Can you help me?

small jugglerJuggling too many responsibilities? Larry M Guzzardo discusses how to be an effective leader and teaching your staff how to resolve their own problems

As a dentist, most of your day is spent treating patients. Because now you are a business owner, manager and leader, gone are the days where you can do whatever you please. Often when an individual graduates from dental school, an explosion of emotion accompanies it. Along with that come some behaviour changes that can make them wonder why they ever wanted to be in private practice in the first place. For some this responsibility has been exactly what you have worked so hard for since starting dental school. For others, however, the reality of being a good business owner, manager, and leader is more overwhelming than they ever anticipated. Because of this many dentists find themselves very ineffective leaders.

A client I consulted with recently is one of these frustrated leaders. A talented dentist, he had a team of five staff members, who were energetic, creative, and professional.

His biggest challenge, and one affecting many dentists, is that he did not spend enough ‘one-on-one’ time with his staff. Eventually the staff became bogged down reacting to problems and just trying to get through each day. He did not realise how difficult it was for the staff to solve their own problems. When just a little planning beforehand could have prevented the problem in the first place. You see, this dentist was known for telling his staff, ‘Don’t bring me problems, I want solutions!’ What he did not realise is that for staff that did not have the skills to solve their problems, his approach just turned them off. The staff became reluctant to go to him for help. The situation spiralled downward to where his staff would make decisions without his input and often made decisions that negatively affected his patients and practice.

Educating the team

As a consultant, I spend a great deal of time analysing the leadership stumbling blocks like the one faced by this dentist. Often it comes down to re-educating the dentist about his role on the team. It is true, a dentist has distinct and important responsibilities in treating patients, but his primary responsibility is leading his team. Anything that is done to stifle the team’s development is a barrier to accomplishing his goals. In short, if the staff does not perform well, the practice will not do well either.

The environment, or culture of the office, which is created by the dentist is going to be the biggest determining factor of whether the staff will feel a sense of accountability to solve the problems they face everyday or just learn to cope with them. This in turn discourages loyalty, creates apathy, and causes job dissatisfaction. Especially for new staff members and the dentist, the first 30 days are critical.

During the initial stages of their employment the following objections must be achieved:

• The new staff member must fully understand their area of responsibility. The dentist must properly communicate what the new staff member’s specific job duties will be when the job is offered.

• Formally train the new staff member on the standards of your office. Keep the new staff member from feeling as if they have been ‘thrown off the dock in order to learn how to swim’. Effective training is not a cost, but rather a sound investment in building a healthy working relationship to base the future productivity of this individual.

• The new staff member cannot feel like an outsider. New staff must be provided with an orientation to the practice and their new job. Take time before the new staff member starts to discuss your philosophy of preventive care. Do not try to do this and see patients at the same time. Have them come in on a day you are not providing treatment. Review your mission and purpose. Be prepared for their first day by having their work area prepared and write a training schedule to review. Look as if you were expecting them. Give them time to meet individually with other staff members. This will allow them to discover similarities and bond with each other on their own terms.

Meet with the new staff member every day for the first two weeks to monitor their training progress and answer questions. This will teach them that they will be held accountable to you for the tasks they are responsible for in their job description.

• Develop respect for the practice. Be a role model. Put simply, respect for the practice comes from respect for the dentist. Just as new staff members need time to settle into the practice, long-term staff members need on-going attention too. Since I know time is limited, make your ‘face time’ with them as productive as possible. Conduct weekly departmental meetings. Yes, departmental meetings.  Your hygiene, clinical, and business office departments each need direction from you. These are not to be confused with general staff meetings where the entire team attends. Think of them this way. Departmental meetings are those where the agenda is specific to the department. Did you ever notice that the attention of the rest of the staff usually wonders out the window as the business office is going into great detail about all the account balances that need to be written off or is discussing their frustration when dealing with insurance companies.

The importance of meetings

How about when the dental assistants are quizzing the dentist about the number of drops of water to use in mixing cement and everyone else decides to use the toilet (and gets lost on the way back?). This is not to say that the whole staff should not be aware of these problems, it’s just that these details are better handled by each department speaking directly with the dentist at their own meeting. No one holds back participation because they feel as if they are taking up someone else’s time or talking about something that does not relate to anyone else.

General staff meetings where the entire staff attends are scheduled separately to conduct specific staff training, solve office problems, and make announcements. I recommend weekly departmental meetings with the business office and a rotating bi-weekly schedule for the clinical and hygiene departments. This is how I recommend you allocate your meeting time. Reserve one hour on the schedule each week. Use the first half-hour to meet with the business office and then rotate the second half-hour between the clinical and hygiene departments. When a department is not meeting with the dentist, the time can be used to maintain equipment, order supplies, or make business calls that require periods when you do not want to be disturbed.

Unfortunately, in my experience, I have found that poor leadership from the dentist causes most job dissatisfaction. Only a small portion of job dissatisfaction is caused by problems with the work environment or the work to be done. When I ask staff why they want to leave a practice or what they would change about their old jobs, many answers sound the same, ‘My boss didn’t recognise my potential’ or ‘the other practice where I used to work put too much emphasis on production and not enough time on providing me with direction.’

Regularly scheduled departmental meetings keep the appropriate staff informed and are the perfect opportunity for busy dentists to focus on one area at a time. To make these meetings pay off, it is important that the time is set in stone. Don’t allow anyone, either the dentist or staff, to schedule over them; otherwise the time will not be taken seriously. Nobody wins when the staff do not feel as if problems can be solved or small details worked out and they are not able to do their best everyday. It is also difficult for the dentist when there is an unresolved conflict because it has not been given the proper attention. The practice loses if the staff cannot do their best work when under stress. Staff members who attend departmental meetings with the dentist are less likely to misunderstand the direction they receive and more likely to readily accept additional responsibility in the future. This will actually create more time for everyone to concentrate on what really matters and that’s patient care.


Larry M Guzzardo has co-authored two books and conducts in-office practice management consultations exclusively for dentists to enhance trust, create organisation, increase profits, and to develop patient relationships that last.


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