"Wanted: Dental hygienist. Must be a team player."

Oct. 1, 2005
There's that word again. Every time I see the term "team" applied to dental office members, I want to scream.

There’s that word again. Every time I see the term “team” applied to dental office members, I want to scream. It seems I can’t pick up a dental-related magazine without finding at least one article about the “dental team.”

My associations with the word “team” conjure up unpleasant memories. Back in high school I was, like Janis Ian, one of “those whose names were never called when choosing sides for basketball.” It wasn’t that I was completely nonathletic. I was good at tennis, running, and swimming. However, put me in the midst of a team sport, such as basketball, and I was pathetic. I tried to avoid the ball at all costs, but occasionally someone would throw the ball to me. Suddenly, there I was, surrounded by girls invading my personal space, waving their arms in my face. My mind would go blank. All I knew was that I had to get that darn ball out of my hands. But which of these girls (all wearing the same ridiculous gym uniform) were my team members? Which hoop was my team heading for? Invariably, I’d panic and just throw the ball as far away from myself as possible. Ninety-nine percent of the time, this did not go over too well with my teammates. Clearly, I was not cut out to be a team player.

After graduation from high school, I mistakenly believed my awful days of team-sport participation were finished. Imagine my horror when I discovered a few years later that my beloved profession of dental hygiene had somehow become a team sport.

Sometime in the 1980s, dentistry borrowed the team concept from sports and has held on to it like a bulldog ever since. My experience with the team concept in dentistry has also been less than satisfactory.

I clearly remember the first time I heard the term applied to dentistry. It was 1988, and my employer announced that he was taking the entire “team” to St. Louis for a weekend course on team building. One of the other hygienists did not want to go; she had medical issues that needed to be sorted out. The dentist was annoyed with this nonteam player and fired her shortly thereafter.

My weekend in St. Louis went well, however. I realized that there were no balls or whistles involved in team dentistry, but rather concepts of cooperation, respect, and encouragement. It all sounded very good - in theory.

Back in the office, I looked forward to the positive changes that would take place now that we were all “team members.” The first change that our “coach” (dentist) made was to decrease hygiene appointment time from 45 minutes to 30 minutes. This was not a team decision; this was a dictatorial edict. I protested and was labeled a nonteam player.

Closely associated with the idea of “team” is the concept of “cross-training,” another term borrowed from sports. My employer announced that we were all to become cross-trained; the lines between our positions were to become blurred, as we all were to learn each other’s jobs (except the dentist’s, of course). In my 30-minute appointment time, I was now to do traditional hygiene services as well as make financial arrangements and reappoint the patient for the next visit. Naïvely, I thought that cross-training would involve some actual training. Instead I was told that I was to learn how to use the computer in my “down” time when it coincided with the appointment coordinator’s “down” time. Of course, this never happened, and I was left to struggle on my own.

I also discovered, through a patient, that this dentist’s idea of cross-training also involved using his assistant to provide hygiene services (illegally) when no licensed hygienist was in the office.

I finally got disgusted, wrote a long letter explaining my reasons for resigning, and found a new job. I told my new employer that I would be adopting a child in a few months and that I would be leaving when the baby arrived. What I didn’t tell him was that I didn’t think I’d survive for more than a few months with him, anyway. He announced right up front that his office was not a democracy; it was a dictatorship. I ended up staying with this dictator for 10 years, until he retired. At times, he was difficult to work for, but I discovered right away that he respected me for my abilities. He complimented me in front of the patients and gave me free reign with the hygiene department. I made many changes, with his approval, because he recognized that I was the expert in the prevention department.

In my case, I was much happier living in a dictatorship than in a team environment. Of course, the reality is that the dictatorship was not really a dictatorship and the team office was not really a team office. The dentists were equally wrong in describing their offices. They were merely describing themselves in the manner they wished to be perceived.

I think the “team” concept has developed because of an all-too-common problem in dental offices. Frequently, dental office members simply do not get along and tension results. When a dentist advertises for a “team player,” I suspect that what is first and foremost in his or her mind is: “I want someone who gets along with others, pulls his or her own weight, and is willing to help out whenever and wherever necessary.” These are certainly admirable qualities in an employee, but does the dentist actually believe that a potential employee would think, “I’m not a team player; I prefer to do things my way and cause strife in the office”?

I’m reminded of the good ol’ days when the help wanted ads read, “Wanted: Dental hygienist. No prima donnas, please.” How many hygienists passed over those ads because they realized they were disqualified?

A good hygienist is a people-person, respectful and considerate of others, and willing to help out in all areas of office life. His or her attitudes were shaped long before becoming a hygienist. “Prima donna” hygienists also had their attitudes formed long before becoming hygienists. The good hygienists behave as team players because it is the right thing to do. The so-called nonteam players behave in ways they’ve been taught, and believe that they are entitled to behave in those ways. No amount of “team-building” exercises will drastically change attitudes that were formed in childhood.

In truth, I’m just tired of hearing the “team” mantra. It’s time for dentistry to return the term to its rightful owner - the sports arena. While they’re at it, they can also return the concept of “cross-training.” A hygienist is not a financial coordinator, and an assistant is not a hygienist. We each have unique, equally important roles to play. That’s not to say we can’t help each other out from time to time. That’s only common (or maybe uncommon) courtesy.

It seems to me that, after all these years, dentistry should come up with a new metaphor for dental office members. How about borrowing from the Bible this time? Let’s think of the members of a dental office as a body. You, doctor, are the head, and we can assign various roles (the heart, hands, feet, etc.) to other positions. “The body is a unit, though it is made up of many parts ... The eye cannot say to the hand, ‘I don’t need you!’ ... On the contrary, those parts of the body that seem to be weaker are indispensable ... If one part suffers, every part suffers with it; if one part is honored, every part rejoices with it” (I Cor. 12:12-26).

Or maybe we can think of the dental office as an orchestra. You, doctor, are now the conductor. Each staff member plays a different instrument, but to produce beautiful music, each person must be playing the same music, albeit different parts; they must be in the same key; they must be in tune with one another; and they must be following the conductor.

I can see it now ... “Wanted: Dental hygienist for our well-orchestrated dental office. No soloists, please.”

Kirsten Brancheau practices dental hygiene part-time in a general practice in Randolph, N.J. She obtained her associate’s degree in dental hygiene in 1977, and her bachelor’s degree in English literature in 1988. Brancheau also works as a freelance proofreader. She may be contacted at [email protected].

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