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12.7.07 Issue #300 Forward This Newsletter To A Colleague
Team Conflict
Leadership Accountability
Employee Laws

Holiday Wish #1: Peace in the Practice
by Sally McKenzie CEO
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It really is the most wonderful time of the year, wouldn’t you agree? After all there are millions of people in the malls and shopping centers. The list of those you absolutely must buy for is virtually limitless. And between the Christmas cookies and holiday parties, that lab coat is looking more like a sausage skin every day. Ah yes, comfort and joy.

Then there are the multiple patients who either don’t show or cancel because, well, you know, it’s the holidays and there’s just so much to get done that they don’t have time for a dental appointment. And don’t forget the team. Just when you thought there was a chance for peace on earth, or at least in your practice, the lid blows on that percolating feud between the person in charge of scheduling and the hygienists. Oh what you would give for just one silent night.

I don’t need to tell you that the holidays are stressful. And during stressful periods existing conflict among dental teams can be particularly pronounced. The sighs, the rolling eyes, the slamming doors, the piercing stares, take a heavy toll on everyone, including your patients.

The irony with staff conflict is that dental employees, for the most part, don’t want to hurt each other’s feelings. They want to just go along and get along. But when problems arise and they don’t know how to deal with them that anger and frustration often manifest in snide comments, lack of information sharing, gossip, and destructive alliances, all of which cause a multitude of other troubles. Read on. 

According to the Employee Assistance Society of North America, 65% of performance problems are the result of strained relationships between employees. Conflict is a primary contributor in at least 50% of all employee departures and in 90% of staff dismissals.

In the dental practice, conflict typically presents itself in the day-to-day routine – namely the systems. For example, the business employee can’t get insurance claims filed because she’s frantically trying to fill cancellations and putting patients in the wrong time slots in an effort to save a sliver of the month’s production goal. The hygienists are irritated because they’re either too busy or too slow. The assistants are plotting their revenge. The doctor, meanwhile, just wants to pretend everything is fine. This too shall pass. Oh don’t worry it’s just a phase. The patients are giving sideways glances to each other because the tension on the team is as flaming bright as Rudolf’s nose on a foggy night. But the issues are ignored until they become critical and the practice starts to see the financial impact of conflict, which, I would almost guarantee, is far bigger than your entire holiday gift budget.

Conflict costs individual businesses hundreds of hours and thousands of dollars per year. It erodes team members’ commitment to the practice and chips away at personal success and professional pride. According to Human Resources Magazine, 25%-42% of a typical manager’s time is spent dealing with conflict. Multiply that by the number of employees in the practice and you start to see the financial toll conflict takes on a dental office. But that doesn’t begin to account for the expense to doctor and team in terms of day-to-day stress.

A report in the Journal of Occupational and Environmental Medicine noted that healthcare expenditures are nearly 50% greater for workers who report high levels of stress, and numerous studies find that stress is commonly a result of conflict in the workplace.

Then there’s the issue of staff turnover. While figures vary, the cost of replacing a staff member is estimated to cost anywhere from 30% to 150% of the employee’s annual salary,  to recruit, hire, and train a replacement. Is that enough coal in your stocking to get your attention?

Next week, take 12 steps to address conflict in your practice and enjoy a bit of peace on earth and goodwill toward all this Holiday Season. 

Interested in speaking to Sally about your practice concerns? Email her at
Interested in having Sally speak to your dental society or study club? Click Here.

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Dr. Nancy Haller
Dentist Coach
McKenzie Management
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Case of the Tail Wagging the Dog

That’s how Dr. Peterson (not his real name) described his office environment. He said, “It’s a case of the tail wagging the dog”. Here’s what else he told me.

His employees aren't working to their full capabilities. He asks them to do things but they don’t. They argue with him when he brings things up at the monthly meetings. The hygienist said she was taking off two days next week. Mind you, she didn’t ask him, she told him. And she did it in front of other employees so he would be intimidated and pressured to say "okay", which he did. One of the assistants comes in at least 10 minutes late every day and the two front office employees are demanding that they get help.

Dr. Peterson dreads going into the office. No kidding! Who would enjoy going to work being intimidated every day by employees, convinced that if you don't meet their demands they will start looking for another job?

It’s plain to see that Dr. Peterson’s practice is akin to a ship without a captain. He’s disengaged from his staff and he’s trapped in a reward system that is fiscally impractical. Furthermore, his employees have more influence over Dr. Peterson than he has of them. It’s time for him to step up and show some leadership accountability.

To be a successful dental leader you need to accept responsibility for the climate in which you ask people to work. It means creating a practice atmosphere that is professional yet enjoyable. It begins with modeling more explicitly the kind of environment you want.

How responsible are you? Does it depend on the situation or are you always ready to accept accountability for your decisions and behaviors?

On a scale of 1-5, with 1 representing "Never" and 5 representing "Always," rank yourself on each of these characteristics of responsibility.

  1. I communicate frequently and accurately with my staff.
  2. If I don't understand something, I seek out information.
  3. I own my own problems and circumstances.
  4. When I make a mistake, I admit it.
  5. I am proactive, often taking the initiative.
  6. I ask for the things I need.
  7. I analyze my actions and ask, "How is this contributing to my practice goals?" and “What more can I do?”
  8. I welcome feedback.
  9. I model responsibility for my employees.
  10. 10. I readily address conflicts in the office.

The higher your score the better. More important than the overall total, take a second look at the items you ranked lowest. What will you do to become more accountable in those areas?

Responsibility is an old fashioned idea that says you are answerable for your actions - and inactions. Being a leader means the responsibility of service to others – the people who follow you.

Leadership is about influencing others and shaping their behaviors toward constructive outcomes. Leaders must advance change, take risks and accept responsibility for making things happen.

Everybody on your team is an ambassador. Be sure to make them a positive representative. Schedule individual conversations with each of your employees. Find out what’s important to them. What do they enjoy about their work? What frustrates them?

Avoid a ‘fix-it’ mentality, especially in the first meeting. The purpose of your dialogue is exploration and discovery. You don’t have to be a problem-solver as much as a patient listener. You can help them to find solutions in subsequent conversations.

By creating an ‘influence plan’ with them and showing interest in their development, you maximize retention and performance. Investing in your staff yields bottom-line dividends. Learn to diagnose the sources of influence that are responsible for your employees’ behavior…and get the dog wagging the tail.

Would you like to elevate your practice? Invest in yourself and become a more effective leader.  Inquire about Dr. Haller’s Leadership Training Course  1.877.777.6151 Ext. 21.

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Michael Moore, Esq.
Director HR Solutions
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Are You Ready For The Perfect Storm?

In the autumn of 1993, two massive low-pressure centers collided over the Grand Banks in the Atlantic Ocean. The result of that collision was a hurricane-force explosion that ripped through New England and caused many ships to founder.

Today, fourteen years later, a perfect storm is brewing in Congress and the states. After many years of employer-friendly legislation, the new Democratic Congress is considering three major legislative packages that would wipe out employer protections in key areas. Health care initiatives in the states also promise to expand employees’ rights to paid time off for medical and family leave.

The three bills before Congress are these: (1) legislation dramatically expanding disability rights under the Americans With Disabilities Act [S 1881]; (2) arbitration reform legislation that would wipe out arbitration of employment disputes; and (3) legislation, like that in the states, which would mandate paid family and medical leave for many employers.

The U.S. House of Representatives is already conducting hearings on the ADA restoration bill, which has strong bi-partisan support in both houses of Congress. The House bill, at last count, had 117 co-sponsors. Whether or not any bill comes to the President for signature before the current incumbent leaves office, it is virtually certain that both the ADA restoration bill and the bill outlawing arbitration of employment disputes will be signed by the next President, Democrat or Republican, early in 2009. Even President Bush would be hard pressed to veto either bill – and he would face an override vote he could not likely win.

What does this mean? The ADA restoration act will make it much easier for an employee to establish a disability and thus a right to accommodation. It wipes away Supreme Court decisions that have almost eviscerated the current law – and even expands on the original intent.

It can be predicted without fear of contradiction that employers of 15 or more employees will face great challenges. Fifteen is the floor that triggers federal ADA coverage. However, as virtually every state legislature will follow the federal law, employers with as few as 3 employees will soon be exposed.

Use of mandatory arbitration as a means of limiting large judgments has been growing dramatically in the employment arena in the last decade. Despite judges’ protestations to the contrary in cases expanding its use, arbitration strongly favors the employer. The new bill will eliminate that protection entirely.

Finally, the expansion of family and medical leave rights, with the attending exposure of employers who do not follow the strict guidelines, presents its own dangers. These laws, both federal and state, are enacted as fair labor standards act legislation, meaning that employers subject to them face strict liability for failure to comply.

And while the current federal law covers employers of 50 or more full time employees, the pressure is on to drop that number to 25 or less. And, many states will no doubt look at lower limits.

Already, verdicts in family obligation discrimination cases are soaring. The average verdict is $100,000, without adding in attorney fees and costs. The largest verdict, so far, is $25 million. Few ADA cases have come to trial in the last decade because of the constraints on plaintiffs, but those that have also resulted in seven-figure verdicts. Without question, the number of cases will come from a trickle to a full tide, and verdicts will rise accordingly.

Our experience has shown that professional practices are at far greater risk than their numbers suggest. This is because dental, medical and chiropractic offices are predominantly staffed by women, both of child bearing age and older. Given that society demands these women have primary responsibility for child care [and, today, elder care] and hold a job, they are the ones who most need time off.

In short, professional practices are directly in the path of these two storms – and those who do not take action now might very well founder on a single case.

What can you do? Our recommendations: First, review your employment human resources policies and procedures to make sure that you are not unnecessarily exposing the practice to a claim. If your policies are old, or punitive in nature, have them revised and updated immediately. Second, seek out and find a resource you can call upon in the event of any issue arising – and use that resource well before a possible conflict occurs. Third, consider training in team leadership and practice management.

We have found that employers who provide written employment handbooks that give employees a structured vehicle for attention to grievances and concerns fare much better than those that do not. And, following effective practice management strategies reinforces that confidence by employees that they are being treated fairly.

Do this, we urge you, and however high the waves become outside, your practice will flourish while the others go down.

Mike Moore is ranked among the best in employment law and named one of the top 10 lawyers in Ohio.  As Director of McKenzie’s HRSolutions, Mike is the creator of The Employment Policy and Handbook geared to provide dentists who are unsophisticated in the legal arena with a step-by-step policy manual.
For more information Click Here.

Interested in having Mike speak to your dental society or study club? Click Here.

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