Have a Problem in Your Practice? Start By Looking in the Mirror

Angela Davis Sullivan


Dr. Lille’s practice was in chaos. Her team was constantly on edge, bursting into tears at the slightest provocation. Hygiene kept failing to meet collection goals. The front and back office continuously complained about each other. Patients were upset because their appointments always ran late. And, Dr. Lille was sick of the way that everyone seemed to need constant supervision and micromanagement. Why couldn’t any of these people think for themselves?

“That does it,” she told her business coach after one spectacularly hard day. “I just need to quit and start fresh. This team is awful, and the practice is beyond repair.”

Of course, Dr. Lille didn’t really intend to close the practice, fire her team, and start again from scratch. But her frustration was very real. There were so many things wrong in the practice, and it was clear to her that the team was the root cause. So if she couldn’t fire everyone, how could she possibly fix the problems? 

The One Constant Piece in Every Puzzle

When your practice is in chaos, it can be hard for you, as the dentist, to spot the root cause. You’re too close to the issue. You’re enmeshed in everything. Your emotions and feelings of worthiness are tangled up in the state of the practice, just like your team’s are.

There’s a secret that every management consultant knows but our clients aren’t always ready to hear. When there’s a constellation of problems holding a dental practice back, 99% of the times, there is a clear root cause—the practice leader. If your practice is in chaos, or even if it’s just not as great as you hope it could be, you need to start by taking a long, hard look in the mirror.

All of Dr. Lille’s complaints ultimately come down to issues of leadership. When a practice has a weak leader who constantly lives in fear of scarcity, it falls apart. When it has a strong leader who embraces abundance, it thrives.

The problem is that many people have a false image of what it means to be a strong leader. By trying to live up to that false image, they create problems. The way to solve these problems in your practice is to replace this mask of a strong leader with actual strong leadership. 

Replace the Harsh Taskmaster with a Careful Steward

Many people believe that strong leaders push their teams, and themselves, to the breaking point. Everyone must give 110% and work until they are exhausted for the good of the practice.

This is not good leadership. It’s leading from a place of scarcity, where the team is lazy and unwilling to contribute and must be forced. It’s also poor stewardship. People can and do burn out, and your most skilled team members will leave for practices that value their time and their skills and treat them fairly. 

If your team is burned out, take a hard look at how you’ve structured their schedules and duties. People who are burnt out can’t give your patients excellent service and clinical care. They can’t make good decisions under pressure. They can’t get along with their coworkers.

How can you relieve burnout? Should you hire more people? Schedule patients differently? Reallocate duties or change your office hours? If you lead from a place of abundance, you realize that treating your team with respect will actually make them more productive than pushing everyone to the breaking point will.

Replace Goals Set at the Top with Team-Created Commitments

When someone is simply pretending to be a strong leader, they tend to make a lot of pronouncements and expect the team to comply. “We will reduce waste by 30% this month! The hygiene team will increase collections by 20%!” To an inexperienced leader, these pronouncements mimic strength. However, they confuse authoritarian behaviors with authoritative leadership.

Authoritarian leaders bluster and threaten, but they don’t give the team the tools they need to succeed. They trust their own view of the situation without listening to people on the ground. They expect goals to be met and punish failure while refusing to take any blame themselves. This leadership style demotivates the team and ultimately creates a weaker practice.

Authoritative leaders, on the other hand, realize they have experience or skills that aid them in decision making, but still ask for input from their team. They want buy-in for their plans, and they are willing to take the blame for failures. They work to clear obstacles and give their team the tools they need to drive the success of the practice. For Dr. Lille to increase production, she will need to become an authoritative leader—the type of leader who uses her influence to create and build up others. To really grow, you must also grow the people on your team.

Instead of setting goals for hygiene alone, Dr. Lille should have a team meeting. She should share with the team what the vision and goals for the practice are. Give the team permission to share what they see and think.  Brainstorm ways to handle those challenges and increase production and teamwork. The leader should speak last, though. Let the team share ideas first. That will help with the buy-in from the team. When they are part of the process, its execution is much more successful. 

After the team has shared, then you add your input. Thank them for sharing. You may be surprised with what they came up with. If they missed something, now is your time to add your thoughts, and don’t dismiss theirs. If you squash everything they shared, you will soon find out that they won’t share their ideas again. By getting buy-in, you increase the likelihood that your team will meet your goals. You also will receive useful feedback about current roadblocks so you can work to remove them.

Replace the Micromanager with a Mentor 

Dentists who micromanage their teams often defend themselves by explaining they have to micromanage. Team members won’t make decisions without constant input. They’re constantly seeking reassurance. Since no one will take initiative, it’s up to the practice owner to do everything. It’s exhausting, but what else are you going to do? Someone has to lead, and it’s up to you.

This attitude tends to reverse cause and effect. You hired your team because they were competent and could do their work unsupervised. If they now need constant supervision, it’s maybe because you made them that way with your micromanaging tendencies. It’s human nature. When we know our leaders don’t trust us, we stop taking initiative. Why bother, when you’ll probably get in trouble?

To transform your practice, replace the micromanager mask with a focus on mentoring. Ask your team where they struggle. Don’t lecture. Demonstrate and teach. If you have team members who are great at something, ask them to train others. After you’ve seen your team perform a task correctly once, get out of the way. Tell your team you trust their judgment. When they come to you with a question about a situation, ask them what they think the right answer is. You’ll find that your team is still composed of the same competent, confident people you hired once you lead from a place of trust and compassion and can can guide and energize them instead of obsessive control.

As the practice leader, you set the tone for the team, the practice, and even the patients. When you act as a caricature of a strong leader, your practice suffers. If, on the other hand, you transform yourself and your approach to leadership, you can have a happier team, more satisfied patients, and a more productive practice. Maxwell says if you want to be an effective leader, you must move from perfectionist to pragmatist. If they can do it at 80% or better, let them do it.

Ms. Davis Sullivan is a practice management consultant with more than 30 years of experience in both the clinical and business sides of the dental industry and the author of Coming Home to a Better Practiceavailable through Amazon.com. She is a certified trainer for Forte’ communication styles and for John Maxwell’s management philosophy.

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