Playing Nicely in the Sandbox

Bullying can happen at any age

My earliest recollection of naughty playground behavior goes way back, to the days of elementary school. Once lunch was complete and our places cleaned, we all went out to the playground to mix and mingle until the bell rang that it was time for us to come back into our classrooms. This day, which I can remember quite clearly, there were lots of secretive “girl” conversations out on the playground, lots of buzzing about something. Turns out that two gals were handing out birthday party invitations both of which happened to be on the same day starting just a couple of hours apart.

I can clearly remember the word “disinvited”, was this even a word I wondered? Nonetheless this is basically what precipitated the chatter within the group. The two birthday girls were bantering back and forth as to which of them was going to change the date, neither would budge. This is when the subject regarding “disinvited” began to circulate. “If you choose her party over mine, I will disinvite you and you will NEVER ever be invited to anything I have in the future”, said one to the other. Hearing this the other classmate made the same announcement and the conversation began to escalate. I can’t recall all the details from here, but my mother who has always been the quintessential diplomat said, “Debbie, it’s easy. You will go to one party for half the time and the other for the other half of the time. The solution made total sense to me and I remember feeling the relief since even at that young age, I didn’t do well with conflicts.

Now looking back as an adult, I can see that each of my classmates were fighting to be the one recognized. Understandably at 8 or 10 they were not able to logically come up with a reasonable arrangement to appease both girls at the time. I was so grateful that my mother offered me a perfect solution to keep both girls as friends. Fast forwarding to today and here I am 60 years later continuing to see similar situations like this one occurring in my adult life. Adults challenging adults to be the top dog. Bullying on Facebook and not by kids, but by intelligent business professionals. Often, I read about plagiarism and stealing systems and protocols. Employers not giving employees the benefit of support when they are underperforming, helping them to make the changes required to meet the goals of their positions. Hearing their challenges and compassionately offering them the

help they may require. Then there are the employees, working just hard enough so that they can fly under the radar without being noticed. They could be taking advantage of CE meetings and seminars just so that they are able to get away, eat in nice restaurants and interface with fun and influential people. They have no interest in supporting your practice or have any interest in bringing some of new skills learned back with them. It’s more about serving their needs and enhancing their own interests.

Back then in grade school I learned that there are solutions that can be applied so that no one loses. I believe that today as adults we need to get back to old ways of working together. Why must so many feel that unless it helps to self-promote or get themselves noticed, they will simply take advantage of anything that benefits them and continue to step on or whoever/ whatever it takes to get them to the top!

How Did Things Get This Bad?

A referee isn’t the answer

I jumped in on a conversation that was streaming on one of the dental social media sites on which I participate. From what I could gather after showing up a little late, the question posed to the group was one in which there was an on-going feud occurring in one of the members’ practices. It was between a “strong” personality hygienist and a “want-to-take-charge” Office Manager. The doctor expressed his interest in wanting to keep them both, but really didn’t know how to resolve this problem. Based on what the latest “riff” was about, it appeared to me to be clearly a power struggle between them.

The way I look at these challenges is that the catalyst (or what perpetuated the challenges between them) is not always critical information to have in order to resolve their differences. It’s more about why they had been arguing and not necessarily what they had been arguing about.

From the little I had to go by, I felt as though they were having a power struggle. Their ultimate goals were the same–getting the patients to stay committed to keeping their appointments. The openings that were occurring at the last minute made the pressure and the stress of the moment take its toll on both of them. I did observe things that could have helped them both to be more successful, but I wanted to stay in my area of expertise so I really didn’t go into too much detail as to how they might remedy the issue causing their conflicts.

My suggestion was to have them work out their differences on their own, given a time frame in which they either come together and make amends without any future repercussions. Or if they are unable to work things out–remember that everyone is replaceable.

I feel strongly that unless the two of them come together without anyone else facilitating their truce, they and the rest of the team will never learn or understand that, as adults, childhood behavior is not acceptable. Behaving poorly sends a terrible message to the other team members, as well as the patients and there is no reason why adults in a professional working relationship should not be able to work in harmony.

I was shocked when the doctor who posted this thread responded with, “Well, I can’t leave them alone to cuss and scream at each other. I need a facilitator or “mediator.” Coincidentally I happen to be trained in Mediation and Arbitration and so I know that the purpose of a mediator is not to solve the problems, but to

guide the subjects in conflict to come to a decision on how to settle their differences on their own.

And how did this problem reach such proportions? Cursing and screaming at each other? Truly? How could an employer let their differences escalate to such a level? What about the team members that DO get along? How do they turn their heads the other way when they have to witness some of this aberrant behavior? Then there are the patients, many of them have had to observe these encounters.

My question is: How long as an employer, should you allow employees to not get along? If they can’t mend their fences and resolve their differences, then it’s time to move on. You are running a business, doctor. Who has time for this type of behavior in a professional environment? Why is it that you have so much difficultly abruptly ending this drama before things get so out of hand that it may require a referee?

Deb Roberge has been coaching and writing about dental team development and related areas for the past 25 years. During her onsite visits to numerous periodontal practices, she quickly recognized the very specific challenges that were prevalent in this particular specialty. She felt it was important to step up and support not only these clinicians, but the team members that work alongside of them, as well as the referring generalists and their teams. OurPerioTeam cloud-based software was created with Deb’s input along with perio practices and teams across the country. OPT is changing the way both periodontists and their referring generalists interact, as well as how they measure their mutual successes.

THIS is What Raises are Made of!

No team member should have to ask for an increase when they have clearly earned it

I talk about the value of team members all the time. I can’t stress enough how important it is to be able to clearly identify the employees that pull their weight “and then some.” I’m referring to those employees that get as much or possibly more satisfaction than you do when they can see their efforts paying off.

I recently worked with my wonderful “work sister”, Cyndee Johnson of scaler2schedule fame, and assisted one of her clients with a couple of team dilemmas. In this case the client believed that one of his business office personnel was not managing her post very well and with that, he asked that we review the additional office employee whom he thought was having her own difficulties with insurance filing and billing. These happened to be her primary responsibilities.

Upon conducting our usual due diligence, it was quite easy to see that there were even bigger problems than anyone expected, but the proof was in the numbers, and with comprehensive research we uncovered a myriad of unsettling issues.

Pre-determinations were filed, approved and tucked away with no appointments scheduled and apparently no follow-up calls even made to those patients that had their paperwork submitted and returned. There were 9 pages of problematic insurance issues that were never addressed where many simply needed an additional x-ray or even a simple narrative. Some claims that were discovered dated back to 2015!

Then there were the statements that had not been generated for a couple of months. And did I mention the major ADA code discrepancies? These were bogus codes obviously fabricated by past employees that were used periodically and sat in the system for years. No one seemed to know the origin of this.

Once we delivered our findings to the doctor (and administered his CPR), I knew it was time for us to now take charge and get his practice back on its feet again. Unfortunately, we had to dismiss the 2 team members, but we had clear documentation that they couldn’t defend, and apologized for not asking for help. They left the practice with the understanding that it was time.

To support the doctor, he like so many others in my experience hired quickly without properly checking to be sure the knowledge required to fill the positions was present. He also neglected to check on status, reports, numbers, etc. He loved his dentistry, was good at it, and felt he could count on his team to handle the business segment of his practice efficiently. This too is not uncommon. No strong hiring protocols, hiring with no formal systems, no information tracking, no period reviews and basically assuming all would be well.

I knew the caliber of candidates we needed to locate, and although it took about 6 weeks to find two great team members, the 2 we were fortunate to find were both perfect for the position. Both had ideal skill sets, terrific attitudes and worked extremely well together! We conducted our interviews with all my “road tested” systems in place, dotted all of our “i”s and crossed all our “t”s. Yes, it took time, but it was so worth it.

Here we are 2 weeks into the Superstar Front Office Team’s partnership and I got a report today. You see, we track the progress and we make sure the team members track their activities as well. We look at the challenges acquired and meet them head-on.

The main concerns were the time-sensitive issues, such as insurance re-filing. I spoke with the person who is managing the insurance this morning, and in only 2 weeks time she has recovered $6,000 of back claims and took the print-out list down from 9 to 7 pages! She has managed more in two weeks than the prior business team handled in 2 years. They actually moved the production back rather than forward.

This is an example of how increases are deserved and earned without a second thought or hesitation from the employer. My Progressive Salary Program is built around this premise and Suzie (not her real name) hit her first benchmark, exceeded her first goal, totally hit it out of the park . So…Suzie’s next pay check will reflect her first 2-week increase!

Deb Roberge has been coaching and writing about dental team development and related areas for the past 25 years. During her onsite visits to numerous periodontal practices, she quickly recognized the very specific challenges that were prevalent in this particular specialty. She felt it was important to step up and support not only these clinicians, but the team members that work alongside of them, as well as the referring generalists and their teams. Ourperioteam cloud-based software was created with Deb’s input along with perio practices and teams across the country. OPT is changing the way both periodontists and their referring generalists interact, as well as how they measure their mutual successes.

Making Changes To Assure Success

 

Quick fixes Rarely Bring Long-term Results

Making adjustments to the way we run our lives and our businesses is never easy. So much of who we are is ingrained in the day-to-day manner in which we conduct ourselves and manage our lives. Fear can easily take over when we attempt to change our comfort zone. Making alterations to the way we operate and handle things can be a shock to our systems.

All of us know to some degree that if things aren’t working satisfactorily then the only way to turn things around is to make changes. Recognizing the importance of making necessary change is not so much the act of enacting it, but sticking with it! We begin with all good intentions and a desire to move forward quickly for immediate results on what is needed. Then why is it that more often than not this determination begins to fade out and eventually disappear, and before we know it our old ways have resurfaced.

We know we need to lose weight, so leap straight ahead with a burst of determination. We don’t just join a health club, but start off BIG by joining a spin class and perhaps a very aggressive Zumba group. We don’t just cut back on some of our poor food choices, but we instead go on a fast routine working to stick with 1,000 calories or less a day. We don’t stop smoking with the aid of a counselor or support meds, but we choose to throw the cigarettes out the window (including the carton we just purchased) and go it cold turkey.

So what’s wrong with these approaches? Shouldn’t we be commended for the strong desire shown and a demonstration that says “we really mean business”?

Yes, a statement is being made and to the outsiders looking in they are quite impressed with your expression of sincerity. Truthfully though, these examples of making changes in one’s life will most likely be short lived. Taking an aggressive approach may sound encouraging yet when it comes to change, change that will stick, it takes planning and at a pace that doesn’t overwhelm.

This same principle applies to changes we make to our businesses. Bringing in new systems, crafting new protocols and getting those “cultural” issues set up and spelled out in the brand new Office Handbook that you are excited to implement can be exciting. Many employers apply these new ways of managing their business and teams in the very same way. Now that they are ready and focused to make the changes they are recognizing as needing to be fixed, making the shift can’t come soon enough. They are ready to roll and can’t wait to implement all that is suggested as soon as possible.

Again, enthusiasm and the desire to get things going is a wonderful thing, but being anxious to get as many changes made as possible as quickly as possible is a prescription for a quick failure. Just as weight loss programs bring long-term success through a slow and steady process, so does the process of making changes in policies and programs that have been a part of a business model for years.

Take one new format at a time and don’t necessarily put a timeframe on what needs to be revised, that is unless you are changing methods that are causing immediate harm to the business/team in some way. When an advisor that you respect and admire offers you advice that you know you need to pay attention to and strongly consider for the betterment of your practice, don’t let any of it throw you.

Between the two of you, evaluate the priority order for the changes you need to make and then slowly integrate step by step. Slowly incorporating new ways of handling things is definitely not easy for most of us, but slowing things down as much as possible will help us to become more and more secure with the change.

Slow and steady DOES win the race.

Do You Hire for the Person Within or the Outside “Packaging”?

Talent may not be “visible”

I fear that we are seeing more and more superficial rationale when it comes to building a dental team. I find it so disturbing when a client paints a picture of the team member they envision and the first words they mention are that they should “look good”, which means what exactly?

While I would agree that taking care of one’s self from the hygienic standpoint as well as a professional presence is important, I don’t believe that we need to be seeking out potential beauty contest winners.

To me, it’s much more about professionalism, dedication, the ability to take direction, to work well with others, to think before they speak, and of course to not flood the office culture with unnecessary dialog or disrespectful banter. While presenting a healthy “look” would make sense in that we are in the healthcare field, I will never support refusing to offer a great employee a position based on some level of perceived physical attractiveness.

Are they neat? Are they well-spoken? Are they talented and skilled? Have they proven to you that they are perfectly qualified to manage the job that was offered to them? If all this fits then it’s not about them, it’s about you!

I realize that this is a touchy subject, but I’m at a point where I felt it was important to bring my concerns out into the open in the hopes that it will bring to light some very shallow thinking and stimulate some healthy assessment when situations of this nature are presented.

Don’t pass up an ideal team member based on superficial values. Many very special qualities are not visible to the naked eye.

Managing Team Conflict

notlistening

Whose job is it anyway?

I Stopped at my favorite local Starbuck’s today and things were jumping.  Could it be coffee for your sweetheart on Valentine’s Day?  Nonetheless, after I placed my order I couldn’t help but overhear what sounded like a heated discussion between one of the baristas and the store manager, Erica.  The level of conversation was high and continued to escalate in spite of the crowds and cross-banter at the coffee bar that should have drowned it out.  I’m sure that not only could I hear the conversation, but I suspect many others could as well.

“She never picks up after herself”, said Trevor, “and with that she runs out the door as quickly as she can and the end of her shift and I never see her grab the garbage or do anything to help the rest of us. I’ve really had it with her. You need to address it as soon as possible.”

The body language was almost as interesting as the dialog, with Trevor leaning forward and Erica looking stunned with almost a glazed look in her eyes.  It appeared as though Erica was near tears and didn’t know how to respond.  I was hoping that with every word Trevor uttered she would be intentionally moving him toward the back room, but this never happened. With Trevor’s rambling, it was obviously difficult for her to get a word in, or move him away from the patrons at least. Erica was clearly very uncomfortable

My coffee was placed on the bar and as they called my name I grabbed it as I heard Erica say, “Okay, stay a little later with me and help me make a list of the things you want me to address with Stephanie. Is there anyone else that has similar issues with her?”

Whoa, really?, I thought to myself.  I see a couple of things here that are unacceptable and problematic at best.  Why not stop him right away noticing the crowd that had been forming in the store? Why not immediately take him to a quiet place for a moment so that others wouldn’t be privy to the conversation? And why oh why would you encourage this employee to continue his anger with you so publically? These aren’t your issues, they are between him and a fellow employee and should be resolved between them without any interaction from their managers, bosses or superiors.

My experience today reminded me of those I have witnessed while working in practices over the years. It’s the team members airing their issues and not always in the most healthy manner or most opportune time. It’s the dentist/employer who will stop and listen to this rhetoric getting much more engaged in the story than they should.

Have you established guidelines and very specific “language” in your practice culture overview or employee manual to manage issues of this nature?

Direct your employees to solve their own problems and become more self-sufficient, for if you continue to offer them a platform to vent, their problems will immediately become yours.

It Pays Dividends to Take Your Time

rush

Rushing a Hire is One of the Biggest Mistakes an Employer can Make

I’m so frequently asked what the biggest mistake I see when it comes to dental team development. Although there are a number of things, by far the biggest mistake of all is hiring too quickly in my opinion.

The hiring dentist receives an ideal, picture perfect resume and almost sight unseen is ready to make the applicant an offer. Then there is the job candidate that presents beautifully, with a resume in hand in a shiny folder. Or it’s the applicant who arrives early and introduces herself to the front desk, shaking hands as she moves from one to the other. While all of this is admirable and great to experience, this is not enough to make a well educated hiring decision. Not by any means.

It’s a process that we need to go honor–one that takes time and one that requires much more than simply the superficial things that initially might impress. Making a hasty decision based on a first impression is not the way to enter into a long-term hire, one where you and your team member can celebrate years of “togetherness” and basically establish a match made in dental heaven.

They do happen, as I have seen many and the one commonality is that there was not a hasty decision made from the side of the new employee or the employer. It took time for everyone to see if the fit was right, if the personalities jibed, the practice culture was aligned, the dentistry was in synch and the mutual respect was reciprocal. These things take time and time is what should be invested by both parties in order to be sure that everyone can expect a long-term, healthy business relationship.

How many marriages have endured based on a very short courtship? Take the time to be sure–from both sides–and once everyone involved agrees, it’s a matter of maintaining the bond that you have created.