Silos, Part 2: Balancing Boundaries
In last month’s article, I wrote an article about Silos - subgroups of people within an organization that have their own specific function. The most common in dentistry are Front Office and Back Office, also known as Administrative and Clinical. Each department performs specific tasks that are uniquely different from one another. Although these divisions are natural, from a practice point of view they absolutely need to collaborate for effective patient care. As the dental leader, your challenge is to simultaneously balance the ‘us’ vs. ‘them’ mentality that accompanies practice silos.
This past week, I had the opportunity to talk with a dental leader whose team was battling the silo-war. A new practice management system was established that necessitated a closer collaboration between Hygiene and Front Desk staff. At first glance it seemed like a rather small task for the ‘front’ to notify the ‘back’ when the next patient arrived. But the change escalated the ‘prima-donna’ hygiene perception and the boundary-battle was on.
The ‘Front’ was too busy already with all they had to do checking patients in and out, handling insurance and collection issues, answering the phone, etc. And why couldn’t ‘Hygiene’ keep themselves on track? Why did they need so much ‘hand-holding’ and ‘baby-sitting’? And from the Hygiene Department...what was so difficult about a simple notification? After all they were treating the patients, setting up and breaking down their room with each appointment, sterilizing instruments, scheduling follow-up appointments, etc.
Most commonly, Doctors get frustrated. They throw their hands up and issue a commanding order of “you just need to get along and work together.” Indeed, that is the goal. But just how do they do that when they’re in an emotional war with one another? In this instance, a dictate to “get along” only increases resistance to change.
The definition of a boundary is the ability to know where you end and where another person begins. It is basic to our core identity. When we talk about needing space, setting limits, determining acceptable behavior, or creating a sense of autonomy, we are really talking about boundaries. Boundaries protect us. They help promote healthy relationships. They minimize conflict. Boundaries in the workplace are designed to create a productive environment.
Therefore the strategy is to reduce the threat that each group feels when asked to collaborate by giving them a sense of safety and security. Then and only then will they be able to have a constructive dialogue about working together more effectively. The plan is to have the Hygiene and the Front Desk departments describe their daily experiences to each other. As the dental leader, your role is to facilitate that exchange by encouraging active listening as these two groups learn more about one another.
Keep in mind that this is not a time for debating or defending. Should that occur, it is very important that you redirect that person(s) to listen. The goal is to allow each group to gain a clear sense of their differences and the problems they experience in doing their work. After hearing each other, ask them to summarize or paraphrase what was said. No editorializing, just summarizing.
It is equally important to recognize that this is not a quick fix. It takes time to get groups to work together cohesively. You may need to monitor several more meetings like this.
During the exchange, it is important for you to continually remind employees of the practice mission and vision. In fact, this is a key starting point to the meeting as it establishes the Direction for everyone. The next step is Alignment but you can't have that until you insure that they understand and accept the Direction, then feel safe to join with others. When Direction and Alignment occur, your next job is to inspire Commitment. That is the formula for leadership: Direction - Alignment - Commitment (DAC).
It may engage your team if you were to start the meeting with a few key questions, such as: Why do we come to work? What is our goal? Who do we serve? What is our purpose? (to name a few). Ultimately, it is about patient care. And, if during the meeting you should find yourself or the group 'stuck', bring it back to the mission or purpose. Again, everyone needs to buy into the mission. Until that happens you cannot align folks to row together.
There’s an old proverb that says, Good fences make good neighbors. Mind your ‘fences’ AND manage them well.
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
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