Is “Cross-Training” the Answer or the Problem?
by Sally McKenzie CEO
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I have to admit that I really like the idea that many dentists have of “cross-training.” Everyone on the team covers for everyone else. It’s a nice, warm and friendly notion that team members just automatically step in and help whenever the need arises. But when I try to gather more details on how this works in their practices, what the protocols are and what training took place to prepare the staff to just “step in” when necessary, the answers are typically long on generalities and short on specifics. One of my favorites is, “Well they just do what needs to be done.” Oh, really?
Unfortunately, doctors’ perceptions are rather idealistic, to put it mildly. What many of these dentists don’t consider is that the dedicated assistant, Mary, who’s been with the practice for two years, doesn’t necessarily know how to just “step in” and help. Sorry—I know that might come as a shock. It’s not that she isn’t willing. But when she’s expected to just “step in,” she’s being thrown into a situation for which she probably has zero to minimal training. Because she has been in the practice for two years doesn’t mean that she knows how to collect from patients, that she understands the specifics of scheduling or that she’s prepared to handle patient phone calls effectively.
Perhaps the business manager spent 10 minutes on the fly showing her how to take care of a few things—a quick and dirty lesson, and definitely not what you can consider training. It’s a common approach that often causes more problems than it solves.
Consider this: If Mary, the assistant, as well as everyone else on staff, is simply expected to collect from patients, who is responsible when revenues are down? If a patient complains that she was treated rudely on the phone, who’s accountable? If the schedule has the doctor racing from room to room and the hygienist sitting around thumbing through magazines for half the day, whose job is it to correct this? The fact is that when everyone has their hand in everything, no one is accountable for anything.
Instead of answers to problems, you hear the chorus of excuses. I thought she was taking care of that. Oh, I didn’t realize that. When did we start doing this? Uh oh, how did that happen? Not because your team is incompetent or unwilling, but because there are no real expectations, there is no delineation of duties and there are no real measurements of performance. No one is taking responsibility or has genuine pride in the outcomes of any one system because they are not allowed to do so.
You cannot ignore solid management practices, or human nature for that matter. If staff are simply expected to “fill in” wherever they are needed, no one has the opportunity to take ownership or to shine, because the focus is merely on getting the job done, not getting the job done well.
Long before you can expect everyone to do virtually anything someone has to actually be responsible for something. In other words, a system of accountability is the foundation for a highly functioning team in which cross-training can eventually occur.
The process of establishing system accountability begins with creating results-oriented job descriptions for each member of your team. The job description includes the job title, a summary of the position and a list of the responsibilities and duties of the position.
It also includes individual performance goals that complement practice goals, such as increasing collection ratio, improving accounts receivables, improving treatment acceptance and maximizing the hygiene schedule.
In addition, provide job expectations in writing and list standards for measuring results. For example, if you expect the front desk staff to schedule to meet specific production goals, they not only have to know what those goals are, they also must have a strategy and the necessary training to achieve them. In other words, they need the tools to accomplish what you expect them to accomplish. Once those are provided, you can hold them accountable for that system.
Should team members be able to step in and help when necessary? Absolutely, as long as one person is designated as the individual responsible for the system, specific system protocols are established and staff are given more than a 10-minute tutorial—in other words, real training to ensure that the integrity of the system is maintained.
Next week make “cross-training” work in your practice.
Interested in speaking to Sally about your practice concerns? Email her at firstname.lastname@example.org.
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