Shared Leadership in the Dental Office – Part 1

Shared Leadership in the Dental Office – Part 1 of 2

Leadership is defined as: “The process of effectively guiding the activities of people to achieve the purpose and vision of the practice.”

Today, more than any time in our history, dental practices need leaders.  Unfortunately, there is an understanding in the public that leaders are born and not created – this is not true.

The time has come in dentistry for the era of leadership. We all can be leaders if we want to; it is not an exclusive club.

The kind of leadership that we look for in dentistry today is shared leadership. It is no longer appropriate to lead by yourself. Here are some examples of shared non-leadership:

• The office which owns a computer and the dentist has no idea how to turn it on. The staff research the computer, make the decision to buy the computer and then buy it. They research how to use it once it is in place.
• There are offices that have a very good Periodontal Disease program in which the hygienist researched the idea, implemented the program, and sold it to patients without having the doctor directly involved.
• In some offices, the staff has generated a new patient flow model.  They have read the books, done the research, and talked with patients so that the new patient interview is created in the dental office.  The dentist had very little to do with any of this except to give the staff his/her support.

In choosing a leadership structure for a dental practice, there are three choices:

• The Authoritative Model: Typically, this is hierarchical with the dentist at the top and the staff in the trenches.  The staff has no direct relationship to the practice.  Communication goes in a top-down flow. There is no communication from the bottom.  People in this model don’t talk to each other about substantial issues like their purpose and vision. This model of leadership is no longer appropriate in dentistry.
• The Laissez-faire Model: There are no goals or guidance.  There is no leader.  There tends not to be a common vision and they are in it for themselves. Inevitably, when there is no leader, one is developed, and the “mother hen” syndrome frequently appears.  A sometimes talented or not so talented staff member takes the reigns and tells everyone what to do, including the doctor.  At this point, the practice is at risk because it is at the mercy of the “mother hen.”
• Non-Hierarchical Model: In this model, there are no higher or lower levels but everyone is on the same plane working together as peers. It is critical to remember that the person at the center of the Non-Hierarchical Model must be the dentist.  The dentist must lead because it is his or her name on the door and hence has a different level of responsibility than anyone else.  The dentist is legally and ethically responsible for everything that happens. Despite the fact that the dentist must be at the center of the model, there are other people who can come to the center and share leadership in select areas.  This type of model requires a great deal of participation from everyone on the team.

In dentistry, there may be a large number of “tyrant leaders.”  These are people who do not know how to nurture, facilitate and develop leadership qualities in others. Dentistry, as a business, cannot afford leadership styles that intimidate and suppress people. The leader must know “when to let go.”

There are four critical things that are needed in order to build a good business:

1. Find the necessary capital to invest.
2. Find a favorable environment in which to apply it.
3. Hire key people.
4. Know when to get out of the way.

The first three are easy and are nothing new.  However, knowing when to get out of the way will make your practice profitable.

The key is to get the dentist to let go of the control of the practice and give it to the staff. However, s/he cannot let go if they do not feel safe. The dentist will not let go if he or she does not think that the staff members will accept some psychological ownership of the practice.  The doctor/leader will not let go unless he or she feels that the people dealing with the practice will act responsibly.

On the other hand, if I am an achiever-type employee who wants ownership of the practice, I must know that I have some freedom and responsibility as well because I want other people on the team to delegate to me.  I must help people to trust me to run things according to the vision of the practice.

The differences between management and leadership:

• Management tends to be a left hemisphere activity. It is analytical and predictable.
• Leadership tends to be a right hemisphere process. It deals more with feelings and intuition.  Managers emphasize knowledge and facts.  Leaders emphasize more belief and commitment.  When you are developing a relationship with a patient, the knowledge and facts don’t come into play as much as the feelings and commitment.
• Managers make decisions based on directions. We need to have budgets and annual planning retreats.  We need to develop budgets and decide how much money is going to be spent on continuing education, lab bills, and other overhead items.  Someone must follow the budget to see how we are doing.
• Managers deal with the short-term while leaders deal with the long-term.
• Management means using the known resources of the practice effectively. These are time, money, and energy.
• Leadership is an expansive concept that helps the practice to discover and develop its hidden resources.
• Management is about probabilities, while leadership is about possibilities.
• The toughest thing about the dentist is that he or she has to keep switching baseball hats. At 9:00 a.m. they are the manager and at 4: 00 p.m. they need to be the leader. This is why it becomes desirable and effective to hand out some of the leadership hats to the staff members so that they can manage their own areas of expertise.

The six functions of leadership.

How do you measure yourself on these six concepts and how do you measure your practice?

1. Practice Vision.

What do you really want?  Dental practice leaders need to be working on developing a vision statement or vision scenarios for the future.  This is what the office should look like a year or two from now.  Leaders are people who keep the vision alive. Leaders are beleaguered by day-to-day emergencies and activities. They continually ask, “are we moving to our preferred future?”

Visions are extensions of your value system and your attitudes. If you think that you psychologically own the office and you believe that its success is important to you, would you own the office? The leader must monitor the vision as well as reinforce it, especially to new members of the team.

Leaders must decide when their vision must change. If you are going to keep the vision, you are going to have to be able to articulate it clearly. To serve as a leader, you must be a model of one.  This is very difficult to do.  If you can’t model it, the people whom you are leading will not follow.

2. Setting the tone.

Tone is defined as long-term spirit and not short-term mood. The tone of an organization is always set from the top down.  Tones never come from the bottom up. A leadership tone for example is as follows:  “I believe in dentistry, I believe in this practice, I believe in our future, I believe in our team, I believe …”

Leaders encourage a positive professional attitude in the practice.  They help to encourage the belief that everyone in the practice is contributing to the whole effort. Everyone is responsible for the short-term mood.

Next week’s blog will continue the discussion of The Six Functions of Leadership.