Leading the practice team to success

Aug. 19, 2013
Effective practice leadership has many components, and what passes for good leadership in good economic times may be wholly inadequate in a difficult economy.

by Roger P. Levin, DDS


Effective practice leadership has many components, and what passes for good leadership in good economic times may be wholly inadequate in a difficult economy. Many excellent dentists struggle with their responsibilities as leaders, especially in the area of team management. At my seminars, dentists regularly ask me questions such as:

  • How do I find excellent team members?
  • Why do members of my staff resist change?
  • Should I hire an MBA to be my office manager?
  • Are bonus systems the answer?
  • How can I get my team to have a more positive attitude?
  • Why do members of my team fail to follow instructions even after I've explained what I want over and over?

These questions indicate that there is a lack of understanding about what a dental team really is and how the practice leader builds a good team.

The realities of team building

According to the Levin Group Data Center™, a majority of dental team members, especially those in nonclinical positions, are high school graduates who have received little or no prior training in practice management, financial management, sales, time management, or organizational management. Front desk coordinators usually have no formal training. Dental assistants and hygienists have clinical training, but typically no training in the practice management aspects of their jobs. Even when dentists hire office managers, they may lack formal training or experience relevant to dental practice operations.

This is the reality for most dental practices, and it will not change. In other words, dentists are being unrealistic if they think they should be able to hire their way to an excellent practice team. Yes, team members must have certain characteristics to perform well, but no matter how good they are, they will still need to be trained. Excellent practice teams are built, not hired. As practice leader, the dentist, who also probably lacks business education, must create the right conditions for building an effective team. This will include not merely specialized training for team members, but also practice systems designed so that staff can readily operate them with maximum efficiency.

Systems based on simplicity and repeatability

When a practice's management and marketing systems are created -- or re-created, which should occur every three to five years -- they should consist of a results-driven series of steps that are simple and repeatable.

In this case, "simple" means readily understandable by any staff member who will be expected to follow the steps. It must also be simple in terms of grasping what targets must be reached on a daily, weekly, and monthly basis. Simple systems enable team members to self-monitor their performance, and provide dentists and office managers with feedback that pinpoints where further training will be valuable.

"Repeatable" means having full documentation of all step-by-step systems used in the practice. This documentation assures that a practice's systems, as designed and refined to achieve maximum results, can be used the right way every time. When team members fill in for someone else on an unfamiliar system, its inherent repeatability makes it easy for them to follow correctly. Repeatable systems enable new team members to quickly duplicate the successful performance of their predecessors.

Dental practices must find ways to maintain continuing excellence, not to mention production, profitability, and income, regardless of staff changes, which are inevitable. As leading business educators such as those at the Harvard Business School have taught, and so many skilled business owners have learned, system simplicity and repeatability are the keys to team success and greater patient satisfaction.

Strategies for improving team performance

As I say in my seminars, the surest method for dental practices to increase production as quickly as possible consists of these three steps:

  1. Set 24 specific, measurable performance targets and assign primary responsibility for each one to the dentist or staff members.
  2. Create and implement documented step-by-step practice systems for the express purpose of reaching those targets.
  3. Train (and cross-train) staff members on the systems, using scripts that not only guide their every step but also motivate patients and create value in their minds for the doctor and the practice.

Beyond these essentials, there are leadership skills that practice owners must develop if they are to build excellent teams and thriving practices. Among the most important are:

  • Doctors need to model the behavior they expect from the team. Good leaders think about the behavior they display to their teams, because it will be emulated. For example, acting pleasant toward patients but making negative comments about them to team members will most likely result in a disrespectful staff. To borrow the common expression, good leaders not only talk the talk but also walk the walk. Rather than telling staff how they should perform in their daily actions and patient interactions, it is far better to show them by setting an example.
  • Show that money is not the practice's primary concern. The difficult economy obliges dentists to attend to the business side of running a dental practice. As the Dental Economics/Levin Group Annual Practice Survey has shown, overall practice production has declined significantly in recent years. Dentists today must make it clear to their teams that regaining financial strength is a prerequisite. At the same time, the practice needs to focus on patients as people in need of the best possible oral health care. Even as the team implements growth strategies, the doctor must personify the "patients first" attitude as an example for all staff members to follow. High patient satisfaction will be a natural consequence.
  • Leaders need to be consistently positive and upbeat. Like everyone else, dentists experience periodic emotional difficulties. Unlike others, however, they must be conscious about how they feel day by day and control their impact on the people around them. Good leaders decide which characteristics they want to display and then present that demeanor consistently. If inconsistencies arise on occasion, practice leaders should explain why to the team so no harm is done.
  • True leaders genuinely care about their teams. Leaders' visions and goals for the practice may change from time to time, but values do not change often. One of the most important values dentists can have is to truly care about the team members of their practices. This means showing sensitivity and toleration for them as people, and also recognizing they may lack appropriate training and leadership. By seeing a need for further training and then providing it, the good practice leader makes it possible for team members to reach their full potential.


The greatest challenge and source of frustration for many dental practice leaders relates to the dental team. The key to creating a truly effective practice team begins with the realization that the best teams are built, not hired. Dentists must hire people with the right capabilities and then lead them. Set the right performance targets, design systems to meet those targets with simple, repeatable, step-by-step protocols, and provide excellent training on the systems. Finally, practice leaders must lead, learning how their personal behavior impacts the attitude, performance, and well-being of staff members. Do all of this and everyone -- doctor, team, and patients -- will benefit.

To learn how to run a more profitable, efficient, and satisfying practice, visit The Levin Group Resource Center at www.levingroup.com/gp, a free online resource with tips, videos, and other valuable information. You can also connect with Levin Group on Facebook and Twitter (Levin_Group) to learn strategies and share ideas.

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