by Sally McKenzie CEO
Conflict is a huge source of stress in the workplace. In the dental office, dentists and their teams will go out of their way to avoid confrontation - at a big cost. They tell themselves that the “go along to get along” approach is working, when in fact the practice is spinning out of control. It’s not until the situation between employees explodes or the system breakdown is so dramatic that it’s having a potentially devastating impact on the practice that conflict is actually addressed.
Typically, the greatest cause of conflict in the workplace is the fact that individuals fail to really understand one another. Rather, they assign labels to what they don’t understand or what they think they see in another’s behavior. If Carol doesn’t say “good morning,” then others assume she’s “rude.” Or if Paula procrastinates on some of her duties, she’s “lazy.” Amanda is “controlling” because she likes certain things done a specific way.
It’s easy to feel negatively toward people who exhibit behaviors that we don’t like, don’t agree with, or simply don’t understand. As Dr. Nancy Haller points out in the McKenzie Management Educational DVD Team Bonding & Building, it is common for extroverts to label their introverted colleagues as being “stuck up” or “moody” because extroverts don’t understand that introverts simply don’t share the same communication style.
Similarly, the dental practice may have several individuals who are much more feeling in their temperament, meaning they care deeply about the feelings of others and are quite sensitive to those feelings. Pair that with a doctor who may be more thinking in her personality type, and she may come across as abrupt, too direct, or even uncaring. The communication styles are misread because the individuals on the team do not have the tools to better understand each other. The challenge for dental teams is to set the labels aside and commit to appreciating each others’ differences and making those differences a source of creativity, problems solving, and positive energy. And that begins with temperament testing.
Temperament testing is essential in getting the right people in the right seats on the bus - to borrow from Jim Collins' reference in his book Good to Great. Choosing the best temperament types for specific positions from the beginning of employment is ideal, but not necessarily realistic. It’s likely that you may be in a situation in which an employee is working in a position for which s/he is not best suited. The first step in addressing a circumstance such as this is identifying what tasks within the job are not being handled to your level of expectation. Once you have identified these, establish performance measurements for the tasks.
For example, let's say your accounts receivable is 3x your monthly production when it should be no more than one month’s. And you know that Emily, the business assistant responsible for this duty, doesn't like to ask patients for money. It’s time to sit down with Emily and discuss the situation honestly and candidly. You may find that Emily needs additional training to help her effectively request payment from patients. Perhaps she needs scripts to guide her in politely asking for payment from some of the older patients who were used to being billed by the previous doctor. Or, you may discover that Emily absolutely hates to ask for money and this is simply not the right “seat on the bus” for her. She's been with you for five years and she knows all the patients. Thus, she may be much more suited to handle scheduling and recall.
The key to better identifying Emily’s role in the practice is first considering her temperament type. And you have to be honest with yourself. Some people are not cut out for certain roles in the practice. You would no more hire an assistant who faints at the sight of blood then hire a collections coordinator who is terrified to ask for payment.
It’s essential that you and your staff utilize the tools that are available to most effectively work together as a team. Not only will everyone be better positioned on “the bus,” you’ll be heading directly toward achieving your most desired goals and objectives.
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Your Email Questions
Many of you send me emails with your questions and comments, and I want to thank you for them. When reading about the issues so many of you are facing in your dental practices, I see that wherever we may be located or whatever our situations may be, there are common problems that keep cropping up. Let’s look at a few of them.
I am a hygienist in a busy general practice. We are scheduled so tightly that I feel that I am running in a marathon every day. I don’t feel that I have time to complete a thorough prophy, let alone talk to patients about their dental concerns. What can I do? I need more time!
Anyone who has been reading my past articles in this e-newsletter knows that I am a big proponent of providing long enough appointments for hygienists to complete their treatment as well as identify possible future patient needs. My opinion is that it’s “penny wise and pound foolish” to cut hygiene appointment times down too tightly. I addressed this in detail in my articles How Many Patients Should the Hygienist See?and The $8,000 Hygiene Day. When patients are rushed through the hygiene department, patient care may be compromised and treatment that patients need and that can provide income to the office may be left unrecognized and undone. Both the dentist and the hygienist can become focused on just getting through the day, which is not conducive to a productive practice.
It is my opinion that the hygiene appointment must be long enough to fully address today’s hygiene treatment and future treatment identification. Conversely, if the schedule in this practice continues in the way this writer has expressed, her problem may have another solution. When patients feel rushed and unappreciated, they leave the practice. This will result in the office having many fewer patients and therefore everyone’s schedule will be lighter! Problem solved.
I work at the front desk. When patients come to me after their treatment for the day, I am expected to collect what they owe. Many of the patients are surprised that they have to pay that day, and often don’t understand the amounts that are due. They get mad at me! What can I do?
Patients should be fully aware of what treatment they are having that day, and what payment amount is expected. It is unreasonable to expect a patient to accept care they don’t completely understand or are not willing to pay for - with or without the help of insurance. This is why a pre-treatment conference is essential. Treatment should be presented in a calm and easy-to-understand way, patients should have time to ask questions, and fees must be fully explained. No surprises!
The pre-treatment conference can be combined with a short restorative appointment if the staff is worried that patients will balk at coming to the office “just to talk.” Some dentists may worry that if all treatment and all costs are laid out up front, patients may be overwhelmed and decide against having care. However, which is worse - having a patient decide against proceeding with treatment right now, or having a patient receive treatment, get angry because they did not understand the fees involved, and subsequently refuse to pay? Those patients receive their restorations, but the office does not receive the income! A practice runs more smoothly when active communication with patients is a priority. Patients who get mad for any reason are extremely unlikely to return or to ever serve as a source of referrals.
I am a general dentist with a good practice. I have worked hard to make my office a place that patients want to come to, and where staff like coming to work. My problem is that when we have the occasional no-show, my staff treats it like an opportunity to stand around at the front desk visiting with one another. This drives me crazy! What can I do to make my staff realize that just because a patient has not come for their appointment, it is not an excuse for everyone to stop working?
Many dentists feel the same way you do about staff “down time.” The best way to address this is to give your team members guidance about what you want them to be doing if there is the occasional broken appointment. This can be talked about and put in writing during your next staff meeting. Each member of the team should have a check-list of sorts that is prioritized by what you would like them to focus on if a patient cancels. For example:
Mindy - Dental Assistant
Jenni - Dental Assistant
Natalie - Dental Hygienist
Every office will have a different set of priorities. The important thing is to establish what these priorities are and set up a designated protocol for dealing with down time.
Each of these three emails has one thing in common - the need for communication within the practice and with patients. Making communication an office priority can reduce problems of all types, and ultimately make the practice run more effectively.
Carol Tekavec RDH is the director of Hygiene for McKenzie Management. Carol can improve your hygiene department in just one day of training “in your office”. Interested in knowing more about how to improve your hygiene department? Email firstname.lastname@example.org.
Carol is also a speaker on hygiene efficiency and profitability for McKenzie Management. Interested in having Carol speak to your dental society or study club? Click here
“Labor” takes a big chunk of your revenue. Turnover is expensive. In addition to disrupting business, staff-replacement costs are generally 120-130% of the salary of the person who leaves. It just makes good sense to coach employees, for performance and retention.Unfortunately, all too often dental leaders postpone or avoid coaching their employees - it takes a back seat to achieving immediate business results. Well-intentioned, they never seem to “get around to it.” But coaching employees is not an event that you schedule after you finish all of your “real” work. Start thinking of the role of “coach” as a daily practice, with a focus on creating a supportive, encouraging and trusting work environment so your team can perform at its best. The practice of coaching can happen in the moment. It might be in an operatory, or walking down the hall. My guess is that you have multiple opportunities to coach in-the-moment without the need for an appointment.
For example - your hygienist comes to you with a complaint about her co-worker who isn’t doing her share. You agree to talk with the other hygienist and solve the problem. There are a couple of ways this could play out. It might be helpful to have your intervention. However, this approach is risky. All too often the co-worker feels resentful and betrayed by the one who “snitched.” If you rush in like Superman you might have situational compliance. But when you intervene, you prevent your employees from improving their working relationship. The likelihood is great that you’ll have more conflict in your hygiene department very soon. After all, no one can solve a conflict between two other people.
Let’s say you take the tough-love approach. Instead of trying to fix the problem - you know you’re too busy to deal with this high-school drama - you issue a directive to “go work it out between yourselves.” The good news is you got it off your plate. The bad news is that the hygienist who’s come to you probably doesn’t have the skills to work it out effectively. That’s why she’s coming to you! The potential is that she feels devalued by you and more irritated with her co-worker.
In this example, a coaching approach may be the most promising from the desirable results point of view. And it doesn’t need to take a lot of time. One of the key components of a coaching mindset is a determination to let the person being coached keep responsibility for the solution. So a coaching leader will respond without taking over the problem. Questions are the preferred medium. "What have you done so far to solve this?" could be a good opening. "What else could you do?" "What do you know about why Mary isn’t carrying her share?”
Questions like these help your employee to consider other options. It takes about the same amount of time as giving advice or issuing an order. It also supports the employee to find a way to solve the relationship problems she’s having with her co-worker. This coaching approach conveys that you have confidence in your employee’s intelligence, good intentions, and capability.
When you add coaching to your repertoire of skills, you will help your employees to shift their perspectives and broaden their abilities. When that happens, they feel pride in themselves and in their work. Certainly coaching isn’t appropriate for all situations. You still need to teach, organize and advise. But coaching is a valuable tool to have in your management and leadership kit.
By communicating this way with employees, you’ll coach them to achieve the results you want!
Dr. Haller provides training for leadership effectiveness, interpersonal communication, conflict management, and team building. If you would like to learn more contact her at email@example.com
Interested in having Dr. Haller speak to your dental society or study club? Click here.
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