Attracting Peak Performers for Twenty-first Century Private Practices

The quality of the team in today’s dental practice constitutes an absolute limitation on the level of achievement for the dentist. It is the team who facilitates productivity, the team who stimulates desire for the finest dentistry. It is the team who promotes confidence in the dentist’s skills and integrity. It is the team who permits the doctor to thrive economically. More than the accountant, banker, or lawyer, it is the team who positively influences the practice’s gross and net. The dentist will gain more economically, clinically, and behaviorally when a talented team is present even with a mediocre dentist than when there is a mediocre team and a talented dentist.

It is easy for a dentist to say, “I want to find team members who are warm, empathetic, bright, committed, accept responsibilities, are self-motivated, personally mature, and care deeply for people in the practice.” It is not difficult to attract applicants who lean toward these traits. However, it is very difficult to create and maintain an environment which excites and challenges these people.

After interviewing thousands of auxiliaries, two psychologists from the University of Nebraska found eight common themes present in high performing team members:

1. Mission. They saw their work having a purpose that went beyond tasks they performed.
2. Interaction. The quality of their interpersonal exchanges was quite high.
3. Rapport. They had the ability to create warm, caring relationships.
4. Gestalt: intuition. This is the ability to see the whole picture when only small pieces are available.
5. Self Esteem. They genuinely like themselves.
6. Activation. They are “action” people who get things done.
7. Empathy. They feel what others feel.
8. Work Relationships. They can work well with their peers.

What is the effect on treatment acceptance by patients in a practice where the team feels they are treated poorly? Although most dentists realize auxiliaries have value greater than “from the wrists down,” it is critically important that they remember this fact: “People go where they are appreciated and stay where they are recognized.” This holds true for the team as well as patients.

As we seek to keep talented people in dentistry, it is essential that we recognize what we are up against. In a national study, 80 percent of the surveys indicated the following complaints from the team:

1. Long hours
2. High stress
3. Low salary
4. Low growth and lots of boredom
5. Poor communication

Strangely enough, the dentists in these offices indicated the same complaints about their jobs:

1. Doctors work longer hours than they would like.
2. They complain of high stress.
3. They are frequently bored by the routine of dentistry.
4. There is low growth potential.
5. They are aware of the poor communication in their offices.

What is surprising is that four to eight people or more who work together 30-50 hours per week in 600 to 1,400 square feet; in such close proximity that they are often in physical contact with one another, share the same problems, but no one talks about it.

Today, only two to three percent of what this work team produces is essential. Except for the emergency visit, most of what today’s team produces represents optional procedures. This means that the doctor/patient relationship is becoming even more voluntary in nature. Much of the time there is no compelling reason for a patient to accept the doctor’s recommendations. Consequently, until someone voluntarily comes into the office and says, “Let’s do it,” the dentist does not have the opportunity to use the full complement of his or her diagnostic and technical skills. This is why a practice with a high performance team has a potent marketing advantage today. The single most distinctive characteristic of a successful dental practice is their ability to have people want fine dentistry. This is the responsibility of the team, not solely the doctor.

Psychologist Fredrick Herzberg identified two basic incentives he believed we all have for working:

1. Hygiene factors. These include salary, hours, fringe benefits, vacation, sick pay, etc. Hygiene factors are anything quantitative that is inherent in the job.

2. Motivation factors. These factors are attitudinal and most often cannot be quantified. They exist within the person, and are not part of the organization. Dr. Herzberg discovered five main motivation factors:

A. Recognition. The desire to be seen as an important person.
B. Fulfillment. The ability to satisfy personal values.
C. Growth. The desire for a future of choice which is not limited to a job description.
D. Shared Information. The need to have access to information on more than a “need to know” basis.
E. Autonomy. The desire for independence and responsibility with authority.

Research has indicated that low achievers tend to favor hygiene factors in their jobs. They want standards imposed upon them. High achievers, on the other hand, expect a high level in hygiene factors; they demand a high level in motivation factors. For these people, excellence is an internal issue, not something to which they have to be directed.

Low achievers are stressed by the uncertainty that high achievers want. High achievers hate the rigid structure and rules that give low achievers their security. Thus, a dental practice will greatly affect which type of person it attracts and keeps by the choices it presents.

To recognize high achievers, look for the following attributes:

1. Optimism
2. Participation in life
3. Seeing themselves as significant
4. Possessing mission and drive
5. Realism
6. Energy
7. Acceptance of others
8. Good use of role models
9. High sense of priorities
10. Resilience
11. Self-revealing
12. Willing to make long-term intimate relationships

As the necessity increases for private, fee-for-service dentists to find and retain peak performing team members, it is worth reviewing why team members have historically left their employers. Reasons include:

1. Lower than expected compensation
2. No opportunity for advancement
3. Not enough respect
4. Not enough communication
5. Lack of appreciation from their employer

The following are suggestions to counteract these problems and help keep the peak performing team in private dentistry:

1. Invest. Do not automatically hire the cheapest applicant. You generally get what you pay for.
2. Prepare. Have a training program for the new team. Better results will be achieved when the team understand the doctor’s philosophy and mission.
3. Focus. Establish clear and concise goals and objectives with the entire team.
4. Educate. The challenge of continuing education creates a team that can be the dentist’s single most potent marketing advantage.
5. Communicate. Many doctors seem to reserve their caring exclusively for the patient and neglect their teams. When communication is weak, motivation dies, and so does productivity.
6. Disclose. Practice numbers should be disclosed to the team. How would you like to play football and never know the score? Good people will demand feedback, and sharing numbers increases the team’s attitude and feeling of ownership.
7. Set a good example. The doctor should not reprimand the team for being late after lunch when s/he is also late. The doctor cannot expect loyalty, commitment to patients, and team play until the leader has these traits.
8. Give respect. The doctor cannot give respect unless s/he is respected. The team likes to know that the doctor will stand behind them 100 percent in an issue with a patient.
9. Don’t poor mouth the practice to the team. A good way to keep gloom and doom is to preach gloom and doom.
10. Show appreciation. The team does not feel appreciated simply by getting a paycheck. Money is important, but praise in front of co-workers or patients is also rewarding recognition.

It is important to remember that good people will take longer to find, require greater investment, and will be important to maintain over time. Ask yourself, how much more valuable is it to seek and maintain peak performers on the team than it is to own the latest piece of dental equipment?