Donít Want to Fire an Employee? Do This Instead
The task of letting an employee go is one of the most difficult and anxiety ridden exercises that a dentist will face during his/her career. It is for that reason that doctors often go to great lengths to avoid confronting staff on issues that beg to be addressed, namely surly attitude, poor performance, instigating conflict, poor patient service, failure to follow established policies and procedures, and the list goes on and on and on. Consequently, many dentists look the other way as poor performers slowly hijack their practices.
Too often the situation is allowed to fester until the dentist is forced to take action. The doctor must address the problem employee(s) in order to regain control of the practice. Invariably, these situations could have been avoided. Let’s rewind the tape and consider what should have been done differently to steer clear of the unpleasant and rocky road of employee termination.
First, implement a few common sense human resources strategies, and you’ll make significant strides in reducing the number and level of employee headaches you’ll have to face throughout your career. For example:
1. Provide clear job duties to employees so they know exactly what is expected of them. You can download job descriptions on my website HERE.
2. Train new employees but don’t overwhelm them. A new hire will be far more likely to succeed if the training program allows them to assimilate information and tasks at a steady rate rather than a rapid-fire pace.
3. Give all employees some form of personnel policy manual. This document spells out the office code of conduct, dress code, policies regarding tardiness, overtime, sick leave, office policies and procedures. All employees deserve to know the rules of the game and what they need to do to remain on the team.
4. Give ongoing direction and constructive feedback. Too many dentists wait until there’s a serious problem or crisis before they give staff any feedback. The doctor is in a highly frustrated state because s/he has allowed the situation to go on entirely too long. The employee feels blindsided and often will assert they had no idea the doctor wanted things to be “this way” or wanted “that done.”
5. Be specific. Don’t candy-coat the feedback and don’t beat around the bush. Be constructive, not punitive. Tell employees what they’re doing well and what needs to be corrected or adjusted to do even better.
6. Know when to cut your losses. The fact is there are times when employees – new or long-term – simply must be dismissed. They may fail to follow established office policies; they may be dishonest, argumentative, or difficult to get along with. They may fail to carry out responsibilities, or they may refuse to be a team player. They may gossip about patients, the doctor, and other team members or bring down the practice morale with snide comments and cutting remarks. They may be late routinely or divulge confidential information. They may not follow directions or they may be secretive about steps they take in performing their responsibilities so as to make themselves seem irreplaceable. Unfortunately, there are a multitude of reasons why some employees don’t work out.
Whatever the reason, problem employees need to be dealt with directly and clearly using an established system. Unless the employee’s behavior is so egregious that you are forced to take immediate action, the team member should be given the opportunity to improve her/his performance over a 60-90 day period. Explain to the employee verbally and in writing the specific issues that are not satisfactory and document exactly what needs to change in the employee’s performance.
With the employee, develop an agreement that spells out what s/he needs to do to improve performance. It should be in writing, signed by both doctor and employee and placed in the employee’s file. Monitor the staff member’s progress, give regular feedback, and document every step and every conversation in the process.
Ideally, at the end of this 60-90 day progressive discipline plan the employee has had the opportunity to see the errors of her/his ways, make the necessary improvements, and everyone lives and works happily ever after. Unfortunately, the fairytale ending seldom occurs. But the doctor is prepared to take necessary action and the employee has been given the opportunity to address the issues.
For more information on this topic and more, visit my blog: The Lighter Side
Interested in speaking to me about your practice concerns? Email firstname.lastname@example.org
Question and Answer
“I am a hygienist trying to develop a periodontal program in my office. If an existing patient comes in for a hygiene appointment, and the periodontal probings are 2-3 millimeters throughout the entire mouth except for the lower right quadrant (which has 3 areas of 5 millimeter pocketing and bleeding upon probing), how do you treat this? Should the infection be treated first followed by bringing the patient back for a prophylaxis? How would this be coded?”
There is no black and white answer to this question. The optimal treatment would be to work on the lower right quadrant (billed out as root planing 1-3 teeth) then have the patient return for the prophylaxis. However, don’t forget to consider what the patient is expecting at the appointment. If you or the doctor suspect the patient will be upset if they do not get their regularly scheduled hygiene appointment, and if you risk losing the patient, then it may be better to go ahead with today’s appointment and have the patient back in to have the root planing done.
Knowing the patient’s personality type and having a strong, trusting relationship with him or her is important. Learning how to read people’s non-verbal communication as you are presenting treatment and educating them about the treatment needed can be priceless. Will delaying treatment for one day or even two weeks really make a big difference? If the hygienist is going to go ahead with treatment, make sure the financial coordinator has time to go over the financials before the patient decides to move forward. If this is not done and the cost is more than the patient anticipated, then again, the office may lose a patient.
If the patient has insurance that you are looking to maximize, we get into another story all together. It is important for your financial coordinator to know the best way to present the treatment. Some insurances will not pay for a prophylaxis after the root planing is done for up to anywhere from 45 to 90 days. Some insurances are perfectly fine with a prophylaxis being done right after a quadrant of root planing, but will not pay for a periodontal maintenance appointment for up to 90 days after root planing. Insurance may not pay for the periodontal maintenance appointment at all if two or more quadrants are not done. And then some insurances will allow not only the prophylaxis, but also root planing on the 1-3 teeth on the same day!
Unfortunately, many of our patients are concerned about cost in addition to wanting to keep their teeth. So, you may end up being better off doing the hygiene appointment today as scheduled and educating the patient about the need for the root planing at a future appointment. Have the patient return for the quadrant of root planing as soon as possible. This will allow the patient to maximize insurance coverage while keeping your hygiene appointment time from being cut into because of the financial coordinator going over finances before you get started.
Here are some questions to ask yourself when deciding between doing the cleaning the patient is expecting or moving forward with root planing. Is it better to go ahead immediately with the quadrant of root planing if you are also cutting into the time needed to perform quality of care? Is it worth possibly losing a good long-term patient of record because you started the root planing that day?
It would be nice if the answers to all of our questions were black or white - it would make our jobs much easier. Regardless of insurance, patients need to be informed of their needs in order to have a healthier oral cavity. It is our responsibility to educate them as much as possible, not only on why they need to have treatment done for their health, but the many options that are available to help them pay for it. CareCredit is always an option to help defer cost, even if they have insurance. The patient needs to be enabled to make an educated decision on their own.
Interested in improving your hygiene department? Email email@example.com and ask us about our 1-Day Hygiene Training Program or call 877-777-6151
Get On Board with Onboarding
You’ve just spent hundreds, perhaps thousands, of dollars to recruit a new employee. Add in hours of your time and factor in the wear-and-tear on your existing staff and your own well-being. You wrote the job description. Placed the ads. Screened resumes. Met the applicants. Verified experience and reference-checked. You may have invited the finalist(s) to a ‘working interview’ in your practice. Finally you made the offer and it was accepted. You have a sign of relief…and all too often, unrealistic expectations.
It may be frightening to hear, but recruiting is only the first step in the hiring marathon. At first it may seem like a victory when a new hire is made, but this is only the beginning. If you want to make it to the ‘finish line’ with an engaged and productive employee, you must commit to the onboarding process.
Unfortunately the prevailing dynamic in many dental offices is that all that time and money spent to recruit the right employee is lost very quickly. Why? These days the mindset seems to be, “I’m exhausted…I’ve got to get back to treating patients.” Rarely do dental leaders see the importance of investing in the new hire beyond a cursory ‘orientation’ phase. There may be an effort to help the new hire feel welcomed and included during the first week or two, but after that they are often left to learn on their own. The mistake is that the onboarding is too short.
Positive psychology states that it takes about 90 days to establish a new habit. In this respect onboarding is about developing new habits. During those first 90 days it’s essential to reinforce the habits that are critical to job success in your practice. They come to you excited and enthused, but remember that they hired you too. That means they are evaluating you right from the start. And when you fail to keep them engaged, it’s very difficult to get back that goodwill and momentum. So reduce your margin for error. Plan out their early days. Give them your personal attention. Demonstrate in word and deed that this is the place for them.
One of the most important aspects of the onboarding process is introducing new hires to the culture of your practice. Get them around the right people so they build the right relationships and don’t gravitate to negative influences to fill the void. Ensure that you have communicated the values, structure and objectives that are vital to your practice. Once your newest employee is on the same page as you, everything will flow much more smoothly. This is so important that it warrants trading a patient appointment twice a month to devote to your new hire. Give them your time, so they know how important they are.
To ensure that your onboarding is comprehensive, create a checklist. Include employment agreements, benefit coverage and other administrative documentation. It needs to cover the marketing or information materials used with your patients and an explanation of your practice mission and philosophy. It should continue with in-depth training of technical and clinical aspects related to the employee’s specific job. Don’t just hand the new hire the employee handbook or policy and procedure manual. Instead, schedule meetings to review the most crucial aspects of how you run your business and treat your patients, and how you expect the team to work together.
The onboarding period must include periodic evaluations of performance. Set benchmarks and be clear on what your new hire should know after 30 days, 60 days, and 90 days. Give them a written plan so they can see a beginning, middle and end and know exactly what’s being covered and how everything is tied together.
In addition to uniform performance goals, tailor goals to each employee and keep in mind the person’s strengths and weaknesses. Strike a balance between ‘hit the ground running’ and ‘spoon-feeding’. Adapt to the new hire’s learning speed and style. Add more responsibilities and complexity once they have acquired the basics. Give them a chance to shine early and help them feel confident. It will carry over as the stakes get higher.
Provide feedback. Every new hire wants to know if they are doing a good job. Avoid the ‘no-news-is-good-news’ style of leadership. Reinforce good habits so they’ll be sure. And correct them right away, otherwise they’ll assume they’re doing things the way you want. Make it clear your practice is all about working hard, and praise their hard work. Emphasize the valuable contributions they are making to quality patient care and excellent teamwork. Help them understand how they fit into the big picture.
Take every measure to ensure that your new hire will succeed, otherwise all the time you spent recruiting will be for naught. Talk with them every day, especially during the first few weeks. Ask questions and check for understanding. Catch them doing things right and verbalize it. The bottom line: set your expectations. This is a marathon - and one that is so worth running.
I’m convinced that if you invest the time and outline and model what you want, you’ll have engaged employees who will stay with you for a long time. Value them and they will add value. Get them on board and make your office a great place to work!
Dr. Haller provides training for leadership effectiveness, interpersonal communication, conflict management, and team building. If you would like to learn more contact her at firstname.lastname@example.org
Interested in having Dr. Haller speak to your dental society or study club? Click here
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