How to Run a Successful Orthodontic Practice - Part V
By: Mark D. Paschen, DDS
This is the fifth in a series of articles outlining How to Run a Successful Orthodontic Practice. In the previous four articles, I emphasized the importance of the receptionist, hygienist, and treatment coordinator, plus I presented some simple and cost-effective internal marketing tips. In this edition, I will discuss the importance of the orthodontic team, how to get your team to work to its fullest potential, and how to be an effective leader. Once you succeed in accomplishing these three things, you will have more fun at work which will translate into a more productive practice.
A good team starts with a good leader. The quotation that I like most concerning leadership is: “A good leader is able to willingly empower others to do things they would not normally do.”(1) Think about yourself as a dentist. We all are micro-managers of our teams, and most of us feel we need a hand in everything that the team does. If you are going to be successful (and productive) in orthodontics, you have to trust your team and empower them to make effective decisions on their own. I have given my treatment coordinator full empowerment to establish orthodontic fees and to set up payment plans based on her “feelings” on certain patients (i.e., financial hardship, family courtesies, seniors, students). By doing this, my production has actually gone up per case, since I tend to be a bit more lenient than she is when setting fees. My treatment coordinator actually takes it personally and feels that she has not done a good job in presenting the case when a patient does not schedule for treatment before leaving the office.
Another wonderful quote concerning leadership is: “Leadership is about realizing that every member of the team has responsibilities of reaching toward a goal and helping each other to achieve that goal.” (2) How many of you set goals in your practices? We, as leaders, need to sit down with our teams and conduct productive meetings and set realistic goals for every team member. These goals can range from training goals (learning and accomplishing new tasks) to production goals (scheduling patients, new patients, patient flow, and efficiency). Nothing is as satisfying for a team member than to have other members of the team congratulate him or her on a job well done. My front office team went through a telephone training course, complete with mystery calls and certification.(3) The course was approximately two months long, and three of my team members received their certifications. We held a ceremony where certificates were handed out, and all team members hugged and really felt great about the front office team achieving this goal, considering this accomplishment as a benefit for the entire team. Since that experience, I am now able to take individual members of my team to certain meetings (that pertain to their area of expertise in the practice) without other members of the team feeling left out. My team members realize we all have different, yet connected, roles in the practice, and we rely on each other to keep the practice running efficiently in order to reach our individual and team goals.
None of the above will be possible without regularly scheduled meetings with your team. I am not an advocate of having a huddle every day. I have found that daily huddles often become complaint sessions and that team members need that time to “unwind” before starting their day, so they tend not to pay very good attention on a daily basis. Instead, we have a half hour huddle, once a week, on Monday mornings before our shift, and we discuss any scheduling issues that occurred the week before. We also go over the upcoming week’s schedule, making sure all lab cases are in and that any potential schedule bottlenecks are addressed. We definitely do not make these weekly huddles a place to vent complaints about other team members or to address major team issues. That would only serve to start the week on a negative tone. You need to keep the huddles very positive.
I am an advocate of monthly team meetings. These are the time to address team issues and other problems that may occur, such as a team member not doing their fair share of cleaning instruments, or not getting patients back in a timely manner, or talking and texting on the phone too much. You have to keep these monthly meetings no longer than two hours in length and adhere to that time schedule. If you run longer than the planned two hours, your team will become impatient and not much else will be accomplished. The exception to this is if you schedule a Webinar during your monthly meeting and the Webinar is longer than two hours. You need to notify your team in advance if that is the case, so they can plan their schedules accordingly. A little bit of consideration goes a long way. There has to be an agenda, or purpose, for holding the meeting. We once had a situation where we scheduled a monthly meeting and the day before the meeting there were not any items on the agenda to discuss, so we cancelled the meeting. Full participation is a must at team meetings with everyone giving some input. If you feel there are team members who are not participating, you need to assign a specific agenda item to those team members and let them know you will be calling on them during the meeting to report on that agenda topic. I had a team member who was a bit shy and who did not participate much in our monthly meetings. I knew she was very good at social media, so I put her in charge of our Facebook page and asked her to report on that at one of our monthly meetings. Her report was fabulous, and she earned the respect of the other team members. Now, she is our social media director and gives a report at every monthly meeting. Find out what each team member is good at and have them give a report on their topic of expertise at the monthly meetings. This will give them a sense of pride and will help to add to the cohesiveness of the team. For each topic of the meeting, it is important to establish a course of action for the topic, who will be responsible for that action, and a timeline for achieving the action. For example, if you want to have a newsletter go out to your patients, you need to figure out what topics will be in the newsletter, who will be responsible for getting the topics together and organizing the content, and when you want the newsletter to go out. Too many times, meetings are conducted and many useful topics are discussed but nothing really gets accomplished.
I need to mention here the importance of the monthly team meeting setting. We use to have our monthly meetings at a restaurant. I felt the team liked having a change of venue and enjoyed eating out, but I found the meetings were not very productive. There were numerous interruptions by the wait staff, and we often felt rushed to leave once we finished eating. Also, living in a small town we needed to be careful about some of the topics we discussed since we never knew who would be listening to our conversation. This included the wait staff who were often our patients. Now we hold our monthly meetings at my house. I have lunch catered in, all cell phones are left on the kitchen counter, and we sit around the dining room table facing each other. It is a very effective and efficient way to conduct a meeting.
A couple of last notes concerning team meetings—monthly meetings do not always have to be structured. We use several monthly meetings a year as a way to engage and bond with each other. We may do activities such as taking a hike, bowling (remember we live in Wisconsin), eating at a nice restaurant, going on a boat ride, or even giving each team member $75 and going to a shopping mall for an hour and having to spend the money on themselves. We then have dinner and share with each other what was bought. This has proven to be a great bonding experience. Food is always involved with each activity in a fun and creative way. Each team member is also paid their regular hourly wage during these monthly meetings. Whether it be the productive, agenda-oriented two hour team meetings which are held at my house, or the activity team meetings (usually 2-3 hours long), keep in mind that these team meetings may be held outside of your regularly scheduled hours, and you may be taking away the personal time of your team members, so you need to compensate them for that.
What constitutes an effective team? My favorite quotation associated with defining a team is: “A team has a strong sense of commitment creating synergy – generating a performance stronger than the sum of its individual members.”(4) We have all had days where the schedule flows seamlessly, every assistant is humming along on all cylinders and anticipating your every move, your receptionists are smiling and answering every phone call and question, and the day flies by and is unbelievably productive. Have you ever wondered why that day was different than a lot of your other days? You need to take a moment and analyze what was different about that particularly productive day, and you will notice that synergy happened. Take the first opportunity to discuss with your team why the day went so well and be sure to compliment and praise them on a job well done.
How do you get to that level of synergy and how can you get that level of commitment from your team members? Again, you need to trust and empower them to control your schedule. Let them direct you as to which room to go to and how the schedule should flow. I’m sure a lot of you are hesitant and not willing to “let go,” but after holding several monthly team meetings and going through proper scripting with your receptionists and assistants, it will be much easier. (5) I walk down the hall, listen outside my operatories, and hear the assistants saying the same things to the patients that I would be saying. We can’t clone ourselves (though I know a lot of you would like to), but if you give your team a chance, they will surprise you as to how efficient and capable they can be. Each team member needs to find his or her particular area of interest within your practice and then let them run with it. One of my assistants does all of the bracketings with me, so she is an expert at explaining home care and answering questions for patients receiving braces. I simply bracket and leave the room. Another assistant does all of the debonds (removal of braces) with me. After polishing, I again leave the room, and she goes over all of the retainer wear and gets the proper forms signed. Yet another assistant does all the appliance inserts with me and explains the proper verbiage to parents and patients. Each team member has a role, and he or she takes great pride in what he or she is doing. Each team member also knows that coworkers are very good at what they do; they respect each other, and realize that the schedule would not run smoothly without each one of them. You need to instill this feeling within your team.
It is also important to compliment your team and give constructive criticism when appropriate. It is said that you should give out four compliments to every criticism and that you should praise in public and criticize in private. (6) I always thank my assistants in front of the patients every time I leave the operatory while they are doing the adjustments. This is a simple thing to do, and patients really like to see this form of respect between the doctor and team members. I also brag them up any chance I get; “You are so lucky to have Mindy taking your impressions-- she’s a real pro at that,” or “Sam is amazing with these appliances. She has been doing this for years.” These extra few lines, directed toward your team, go a long way.
Fortunately, we do not have a lot of team conflicts. If you follow some of the principals outlined in this article, it should help decrease your number of conflicts, also. Conflict in the office is inevitable, and I constantly alert my team to that fact. It has been helpful to view my relationship to my team as you would view a marriage.(7) You can’t expect smooth sailing every day, there will be arguments, and there is definitely give and take. Pick your battles and sometimes you need to be willing to sacrifice your personal feelings for the benefit of the team.
Lastly, I tell my team that if they come to me with a problem concerning another team member, they need to be prepared to offer a reasonable solution to that problem. We, as dentists, are not psychologists or behavioral specialists, and we need help in arriving at a solution. I also let the team member issuing the complaint know that they need to be willing to meet with me and the accused (all together) to help resolve the problem. Another thing I have learned concerning conflicts or other “controversial” decisions in the office is that I never make a decision until the next day (granted the decision is not an emergency). For example, “Mary wants to take the last three hours of work off next Thursday to watch her daughter play volleyball.” This decision takes some thought, as it will open the flood gates in allowing other team members to take off for their children’s events. By hesitating and letting Mary know that I will think about it and give her an answer the next day, she knows that I am not too keen on the idea and that her request is a big deal. I also give other team members a chance to give heir input to Mary’s request, and if they are willing to cover Mary’s patients, it usually is not a problem. That way, Mary knows the team is making a sacrifice for her, and she will do the same for them. We actually have incorporated an “unwritten policy” in our practice that each team member may take off to watch one of their children’s events per season or semester, as long as the schedule is accommodated and the rest of the team is notified in advance and agrees to it. Most decisions at work are made by the team and are not unilaterally made by me. Remember empowerment.
The next article in this series will deal with communication--communication between the doctor and team members, communication between the doctor and patients, and communication between team members and patients. We often take for granted how we talk to each other, but words and how we say them have a tremendous impact on how patients perceive our practices and how willingly they will accept treatment from us. I will also outline what patients look for (and don’t want) in a dental practice.
As always, feel free to contact me at firstname.lastname@example.org with any questions. Please put IAO Journal Article in the subject line.
1. Norman Schwarzkopf, commander of the U.S. troops for Desert Storm
2. Alison Levine, AAO San Francisco 2015, first woman to lead an all-female team to the summit of Mt. Everest.
3. Scheduling Institute, Alpharetta, GA. Telephone training module
4. Unknown source, but often quoted.
5. J Swift Consulting, Phoenix, AZ office visit 2014
6. Rosemary Bray, IAO Annual meeting, Scottsdale 2010
7. J Swift Consulting, Phoenix, AZ office visit 2016