Situational Leadership for Dentists...and Now for Teams, Too!

All dentists want self-motivated staff members who are high achievers. Unfortunately, such employees do not arrive in the practice like sea monkeys, fully formed and only needing water to become activated. Cultivating self-motivated employees is a process that begins with hiring and continues throughout the person's tenure. Sadly, too many dentists do not know how to lead people to excellence. Leadership can be especially challenging because we find that an employee's performance strengths and problems have different causes and require not just one approach to handling them but a variety of leadership skills.

Consider, for example, an appointment coordinator who has always been competent at her job but goes to pieces when the dentist gets a new software program that is completely unfamiliar to her. Contrast that to a hygienist who has always taken the patient's blood pressure reading during the hygiene appointment as a value-added service requested by the dentist, but who recently—and inexplicably—stops doing that. In each case, the employee is underperforming. But in the first case, the employee lacks the competence to perform a task (using the new software); in the second case, the employee knows how to do the task (checking blood pressure), but lacks the commitment to perform it. When confronted with employees that are at different levels of competence and commitment, and when the staff's performance levels change with different tasks, what's a dentist to do?

We found the answer in a renowned management theory called Situational Leadership. (Note: Situational Leadership is a registered trademark of the Centre for Leadership Studies.) This concept was created by Paul Hersey and Ken Blanchard and then expanded by Blanchard to what is now called Situational Leadership II, which is described in this article.

Situational Leadership teaches that there is no cookie-cutter approach to all staff at all times. In the words of Blanchard, from The Heart of a Leader: Insights on the Art of Influence,1 one of his many bestsellers, "The problem [Paul Hersey and I] found was that asking inexperienced members of a team to participate in decision making amounted to "pooling ignorance." Some people need a "directive" leadership style until their knowledge and skills mature. Our response was to develop a concept called Situational Leadership, which can be summed up in the statement, "different strokes for different folks."

The appointment coordinator in our example needs direction on the task of using a new software program in order to boost her competency. This includes leadership that provides structure, organization, teaching, supervising, and evaluating. The hygienist, who already knows how to perform the task of checking blood pressure, needs coaching on why she isn't doing it and on what she needs to boost her commitment. This includes leadership that asks her for input, listens to her, facilitates problem solving, explains why the task is important, encourages, and supports. Situational Leadership recognizes that staff members are at different development levels and that those levels can change depending on the tasks performed. The levels the staff members are on depend on their competence in performing the task and their commitment to performing it. Their commitment depends on the confidence and motivation they have in doing the task.

Situational Leadership shows dentists how to diagnose the development levels of their staff members and determine what leadership skills they need to best address the situation. The leadership skills include directing, coaching, supporting, and delegating. Once the leader diagnoses the staff member's development level and selects the leadership skill to deal with it, Situational Leadership involves partnering for performance with the staff member; ie, sitting down with the person and addressing the situation in a collaborative manner. Per Ken Blanchard: "Leadership is something you do with people, not to people."

Corporations worldwide have used Situational Leadership to handle circumstances that arise with employees and customers. Because dentists experience similar problems and also need variety and flexibility in their leadership skills, our company trained with The Ken Blanchard Companies to teach their leadership program and to customize it for the dental practice.

STAFF DEVELOPMENT LEVELS

Let's look more closely at the development levels of the staff so that you can begin using Situational Leadership. Let's say that you ask Mary, your assistant, to review the way she orders dental supplies to reduce costs. Mary knows this will require some work and  doesn't feel she has enough time. She's also concerned about not having a good grasp of what you want: of the supplies you think are too costly;  of how to contact alternative vendors; or of the amount of money you think she should be saving. Lacking sufficient time, a clear-cut idea of what to do, and specific goals to aim for, Mary feels frustrated, uncomfortable, and stressed. What development level is she on?

In the language of Situational Leadership, Mary is the disillusioned learner. She needs direction because she does not know what the guidelines are. She also needs support because her confidence and motivation are low. Once you identify the development level that Mary is on, you can understand her needs and provide the kind of leadership to help her excel at the task.

Let's take another example. You ask Pat, your inexperienced patient coordinator, to discover and record more information about new patients when they call to schedule their first visit. Pat conveys to you that she is happy to interview patients and likes communicating with them, but she isn't sure what to do. What development level is Pat on?

Pat is what we call the enthusiastic beginner. She is a beginner because she has no skill at the task, and she is enthusiastic because she has a strong commitment to learning it. This contrasts with Mary, the disillusioned learner, who feels unenthusiastic, or frustrated, when confronted with her new task.

Can you see that these employees need a different leadership approach from you? Situational leadership teaches you to be flexible in the leadership tools you use so that when a staff member needs a more directive approach, you give it, and when the person needs a more supportive approach, you give that. You learn how to be comfortable with all of the skills required to be both a directive and supportive leader.

To summarize, Situational Leadership gives you the tools to assess a staff member's development level (defined as the level of commitment and competence the person has) for a given task and to identify the leadership style (directive, coaching, supportive, delegating) that would work best with the person. The 3 skills of a situational leader are: (1) diagnosis of a staff member's development level, (2) flexibility in giving leadership appropriate to the situation, and (3) partnering with the staff for optimal performance. You can learn to inspire your staff to become self-reliant achievers" ”employees who have both strong competence and strong commitment in their jobs.

SITUATIONAL LEADERSHIP IN DENTISTRY

Does this approach work in dentistry? In the words of Blanchard executive Mark Manning, "Because dentists are the CEOs of their practices, they have the ability to see effects from the training much quicker and more dramatically than the large companies we deal with, which have layers of management to get through."  So Situational Leadership, we have found, is well-suited to the dental practice setting.

After several years of teaching Situational Leadership to dentists, we are now able to take this concept directly to the dental team by means of a new training tool offered by the Blanchard group: Situational Self Leadership. Once the dentist is secure in the Situational Leadership model and wants to make this approach an important part of the dental office culture, it is vital for the team to understand the same concepts and speak the same language. This is accomplished through Situational Self Leader-ship, which takes the pressure off the leader and truly creates a partnership with the team members. Employees learn to recognize the kind of assistance they need in order to perform a task well, and they learn to take responsibility for getting their needs met. Team members are taught that another staff member, as well as the dentist, can serve as a leader to them. This empowers the entire team to leadership. As quoted from The Blanchard Companies: "A leader is anyone who can give you the direction and support you need." Situational Self Leadership teaches employees that it is their job to find that leader.

Ann Phillips, the trainer from The Blanchard Companies who has qualified Pride's staff to deliver Situational Self Leadership, says, "A good business is defined by achieving the hard and fast quantitative outcomes everyone is looking for, but it's also defined by creating an environment that people want to work in and that they thrive in. Situational Self Leadership gives dental practices a full complement of skills to achieve just that" ”a good business."

In Situational Self Leadership, dental teams identify challenging tasks of their jobs and their development level at performing these tasks. They come to understand what they need from their leaders in order to become high achievers, and they develop actual scripts with which they can communicate their development levels and needs to the dentist.

A very important feature of this new program is a 15- to 30-minute meeting with the dentist called a one-on-one meeting, which the employee has the freedom to ask for once or twice a month to discuss specific goals, tasks, and skills needed to be successful. In this meeting the employee communicates what his or her development level is and what leadership style will best help him or her to attain the goals. The dentist and employee can jointly set goals and create action plans in which they both have responsibilities, depending on the direction and support needed by the employee. Situational Self Leadership teaches the staff member to be appropriately assertive in asking the dentist (or another staff member, who may serve as a leader in a given situation) for help in gaining the necessary competence and commitment to properly perform the task in question.

According to Phillips, "What distinguishes the one-on-one meetings is that they're based exclusively on the staff member's needs" ”not the leader's. It's the individual contributors who drive the conversation. The meetings are based solely on what the contributor wants them to be about. The purpose of the meetings is to help leaders and teams stay in touch and to allow employees to tell the leader what their development levels are and what they need."

Take the example we mentioned earlier of the appointment coordinator challenged by a new software program. After years of competently using the old system, she suddenly finds herself lacking the skill to do the new task, which leaves her feeling anxious and incompetent. She is a disillusioned learner. The Situational Self Leadership program teaches her that she does not have to feel embarrassed or ashamed of being a bit disillusioned, that it is part of the learning process, and that there is a way to reach for direction and support. She can safely, without risk or reprisals, communicate through a common language her development level and her needs. For example, she can say, "I need direction in using the new software program. I need to have more information about it and lots of practice. And because I'm feeling stressed about it, I would like to ask you to work with me and be supportive."

The program takes the pressure off. The appointment coordinator does not have to feel it is a shortcoming to ask for help; she understands that it is part of the learning process, and her leader understands that, too. Her being tuned in to the concepts and language of Situational Leadership greatly assists the dentist in knowing what to do to help. For example, the dentist may need to arrange for more training or technical support until the appointment coordinator masters the new system. The dentist will also need to coach and collaborate with the staff member while she is learning, which can include feedback, acknowledgement, and reward.

As you can see, when staff members are able to tell their leaders where they are on the developmental ladder and what they need to become high achievers, the dentist has a heads-up on what to do and therefore does not have to lose sleep over unhappy, frustrated employees who cannot get the job done.

CONCLUSION

Situational Leadership gives dentists and staff members leadership training, a common language with which to communicate, a way to diagnose performance challenges, a method of identifying a staff member's needs in fulfilling job goals, and a way of knowing the kind of leadership that is required to help staff members do their very best. The result of this program is to create within the practice a culture in which self-reliant achievers can flourish and dentists can avoid being overwhelmed by staff problems so that they can do what they most want, need, and love to do...the dentistry!


Reference

1. Blanchard K. The Heart of a Leader: Insights on the Art of Influence.  Colorado Springs, Colo: Cook Communications; 2004:73.



Ms. Morgan is chief executive officer and lead trainer of Pride Institute, a dental management consulting firm serving dentists since 1976. For 18 years she has consulted one-on-one with hundreds of doctors to end cash-flow crises and to improve practice management. Ms. Morgan has conducted seminars and workshops for thousands of dentists and their teams to turn average or underperforming practices into satisfying and successful ones. She and a team of Pride Institute consultants have been qualified through The Ken Blanchard Companies as the exclusive trainers in dentistry to teach Situational Leadership and Situational Self Leadership and to customize these programs to the dental practice. For more information on leadership and management study, continuing education courses, and training materials to provide efficient management systems and quality care, call Pride Institute at (800) 925-2600. Ms. Morgan can be reached at (800) 925-2600, This e-mail address is being protected from spambots. You need JavaScript enabled to view it , or by visiting prideinstitute.com.



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