The nine faces of an effective dental leader

The partners in Breathe Business have worked with approximately 750 dental practices in the last 11 years and we have trained, consulted and coached them in the implementation of eight key strategies to produce ‘more profit in less time’.

Quantative results are an average 25% increase in bottom-line profits in 20% fewer working hours for the whole team (whilst maintaining clinical and customer-care standards). Qualitative results include happier principals, team members, patients, suppliers – and maybe even bank managers!

Previously, I have written articles on team-building in dental practice – I now want to expand on this theme by looking at leadership as distinct from management – focused on the role of the principal, but equally relevant to practice managers and, for that matter, all team members.

Firstly, I would like to offer a distinction that has really hit home to me this year.

Managers manage systems – and good managers create, measure, maintain, adapt and improve on effective systems that allow a business to run smoothly and respond quickly to change.

Leaders lead people – and good leaders share their vision, listen to their teams, let go of control and lead by example.

After reading The 8th Habit by Stephen Covey earlier this year, I realised that much of what we do in Breathe Business is all about systems – and that I haven’t spent enough time with my clients on their understanding and implementation of leadership – in fact I haven’t exactly been a great leader myself.

Discovering leadership has been a voyage of discovery, reading further books on the subject, observing myself and my clients, discussing with people I regard as ‘good leaders’ what makes them tick – and beginning to reach some conclusions.

What follows are my initial thoughts and the contributions of some of my clients in dentistry.

The Management/Leadership Matrix

As always, a matrix is a revealing way of measuring the effects that different combinations of performance (management) and behaviour (leadership) have on the principal and their teams (You can obtain a copy of a PowerPoint slide if you email me at [email protected])

1. Good manager, good leader = a team that feel inspired and fulfilled in their professional lives

2. Good manager, poor leader = a team that feel dominated by an impersonal boss who wants the business to run like a machine but doesn’t care about the people

3. Good leader, poor manager = a team that love the adrenalin rush in short doses but recognise that man cannot live by adrenalin alone – and eventually they tire and die

4. Poor leader, poor manager = stressed out people looking for another job.

Do you recognise yourself in any of those quadrants? So what must be done?

1. Leadership by direction – in our dental workshops I often ask team members to share with me their knowledge of the principal’s three-year vision, 12-month plan, 90-day goals and monthly tasks. You can imagine the blank faces I see and I have developed an interesting metaphor – as to whether the team can be likened to slaves on a Roman galley (down in the dark – just keep rowing) or warriors on a Viking long boat (with equal status and a clear knowledge of their objectives). Leaders know where they are going and take the time to communicate that to their team, remind them on a regular basis, demonstrate ‘what’s in it for them’ and inform them of the regular course corrections that have to take place in a small business.

2. Leadership by example – it’s no wonder that I have seen staffroom doors in dental practices with the sign ‘backstage’ on them. These enlightened leaders are sending a message to their teams that the opposite of ‘backstage’ is ‘onstage’ and that when we are ‘onstage’ we have to suppress our personal feelings and deliver the show to the audience. The same responsibility applies to the leader of the business. If you are miserable, depressed, stressed, angry – any negative emotions – then do not wear them on your sleeve in front of the team – because your mood sets the tone for the whole practice and gives permission for others to copy. Yes, there is a time and a place for the authentic expression of feelings – but that is not ‘onstage’ and during the performance – it’s in rehearsal. Let’s not forget the word ‘integrity’ in this context – your team will be watching you all the time and if your actions are out of integrity at any time, they will lose faith in you.

3. Leadership by listening – your team members (all them) know more about your business than you do. Do you plan time to hear what they have to say? Especially in dentistry, you are locked in a surgery most of your professional life. Profit doesn’t pour out of a business, it often leaks through the cracks – cracks that you will never notice. When my former business manager, Barbara Trotter, joined me in early 2004, she was able to identify a small change in our systems that generated an increase in profit that was higher than her annual salary – and yet the clients didn’t mind and I hadn’t noticed. Do you listen to what your team have to tell you about your systems – and listen to what they have to say about your behaviour?

4. Leadership by removing tolerations – the classic example is the affluent patient who is rude and disrespectful, not to you as owner of the business but to your team members. When you challenge that patient, they will either change their behaviour towards your team or they will leave the practice. Either way, you will be a hero. Conversely, if you support a rude patient and vote with them (and their chequebook) rather than with your team, you will undo all the training that has been bought in an instant. Have you removed tolerations around suppliers, patients, other team members and the physical facilities?

5. Leadership by genuine appreciation – I work for the money and the money is good – but at the end of a training day or the end of a busy week, one client who thanks me for ‘the difference you have made’ is worth more than the money. People just love to genuinely appreciate. Do you spontaneously say ‘thank you’ for a job well done and is there a standard of mutual courtesy in your business at all times?

6. Leadership by training, consulting and coaching – training is showing people how to do things, consultancy is showing them how to apply the training to their own circumstances, coaching combines a shoulder to cry on with accountability. Do you have robust training systems and protocols so that people can find out how to do their job properly? Do you have ongoing supervision so that they can get better – and do you create an environment in which they can regularly check on their own progress?

7. Leadership by extreme self-care – if you are exhausted and unwell then the whole team will suffer. If they see you burning out they will become demoralised and fearful for their own job security. If they see you falling behind on attitude, skill or knowledge then they will slow down and coast – why shouldn’t they if you don’t seem to care. An effective leader looks after themselves physically, mentally and spiritually. Do you take enough time off? Do you enjoy a balance between your professional and personal life?

8. Leadership by inspiration – good leaders are those who inspire one to commit to something greater than one’s self. In doing so, leaders ask people to take advantage of their own skills and abilities, and to stretch and grow. Within my own client-base, I have witnessed examples of dentists creating environments where their people become very motivated and inspired to live life more fully. Leadership is about providing real hope for the future.

9. Leadership by innovation – dentistry is in a state of constant change both clinically and operationally, so the ability to research and respond to those changes will further inspire your team that they are working with a real pioneer in the profession. Conversely, an attachment to outdated methods and ‘machinery’ in your practice demonstrates a lack of enthusiasm for the future.

In June 2006, we held our first ever Leadership Intensive, inviting clients to invest two days in discussing their challenges around leadership and suggesting solutions. A total of 19 guests attended, including principals, their spouses and some practice managers.

The track we were to run on was only vaguely defined before the event began as we were enrolling our guests as an R&D team on the subject of leadership. As things turned out, we followed the steps outlined here:

• The Discomfort Zone – why it is necessary to face uncomfortable truths about ourselves before we can learn

• The finish line – what has to be achieved for each guest by the end of the Intensive

• The 15-minute life story – personal introductions by the guests

• The Management/Leadership matrix – a description of the points made in this article (originally written a year earlier)

• Which quadrant are you in? – personal identification by each guest of which quadrant they occupied

• Leadership Evolution – the journey around the Matrix – following dental principals as they journey from one quadrant of the matrix to another

• Distinction between M & L – the distinctions between management and leadership

• Unique ability – identifying each guest’s ‘great work’

• What’s in the way? – identifying what is ‘getting in the way’

• How to control your mood – controlling emotions

• How to delegate – effective delegation

On Day Two we began to construct a list of the characteristics that would have to be displayed by a truly great leader – the PowerPoint slides are also available if you email me.

Chris Barrow

E: [email protected]

M: 07713 644437



Chris Barrow will be speaking along with Iain Scott and James Goolnik at Marketing essentials for a more profitable practice on Friday 12 September 2008 at the Royal College of Physicians, London. Please call Independent Seminars on 0800 371652 or visit for further information and to book your places.

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