman and CEO of medical equipment manufacturer Medtronic, a Fortune 500 company. He spoke about authentic leadership. In his book by that title, he defined authentic leaders as those who are "committed to stewardship of their assets and to making a difference in the lives of the people they serve."

The last part of his definition has always resonated with me because it relates perfectly to the commitment we all made when we became dentists. Staff members do not necessarily come to dentistry to improve patients' lives, so it's up to practice leaders to use vision, goals, exemplary behavior, and inspiration, all within a patient-centric culture, to motivate staff to share this commitment.

To learn more about how to inspire your team, attend Dr. Roger P. Levin's one-day seminar "Are You Moving Forward or Backward?" in Berkeley, California, on Dec. 5, or his two-day seminar "Peak or Valley - Where Is Your Production Headed?" in Las Vegas, Dec. 12-13. To find out more, visit www.levingroup.com/gpseminars.