Performance Appraisals, Staff Expectations, and Team Unity

Dental Practice Management – Performance Appraisals, Staff Expectations, and Team Unity

You know Mary, don’t you? She’s a hygienist. She’s really great at scaling and root planing, helping educate patients about periodontal disease, and identifying developing dental problems with patients. She’s been in the practice several years now, and for the most part, she’s well-liked by the patients. The problem is she doesn’t participate in staff meetings, doesn’t help out with other necessary duties around the office, and her attitude towards staff members has been declining.

And what about Dr. Jones? He’s that heckuva’ nice dentist a few miles away that always seems to be available to help by lending supplies or equipment, or seeing that emergency patient for you when you’re out of town. His practice seems to do well; you see him at CE courses, and a few patients who have left his practice to come to yours – despite your trying to have them return to Dr. Jones – have excellent dental work in their mouth, all completed by Dr. Jones. The problem is Dr. Jones has constant turnover in his office. He’s always looking for another employee, or at least it seems so.

Are we really that inept?

Leading a practice is no small feat. One of the problems is that we dentists have had it pounded in our head that we weren’t taught the necessary skills to run a business, and that we don’t know how to communicate effectively with patients or staff. I disagree, and we’re going to prove it.

Let’s examine each situation and problem-solve them both.

There’s something about Mary...

Mary is one of those high-performing dental hygienists who are valuable to any practice. She’s smart, capable of communicating effectively with patients, experienced, and worth her weight in gold. The doctor she works for feels lucky to have her, but wants her to participate in other aspects of the practice. He’s frustrated because he’s paying her on a commission basis, but wasn’t clear when he hired her that she must attend all team meetings and participate in other duties in the practice. And because the rest of the staff is being paid hourly, he feels even more handcuffed – even fearful – that other staff members might “find out” how she is being paid, leaving him with an even bigger problem on his hands.

Mary thinks everything is going well; the patients like her, the doctor seems to acknowledge her abilities and excellent skills, and she can’t remember having even one patient upset with her. As best she can tell, the staff seems to be fine with her when she’s around, so all must be well.

Is there fault here? What’s the problem? Can this be solved, or is the doctor going to have to live with it until he’s so upset that he makes an error in judgment?

Of course, the answer is that it would have been easier if he would have provided a clear understanding of the expectations he had of her when he hired her. And yes, it would have been nice if Mary had a Job Description, Performance Appraisals, and Growth Conferences, but she didn’t – and hasn’t. The doctor has actually dug himself a hole, so let’s help him climb out of it.

As a professional coach, I believe you have the answers. As a practicing dentist, I’ve been there. You may need some prompting, some re-focusing, some greater awareness, but you’re not inept.

The doctor had hired Mary a few years ago when he was in a real bind to find a hygienist for the practice, and he hired her hurriedly. Fortunately, she turned out to be a gem. Because the doctor has a successful practice and is sometimes too busy, he hasn’t taken the time to do those things for each staff member I previously mentioned. So do we condemn him? No way. Let’s get back to helping him work out of this. Here are our suggestions:

  • It’s never too late to implement Performance Appraisals, Growth Conferences, Job Descriptions, Compensation Reviews, and others. Suggestion: get the necessary forms to do just that, and start today. Each of these is an opportunity to open the communication door, to develop a relationship with each staff member that will withstand mistakes, disagreements, and other storms – as well as help protect you legally.
  • Find some time to sit down with Mary and have a talk. Your goal is to reconnect with her and strengthen her sense of partnership in the practice. Try asking for feedback about how things are going for her, areas she’d like to develop, leadership opportunities she’d like in the practice. Brainstorm with her how the practice image could be improved/perfected, ways to market to potential new patients, areas the practice might improve, and others.
  • Be understanding of Mary’s response when she does hear of your expectations for her position, whatever her response may be. Avoid making it a Win-Lose, Lose-Lose, or Lose-Win proposition. Listen intently, thoughtfully, and sensitively. Look for ways to compromise – if reasonable – while still achieving your expectations. Reiterate your commitment to her continuing to be a valuable member of the practice. Avoid gossip and assumptions, and remain calm and level-headed. Don’t push to get to an agreement in one conversation. Mary may need time to contemplate your expectations, especially if she is surprised. Agree to talk again at a later time, if needed.
  • Never bring in any comments made by other team members. Your comments must be authentic about your experience with her. You must be honest about your mistakes and oversights. Staying with the truth will bridge any gap that may try to develop between the two of you.

What about Dr. Jones?

All of us can relate to having an “employee turnstile” at least one time in our practice. It seemed we were always having to return to “Square One” with our team, to train, re-train, and then only to have to hire again…all the while trying to manage a busy schedule, overhead, and doing quality dentistry.

So the central question is, “Why the turnstile?” I already suspect a few areas that might need shoring up, so let’s brainstorm this and help Dr. Jones out.

  • Is Dr. Jones 100% committed to the success of each employee? Far too often, a staff member is hired, trained briefly, and then put to work at a job they may not be ready to completely handle. It’s almost an “I’ve-hired-you, now-show-me-what-you-can-do” attitude that the doctor has. If you’re not 100% committed to their success, it was probably best not to have hired them in the first place. Most employees will almost always fail at some point somewhere down the road, where they’ll really need your commitment to their success.
  • Does that new employee Dr. Jones just hired have the capacity to be a ‘10’ at their position? Many of us have felt pressure to fill a vacant position in our practice because we depend so heavily on each member’s duties and responsibilities to operate from day to day. When someone is absent or when there is a vacancy, the practice suffers – and so does its team members. Avoid the pressure to just “fill” a vacancy – wait for the right person and make alternate plans until then.
  • Does everyone understand their responsibilities? Miscommunication, unknown expectations, and poor organization kill the spirit of a new employee who wants to do a good job. Make sure each team member receives a Job Description and that they are properly trained, with the end result that they feel confident they have the information and skills to do their job well. Meet with them frequently during the first few weeks and months of their employment to clear up misunderstandings, miscommunications, discover areas they may need more training, and to give them feedback on their progress to date. Good communication leads to employee retention.
  • Step up and be a leader. Every team needs a leader, and for most every practice, it’s the doctor-owner. Stay in contact with the pulse of the practice; avoid coming in, going to your private office, seeing patients, and then going home. Take the time to have staff meetings and retreats, be a model of excellent communication and relationship skills, and set the course for the practice. A team without a leader is a rudderless boat, and employees get frustrated not knowing where the practice is going.

You did GOOD!

By now, you’ve realized you really do know more than what you’ve read about yourself, don’t you? It’s truly just a matter of setting priorities, doing the things you know you should do, and being a participative leader.

And what about Mary? Mary will do fine. But if your best efforts with Mary still result in a partnership that doesn’t work out, someone else will come along and be a far better fit for your practice.

And Dr. Jones? Oh, he just needed some prompting and refocusing, and maybe a little more attention to the details he knows he should manage. With some effort, he’ll stop that turnstile and settle in to more of what he truly enjoys: helping people lead better, healthier lives— this time with the help and support of a committed staff.

Sometimes doctors just needed a little coaching, that’s all.

 

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