Excellent Staff: The pillar of practice success

June 1, 2004
Hiring and retaining a talented team is the primary challenge for dental practices. Effective leadership can help dentists build a motivated, enthusiastic, and united staff.

By Richard Mounce, DDS

Staff recruitment, selection, training, monitoring, and retention are either a source of significant satisfaction or frustration. An excellent staff is a key pillar of professional dental success. A motivated, professional team makes achieving the best results almost effortless. This piece will share the strategies that have worked well for me personally, as well as the caveats that practice owners may face.

Staff challenges are myriad. Inattention to detail, cleanliness, follow-through, and punctuality commonly challenge dental offices. Sometimes cliques form, or there may be personality clashes within the staff.

Another typical problem is when one employee overfunctions or performs far more of the workload than is his or her responsibility. The doctor may depend on this person to a burdensome degree. This, in turn, makes the practice vulnerable if this employee leaves. This type of situation also may marginalize other staff members due to perceived favoritism. This can flatten creativity and staff effectiveness because the other employees develop an attitude of "Why should I work hard ... he/she will take care of it."

Such challenges may seem obvious, yet dentists often are unaware of them. By nature, doctors want to practice their healing art and avoid personnel and business matters. As a result, the staff has no direction or guidance. Problems fester, and the consequences can be disastrous.

Overcoming staffing challenges is a normal part of practice management. But how much more effective and profitable could you be if your staff shared your mission, goals, values, and work ethic? How much would your stress level diminish, and how much more enjoyable would practicing dentistry be? I suspect the answer to all of these questions is, "Much more," which begs two more questions: Why don't you have the staff you want now, and what can you do to get it? How can you infuse passion for your practice within your staff that mirrors your own, gives them a sense of ownership, and sparks their enthusiasm and motivation?

It takes a leader to bridge the gap between the staff you have now and your dream team. Simply put, when doctors lead, the staff will follow. If the doctor lets the staff lead the practice, it's like a ship led by the tide and wind. Leadership may be difficult, but it's essential for a successful practice.

Dental practices are small businesses that seldom have human resource departments. Qualified candidates are few, and those who are available may have quit or been fired from other offices. How do we avoid this employee recycling? Additionally, once you hire an employee, you must assess whether you are providing a stable platform with clear, consistent training and job manuals that clearly define roles, duties, and policies. Do your employees know what you expect? Have they been given the latitude to be creative and find better ways to perform? What do you give employees that sets your practice apart from your competitors?

The doctor-staff relationship is the primary personnel challenge for most doctors. It's essential to treat our team members with respect and fairness; however, our employees are not and should never be our friends. At the end of the day, they are employees only. If you disagree with this viewpoint, ask yourself: Would you socialize with your employees if they didn't work for you, and would they socialize with you if they didn't receive a paycheck? The distinction is important. It's difficult if not impossible to reprimand or fire a friend.

Dentists must stay above the fray and resist becoming involved in the mini-dramas that are a normal part of any group. Maintaining a professional distance is imperative. It allows the owner-doctor to lead similar to a coach for a professional sports team. Clearly defined roles within a practice, with the dentist as coach/leader and a well-trained staff as the team, fosters security, confidence, and success.

Problems arise in even the most perfectly managed offices. Deal with problems head-on before they mushroom into something destructive. This is easier said than done. Doctors seldom emerge from dental school with management training, yet there is a delicate balance to managing staff and personnel issues while treating patients.

The road to having a productive staff and solving these challenges might not be entirely straight, but it is relatively well marked:

* Declare yourself the leader — Be clear about what you stand for, where you want to go, and how you plan to get there. What are your office's goals, vision, and values? Do you have a business plan? Do you have a budget? Develop a manual and written checklists for every system in your office, along with protocols for every repetitive task. Then, review these materials regularly with your staff. Listen to their comments, and hone those systems that re-enforce their commitment to your "brand" of dentistry. Achieving this level of communication with your staff will go a long way in avoiding misunderstandings and duplication of effort. If a few stubborn employees resist these changes and refuse to commit to your newly defined mission and values, replace them. It's better to train someone who is inexperienced yet motivated than to keep an employee who poisons the enthusiasm of your office.

* Give your staff incentive to perform well — For example, set a target productivity increase for a three-month period. When the goal is met, give your team cash bonuses. Such a bonus not only rewards hard work and creativity, but it gives your staff members a sense of ownership — they have a financial stake in the practice's success.

* Listen — Employees sometimes may have superficial complaints and concerns. It's up to you, the leader, to listen and determine their validity. If your policies and office standards are clear and concise, such complaints should be easily managed. Expectations regarding most issues should be pre-established, and the dentist/leader needs only to refer to the office policy regarding the issue at hand. If the complaint is legitimate and not dealt with in writing, then office policy manuals need to be amended. Such exceptions should be very rare.

* Team meetings should be relatively frequent, orderly, and brief — They should start on time, and everyone should have a chance to contribute. When the meetings result in change or new tasks, minutes should be printed and distributed. Any subsequent duties assigned should have a set time schedule to measure achievement and provide follow-up to ensure the issue was resolved.

* Take your time when hiring new team members — Interview extensively until you find the right person. Patience really is a virtue; don't hire someone just because you need a body. It's less stressful and expensive to deal with a vacancy temporarily than to hire the wrong person and have to replace that individual.

* Spouses in the office — Tread this line carefully. Many doctors and their spouses make effective leadership teams. However, in a busy office, lack of communication about vision and goals between the doctor and spouse can lead to conflict or confusion. To the team, a spouse may represent a second owner, and they may be unclear about whose direction to follow. Or, the staff may interpret a spouse in the office as a sign that the doctor does not trust them. Why else do so many spouses collect money, write checks, and make deposits?

If your spouse works in your office, make certain you are united in your goals and vision for the practice. Make certain that your spouse's role is clear and defined. Finally, maintain a united front, and resolve any disagreements privately.

* Performance reviews — Periodic written evaluations are invaluable. Aside from creating a legal record of staff performance, they eliminate uncertainty about the level of staff performance and enhance communication. They give doctors an opportunity to praise employees individually for their successes and reward them for strong performance. Conversely, employees performing below level can receive constructive criticism and instruction on where and how to improve.

Adhering to these strategies is a starting point for achieving and maintaining an excellent staff. In the end, doctor and staff will achieve optimum results in an office with strategic leadership, consistent communication, and clearly defined roles.

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