Th 204248


March 1, 2006
Who you are and how you behave every day are more important in determining the effectiveness of your leadership than a handful of principles touted by the guru du jour.
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Who you are and how you behave every day are more important in determining the effectiveness of your leadership than a handful of principles touted by the guru du jour.

Visit your local bookstore and likely you will find an entire section devoted to leadership - an array of best sellers written by some of the most successful business leaders of our time. Rummage through your back issues of Dental Economics® and you will discover a plethora of articles outlining the contributors’ interpretations of leadership principles, each distilled from a combination of popular literature and personal experience. There is no lack of ­information about leadership, yet becoming an effective leader is more challenging than the literature suggests. In practical application, effective leadership is paradoxical in that it is simple but not easy.

Leading a dental team has little in common with how Donald Trump runs his empire or the strategy Jack Welch employed at General Electric. Many of their leadership concepts fail when applied in a small-by-business-standards, owner-operated business. Under these special circumstances, who you are and how you behave every day are significantly more important in determining the effectiveness of your leadership than a handful of principles touted by the guru du jour. This is not good news for the dentist who longs to focus on clinical care and leave the driving to someone else. The how-tos are hard-tos because they require thoughtful intention, daily effort, reflection, revision, and courage.

Who you are

Getting your own house in order might seem to be a tall order. Dang it, you work hard already, and now you must do all this self-evaluation? But self-assess you must. Ask yourself, “Am I the type of person with whom an excellent group of employees would want to be associated?” Well, what type of person would that be? Are you clear about the purpose of your practice and whether that purpose is at least as other-serving as self-serving? My favorite leadership guru, Max Dupree, said that nobody comes to work to make the boss rich. This is profound in its simplicity and makes it clear that the best employee candidates are attracted to practice purposes that match their personal belief systems. Moreover, in the absence of a solid reason to follow you, people will choose their own direction or a more compelling leader. It might be expediency or self-gratification. It takes time and effort to arrive at this level of clarity, but it is essential.

The question that follows is whether your everyday behavior - not just what you say on special occasions such as team meetings - is congruent with that purpose. Are you an example of what you purport you are striving to achieve? Your practice purpose cannot just sound good on paper; it must be concrete and not simply dressed up with platitudes. It must provide guidance and direction and identify the non-negotiable belief systems you have developed. It must outline the standard of care within which you and your team must operate. And it must define the ethics to which you hold yourself and others accountable. You must believe in your stated purpose and be driven to accomplish it because you cannot do otherwise; pretending is too hard. Leading a team is as simple as this, yet it is not easy.

Everyday behavior

Never promise more than you can consistently deliver. It is easy to say you intend to be in service to others yet challenging to conduct yourself accordingly. Your team takes their cues from your behavior. And guiding them means you must first hold yourself accountable to the standards you have set. Your public actions must be fully congruent with the principles you have outlined for your team, and your private behavior must be conducted as if it could become public. While it is easy to complain about patients behind their backs, withholding and redirecting such comments speaks volumes to those you lead. An undisciplined habit of speaking poorly about one team member to another suggests that you lack the courage to deal with legitimate issues directly, causing others to wonder how you feel about them and to question your truthfulness on other issues. This doesn’t mean you must be perfect. It simply requires that you quickly recognize and openly acknowledge when you make mistakes.

I have emphasized the importance of a concrete set of guidelines for your team because you will rarely be available throughout workdays to provide guidance and direction when situations arise. Beyond that, however, high-caliber employees want and need to make decisions on their own. When your standards are so clear that employees can approach each circumstance confidently with your trust, you have accomplished a major leadership obligation. While many will tell you to hire good people and get out of their way, you must also provide those good people with the tools they need to perform well. Because your guidelines are not rules, the straitjacket of rigidity is removed and allows staff members to assess the circumstances. Then each team member may determine how his or her behavior should represent the overall purpose of the practice as well.

This marriage of purpose with everyday behavior is the essence of leadership in a dental practice. While these two issues are fundamental, other characteristics may determine your effectiveness as a leader.

Thoughtful fairness

Dentists sometimes confuse fairness with equality. While equality suggests sameness, fairness lends itself to justice. Because many dentists think they must treat staff members equally, they behave accordingly and diminish their leadership impact. On the contrary, you must attract people with different skill sets, styles, and perspectives, yet they must function well within the guidelines your purpose, standards, ethics, and belief systems have outlined. Thoughtful fairness requires you to be clear with each member of the team about your expectations, even while those expectations may vary from one employee to the next. It requires you to deliver timely feedback in a way that preserves the dignity of each person. It requires you to be tough on issues and tender with people.

This is difficult for many dentists and there are lots of good excuses for not dealing with employees this way. I understand you are busy and tired at the end of the day. Yes, you don’t like confrontation and have a hard time dealing with tears. Nevertheless, your team members are entitled to understanding your expectations and receiving your feedback. They will learn whether you hold those belief systems you outlined by the way you work with them. The goal is to support and foster their success through the fairness of open, timely, and honest communication. This is where your belief systems get tested. Do you believe people want to do a good job, or are you cynical about employees in general? Do you believe staff members should be placed where their skill sets match the demands of the position? Do you think good people will rise when presented with clearly defined performance standards, a culture that focuses on supporting their success, and regular feedback? Each question exemplifies thoughtful fairness, an essential element of effective leadership.

Yet fairness can operate only in an environment in which you have hired people with the skills you need, the work ethic required to get the job done, an alignment with your other-serving purpose, and a pleasant, agreeable style. You cannot afford to hire people without these characteristics. It is too hard to mold, train, and align them, and there is no guarantee your efforts will be rewarded. Moreover, most dentists lack the human resources training and skills necessary to bring along a less-than-qualified applicant. An effective leader will hold out for people who are smarter than they are in important areas of the practice and support them as they re-interpret their special skills within that context.

Fairness isn’t just making nice, for it requires an awareness that allows the leader to recognize early when ­something is not working. Under these conditions, the dentist must respond with new ideas, experimentation, and a culture that helps people work together rather than in competition. Harder still, yet equally important, is the strength to be clear about what one will not tolerate, such as immature behavior, mean-spiritedness, and passive aggression.

Willingness to invest in resources

Effective leadership often requires ensuring that team members have access to appropriate resources and tools to perform optimally. Basic equipment and supplies are essential resources, but sometimes your time can be more important. Thus, not all resources cost money. An effective leader understands that investing time to discuss expectations, clarify roles, and review how members of the team must work with one another will pay off in a more productive practice. Regular team meetings with clear direction and worthy agendas breed a stronger team and more cohesive culture. When dentists conduct themselves well during these events, it sets a standard for others. Show up on time. Be prepared. Use the allotted time judiciously. Focus on the agenda. Have fun while learning and growing together but be serious with issues that require that mindset. Most of all, follow through on plans and decisions and demonstrate accountability and maturity.

While it is often difficult, you must provide the resource of a solid training program for new employees to ensure that they have the tools to succeed in their positions. But strong leaders take on the difficult and sidestep potential disasters by planning for success rather than waiting to see what happens without their direction. An effective training program is intentional, measured, and involves every member of the team. It also builds in early and ongoing evaluation, coaching, and experimentation. This is a huge task for a dentist who is already busy with day-to-day obligations of serving patients and running a business, but doing otherwise wastes effort and money. One of the greatest expenses for a practice is replacing staff. While staff loss occurs for many reasons, an effective leader ensures that employee turnover is not a result of misunderstandings or factors within his or her control.

You must provide tangible resources as well. Team members require adequate workspace, including private space. They require modern, functional equipment that allows them to be efficient with things and effective with people. You cannot overlook maintaining a modern physical plant, a telephone system that provides flexibility at peak times, and a computer system that makes information readily accessible to team members. The days of cumbersome and error-prone paper charts are over, and the internal systems of the practice must be as modern as the clinical suite.

Clear and frequent communicator

Message to dentist: Team members cannot read your mind. Maybe you think they should be able to infer things from your eye rolls and sign language, but somehow the subtleties of non-verbal communication escape them. You must actually speak clearly about what is on your mind - even when you are at the beginning stages of thinking. If you are unclear, say so. If you are reluctant to make a commitment, acknowledge it. When you are certain, be forthcoming. When the team hears your thought process and is included in your development of ideas, they can contribute helpful thoughts and perspectives. While many dentists groan at the thought of walking an employee through a concept or reviewing for the second or even third time a set of ideas, effective leaders understand that this is a natural part of creating the culture of openness, inclusion, and problem-solving.

I cannot emphasize enough the importance of access and feedback. They must occur naturally rather than be scheduled events. The No. 1 complaint I hear from team members across the United States, Canada, and Australia is a lack of appreciation. The best leaders comment often, freely, and publicly - almost casually - as an expression of the admiration and thanks for even small things done well. They understand that appreciation and approval allow for legitimate and valuable critique and correction. Ineffective leaders are so immersed in their own perspectives that they overlook opportunities to comment on the performances of those around them. Altering one’s style in this area is easy, for it is merely a matter of adopting a new set of habits. At first it can seem artificial: “Thanks, Jane. She was a tough patient and you handled her well,” or, “Great call there on the shade.” Yet with intention and practice, it can easily become a part of who you are. Zero dollars. Fabulous return.

And finally, good leaders understand that they must be accessible to their team members and pay attention to matters of shared importance. Accessibility includes informal interaction as well as meeting time. Frequent lunches with the team and an occasional after-work coffee or glass of wine help form a camaraderie that builds stability through understanding and respect. Getting to know your team members and what is important to them and their families - with respect for boundaries - supports an integrated culture. Team members will ask for your attention when they require your input and guidance in tough situations. Timely response is essential and they must know they have your support when they act on your behalf.

All of this is a tall order, but it is possible with hard work and intention. You might need help. The final characteristic of a good leader is not being afraid to ask for help when you need it.

Sandy Roth has been serving dentists and their teams for more than 20 years through her company, ProSynergy Dental Communications. She has been a frequent contributor to Dental Economics®, the Seattle Study Club Journal, and is a contributing editor to the Journal of Cosmetic Dentistry. Her expertise in communications, hiring, team building and patient relations are available in presentations to study clubs and associations. She divides her time between speaking and private, in-office communications consulting. Reach her at (800) 848-8326, or [email protected]. Her Web site is

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