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You must have conversations with bad dental employees.

When an employee makes you nuts: 3 tips to change behaviors

March 11, 2024
Do you have a difficult employee? Diffusing the situation calls for an understanding of the employee's situation, and sharing how their behavior is affecting the office as a whole.

Do you have an employee whose behavior is so frustrating it's triggering you to grind your teeth, or any other number of stress relievers? Have you threatened to write up the employee if they don’t improve? Did this threat lead to a grudgingly compliant employee who now does just enough to avoid your wrath?

What if you could have performance conversations that conclude with employees who feel motivated to change because they see the consequences of their behavior and the benefits of a new behavior.

Here’s a look at a real situation in an office and the approach I recommended. Read on for the plot twist that altered my approach.

Background to the situation

Laura is the financial coordinator in a medium-sized practice where she’s worked for six years. Her performance has presented some challenges and lately has gotten worse. Employees have told the dentist that Laura avoids answering the phone and is cranky and uncommunicative. One employee described her as a Negative Nancy due to her constant complaining.

The dentist observed that Laura passes off patient inquiries to other staff members. She sighs and looks annoyed when the dentist addresses her. She can be critical and dismissive. For example, during huddle, she rolls her eyes when others speak and describes patients as deadbeats who never pay or who are too irresponsible to show up. When asked why she doesn’t ask for payment before an appointment or why she reappoints chronic no-shows, Laura derails the meeting with defensiveness and arguments. 

What should the dentist do? Here’s what I advised.

Identify goals for the conversation

Before starting a conversation, identify your desired outcomes. I asked the dentist to describe what she wanted to happen as a result of the conversation. She wanted Laura to:

  • Agree to a process of answering patient financial queries instead of deflecting all calls to someone else.
  • Change her attitude during the huddle.
  • Be a better team player.
  • Stop complaining and help others without an attitude.

Review these goals. Do you notice any problems with the phrasing? The first goal is good because it’s specific, action-oriented, and measurable. But the other goals are about attitude. Changing someone’s attitude is usually a long, frustrating, uphill battle. Focus instead on behaviors. Spell out what you want the employee to do instead of what they should stop doing.

The dentist and I created new outcomes for their conversation.

  • Laura and the dentist will decide which calls she will respond to, and which calls she will forward.
  • During huddle, Laura will use nonjudgmental language when describing patients. “This patient has a history of…”
  • Laura will describe her actions to address patients’ behaviors. “Because this patient has a history of late payments, today I will…”
  • Laura will respond to requests and questions with respectful and helpful verbal and nonverbal communication.

Describe how the negative behavior impacts the employee

It is ideal to have employees who connect the success of the practice to their own growth and goals. But many employees are more invested in their own needs and lives.

So, instead of struggling with them, meet these employees where they are and leverage two internal motivators that most people care about: their reputation and their relationships. (If your employee doesn’t care about these things, you have a bigger problem.) 

The purpose of the performance conversation is to provide feedback so that the employee realizes their current behavior negatively impacts how they’re being perceived by their peers and you. If they want better relationships, they need to change. 

We came up with the opening lines for the dentist’s conversation with Laura. Note how it directly links Laura’s behavior to team perceptions.

“Laura, we’re talking because I’m concerned about how your actions and communication style affect your relationships with your colleagues and me. I suspect you might not be aware of how you’re perceived and the damage this is doing to your reputation. 

“For example, when you roll your eyes, gossip, and complain, it gives the impression you don’t respect others. This leads your colleagues to believe they can’t trust or rely on you. 

“When you arrive at work and bang your stuff on the table without acknowledging anyone, they get the message to stay away from you. When they ask for help and appear annoyed, they won’t want to help you out either.

“Is this truly the reputation you want to have in our practice? Would you be open to changing how you communicate so that you can be seen as the reliable professional I know you want to be?" 

Document the conversation and the agreements

Every human resource person will advise you to document every performance improvement conversation in case you need to defend a dismissal. This also creates a work plan for the employee. Before you end the conversation, outline how you will measure and evaluate the employee’s changes. Create specific milestones and schedule your next meeting to evaluate the employee’s progress.

Now for the plot twist

Near the end of my call with the dentist, I asked a question that led to a plot twist. I wondered why the dentist had been putting up with Laura’s behavior for so long. I asked, “Has Laura been like this since she started working for you six years ago?”

The dentist told me that in the last 18 months, Laura’s husband was jailed for a fatal DUI. She was in the process of divorcing him. Then, Laura’s car quit working, and she’s struggling to afford another one on her salary.

Someone’s personal life can be a major factor in their behavior at work. This doesn’t make their behavior appropriate, but it does put it into a larger context. We changed the dentist’s opening lines in their conversation to acknowledge this.  

“Laura, I’m so appreciative of your work here the last six years. Until recently, you’ve been reliable and dedicated. I recognize that things have changed in your life, and I feel a great deal of compassion for your situation. I recognize that it can be hard to leave your personal troubles at the door, and perhaps you don’t realize how your interactions with us have impacted your relationships and reputation.

“We need to talk about how to turn this behavior around so that your colleagues and I can rely on you again. I believe that if you make some changes, you’ll be on a path to reach more of your life goals.”

This acknowledges Laura’s circumstances but still holds her accountable. It allows her to see that changing her behavior can bring her benefits.

There’s an old joke about therapists and light bulbs that ends with, “it depends if the light bulb wants to change.” Your employees will be more likely to want to change when they believe that a different behavior will lead to something they genuinely value.

Editor's note: This article appeared in the March 2024 print edition of Dental Economics magazine. Dentists in North America are eligible for a complimentary print subscription. Sign up here.


Sharyn Weiss, MA, is the CEO at Weiss Practice Enhancement, a Bay Area practice management firm serving dentists nationwide. She has worked with hundreds of dentists during the last 20 years with a focus on patient and team motivation. Her mission is to help dentists become confident leaders of a profitable practice. If that’s your goal too, contact Sharyn at [email protected] or weisspractice.com.

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