The Grand Huddle - A 21st century communicator

April 1, 2000
The Grand Huddle shows you how to play the game, week in and week out. This is where you put into operation all of the principles of leadership.

The Grand Huddle shows you how to play the game, week in and week out. This is where you put into operation all of the principles of leadership.

Dr. Hugh F. Doherty

All businesses in corporate America have quarterly meetings to report their progress. Meetings are held the first week of January, April, July, and October. Dentistry is the business of a professional person and should operate in a like manner. Thus, the same type of quarterly meetings should be held four times a year to determine the progress of the practice. The nomenclature I instituted to describe this activity is the Grand Huddle.

Why this title? Because the staff as a team coordinates and directs the meeting, as opposed to the traditional staff meeting run by the doctor. This places staff members where they belong - in the forefront. A self-evident, obvious truism that is the foundation for all successful practices is: You will never have a great practice unless you have a super staff working together toward a common goal as a team. What do teams do when they want to plan strategies? They huddle!

The Grand Huddle shows you how to play the game, week in and week out. This is where you put into operation all of the principles of leadership ... where you use all of the tools at your disposal - the game plan, the goals, forecasting, budgeting, monitoring the standards for each activity of each part of the practice (clerical, clinical, and hygiene), the payout levels, the different ways of winning, etc. This is how you constantly regenerate the pride and the sense of ownership for staff ... how you create mutual trust and respect between doctor and staff ... how you light the fire and get people excited about their jobs. Above all, this is how you drive ignorance from the workplace, teach people how to make money, and show them what needs to be done to be successful.

As the team goes from one Grand Huddle to the next and sees the practice numbers change and hears the stories behind them, the doctor and staff are learning about business, life, and that there really is a pot of gold (net profit) at the end of the rainbow. Everyone is learning all the time. Hopefully, everyone also is having fun.

Believe me, none of that would happen without the Grand Huddle. It serves as the foundation for your organizational process to maintain and operate the systems in your practice. It is the means by which doctor and staff stay connected to one another. It sets the pace, the tone, and the mood of the entire practice. When I observe what this type of meeting has done for my clients, it amazes me that so many other practices try to get by with having only regular staff meetings. Many thanks to Dr. Tim McAdams, a successful general practitioner from East Greenwich, R.I., who was very instrumental and helpful in the conception and development of this type of meeting.

A roadblock

What is the major problem with most staff meetings? It`s the doctor-boss. He or she is the only one communicating. Those kinds of meetings waste everybody`s time, including yours, if you`re the boss. You are not getting the necessary information you need to be a good leader. Worse yet, you sure aren`t getting help from your staff. Your messages are not even getting across. Every one of your messages is being interpreted and distorted in ways you would never suspect.

The main message you send, moreover, has nothing to do with what you say. It comes from your actions. When the doctor dominates staff meetings, you are telling staff that you don`t value their contributions and you don`t think that they can make a difference. That`s probably not the message you intend to deliver. You may not even believe it.

But it`s what they hear. Bear in mind that I am talking about the regular staff meetings that most practices use for internal communication.


Communication is one of the most difficult challenges in any business, because people only hear what they want to hear. If they don`t hear anything, they speculate. They start rumors, often unintentionally. Communication is the number-one problem in most doctors` personal and professional lives. Show me a practice without regular meetings, and I`ll show you a practice with a host of problems. That can cost you lots of money. Inept business communication can be most expensive. The failure to communicate properly potentially breeds fear, mistrust, divisiveness, unrealistic expectations, and ignorance among all involved in the practice. It takes all the problems a practice has and magnifies them. The end result is chaos and a workplace filled with stress.

To overcome this impediment and to achieve a greater cohesiveness between doctor and staff, the practice still must utilize and devise specific meetings, such as a monthly one-on-one with the doctor and a staff member, periodic staff meetings, and morning huddles. But the "icing on the cake" would be to institute the ultimate meeting - the quarterly Grand Huddle. The uniqueness of the Grand Huddle is quite simple. The staff members, as a team, are the featured "stars of the show." They are the driving force that produces the right tempo for a successful meeting.

The Grand Huddle meeting belongs in a category by itself. It is special because it plays a special role. Its most important function is to build good communication and to organize the infrastructure of the practice. It draws the people in the practice together, helps to educate them about the business aspects of the practice, and provides the doctor with the tools needed to lead, plan, organize, and control the practice and the staff. A Grand Huddle, run properly, should be sending clear, unambiguous messages. It should be encouraging communication at every level. It should be unifying people around common values and goals. The success of the entire practice depends on them. After staff members have experienced a few huddles, they will look forward to them. You must avoid boredom and make them fun.

Act like a business

For many years, doctors have been told that their practice is a business. What they haven`t grasped is the fact that they must now start to act like a business. A serious factor for success is that people have to see the effects of what they do or they won`t care. It doesn`t matter if the effects are good or bad. If you work every day, and nobody notices whether your progress is good, bad, or indifferent, you will stop caring about your job. Having a meeting like the Grand Huddle tells people (your staff) that you (the doctor) really care about them; that you want to know how and what they are doing. If you want your practice to be a business in action, you measure performance and you send this message out every quarter of the year.

To have better control of the practice dollars, it is absolutely imperative that the staff has a total picture of what is happening financially in the practice. You need to share the financial data with the staff. This is something that a lot of doctors are uncomfortable with. The main concern is the fear of the staff knowing how much the doctor makes. When you are open and honest with staff members, pay them well, and treat them well, they are not concerned about "how much money you are making." The attitude of "I don`t want them to know what I make" is childish, immature, and not good business sense.

Sharing the computer-generated data reinforces the value of staff knowing how well or how poorly their areas of responsibility in the practice are performing. Everyone`s activity is measured - even the doctor`s. There is no better way to give staff the feeling of "ownership." It is another great communication tool and a super motivator for staff, because it creates a feeling of being in on things.

The purpose of obtaining the practice "numbers" is to measure and analyze. They demonstrate very clearly:

Where you have been

(1) Where you are going

(2) How well you are doing getting there

Why numbers?

The doctor must know when to push, when to hug, when to cheer, when to boo, and when to kick people in the butt. That can be very difficult. It`s easy to get distracted, to blow little problems way out of proportion, and to miss the big ones. If you don`t have some means of maintaining perspective, you may run around like a raving maniac, sending the wrong signals. You may demoralize the team when you should be building it up. You may meddle when you should be standing back. So, you need something to guide you. That`s where the numbers come in.

The numbers tell you what`s really going on in the organization. They tell you who is doing well and who is in trouble, who is improving, and who is slowing down. A leader`s job is to be on top of the organization`s numbers. Systems make that job very easy. People produce the numbers and the numbers can be used to guide you. Using the numbers, you can spot trends emerging before they become crises. That allows you to take action while things are still going well. But while the numbers can tell you that something is wrong, they cannot provide the solution.

The modus operandi

You start the Grand Huddle at 9:00 a.m. in a comfortable environment away from the office with no threat of interruptions. The staff gathers around joking with one another and exchanging news. Everybody seems to be relaxed. But there is a certain buzz in the air, like the sound you hear in a theater before the lights go down and the curtain goes up. The meeting is about to begin.

The learning objective of this process is to see how well the practice is doing productively and profitably. You will review the practice progress by calculating the score from the numbers generated over the past three months. The businessperson is the one responsible to accumulate these "numbers" and is the overseer of the meeting. The reporting sheets for the meeting are generated from the software package, QuickBooks Pro 2000.

Staff members are given the latest numbers from their individual activities in the practice; i.e., clerical, clinical, and hygiene. They will then be responsible for reporting their numbers in the meeting. The whole idea is to match the numbers with the people who have the greatest control over them. They also are provided with numbers that relate to the total activities of the practice. For every entry in the income and production statements, there are numbers representing the most accurate, up-to-date assessment of each staff member`s participation over the last three months. Attach real people to every number and every line. When you go around the room, the numbers aren`t coming from "them" - you are hearing directly, for example, from Pam on scheduling, Susan on hygiene, and Irene about production.

After a brief introduction by the businessperson chairing the meeting, you start around the room and each staff member announces his/her numbers. There are "oohs" and "aahs" and good-natured digs. So every announcement provokes a response. There is bravado. There is daring. There is trepidation. Some people are confident, even bold. Others are a little bit nervous. Everybody is on stage, and nobody wants to let his or her colleagues down. You want to come in with a good number. People love to be heroes, but to be a hero here, you and your department have to perform well.

Everyone can see how the reported numbers differ from the ones in the "game plan" forecasted in December of the previous year. The new numbers are printed on one sheet. On another sheet, there is a tally with respect to how the practice is doing year-to-date (YTD). What makes it all possible is the communications system centered around the meeting. The process ensures that everyone always is able to follow the action, be up-to-date on all of the latest scores, in all of the areas in each segment of the practice - i.e., clerical, clinical, and hygiene. The meeting is the focal point for everything you do. It is where all of the numbers you generate come together, where they get added and subtracted and totaled up, so the staff can use them to do their jobs. It provides your staff members with the information they need to play their positions well.

Everyone is using the same tools: the financial statements and the practice monitors. So everyone is moving in the same direction. You are like a big team of Clydesdale horses, all in step, pulling the Anheuser Busch beer wagon. There are no mixed messages, just the results.

You touch on all of the financial aspects on the income statement - i.e., collections, dentistry presented, dentistry accepted, accounts receivable, are we on target for a bonus? etc. That`s always interesting. When you finish, you will know how you are doing on your pretax net profit goal. Meanwhile, the financial person for the practice is putting together a cash-flow statement, using the numbers announced during the meeting. Now, everyone can see how you are doing financially toward achieving your financial goals. The cash-flow statement shows you how much cash you have, how much you are generating (production), and where it is all going (overhead) ... all of which will help determine whether or not you hit your projected targets.

After the first go-around, you do another circuit around the room, giving your staff members time to report any news or other information they feel the group would want to hear. Push to get at the stories behind the numbers. The stories show where the numbers come from. They connect the numbers to real faces and real events. Get staff to relate those stories every chance you get, because it`s from the stories that people will learn. They should highlight the important points - i.e., new patients, doctor and hygiene production, cancellations, no shows, important milestones, individual accomplishments, whatever. This part of the meeting has the flavor of a town meeting, with each staff member getting up to tell a little bit about what`s happening in his or her work-related environment. Encourage the staff to vocalize personal anecdotes/stories of human interest. This is the fun part where there is much joking, commiserating, congratulating, and laughing.

After your second pass around the room, you give out another scorecard, this one a blank cash-flow statement. The chairperson announces the numbers, and the staff fills them in. So now you have a reading on both the quantitative and financial goals. In the initial handout that was distributed, it showed where you stood as of the last meeting and what you would have to do to hit your targets if perchance you had fallen short of the projected goals. The objective is to avoid any agonizing near misses in the future. Now close the meeting after the summary of the results is presented.

The reward

As with any meeting, however, the real payoff comes from what happens after the Grand Huddle. When you come out of the meeting, doctor and staff can see the whole picture before them. They know who is where and how the picture is unfolding and what each team member has to do to make sure we keep moving in the right direction to achieve our goals. The total team is linked up to the Big Picture.

The meeting is just one link in a chain of communication that is constantly moving information up and down through the practice. Within an hour or two, virtually everybody has the latest information about where they stand and what they have to do to keep improving. Staff members use that knowledge in their individual jobs. They, too, can now see the whole field. They know what it will take to close in on and earn a bonus. They accept the responsibility to perform well. How they do this is up to them. The team is working together to make those fractional improvements that determine whether or not we succeed as a business.

What they do is apply the information gleaned from the Grand Huddle to the nitty-gritty circumstances of their jobs. Maybe cash is tight, so they cut back on expenses and are more careful with supplies ... maybe they have to control more overhead to get into the next payout level on the profit goal ... maybe they put off their housekeeping or administrative chores and focus on raising fees. Whatever the situation, they do what they must do to improve the score, using the standards as a guide. Meanwhile, the doctor can act as a coach or a facilitator, if asked, to assist the players in enhancing the areas that need improvement.

Write it down

Insist that everyone have a three-hole notebook binder. Have them insert all of the "numbers" handout sheets in it. Next, have staff write down all the points of interest addressed during the meeting. When you get them to write the information down, you teach. Education comes by repetition. It`s like learning the multiplication tables. This is actually an important step in the whole communication and educational process. You want to be sure that we are really teaching people what they need to know; that we are taking ignorance out of the workplace; that we are educating people to understand what needs to be done. I recommend that you give a prize for the best-recorded notes.

If you are interested in obtaining any forms pertaining to the Grand Huddle, our bonus system, or the use of QuickBooks Pro 2000, contact me by e-mail at [email protected].

Summarizing the steps

It`s important to have staff assume responsibility for their performance. When team members report especially good numbers, cheer along with everyone else. When a bad number is reported, stop and get an explanation. If the hygienist reports bad news on hygiene, ask if she needs help.

Good or bad, you want to hear the stories behind the numbers. There are messages contained in the numbers. Never lose the personal connection. Support each other. When one person is down, someone else steps in and picks him or her up.

By the time you finish, certain themes will have emerged. You can see where you are weak and where you are strong ... what areas you have done well in and where you must improve to hit your targets.

Never forget: what happens after the Huddle is more important than what happens in it. The whole exercise is a big waste of time if the information stays with the people in the room. Effective Grand Huddle meetings will:

- produce superior communication

- motivate staff

- increase practice productivity

- increase profitability

Now for the doctor: Be a leader, not a boss. Be careful to avoid the trap of being the person with all of the answers. During the meeting, the doctor occupies a seat in the rear of the room. The only participation is a two-minute summary (maximum of three minutes) of what he or she heard. For the conclusion of the meeting, end on a warm, friendly note. Thank people for their participation ... and then break bread together.

For more information about this article, contact Dr. Doherty at (800) 544-9653. A biography of the author appears on page 12.

Tips for Successful Grand Huddles

- Gather data to be used at the meeting with a QuickBooks Pro 2000 software program.

- Start the meeting with a few brief comments designed to set the tone and establish a theme.

- Develop some sort of system to draw people into the action.

- Ask people for their ideas.

- Develop a language and a style where everyone feels comfortable.

- Hold the huddle quarterly.

- Keep the meeting regular (same day, same time, same place).

- Insist that everyone be there on time.

- Have FUN - don`t be boring.

- Keep the pace fast.

- Make sure the content is interesting.

- Meetings should last about an hour-and-a-half.

- Encourage people; don`t beat on them.

- Be a leader, not a boss.

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