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There is one overriding constant in practices that struggle: Lack of consequences. If you are new to our blog, we are beginning a series of articles concerning action steps to salvage the last quarter of 2015, while staging an exceptional start to 2016. Each step needs to become a foundational principle in leadership, systems, and protocols. Last week I asked you to take about 90 minutes and be introspective about goal setting and creating a ten-year vision for your life and practice. This is the second step, but I warn you that you must go back and take the time to actually stage these action steps with the fundamental tools we gave you last week. Skipping any step just reinforces the habits you developed in the past and guarantees that you will once again fall short. There are no short cuts, and persistence will rule the day.

There is a relationship that forms and a culture that develops in every practice. If you have read The Super General Dental Practice, you understand that great practices are built on the principles of Purpose Driven, Doctor Led, Staff Owned foundational principles. Too often I have doctors bring me what they call “problems”: Too high accounts receivable, too few new patients and direct referrals, a too high overhead and low production. Each of these so-called “problems” are actually “symptoms”. Too high accounts receivable is the symptom of poor financial arrangements. Too few new patients and direct referrals is the result of poor “consumerism” with a result that patients don’t like you. Poor production and high overheads are caused by lack of budgeting, and systems to stage case acceptance. The trick in taking a practice to the next level is to identify the actual problem rather than obsessing about the symptoms.

One of the most divisive symptoms that compromise even good practices is not creating a very black and white set of rules and consequences when it comes to staff and the leadership and management culture you are trying to ingrain in your team. Today, we are going to begin a journey at reversing this disastrous trend in most of the offices I have visited.

The first step is to have a comprehensive policy manual that is specific for the HR laws and statutes for your particular state. A firm that specializes in HR law and continues to monitor the courts and changes in laws to continually update the crucial document must craft this manual. A great policy manual minimizes the chance of litigation and misunderstandings, while creating a remedy for any and all current and future challenges to staff management and business protocol. For over a decade I have recommended that each and every client consider contacting CEDR Solutions ( to craft your policy manuals. A properly constructed policy manual will create a black and white foundation of truth for both employer and employees to create a specific standard and culture to operate and build other systems upon.

Once you have a policy manual, the next step is to create job descriptions for every position in the office to insure that each and every employee understands your expectations and precisely what their job entails. These job descriptions will be added to your policy manual and HR files. I would say that if I had a doctor and an assistant in front of me now, and asked each to write a job description for the assistant without any collaboration, the two descriptions wouldn’t even appear to be the same person. Now imagine working every day with some imaginary idea of what your assistant should be doing and finding yourself getting upset because she failed to actually do what you thought she should be doing. On the other hand, imagine being that assistant who is constantly fearful because she thinks her boss is crazy because he/she gets mad about things that aren’t really her fault or her job as she understands it. Creating these job descriptions is paramount in beginning to take back control of your office and vision of how you would like it to operate. By collaborating with each staff member and being able to modify the job descriptions, you have in effect hit a redo button that will reset the expectations and culture for the office. Having completely reinforced and consistently reinvented each job description, you have the foundation for creating consequences for poor behavior and failed performance. If you just follow each team member’s performance while using planned follow-up conversations, you will weed out underperforming staff while reinforcing and recognizing the work of great team members. You need to understand that you will never go any farther than the one staff member with the lowest commitment to your vision and culture. There are only two types of staff members: The ones that need a little more attention and training and the ones that need to have their future freed up. Without consequences you are allowing staff to do whatever they want, act any way they want, and reap poor results. There needs to be a standard of employment in every business. I feel like if you follow these steps and each staff member understands what the policies of your practice are, understand and embrace the job descriptions that the two of you completed, and you are measuring their performance, there will never be a misunderstanding about where each of you stand. If someone fails to follow through and perform their duties as outlined, you can assume that they are asking you to let them leave. Don’t hesitate. This is how you Summit.

Go to this link to see examples of a few well-written job descriptions that you can use to get started. You need only add to or subtract responsibilities based on each staff person’s position and your desire for him or her to perform each job in a certain way.

Mike Abernathy, DDS
[email protected]
972-523-4660 cell