Campbell Macbean, Dr Michael Sernik, May 2004 - Here’s a true story of two dentists and their leadership.

What the problems were

Robert was a solo practitioner in the suburbs with a modestly successful practice and a very loyal patient base. When he started working with Prime Practice he was putting in really long hours with patients, regularly staying back till 7, 8 even 9 o’clock at night to finish treatment or handle emergencies. He initially had two staff that also had to put in long hours and, frankly, it was taking its toll on them. The only saving grace was that the staff got on well with each other, having developed an ‘us against him’ approach. This approach was necessary to cope with his angry outbursts, his frequent meddling with the appointment book and occasions when he would humiliate them in front of patients over some trivial thing they hadn’t done the way he wanted.

Julia was a highly successful solo practitioner in the middle of a city. She had a reputation for excellent cosmetic dentistry, worked four days per week and escaped to the coast on weekends. Things looked good on the surface but scratch deeper and it was a very different story. In order to accommodate recall patients and large cosmetic cases within four days, working days started early and finished late. She would spend too much time in social chitchat with patients and begin unscheduled treatment without time being available for it in the appointment book. As such, she was consistently running late for appointments. In addition, she would regularly engage in involved phone conversations before, during and after treatment. This led to an enormous sense of frustration among her staff – “we love her but she’s driving us nuts!” The result was that staff came and went with such monotonous regularity we dubbed it her ‘revolving door staff’.

Now chances are many of you reading this can identify with Robert and/or Julia to some extent, albeit uncomfortably. Dentistry is hard enough without having to worry about getting staff involved or fulfilled. We often hear:

• If I didn’t take phone calls during treatment I wouldn’t have a life.
• No matter how much I explain it they never seem to get the appointment book into shape.
• If I don’t squeeze the emergency patients in when I can, how can I grow the practice? Why can’t my staff understand that?

The reality is dentists have practices that are a reflection of them and all of the problems above have their roots in the leadership, or lack of it, shown in the practice. Yes, as a starting point there need to be practice management protocols put in place taking care of patient flow, appointment scheduling, financial arrangements, purchasing supplies etc. But ultimately, for the staff to follow you in creating your ideal practice, it’s as much about your leadership skills as about what systems you put in place. Now some of you may be thinking, “hang on you can’t create leadership, can you?” To answer the question let’s look at what happened next to our two dentists.

What they did

One of the key things to learn about leadership, whether in small business like dentistry through to big business, is fostering effective communication and giving feedback across the board. Leadership nowadays doesn’t mean creating followers as much as developing staff capable of leading as well. To do this, creating formal and informal avenues for communication such as daily/weekly meetings and also regular feedback becomes essential. One of the first things Prime Practice asked both dentists to do was to meet regularly with staff. Robert was initially resistant to giving importance to these meetings because he saw his leadership role as one of commander rattling off orders, whereas his new role in morning meetings was one of participant. For months he couldn’t see the point of letting the staff tell him little bits of personal information about each patient he would be seeing today, “I know the patients anyway, what’s the use of them telling me”?

Even though he took a more active role in the weekly meeting, shutting up and listening really irked Robert initially. Gradually, however, it dawned on him that with the team working towards a common goal he was actually fostering initiative, more of a personal sense of responsibility in his staff, and he could concentrate more on dentistry. Once this happened he started giving informal positive feedback to his team members for things they were doing well rather than what they weren’t doing. Suddenly they were more open and warm towards Robert, taking pride in their work – even the patients noticed.

Meanwhile Julia was struggling. She seemed to understand at an intellectual level the reasons for formal and informal channels of communication through meetings and feedback. She started to put all the management structures in place including daily and weekly meetings and said all the right things about giving positive feedback and participative leadership. In practice however, it was a different story. She had little patience with being a participant at morning meetings and eventually stopped attending. She came to weekly meetings and even participated, but used her time to berate the staff for what they weren’t doing in implementing the systems, how it just wasn’t good enough. She would not curtail personal phone calls and consequently continued to run late most days. Staff continued to leave.

The point
As we’ve said dentists have practices that are a reflection of the dentist so their successes are also due to them. What they usually don’t acknowledge is that the challenges their practice faces are also because of their oversights in leadership, in judgment etc.

However, dentists can change.

Robert started out with a commanding style of leadership but was willing to change to a more participative style. He was willing to grow at a personal level, to be more patient, to welcome input and ideas from staff and ultimately to take his role as a leader in the practice seriously. His practice began to thrive and grow. His take home pay doubled. He took on a hygienist, and is currently investing in new larger premises in order to bring in an assistant dentist. Julia, on the other hand, could not alter her authoritarian characteristics. She tried to avoid participating in the leadership process and attempted to force staff into simply handling all the details. Consequently she continued blaming staff for things they hadn’t done. She continued to be impatient and could not understand the power of giving praise in a focused way. In leadership terms she was highly resistant to personal change.

As dentists change, develop and grow in their abilities, so too their practices change, develop and grow. What all dentists should continue to do is invest in themselves and their abilities. In so doing they will reap rewards far greater than their initial investment. Typically when most dentists choose to invest in their practice to improve things they choose to invest in new clinical skills and new technical equipment, thinking this alone will solve their practice problems. Changing the mindset, investing in business, management and leadership skills, is far more likely to produce the ideal, low stress, smooth running practice with lower turnover of staff and higher financial rewards. But in the end, to get results like Robert, YOU have to be willing to change.

[Published in Australian Dental Practice Magazine May/June 2004]