Get Out of the Way!

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They say there are five basic obstacles to success: fear, lack of goals, holding onto the past, distraction, and poor influences. I think this holds true for dentistry and I would add one more : yourself! I have found this to be true in my case and if you are a dentist wondering why you aren’t finding the success you envisioned, let me humbly suggest that you get out of the way of your own success. This is how I did it.

After twenty one years in practice, I find myself with a large family practice in a great community, and a second practice that recently opened in downtown Knoxville, Tenn. I am working 12-hour shifts to cover both offices and now have more employees than I ever thought I would have. You might think that this sounds like more work than success, but I have to confess I am having more fun than ever in my career. I love what I do and I am excited to go to work every day. Did you hear that? Dentistry can be fun! How can that be?

The simple answer to creating fun in my career stemmed from developing a structure from where there was once ambiguity – a structure that formed when me and my ego got out of the way and allowed my team to unleash their talents and abilities on behalf of my patients. My job is a lot easier now. I show up, diagnose, and treat to the best of my ability then I GET OUT OF THE WAY! How I arrived at this happy state of affairs can be reduced down to four principles: first identify your practice leaders, second maintain and cultivate them, third delegate and empower your staff, and lastly have fun!

Identify Leaders – and other key team members

When adding a person to our team I always ask, “Do they want a job or a career?” A leader will almost always have a career-based view of the opportunity; whereas a regular employee will think of their position mostly in terms of income. Both leaders and regular employees are important to the success of the practice. Leaders will help you give shape to the vision of what the practice will become while setting the pace and the attitude that the regular employees will follow.

Finding a leader is not always easy and requires some creativity on your part as to where you find them. Don’t constrain yourself with preconceived notions of where to find leaders. My wife is great at this. We have always had the philosophy of “Hire for personality, work ethic and people skills, and train technical skills.” We have hired a bartender (great multitasking and people skills), an athlete (great team skills and work ethic), even a hair stylist (know how to make people feel good about themselves.) It may sound like a haphazard way of going about staffing an office but remember, it only takes a couple of “All-Stars” to create an environment that drives excellence. Once you have effective leaders in place you will find that you naturally attract and develop employees needed, so that the dentist can get out of the way and focus on the dentistry.

Maintain and Cultivate

Once you assemble the right mix of leaders and employees, don’t screw it up by micromanaging! No matter what, you must respect those that work with you, which is done principally by trusting them to own the job they are doing. I have found that when I try to make staff members do things a certain way for no other reason than that is the way I like it done, tension creeps into the office. An effective working relationship that allows for continual process improvement requires two-way communication, not simply top-down management of every detail. Once I started approaching my staff with that in mind I was able to get out of the way and focus on the dentistry. They felt empowered and went out of their way to make sure things were done effectively and efficiently. As the old saying goes, “Respect goes both ways.” If you want to lead then you must have their trust and respect.

If tension is a common part of your staff dynamic, you are probably in the way. If there is tension between you and your assistant or hygienist at the chair, it will be visible to the patient through your body language. Talk about killing case acceptance. It is hard to for a patient to see the value in the treatment you are presenting if there is tension between yourself and your staff.

I believe one of the key indicators of a cultivating environment is the level of involvement that staff members have in the case. If you and your staff work in a silence that is punctuated by short directives from you to them, you are not cultivating your team. I always try to praise assistants in front of the patient when things go well. My assistants select almost all shades, so when we nail one, I make it a point to really brag about how lucky I am to have the staff I do. This accomplishes two key things: first, it assures the patient that they are in good hands and that they also are lucky to be a patient at a practice that has such excellent staff. Second, it affirms the staff’s contribution and results in a more detail-oriented assistant who feels appreciated.

Make it a point to involve the entire staff in the outcomes you deliver to patients, and let them feel your passion for what you do. Passion is contagious. We try to get the entire team involved in our bigger cases, not just the assistants. Share the patients’ stories and the impact dentistry has had in their lives and watch your staff blossom as your life gets easier.

Delegate and Empower

This is one of the most important, yet most difficult aspects of getting out of the way of your own success. In my role as a member of the Dr. Dick Barnes Group, I meet many doctors that can’t give up control of any part of the practice. They micromanage things to the point that their staff is paralyzed because they don’t feel empowered to do anything without approval. When this happens, doctors, you will not have time to focus on your passion because you will be spending a majority of your time managing details best handled by simply getting out of the way and focusing on patients. I have found that giving every staff member a responsibility makes them feel ownership in our practice. And that is exactly how I refer to it: “OUR” practice.

When someone shows a strength we let them run with that task. They may make some mistakes but that is the best way to learn.

Here are some examples of duties delegated

-interviewing new patients
-postoperative calls
-new patient follow up letters
-presenting treatment
-expanded functions , making temporaries, adjusting appliances
-anesthesia (hygienists, where legal)
-phoning in prescriptions
-gifts to patients
-marketing and promotions

It’s amazing how much easier it is running a practice when the worry is shared by an empowered and engaged staff.

Have Fun

Dentistry is hard enough under ideal circumstances, so why not try to keep the mood light and positive? My wife Trish and I keep morale up by planning periodic events designed to affirm our appreciation and team effort. This can involve various activities as well as incentives as a reward for a job well done. For instance, we involve everyone in March Madness, where a random draw gives everyone teams from the NCAA tournament, with the winner receiving an iPad. This one really gets the camaraderie going (as well as some good trash talking.) We have rented box suites for local professional baseball games. Spontaneous shopping sprees have been fun, for obvious reasons. We surprised them at lunch, and took them to the mall where they had 30 minutes to spend $150 with the stipulation being it had to be spent on themselves.

We also involve our team with “thank you” gifts and incentives for patients. They are the ones who hand out Starbucks or Subway gift cards when we have run behind or inconvenienced the patient. Along the same lines, they help decide who will be our candidates for charity cases or models for Arrowhead classes. This is fun for them and reinforces the sense of ownership of the practice.

The bottom line is that I truly believe the biggest obstacle to a successful practice can be the dentist. The difference between a leader and a dictator is often seen in the outcome. Do you catch yourself uttering the phrase, “do I have to do everything?” Is tension is a constant presence in your practice? Do you find that most of your day is spent running the practice instead of focusing on patients? If so, I would tell you that you are a dental dictator. Success is found where leaders empower those they work with. Getting out of the way has allowed me to find a level of success and fulfillment in dentistry that I didn’t know was possible, and I am sure it will work for you.

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Buzz Nabers received his D.D.S. from the University of Tennessee in 1992. He has practiced in the Knoxville area for thirteen years. He currently maintains a family practice with a strong focus on adhesive restorations and cosmetics.

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