For Better or Worse

Every time I accompany one of our Crown Council humanitarian expeditions (www.CrownCouncil.BlogSpot.com) to the Dominican Republic, I take at least one of my daughters to work and learn from the experience. Last week’s expedition included my 12 year old daughter Abby who helped every day with set up, sterilization, assisting, handing out hygiene kits, clean up, and whatever needed to be done. Abby even spent some time entertaining the other children while they were waiting their turn to see the dentist. One of her most significant accomplishments was the 750 hygiene kits she assembled to take on the expedition so that each patient could leave with a tooth brush and other essential hygiene items along with written instructions for homecare.

On our last clinical day, Abby assisted Dr. Jonathan Nicolas of the Dominican Republic. Abby held the flashlight, instruments, and did whatever Dr. Nicolas needed as they treated patients together. When we broke for lunch, Abby and I debriefed the morning wherein she made the following observation: “Dentists make things worse before they make them better.” Having watched Dr. Nicholas treat several cavities, she saw how much tooth structure had to be removed to make sure the decay was gone before filling the tooth. She, like most people, was amazed at how much had to be taken away before the tooth could be “put back together again.”

After listening to Abby’s fresh perspective on dentistry, it made me think of how many other things there are in dentistry and in life that have to get worse before they get better. Because we know it will have to get worse first, we often avoid taking action. How many of the following “worse before better” issues have you ever found yourself avoiding:

• Taking disciplinary action with a team member for fear of his or her response.
• Telling a patient everything that is really going on in their mouth for fear of how they will react.
• Making a change in an office procedure because of the time and effort it will take even though you know it will make things better in the long-run.
• Scheduling a long over-due C.E. course that you know will make you a better clinician because of the time and investment it will take.
• Remodeling or updating the office because of the investment.
• Taking the needed time to really train the team.
• Working with a coach to improve the practice for fear of having to face the truth about what is really going on.

When you think about it, most things do have to get “worse” before they get better and that is what stands in our way of getting started or taking action. But that same inaction makes it even worse than it would be if you just jumped in, felt the pain, and did it anyway.

So what is the biggest “worse before better” action you are avoiding? Could I challenge you to step up and start “prepping?” You might as well be in charge of the “worse” part instead of letting it be worse on its own. The faster you get busy and work through the “worst,” the faster it will get “better.”

What is your team culture?

Well over ten years ago, we made a hiring mistake. (It was the only mistake I have ever made…!) We hired and “office manager.” Within days the mistake was apparent. Team members from all directions were complaining:
“I can’t get any work done."
"He is too nosy."
"He’s driving me crazy.”

Upon further investigation, we discovered that the “manager” in question would give someone something to do, and then would constantly badger that person with frequent questions like, “How’s it coming? What kind of progress have you made so far? When are you going to have that done?” That approach communicates a lack of trust and a culture of irresponsibility. There has to be a better way.

In contrast to the above, imagine an office where each week the team meets for one hour. The agenda is prepared in advance and everyone knows what to expect. Just about anyone could run the meeting because it is run the same way every week. Systematically, each team member reports to the rest of the team on his or her area of accountability including results compared to the goals and the action plan that he or she has developed to further the results in the right direction. After giving the report, he or she asks for further input from the leader and the rest of the team. When done, the next person does the same thing until each area of the practice has been covered. That is what you call Team Accountability. When set up correctly, it can take tremendous stress off the dentist or the leader and the results will be far greater than the alternative approach.

Here are some of the characteristics of a Team Accountability:
1. Areas of accountability are clearly defined.

2. Some ONE is assigned to each area of accountability. Others may help, but just one person is accountable for ultimately answering for the results.

3. With each accountability is given the proper tools to get the job done.

4. Desired results are identified in advance so the person accountable understands the end result for which he or she is ultimately responsible.

5. Diagnostics are put in place so there is an easy way to measure results. Those who are accountable for specific results need to have a way to measure if they are indeed getting the results for which they are accountable.

6. Regular reporting intervals are set up in advance so the person knows when he or she will report to the team and to the leader on the results to that point and the action plan in place to continually improve.

When set up properly, the only question that the leader needs to ask is a follow up question or two for clarification or suggestion. Leading has never been so easy!

After the “Office Manager” disaster mentioned at the beginning of this article, the team pleaded with me NOT to find a replacement. “We don’t need to be managed,” they said. Just tell us what you want and we’ll do it. It was at that point that we implemented the 6 steps above. Then on a regular basis, we got together and each person reported on his or her area of accountability accordingly. Amazingly, but not surprisingly, moral and motivation went up, results came much faster, and everyone enjoyed their work more.

So what kind of culture do you have in your office? Is it a culture of irresponsibility or do you have an accountable team? Put the 6 steps of accountability in place today. It may take some time for your team to make the shift from your badgering to their reporting, but they will ultimately enjoy their work more and appreciate you as a much more effective leader.

(Team accountability is just one of the many principles taught at the ToPS “Leading a ToP Team” course for dentists and key team members. For dates and availability go to www.TotalPatientService.com or call 1-877-399-8677.)