05.15.09 Issue #375 Forward This Newsletter To A Colleague

One or Two Employees Don't Make a TEAM
by Sally McKenzie CEO
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I recently had a conversation with a dentist on that ever - popular topic: employees. This doctor went on and on about how fortunate he was to have had the “best” office manager any practice could hope for, but now he was frantically looking for someone to replace her because she’d turned in her two-weeks’ notice. He was crushed.

I asked him what set this person apart from the others. “She just takes care of everything,” he told me. I was intrigued. “Everything?” I asked. The good doctor went on to explain that he could delegate virtually anything to this person and it would get done. She could take care of insurance, collections, billing, payroll, recall, staff communications, case presentation, treatment planning. Why, she even oversaw the office parties. If it was someone’s birthday, she baked the cake.  What a gal! He was about to start a practice newsletter and this employee was going to be responsible for writing, designing, and distributing it. She might as well leap tall buildings and wear a red cape.

I was seeing red flags. “Are all of those duties in her job description?” I asked. “Oh no,” he puffed. “I don’t like job descriptions; they just limit everyone’s responsibilities.” Yes the alarm bells were blaring loud and clear. “You mentioned ‘staff communication,’ what does that involve?” I asked. “I have problems with my other staff. My assistants don’t do things the way I want. The hygienist is too chatty. You know, the usual stuff. I just tell the office manager to handle it and she does.”

This was, indeed, a full-scale alert. No job descriptions, no accountability, no leadership. Clearly, there are significant problems here. The doctor had used the office manager as a gatekeeper to insulate himself from the other employees and from serious matters that required his direction and involvement. Whatever issue he didn’t want to deal with, he just handed off to her, from clinical particulars to patient relations to business operations. Not only was she the office manager, she was the de facto leader, responsible for virtually every major system in the practice except the actual dentistry. With pressure like that, it’s no wonder she quit.

Why didn’t she speak up? It’s not uncommon for the good employees to remain silent. They don’t want to bother the doctor. They just keep taking the pressure, being the good stewards that they are until they crack. And in reality, the fact is there is probably little she could have done. In situations like this, the doctor simply will not or cannot see where he/she is wrong. This particular dentist believes that his office manager is responsible for “managing” every aspect of the office as the doctor sees it. And as far as the doctor was concerned, it worked, why change it.

It usually takes a seriously troubling event – such as a major financial shortfall,  the departure of a critical employee, etc. – for the doctor to even take notice. From there it takes an outsider, such as a practice management consultant, to sit down with the doctor and discuss his/her frustrations, why he/she cannot trust other staff, determine where the system shortfalls are occurring, assess training weaknesses, and get to the bottom of why the doctor cannot or will not lead his/her team.

This case is particularly unfortunate because it appears the doctor had a very dedicated and highly competent employee, which is common. Practices will have one or two rock-solid staff and a host of mediocre chair warmers. Instead of creating systems of accountability, instituting training programs, developing job descriptions, etc. doctors will simply pile the critical duties on those that they know they can count on. Ultimately, everyone loses.

The good employees eventually break or burnout. The weak employees are never given the opportunity to grow and flourish. And the doctor is losing a fortune because, whether they care to acknowledge it or not, things are falling through the cracks, simply because there are not enough capable hands on deck to ensure they don’t.  Yet with some outside assistance, most practices can create entire teams of high performers.

Next week, the recession is no guarantee that your good employees will stay. Take steps to keep them.

Interested in speaking to Sally about your practice concerns? Email her at sallymck@mckenziemgmt.com.

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