Every great leader, in this case, Im speaking to you…doctor, is also a good communicator. In fact, you can’t inspire people to follow you if you cannot effectively communicate a vision or purpose that they want to be involved in. Leadership and communication go hand in hand.

Effective communication is more than finding the right words to say. It requires listening before the other
person speaks, and being able to hear what is not actually said. We all do this to some extent: for instance,
if you’re buying a present for someone, chances are you think about what that person wants and likes, and
then shop to buy them something that would please them. In creating and designing your practice, you
seek to have it be a place and an environment that will attract and please the kind of patients you want to

When it comes to general conversations, we’re not as adept at listening, especially when it comes to getting others to do things we need done. As a business owner you need to give a lot of direction, training’ you make requests and demands, and ultimately manage employees. Not all speaking is a full “conversation,” and not all conversations are true communication. It’s critical to make distinctions in speaking in order to have it be actual communication. I will discuss this more fully later.

One of the things I strive to do with my clients is to instill principles that lead to “top down” thinking, as opposed to telling them what to do and say. Following principles lead to appropriate actions that allow for individual circumstances and situations. They act like laws of the universe in that they remain constant regardless of circumstances.

The over-riding principle for effective leadership in a practice is to be clear “what’s the message?” What is it that you want your patients to be saying about your practice, and then manage that conversation as your patients are your best advertisement! You have to start at the end and work back to the beginning. To quote Yogi Berra, “If you don’t know where you’re going, you’ll probably end up someplace else!” So, for example, if you want patients to being saying “Wow, that was the best experience I’ve ever had in a dental practice,” then you have to ask yourself what should your website look like, what should the patients hear when they call your office, what should they see when they come to the practice, how should they be greeted, etc.

It is important to formulate what your vision for the practice is. Again, start at the end: on the day you retire and leave the practice, what is the conversation you want your staff, your patients, your family and the community at large to be having about you? What is the impact you want your practice to have made on all these people? Once you have created the vision (and it may be subject to edits and change over time), you can begin to formulate what the practice should look like, what kind of team you want to surround yourself with, and what the experience should be for the patients that you want to attract. This is an important starting point in the hiring process. Staffing your team means more than hiring people to do a job—you need to hire people to fulfill your vision! While prior work experience is helpful, seek first to hire character, attitude and personality. Hire people who you think will be great ambassadors for your practice; your team are actually an extension of you and in fact will spend more time with your patients than you will. Create a list of “must have” and “nice to have” qualities and characteristics of your “perfect” team member that are tied to your core values. In the list of core values for your practice, there needs to be integrity, accountability and contribution. In my years of consulting experience, these core values are the foundation on which to build a strong and healthy practice.

There are a raft of assessment tools available to you, such as the Wonderlic test which assesses both personality types and skills aptitude; also companies such as Bent Ericksen and Associates offer a full complement of pre-employment tests. I also recommend doing a pre-employment credit check, not to see if the applicant carries debt, but rather to give you some insight as to the individual’s integrity and accountability regarding commitments he/she has made. (You should first check on local labor laws to see if it is permissible in your state.)

Even with the best team in place, any leader also has to be a good manager. I mentioned earlier that there are distinctions in conversations: orders, requests, corrective conversations and conversations for change.
Orders, in which there is no room for negotiation, are based primarily on the standards you set for the practice, and should be clearly stated in your employee manual. Again, make distinctions of what you “must have/must not have” and “should have/should not have”, the latter being negotiable. For example, wearing uniforms to work and mode of dress; if you alter color of uniforms for different days of the week, requiring everyone to wear a nametag, banning open-toed shoes or flip-flops; days and hours of operation for the practice, use of personal cell phones at work, etc. When anyone doesn’t adhere to these standards, it is imperative that you take decisive action for anyone who doesn’t comply. And I say “anyone,” meaning your most senior team member, your most dependable team member, your most “critical” team member, etc. If you don’t stick to the standards you set, or if you make exceptions, or overlook someone not complying then I can assure you, others will expect the same exception or you will generate whispers among the staff that you show favoritism. Whatever rules you set up, you must follow them! Don’t expect people to follow you if you operate in a “do as I say, not as I do” manner.” This behavior and attitude will foster resentment and erode respect from your team. The axiom is, “as the leader goes, so go the followers.”

Requests of and from your team involve negotiation. If there is no room for negotiation, it’s called a demand or order. What is negotiable in a request are the terms or conditions for satisfaction. For example, you make a request that a team member meet with you to discuss job performance. The day and time may be negotiable but not the request to meet. Also, the request needs to have specific actions stated. Requesting that someone improve their clinical skills is not specific. Requesting that someone be trained by a senior clinician to tie in an arch wire within 5 minutes by a certain date is specific; and gives all parties involved a chance to negotiate the terms until everyone can agree. It is then critical that you follow-up on the request on or before the agreed due date, or your requests will not be taken seriously.

The importance of follow-up leads to one of the core values that I stated earlier that need to be part of the foundation of the business: integrity and accountability. There can be no integrity without accountability. Unfortunately, accountability is sorely lacking with most people. Notice what happens when you let someone know he/she made a mistake: more often than not, you will get an excuse, and explanation for it, or who’s to blame for it.

As a leader, it is imperative to make it “safe” for people to be accountable for their actions. This is another time when the principle of “if you want to be heard, you have to listen first.” Almost everyone avoids confrontation and fear retribution if they do confront someone on any issue. If you apply the listening principle, then the way to have corrective conversations becomes easier and more effective. First of all, don’t confront people with issues; confront issues with people. Use the “sandwich model” for corrective conversations: start with praise; then identify the issue and make a specific request to correct the problem; followed by praise. For example: (Praise) “Joan, you have really improved your case acceptance over the past month; I’m really proud of how you have applied the training you’ve gone through for that.” At all costs, DO NOT follow this up with the word “but” as this will negate what you just said. (Request) “I notice that you have fallen behind on following up on the suspense file. I request that you commit to making at least 5 follow-up calls each day. (Here is where you can negotiate how many calls to make/day; find out what she needs to be able to do that, etc.) When you and she agree what the plan will be, you complete it with praise: “Thank you. I knew I could count on you to be open to finding a way to tackle the suspense calls, and I am proud of the way you support me.” This final acknowledgement should connected to the behavior you want to see more of.

Praise and acknowledgement are your best tools for training team members. There’s an old saying about praise: “Babies cry for it and grown men die for it.” Most people’s work experience is that managers are quick to criticize and slow to praise. And to quote my mother, “Put the ac CENT and the right syl LAB le!” Find ways to publically praise your team, especially in front of patients, as well as privately, including in written notes.

Finally, there are times when you need to engage your team in conversations for change. If you apply the “listen first” principle, you will effect whatever change you want with a lot less stress and resistance. Imagine being a team member and your doctor says, “We’re opening a satellite office next year.” Chances are you will say to yourself, “Oh great…more work.” At that point, everything else you hear will be filtered through the “more work” mindset.

Conversations for change or for introducing new projects are really enrollment conversations. As Christopher Morin said, “The fastest way to connect with your audience is through the heart, not the head.” In order to do that, you need to put yourself in the listener’s shoes. The following are the spaces to be completed to successfully enroll your team in the changes you want to make, or projects you want to take on:
Background of Relationship: “When we first opened this practice I knew that the only way to make my vision come true was to have the right team with me…people who saw working here as more than just a job; people who wanted to do meaningful work that touched people’s lives. You have been the right people, and together we have achieved goals and made my dreams come true.”
Conversation for Possibility: “After reviewing our end of year meeting, and the notes on what worked and what didn’t work during the year, I started to wonder what would be possible if we applied those lessons now. Around the same time, I was told of an office space, about 15 miles from here, that is available; and I thought it would be a good location for a satellite office. I’m not sure it’s something that we can do, but I want to investigate that possibility.” Tease out the possibility—how many people could we serve, who in our practice now would have an easier travel to the office, etc.
Conversation for Feasibility: At this point, engage the team in any and all considerations a satellite office and let them freely express themselves. The only requests at this point is to investigate—what would it take; how could we handle the problems associated with opening a new satellite. Up to and through this space, the conversation is strictly speculative. The only requests you make are for individuals to find out answers to the issues and concerns raised.
Conversation for Action: When you meet again after the investigation process is complete, review the findings and choose whether to go ahead. If you decide to go ahead, set up a timeline with specific requests for the actions that are needed.
Conversation for Breakdown: The best laid plans often go asunder. However, if when you complete the plan, you then ask, “What could go wrong?” you can set up contingency plans in advance and not be stopped by any breakdown that may occur.

In closing, I’d like to share a question I have asked clients: Would you want to work for you? If you are a micromanager, would you want to be micromanaged? Are your conversations with and about them full of praise or complaints? The emotional environment of your practice is in your hands. Remember, how goes the leader, so go the followers!