Exceptional Dental Practice Management

I'm So Happy To See You!

Do you make your staff feel like that when they arrive in the morning?  Chances are you don't.  I don't think I really do, consistently.  This is what usually happens:  I'm usually the first to arrive by at least 30 minutes and I'm usually deep into something by the time they get there.  Cathy usually gets the best greeting because she comes in the front door and we say hello and often have something to discuss from the day before.  Julie and Annette come in about 20 minutes after her and shout up the hall.  I don't know if they even hear me grunt my reply, which is usually something like, "Uh, huh" or just "Huh" if I'm really into something.  Harris flies by with barely a nod and passes by so fast that I could easily miss her. My boss yells hello down the hall and heads straight to his office. I often feel a little miffed at the abruptness of it all.  Why don't they walk the extra few steps down the hall to make visual contact with me? Why doesn't she slow down and say "Hello?" Well, why don't I go to them?    When we all finally get into the breakroom for morning huddle, we give each other a more considerate greeting.
I started wondering today, what would it be like if I broke away from whatever "important" thing I'm working on and was waiting to give them a really great greeting.  What if they felt that I was really happy to see them.  Because honestly, I am.  The day is always better when everyone shows up.  When I start to realize that it's 10 minutes past the time anyone would normally get there, I start to worry like the mother hen that I am.  So, how can I start the day by letting them know how happy I am that they've arrived?  I already have the coffee brewing when they get there, and to be honest, they take it for granted.  If I forgot, they'd just make it themselves, so that's not such a big deal.  I think I'll try just getting up from my desk and going to them and asking how they are today and really listening to the answer.  What if I made greeting them the important thing.  Now, they might think I've finally cracked, but they might also realize just how appreciated they are.  People like to be noticed.  Often, they'll do whatever it takes to be noticed, even if it means they have to cause some trouble before anyone pays attention to them.  They love it though, when you notice them for who they are.  Don't group them into "the hygienists", "the assistants", or the "front office".  See them as individuals who each add something valuable and unique to the practice.  Ask them how they feel and what they think about what you're doing together.  Really listen to understand.  When people see that you notice their contributions, they tend to contribute more.  When they see that you acknowledge change that you've requested, they are more willing to comply with your requests in the future.  Best of all, when you show them that you're happy to see them, they tend to be happy to see you, too.

Do You Really Know How To Lead? Really??

Leadership is an interesting concept.  I call it a concept because there are really no set rules about how to lead.  There are no real leadership schools, because it's something you learn along the path of life.  I think that very few of us are ever finished, we've never learned all we can about leading others. 
I remember when I started managing our practice.  I felt like someone threw me into the middle of the ocean and said "Swim" without also teaching me how to tread water, or at least tossing a life preserver in after me.  So I did what anyone who wants to survive would do, I desperately paddled and waded, went under a few times, (felt like staying under a few times) and finally started making some productive progress.  It wasn't too long before I thought I knew all there was to know about swimming leading.  I'd soon find out that all I really knew was just enough to keep me from drowning. 
I have found that just when I think I'm really a good leader, reality smacks me in the face and I realize that I have a lot to learn.  Here's a little of what I now know:

1. Leadership lends you no power.  If you are accepting a leadership position, don't do it for the power you think you'll have.  If you try to lead by might, you'll find out how weak you can be.  You will realize that you are dependant on those you lead, not vice versa.  If they don't like you, don't agree with you, don't like your methods of leading, you will be as effective in getting things done as a bird with no beak or wings.  The power is in the relationships you build with your team.  It is in the example you set.  The power is in the character you unfailingly display.  It is in your consistency.  The power is in the trust you build.
2. Speaking of trust, in case you didn't know, you build it with every word, every response, every facial expression, every nuance and every action you take, every conversation you have, the way you handle good times and the way you react in harder times.  When you are doing it right, your staff will look to you for reassurance, they will base their response on the way you seem to feel about a situation, and they will mirror your attitude toward others. If you want to test this, walk into a meeting and just be quiet and don't display your usual upbeat personality.  You will see the mood deflate and become flat.  They trust you to set the tone for the day.  If you think it's a downer, it must be.  So if you want to have people who are working together in harmony for a common goal, you better make sure you do it first.  Make sure you're happy doing it, too if you want to work with happy people.
   
3. You don't get a bye when you are in a leadership position.  It doesn't matter if the boss is grumpy, the patients are nuts or the staff seems like they just hopped off a party boat, you have to be consistent.  You get to have a bad day now and then, hey, you're only human, you just really shouldn't show that you're having a bad day.  I guarantee you, if you do, and if you do it too often, you'll lose credibility.  I'm speaking from experience, so believe that I know what I'm talking about.  And if you think it was hard to establish credibility to begin with, it's much harder to regain it.   Control yourself in the short term to make your own life easier in the long run.  It's a choice and you know you're making it when you decide to give in to a bad mood or other negative attitude, so dig in really deep and pull out that strength of character and save the meltdown for the car ride home.  Or, instead of melting down in the Honda, congratulate yourself keeping it together instead.  Don't worry that no one would have known that you were upset about something.  It's not wasted, be proud of yourself for dealing with it and not letting anyone see you sweat.  Let it be over and move on.  (Note to self, let it be over and move on).
   
4. Leadership is all about impact.  What do you teach the others around you?  Do you model patience, or are you often exasperated?  Do you persevere, or are you always on the verge of throwing your hands up and the towel in?  Do you have faith, because in this economy you really need to be positively realistic and realistically positive.  You have to find ways to keep your practice afloat and even thriving, but you should not promise the impossible and then fail to deliver.  You inspire faith when you set achievable goals and have a plan for reaching them.  Then you lead the way.  You inspire faith when you do what you say you will do.  Do you really believe in your boss and his/her skills and character or do you roll your eyes and complain behind their back?  The staff will do what you do, so I hope you have faith in the person who trusts you to lead their practice.  If you have faith, the staff will have faith.  If you all have faith, the patients will, too and that's the impact you want.  If you have a hard time with this, better to leave your work then to work in  bitterness.  (Someone else said that first, I can't remember who it was). Remember always, it's an honor to be asked to run someone else's practice.  It really is, so respect that and leave it if you cannot fully support the dentist.
   
5. Leadership is about dedication.  Do you dedicate yourself to the staff?  That means caring more about them looking good, then looking good yourself.  It means giving them wings and teaching them what they need to know to succeed.  It means helping them before you help yourself.  Stopping to show them how to do something, rather than attending to your own work.  Then later, you don't suffer because you have to stay a little late to finish the task you postponed to help, you just do what needs to be done.  Do you dedicate yourself to your patients?  Do you spend time helping them understand why they need treatment, and what their condition means?  Do you maintain your composure with them, even when they seemed determined to make you lose it?  Do you continue to be respectful to them despite the fact that they may be  behaving rudely to you?  Do you dedicate yourself to your boss?  Do you know what his vision for the practice is?  Do you listen to him and give him suggestions when he needs them?  Do you partner with him in making the practice and staff successful?  Do you dedicate yourself to yourself?  Do you have balance in your life or is your job your life?  Make time for the things you enjoy away from work.  Save attention for the people you love and the things you like to do.  Don't be boring and if you are only interested in work, guess what?  You're boring.  Dedication doesn't end as you lock the door behind you. You're always watching what others do in their business that makes you feel good, and then incorporating that into the practice.  It's talking up the practice, dentist and staff whenever the opportunity arises (without being annoying, use common sense here).  It's not about doing it all yourself because it's easier, it's about sharing what you know and being confident that you'll still be needed.
6. Leadership is about perseverance.  "Never, ever, give up."  Winston Churchill said it succinctly.  So did Thomas Edison, "Most of life's failures are people who didn't realize how close they were to success when they gave up."  Don't give up on your doctor, your team or your patients.  Don't write people off.  Invest in them.  Spend time trying to understand who they are, how they are, what interests them, what motivates them, and what their talents are.  Then take that and use it to help them get where they need to be.  Realize that not everyone will be ready to be where you think they need to be when you think they need to be there.  Also realize that even if they aren't, and it doesn't work out that you'll continue a relationship with them, you still never have to give up on them.  You can accept that it is what it is, and separate with goodwill.  It will always serve you well.  Persevere when things seem hard, it won't kill you.  Be aware of your emotions during difficulty and try to call on an emotion or attitude that will aid you in difficulty rather than pull you down.  When you feel frustrated try to figure out what is frustrating you.  Maybe it's a team member who has a bad attitude.  Will frustration on your part make a dent in her attitude?  It may actually increase it and take away from your credibility.  You can't control her attitude, you can only address the problem, discuss the change you expect to see, and let her know the consequences of staying the same.  No need for frustration when honest, open communication is available, and it always is, you just have to be brave enough to use it.
7. And the last one for today.  Leadership is about courage.  It's not easy to tell someone else they have to change.  It's not easy to keep going back over mistakes or bad attitudes.  It's hard to be the one who has to give feedback and face the fury of a staff member who doesn't want to hear it.  You get tired, you get hurt, and sometimes you wonder, "Who cares about me, who worries about me, who tells me I'm doing ok?"  The honest answer?  You do.  You are your own mentor, you are your own cheerleader.  You supervise yourself.  And you have the courage to believe in what you are doing.  You know that you want the best for everyone and for the practice.  You have the courage to put yourself in front of everyone and make mistakes.  You have the courage to put yourself behind everyone and push them to success, even though there may be mistakes along the way.  And when success happens, you place yourself beside everyone else and share the victory equally, knowing that it really is equal, because without them allowing themselves to be led, you wouldn't get anywhere.  Knowing that you did what it took, gave what you had to give, to develop the influence that made them choose to follow you is enough satisfaction for you.  You lead.
   

Get Away To Gain Perspective

"During  periods of relaxation after concentrated intellectual activity, the intuitive mind seems to take over and can produce the sudden clarifying insights which give so much joy and delight."  ~Fritjop Capra

"Stress is an ignorant state.  It believes everything is an emergency.  Nothing is that important."   ~Natalie Goldberg~

"Acquire inner peace and a multitude will find their salvation near you."

~Catherine Du Hueck Doherty

"There is no need to go to India or anywhere else to find peace. You will find that deep place of silence right in your room, your garden or even your bathtub."  ~Elisabeth Kubler-Ross

 You may have figured it out.  I've been on vacation.  I always find that when I'm away from work, I'm almost as productive, and maybe in a more meaningful way, as I am when I'm actually at work.  Here's why; when something, or someone is not right in front of your face, in the midst of a million thoughts, questions, decisions and problems, you can actually appreciate it all with some clarity.

    I don't know about you, but in my role of manager, I often feel a lot of pressure (probably self-imposed) to make a lot of improvement.  So, I'm always looking for weaknesses to improve, ways to make our service, ourselves and our practice better.  When I'm away, I can reflect with some realistic thinking about where and who we are.  I always realize this:  We're pretty darn great! 

 

Yeah, Yeah, you're probably wondering just what's so great about our little dental team and practice.  When I think about the people I work with I know, without a doubt, that they all care.  They all have a heart for the practice and the patients.  If we hear sad news about any of our patients, we all suffer the news.  We don't just pay lip service, we feel it.  If one of us is dealing with sadness, the others hurt for her.  I had a phone call from my son the other day about some news he was struggling with and when I looked up I saw the two concerned (truly caring) faces of our hygienists in my doorway.  They are on vacation too, but have emailed me to see how things are going. 

    I hate to admit it, but there are times I don't give them the credit, in my mind, that they deserve.  Sure, I encourage, persuade, influence and cajole, but sometimes I forget to take stock and give thanks on a regular basis.  When I'm on vacation, I can really review it all with a relaxed mind and I always find myself amazed by how lucky we are.  So, I think it would be a good idea to take regular vacations from the busyness of business and be realistic about reality.  If you can do it, I highly recommend it, and I suggest that you can do it.  Maybe a good hot soak will give you some perspective.  Maybe a walk in the forest.  Whatever relaxes you, do that as a way to gain perspective on the reality of your good fortune.  An appreciative heart and mind pave the way to a peaceful soul and a pleasant demeanor.  Can't go wrong there.

Recoginition Demands Innovation

   

Ok, so if we need goals to inspire great performance, and we need recognition to acknowledge and reinforce achievement of those goals, we may, hopefully, find ourselves giving a lot of positive feedback pretty soon.  After a while, the same old thing, gets to be, well, old.  We need to be innovative in the ways in which we recognize outstanding performance, that is, if we want a lot of the performance in our practice to be outstanding.  And who doesn't want that?
    That means we have to think differently about reward.  A reward should be a concrete symbol of pleasure and appreciation in return for good service or behavior.  So, what should we reward?  Anything that enhances the quality of life in the practice and anything that promotes good word of mouth about the practice.  What should a reward be?  Individual and suited to each person, or it can be something that benefits the group.  For instance, all clinical staff wash their hands a few dozen times a day.  Make some really good hand lotion available to them.  The best I've found is Aveeno Intense Relief Repair Cream, by the way.  A patient told me about it and it really works, and I should know because I've dealt with cracking, sore hands for years and I've found immense relief with this.  It's a little hard to find, but Walmart seems to carry it.  Or, if one staff member has gone out of her way to help everyone else, maybe a gift certificate for a manicure may be just the right thing.  But, you have to know she'd enjoy that and that's why you have to really know your staff.  Giving her a manicure that she'll just pass on to someone else won't make her feel appreciated.  She may even be annoyed that you didn't know her better than that. 
    If a staff member always talks about the new movie she's been to see, she just made it easy for you to reward her.  A set of movie tickets will make her day.  Your front desk assistant loves to knit?  Give her a gift certificate to a yarn store, she'll love it.  Keep that in mind.  You want to think, "She'll love that!" after you choose a reward.  You are asking your staff to serve others, so why not serve them in a special way?  Once a year or so I have a party or dinner for the staff and their families.  I call it Italian Night and go all out with making lots of different dishes for them.  I make sure to make a few meatless dishes for our vegetarian staff member.  Think that makes her feel special and welcome?  You can bet she appreciates it, and the fact that I don't call attention to it, I just serve enough for everyone and don't single it out as "her food."  She always thanks me.  These dinners are a lot of work, but so worth it for the chance to see each other as friends and not just co-workers, the opportunity to see our co-workers as mothers and wives, fathers and husbands and the goodwill that lasts way beyond that one night.  It's a labor of love that boomerangs back to me and the practice.
    So, in reality, if you want exceptional performance and effort, you have to recognize it in both big and small ways.  After a while it becomes a part of what you do and how you work.  You'll even find you enjoy thinking up fun and interesting new ways to reward your staff.  The best part is, they are always delighted.  Now, who doesn't want to work with a group of delighted people.  Oh, and don't forget to compliment and reward the dentist, as well.  Next week, pick a day and thank him/her for a really great day at work.  I guarantee, he/she will look shocked and then very pleased.

Set Goals To Inspire Your Team

   

One frustration of training new people seems to be getting them to learn things the way we want them to do them.  Often a new set of eyes sees a different way to do things.  That's ok, but later.  First master what is being taught, then we'll talking about making changes.  To help employees master the work we must set clear standards for them to follow.  We must give them goals to measure their progress against.  We must encourage them.  We must explain the values and principles that are important to us in the practice.
    It's the same with the rest of the staff.  Just because someone has been at it for years, doesn't mean they don't need to hear that they're doing a great job.  Praise and recognition are the antidote for burn-out.  It's surprising how easy it is to forget to praise a great employee because we've begun to take their effort for granted.  "Oh, Kathy, sure she's really good, I never even have to think about her, she's on auto-pilot."  Nice for you maybe, but I bet Kathy is starting to feel taken for granted or invisible.  Giving Kathy some new goals will inspire her and keep her interested. 
    How do you know which goals to set?  Think about what you need from your staff.  Teamwork, attention to detail, service to patients, efficiency, partnership in treatment, patient education, and so on.  Now, expand on each area so that they have no doubt about your expectations for these goals.  What does supporting teamwork in your practice mean?  How will you know they are paying attention to detail?  What does great service to your patients look like?  Be specific and ask them for input.  Write it down and keep it where it's easy to see.  Go over it at staff meetings and morning huddles.  Recognize those who meet those goals and uphold those standards.
    Goals will help everyone concentrate on what's important.  It will help them focus on what they're doing.  Recognition for meeting goals will inspire attention to quality and excellence will be the result.  Goals add more meaning to our work and give us a sense of purpose.
    Meeting goals and expectations and getting honest feedback about how we are doing will keep staff interested.  A lot of the work in a dental practice may seem pretty routine.  Every day we come in and do the same set-up tasks.  We sit for morning huddle and often staff members may go through their patients in a monotone.  Then we all disperse to get through the day.  What would happen if the manager came to morning huddle with some muffins to thank everyone for having everything set-up so consistently every day?  Imagine going through the list of patients and commenting on how well the hygienist educated Mrs. Edwards the last time she was in, or on how kind the assistant was to an older, lonely man who just lost his wife.  Maybe the front desk assistant worked really hard to get a patient in who had a tough schedule to deal with.  You've commented on all that in front of the group and now everyone is sitting a little taller with a smile on their face.  You cap it off by saying, "You're all doing a great job of maintaining the values in this practice and meeting your goals.  I'm proud of you and grateful to have you in our practice."  Wow, wouldn't that be a great way to start the day?
    What if someone isn't performing so well?  It's just as important to encourage that staff member.  Just make sure your feedback is designed to encourage her to do better.  Talk to her and find out why she's struggling.  Work with her to find a way to improve her performance.  In the end she'll trust you and see feedback from you as a positive thing, even when there's a problem.
    Encouragement costs nothing except a little bit of yourself.  You have to take the time to see your staff as people who need encouragement.  You have to get past any personal likes and dislikes and find out what encourages them.  You have to be interested in them.  People need to feel that they are making a difference.  Get your staff to understand that without any one of them, things wouldn't be as good.  Once they see that there is a deeper meaning to what they are doing and to their place in the staff, they will be more committed.  Then their focus will shift to working for the common good of all, rather than what's in it for me.
    To get started, ask yourself these questions:

1. What are the values and principles that matter in this practice?
2. How do I explain those values and principles to the staff?
3. Do they share those values and principles?
   
4. Do I instill meaning in what we do every day and in what I ask the staff to do?
5. Do I let them know what I expect by setting goals and do they understand the goals and expectations?
6. How do I recognize success and achievement?
7. How do I give feedback?
8. How do I get feedback on how I'm doing?
9. Is the feedback you give designed to help others improve, or is it just telling them what they're doing wrong?
10. How can you improve the feedback you are giving others?

I See You

   

Think about it.  How does your day in the office start out?  Maybe you're sitting at your computer, or maybe you're setting up rooms, checking the answering machine or drinking coffee.  How attentive are you to the people entering the office after you?  How much do you recognize the people that are already there?  Even in our own practice, I often noticed that sometimes people would come in, put their coat away, say hello to those they passed, but never come to greet those of us who were at the other end of the hall.  The hall's not that long so it's not a big excursion, it just never entered anyone's mind to do so.  Often I'm sitting by myself at the front of the office and it was odd to hear people come in and say nothing.  So I said something and it was obvious that no one realized they were doing that.  Now they at least shout a hello my way.
    If you're the dentist, how much of a greeting do you give your staff as you or they arrive?  Do you even look up from your computer and smile or do you just wave your fingers as you keep on with what you're doing?  I know you are probably doing something very important, but think about it.  Your staff is very important to your success.  They might get used to your unenthusiastic greeting, but it won't inspire them. 
    If you're a team member, how do you greet your co-workers?  Someone is going to set the tone for the practice.  It is usually the person with the most persuasive, assertive personality.  Many times it's a bully.  They can make everyone believe that nothing is fair or that every day is a chore.  Are you going to stand there and let it happen, or are you going to assert yourself and recognize everyone with a smile that let's them know they count with you?
    Think about how you react when someone you really like that you haven't seen in a while, walks into a room.  Your whole body reacts.  You sit up straighter, lean forward, you don't just smile, you beam and they have no doubt that you're happy to see them.  That's how I react when when of my children comes home from college.  I can't hide my delight in their presence. 
    How would your boss, staff or co-workers feel if you showed your delight in their presence when they walked into the office every day?  I'm not suggesting you overdo it.  Not at all.  What I want you to do is to think about how much these people really do mean to you.  What they bring to your day and your work.  How you would like them to feel as they go about their day.  How you would like to feel in their presence.  How you would like to go about your day.  Do you think you have any influence in that?  You can do your part.  You can let them know you actually see them, for starters.  Really see them for who they are and what they do.  That will make it easier to enjoy them because they will react positively to your recognition.  From there it becomes ridiculously easy to just build better and better relationships and a better practice culture.
    I see you.  You're sitting there reading this and wondering if you resemble the guy sitting at the computer barely grunting a hello. Or maybe you're the one drinking coffee and dreading the 10:00 patient who always complains and won't let you lean her back.  But, do you really see her?  See how it goes?  If I see you, you might see me, too.  Before you know it you'll be seeing everyone in a different way.  Maybe they'll be less dreading and more enjoyment.  Can you see how much better that might be?

Inspiring Leadership

It's a question I've heard and read about.  Can people be taught leadership?  If leadership requires self-confidence, strength, dedication and insight, can we give those positive character traits to others?  I believe we can inspire those traits in others.  I think that we all have the possibility of leadership, but sometimes the necessary traits are lying dormant inside of us.  An insightful, caring leader may be able to draw them out.

I'm reading The Glass Castle by Jeanette Walls.  She has written about her life growing up in an extremely dysfunctional family.  My son was assigned this book for summer reading for college.  After he read it he urged me to read it as well.  I'm only part way through it, but he's anxious to discuss it.  I pointed out that it's amazing that children in dysfunctional families accept their circumstances as normal.  He said, "Yes, but as they grow up and become more aware of the world, they start to see that it should be better." 

What if the same is true with adults in their careers?  What if a caring leader could show their staff that things can be better.  What if they could dig in there and awaken those dormant leadership traits in others?  Wouldn't everyone benefit, both the leader and the team, and everyone they touch? 

Sometimes managers worry that encouraging team members to be leaders will eventually make the manager lose their own importance or even make them unnecessary.  Inspiring leadership in those we lead doesn't work us out of a job or position.  Rather, it improves morale and the effectiveness of everyone and highlights the impact the leader has on the team. 

I really think that Linda Miles has a lot of great information and she has a great attitude toward dental teams.  She has an article in the July Dental Economics that talks about recognition for dental assistants that have gone through assisting school.  Let me just relay a small segment of her article.  A dentist asked his assistant to train another assistant who had no dental experience.  The assistant was upset because she felt she had invested time and money in her education and now was being asked to give it away for free.  Linda asked her the following 3 questions:

1. 
   Will it benefit the patients for assistant #2 to be very well trained in clinical and communication skills just like you?

2. Will it benefit the practice as a business for your doctor to have two exceptional assistants?
3. Will it benefit you personally to have skilled help everyday?

If the answer is yes then it actually is a good thing to be a mentor and trainer for others on the team.  Linda explained that our world would be terrible if every teacher felt the way she did, and that as you teach, you also learn.  That assistant finally came to embrace that understanding and has since continued to thank Linda whenever she sees her.

Good leaders guide others, they do not command them.  I remember a rather abrasive person once telling me this, "I don't earn respect, I command respect."  She was fooling herself.  Not only did she get very little respect from others, she was disliked. She spent her time frustrated and blaming others for what she say as their inadequacies, when it was actually she who was lacking humility and empathy. 

I believe that we inspire others and as a result they respect us.  When we guide others into leadership we inspire them.  Is is so satisfying to hear someone that you've taught or guided, teaching someone else the same thing.  If you really think about it, that lesson being taught could very well go on to be repeated long after you are gone. When you continually teach others and inspire them to pass it on, you give yourself more time to learn, as well.  It's a continuous journey leading to greater success and satisfaction.  In the process, you may leave a legacy of teaching, learning and inspiring. Not a bad way to be remembered, is it?

The One Thing

    What is the one thing, that if you could change it in your practice this week, would make a big improvement in your day to day life?  It may be something you would take away or something you would add.  It's something that bugs you on a regular basis, but for some reason, you haven't done anything yet.  It may be something you find yourself wishing you had, or didn't have.  You're going to have to help me here, by commenting.  It may be worth it, you may find yourself with suggestions that can make your wishes a reality.  So, what would that one thing be?

You! Make It Happen

    That's right, I'm talking to you.  The manager.  Whatever it is you want to see happen in the practice, get going and get it started.  Now, I'm not saying don't delegate, but I am saying instigate.  Instigate the change or development you want to seeing by being the first one moving. 
    Sometimes we managers see ourselves as overseers.  We list what needs to be done and tell everyone else to do it.  Then when it doesn't happen we can feel like victims.  We're at the mercy of our team and they just won't do what we want.  Well, get in there with the team and get the ball rolling.  Then whatever is happening isn't happening to you, it''s happening because of you.  It's easy, but useless to stand by and criticize.  It's productive in so many ways to be a part of the process.
    Sometimes we're so busy critiquing our staff that we forget to evaluate our own performance.  We may have this vision of ourselves as being the leader of the pack, but if in that vision we are watchers, we're drawing the wrong picture for ourselves.  Just as we expect our team members to grow and evolve, so should we.  Make it happen by doing.  Your actions tell your team who you are.  Are you someone who stands over them and metes out criticism or praise or you someone who stands beside them and offers a helping or guiding hand?  The difference between a good leader and a poor manager is right there.  When you're right in there with them you have opportunities to discover strengths and weaknesses, to inspire, to teach, and to build a stronger team.  When they see that you are in it with them, you gain influence with them and they will do as you ask for the right reason.  They will follow you because they want to.
    Being a manager who makes things happen sets you apart from the crowd.  Being a cookie-cutter manager, that is just like all the rest, will get you mundane results.  Being a manager who inspires will get results that will launch your team to new heights.  Since your team's performance is a reflection of your performance, making good things happen will be good for everyone.

It's Your Own Fault

    I was talking to a consultant the other day and we were discussing a dilemma I was having with a staff member who wasn't performing up to par.  She listened to my problem and then said, "It's your own fault."  I was taken aback because I had talked with this employee and been quite clear about what was needed.  Then she explained her statement.  When an employee isn't performing well and it continues, the manager or dentist isn't doing something right.  Either they aren't being clear with the employee, or they aren't explaining and carrying through with consequences for failure to bring performance up to an acceptable level. 
    Many times we let fear rule our actions with employees.  Or we make the mistake of letting our personal feelings about an employee overrule our objective evaluation of the employees performance and value to the practice.So the consultant was right.  If we keep complaining and finding ourself in the same place all the time, we have either decided to accept this performance from the employee or we have lowered our standards to avoid taking action.

I'll be at the beach for the next week so I may not be posting much.  Have a good week, I know I will.

Brick Walls

    "Ouch!  It hurts when I hit that brick wall.  I hate when that happens. Well, don't do it again."  Remember that old SNL skit with Billy Crystal and some other guy?  Well, it seems like that's what leaders and managers do sometimes.  They run up against brick walls over and over and it gets so frustrating that they feel like they're banging their head against...what else, a brick wall.
    One problem is, recognizing the brick wall for what it actually is.  Let's use the example of an under-performing staff member, one that you know has the potential be do better and be a great staff member.  If you're like me you tend to think about outside influences on her behavior and performance.  Maybe she doesn't understand what you expect, maybe she's having problems in her relationship with her boyfriend, maybe she doesn't like what she's doing, she's bored, she's pregnant, she's mad about something, and on and on it goes.  The yadda, yadda in your head goes round and round while you search for the answer.  You'll never find it in there, you have to look in her head for the reason. 
    That's right, you have to have the dreaded performance discussion.  She has so many good personal qualities that you want to try to make it work.  It's not easy to find someone with so many good character traits.  Brick wall #1- there's an element of fear there, and to be realistic she's not the only nice person out there, you just really don't want to go through the hassle of replacing her.  Yes, I'm sure you like her, but you can't let personal feelings about an employee cloud your judgment about their performance.  If a strong work ethic and desire to improve aren't on the list of sterling characteristics for her, she may not work out.
    Maybe you think you can teach her to think like you think.  After all, you learned to prioritize, to understand how to work efficiently and independently somewhere, didn't you?  You probably learned it from life lessons along the way, maybe at your mother's knee, but no one actually had to sit down and spell it out, step by step.  You learned it from the consequences of not doing it to begin with.  There's brick wall #2, and you're it.  By being afraid to hurt an employees feelings and risk their leaving, you may be standing in the way of the lesson they may need to experience.  Yes, what they learn as a result of you not accepting sub-par performance may make them someone else's great employee, but maybe that's the part you were meant to play in their development.  I have had past employees say that they wished they understood at the time that I was trying to make them better at what they do.  Now, they wish they could be part of an excellent team again.
    A third brick wall is just putting up with poor performance and hoping it will improve.  Hope in itself is noble, but you can't run a practice on it.  Hoping someone will finally grow up and get it is a huge time waster.  It's not fair to the staff and patients and it's not fair to the employee either.  It causes a roller coaster of emotions for everyone.  On the rare occasion that the employee does something notable everyone enjoys the break from stress on the ride up, but when mediocrity returns, you start to dread the descent.  When it gets to the breaking point on the way down, resent kicks in and you feel fooled by the reprieve.  Nothing changes because nothing changed.
    So, how do you knock down, climb over or go around these brick walls?  First, you take down the brick wall of your own thinking.  You can't possibly know what motivates another person or what they're thinking.  So, ask her.  She may be satisfied with where she is right now.  You're not, so there's the problem.  She has a choice to make, either begin to do better or it won't work.  She may truly not understand what you want so make sure you have a written job description and that you review it with her.  Give her a chance, observe her while she's working, listen to her and if all that fails, climb over the brick wall that's keeping you from letting her learn that if she wants to succeed she has to fulfill the position to the satisfaction of the standard that has been set before her.  Kindly let her know that you will need to hire someone that can do what is needed.  It's never easy, but no matter how nice the staff member is, she has to be able to do the job.  It's that simple, and that difficult. 

Goals

"In the absence of clearly-defined goals, we become strangely loyal to performing daily trivia until ultimately we become enslaved by it."      ~Richard Heinlein~

   Are you nodding your head in agreement?  If not, then what do I have to say to convince you?  Clearly defined goals that have been set before your team, discussed and agreed upon will keep everyone moving toward the same target.  The above quote makes me think of automatons working mindlessly and repeating the same actions and responses day in and day out.  It's true for a group, as well as for individuals. 
    Let's pick on hygienists for a minute.  I choose hygienists for this example because their position seems to be the one that has the highest chance of becoming repetitive.  If a hygienist adopts the belief that she comes to work to clean teeth and then leave, she seems to stand a high chance of mediocrity and burnout.  If each action becomes rote, the only difference between patients is their plaque score, and Tuesday is just one day closer to Thursday, I would think that having a goal would seem like a nice, but pointless idea.
    An assistant without a goal might stopping being curious, stop learning and stop seeing what she does as a profession and start wondering what she wants to do when she's ready for a real job.  Instead of the enjoyable career that it can be, dental assisting might seem like a thing to do until she's ready to find something to do for a lifetime. 
    A dentist without goals may someday find himself walking through his days feeling like a trained monkey.  Check hygiene one, check hygiene two, anesthetize Mrs. Lane, adjust Mr. Morgan's denture, extract Mrs. Lane's tooth, anesthetize Mrs. Edwards....  You get the idea, day after day without a goal becomes day after day and then you retire.
    What makes life so much better with goals?  The thrill of achievement.  Seeing something come closer and closer to your reach and then, once there, enjoying that achievement, all the while knowing that you can recapture that feeling of accomplishment with the next goal you set.  Goals give you a way of measuring and even noticing growth.  They allow a group of people to come together as a team and give them something to work toward and help each other with.  Talking about teams is a positive thing, setting goals for them to work toward is the first step in actually making individuals want to work together to succeed.  When you see two team members hovering near the operatory of a third team member who is running behind, ready to help her clean it and set up, it's a sign that everyone is working for the common good.  People are seeing other people and thinking about their experience.  If you really think about how rare that is, you'll realize it's a worthy goal.     A goal doesn't have to be something that will bring in revenue in the usually recognized form.  Those staff members waiting to help another are building up something just as valuable as money in the bank, they are building trust and a spirit of cooperation.  That is the invisible currency that ensures success.  Success is that feeling you have that, "Yes, there is something special happening here."
     Once that feeling exists for you and your staff, your patients will become aware of it.  Every service person and sales rep that comes into your practice will feel it and talk about it to others.  You will become a practice of choice and an employer of choice.  That is the cornerstone of success.  And it all started with a goal.

Begin With The End In Mind

    If you manage a dental practice, or have any kind of leadership position, it will serve you well to remember to begin with the end in mind.  I first read this advice in The Seven Habits of Highly Effective People by Steven Covey.  What it means is to figure out how you want a situation to turn out and work to make that happen.
    There are times when a staff member just seems to be behaving in a baffling way or just not performing as well as you'd like them to.  Your first thought may be, "I have to do something about this."  Actually it should be, "Ok, what is the result I want?"  Then figure out what you should do or say to open the door for that result.  People spend a lot of time slamming doors shut as a response to frustration or aggravation.  Then, when they see the end result, they wish they had thought the scenario through.  So, how can you foresee the result you'll get before you address a problem?
    This is where involved management comes in.  You have to really try to know the people that you are leading.  Listen to their conversations and make mental notes of the way they say they acted or responded in stressful situations.  Do they see constructive criticism as helpful feedback or confrontation?  Do they have a quick temper or are they laid-back and easy-going?  Then, treat them the way they would want to be treated.  Even though a defensive person may never like to hear that they need to improve, they will accept it better if you assure them that they are a valuable member of the team and then ask them to brainstorm with you to find a solution.   Conversely, some people crave feedback and feel stressed when they don't receive it.  Keeping the end in mind for them may be more about setting goals that they can work toward and regularly giving them feedback on their progress.  Finally, if you're just completely baffled, you may just want to explain the problem to them and ask for their solution. 

    You can begin with the end in mind with any situation.  Over the years, I've read about many difficult practice transitions.  When faced with the transition of our practice I tried to picture a best case scenario in which the retiring doctor could walk away with dignity, and feeling that we were grateful to him and wished him well.  The new doctor would come into a situation in which the staff was supportive and accepting.  I worked with that vision in mind and let my actions be guided by the path I envisioned leading to that reality.  Last night we had a retirement party for my former boss, who seems at peace with his decision.  My new boss was there and I watched him looking happy and relaxed as he got to know some of the other doctors who will be his friends and colleagues in the future.  I'm glad we all chose to begin with the end in mind.  The path has been pretty smooth and easy.

Inspiration + Appreciation = Influence

"Leadership is based on inspiration, not domination; on cooperation, not intimidation."

~William Arthur Wood~

   

As you may have noticed from previous posts in the last week, I have a new boss.  He's about to turn 35, and while I would've had to have started pretty young to be his mother, I could have been his babysitter.  I obviously had a great deal of respect and admiration for my former boss, Jeff Price.  He was a mentor and teacher for me, as well as a boss.  So, were you wondering, just a little, how I'd adapt to a new, younger boss?  Well, if you weren't, I sure was.
    I really felt like I was at the top of my game, you know?  Here I was, managing the practice of the best restorative dentist in the area.  He is respected by dentists far and wide, and assisting him was like working with one brain and four hands.  We didn't have to say a word, it just happened.  So what would I do with Dr. Nigel Morgan?
    The first few times I assisted Dr. Morgan it didn't feel like one brain and four hands, it felt like no brain and all thumbs.  He felt it too, and we were both anxious about it.  I didn't want to disappoint and I began to feel like maybe I was a good assistant only because Dr. Price had it all together.  I worried that I'd miss the satisfaction I got from assisting Dr. Price.  Well, time is all we needed.  We've gotten used to each other and it's back to one brain, four hands.  Whew! 
    The other thing that concerned me was this; Dr. Price has known me for nine years.  He knows what I can do.  Was Dr. Morgan going to plunk down a pile of cash for a practice and hand it over as willingly for me to manage as Dr. Price did?  He has done so gratefully.  Whew, again!  So, now I'm starting to like the new guy more and more.  Of course the fact that he has an easy smile and a good sense of humor doesn't hurt either.  He's fun to be around.
    Finally, would I be able to accept leadership from him and share leadership of the staff with him?  Remember, I could have been eligible for diaper duty with this guy a few decades ago.  I need not have worried.  He has the right combination.  He inspires us with appreciation.  Verbalized appreciation of our skill and for what we give.  His own generosity of spirit allows him to praise and thank his staff.  Last week was his first week owning the practice.  At the end of the last day, he gathered us all in the hall and thanked us for making it a great first week.  I looked at the faces of the staff and saw pure joy, but I saw something else.  In that one sentence, he earned influence with them.  Now they will do anything he asks, not just because they want to keep their jobs, but because they want to do it for him.
    Earning and keeping influence is the secret to becoming a great leader.  For some people it comes easily.  I suspect it does for Dr. Morgan because he seems at ease with himself.  It can be a developed style though.  You may have to be more conscious of what you say and do if giving those things doesn't come naturally to you.  I think that the results will inspire you to keep doing it, though. 
    If you go home at the end of every day feeling stressed, beaten up and used up; think about this.  I'm sure that Dr. Morgan feels a certain amount of stress in the evening.  He's a brand new owner, so it would be natural to assume that he has a lot of new worries to think about and new things to adapt to.  But, I feel comfortable saying, I don't think he goes home feeling distress.  I doubt very much that he goes home and worries about his staff.  He knows we are going to be there every day, helping him and making his practice a success.  In just one week, he earned that.

What Are You Going To Do About It?

    Every now and then even the best teams have problems that need to be addressed.  Sometimes good practice managers can start overthinking and lose focus.  When both things happen at the same time, you can get into a cycle of complaining and blaming.  That is a cycle that leads everyone in a circle.  If it goes on long enough and builds up enough power, your small problem can develop into a tornado.
    Complaining does no good.  It's not productive and actually, venting increases stress rather than acting as a pressure release.  When you vent, you stayed focused on the problem rather than identifying the solution.  I can vent with the best of them and the thought of going ventless is a little daunting, I'll admit it.  Complaining only gets you one thing, the reputation of being a complainer.  Not something you'd want mentioned during your eulogy, so don't do it. 
    Blaming is a tempting refuge to an employee who is faced with a complaining manager.  Pushing the responsibility off onto another seems like a good idea in a panicked moment, but that just adds another dimension to the problem.  Rather than just having an aggravated manager to deal with, you'll soon have to face the wrath of the team member you snitched on. 
    So, here's the deal.  If you have a recurring problem with the way a staff member or members are doing something, sit down with them and talk about it.  State the problem and ask them how they intend to fix it.  For instance, I have a very specific system for storing and ordering burs.  Our assistant and roving assistant are responsible for changing the burs on the bur block once a week.  I have them well organized in bins, or so I thought.  I went to inventory them and was dismayed to see they were no longer organized and it seemed that we had way too many of one type of bur.  This told me that the bur is not being changed regularly.  I've talked to them about this before, but always informally.  When I asked the assistant she immediately said the roving assistant must have done it.  Since the roving assistant wasn't there, I didn't get an answer. 
    I vented to my boss who looked at me and said, I don't worry about those things, if I was willing to, I wouldn't need an office manager.  Well, my job in danger antenna went up, and I asked his advice since I had already talked to them.  He told me to sit down, state the problem and wait.  Rather than feeling that I had to come up with a solution, I could see that I would be forcing them to take responsibility.  Then, rather than be frustrated and feel that they don't care, I was giving them the opportunity to show me that they do.  So, next time you have a problem with a staff member try sitting down, stating the problem and asking them, "What are you going to do about it?"  Then sit back and be quiet. 

You Get What You Create

   What is the reality of your practice?  Whatever it is, you created it.  This is true for everyone in the practice from the dentist, to the staff, all the way to the patients. 
    Let's start with the dentist.  Sometimes dentists seem to have created a miserable life for themselves.  The people side of the business can be extremely distracting and confusing.  They are in the lousy position of being the professional that most people dread seeing.  And patients let them know about it, too.  If I had a nickel for every patient that answers my boss's pleasant greeting with, "Don't take offense, but you're the last person I want to see."  I'd be rolling in nickels.  Of course it's offensive, no one likes to be greeted that way.  And then there's the other standby, "I guess I'm paying for your new car with the fees I'm being charged."  Actually, his car is older than mine.  Then dentists have this weird dichotomy with their staff.   The staff are the only co-workers the dentist has, but he has to be careful of becoming too much or a friend or he'll have a problem when he has to be the boss.  It gets lonely.  If he's a male, he has the added challenge of working with all females for the most part.  Ever see a guy try to figure out one woman?  Try four or five at various points in the cycle or worse yet, in between hot flashes.  I can say that, I'm a human flame thrower at any given time during the day.  One other weird thing that seems especially prevalent in dental offices is the fact that some staff members seem to think that the dentist should try to make them happy.  They expect bonuses, trips, presents and complain that it's never enough.  Hopefully this is the exception, but it seems I hear about it more and more.  Then there's abuse of time off, the internet and sneaking cell phone calls in the bathroom.  How did it get like this? 

    Then there are staff members that always seem to be in the midst of drama.  They're misunderstood, underappreciated and taken advantage of.  They make sure everyone knows it and they don't understand why they're always in trouble.  When review time comes, they fret and worry and are shocked to find out that the dentist thinks they have some behavior issues that need to be changed.  One of these days they'll show everyone and quit.  Then everyone will know how good they were.

    Some patients make every visit tense.  They come in just knowing everything will hurt and that they'll hate the whole thing.  They're the ones that tell the dentist that he's the last person they want to see.  Guess what, the feeling's probably mutual.  They are reaping what they're sowing and it's not fun.

    Don't despair, there's another side to the story.  There's the dentist who creates he practice that she loves to come to every day.  She projects a positive attitude and others respond in kind.  If an employee just doesn't get it or won't work in a way that supports team health and growth, she doesn't keep hanging on.  She finds the right people for her team.  She does the same with patients.  She doesn't keep inviting people back who drag her down so that she's worn out for the ones who appreciate what she does.  There are team members who do what it takes to make the practice thrive.  Hopefully you have a team full of them.  You let them know clearly what's expected, you hold them to it and they deliver.  It's the best way to work. This is a team you want to do nice things for and they appreciate it.  They would never dream of demanding anything or complaining that it's not enough. Patients in a practice like this thrive as well.  They are taken care of so well that they really do enjoy their visit and comment on it.  They see the fees as fair and well-deserved.

    It's the right mix of self-discipline, attitude and maturity all coming together.  This is what it takes to create the practice of your dreams.

 

Magnify and Multiply Goodness

    I was talking to an older friend last night who I find to be very wise.  She is a people magnet, everyone loves her within minutes of meeting her.  She deals with health issues every day and rarely complains and is always interested in others.  Not what you can usually expect from someone who is chronically ill.  I asked her how she ended up with so many friends.  I wanted to know what makes everyone love her.  She answered very simply.  "Linda, there is good in everyone.  I see it and I focus on it.  That magnifies it and multiplies it." 
    She may have just stated the meaning of life; to magnify and multiply goodness.  Imagine what could happen if we used that approach with our staff and patients.  I actually had a team member that had some personality traits that I found annoying.  I realized that I tended to focus on those traits and not only did I become more aggravated by them, she seemed to do more of what drove me nuts.  After a while she came to me and said that she could tell that she rubbed me wrong, but didn't know why.  She was willing to sit there and hear what my answer would be.  We finally had a good talk and I found that even though she toned the offending behaviors down a little, they were still there.  I also noticed that they didn't annoy me as much.   I think that when she came to me to talk, she gave me something to admire.  The more I focused on that, the less the other stuff mattered.  I also realized another good thing about her, she keeps on trying.  So there are two good traits to counterbalance the annoyances. 
    She came into my office the other day and closed the door.  I wondered what was up, of course.  She sat down and very nervously and asked me how she's doing.  I looked at her earnest face and felt so proud of her.  It wasn't easy to come and ask that, I could see it, but she cares.  There's good trait number 3.  Seems like there's something to that multiplication thing.
    Looking for the good isn't always easy to remember to do, and sometimes the good can be hard to find.  It doesn't mean that you'll never have to ask another employee to leave, either.  What is does mean is that maybe you'll help people find things in themselves that they didn't know were there and maybe the ones that have to leave will still think of you as a fair person who gave them a chance.

Shine

    "A person wrapped up in himself makes a very small package."
                                                                                       ~Denzel Washington~

    If you've read this weblog for any time, you know by now that I like Oprah. Denzel  Washington was a guest on her show this week.  I like him just as much as I like Oprah.  While she was interviewing him she commented on the fact that he enjoyed seeing others  do well.  She also said that most actors aren't like that, they're only concerned with their own success.  He replied that he wasn't about that at all.  As his co-stars in his recent film joined him on stage, you could see that was true.  He really seemed to love listening to them and seeing them shine.  One thing I noticed was that as more pleasure showed in his face while they spoke, the more likable and genuine he seemed.
    I think Oprah was only partially right.  I don't think the tendency toward self-interest exists only in Hollywood.  I think it cuts across all walks of life.  How many times do existing staff members seem threatened by an enthusiastic new team member?  Back-stabbing and gossip seem more commonplace in many offices than cooperation and generosity of spirit. 
    As managers, we have to put the success of those we lead at the forefront.  We shine when they do.  We can bask in the warmth of their success when we've helped them attain it.  There is something wonderful about watching someone come to love what they do, to really care about how they do it and to feel confident and good about themselves as a result.  Your reward is in the quiet knowledge that you were honored to have been a part of that.  I say quiet knowledge because once you begin taking an ounce of credit for the success of another, the light begins to dim for both of you.  Leave them alone with it and you will earn much more than the spotlight.  You will earn their respect and regard.  The good regard of another human being is worth more than anything that can be written on a paycheck or stuffed into an envelope.

    Sometimes it's not easy to get started.  Human nature makes us want to be noticed.  We want to be appreciated.  It is short-sighted to think you can only attain that by being in the spotlight.  The spotlight highlights flaws as well as achievements.  If one of your flaws is a need for attention, you may shine brightly for a moment, but you will burn out those watching pretty quickly.  When pizazz is your forte, you will find it exhausting to deliver over time.  Quiet strength, knowledge and sharing are what will make you a legend.  Do your job right and watch with pleasure as others achieve.  That, in itself, is your success.  That's how to shine.

Who's Afraid Of The Big Bad Staff Member?

    Have you ever had a staff member that didn't perform well, didn't get along with others, or just drove you crazy for any reason?  Maybe you tried to reason with them, sent them for more training or tried to rationalize your feelings.  Things still didn't get better, but you are frozen in indecision.  Why would that happen?  Are you ready for the answer?  Fear.  Plain and simple, you're afraid.
    What are you afraid of, you're the boss, the owner, the head honcho, aren't you?  Well, there are a lot of things that enter into decisively disciplining or even finally terminating an employee.  A big thing that prevents you from doing that is fear.  For one, you may be afraid of the employee's reaction.  They may cry, accuse you of being unfair or spend an inordinate amount of time telling you that you're wrong about them.  You may be worried that they'll quit if you criticize them and then you'll have to start the search for a new staff member.  You'll go through the whole interview process, spend all that time and money on a newspaper ad, and it's all a crapshoot in the end, anyway.   The perfect candidate that you interviewed and hired shows up for work with facial piercings, tattoos and an attitude.  Now you're worse off than before.  Don't let your imagination run wild and freeze you into inaction.  By the way, that example was a composite of three different staff members that didn't cut it with us.  And yes, I hired each of them.  Each was a valuable lesson for me.  Each made me know what I didn't want and now I have a fantastic group.  Face your fear and you may too.
    Maybe you're worried about what the patients will say..."So much turnover, what do you do to your staff, doctor?"  Don't worry about that, only the gossipy troublemakers will say that, so you'll be making their day.  Then again, maybe the disgruntled staff member will bad-mouth you in the community.  What makes you so sure they're not already doing that?  If they sense your displeasure, I bet they already are.
    I'm not suggesting that you go into your office with a fist full of pink slips.  I am saying that if someone on your staff is causing the irritation and disintegration of your stomach lining, be not afraid.  Sit them down and hold them accountable.  Let them know that they must start doing as you ask or they will be asked to leave.  That's fair.  And there's nothing to be afraid of.

The Ripple Effect

    One of the most difficult things you have to remember, as a manager, is to assess staff members on their ability and performance, not on whether you like their personality.  Then, having said that, you have to realize that when you like someone as a person, you tend to see what they do in a more favorable light.  If they do something that's not so great, you'll tend to be more forgiving if you like them.  On the other hand, if you're managing someone who gets on your nerves, you may find yourself much more annoyed when they do something wrong, just because it's them.
    It's not easy to put it all in perspective.  You have to find a way to seperate personality issues from job skills and performance.  If their personality disrupts the team, then it becomes an issue, but if the person just rubs you the wrong way, it may be something you just have to deal with.  This is where wisdom and maturity come into play.  You must have the wisdom to see your feelings and reactions for what they are, and the maturity to discipline yourself to treat the employee fairly. 
    Maybe you think you should let them know that they bug you.  What good would that do?  They are what they are and they're being honest about that.  When you accepted a leadership position, you accepted the good with the bad.  That means you have to find ways to accept what you might not like and to grow in patience and tolerance.  You have to be able to look at every employee objectively and determine what they bring to the practice.  You have to lead them based on that, not on your reaction to them.  You may think that you can just stay away from them as long as they do their job, but that would be a failing on your part.  They deserve interaction and feedback from you, just like the employees that you enjoy do.  Like it or not, you have to build a relationship with the employee that you don't like.  The bonus is that you will strengthen your own integrity and the team will see you do that and admire you for it.  They will probably be inspired to show patience and understanding with each other and their patients.  It's like throwing a pebble into the water.  The effect spreads out.  Start by finding one thing to admire about the person.  Then mention it to them and you'll start seeing it more and more.  Then notice how that attribute affects other things they do.  You may surprise yourself by pushing aside the annoying things and focusing on other good traits.  You may never become a raving fan of this person, but you can learn to accept and appreciate them for who they are.  They may just be doing the best they can right now.

Leading Change

I just found a post called the three principles of change on Dick Richards Come Gather Round weblog.  Here are the principles:

1.  In the realm of human activity, things change only after they are accepted for what they are.
    I'll relate this to my own experience in our practice.  After being his only assistant for 5 years, my boss asked me to become the practice manager.  That would mean adding another assistant and less assisting for me.  All I could see were negatives.  I let my mind run away and some of my thoughts became pretty unreasonable.  After all I thought, "I am a very good assistant, why would he want me to stop doing that and sit at a desk?"  That turned into,  "He doesn't like me as a person and can't stand to work with me all day."  Crazy right?  Why would he give me the honor of running his practice if he didn't like me as a person.  Only when I accepted the fact that although he valued what I could do clinically, and still wanted some of that, he believed that I could have a positive impact on the practice by taking on an administrative role.  He knew that he trusted me and that I could work independently, freeing him from the administrative duties that took so much of his time.  Once I accepted things as they really are, not as what my mind had distorted them into, the change wasn't so hard.

2.  Change occurs as a function of distress, vision, capacity for change, and achievable first steps.
     My boss often says that people don't change until it becomes too painful to remain as they are.  I have seen employees hold onto bad behaviors until it got to the point that they either changed or left.  Some chose to leave and  they continue to have the same problem at every office they work in.  I have also seen an employee finally surrender to the fact that what they are doing is sabotaging them.   She asked for help and then things got better.  Sharing a vision can cause remarkable change.  Often staff members don't understand what their dentist wants or what he believes in.  Trusting in their capacity to care, understand and change can give the dentist the practice he thought he could only dream of.  Accepting that it will happen in small, achievable steps lets the team know that you have a realistic understanding of the process of change.

3.  People are more likely to act on their own conclusions than on someone else’s.  

 Many times when a manager wants a team member to change, they do all the talking.  They go to the team member and tell them what is wrong with what they're doing and what they want them to do to improve.   Now, that is all  information that the other person needs, but remember the old saying, "You can lead a horse to water, but you can't make him drink?"  Well, you can lead an employee to understanding and help them discover what they need to do to improve, but you can force them to do it.  If they can see for themselves that what they are doing is a problem and figure out a solution, lasting change is much more likely to occur. When you tell someone, "You get in late every day.  If you can't be on time, we'll have to find someone who can!"  their reaction will be to defend themself.  They stop listening and start thinking of how to counter the attack.  Now, consider this, "Mary, I notice that you have difficulty getting to work on time.  What can you do to make it here by 7:40?"  Now Mary will start thinking of solutions rather than defenses.  She will probably realize that she needs to leave a little earlier so that she's not late.  Or she may have a reasonable explanation for her lateness that will allow you to make an exception for her if her work doesn't suffer.  Either way, she comes to the conclusion herself and has no reason for defensiveness.

 I really enjoyed Dick's 3 principles and intend to see what else he's got on his blog.  You might just want to take a look yourself.

Ultimate Measure

     "The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy."

 ~Martin Luther King, Jr., Strength to Love, 1963~

   

As leaders there are many opportunities to decide where we stand in times of challenge or controversy.  Sometimes people who take on a leadership role mistakenly think that they have to control every situation and solve every problem.  That is short-sighted and prevents others from developing confidence and trust in themselves.  It also sends the message that you don't think they are smart enough or good enough.
    Sometimes it is very important for the leader to take charge and prevent a situation from getting out of proportion.  It may take a great degree of inner fortitude to step forward and deal with the angry spouse of someone who was just fired, a disgruntled patient or to mediate an argument between co-workers.  It is difficult to deliver news that you know will not be appreciated, but has to be told anyway. 
    At other times a leader needs to know when to step back and let things unfold so that the people they lead can develop problem solving skills.  The solution may seem so obvious that we have to bite our tongue to keep from shouting it out, but there are times when we have to let experience be the teacher.
    The most difficult thing is knowing the difference.  Staying quiet can portray just as much strength as speaking up. Be discerning about the piece you speak and the peace you keep.  Know when it's imperative that you act and when it's wise to remain silent.  It's like a fat lady wearing spandex.  Just because you can doesn't mean you should.

You Go First

"Leadership is the  art of getting someone else to do something you want done because he wants to do it."

            ~Dwight D. Eisenhower~

     Ever notice someone doing something they don't want to do?  Of course you do, they want to make sure you notice how miserable they are and what an effort it is.  They heave dramatic sighs, struggle as though they are doing whatever it is with a gorilla strapped to their back and generally suffer.  They want you to know that this is something they don't want to do and that you better not ask them to do it again anytime soon.  They want you to ask them what's wrong so they can tell you just how inconvenienced and abused they feel.
     Now, contrast that with someone who feels a purpose behind what they're doing or an appreciation for who they're doing it for.  There's determination and pride and a sense of accomplishment.  If you ask them what they're doing and why, they'll happily tell you all about it in excited or proud tones.  That's because someone led them to the chore through encouragement and appreciation of their talents.  Someone they would do anything for.  A good leader. 
     Putting in the effort and will to be a good leader pays off in a team that is dedicated and inspired.  The effort is the example you set.  Be honest with your team and you'll get honesty back.  Serve them and they will serve when asked.  It's totally reciprocal, but you have to go first.

What's Wrong With A Little Micro-management?

 "The best executive is the one who has sense enough to pick good men to do what he wants done, and self-restraint to keep from meddling with them while they do it."             
        ~Theodore Roosevelt~

    Ok, so you've assembled a great staff.  They have fantastic work ethics, are good team players and have adopted your vision for the practice and have made it the purpose behind what they do.  So, why can't you let go and let them do their job?  If you haven't got a speck of micro-manager tendency in you, then you might as well forget me today.  But, I bet somewhere inside you there's a tiny bit of discomfort at what I just said.  We all want things the way we want them and many times it's hard to let go and trust that others will do just fine.  What's wrong with a little micro-management?
    A little goes a long way toward destroying desire and commitment.  It's hard to really support someone who doubts your ability.  It's disheartening to want to give your all and get handed half back.  Sometimes we have to be big enough to allow others to make mistakes and take their lumps while they do it.  Experience truly is the best teacher.  Once you've given the proper instruction, have the self-restraint to take off the training wheels and step back.  Because once they've got some experience under their belts, your team can free you up to do other things. 
    What do you gain by allowing others the freedom to put their own stamp on their job?  Their dedication and respect for starters.  Their desire to keep on improving.  They will develop a sense of ownership that will protect your practice and patients and everyone will thrive.  Pretty good payoff for extending a little trust and confidence, isn't it?

The Geek Squad

 " Leaders are visionaries with a poorly developed sense of fear and no concept of the odds against them." 
            ~Robert Jarvik~

    Let's apply this to trying something new in a dental practice.  When I became the manager of our practice I decided that I wanted to shake up our staff meetings... a lot.  My boss led pretty basic staff meetings that gave the information he wanted to impart, but I wondered if we couldn't do more to make our team a dream team.  I knew we had talent on the team and I suspected that we had depths of character that hadn't been fully tapped yet.  I asked my boss to buy If Aristotle Ran General Motors by Tom Morris for each team member so that we could read it together and review what we read at staff meetings.  He fully supported me and agreed to the purchase.  I had no concept of the odds against me and, since it all turned out wonderfully, fortunately I had no fear.
    Well, the initial reaction was similar to the one you get when you tell a 13 year old boy to kiss his 85 year old Aunt Agnes.  You know, the one with the hairy mole?  Not too enthusiastic.  I told them we'd read 30 pages a month and discuss them at the meeting.  They read them (I think), but I did all the discussing.  That wasn't very useful and certainly not what I'd envisioned so I decided to assign each staff member a range of pages to review at the next staff meeting.  At first it was very stilted and they basically just read straight from the book.  I thanked them and then I refined my explanation of what I wanted them to do.  I wanted them to tell us what they thought about what they'd read.  I didn't ask them to do it naked, mind you, but from the looks on their faces you'd have thought I just announced the beginning of the nude book review club.  Much to their credit, they went along with me, fully clothed needless to say.  Every time we got together they got a little more into it.  When people started to actually have trouble waiting their turn to speak, I knew we'd accomplished something great.
    The other day I was discussing the new book we're reviewing, The Energy Bus.  I said, "I know, I'm a geek but I really get into this stuff."  Well, to my surprise, the person who used to be the most cynical about my ideas piped up with, "You're not a geek, we like this, too."  So maybe I've created a geek squad, but we're not afraid of much and I have a feeling that the odds are with us.

Communicate Their Worth

"Leadership is communicating to people their worth and potential so clearly that they come to see it in themselves."

Steven Covey

   

When you lead a group of people you have a responsibility to them.  They are throwing their lot in with you, believing you know the way.  I have seen and heard of some practices in which the dentist identifies one person as their right hand person and together they belittle and ridicule the rest of the staff either in front of them or in whispered, but overheard conversations.  I've actually spent a year in a practice like that.  It was horrible. That behavior destroys the culture of the practice and the spirit of the staff.  Even when the dentist doesn't actively engage in this behavior, if he lets a dictatorial manager run roughshod over the staff, he'll end up with the same result.
    You can never build up the self-esteem of your staff too much.  It won't make them conceited or cause them to look for bigger pay increases.  Both of those behaviors come from staff that doesn't feel good about themselves.  They have to resort to those actions to see how you'll react.  It may be the only indication they get that they are valued and doing a good job.  Find big and little things to talk about.  Morning huddles are a great time to praise the staff as a whole or to mention individual accomplishments and deeds.  Praise in public, correct in private.  It works.  People crave security and nothing sounds sweeter to the human ear than a compliment or praise.  Your employees want to know that you see them as people as well as staff members.  You might find that there are things about them that surprise you and strengths and character traits that you admire.
    Potential is a wonderful thing in that once you reach it, you increase it.  Keep pointing that out to your staff and you'll keep them focused and excited.  Yes, people can be excited about their jobs.  I wake up looking forward to each day at work because of the possibility of new experiences and the opportunity to spend another day among such great people.  Just try making that statement to your staff and watch their eyes light up.  When you can receive pleasure in seeing the positive impact you can have on your staff, to  quote Dr. Seuss, "Oh, the places you'll go." 

Sticky People

   By now you must realize that there's always some kind of method to my madness.  You didn't think I'd go to the effort of copying and pasting all those leadership quotes just to plop them on the page and ignore them did you?  Of course, I have to add my two cents to them.  So, let's start with President Eisenhower:

I would rather try to persuade a man to go along, because once I have persuaded him he will stick. If I scare him, he will stay just as long as he is scared, and then he is gone.

 Dwight D. Eisenhower

    A lot of managers try to intimidate their staff into doing what they want them to do.  I think that is because they don't really believe in them self or in what they are asking people to do.  If a leader feels inadequate, like she has no impact on the people she is leading, she will be ineffective.  Then, out of fear, frustration or both, she will lean heavily on them, micro-manage and intimidate them to get the performance from them she desires.  She may get it for a while, but she will need to return to the same behavior the next time she wants something.  This not only undermines her leadership, it causes her staff to stagnate and eventually leave.  If she tries to scare them into doing what she wants they will resent her.

    Sometimes managers resort to intimidation out of desperation.  I had an employee that I had tried everything with to encourage her to grow in her position.  When I could think of nothing else I said, "I'm concerned that if you don't do better, you'll lose your job."  In my mind I told myself that I was trying to let her see how serious the situation was.  In my heart I know I was trying to scare her a little.  She would put forth a new surge of effort and things would be better for a while, then she would go back to her set-point of performance.  Employees impose this set-point on themselves when they have no desire to keep improving.  She told me that she had done it in so many words, "I'm as good as I'm going to get."  Next time I'll believe those words.  I was desperate to help her save her job when I should have been more interested in releasing her from something she wasn't suited for and finding someone who was.  It is the leader's responsibility to recognize when the situation has deteriorated past saving and to respond wisely, without intimidation so that the remaining staff can feel confident in you.  That's how you get a sticky staff.

Planet Chaos?

   

I'm training two new, very young team members right now.  One is here for the summer, the other is permanent.  They are sweet and have great attitudes.  But, they're young and they don't understand the world of a professional dental practice yet.  They think as long as they're doing something, they're working.  Well, anyone who has been around a dental office for a while knows how intense the pressure can be.  Time spent waiting in the reception area seems like an eternity to patients.  Patients are getting less tolerant of being kept waiting because they have somewhere else they need to be.  They are also quite willing to tell you how unhappy it makes them.  So you have to impress the importance of staying on time to these newbies.
    They try so hard to do things right that it makes me want to hug them, but they go so slow.  Removing cement from a provisional crown should take 5 minutes, but in newbie world it can take 30.  I'm not mocking when I say newbie world, I can't think of anything better to call it and to those of us in dynamo-ville, it really does seem like a foreign land.  I don't remember the last time I felt that little pressure to be efficient.  I guess it was before somebody told me to get a move on.  Great, I get to be the somebody that rocks their peaceful, happy world.
    The pressure is on me to rev them up without breaking their spirit.  They really are working hard, they just need to point their effort in the right direction and rev up the engine a little.  I have what they need, the knowledge about how to make it all flow.  I am more than willing to give that to them.  So then why do I hesitate and wonder how to phrase it just right so that they don't feel unappreciated and I don't make them lose confidence in themselves?  Because I know that I have to serve them well so that they'll want to follow me.  That means being there and guiding them even though I know that if I don't finish the pile of things that I need to do, I'll be staying late and then working a little at home.  It's hard to tell someone who wants your approval that they need to improve or change something that they're doing.  Part of it is because we all want to be liked.  Managers don't like walking around thinking that someone's giving them dirty looks behind their back.  We don't want to be the subject of derision or dislike.  Sometimes no matter how nicely you phrase your feedback, the staff member may take it hard.  The other day I asked one of the newbies why she didn't do something I had asked her to do and she burst into tears.  Now, I asked nicely and wasn't angry so I was confused and surprised at her reaction.  When I told her that she said, "I never want you to be mad at me."  So, you see, they really want to please and are trying their hardest.  That's why it takes guts to do this job right.  You have to figure out how to make dynamos out of the adorable newbies without making them miserable. If you make them miserable you'll just find yourself greeting fresh newbies every few months.  If you get them to move to dynamo-ville, it may not be happily ever after but it sure beats ending up on planet chaos with newbies and dynamos running amok.

Sudden Impact

    I had a revelation today.  I realized what an impact a manager makes on the people she leads.  We have a wonderful new assistant.  Her skills are good so far, but her disposition is what's wonderful.  She's a sweet, kind, caring young girl and we're lucky to have her.  She started as a student and she graduates in August.  In the meantime I've hired her and she rotates for school and works and gets paid the rest of the time.  Today we were busy and in the afternoon I was in my office trying to do some administrative stuff.  She was supposed to clean a room and her patient kept her talking so I went in and cleaned the room and set it up.  I didn't know why she didn't do it and was concerned that she wasn't handling her time well.  Afterward I asked her why she didn't do it.  She burst into tears and told me about the chatterbox patient.  She apologized profusely and said she never wanted me to be mad at her.  I was appalled that she was so upset and thought I would be angry with her. I wasn't mad, I was just trying to make her understand that she had other duties besides working chairside.  I was also touched that it bothered her so much.  I hugged her and told her it was fine, she did the right thing, attending to her patient.  I wondered if I had done something to make her think I was mad.  I also realized and understood the enormous responsibility we really have to the people that we ask to allow us to lead them. 
    First, it is important to realize that they allow themselves to be lead.  They don't have to follow. If none of them followed, we wouldn't be very effective and we probably wouldn't last long.  I remember when one of them didn't.  It made my life hell.  People are fast to say that you should just fire someone like that, but you have to weigh what they bring against the problems they cause.  If we didn't nobody would last anywhere long. I knew there was a reason for the way she was acting.  I worked to unearth it and when I did, we dealt with it and moved forward.  The only way that people will allow themselves to be lead is if you prove to them that you're worthy of that.  They have to believe in you.  Once they do, the impact you have on them is enormous.  When your happy and approving, they're floating on air.  When you're disappointed or annoyed, they're anxious and tense.  You must respect that and protect what you have built together.  I have tremendous respect and love for our staff and I let them know it.  Sometimes I get frustrated with them, but hey, I'm sure the feeling is mutual.
    We had a staff meeting today and were to celebrate one staff member's birthday afterward.  I started to say that I had a compliment for the birthday person about some great things she had done that week.  As I recounted the things she had done for her patients I noticed the reactions of the others.  They looked proud of her and happy for her.  That's one impact.  Then I realized I wouldn't feel right if I left them out.  I was able to easily recount something special each of them had done or a grateful comment that a patient had made about each of them. They were thrilled to hear it.  It was then I realized the impact they had on me.  I felt overcome by such pride in them and gratitude to be in a place filled with people of such high quality.  I understood the honor that my boss placed on me by entrusting me with leading this group and running the practice he worked so hard to build.  It was almost overwhelming.  When I think about the fact that I get to spend so much time in this environment I realize how fortunate I am and we are as a group.  We worked to make it a reality and now that we have it I am so happy that the sudden impact of the realization of what we have achieved hit me with such force.  It's wonderful to have it good.  It's even better if you actually realize it.

One Is The Loneliest Number

    Can a manager ever really be friends with the people she manages?  Not in the same way that they can be friends with each other.  You can try to rationalize it, you can try to set boundaries, but you will probably come face to face with the reality of this dilemma.  Some day you will have to give feedback that your friend doesn't want to hear and that is when the difference becomes apparent. 
    Here is the difference.  If a manager who does not have a personal friendship with a staff member disciplines them, the staff member will usually listen to what the manager has to say and go on to either make the change or not.  Then the manager will be able to take the proper action in response.  She will consider the good of the practice without being sidetracked by her personal friendship with the employee.  When there is a friendship involved, the manager has many different avenues in which her thoughts will travel.  There are more repercussions, there is more to lose, and the importance of the good of the practice may become diluted by the risk to personal interests. 
    If the "friend manager" does try to give feedback, the friendship may be used as a weapon or bargaining tool.  At any rate, the employee will feel  freer to argue with the manager who is their friend than the manager who is, first and foremost, their manager.  That is where you lose currency with the staff.  It is also where you lose effectiveness in your position.
    Does that mean that you can't have friendly feelings and a relationship with the staff members?  Of course not, that wouldn't work either.  It means that you set limits about how emotionally involved you will get with the staff.  A friend and mentor once told me that when you accept a leadership position, you accept a certain amount of loneliness.  He was right.  There are times that a leader must wrestle with the rightness of what she knows she needs to do as opposed to how it will feel to do it.  She has to work out her feelings about it alone and come to a decision about how to proceed.  She can try to enlist the dentist in her dilemma, but then she will know that she is only dumping the problems he wants her to solve back at his feet.  And honestly, she knows what needs to be done, she just wants to dilute some of the stress by sharing it.  In the end, she only adds to her stress because she knows in her heart that it is her burden to shoulder. 
    The only way a friendship could survive in this situation is if both people are extremely mature and dedicated to the sanctity of the friendship.  It would mean that the staff member would understand and accept that when it came to the business of the practice that the job was more important than the friendship.  After work, the job can be left out of the relationship and take precedence, but managers work hard to get where they are and they owe the practice and the dentist that loyalty.  The practice is the dentist's dream and life's work and to be asked to take responsibility for the operation of it is a huge honor and a statement of faith.  If you can get that straight between friends, then maybe the friendship will make it.  It think it is a difficult task.  A successful friendship requires that the friends are on equal footing.  When one person has influence over the other's job security, and they try to maintain a close friendship, that is where the slippery slope begins to get difficult to negotiate.
    To give a definitive answer, socializing is fine, friendly feelings are good, go ahead and care and serve, but a true heart to heart friendship is probably going to create too many crossroads and color decisions that should be crystal clear.  What do you think?

What Is Your Vision?

    What is your vision for your practice?  What do you want it to tell the world about you?  A lot of times we forget that we are always saying something about who we are, what we are doing and why we are doing it.  You may think, "I'm a dentist.  What more does anyone need to know?  I fix teeth."  Well, there's a lot of ways to do that and a lot of reasons to do it, too.
    What do you love about what you do?  What excites you about it?  Your possibilities stretch endlessly before you, just waiting for you to notice.  Do you define your practice by your vision for it, or do you just numbly go through each day being propelled from room to room by whoever gets your attention first?  One day leads to another and before you know it a lifetime of choices and decisions is behind you.  Will they have been the ones you really wanted?
    Wouldn't it be exciting to ask yourself how you really want to work and then make it happen?  The first step in that process is something only you can do.  You must look inward to see and feel what your vision of your practice will be.  It's in there, you have to look around for it.  First you have to push what everyone else thinks it should be out of the way.  This is your's, you can share it once you develop it, but just as only one woman can give birth to a child, only one person can develop the vision for their practice.  Next, share your vision with those who will help you make it a reality.  Only one woman can birth a child, but it takes a village to raise it.  Brainstorm to find ways to make it happen.  Listen to hear where the ideas are coming from.  Some people can truly invest themselves in another's vision.  Other's can't even begin to respect the idea of a vision to begin with, let alone get excited about it.  Hopefully, you've got the right people in your village and everyone will help raise this baby. 
    Picture yourself working the way you want to work, looking back over your day with satisfaction and gratitude.  You have put the time and effort into your education, the finances into your practice, the trust and respect into your staff, so take these blocks and build your cathedral.  A good dentist makes their patients teeth feel better.  A great dentist changes lives.  When you have a definite vision for your practice you will then find the way to guide your staff correctly, to present treatment to your patients that will allow you to provide them with the kind of dentistry you want to perform and you will distinguish yourself as a professional who has a vision and the will to pursue it.

Be Reasonable

    Here's an interesting dilemma.  What do you do if you lose power and can't see patients?  You know how it goes sometimes.  You walk in and things are beeping and flashing, but the lights don't go on, the suction doesn't suck and the handpiece just stares at you like a kid who won't eat his spinach.  The staff is assembled and they think it's party time.  What a great time to catch up and talk about the weekend, right?  Well, not for what your paying them!  So, what can you do?
    Sometimes it's nice to have them hang around in case the power comes back on.  Some people actually have work they can do, like calling patients and telling them about the problem.  But, what about the employees that are less self-motivated or the ones that will stand around until someone escorts them to a chore and says, "Get moving?"  Look around for all the little things that no one ever has time for.  Someone can clean out the fridge.  Another can straighten up the stockroom.  If you're due to have a staff meeting and are pretty well prepared for it, go ahead and have it now.  Then you can schedule patients that were canceled into that time.  If worse comes to worse, send the staff home with instructions to keep their cell phone handy, you can call them in if the power comes on.  If not, they can make up the time another day. 
    Did I hear someone wonder if it's fair to expect them to be on call without pay?  I don't know about fair, but it makes sense.  They are still reasonably free to do what they'd like and I don't know that it's fair to expect to be paid without working, either. So, call it a wash and each side give a little.  We lost power because of the wind today and that's exactly how I handled it.  No one minded and everyone could see the benefit in that arrangement.  Sometimes you have to swap fair for reasonable.  I think it was a fairly reasonable arrangement.  Don't get immobilized by worrying about fair.  Just be reasonable.

Aim To Inspire

    I came across this quote today and want to share it here:

     "The mediocre teacher tells,
     the good teacher explains,
     the superior teacher demonstrates,
     the great teacher inspires."
        -William Arthur Ward"

    Since good leaders have to be good teachers, the words leader and teacher are interchangeable in this quote.  What happens when the mediocre teacher simply tells an employee what to do or how to do it?  He makes more work for himself.  That's because he'll probably have to go back and explain how to do it, check to see that it gets done, or do it himself when he gets tired of telling over and over again. 
    Maybe good is good enough for you so you're thinking, "OK, I'll take it one step further.  I'll tell them what I want and explain it, as well."  Well, that's better, but you'll still have to tell them again next time and maybe even check to see that it gets done.  Why?  Because if it doesn't seem that important to you, then it to them.  You still haven't invested yourself in it very much.
    OK, so you don't have to be at the top of the class; you'll tell, explain and even demonstrate.  What more do they want from you?  They want to know that it's important to you and that you value what they will bring to the task.  They want to understand your expectations and your opinion of their ability. 
    So, is your hand still raised?  Do you want to be the kind of leader that inspires?  Then take the time to let your employees know how important your work is to you and how important their contribution is to your work.  Share your mission with them and ask them to help you achieve that dream.  Let it be their dream too and you can rest a little.  So serve first, and then tell, explain, and demonstrate once because your inspired team will take it from there.  That sounds like a pretty good deal, doesn't it?

Leaders-Do You Have What It Takes To Succeed?

    It seems that things are coming to me in 12's these days.  I always find at least one interesting thing on by Michael McKinney at LeadershipNow on his Leadership Blog.  This time it's his article "Are You Hard-Wired For Success?"  that's got me thinking.  It's based on the book Smarts and covers 12 skills that are necessary for sound decision making and rational behavior. The author proposes that the basis for these skills exist in us and birth and must be developed into adulthood, at which time they are permanently fixed and unchangeable.  Let's see what the 12 are and how they relate to managing a dental practice.
1.  Self-restraint -it does help to be able to stop yourself from strangling the assistant who shows up with a hickey, the hygienist who loves to print recipes from the Food Network, the receptionist who thinks you can't see her leaning under her desk talking on her cell phone or the dentist who is chatting for 15 minutes about fly-fishing as the schedule sinks into mayhem.  Now the hygienist and assistant are both demanding you "Do something" about the chatting dentist.  You'd give anything for a fly reel with a sturdy hook right now. Yes, thank God for self-restraint.
2.  Working memory - we all need that.  Otherwise who would remember to call the lab, order the special gloves for the fly-fishing dentist, get the repair guy in to fix the autoclave and plan whoever's birthday lunch is next.  And you're remembering all this as you're listening (really listening) to the new patient tell you all about her past dental history.
3.  Emotional control - the ability to manage the staff, monitor the accounts receivable, listen to a patient tell you why everything you did is a mess, all while realizing that nobody put impression material on the order pad and you've run out right before that patient scheduled for a 6 unit bridge walks in the door.  You'd love to throw yourself down on the floor and kick your feet and pound your fists, but you've got emotional control.  You just smile and say, "Don't worry, I'll take care of it."
4.  Focus - this comes in handy when you're writing up a case presentation and the hygienists and assistants come into your office demanding that you make a rule about who is responsible for filling up the ultrasonic.  Focus is the ability to wave them off with one hand while the other never misses a key and keeps on typing.
5.  Task Initiation -  take a look at the stockroom, where all those employees who love the phrase, "That's good enough", toss items when they don't know where to put them.  If you possess the wherewithal to start pulling all that mess out of there and restocking it in a sensical manner, you've got the skill of task initiation.
6.  Planning and Prioritization - it is essential to be able to decide what needs to get done and where to start.  Otherwise, you'd all sit in the car in the parking lot at lunchtime saying, "You pick, I don't want to pick, I picked last time.  OK, let's go for pizza.  Pizza? No way I had that for dinner last night.  Oh, now it's too late to go to lunch!"
7.  Organization - the ability to decide who's car is big enough for everyone to ride in to try to go to lunch.
8.  Time Management - the ability to fit all the above into one day and still get some dentistry accomplished.
9.  Defining and Achieving Goals - the ability to get everyone on the same page, tell them what it says on that page and getting them to do it.
10.  Flexibility - the ability to accept the fact that 99% of the time you will not actually work the same schedule you started with in the morning.  Stuff happens, things change.
11.  Observation - the ability to watch everything going on around you and base your decisions on what you see without putting your index finger to your lips and making that little propeller noise.
12.  Stress Tolerance - need I say more?
    I hope it's obvious that this is totally tongue in cheek.  I did that because this list is missing one vital skill necessary for good leadership.  That is a sense of humor.  Without it, you'd just be working and what fun would that be?
My apologies to all assistants with hickeys, recipe-loving hygienists and fly-fishing dentists, you know I love you all.

Office Manager - Are You Too Much of a Good Thing?

    A dentist I was speaking to was wondering what to do about his office manager.  She was great, really devoted to him, but a little over the top and she was beginning to relate poorly to staff and patients.  He wanted to help her because he is grateful for her dedication, but he didn't know how to approach her and didn't want to hurt her feelings.
    The office manager in a practice accepts a huge amount of responsibility.  It's a great honor to be asked to manage someone's practice, but the weight of the responsibility can often build to a knee-buckling level.  Think about a competitive weight lifter attempting to jerk and press more than he ever has before.  His concentration is centered on making his body do  more than most people would even think about attempting.  He puts every ounce of effort into getting the job done.  His face shows the incredible strain he is inflicting on himself.  If he succeeds he will be cheered, people will be amazed.  If he fails people will say, "Well, that was too much, he just couldn't do it." , and they'll forget and move on to the next interesting thing.  He will be frustrated to have missed this next goal.  For him, moving on to more and more weight means survival in his sport.  If his burden is too much to bear, he will watch success recede into the distance.
    Sometimes office managers may feel like that.  They feel the responsibility as something that is always building and they are always aware of a pressure to perform.  On one end of their weight bar are patient needs and staff issues.  On the other end are the practice and dentist needs.  Every now and then, to make the bar heavier, add on anything new the dentist asks of her, any problems that crop up and the ups and downs of the financial health of the practice.  So, she lifts.  Knees shaking she pushes the bar over her head, holds it there and triumphantly slams it to the ground.  She looks around and everyone nonchalantly smiles, nods and walks away.  Where's the cheering?  No applause?  Why would they, they expect her to succeed.  They need her to succeed.  They are so sure she will, they expect nothing less.  She trains alone, she practices alone and she succeeds alone.  If she fails, now that's unexpected and that will be noticed.  I hope that's not how it really is all the time, but that's how is may seem to some managers.
    The reason for that is the expectation the manager puts on herself.  If she sees everyone else's failure as her own, she is too heavily invested.  If she see a patient's broken appointment or missed payment as a slap in the dentist's face, she is taking it too personally.  If she sees every success or failure of the practice as her own, she is not sharing ownership.  Mangers can put their dentists on a pedestal that they don't want to be on.  It's hard to be a hero and an unfair burden if someone else decides to make you one.  A dentist is just a guy who went to school a little longer and learned to take care of teeth.  He is not performing amazing feats of bravery all day long.  If he's nice and kind in the process, acknowledge that and be grateful for it, but don't slap a superhero label on his chest. 
    When an office manager becomes too much of a good thing she can becoming controlling and insensitive.  She may start to look at the staff as a bunch of slackers that would stand in the kitchen eating all day if it weren't for her.  She may look at patients as ungrateful losers who don't care about what their broken appointment does to "her" schedule.  She can become demanding, demeaning and controlling.  Doesn't sound too good for someone who is determined to do a great job.  So, what can a manager like this do to change?  First understand that you can't prevent all problems and you can't control the actions of others.  The only thing you can control is your response to those things.  When something goes wrong it is a learning opportunity.  You can't teach anyone how to fix problems if they never arise.  Look at problem solving as a part of the attributes that you possess and be enthusiastic about putting that into practice when the need arises.  Most importantly feel gratitude.  Look at each team member and focus on something good she brings to the practice and feel grateful for it.  If the nature of the office manager beast is to solve problems, it can be easy to forget that there are other attributes needed to be a good manager.  The ability to solve those problems in a way that makes it look easy is one.  Making staff feel appreciated and patients feel wanted is another.  Don't focus in on one aspect of the job to the point that you forget the others.  Too much of a good thing obsessing about being perfect is hard to be around, hard to work with and, in the end, never appreciated. 

You Can Only Lead

    Have you ever tried to tell someone who was doing something wrong how to do it right?  What was that like for you?  Well,  two employees that I've worked with come to mind as opposite ends of the spectrum.  One could never hear that she is doing something incorrectly without telling me I'm wrong.  Either that or she is going to try to convince me that it's someone else's fault.  Who cares?  Just do it right.  I don't want to debate it, I don't have the time to waste.  I want to deliver my message, answer any questions that will get the result I want, and move on to the next order of business.  When I have to listen to excuses and justifications, I just get frustrated at the lack of progress and the needless wordiness.  Please just do it.  If that sounds abrupt, you're right.  I agree.  I don't like to be that way.  It is the response I must choose to have any time for anyone else when dealing with someone like that.  Otherwise, I risk being sucked into the tornado of excuses.  I'd be willing to spend more time, in a more relaxed way, helping this person, but she makes it too hard.
    Now the other person is brand new to the working world.  She is just dying to soak up all the knowledge she can.  She is fascinated and wants to know what I want from her and how I want it.  She appreciates the time that is spent helping her learn and grow.  It is a pleasure to teach someone like this.  I may spend just as much time, put in just as much effort and do the same amount of talking, but the result is vastly different.  This person is excelling.  She is learning what I want from her and making a great impression.  She has been a success from day one because she is interested in doing things correctly.  She adds to the team.  When I think of her I am happy, not aggravated. Her way makes me enjoy spending time working with her. That is the feeling you want your manager to have when they think about you.  Seems like an easy concept. 
    So what makes these two people so different?  Probably something in the way they were raised.  One probably was told she was stupid when she made mistakes.  Now, years later when she is corrected she only hears stupid.  She cares about your impression of her so she wants to make you think she is right and therefore, not stupid.  Of course, the concept of stupid probably never entered your mind.  You just wanted something different than what you were getting.  Knowing this, you still can't go to her and say, "I know you're not stupid, I just want something different."  That wouldn't go over very well.  I think you have to ask her what she thinks you are saying to her and why she thinks you are saying it.  Maybe then you can understand her response and correct any misconceptions she might have about what you think.  It's a pain, it's more work, and only you can decide if it's worth it. 
    Now the other person was probably encouraged to try things and congratulated for the effort whether it turned out perfectly or not.  Her strengths were probably focused on more than her weaknesses.  She goes out into the world feeling good about herself and that feeling is mirrored back to her.  She's easier to like and easier to be around.  Two self-fulfilling prophecies, and each creates their own experience in the world.
    What is your responsibility leader?  The way I see it, a leader needs to find a way to bring what they see into focus for the staff member and challenge her to change her approach if it's not working, and encourage her to build on it if it is.  You can only lead, not force.  Once lead, the person must decide, knowing that the path they choose may lead them away from where they are, to something better or worse.  You can guide, but you can't choose for them.  So lead.  Do your job and let go.  You don't help someone grow by protecting them from the natural consequences of their choices.  You don't succeed yourself by strong-arming others into acquiescence.  You lead, you teach, you trust, and you accept the choice they make.

Who Me?

    Someone asked me the other day if I see a staff member's lack of progress as a failure on my part as a manager.  Truth be told, yes I do to some degree.  I tend to think that I should have done  more or done something better to make the staff member succeed.  I can really get into the dramatic mindset that makes me take these problems home with me and drag them everywhere I go like a stress monkey on my back.  Just today I was contemplating the pressure I feel to make everything and everyone work well.  Just as pressing is the feeling of having to be able to discern that someone just won't make it and then figure out the appropriate action to take to help the employee accept that and find something that will work better for them. It didn't help that as I was walking down the hall with the self-imposed weight of the world on my shoulders, everyone else seemed to be enjoying their day.  Oh, you can really make yourself feel put upon and heroic, can't you?
    Then I read Ed Brenegar's article on his Leading Questions website.  It's funny how things appear just when you need to read them.  Ed talks about the author Norman Mailer.  Mr. Mailer says people can either grow or shrink.

 The fatal thing is to shrink, to be interested in less, sympathetic to less, desiccating to the point where life itself loses its flavor, and one’s passion for human understanding changes to weariness and distaste.”
    
    Imagine applying the above to yourself as a manager.  What if you allowed your passion for human understanding to change to weariness and distaste.  Can you truly say it's never happened?  I am sad to say that I can't. There have been days when I've felt just sick to death of it all. Days when I ignored my good fortune in being entrusted with someone else's dream and other people's sensibilities.   I intend to print that sentiment out and attach it to the wall above my computer as a reminder.  It will join other such sentiments that remind me of the responsibility I have to remain passionate about what I do and about understanding the people I work with.  Ed says something very powerful in this post:
     

  For leaders this means that building a team requires each person contributing a part of themselves to the group. It is making a commitment to share in the values of the group. When I stand a part as an imperial subject of the self, I have not discovered my true self, but lost my true grounding in reality.

This is one of the reasons why I see relationships as central to the well-being of organizations, and a central responsibility of leaders.

 What I discovered in reading this is that one of my big mistakes is in focusing on me.  On how the performance of others reflects on me.  On how I feel about how things are going.  On how the team will feel about me if things don't go well.  On how everyone thinks I'm doing.  Even on how I can make myself a better manager.  The thing to focus on is the organization.  More specifically, from what Ed says, I should focus on strengthening the relationships within the organization.  If I do that, and do it well, the pressure that sometimes seems so oppressive might even slide away as a result.  Focusing on the bigger picture takes us away from ourselves and makes us more available to the team.  It brings us into reality and allows us to see ourselves and our team more realistically. 

INCOMING!

    Problems.  If you manage anything you know by now that once one is solved, another is probably on it's way.  How do you react to that?  Do you run and take cover, stand and face it like a man (or woman), or, heaven forbid, make it even worse?  I just read Ellen Weber's post on this subject on her Brain-Based website and not only does she tell us what we do wrong when faced with difficulties, she tells us how we mess up our brains by reacting to stress in negative ways. 
    I think the best way to face and solve problems is to see them coming as they develop.  Don't wait until everyone is upset and reacting.  It's much harder that way.  Anticipate the problem.  Start by watching those around you in the normal course of things.  You get little hints.  Someone walks in at the beginning of the day and says their stomach has bothered them all night.  Wait about an hour and bring them some hot tea.  They will be delighted.  It is wonderful to feel cared for and tea always does the trick better when someone else bothers to make it for you.  It takes minutes but the effect is lasting.  If a patient is starting to seem upset by some technicality, slow down.  Take the patient somewhere private and start over.  Try to understand what they want and let them see you're on their side.  Even if you don't get exactly what they want they'll know you tried.  Don't make enemies.  If the specialist you're referring to doesn't have an appointment for your patient as soon as you'd like, be courteous.  Ask them if they will place your patient on their priority list and tell them you'll let the patient know how good they are about trying to accommodate the patient's needs.  You'll get a better result that way. 
    Your autoclave dies and the repair guy can't come for two days?  You want to hit the roof, don't you?  Your boss isn't going to like this one bit.  Ask for the manager.  Tell him how great the service always is and that the repair guy is a gem.  Now ask him what he can do to make your case a priority because you can always count on him to recognize a true emergency. Offer to come in a little early in the morning or stay a little late in the evening to accomodate their schedule.  Don't pull this out too often, so when you need it, it works.  Solve problems with flexibility, don't expect everyone else to do all the bending.
    Do you have someone you have a difficult relationship with at work?  I bet that you both spend most of your time trying to prove the other one wrong and yourself right.  It may be so subtle that you don't even realize it.  Try something different.  Allow your differences to exist side by side and leave it alone.  Examine the other point of view for some validity and you might even find a better way.  Recognize that if it is so important to you to be right to the other person, there must be something you admire about them.  Otherwise you wouldn't need to convince them.
    Does that all sound phony or contrived?  Well, if it does, that's OK, as long as the patient is served well and the right outcome is achieved.  You may feel like you're playing a role, but that may just be because you've never tried to solve problems in this way before.  Be innovative and positive and your problems will resolve much more successfully than they did before.  Problems keep us on our toes and if you look at them as opportunities to think and use your brain in new ways that increase your intelligence, you just might look forward to a new problem to solve.

Seek To Understand

     Trying to get an employee to accept more responsibility, grow in their position or set new goals can be an exciting progression for both the staff member and the manager, or it can be what seems like an exercise in futility and an agony similar to (no pun intended) pulling teeth.  The first, positive experience usually results when you have a motivated employee who likes to see where the next step will take her and a manager who sees her potential and has confidence in her ability to reach it.  So, understanding that, both move forward easily, or at least without fear of failure tethering the employee or manager in place.  So, that's great.

     The second scenario is the tough one.  Regular readers may have noticed I've been struggling with motivating an employee who was dead set against it lately.  I kept thinking, "What's wrong with her?  Why doesn't she just do what I'm asking her to do?  If it were me, I'd be all over it!"  Aha!  "If it were me."  It's not me.  That's why I wasn't getting anywhere.  I have a pretty good understanding of me; what motivates me, how I react to feedback, and how I feel when I'm getting feedback. I was beginning to truly doubt this employee's potential and I certainly was losing confidence in her ability to progress and my ability to motivate her. I was relaying my frustration with my lack of success with this employee to my boss and I told him I saw a hundred solutions, but how would I decide which approach to take next.  He asked me if I had ever read Steven Covey's book The 7 Habits of Highly Effective People.  He recommended the chapter entitled Seek First To Understand.  Another Aha moment (Oprah would love me).  I easily understand what makes me tick.  I was being short-sighted and narrow-minded in thinking the same thing would make her hum along as well.  So, thank God I have the ability to learn.  Now I can get somewhere and help her come with me.

    I thought about everything I know for sure about this employee from my experiences so far.  She doesn't like to hear that I am not happy with what she is doing.  She doesn't see solutions to dilemmas as naturally as I do.  She thinks she has come as far as she can go.  Let's start there.  First, I decided not to say I had any problem with what she was doing.  Rather, I sat down with her and said, "This is how I want you to do this from now on.  I then wrote a protocol for the way the tasks we were discussing were to be handled. I also gave her a document to plan her day with and follow.  She was excited about having very definite guidelines to follow.  Next, I told her that I realized that the things I see regarding problems come very naturally to me, but not so much to her.  Knowing that, I told her we would set up some systems that would trigger certain responses to specific situations.  It's not a matter of one person being better or smarter, just different folks requiring different strokes.  Finally, I told her that I expected her to use these new tools to present ideas to the staff at morning huddles so that she would be a partner in not allowing patients who need treatment to fall through the cracks.  I pointed out that by accepting these ideas and using them, she would integrate herself more fully into the team in all aspects of patient care.  She was more hopeful and enthusiastic than I've seen her in a while.  I feel more confident that she'll stay that way. 

     When we know better we do better and we both know better now.  If we, as managers, can look at the more challenging situations we face and find the opportunities for growth, we can only get better at what we do and lead others in ways that enhance the team member and the team.  It is easy to get caught up in looking for the next problem to solve, but it is important to give others the tools they need to solve their own problems.  My hope is that the next time this employee gets stalled, she may pull out a few of the solutions we developed today and apply them in a new way to the next situation that confounds her.  If she doesn't, I'll be here to help again.  Now that I know better, I hope to be able to get to the solution faster.  I will make understanding the first thing I try.

What Does Your Wake Look Like?

    When you accept a management position, you accept responsibility for many things.  Sometimes you even accept responsibility for what others do.  Is that fair? It doesn't matter if it's fair or not, it's the way it is.  Sometimes you really do have some responsibility for the actions of others because of the wake your management style leaves behind. 
    In his book, "Integrity, The Courage To Meet The Demands Of Reality" , Dr. Henry Cloud discusses the wake managers and others leave behind their actions.  Think about the wake that is left behind a boat or ship.  It tells you a lot about the way the captain is steering the boat.  If it's a nice smooth, steady line you get the feeling that all is well and he knows what he's doing.  If it is erratic and wavering, you know that there have been some difficulties to deal with.  People also leave a wake behind them in a business.  The wake tells us how the work is being accomplished and what the relationships are like.  In other words, what has been accomplished and how did everyone work together? 
    If the work is being accomplished and goals are being realized, the wake may swerve gently from side to side at times but will basically proceed forward.  If the work is erratic or uncompleted, if focus or interest is lacking, the wake will reflect the struggle and the result will be unnecessary wear and tear on the boat, frustration on the part of those manning the boat and loss of progress.
    The relationship side of the wake is just as important. Every action and interaction we have with the people we work with and our patients leaves a wake that effects their hearts, minds, and souls according to Dr. Cloud.  Think about a person water-skiing behind a boat.  If the driver is doing a good job the wake is even and smooth and the skier will enjoy riding it.  They are working together to accomplish something both can enjoy and benefit from.  It is the same with work.  If people cooperate to achieve a goal it is not only productive, it is enjoyable and satisfying as well.  Now think of the same scenario, but the skier is being towed by someone who either does not know how to drive the boat well, or doesn't care if the skier is having a good ride as long as he is getting where he wants to go.  The skier will lose trust and feel cheated or manipulated.  He may even end up getting hurt.  How will the skier feel about himself?  Will he feel inferior, embarrassed or ashamed?  How will he feel about the driver?  He may feel like he is out for himself, uncaring and disloyal.  He may even decide to wait for his chance to get even.  Sooner or later, that boat's going to sink.
    Whatever your style, the wake you leave tells about your character.  Can you think of a time, as a manager, that you did not handle a situation or staff member well?  You left a wake behind that was felt by that staff member.  If you are a staff member, think of a time when rather than cooperating, you tried to act like you were being asked to give too much or just responded unpleasantly.  Your manager feels your wake, too.  When you walk away from an encounter with a co-worker are they smiling or shaking their head and wondering what your problem is?  Consider the character of the wake you leave behind.  Be aware of it, because you can bet, everybody else is feeling it.

Looking Forward/Looking Back

    Here we are at the end of another year.  I don't know about you, but sometimes when I look back at past events I wonder how I still managed to end up right here.  Some things, in retrospect, can seem so difficult or overwhelming that I wonder where we get the perseverance and tenacity to muddle through.  On the other hand, some things seem so amazing and wonderful that I wonder what I did to deserve the experience.  Life is great that way.  It gives us balance.  If everything was always difficult, we might lose hope and resign ourselves to failure.  If everything was always easy, we might never develop strength of character, persistence or hope. 
    I realize most at this time of year, that while I love what I do at my job, none of it would have meaning without the people in my life who support who I am and what I do.  My two oldest children are not living at home now and having them with us at the holidays is redefining for me.  They and my husband are it for me.  They are the top tier.  So many times in the frenzy of keeping everything going and worrying about how things at work will turn out, I can forget that in the end they are always there.  They are what I win or lose at.
     Managing can distort your focus if you're not careful.  Taking home problems is a waste of time for the most part.  Once you leave the office, leave the problems there too.  They'll be waiting, you'll get another crack at them.  The people you love deserve equal time.  They deserve their own time.  Your hobbies are important, too.  This weblog is one of my hobbies.  Even though it deals with dentistry, it is not work for me.  Sometimes it's a way to figure things out.  It's fun for me to share what I learn, even though at times, it's what I learn from my mistakes.  Writing a weblog puts you out there.  You get equal amounts of praise and criticism.  While I enjoy the praise more, I learn from the criticism.  I'm an incessant thinker.  I love to ride my bike and do some of my best thinking then because there's not much distraction.  I can look back over the week and recap it for myself.  One thing I have to try not to do too much is ruminate over problems.  I like to understand why things happen and that, taken too far, can cause problems.  At some point you have to dismiss the case on bad experiences.
    So I like to look back at the things I don't want to repeat and make a mental note of that.  I also like to figure out what worked and reinforce it in my mind so that I'll continue to do more of the same.  Then I like to have some fun.  My boss gives us the week between Christmas and New Year off and that in itself is better than any material gift or cash he could give us. We get to have our time to ourselves and relax and recharge.  We go back to work looking forward to a great year and new accomplishments.  We know we'll screw up, but we know we'll look back and figure out how to fix it, too.  So look ahead to a great year, but remember to enjoy what's happening right now, as well.

Got Maturity?

    Does anyone ever feel truly mature?  Are you still waiting to feel 'grown up'?  Many times I think maturity is in the eye of the beholder and in the heart of the individual.  One person's clown may be another person uplifting friend.  Let's think about maturity in the workplace.  If you manage a dental practice or any business, you may sometimes feel like throwing yourself into a tantrum with enough abandon to impress any experienced two year old.  Sometimes the uncertainty of your decisions, the pressure to make it all work and the weight of responsibility can make you search for validation from anyone who will give it to you.  You know what?  You'll never get what you need outside yourself.
    So, what do you think about that?  Here's what I mean.  If you don't believe that you're good enough, you'll project that to others and they won't believe it either.  Ask yourself why you need others to validate what you do.  Do you think they can give you confidence?  Do you have a need for praise?  Ed Brenegar makes a simple, insightful comment about this here.   He says that as you grow in confidence, you should also grow in humility.  Therefore, if you know you're capable and competent, you don't need to hear it so much from others.  So, save yourself the anxiety of wondering when your boss or co-workers are going to appreciate you and do some self-examination.  Look for areas that you excel in and take a moment to feel good about that.  Now, take an honest look at the areas you need to improve in and get to work on it. 
    Ed mentions that confidence is a product of maturity.  How so?  It took me a little while to come up with an understanding of that, but I think I've got it.  I think he means being able to depend on yourself and not needing others to constantly confirm your progress to keep you on track.  It means that you can keep your own counsel and manage yourself.  Think about a baby learning to walk.  It needs it's parent's constant encouragement to take the first step, then another.  Finally, that baby is tearing up the road with the hapless parent racing after her before she runs in the street. She hasn't gained the maturity to make a good decision for herself and earn the parent's confidence.   One day, the parent can send the child out knowing that she has matured enough to look both ways and safely cross the street.  The child doesn't need the parent to compliment her ability every time she returns home safely.  It becomes a commonplace occurrence.  The parent and child are confident she can do it.  No more encouragement is necessary and the child doesn't feel the need to brag about her prowess in maneuvering the sidewalk.
    Finally, Ed says that confidence and humility are the gifts of friendship and insight.  Another brain-teaser.  I see it this way.  Your friends like you.  They want you to do well.  They will cheer your accomplishments and tell you when you've lost your way or are about to go wrong.  They don't always tell you what you want to hear, but they always tell you what you need to hear.  Knowing that; you know someone has your back.  You won't go too far astray without being yanked back.  You want to make them proud, so you watch your actions and do what's right.  You see yourself as you really are through your true friends.  My friend Nancy and I have been friends for about 20 years.  She is my sounding board, my reality check and she cares about me.  She let's me know when I'm off about something, she builds me up when I'm down and she has the guts to tell me the truth about myself.  I love her.  I hope you all have someone like Nancy.  Got maturity?  Nope, not always, but when I don't, I've got Nancy.  The rest of the time, I'll depend on myself.

Leadership Self Deception - Life Outside My Box

    I have been managing the practice that I work in for about two years now.  Last year I read a book that my friend Ed Brenegar suggested called Leadership and Self Deception  published by the Arbinger Institute.  It's a book that I think anyone in a leadership position should read.  Actually anyone who interacts with other people could benefit from it.  It's a short, quick read but can make a real impact on you and change how you think. 
    The basic idea is that most of the problems we encounter over and over, usually have more to do with us than with others.  Let's face everyone else can't be acting exactly the same way so you must have something to do with it.  That was a real eye-opener for me.  In general, none of us sets out to do others harm, but it happens, doesn't it?  And we suffer too, don't we?  The book follows a business executive through a time of self-discovery.  He soon learns about being out of the box toward others.  What does that mean?  It means seeing others as they are and not as you assume they are.  Thinking about the affect your actions and words have on them.  Seeing them as people with hopes, dreams, desires and feelings.
    Sometimes we get so wrapped up in our assumptions of what other people are and why they act the way they do that we completely close our minds to other possibilities.  By doing that, we most often, close our minds to reality.  Because, our reality about others usually isn't true for them. 
    Now that I've read this book, I can't stay in my box all the time anymore.  I live with more awareness of what other people are going through and I try to see how the things I do and say may affect them.  As leaders, we have an awesome responsibility to others.  The ripple effect from our actions spread far beyond what we imagine.  More and more I feel compelled to get out of my box toward others and really consider them.  As people, as working people, as strivers, as thrivers and survivors.  I can see them as the children they used to be and the elderly people they will become.  I see them as mothers, fathers, husbands, wives, sisters, brothers, friends and not too often, enemies.  I see the whole person, as much and as often as I can.  Past, present and future, we bring it all with us.  The past is what made us what we are up to this moment.  The present is our opportunity to become what we will be.  And the future is our hope and our fear.  I see that we are all in this together and we are all just trying.  We all know that we want to keep what we have and get a little bit more.  We all want to stay healthy and protect those we cherish and love.  And we are all doing the best we can, as much as we know how. 
    I also learned that I am one of those people too.  I am doing the best I can, as often as I am able.  I make mistakes and I have my triumphs.  I know that I am not so different than everyone else and they are much like me.  So I am trying to learn to love like I want to be loved and care like I want to be cared for.  I try to appreciate because I know how good that makes me feel.  I am striving to learn to see the best in others and ignore the worst because I want that from them for myself.  It should be easier to do but I guess my own insecurities need more taming.  I know I am a striver, a thriver and a survivor.  My interactions with the people I manage are better and less stressful.  When they see that I acknowledge them and want to give them what they need to do their best, they trust me more.  They let me know it more and they show me and tell me that they appreciate the effort.  These are the things I've earned by being willing to be out of the box toward myself, as well.  When I saw myself as I appeared to others, I didn't just have to change, I wanted to.  I wanted to be someone I would like to follow.  Someone I could respect and trust.  I wanted to see myself as an old woman who could look back on her life and feel no shame. I want to get there with few regrets and many happy memories of how great it felt to be part of a team that really made a difference in patient's lives.  I want to look back over my life and feel lucky, because I know that I am.  I feel grateful for having found all this out already and for the people who are out of their own boxes and have helped me get out of mine. The most important thing I've learned is that it's easier this way.  We all need each other and we all need to help each other.  It's in needing that we strive and in helping that we thrive.  That's my answer.

This post is dedicated to Ed Brenegar and Tom Morris.  They have been my mentors and my friends and they have dragged me kicking and screaming out of my box. 

Life Off The Leash

    OK, so you've decided to let your team off the leash.  You may notice something you didn't expect.  Now that my dog is allowed in the yard free and clear of her leash, she isn't so brave.  She keeps looking back at me as if she expects me to snap that leash right back on.  She almost looks like she wishes I would.  Think about it.  On the leash, she knew she could only go so far.  I wasn't about to let her get into any trouble or let anything bad happen to her.  Off the leash, she gets to make some decisions for herself.  I don't think she's sure she's up to that.  All right, so maybe I'm giving a dog too much credit for thinking and analyzing things, but she looks nervous to me.
    Now think about your staff.  If you've given all the direction and set all the limits till now, do you think it might be a little disconcerting to suddenly be given a lot of autonomy at once?  Now that they've got their freedom, they may not know what to do with it.  You may have to give them what they need to succeed and thrive.  Encourage them to try something new.  Share dental publications with them that might give them new ideas.  Provide opportunities for CE so that they can learn new ways to do things and network with other dental professionals.  Show them that their input and ideas are worth taking seriously.  Ask their opinion and ask why they feel the way they do.  Get to know your staff and let them get to know you.  One time, as an activity at a staff meeting, I paired everyone up with someone else for six minutes.  Each person took a turn asking their partner something about themselves and the person had three minutes to answer.  Everyone kept switching partners until everyone had teamed up with everyone else.  I think everyone was surprised at what they learned that day.  Some of us had worked together for years and some were new employees. Even the dentist participated and it was a insightful for some of the staff to actually ask him a question about himself and hear that he too, is just as human as they are. It's amazing what you find out if you just care enough to want to know something more about another person.
    So, what will I do about my dog?  To start with I'll keep letting her try so that she will gain confidence.  I'll also curb my innate desire to try to protect her and keep her out of trouble.  Sounds like something that might work for staff too.  If people never get into trouble, they probably never take chances.  If they never take chances they probably don't grow and expand their potential.  That is called being stuck in neutral and a practice that is stuck in neutral might as well be on a leash.  Encourage and empower your staff so that they and your practice can get moving and keep going.  Life off the leash may be scary, but with a little perseverance and courage it can get pretty exciting.  Isn't that the way you want to live?

Off The Leash

    I got a new dog recently.  She's a black lab and she's 4 years old so she's not a puppy but she's new to us.  I adopted her from an animal rescue organization and she was a nervous wreck when I brought her home.  The first night she wouldn't even sit in the room with us.  I laid down on the floor and waited.  Little by little, her natural curiosity overcame her learned fear.  She wiggled her way over and finally arrived and rolled over to submit and trust me not to do her harm.  I love her madly and that is making the difference in her.  When I first got her I would not let her out without being on her leash.  She was unpredictable.  I didn't want her to run off and I didn't know what she'd do if we encountered another dog or another person.  So I wasn't going to take a chance....yet.
    The first time I let her out in my unfenced yard without her leash I was ridiculously nervous and that made her nervous.  She wanted to explore but every time she moved too far away I would screech at her to come back.   I'm sure my neighbors were shaking their heads in amazement.  Little by little she proved that she could be trusted and I limited my worrying to praying silently that she wouldn't run off.  Today I let her out and didn't think twice about it.  She's earned my trust and I've loosened my control over her.
    So, what does my dog have to do with dentistry or management?  Think about how you manage your team.  Do you keep them on a 'leash' so that they'll do only what you think they should do and yank them back if they go a little further than you're comfortable with?  That may keep things safe, but it will also keep everyone from expanding their horizons.  And who knows what they may find out there?  Maybe that's what makes you want to keep the leash on.  Fear of what might be out there and what they might bring back with them.  Let's imagine they might discover something great.  Wouldn't that be worth the chance?  What you might find is that your staff might grow.  When I watched my dog today I realized how much she's changed from that scared, cowering creature I first brought home.  She's inquisitive and more confident now.  She's still a little nervous but it doesn't stop her from going a little further than she did before and now I trust her to come back.  It's rewarding to feel that I helped her.  You may find that you enjoy seeing your staff grow in confidence and inquisitiveness.  That's how things improve.  When people go beyond the ordinary they can't help but become extraordinary.  We are each here to help others reach their potential and expand it.  While we're helping others, someone is helping us.  There's the circle I talked about yesterday. 
    It all comes down to trust.  For any staff members that may be reading this, trust must be earned.  It may be extended by a very generous boss without you having to do anything to get it, but you will still have to earn the right to keep it.  Don't take trust for granted.  Appreciate that you have it to give and to receive and take care of it.  If you damage it, do something to fix it.  Trust has enormous strength and incredible fragility, both at the same time.  Once built it can be a tower but can shatter like a tower of glass if not protected.  Really think about what someone is giving you when they give you their trust.  They are giving you a piece of their heart to do with as you will. Know how important trust is and try your best to take care of it and you'll understand why it is so important to earn it if you want to be off the leash.  And managers, if you want to get anywhere with your staff, learn to trust them and see what they come back with.  That could be the start of something bigger than you could have ever imagined.

Love Never Fails

    I went to a wedding yesterday.  The bride was the youngest of five daughters and I looked around the church and realized that many of her parent's friends also had large families.  All of those families were intact.  They had their challenges, as any family with children will have, but they worked with them and through them and were here to celebrate the beginning of another new family.  One of the readings the young couple selected for the ceremony was the love passage from 1Corinthians 13.  Listening to it I realized that it is really a map for life and that these large families had understood that and used it to raise their families.

    Love is patient, love is kind.
    Love doesn't envy, love doesn't brag.  It is not proud.
    Love doesn't behave inappropriately, it doesn't seek it's own way.
    It is not provoked, it takes no account of evil.
    It doesn't rejoice in unrighteousness, but rejoices in the truth.
    Love bears all things, hopes all things, endures all things.
    Love never fails.

Now, read it and apply it to your day at work.  Every day.  Think about the things you face that seem so important, so catastrophic, so annoying.  Find the line above that corresponds to that situation and apply it.  Can it really be that easy?  I hope so, I'm going to try it. After all, aren't we like families too?  There are jealousies and annoyances to deal with.  Fairness is measured in a different way but not that far removed from the drama involved in the mis-dividing of M&M's.  People are different and require different responses and approaches just like the children in a family require their parent to interact in a unique way with them.  As a leader aren't you guiding your staff the way a parent guides their family?
     You don't have to be religious to understand or believe in this passage.  You just have to have lived and tried and failed.  I plan to frame this and keep it in sight.  The people that I manage count on me to be fair and to handle things appropriately.  Sometimes it's hard for me to figure out what is fair and appropriate for everyone.  I think this passage will be a good guide. The priest who was conducting the ceremony suggested inserting your name into the passage as a way of gauging your own behavior.  In other words, Linda is patient, Linda is kind and so on.  Kind of takes on a new meaning now, doesn't it?  Try it with your own name, you'll see what I mean. Leaders accept an awesome responsibility when they agree to lead.  As I have said before, you affect the way people feel about their day, their job and even them self.  That in turn affects the people they care about and can even affect their marriage, their parenting and their relationships with other family and friends.  It is not frivolous and not to be taken lightly.  You, as a leader, are obligated to find a way to lead that is good and respectful to the needs of the spirit.  When you can lay your head on your pillow at night knowing you've done no harm, you will know you have been a good leader that day.  After all, can leading with love fail?

End Of Discussion

     Sometimes enough is enough.  This may sound like flip-flopping.  After all, my last post was all about having an open mind.  Well, sometimes you just have to say "That's it for right now".  When a problem or issue is being debated to death and the conversation is running in circles, the best next step may be to close the case for the day.
      What does that accomplish?  It ends futility for one thing.  Once people have reached a point where the only thing they want to hear is their own point of view the discussion is going nowhere.  It also allows cooling off time.  Things that seem so important in the heat of the moment can lose a lot of substance once rational thought is allowed to return.  I say allowed because once emotion enters the picture rationality can begin to recede.  If you find yourself on the edge of your seat, just raring to get your two cents worth in, it's probably time to wind it up for the day and allow your more rational mind to review the information.
    There's nothing wrong with spirited conversation.  It's great to be passionate about your ideas and what you do.  Problems require a level head and reason.  When tempers flare and words are being spoken rashly, it is wise to retreat, regroup, rethink, prepare and come back later refreshed and ready to reach a solution that works.  Words spoken under duress may sound so foreign to the speaker later that they can't believe they really said such things.  Then it may be too late.  All it requires is for one person to have the presence of mind to bring the fact that the conversation is disintegrating to the attention of the others and to suggest the topic be tabled for a while.  It is hard to walk away when you think you can still say the thing that will make everyone realize how right you are.  It's a maturity issue.  You may even decide later that you were saved from making a drastic mistake.  What sounds so great at one moment may sound ridiculous, even to your own ear, later, after the urgency is past.  One way to tell if the conversation has ended and a fight has begun is to look at the other person's face.  Do they look furious?  Stunned?  Disgusted?  Appalled?  Then slow down, admit that things are snowballing out of control and ask for a time out.  Admit that you are too stressed or emotional to continue the discussion right then and set a time to return to the topic.  That's just smart.  It may save the relationship and even promote the progress of the resolution of the problem rather than delay it. 
     So remember, there will always be time later to make your case, if you still feel the need to.  You may not always get a chance to unmake your case if you speak and act in haste.  Control your emotions and counsel yourself before you speak too strongly.  The listener may not be as willing to excuse you as you are to make an excuse.  Save yourself the grovelling later by letting wisdom and evenness be your guide.

Open Wide... Your Mind Not Your Mouth

    The definition of insanity:  Doing the same thing, the same way, and expecting a different result.  Bet you've heard that before.  Lots of people do that, don't they.  Are they all insane?  I hope not, I'm often in that category.  But, there's hope for me and hope for you, too.  It's not easy, but it's possible to change this habit.  All you have to do is open your mind.  I told you it's not easy, if it was, we'd all have done it already and there would be no war, no poverty, no discrimination, no school bullies, just peace, love and happiness. 
    Where do you start?  Everywhere, if you can.  Let's start with awareness.  That's the first step.  You have to be aware that you don't have an open mind and you have to be able to own that.  Now, think actively.  By that I mean, don't just react to whatever comes your way.  Question, challenge and analyze your thoughts and feelings.  I know, it seems so exhausting and unnatural, but it will become more natural and in the end you'll be energized because you should have less problems to deal with and more time for people and things you enjoy.  Whenever information enters your awareness and you feel a reaction that is above or below the midrange, question it.  Is your  natural response something that will make the next thing that happens positive or negative.  And then what, and then what, and then what?  All the way to the conclusion.  Now you know what to do and what not to do. 
    Someone came to me today and wanted to warn me about a patient's mood.  Good intention, but likely to be a negative influence on my next move.  Why?  Because, with that information I'd approach the patient differently than without it.  I'm a big girl, I can figure out if someone's grouchy or not.  If I am employing open-minded thinking, I can decide whether or not to let it influence my interaction with that patient.  I don't need to have my pump primed. 
    If a staff member comes to me and is upset with something that happened on the job I can decide to think of her as a complainer and approach her that way or...I can think that she really cares about what's happening and I can help guide her thinking to resolution.  While I'm doing that I am helping her to have an open mind. 
    If a patient is upset about an extensive treatment plan I can give up and decide that nothing I can say will change their mind.   Or I can be patient and educate them about what they need and why they need it until they "want" the treatment. 
    If my boss is grouchy I can worry that I've done something to displease him and even carry it out to a scenario so extreme that I can convince myself I'm unappreciated and maligned or I can do a quick mental scan and know that I haven't done anything wrong and he's likely upset that the dog jumped up on his clean shirt with muddy paws just as he was walking out the door. 
    If something isn't working for you as a leader or in any area of your life, open your mind and find a new approach.  Admitting you need to change is painless and may even help eliminate future pain.  It takes nothing away from you, it makes you bigger and better.  The only regret you'll have is that you didn't start sooner.

Nobility and Humility

   

Since I've started this weblog, I've gotten a few e-mails from other practice managers that convey a feeling of "Why am I doing this, what do I get out of it?"  That's a familiar feeling and there's nothing wrong with feeling it.  You are in a position that requires giving.  You must give encouragement, guidance, education and most of the time, you must give other's the credit for anything good that happens.  That can get frustrating if you only think of it that way.
    In case you haven't noticed from my favorite book list, I really like the books that Tom Morris  writes.  "If Aristotle Ran General Motors" was my textbook on how to become a practice manager.  There is a quote in that book that can show you how to think in a different way about the frustrations you may face in managing a practice.  Here it is:
    A man should always wear a garment with two pockets.  In one pocket, there should be a note which reads, "I am but dust and ashes."  In the other pocket, there should be a paper which says, "For me, the world was created."
    Tom goes on to explain that "people are inspired by a sense of nobility in who they are and what they are doing.  If you can convey a sense of nobility to the people around you, you can unlock their deepest potential." 
    Not everyone is aware they are capable of more.  You can only show them by modeling the actions and behaviors you expect from them.   Let them see that you believe it is within them to do the same.  The satisfaction comes in watching the awareness overtake them.  When you see the dawning realization that they are more than they thought were, then you will understand humility.  You will know that it truly is better to give than to receive when you see someone develop a belief in them self that they didn't have before.  It is an awesome thing to be a part of.  You will wonder who receives the greater gift and you will know that by lifting, you are also lifted.
    To be humble is to be dignified, reserved and respectful.  It doesn't mean that you think lowly of yourself.  It means that you value your capabilities and accomplishments but also realize that they are given to you so that you can join them with others to create something that goes way beyond anything we could accomplish alone.   
    This is the way to deal with the frustrations of managing.  Look at the people you work with and see the wonderful qualities and potential in them.  They are your canvas, but always remember, they are also the brush and the paint. You are the hand that guides them.  Without them, you would accomplish nothing in this endeavor. 

No Problems? Yeah, Right!

    Can you imagine a day in a dental practice with no problems?  It will never happen.  There are too many different people, with all their unique personalities, trying to achieve their individual desires, dealing with their own perspectives, to get through a day without any problems.  So accept it and deal with it.
    There are ways to face the problems of the day without letting them cause friction or breakdown of attitudes.  First, let's talk about how you approach others about your problem.  Don't talk about how something doesn't work, give a suggestion for how to make it work well.  For instance, don't say "I'm being taken advantage of because no one helps with set-up chores in the morning. I do them all or they won't get done".  Instead, ask your office manager if you can discuss a chore sheet at the next staff meeting so that the chores are distributed among the staff. 
    If you are bothered by someone else's behavior, wait a little and see if the feeling goes away.  If it doesn't, talk to them about it.  The operative word here is them, not everyone else but them.  They might not have intended to annoy you or bother anyone.  Or they might not have realized they were being offensive.  Try to have a calm and respectful talk about it.
    If someone comes to you with a problem with your behavior, listen, don't make excuses or try to invalidate what they are saying.  Ask them what you could do to improve the situation.  Listen and really try to hear what they are saying, evaluate it's meaning and try to come up with a solution that works for both of you.  Then put it behind you, don't dwell on it and turn it over and over looking for something to resent.
    As far as patients go, try to understand where they are coming from.  Make allowances, they are probably not too happy to be there to begin with.  We never really know what is happening in another person's life so try to let small things go.  That doesn't mean accepting abusive behavior, but in reality, how much is truly abusive and how much is simply rude.  Try to remember that rude people only diminish themselves in the eyes of others. 
    Schedule interruptions, running behind and cancellations are common occurrences in dental practices.  Put it in perspective.  It will be rare that you actually work the exact schedule that you start the day with.  Accept that as reality and you won't be surprised when it happens.  Flow with the tide and make adjustments as needed.  It is required if you want to excel.
    Learn to be flexible.  It is more reasonable to expect that things will change from day to day and to be able to respond appropriately.  Realize that nothing and no one is perfect and you won't be disappointed.  Understand that most days will include struggles and frustrations as well as satisfaction and smooth sailing.
    Don't overdo things.  Even good things carried to extremes can get annoying.  Think of the person who always goes way, way over and above what is expected.  Does that person leave room for anyone else to shine?  How about the constant comedian?  If you can never be serious, you can probably never be sincere either.  Over-complimenting rings false, over-complaining is exhausting and too many questions make you seem to lack in confidence. 
    Accept responsibility for making decisions.  Don't always try to get other's to make the tough calls so that you can't be blamed if something goes wrong.  Don't look to place blame on others for mistakes, spend that energy coming up with solutions.  Find ways to be more positive and to ways to work smarter.  Take a look at this post byDavid Cheong .  He has some good suggestions for all of us about developing positivite patterns.
    Basically expect problems to happen and plan for them.  Develop responses for common problems and keep the big picture in mind.  Today will end and whatever happened will be done and over.  Tomorrow will arrive with new opportunities to come up with great solutions to whatever the day presents to you.  Start with a good attitude and you'll be more likely to end with one too.