LEADERSHIP and MANAGEMENT
I will continue to paint a word picture of active leadership in your practice. It is not enough to just read each aspect of the 180 Degree Dental Journey; you must apply what you read. There is no learning without application. If you made it this far, or started out of sequence or this is the first time you are reading a chapter of this journey, stop and go back and read each step in the order they were written. Picking and choosing is not a wise strategy towards success. Take the easy with the difficult and act. Commit to taking actions, and don’t delay. We are taking a deeper dive into separating management from leadership. Certainly, there are crossovers and vague boundaries, but each and every one of you need stronger leadership. Competence increases confidence. Reading and applying these aspects of the 180 Degree Journey require commitment on your part as well as sharing this information and encouraging each team member to participate in this journey. You will not make this alone. Don’t wait for months to do the right thing. Make this journey a part of your staff meetings and overall vision and goal planning.
Of all the principles of building a great business, leadership is number one. I seem to run into a lot of doctors who would say that they are pretty good leaders. The problem is that when I look at their results and numbers, I don’t see that they are very effective. If you think you are a leader you must have followers. Can’t have one without the other. If you just have a group of people who work together, rather than a team, you are not a leader. If you find that you constantly micro-manage, you’re are not a leader. If there is no leader in the office, where will you end up? Not where you wanted to go. I would like to give you a series of rules of leadership that are short but profound in their truth and ability to drastically reshape your results.
Number 1: Whatever you allow, you encourage. This is one of my favorite quotes about leadership as it relates to a dental practice. Let’s take a minute and talk about leadership. This is what separates winners from losers in this business.
Ever wondered why your staff don’t seem to do what you want and need them to do? Actually, we’ve all been here at some point. Leadership is all about influence and inspiration. It’s showing people by your actions what’s important to be successful in your dental office. People can’t listen to what you say because your actions speak so much louder than your words. 89% of people are visual learners and if you are struggling in your business, you are modeling the wrong behavior.
If customer service is supposed to be important at your office, but you complain about a patient in front of your team, or don’t get back to clients quickly, what have you just done? You have just shown your team that customer service really isn’t that important at your office. When you don’t take the time to share good news and bad with your team, or you don’t recognize an incredible new patient that one of your staff just referred, what have you just done? You have just shown that communication and your staff really aren’t that important in your dental practice.
Too many of us are constantly searching for new, great ideas with which to improve our practices, and attract new patients. We think new software will save the day, or a new piece of equipment will enable us to make a ton of money. Yes, they can make a difference and they are important, but success in your small businesses is rooted in your people and your leadership.
The behaviors you don’t want to permeate your organization need to be addressed and eliminated from your culture. If you want to win in dentistry, you need good communication, a culture of accountability, and good leadership. Let me make a suggestion to you: Go buy John C. Maxwell’s The 21 Irrefutable Laws of Leadership and read it.
The first law, and my favorite, is the Law of the Lid. Your leadership is like a lid or a ceiling on your organization. Your dental team cannot rise beyond your ability to lead. People often think if they just work hard, they’ll find success. Yes, you may find a little success, but the rest of the people on your team will not. The key is to develop others around you to take the lead. This is what allowed some to the best dental practices in the US to get where they are today. They are complete practices made of owners who lead themselves.
We all would be well served to pay very close attention to our actions more so than to our words. I firmly believe that a leader shows what’s important to them by what they do, more so than by what they say. If you want your career to be a success, I think you need to focus on leadership in three specific areas.
Production: We must have dental patients and treatment to make a dental practice work. What are you going to do to get things headed in the right direction? Are you finally going to be open consumer hours, not Monday, Tuesday, Wednesday, and Thursday from 8 to 5? Are you going to look at the competition and demographics of your area to modify your marketing? What about bringing in a partner or another hygienist? Will you do whatever it takes to increase your production?
Customer Satisfaction: How many clients are you going to inspire to increase direct new patient referrals? What investments are you going to make in order to help your team offer better customer service? Are you going to be known as the best office in town? Communicate the goal, hold people accountable to those goals and lead the way.
Profitability: What costs are you going to cut? Is this the year you implement all of the 180 Degree Dental Journey strategies for overhead control? Will this be the year that you take home a 25% raise because you lowered your overhead below 60%? Communicate the goal, hold people accountable to those and lead the way.
Leadership is what separates winners from losers. I told a friend recently that whatever he allows, he encourages. He responded: “You deserve what you tolerate.” I love that. What are you allowing and encouraging in your office? This year communicate the goal, hold people accountable to those goals and lead the way. Take it from Captain Obvious, that’s what leadership is all about and this is how you Summit.
Number 2: You are the reason. In this second rule of leadership tips and traits that everyone has forgotten but knows are true, we reach the point/counter point that each of us face. You are the number one reason the practice does well and the number one reason the practice struggles. As obvious as this appears to me, I see most doctors pointing the finger at others for their lack of success. Leaders are accountable for their actions as well as for their offices’ performance regardless of the noise and confusion that surrounds them every day. There seems to be a “rhetoric-reality gap” in almost every office I have visited: A direct contradiction between words and actions. Actions rather than words provide meaning to your staff and your offices performance. Everything that you, the leader, does, should model the actions you want to get from your staff. Your staff is watching and taking their cue from you. They will act as you act, do as you do, speak as you speak. I think all of us could be better examples for our team.
If you find yourself frustrated with the performance of others in your office, there is a good chance that you are the problem. Before you start making changes in others, take a close look at yourself. If you ask the question, “Who first?”, the answer will always be YOU. By omission or commission, you are responsible for everything that happens in your office. You hired your team preemptively with a plan or from desperation, trained or did not train them, paid them well or poorly, took the time to on-board them or you didn’t. Is it any surprise that you don’t get what you want? Life, and business, tends to give us what we deserve, not what we want. If you want more you have to be more. Poor modeling and actions, as well as micro-managing every aspect of your practice points to an absence of acute self- awareness and leadership. As Clint Eastwood would say: “A man has got to know his limitations”. Good practices can be managed, but great practices must be led. Managed practices will always end up being average and no one needs another average practice. The obvious part is that you are the number one reason for the office doing well and the number one reason it struggles. Let’s dedicate our actions to being part of the solution rather than part of the problem. Once you lose your excuses, you will find your results. If these rules are not resonating with you or they are not obvious, you too may struggle with leadership.
Number 3: You must precede your practice to the next level of production. If you want more, you have to do more. Another level of practice is always preceded by the next level of commitment. This new commitment is called “inspired leadership”.
For the life of me, I cannot figure out how to get struggling doctors off of top dead center sometimes. The facts don’t lie and the path is clear, yet few of these doctors actually see it. For the most part, we have to inspire the staff with very little help from the dentist/leader, and create systems that compensate for the doctor’s lack of commitment and engagement. It is as if we must create an alternate universe for the staff and practice to compensate for the limiting beliefs, lack of taking action, and mind trash from the doctor. While that can be effective, it will only last as long as these doctors have the pressure of accountability from a mentor or coach. Our hope is that if we can reveal the truth of success long enough, it will become habit for the needed culture to prevail in the practice. With that said, far too often when we leave the practice and slowly over years, it begins a slow death spiral back to the lower levels that were there before we showed up. It is as if the doctor’s limiting beliefs of what he/she thinks they deserve, causes them to self-sabotage all the good work and high-level systems that we helped implement.
So, where do we get this inspired leadership that will sustain change for the good? With “change” as your new mantra and new goals as your guide, make sure that any improvements in your practice begin with you. You need to look into the mirror of results and clearly judge where you are and where you want to go. Some of us find dentistry so smothering that we would rather do anything else but step up and own our performance.
While you are looking in the mirror and seeing the real you, what would your staff say about your performance and leadership abilities? Could you handle the truth? Once you heard the truth, could you do what great leaders do and start the change process with yourself? This is a tough pill to swallow, but a necessary step in becoming an effective leader. Notice I did not say great. Great is not what you should seek. Effective is good enough. It’s better than good enough. Just arriving at the point where you know what your own limitations are and acting to hire staff and design systems to compensate for those shortcomings in your ability to lead will create unlimited success. I am going to suggest a bold step that only a few have the courage to take. I have included a review process for you, the owner doctor, at the end of the text.
Take a copy for yourself and fill it out before they return their copies. It is important for you to evaluate yourself before others do. Be honest and use your copy to compare to a collated summary from the rest of the staff.
Have your office manager or a staff member that the others feel is trustworthy tabulate the scores and present them to you.
Finally, pass out the final tabulation to all the staff at a meeting and openly discuss where you fell short and what you are willing to do in order to improve the scores.
I would post the final tabulation in the staff area for all to see and show them that you have a new commitment to action. They need to see you “try” to improve.
NOTE: I highly recommend that you get a copy of Patrick Lencioni’s book: The Five Dysfunctions of a Team, and read it cover to cover before embarking on this leadership strategy. It is important that you understand what a team is and how a great team should function. Once the dust settles and you have begun to work on your list, have a staff meeting and explain the Five Dysfunctions of a Team to the entire staff. You will be amazed at the inspired attitude of the staff, their desire to improve, and their openness to change. Welcome to a do over button for leadership. This is how you Summit on the road to the 180 Degree Dental Journey.
Number 4: Management vs Leadership myths, mistakes, and miscalculations. The final rule of leadership is that owners who do not have people following them are not leaders. Kind of “duh” statement in a Captain Obvious fashion, but one overlooked by almost ever doctor I talk to. The symptom would be a “group” of people working together rather than a “team”. These doctors feel they need to micro-manage every aspect of their practice because there are just no good employees where they live. You are always creating a carrot and stick scenario where you can get staff to comply but not willingly. We are coming full circle again: You are the number one reason your office does well and the number one reason it struggles. It comes down to the difference between management and leadership. Your goal as the leader is to transform your staff by leading in a manner that inspires others to follow.
On the other hand, doctors that have learned to lead find that their first job is to define what is core in their offices. It is vision driven. We must understand that without a strong and clear vision, there is no way to assemble a team of like-minded employees. These same doctors embrace change, rather than hoping the current dental economy will return to the way it used to be. As that gifted leader, you must model the values and performance you expect in others. This is the only way for you to create the culture that will perpetuate the vision of the practice you always thought you would have. In this ideal culture, there are goals, accountability, and consequences. You ultimately empower your team through culture and results that yield teamwork based on the commitment to the vision.
Great teams are the result of the ultimate goal of leadership. These teams are committed to the desired results driven by your culture and vision. This is a far cry from just having them comply to your rules and regulations. The miracle of transformational leadership is there is no need to manage your staff. They become self-policing and internally motivated. Instead, you can focus on managing the process, not the people. Great processes that are understandable, scalable, repeatable, and adaptable regardless of the situation or economy, ensure your consistent growth and long-term retention of employees. You, the doctor and leader, become part of the team. You and those you lead finally find that partnering with one another solves a plethora of challenges. These descriptions of transformational leadership are what you have always been looking for. In The Super General Dental Practice, you will find it in our moto and way of life: Purpose driven, Doctor led, Staff owned. These chapters will change your perspective and add rocket fuel to your growth. Please go to www.supergeneralpractice.com and get your free copy and go back and start at the beginning of our journey. The 180 Degree Journey continues next week.
Michael Abernathy, DDS
PS. If you would like to receive a pdf document of what follows, just let us know.
Performance Appraisal Form for Doctor __________________
In the following sections, circle the number for the rating definition that best describes the doctor’s performance.
Quality Of Clinical Work
- Makes frequent errors; frequently produces clinical work that must be redone.
- Produces clinical work that is passable, although quality needs improvement.
- Quality of clinical work is good. Makes few mistakes.
- Clinical work is very functional and aesthetic. It makes me proud to work for this dentist.
- Clinical work has a high degree of functionality and aesthetics on all work produced. I can enthusiastically recommend my dentist.
Quantity Of Work
- Very slow. Seldom completes treatment in required appointment time.
- Requires constant prompting from team in order to complete treatment within appointment time.
- On time record is satisfactory. Most patients are seen on time.
- Very good time manager. Stays on schedule on all appointments.
- Superior time manager. Frequently completes appointments ahead of schedule and has time to see emergency patients without making others late.
- Frequently rude or blunt.
- Only talks to patient about the doctor’s own interest.
- Talks to the patient too long, making the whole team run late.
- Consistently very good with patients and seldom runs behind. Leaves patients with a good feeling towards the office.
- Extremely skilled in dealing with people. Goes out of the way to be helpful and courteous, but never runs behind.
Ability To Present Cases
- Consistently talks over the patient’s head and fails to prioritize needed treatment.
- Consistently talks over the patient’s head but attempts to prioritize needed treatment.
- Explains case in laymen’s terms, but fails to prioritize needed treatment.
- Explains case in laymen’s terms, generally prioritizes needed treatment and sometimes emphasizes the most important next step.
- Clearly explains case in laymen’s terms, always prioritizes needed treatment and clearly identifies the most important next step.
Ability To Motivate Case Acceptance
- Fails to create any sense of urgency for needed treatment.
- Creates an inappropriately strong sense of urgency for needed treatment by emphasizing unlikely consequences of refusing or postponing treatment. Patients feel pushed into treatment.
- Attempts to create an appropriate sense of urgency but fails to explain consequences of refusing or postponing treatment. Patients do not understand why treatment is needed now.
- Attempts to create an appropriate sense of urgency and explains the likely consequences of refusing or postponing treatment to most patients. Patients understand reason for urgency.
- Effectively creates an appropriate sense of urgency and explains the likely consequences of refusing or postponing treatment to all patients. Patients are motivated to book treatment.
Ability To Train Team Members
- No training is provided. Team members must sink or swim.
- Minimum training is provided, but instructions are unclear. Feedback is negative or never offered.
- Minimum training is provided and instructions are clear. Minimum constructive feedback is offered.
- Adequate training is provided and instructions are clear, however feedback is negative or never offered.
- Adequate training is provided, instructions are clear and feedback is constructive.
- Poor attitude. Unfriendly and uncooperative in contacts with team members.
- Usually cooperative. May occasionally have problems in this area.
- Works well with team. Gives constructive directions and takes direction from team as well. Cooperative.
- Alert to needs of team members and is willing to provide assistance. Doctor is quick to respond in a constructive manner.
- Goes out of the way to be cooperative, gives constructive directions and provides assistance. Works exceptionally well with team.
Ability To Show Appreciation
- Never expresses appreciation of team or individuals.
- Expresses appreciation to the same favored individuals, while ignoring the contributions of others.
- Offers words of appreciation after the team has begged for them. They come across as too little, too late.
- Occasionally remembers to offer appreciation in a timely fashion.
- Offering appreciation is a top priority with our dentist. He/She looks for opportunities to give us encouragement.
Willingness To Support The Team Bonus System
- Uncommitted and unsupportive of producing at bonus levels.
- Gives lip service to the bonus system, but allows untouchable team members to restrict bonus opportunities.
- Committed to making the bonus system work, but inconsistent in personal support, i.e. underdiagnoses, schedules time out of the office at the last minute or fails to attend morning huddles.
- Committed to making the bonus system work for now, but unwilling to hire team members (including hygienists and doctors) who can help take this practice to the next level.
- Committed to making the bonus system work by consistently improving personal performance, encouraging team improvements and facilitating clinical and business processes that influence the team’s success in reaching their goal. Always looking for ways to expand the practice production to ensure continued raises in the bonus.
Willingness To Lead
- Avoids leadership role and is disengaged from the team.
- Dictates every decision and discourages input from the team.
- Easily swayed by uncommitted team members and ends up doing all of the work himself/herself.
- Attempts to lead the team and invite their input; however when an issue incites a confrontation he/she avoids it and never resolves it.
- Inspires the team to follow their lead and actively solicits the team’s input. Appropriately delegates work. Resolves confrontations in a way that respects human dignity and keeps the practice on course to reach its goals.
Attendance & Punctuality
- Often late or absent.
- Seldom late or absent.
- Very dependable. Comments:___________________________________________________________________________________________________________________________________________
Ability To Accept Change For Practice Improvement
- Flatly refuses to listen to all suggestions for improving the practice.
- Accepts every change that blows on the wind.
- Listens to recommendations, but always finds a reason why new ideas will not work.
- Afraid of change generally, but listens to ideas and tries some of them.
- Recognizes a need for change and can identify appropriate options for your unique practice. Embraces and implements change in an appropriate time frame.
Ability To Follow Through On Change
- Once changes are accepted, nothing ever gets done.
- Goals are set, but plans for accomplishment are not made.
- Goals are set, plans are made, but target dates are not set.
- Goals are set, plans are made, target dates are set, but evaluations of results are not done.
- Goals are set, plans are made, target dates are set and results are evaluated for effectiveness.
Ability To Ensure Practice Growth
- Drives patients away from the practice.
- Drives employees away from the practice.
- Content with practice and income level. Wants to maintain status quo.
- Sees the need for practice growth and open to suggestions for it.
- Actively seeks ways to grow the practice in order to annually increase personal, team and practice income.
- Often fails to finish business projects that they start.
- Stays busy doing activities, but seldom delivers results
- Consistently delivers results, but doesn’t care how they get them.
- Focuses their efforts on delivering results, not just staying busy.
- Consistently delivers results in a way that inspires trust.
- Doesn’t think about concerns of the practice outside of the challenges in the his/her own job area.
- Operates from a belief in scarcity. Doctor believes there is a limited amount of opportunities and credit, so he/she actively competes for his/her share.
- Operates in a way that makes people question if he/she has the best interest of others in mind.
- Operates in a way that clearly demonstrates he/she has the best interest of others in mind.
- Operates from a belief in abundance. He/She believes there are enough opportunities and credit for everyone to share. He/she seeks win/win solutions for everyone.
- Never acknowledges he/she is wrong. Justifies misrepresenting people and situations.
- Spins the truth to get the results they want.
- Sometimes there is not a match between what he/she says and does because he/she lacks the courage to stand up for what he/she believes.
- Clear on his/her values and stands up for them.
- Thoroughly honest in all interactions. Admits mistakes, and consistently honors commitments that he/she makes to himself/herself and others.
List three essential things that the doctor is doing well:
List three essential things in need of improvement:
Run off enough copies for everyone (or send them digitally) and have them answer the questions anonymously. Make sure that there is no way that you will be able to know who filled out each questionnaire.