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Principles of TEAM building

Sept. 1, 2005
Your practice’s success requires a productive team, but building that team is one of the most challenging managerial tasks in dentistry.

Your practice's success requires a productive team, but building that team is one of the most challenging managerial tasks in dentistry. Because of patient-care demands, dentists often encounter difficulty when providing hands-on training to their teams. Many practices employ excellent teams, but employees are not trained within systems that encourage and motivate teamwork. This lack of cohesiveness causes much of the stress found in practices. Staff members may possess outstanding skills, but many lack understanding on how to best ­cooperate and benefit the practice. The secret? Transform your employees into a focused team.

Successful team building starts with leadership, which, in dentistry, begins with you - the doctor. To use a sports analogy, you serve in a dual role as player-coach. As the main producer for the practice, you’re like a quarterback or point guard who generates offense for the team. As the practice owner, you must manage and direct team members. Without the proper systems, many dentists experience frustration trying to juggle conflicting responsibilities of both roles. A dentist’s frustration translates into increased stress for the team. A high-stress environment often results in conflicts among staff, poor customer service, decreased production, and disappointing profits.

Building a high-performance team allows you to delegate more responsibilities to team members. Remember, no matter how talented a dentist you are, you cannot run the practice alone. The biggest oxymoron in dentistry is the term “solo practice.” No dental practice, if the owner wants to be profitable, is a one-person operation. Yes, it may be a one-dentist operation, but three to six other people usually support that dentist. As National Baseball Hall of Fame pitcher Jim Palmer said, “You can’t win if nobody catches the ball in the outfield. You’re only as good as the team you have behind you.” For practices to reach the highest levels of success, dentists need the support of strong teams. The following eight principles of team building can help your practice reach success.

• Principle 1

Implement data-driven systems
All practices have management systems, but are those systems effective in achieving goals? Early in most practices, whether the dentist opens a new practice or purchases an existing one, he or she uses basic management systems. Frequently, those systems evolve in a disorganized fashion as the practice reacts to changing circumstances. Those systems hold the practice together, but do not necessarily ensure it will achieve its highest levels of efficiency, productivity, and profitability.

Without step-by-step systems, practices find it difficult to build strong teams. Documented business systems allow offices to hire new team members and train them faster and more effectively. The Levin Group Methodhelps dentists create and implement expert systems. Establishing step-by-step guidelines for every situation from scheduling to tray setup is critical to success. Teams must know exactly what to do.

• Principle 2

Train the team
Once you establish systems, the next step is training. When you write step-by-step systems with accompanying scripts, you can better train your team. This standardized approach benefits new team members and those without extensive dental backgrounds. It also establishes responsibility and accountability when combined with job descriptions for each position.

You can’t train your staff in 10 to 20 minutes between appointments. To ensure team members understand their roles, establish a time away from patients - and maybe even outside the office - so you can achieve total concentration. You can provide additional focused training during morning meetings and monthly staff meetings.

• Principle 3

Compensate the team well
Most discussions of team building do not include comments about compensation, but your team thinks this is important. As in any business, a concern about compensating staff too much exists. In dentistry, labor is the highest expense. The expense ranges between 20 percent and 25 percent in most general practices, and usually is lower in specialty practices.

How do you evaluate staff compensation? One of the best ways is to acquire a sampling of nearby dentists’ compensation levels. Dental Economics®often surveys staff compensation by region. In addition, some organizations sell standardized market research data on jobs and salaries.

If you are below a proper compensation range, bring your staff compensation to an acceptable level. If you are within the range, then look at bonus systems. At Levin Group, we evaluate team members for bonus systems after they have been in the program six months and have improved their skills. This allows staffs to continue increasing production and profitability. Remember, tie any bonus system you select to increases in practice revenue.

• Principle 4

Get buy-in through a bonus system
Base your bonus program on a regular interval. One month is too short, and one year is too long. Base your bonus program on a collection model and a two-month cycle. All team members must know each day where they stand relative to achieving the goal. Share this information by posting it in the staff room and reviewing it during morning meetings. The momentum and excitement will build as your team gets closer to the goal. Once the team achieves the goal, make it even more exciting by ordering flowers or celebrating during lunch or after work.

A strong bonus program creates an ownership mentality that leads to increased practice production. In thousands of our practices, energized teams make dramatic strides. Even if team members come and go, your practice culture and strong systems will quickly indoctrinate new ones.

Nevertheless, simply establishing a bonus system is not the answer. Skill enhancement and additional knowledge are musts for successful bonus programs. As a modification of an old expression, “If you motivate someone lacking skills and knowledge, you will have a highly motivated person who can’t do anything.”

• Principle 5

Your team members want to know that you care about them. Team building does not begin with the team itself, but rather with each person’s relationship with you. Most dental offices have between four and seven staff members, making it easy for doctors to know each person professionally and personally. Regardless of their practices’ sizes, doctors should develop strong relationships with all staff members. Doctors lead practices, and staff members want to know their leaders.

The above statistic is from a national survey of 7,000 practices conducted by Levin Group, Inc. on behalf of the American Academy of Cosmetic Dentistry.
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You may demonstrate your caring for staff members by sending cards and gifts on birthdays or allowing schedule flexibility for family events such as children’s graduations. I know of one office that sends staff members who have been there 15 years on two-week trips to Europe. Ideas can range from free to expensive. Think about each staff member individually. Once your staff knows you care, you can build a high-performance team.

• Principle 6

Establish common goals
In many practices, team members do not understand practice goals. I am not referring to vision statements, which are usually two or three paragraphs about the practice’s future, or even a long list of one-, two-, or three-year goals. I mean sharing information. Many doctors fail to share information with their staffs. For example, everyone on the team is responsible for practice production. If no one knows the production target, then it is difficult to work toward a specific achievement. Establish clear goals for production, collection, new patients, average production per new patient, and other targets. Each team member should understand his or her role in accomplishing goals so your staff is galvanized toward team ­achievement. Sharing your goals creates group commitment, a purpose for coming to work, and a feeling of belonging.

• Principle 7

Ask for feedback
Your team is not just a group of workers who provide pa
tient care each day. They are a group that needs to be coached, supported, and encouraged by a leader. Help them grow and obtain satisfaction in the practice and their performances.

Levin Group has found that the best ways to ­encourage teams to come together while doctors are providing patient care are to:

1) Ask questions. Rather than giving directions to team members, ask questions. It’s easier to tell a front desk coordinator, “Schedule her at 3 p.m. Tuesday,” but it is more of a growth opportunity to ask, “Where do you think we could put this patient?” or, “Do you think there is a time that would be suitable Tuesday afternoon?” Asking questions taps the expertise of team members and allows them to take ownership in the practice.

2) Ask for opinions.Team members have an excellent understanding of the practice even at times if only on an intuitive level. They know issues and problems from working with patients and can offer informed perspectives on practice issues. Ask your team members’ opinions. Ask about non-clinical issues. This process will lead to some mistakes, but as the expression goes, “You often learn more from your mistakes than from your successes.”

• Principle 8

Listen to team members
Dentists have little time to engage in management because it requires listening to staff members. This is difficult when you’re running between patients, 20 minutes behind, and the front desk staff wants to know what to do about Ms. Smith’s insurance. It can appear that dentists are set up for failure as day-to-day managers because they do not have time to listen.

Set aside times to listen, such as staff meetings and performance reviews. Staff meetings give you a chance to ask questions and include everyone in the answers. Instead of jumping in, interrupting, or assuming you have the answer (although you always have the final say), let a team member talk through an issue even if he or she is going the wrong direction. Remember, you can refocus them or politely disagree at the end.

The second way is a semi-annual performance review. While these reviews take about an hour, they are invaluable in building better teams. Performance reviews should not be done at the end of the day when team members want to go home. Schedule them for lunchtime outside the office to change the physical and ­psychological ­environment and focus on three things:

What has gone right for the team member in the practice during the past six months?

What can the team member improve during the next six months?

In the team member’s opinion, how can the practice perform better?

These performance reviews should encourage the team member to do 80 percent of the talking in an open, non-defensive manner. The reviews are not about firing people for poor performance - that probably would have happened before a review if the person were ­performing that poorly. These reviews are meant to be positive, growth-oriented, and informational. They also represent opportunities to listen to employees.


A strong team can help you achieve long-term practice success. Building a high-performance team is one of the most difficult challenges faced by dentists. These eight principles can help transform individual staff members into a cohesive team. If you lead the way, your team will be sure to follow.

To receive a complimentary excerpt out of Dr. Levin’s “The Bonus System That Works” book, call (888) 973-0000, or e-mail customerservice with “bonus system” in the subject line.

Roger P. Levin, DDS, MBA, is founder and CEO of Levin Group Inc., a leading dental-management consulting firm specializing in implementing documented business systems into dental practices. Levin Group can be reached at (888) 973-0000 or at

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