Oral Health Group

What Is Your Leadership Style

March 1, 2008
by Lisa Philp, RDH, CMC

As you begin your journey into the field of dentistry, you may be wondering what it takes to make it to the top. Be one of those dentists who has it all: strong leadership presence, a high-performing team, financial freedom, solid patient relationships, an exciting career with boundless enthusiasm and energy.

Our experience of coaching dental teams and their leaders have found there are many common elements that make a good leader. One area to begin with is to assess your own personal leadership style and assess how it will serve you in meeting your needs and achieving your goals.


The consulting firm, Hay/McBer, in conjunction with Dr. Daniel Golemen performed one of the first quantitative studies in which they drew a random sample of 3,871 executives from a database of 20,000 members. They found six different leadership styles that directly impact team behaviors and the culture of a work environment. They also discovered that leaders with the most success were the ones who didn’t depend on just one style, but were able to adjust their style based on each individual business situation (see Table next page).

The Coercive Style

A dental practice was a sole practitioner environment with eight team members in total. The team generally was a cohesive group and all personal friends. The practice was financially healthy for a number of years. The practice was extremely busy with three full time hygienists and 3500 active patients. The team felt that they had enough patients and because of their volume, they didn’t see the need to market and grow the practice with new patients or devote any energy to existing patients because they would always be loyal and stay at the practice.

One day a new dentist moved into town and quickly became a major competitor. Patients began requesting their records to be transferred to the new dentist at an alarming rate, and they lost 1,000 patients in the first year. The practice was in crisis mode. The new dentist’s facility was modern, state-of-the-art, and could accommodate appointments within two weeks as opposed to two months. Production began falling and the schedule had hours of voids each week. The practice value was diminishing although the team felt they were doing their best to stop the bleeding.

The dentist/leader became desperate and was determined to turn things around and deal with the erosion. He called an emergency meeting and told the team that they needed to change, what to do to change, and told them if things didn’t get better they would be out of a job. If they didn’t adhere to his orders they would be reprimanded and/or written up. The dentist in this case used a coercive style of “do what I tell you,” because of the crisis. He created a reign of terror, demeaning his staff, and passing on his anxiety when the day didn’t run smoothly.

Although this tactic did cause a turn around short-term, production began stabilizing and the team worked to fill the voids in the schedule. The morale was at an all-time low, and two key team members defected to the competition down the street. The team members didn’t want to share any ideas, lost all sense of responsibility, and actually became sabotagers, saying “I am not doing anything more to help him.” There was no commitment and team members were alienated from each other. Their roles became “just a job” in a high-stress environment.

Given the example above, we can see the impact of this style on leading by fear and threats. We would think it should never be used. However, there is a small place for it, but it should be used only with extreme caution in a few situations. It will work only when there are problem employees from the beginning and when desperate change is needed, when all else fails. Once the emergency has passed, it is time to use another style to suit the environment.

The Authoritative Style

A dental practice was a new dental practice start-up. It was opened from scratch and had twelve patient charts on the first day. Everyone on the team was aware that there would be a lot of growth and building to do. Six months after opening, the team evaluated its goals and realized that they had built the patient base to only 200 patients. They became concerned and wondered what could be done to expedite growth. The dentist became worried as his loan payments were due and he was in a financial crunch. The leader recognized that the team needed a new course. The leader facilitated meetings once a week for several hours with the intent of mobilizing the team toward a common vision. They spent time developing a mission statement, taking into account all team members’ values. They spent time writing goals for each week and defining each person’s description of the role each would play in the practice growth. Once this plan was in place, the dentist managed to get the team members focusing on the future, not on the past six months of what they thought was failure. The team developed a marketing plan that was driven by “what does the patient want?” They analyzed the current patients’ expectations and identified the wants of the consumer as the primary goal of daily operations, instead of focusing on what the practice needed.

Their focus and plan caused changes to come quickly, and within months the practice was building, with 75 new patients a month. The team felt respected and took ownership for their role in the success of meeting the patients’ needs, and the dentist acknowledged their contribution with a team event. The authoritative style used here by the leader had a positive impact on a work environment and drove up morale by focusing on a vision, the future, and not making the team feel as if they were to blame for the past. The authoritative leader is a visionary; he/she motivates people by making it clear how they fit into the larger vision. The team understands that what they do matters, and why.

The Affiliative Style

The affiliative style has a primary focus of trust and inspiration. This style can be demonstrated in a situation with a large group practice with three partners and 21 team members. The practice had just terminated a long-term office manager, who took credit for the employees’ work and pitted one team member against another. The team was run down, suspicious and wary about the future. They wondered who was going to replace the previous manager and how they wouldn’t like whoever it may be. The dentists were not communicating what was going to happen, which caused more stress, and the daily operations were in chaos due to lack of direction and communication.

Eventually, they hired a new office manager who had a challenge to win over the team and get them over the past experience with the previous manager. The new manager was determined to use an affiliative style and a “people come first” approach. She spent her first three months interviewing team members, listening to their past experiences and ideas of how they could be more effective in their role.

She organized the departments into regular meetings and taught them how to create productive agendas and she worked to earn their trust. She managed to adjust the rules to match the individual team members and built strong emotional bonds. They shared ideas and were creative with solutions to inspire innovation. She gave them the freedom to do their jobs in the way they thought was most effective with regular, positive feedback.

The Democratic Style

An example of a democratic leadership style is demonstrated in the example of a dental practice we worked with in the southern United States. The practice was owned by a husband and wife team in a small town of 500 people. They had an extremely loyal team and a large patient base. The practice was functioning well and the leaders involved the team in all decisions. At first the democratic style was working well and the team enjoyed being asked for their opinions. Then two members relocated out of the area and the team couldn’t find replacements. They were all chippin
g in to pick up the slack, and, after four months, they became exhausted with the long hours and got behind in their duties. The dentists continued to use a democratic style and ask their team’s opinions on what should be done. It became evident that the team disliked being asked what to do by the leader when they didn’t know. Morale began to drop, and the team judged the leader negatively for not having the answers. They felt it was time for the leader to give direction and stop depending on them for every decision. They began to ask for raises, demand performance reviews and refused to participate in team meetings.

The overly democratic leaders couldn’t understand why the team felt this way and why they all of a sudden needed feedback and direction. The doctor and his wife felt that the team should know how they were doing without having to be told after every decision. These leaders did not see that, even though the team was involved in the direction of the practice, they still experienced situations when they needed to look to a leader for guidance and direction. Often business owners have to make decisions before asking the team’s opinion. The democratic approach is detrimental when the team does not have the tools needed to guide decisions being made.

This style’s impact on the work environment can be effective when the members know what to do to solve a problem. It is not as popular as some of the other styles because of the exasperating consequences of endless meetings where ideas are mulled over, consensus remains elusive, and the only visible result is scheduling more meetings. Some democratic leaders use this style to put off making crucial decisions, hoping that thrashing things out will eventually yield a blinding insight. In reality, their people end up feeling confused and leaderless. Such an approach can even escalate conflicts.

The Pacesetting Style

Take the case of a Karen, a new associate who joined a dental practice. She immediately set extremely high standards and demonstrated the standards daily. She had superb technical ability, built loyal patients and was the person everyone turned to for help. She developed numerous programs, including a periodontal program for hygiene and a treatment planning program for large cases. She communicated these programs daily and was continually looking for ways to perform better and faster. She asked the same of everyone around her, but was quick to pinpoint her co-worker’s mistakes. When team members made mistakes, she jumped in and took over because she could do it better. She was destroying the morale without knowing it. The team felt that she expected them to know what to do without direction and found themselves second- guessing what she wanted. They were burned out and didn’t feel like they were trusted to make decisions for themselves.

This leadership style works well when everyone on the team needs little direction and is a self-motivated professional. With this type of team in place, leaders with a pace-setting style are able to get projects done on time and ahead of schedule.

The Coaching Style

Of the six styles, the coaching style is used the least, but it could prove to be the most effective towards developing a positive environment and getting results. Let’s look at a dental practice that had a high-performing team, was coasting along doing what they had done for years, and got stuck on a financial plateau for two years. The leader decided that they needed an outside coach. The coach came into the practice and worked with the team to identify their unique strengths and weaknesses and how these related to their personal and career aspirations. She taught them long-term development goals and helped them conceptualize a plan for attaining them. They made agreements with each other on each person’s role and responsibilities in enacting the plan. The coach gave ample instructions and feedback. She also delegated challenging assignments, even if that meant the tasks wouldn’t be accomplished quickly. She was willing to put up with short-term failure for the sake of long-term learning.

When employees know that a coach will observe them, and they care, they feel free to show initiative. The implicit message is, “I believe in you, I’m investing in you, and I expect your best efforts.” Employees very often rise to the challenge with their heart, mind, and soul.

The most positive style as far as impact on the success of a business is the authoritative style. The other positive styles depending on the situation are affiliative, democratic and coaching. The key to effective leadership is to understand your dominant style and how it serves your purpose and then look at which other styles would be worth learning, based on your individual situation. Leadership is a journey, not a destination.

Lisa Philp is the President of Transitions Group North America, a full service coaching company for dentistry. Lisa is a certified effectiveness trainer, certified facilitator in Integrity Selling, a Certified Management Consultant as designated by the Academy of Dental Management Consultants; has been recognized in the National Register’s Who’s Who in Canadian Dentistry; is a member of NSA (National Speaker’s Association) and CAPS (Canadian Association of Public Speakers). Lisa also teaches the dental students at the University of Toronto, Faculty of Dentistry.

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