Editor’s Note

The Importance of Professional Staff

In the nineteenth century, when dentistry was in its infancy, most dentists were truly “solo practitioners”, plying their trade with little or no help from others.  Today, there are very few dentists who would even attempt to practice in this fashion. “Few dentists”, observes Doug Young (1), “have the energy or the time to carry out the increasingly-large number of tasks and responsibilities that might traditionally fall to them”.  Caring and competent staff members are not only essential, they are our most valuable asset.  The ADA’s Council on Dental Practice experts believe that a productive office staff is even more important than our patient base, which is, of course, our primary source of income. (2)  Why do they feel this way? First, office staff can make or break a practice.  A good staff allows us to accomplish more in less time. Second, patients often judge the practice on the quality and attitudes of staff members.  Third, maintaining staff represents a major investment in training time and money, requiring as much as 31% of total practice expenditures (3).  Most experts believe that a competent staff is the single most important factor in building a successful dental practice.  “A cohesive, knowledgeable staff will integrally contribute to the growth of your practice”, notes Lisa Schildhorn, President of Dental Power of Delaware Valley, Inc. (4)

Finding competent staff members, motivating them and having them function as a team is no easy task.  Our dental school education left us unmercifully unprepared in this critical area.  Although we are experts in diagnosing and correcting dental disease, we are not at all well trained in leading a happy and productive dental team.   Many practitioners simply copy dental school’s “authoritarian” model of management, in which the instructor tells the student what to do (sometimes in a very demeaning way). This system of management only works well under such adverse conditions as depression, wartime, and dental school, where those who must struggle to survive are willing to put up with anything for a little money and job security.  Today’s staff members are altogether different. Their primary concern is not survival; but job satisfaction, recognition and quality of work life. (5)  They are likely to be more educated, have their eye on the horizon and  much more mobile than staff members of the past.  Says Mark Sussman of Jackson, Lewis Schnitzler & Krupman, a New York employment law firm, “they don’t feel that a job is an asset they’re lucky to have.  They have greater expectations.” (6)  Many dentists, it seems, are failing to meet their expectations.  Dr. James Pride, a noted Practice Management expert and director of the Pride Institute, reports that the average tenure of an employee in a dental office is two years. (7)

Dentists often attribute loss of staff members to better benefits and salary opportunities found elsewhere. “Many dentists” explains Katherine Grinnell, a dental auxilliary utilization teacher at the University of Oregon School of Dentistry, “don’t want to hear that it is their fault that staff members leave because they are unhappy.”  (8)  However, her survey of 120 dental auxilliaries at a recent convention demonstrated that although employees are attracted to good salaries and benefits, “in the long run, employees stay with a dentist based on how they are treated”.  They want to be respected, accepted and appreciated, notes Dr. Pride (7), otherwise, “you can pay somebody $200,000 a year and they will still quit”.

Dentists and entrepreneurs in industry, face the same challenge as they compete for competent employees. Both must shift away from the “authoritarian” method of management, which  controls people by telling them what to do, to the concept of  leadership, which  controls people noncoercively (6) through empowerment and motivation. The leadership concept offers employers far greater rewards in productivity than the outdated management concept. According to Sally McKenzie, President of McKenzie management, a dental consulting firm, carrying out instructions only utilizes 35% of a staff member’s actual capability. (9)   However, most management gurus agree that motivation to exercise judgement and initiative can coax out the other 65%.  Thomas Peters and Robert Waterman Jr., the authors of In Search of Excellence, explain that “if people think they have even modest personal control over their destinies, they will persist at tasks.  They will do better at them.  They will become more committed to them.”(10)

Sherry Conger, president of Conger Consultants, Inc. in Atlanta, observes that most experts agree upon nine strategies essential to building a winning team (12). The first strategy is principle-centered leadership.  To build a superior team, dentists must have a vision of where they want the practice to go and set goals for the staff accordingly.  That vision must be supported with a practice philosophy consisting of such  principles as a “patient-first” attitude, a committment to excellence and continuing education; and a belief in personal development.  “The foundation of team-building”, explains Elizabeth Barr, a Denver pedodontist, “is applied strategic planning in which each member contributes to and believes in the philosophy and goals of the organization”. (11)  The other eight strategies include motivation/empowerment; performance/compensation planning; delegation of tasks; communication; praise; maintaining calm in all situations; focus on important issues instead of petty details, and living up to promises.

As employers we must recognize that we are continually  being judged by our employees.  What do employees look for in a dentist/employer?  Katherine Grinnell’s survey of dental auxilliaries revealed that employees seek out employers with the following attributes (8):

  • Cheerfulness and enthusiasm for life
  • Eagerness to promote the employee’s happiness
  • Respect for the employees as equal team members
    in front of patients
  • Acceptance of personal obligations such as medical appointments and caring for family
  • Basic adherence to infection control techniques, including provision  of gloves and masks
  • A philosophy of dental care consistent with that of employees
  • Empowerment of employees to  talk to, instruct
    and inform patients
  • Compensation that allows employees to better enjoy life, including unscheduled bonuses
  • Encouragement of continuing education for employees
  • Institution of monthly improvements in technique
    or routine.

When employees join the dental team, they build a relationship with their employer, the team’s leader, based on trust that he or she will provide these things.  Steven Covey, in his book Seven Habits of Highly Effective People, likens the amount of trust built up in a relationship to an emotional bank account.  Instead of money, the employer deposits “courtesy, kindness, honesty and committment”. (20)  The reserve helps cover any slip-up.  “If you’re running late and you’re not all smiles with your employees”, explains Risa Pollack, “the reserve compensates for it–providing your behavior is an exception”. (20)

As team leaders we have the ability to touch more lives than by merely managing employees.  We can make a difference for our patients by improving the quality and efficiency of their care. We can make a difference for ourselves by increasing practice productivity and enjoyment. We can make a difference for our team members by creating an atmosphere of self-motivation, self-esteem and personal growth. Lastly,  we can help our profession through our demonstration of leadership by inspiring others to seek careers as dental auxilliaries.  Teamwork in the dental office is, in summary, a win-win situation for everyone!

The above article appeared in the Ninth District Bulletin, March 1994