One of my favorite leadership quotes is by Walter Wriston, former CEO of Citibank: “The person
who figures out how to harness the collective genius of the people in his or her organization is
going to blow the competition away.” I have made it my purpose to be the catalyst for business
owners to figure out how to do just that.
The essential key is communication. Effective leaders are effective communicators; and that goes way beyond being a good orator. It starts with listening…what you listen to and for and your ability to listen to what is not said. I will discuss this in more detail later.
As the owner of a practice, you wear many hats: doctor, leader, manager and coach. Chances are you’ve spent a great deal of time and money mastering being a doctor, and invested very little in being a leader, coach and manager. Many of you have had experiences associated with being a leader or coach in high school and college if you participated in sports or were part of student organizations, and this is helpful. But the curricula in dental and orthodontic programs do not include more than a smattering of attention to practice management issues. So it’s of no surprise to me to hear doctors lament about the plethora of management issues they face when they become owners of a practice.
World renowned coach Vince Lombardi said, “Winning isn’t everything, it’s the only thing!” In the game of leadership, the same can be said about communication. The better your communication skills are, the better your coaching, managing and leadership skills will be.
As I said earlier, communication is not just about speaking and choosing the right words. It starts with listening.
And listening demands empathy, the ability to put yourself in the other person’s shoes. More often than not, we speak without first asking ourselves what it would be like to be the other person receiving this communication. As a leader, it is critical to have empathy for your team…to allow yourself to imagine what it would be like to be an employee who has limited power and numerous responsibilities. After observing a doctor client in his practice for a couple of hours, I asked him, “Would you want to work for you?” He admitted he would not, and explained that his autocratic style of management, with frequent criticisms and no praise, was how the doctor he worked for as an associate managed a successful practice—despite the high staff turnover! He also admitted he couldn’t wait to also quit and start his own practice. Much to his credit, he did a complete about-face, and the results were increases in production and collections, and no staff turnover.
The autocratic management style is the first leadership mistake doctors make. It’s the “I’m the boss and you’re not” approach to management that creates a deep divide between you and the team. Please understand, I am not a proponent of you being friends with your team. There is a fine line that must be maintained. I am an advocate of you being friendly, compassionate and empathetic with those who work with you, and you really need to like the people you hire. As Zen master Fuschan Yuan says, the three essentials to leadership are humility, clarity and courage. Humility means not letting your ego put you above the practice mission itself or to consider those you hire to be inferior to you, or to think of them as your minions. Your responsibility as the practice leader is to cultivate your team to be stake holders in the practice.
The second leadership mistake is the lack of clarity in communications. When you hire someone, that person becomes an extension of you. In essence, you are depending on that person to be you as she/he is answering the phones, doing lab work, collecting money, and so on. Without you clearly communicating your vision and mission, and training the employees on exactly how that would work, you’re depending on the luck of the draw to have the practice you want.
The mission statement is the first communication to your patients and to your team as to what you value and the principles that will guide everyone’s actions. It should be read at the start of each morning huddle as a reminder of how you all will conduct yourselves throughout the day. Rather than just reading it from rote, have someone say in his/her own words what that means. It’s a great idea to create a slogan or motto that encapsulates the mission and serves as an anchor to your purpose. The Ritz Carlton has a great slogan that is a book-long sentence: “We are ladies and gentlemen serving ladies and gentlemen.” Some I’ve heard for orthodontic practices: Changing the world, one smile at a time; Beauty with Class; Creating smiles that make you smile!
The most important thing is not to let the mission statement gather dust on a shelf…make it real, and breathe life into it every day!
Clarity of your vision and mission is also critical to avoid making Leadership mistake #3: hiring someone to fill a job or position. Rather, you need to hire people to fulfill your vision since it is your team is who is selling your services. When you are looking to hire someone, look first at the candidate’s character and personality and then the specific skills. Given the constant changes in technologies and techniques, you will always be training your team; but character and personality are not something that training will have an impact on. If you want to look forward to going to work every day, make sure you hire people you like and respect, and who are partnering with you in your vision. Among the core values you should look for in a candidate are integrity, accountability, contribution and gratitude. By using open-ended questions in the interviews, you can identify these traits and the strength of them in the person. Some examples of open-ended questions might be: We are all humans and we therefore make mistakes. What actions do you take when you make a mistake? If someone else points out a mistake to you, what do you do? If you see someone else make a mistake, what do you do? At level three of the hiring process, be sure to check references and TEST TEST TEST! The Wonderlic Cognitive Ability assesses the aptitude of potential candidates for learning and problem solving; the Personalysis measures motivation, drive and intellect, and The Four Color Personality Test evaluates how people are prone to respond in different situations. Of course there are many other tests available; these are only examples. At this last level of the interview process, have the team go out to lunch with the candidate to see how they relate to each other. In this relaxed setting the team may also find out information that you can’t learn in the structured conversation of the interviews.
Leadership mistake #4 is the lack of consistency in your requests and orders, how you handle policies, whether you follow through on plans, and whether you call people to account. The lack of consistency is the source of team members’ complaints that the doctor plays favorites, and it results in breakdowns in teamwork. For example, when a team member asks for time off when she has used up her vacation and personal days, your first response needs to be, “What does the policy manual say about this?” This has to be true even if your most senior team member or your star performer is making the request. If you make a rule, you must stick to the enforcement of it; if you make a rule, you need to keep it also! If the morning huddle starts at 7:30 a.m., you need to be there no later than 7:20. If you call in and tell the team to start the huddle without you because you had to run an errand before work, don’t expect your team to conduct themselves any differently. How goes the leader, so go the followers. This harkens back to Mistake #1, holding yourself above the rest.
This also leads to Mistake #5, training the team on what and how to do their job, but not how to BE! We’ve all heard the saying that attitude is everything. While this is true as a universal principle, it is a critical factor in creating a practice that your patients want to brag about and refer their friends to. In fact, from the patients’ points of view, the only thing that distinguishes you from your competitors is the experience the patients have when they are in your practice. Are they welcomed with a smile and greeted by name when they come in, or is the receptionist too busy to say hello? Does the receptionist answer the phone with a smile in her voice, or does she sound busy and distracted by the phone ringing? When in the operatory waiting for you to check the patient out, is the chairside assistant engaging the patient, or does she abandon the patient to go check her cell phone for messages? Do you have a Debbie Downer on the team that drags everyone else down with her? Does your team whisper amongst themselves and gossip, or do they address complaints directly with the person with whom they have a problem? When your patients walk out of your practice they are either saying something good about you, saying something negative about you, or they are not saying anything at all. So you have a one in three chance of having them be your volunteer sales force. If you don’t pay attention to the “soft” side of the business, you will be wondering why new patient calls have dropped and why case acceptance is low. People can sense when a practice is in harmony and when it isn’t. If the practice is not a happy place to be, patients will go elsewhere…even when the competing orthodontist charges more! If they are going to spend $5000-plus over a course of two years coming to your office for appointments, they want to feel special and appreciated when they are there.
In fact, the same can be said about your team and you! You all want to be happy to go to work. If you’re going to spend the majority of your waking hours with people other than your family and friends, all of you need to get along. It is the responsibility of the leader to ensure the emotional space of the practice.
There are three keys to creating and maintaining healthy relationships: first, do no harm; second, tell no lies; and third, resolve tolerances. And these are in prioritized order. Sometimes you have to weigh if telling the truth is harmful, or if not telling the truth is harmful. Telling someone she/he has bad breath may hurt the feelings of the recipient of the communication; but not telling her/him could be more harmful. Most of these kinds of conflicting messages can be resolved by choosing the appropriate language and the proper time and setting.
The third key, resolve tolerances, usually is the most difficult one to deal with, and leads to Mistake #6, tolerating the intolerable. Doctors put up with tardy team members, poor attitudes, bullying, gossip, and lack of professionalism for a variety of reasons: she’s a good clinician; the patients like her; it’s hard to find good employees; it’s the busiest time of year; you don’t like conflict and don’t know how to handle it. Often the doctor is the last one to witness the poor behavior, since the offending team member invariably makes sure to be on best behavior around the doctor. But the bad seed on the team can cause havoc for everyone else. As a big fan of NCIS, I’ll quote Leroy Jethro Gibbs, the star of the show: “A leader fights for his men.” The team is depending on you to create a healthy work environment. While each person is responsible for handling situations as they come up, their power to effect real change is limited. In coaching doctors about this issue, I can assure you that the most common mistake they report making is hanging on to poor employees too long. Great practices have great employees. It’s that simple. As the father of motivational speakers, Zig Ziglar, said, “The only thing worse than training employees and losing them is not training them and keeping them.” What you have to communicate and train team members in is what it takes to succeed as part of the team. Give people direction and coaching and sufficient chances to succeed; but when all efforts fail, let them go! Noted speaker and trainer, Brian Tracy, has said, “Teamwork is so important that it is virtually impossible for you to reach the heights of your capabilities or make the money that you want without becoming very good at it.” When you become complacent about the practice environment, it is the beginning of mediocrity. You can never take your foot off the accelerator. No one will ever drive the practice like you: not the office manager, not your senior team members, not the star of the team. If you don’t know how to effect the necessary changes, hire a coach, read books, go to workshops and seminars. Help is available…you don’t need to reinvent the wheel or go it alone.
Leadership Mistake #7 is thinking that the paycheck and bonuses you give are sufficient for team members to be motivated and feel appreciated. In fact, bonuses can have a detrimental effect on attitude and motivation. I have heard numerous doctors lament that they rarely, if ever, hear someone say “thank you” for a bonus, and even have had team members complain that they expected a larger bonus. I recommend you read the book, Drive—The Surprising Truth About What Motivates People. The author, Daniel Pink, reports that people are motivated by autonomy, purpose and mastery. Due to time restraints for this article I can’t go into detail about the book; however, I can tell you Pink’s main point is that the carrot and stick philosophy of motivation doesn’t work, and what does work is developing people’s talents and creating an environment that leads to autonomy and mastery.
Your best tool for developing your ideal team member is praise and acknowledgement. Too often managers are quick to criticize and slow to praise. Yet praise is the most effective tool for training and improving performance. It also has the greatest impact in creating loyalty with employees. Most important is that someone who feels appreciated does more than expected. Hearing praise, especially in front of co-workers and patients, is one of the simplest and most uplifting things a team member can hear. There’s an old saying about praise: Babies cry for it and grown men die for it. I’ve heard many doctors say they’re not good at giving praise and they forget to try. Is that an excuse you would find acceptable from a team member when told to do something? There are many ways you can get good at it. One of the most effective is to put five coins or pebbles in your left pocket. Each time you acknowledge someone, take a pebble or coin and put it in your right pocket. Make sure all the coins/pebbles are in your right pocket at the end of the day. At the morning huddle and at the evening clearing meetings, make sure to acknowledge at least one person for catching them doing something right.
Set up a “mailbox” in the staff lounge and have slips of paper available for people to write thank-you notes or notes of praise to other team members and “deliver the mail” before everyone goes home for the weekend.
As I said earlier, attitude is everything. The corollary to that is the attitude of gratitude determines your altitude.
To conclude, I’d like to say is that it is normal to make leadership mistakes. It is also a myth that leaders are just born that way. It takes work, intention and commitment to develop your leadership skills. You spent a whole lot of time and money getting trained to be an orthodontist. Make sure you protect that investment by developing yourself as a leader. The return to you will not be limited to financial gain, but more important, a windfall in joy and fulfillment.