Really? Don’t be so sure

I established in my last post that most of the confrontation that takes place within the four walls of the average dental practice is due to the emotional makeup of the people that comprise the group.  This is the dentist and his/her team of dental professionals, and what a sensitive bunch we are!

Back in 1998 I was fortunate to learn about a great course in Mediation and Arbitration techniques that was given for free at Arizona State University in the school of law.  It was an accelerated 6 week program that was actually developed so that the public could participate in the proper techniques to assist the Arizona courts in keeping more of the disputes out of the courtroom, thus saving the state money.  It was a wonderful opportunity for me to learn how to interact with conflicts that often arise within many dental practices.  To me, having the ability to understand the facilitation of healthy conflict resolution would be a precious skill, given the many times I’ve personally experienced “team unrest”.

Yesterday I was called by a client who I worked with in the recent past.  He was a nice young dentist who had limited experience as an associate when he chose to purchase and merge two side-by-side practices that shared one common reception area. There were two separate treatment rooms, instruments, equipment, practice styles and team members.

My purpose was to blend the two very different cultures and team members into one unit.   It also required coordinating the different philosophies and fee schedules, along with all the other cultural differences that existed within each practice.  Interestingly, getting the business models to align was the easy part. The bigger challenge was getting the two separate team members together on the same page, and with the same focus and culture.  Most integrated well, but a couple could not buy into the total revision of just about everything pertaining to the practice. All but those two employees have stayed for over 4 years now.

The dentist, calling in panic mode, only had time to share a quick synopsis as to what was going on:

“Deb, it’s all about money.  She simply wants more and I am not in a position to give her more right now. Here in the desert the summer slows everything down including the patients that are not interested in getting into a dental chair when it is 105 degrees.  No one wants to sit in a sticky treatment room for their 6 month recare appointment with my hygienist, and I told her it’s her job to convince them that they should.  I told her she needs to “try working a little harder and get the patients to keep their appointments and commit to necessary treatment, then I can justify giving you an increase.”

While this makes perfect sense and really is the way to move a successful dental practice forward, there was one “unspoken” piece that I was hearing loud and clear based on the delivery of his message, and that was “You don’t work hard enough so this is why I don’t have the money to pay you more”.

Anyone who follows my blogs knows that I frequently talk about the team “earning their keep” and “proving their value”.

With this said, I will also let you know that the Business Team in this particular practice chose not to replace a third team member who left the practice about 3 months prior.  The two remaining team members voted and were openly willing to work that much harder to replace the missing third contributor.   And yes, they were working hard–extremely hard.  But they are only two people supporting 2 dentists and 3 full-time hygienists. Pun intended, they bit off more than they could chew J

They were very much short-handed, and in spite of how hard the two remaining business office team members worked, there was no way for them to keep up with confirming calls, getting overdue appointments back on the book, checking patients in and out, presenting treatment plans, scheduling appointments for the doctors, etc.

Very simply they are now understaffed and were trying to assume the role of that missing third person. During our session the doctor kept repeating, “I can’t pay you more, for if I had it I would.” During the conversation, the team member was referencing the past owner of the practice who she worked with for over 20 years prior to the new dentist’s practice purchase. “He was great to me”, she said. “He would bring me coffee periodically, tell his patients he would be lost without me and never complained about how I was working. “You, Dr. C., fly into the meetings in the mornings, always in a rush, hardly ever ask how I am in spite of how hard I work for you, which is why I deserve a raise”.

As I was taking in their back and forth banter, it was very clear that money was not the issue, not even close. It was all about being appreciated, and being recognized for working so hard in light of the fact that they were down one employee.

Sure, it was a mistake for the business office team to think they could carry the load for three. As for the doctor, he heard them say they could handle it, so why isn’t it happening when they promised me they could?

The doctor was so wrapped up in his emotions, and the employee was so wrapped up in hers that no one was grasping the bottom-line issue during this very heated argument. As I sat listening intently, it was so clear to me that they were both missing the point.

After a few minutes of useless number crunching and histrionics, I stopped the two of them dead in their tracks and asked each of them if they want to stay together.  Without hesitation they both loudly chimed in with YES! This re-direction took them to a totally different place, and before we knew it we left the compensation issue and were suddenly concentrating on why this heated discussion ever took place.

Emotions were high during this exchange, but once put on the proper path they came together, recognizing where they were putting all their energy.  And by the way, the doctor did end up giving both of the remaining team members well deserved increases.  The team member was appreciative, but was more grateful to hear the words “you both have done a wonderful job given the circumstances, and what we all learned is that we still require some type of additional support.”