Posted on March 20, 2013

    No dentist practices alone. At minimum, you probably employ an assistant, hygienist, and receptionist. Many of you have multiple people in those roles, as well as an office administrator, other dentists and perhaps a finance person. Your profitability, your patients' comfort, and your own pleasure in your practice are tied directly to how well you and all of your staff operate as a team.

So, how is your team doing? … Do any of these comments sound familiar?

• "We keep solving the same problems over and over again."
• "We often run out of materials despite having set up a foolproof system of when to re-order."
• "I can't get my staff to show up on time."
• "My staff bickers and argues over nothing. It makes my stomach hurt. I wonder what my patients think."

Don't feel alone. Many dentists suffer the same problems that your team does. The vast majority of dentists have not been trained how to create and maintain a high performing team.

Teams that under perform often suffer from difficulties in their psychological infrastructure. I am not suggesting that team members have psychological problems. In fact, with only a few exceptions, that is precisely the wrong way to think.

Rather such teams have not established a shared set of behavioral norms to govern the ways that members relate to each other. The answer, therefore, is not to fix individuals. Just as most occlusal problems can involve misalignment of several factors, team problems are usually based in misaligned norms/expectations about interpersonal interactions. The path to team success is to adjust the interactions. Here is a model that many teams have found to serve as a helpful guide.

Vital Behaviors of a Team ¹

Five behaviors set strong teams apart from those teams that erode profits and patient satisfaction. Picture a pyramid with five levels. Each level builds on the one below. In this installment, we will examine the absolute foundation, trust. In a second installment, we will discuss the next two vital behaviors and give you ideas about what you can do to bring them to your team. Finally, the third installment will complete our description of these vital behaviors, again with action steps.

Trust: The foundation level of high performance teams is trust. Members come to trust each other to be genuine. They give up the pretense and are willing to acknowledge about their office-relevant mistakes and weaknesses.

Doing so isn't easy. Our competitive culture encourages us to be fearful of attacks by others for our weaknesses. Experiences with some teachers (grade school or dental school) have made many of us fearful of mistakes. We got punished or shamed rather than being helped to see mistakes as opportunities to learn.

The drive to seem perfect causes us to lie to each other (and ourselves). We are not genuine. Instead, we affect a sense of superiority and invulnerability. Such behavior feels like an attack to our teammates. When team members fear attack from co-workers, communication is impaired. No one tells the truth. No one has the right information. The team is hampered from being able to correct errors and shortcomings that are always a part of human life.

Action Step: As team leader, you can help your team build trust:

• Be trusting. Give up your own need to be perfect or invulnerable. Admit to flaws and mistakes that affect what the team is trying to get done. For example, if you have trouble with case presentations, as many dentists do, acknowledge it to your team. They probably already know it and will admire your candor. As another example, maybe there is a patient who you hate seeing on your schedule. Let the team know how you feel, not to get them to take any action but rather just so they know that you are human.

• Be trustable. Accept other's flaws and weaknesses. This does not mean that you overlook mistakes. Rather, it means that you allow people to be human, i.e. imperfect. Suppose your receptionist tells you about mishandling a call. She needs respectful understanding, such as; "Thanks for telling me about that Mary … I know that you wish it hadn't happened." Such a response creates openness so that problems can get airred.

  Suppose that your hygienist confesses that she hates "selling dentistry." A sharp response from you will ensure she never ever tells you another shortcoming that she has. She will know that she can't trust you with that information. However, what if you are the teacher you wish you had (or were lucky enough to have had). You might respond: "Telling others what they need to do is scary for most of us. Maybe I can help. Let's start with you telling me what makes you the most uncomfortable." Such a kind response will help her to know that this is an office in which she can learn and develop. It is safe to admit skill deficits, always the beginning point of learning.

Let's stop here for now. Practice these two behaviors and see what results you get. Feel free to come back and share what happens with other readers. 

¹The Five Dysfunctions of a Team: A leadership fable by Patrick Lencioni, Jossey-Bass, San Francisco 2002.