Great Expectations

“I don’t know what the dentist expects of me”

Has anyone in your office ever uttered this phrase?

It is one of the most common statements we hear when working with offices struggling to achieve their full potential. When team members are unsure about your expectations, the result is usually too much open time, missed appointments, un-submitted pre-determinations, patient’s overdue for treatment or a lack of follow-up on diagnosed treatment that was not initially accepted.

All of these factors will have a negative impact on both your financial bottom line, as well as the quality of care received by your patients. Therefore, setting out clear expectations of your manager and team members is vital to your overall performance.

And expectations are best established from the top-down. It is imperative that you begin with your office manager. Set out not only the tasks you expect of them, but also the level of authority required to undertake those tasks on your behalf. In doing so, you will be taking the first step to establishing clear expectations for all of the members of your team.

If It Is So Important, How Come Dentists Never Outline What They Expect?
The answer to this question can best be encapsulated by another sentence common in the dental world. Namely, “we just want the dentist in the back doing dentistry”!

On the surface, this idea seems to make sense. Dentists are trained and educated to be clinicians and to play their vital role in providing the best oral healthcare to their patients. It goes without saying that the doctor’s ability to diagnose and treat patients is essential to the financial well-being of the practice. If there is no dentistry being done, there is no money being made!

However, the business of dentistry will not take care of itself. Steering your practice in the right direction does require at least some of your attention and leadership. If you choose to have a manager assume some of this responsibility, that person will need to understand and appreciate the direction in which you wish to go and the extent of his/her authority to support you.

So How Do I Create this Authority?
The first thing you need to acknowledge is that this is not a task you can accomplish in an hour. Nor is it a task you should undertake on your own. Be prepared to commit the time it takes to do this properly. More importantly use the input of the person you have hired to manage your practice.

We recommend that you begin by listing every administrative task that is relevant to the management of your practice. From the ordering of supplies for the business office to the negotiation of an agreement with a prospective associate, every task should be included.

To the extent possible, this list should also indicate the frequency with which those tasks need to be undertaken. For example, some will be performed on a daily basis, while others may be weekly, monthly, quarterly and so on.

Simultaneously, have your manager undertake the same exercise. Doing so will help each of you envision the overall management of the office while also ensuring fewer items are overlooked.
Creating the task list is the easy part. Once you have compared and agreed upon its basic contents, each of you needs to assign a degree of authority the manager should have over every item on the list. I refer to this as “following a five point plan” because I use five different levels of responsibility.

Following The Five Point Plan
The first thing to understand about the Five Point Plan is that it is simply a methodology to assign responsibility for the performance of a list of tasks. Every office will be unique in its management style. That means every office can assign degrees of authority as they deem appropriate. It is not a “one size fits all” solution.

Having clarified that matter, the question remains what are our Five Points?

What you call each point is not important. Choose whatever title for the table you like. I have my five and they are a reflection of my own, quirky personality. Below are the labels I have chosen along with a description of each point:

Just Do It! As the manager, this one is all yours. I don’t want to hear about it unless something really goes wrong!
Do It…But Tell Me! Go ahead with this one. But remember, it does affect my routine so I need to be informed.
Tell Me What Needs to be Done and We Can Decide! Give me your recommendation and why. I will decide how we proceed.
Delegate Away, But…! True, you do not have to do everything hands-on. Go ahead and assign roles to others. But at the end of the day, you are the manager and you are responsible!
I Got This One! Yes…it is a managerial task. However it is one I would like to keep for myself.

Now the time has come to review your task list and assign each one the degree of responsibility you would like the manager to have based on the Five Point Plan. For example, if an admin team member calls in sick, the task of finding a replacement or re-allocating duties for the day can easily fall under “Just Do It”. There is no reason to involve the dentist.

However, creating an entirely new employment position may fall under “Tell Me What Needs to be Done and We Can Decide”. A new hire means an additional expense. Perhaps it is justified and may even help improve the overall performance and profitability of your office. But it is the dentist’s money being invested and, as such, that dentist may wish to retain the decision-making authority for this.

The point to the exercise is not only will you have a clear list of the work you expect of your office manager, you will also have established the scope of her authority for that work, and opened the lines of communication on those items that will require more of your involvement and input. In other words, you will have outlined what you expect of her!

Now the key is to stick to it!

The Challenge of “Sticking To It”!
Living by these agreements is not always easy! One of the first challenges you may encounter could come from other team members who might not support your manager’s decisions on issues in his/her scope of authority. As the owner of the business, they will come to you, hoping you will override that decision.

Don’t do it!

If you do, they will continue to come to you. It is imperative that you reinforce the manager’s authority and maintain your lines of communication by referring those issues back to your manager. This tells your team that the manager has your support. It also tells them not to come to you on these matters, thereby freeing up more time to do what you love…dentistry!

A second challenge may come from you…the doctor…particularly if you are prone to micro-managing. Resist that urge…particularly on those tasks you identified as “Just Do It”! If you want your manager to have the authority to make those decisions, then give that authority. Do NOT interfere.

This does not mean you do not get to be involved. Remember…there are tasks the two of you have agreed require your knowledge and, in some cases, your input. Schedule regular meetings with your manager to review those items so you can always feel confident that you are in control of your practice.

Five Points to Expectations
There are two vital ways the Five Point Plan can prevent you from ever hearing that phrase “I don’t know what the dentist expects of me” again. The first is by clearly delineating those aspects of the practice your manager has autonomy over. Your manager can now be confident of knowing what can be done independently and when to seek your input or advice.

The second is through regularly scheduled meetings. Both of you know what information to share and discuss…but you also know when that will happen. In other words, you have clearly established and opened the vital lines of communication that keep a business operating at peak efficiency.

You can then follow the same exercise to create similar Five Point job descriptions for every member of your team. When you extend this plan to the entire team, everyone will understand both the scope of their autonomy as well as their responsibility to share vital information with other team members.

This exercise may take some time to complete. But effective business operations do not simply happen. You have to invest the time away from the operatory and on business matters if you want to become more efficient. When you see the results, you will find it was time well spent…and your practice is worth that investment in time!

About the Author
Shawn Peers LLM, MBA, is the President and Owner of DentalPeers, a Canadian buying group for independent dentists with members from Whitehorse to Halifax. Having both a Masters in Law and Business Administration, he enjoys combining his business and legal skills to negotiate the best pricing for dentists on a vast array of products and services. Through DentalPeers, Shawn also provides an office management training program to help offices develop systems and open lines of communication that improve efficiency. Shawn lives in Ottawa with his wife and two children, one a teenager and the other about to become one…keeping him active and on the go…just the way he likes it!