Why (most) dentists are terrible leaders and what to do about iton 4th March 2019
Their pay gets your practice team to turn up for work, but to get the most out of them the principal dentist needs to offer a bit more, as Simon Hocken explains
Many of the problems that clients and would-be clients bring to us are to do with their frustrations at the behaviour of the people they employ and work alongside.
Many principals feel that because their team are paid fairly and are provided with a nice environment to work in, they should just do the job in the way they’ve been asked to and when necessary, shift up a gear and go the extra mile for the practice. I think these dentists are very naive. What they are really saying is that they want their team to work harder and go above and beyond in order to ensure the personal success of the practice owner.
I suggest that it’s possible that your employees and colleagues (to some extent) already resent your success and they are only likely to work harder or faster if there is something in it for them! People are messy and complex, have their own agendas and have plenty of choice these days about who they work for and where they earn their (modest) dental practice salaries…
The practice owners see it as simple. They want a practice that has:
• An effective and pro-active practice manager who will identify and fix operational problems without the practice owner having to get involved
• A charming and capable reception team
• Skilled and caring nurses who will work late without being asked
• Hygienists who are painless, well-educated, great communicators and capable of changing patients’ behaviours
• Loyal, hardworking, productive, skillful associate dentists, who work with the practice rather than against it and who are willing to follow practice protocols.
In short, a team of people who create more than the sum of their parts and on a daily basis; contribute and add to the practice rather than just take away from it.
However, very often what they get is a team who just about do enough. They move slowly, stopping often for a chat or gossip whilst checking their phones, disinterested, disloyal and clock-watching. Stuff doesn’t get done, the client journey is ragged, the practice barely compliant and patients sometimes left to take their pathology home with them or to find another practice.
So, why do most dental practice personnel have no real interest in going the extra mile for the practice?
In my experience, it’s because for most of their time at work, they are left to get on with things (until something goes wrong) and they rarely ever experience any practical (let alone inspirational) leadership. In the absence of this, they go to work for themselves not for the practice, which means apart from filling the day and finding a mate (70% of people find their partners at work) they go to work for the money. They see little evidence that the practice benefits anyone except the owner(s), and this is regularly confirmed by viewing the owner’s lifestyle in comparison with their own.
Not just the money
Okay, so going to work is not just about the money. Some people work for their love of the work; others work for personal and professional fulfilment. Some like to feel as if they are contributing to something larger than themselves. Some people have personal missions they accomplish through work they see as meaningful, whilst others truly love what they do or the clients they serve. Some like the camaraderie and interaction with customers and co-workers. Other people like to fill their time with activity. The bottom line, however, is that almost everyone works for money. Money pays the bills.
So how do you get your employees and clinicians to display all the qualities and behaviours of a joined up, synergistic team?
I’m not suggesting this is simple but there are two factors you have to get right before you can even get started in building such a team and they are: Give them something bigger than your success to work for and lead them towards this. Be the best payer in your town. Nail the money once and for all.
Let’s deal with the money first as it’s a lot simpler than becoming a great leader!
Be the best payer
A motivated and well-paid nurse or receptionist will be much more productive, possibly even doing the work of one and a half folk! The difference between paying well and paying like the rest of the practices in your town is likely to be as little as 2% on your fees or 2% of your practice gross.
Here’s an example. In a modest practice with four nurses and two receptionists, the wages for these people will be something like:
@ £11/hour x 37.5 X 52 = £21,450 X 6 people = £128,700/annum
If another £1 an hour makes you the best payer in your town:
@ £12/hour x 37.5 X 52 = £23,400 X 6 people = £140,400/annum
That’s an additional cost of £11,700/annum. The practice fees (or the practice gross) would have to go up by just 1.7% to pay £12/hour to your nurses and receptionists in a practice grossing £700,000/annum.
No one wants to work for £9 a UDA or 35% of gross fees after lab. Spend time with and mentor your associates so that they can gross more than £1,500/day, and then you can justifiably pay them 50% of their gross fees after lab.
Give your team something bigger than your success to work for and lead them towards this. People find it easy to raise money or donate their time for a cause they feel is worthwhile (like the county air ambulance or the local hospice). So, if your dental practice is about so much more than your success, your team will feel similarly able to go the extra mile for it. Your practice needs a cause, a reason why your team can be proud of where they work. Many practices I have worked with over the last 20 years have achieved extraordinary transformations for some of their patients, from rebuilding the mouths of those who have suffered trauma, to giving teenagers straight white teeth, to helping phobic patients visit a hygienist for the first time. I don’t think it’s overstating the case to say that a dental practice team can help change someone’s life – a cause worth working for? Of course!
So, here’s the important bit. Your team are not that interested in your success (unless they have some personal stake in it!) Your success is not enough to have them behave well and deliver remarkable customer service. Unless you can come up with something more interesting than that, they will run their own agenda, go to work for the money and leave as soon as something better comes along.
However, if they believe that the practice offers a remarkable and life-changing service to its patients (and you become successful as a result of this) they will support you. If you can give your team a better life by working in your practice rather than working somewhere else, then they will stay and contribute. Your team want a combination of: 1) having something to be proud of at work, and 2) being well paid.
Paradoxically, your practice is likely to be contributing more to the quality of life of your patients than you realise. Patients these days don’t come to your practice out of habit or duty (there is no longer any shortage of dentists in your area), they come because they believe that you and your team provide them with an important and useful service. If you don’t think your practice delivers this then maybe you should consider a change in career…
Try asking yourself these questions (and then ask them of your team):
• What or who is the practice for?
• What does it achieve for its patients?
• And how does it contribute to the local community?
• What can we be proud of?
• And what do we want to do more of?
The answers to these questions will start to create a practice mission (not a cheesy 1990s mission statement, but something that you and your team can rally around).
Once you have a cause or a mission you can rally your team around, you can start to step-up as a leader. Many years ago, my mentor taught me that, ‘People are longing to be led’. And I have always found that to be true. Your team are waiting for you to show up as a leader and the poor behaviours I described earlier are a result of the lack of your leadership (together with some basic recruitment mistakes!).
Of course, you have to start by being effective at leading yourself. You have to set standards for yourself and then meet them before you can expect your team to do the same.
Here are some of the more important behaviours you will need to display if you are going to lead your team and clinicians effectively:
• Be energetic and motivated yourself
• Go the extra mile/walk the talk (every time) and give your team your time
• Do what you say you are going to do
• Arrive early and go home late
• Give them a bigger cause than money or personal success
• Be passionate about the practice mission
• Talk to your team (often) about the practice’s values: what you will always do for patients, what you will never do for patients
• Collect reviews from satisfied and grateful patients and display them
• Help your team achieve their goals, personal and professional. Be a coach/mentor to them
• Don’t spend all your time at work in your surgery. You can’t lead anybody from there.
None of this is easy, but all of this is worthwhile. And it will bring you and everybody who rally around the flag success. Big time.
If you would like to learn a lot more about becoming an effective leader, we are running a three-day workshop for a small number of participants in November 2018. Contact me for a chat about whether this might be right for you.
Simon Hocken established three practices as a dentist before founding the dental consultancy Now Breathe in 2007. He specialises in supporting principals and their management team in making change happen. He speaks regularly at major dental forums, as well as writing for leading publications, and lectures and writes for academic courses.