Implementing Change

Dec. 1, 2006
Last month, we discussed the challenging issues surrounding change in an organization. This month, we’ll look at steps you can take to resolve these issues and gain support for changes that need to be made in your practice.

Just as each season brings its own special beauty, so change gets you out of a rut and moves you ahead.

by Cathy Jameson

Last month, we discussed the challenging issues surrounding change in an organization. This month, we’ll look at steps you can take to resolve these issues and gain support for changes that need to be made in your practice.


The first step in making a change is awareness - awareness of the need to change, the benefits of change, or both. The last thing you want to do is stifle your organization - or yourself - by remaining status quo because of your inability to change. As I said at the beginning of the last article, change is not easy and many people avoid change at all costs. But it costs you more not to change. Change gets you out of a rut and moves you ahead.

You may feel overwhelmed when thinking about things in your life that need to change. But remember how to “eat an elephant” - one bite at a time. Start with one thing you want to change. Work on that one thing. Celebrate small victories along the way, then move on to the next thing. You’ll progress more quickly than you think. Every journey begins with the first step. Don’t ever stifle yourself by thinking, “Oh, there’s so much to do I can’t ever get there, so there’s no reason to start.” That kind of negative thinking has never been part of a forward moving person or organization.

Remember the coin called risk? One side of the coin is the possibility that you could make a mistake. But commit to learning from that mistake and you will be wiser on the other side. On the other side of the coin called risk is ultimate success. No one has ever found success without taking some risk.

I recently worked on an article about success. I interviewed numerous people from various professions who had accomplished success. I asked them, “To what do you attribute your success?” Every one of them - every one of them - had the same answer. Without coaching, each said, “The mistakes I have made.” Don’t be afraid of your mistakes. You will make them. But you will learn what doesn’t work and you won’t do it anymore. You will choose an alternate plan of action. This is a great learning opportunity.

If you decide to change something in your practice or personal life, soliciting the support of others is essential to the success of your project.

Here are 10 ways to solicit that help. This is an essential part of leadership. As a leader, you want the people in your life to support change and be interested in moving the practice forward.

1. Identify the major influencer(s) in your practice.

Every organization has influencers. They may be in any position in the practice. Know the influencers before you initiate change. You can predict the success of a project by how many influencers support it. As in any game plan, you need to know who your best players will be for each role. Think this through. Follow this five-step process for strategic planning before you initiate change.

(a) Write the goal that you want to accomplish.
(b) Design a plan of action. What are you going to do? How are you going to do it? What are the steps? Why is each step essential?
(c) Who will do what? Identify your influencers and what roles they will play.
(d) Establish time frames for accomplishing each step.
(e) Evaluate your progress to see if you are getting the results you desired. If not, go back to the influencers. Ask them what is working and what isn’t. Ask them to share their perspective on the project and what they think the barriers might be. They will have insights that you will not have. Trust them on this one.

2. Identify how many people will be impacted by the change.

You should identify who will be directly impacted by the change and speak with them individually or as a department. For example, if you plan to change a material you have been using in the clinical area, you should have a discussion with your assistants before you use the new material. They are the ones who will be influenced by the change.

If the entire team will be impacted by a change, address the change at a team meeting. For example, if you plan to alter the way you do scheduling, this impacts everyone and you need to:

(a) Share relevant information
(b) Stress the results you want to accomplish
(c) Encourage discussions, including concerns
(d) Help everyone see the benefits of the change to gain their support

3. Identify who may be indirectly impacted by the change.

As you lead your team to accepted change, make sure that people are not left in the dark. Even if someone isn’t going to be directly impacted, or they aren’t the one performing a certain task, they still need to be informed. If they will be answering questions about the change or they will be expected to support it, make sure they are informed. Nothing drives people crazier than not being able to confidently answer questions.

For example, I am never going to be a hygienist, and I am never going to perform nonsurgical periodontal therapy. However, as a business administrator, I need to know how to schedule these procedures, I need to know how to make the financial arrangements, and I need to be able to answer patient questions. In this example, the business administrator needs to be informed about what is going on and why it is important so that he or she can be a positive influence on patients’ willingness to accept change.

4. Who will probably be positive?

Your positive influencers can bring enthusiasm and “possibility thinking” into the mix and can be assets in the change process. Sit down with these people and tell them how important their influence is on the group. Be honest and tell them you need their support, and ask them to support the change. You may need to give them an idea of what you want to do. Speak about the results you want to accomplish, and remember to focus on the benefits.

Everyone on the team is a leader - a leader of himself or herself, his or her teammates, and patients. Your leaders who have positive attitudes are priceless. They will be behind you and your idea.Their faith in you will spread to others. Also, if there are negative conversations behind closed doors (those that take place in the sterilization area or at lunch), your positive attitude folks may just stick up for you and squelch some of the negativity. Do not underestimate how influential these team players can be regarding change.

5. Who will probably be negative?

Then there are the negative attitude people. Hopefully you don’t have any negative influencers in your organization. Negative influence can shut down progress before it begins. These are the “doomsayers” who think that innovative recommendations are bad, frightening, or unnecessary. There is nothing that will sap the energy and life out of a project or practice more than negativity. The power of negativity is immeasurable.

So if you have negative folks on your team, enroll them in your project before they have a chance to ruin everything. Sit down with them. Let them know you need their help. Let them know that you are aware of their powerful influence on the team and that you value their support.

Ask them to be straight with you. If they are going to be negative about your ideas, ask them to address their concerns with you immediately. It is better to face a negative person before you are in the group. Then you have a chance to address their individual concerns, and hopefully change their negative attitude. If you support the negative person, but not their negative attitude, you may see a turnaround.

6. Which group is the majority?

If you are initiating a change, you need to know which is larger - the group that supports the change or the group that doesn’t. You do not want a “majority rules” method of management. Rather, you want to incorporate Dr. Thomas Gordon’s “Win-Win Problem Solving” method. If you have a majority rules method of management, someone will lose and that doesn’t make for a terrific office atmosphere.

Be careful not to show favoritism to a strong person or group within your practice. This undermines the potential leadership skills of others and the less strong will become even weaker. Give everyone a chance to step up to the plate, and let everyone know that you not only respect their ability to lead, but you expect it.

7. Which group is the most influential?

It is very important to nurture your influencers. You need to know where your negative and positive influences are coming from. If you have one group more influential than another, you may have some work to do. If you have a particularly positive group, encourage those people. Give them leadership responsibilities and the trust that goes with that. If your negative group is more influential, you need to enroll their support.

8. Positive group

If the positive group is stronger, discuss the desired change in your team meeting or a special group meeting. Let the positive influence set the tone for the change and creation of your action plan.

9. Negative group

If the negative group is stronger, meet with them and follow the protocols outlined in No. 5. Do not introduce a project or change at a team meeting if your negative group is stronger. You run the risk of the negativity ruining the project immediately. Again, this is the reason you need to think through the people part of your project before you begin. Get everything in order so that your chances of success are greater. Don’t just think about what you are going to do, think about how you are going to do it.

10. Know the key to each influencer.

You have identified your influencers, both positive and negative. As you get ready to initiate change and solicit support from your influencers, think about their motivational hot buttons. What motivates them? What do they like? What do they not like? What is important to them? What is their personality style? How do they work? Are they slow and deliberate in their thinking or do they dive in and go for it?

As you work with people, focus on their motivational hot buttons. All behavior is driven by “What’s in this for me?” It’s good leadership to address things from this perspective. You will show your interest and understanding of others. You will let people know that you care about them. You will show you appreciate their individuality.

Opening the parachute

Change is difficult. For a person to be willing to change, he or she must see the need or benefits of the change. Only then will behavior be altered. If someone is closed- or narrow-minded, it may take time to gain reception. Soliciting support for change is a major element of leadership. Leaders understand that they only get things done through people, and enrolling people in the development of the organization is a major responsibility of a leader. Persevere. Once a slow decision-maker does decide to move forward, he or she will persist in making things work well. “A mind is like a parachute. It only works when it is opened.”

Cathy Jameson is the president and CEO of Jameson Management, Inc., an international dental practice-management consulting, lecturing, seminar, and product provider. An accomplished speaker, writer, and workshop leader, Cathy’s work in organizational psychology focuses on effective stress-controlled management. Cathy’s books, “Great Communication = Great Production” and “Collect What You Produce,” are top sellers for PennWell Books. You may reach her toll-free at (877) 369-5558, or by e-mail at [email protected].

Seven Steps to Problem-Solving

  1. Identify the problem in terms of the needs of all parties.
  2. Brainstorm solutions or possibilities.
  3. Discuss the pros and cons of each suggestion.
  4. Come to a consensus on the solution of choice - one that meets the needs of all parties.
  5. Using the five-step process of strategic planning (outlined in Part 1 of this article), design a plan of action.
  6. Implement the plan.
  7. Evaluate your progress.

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