Professional Business Management, Inc. Douglas D. Aiton, President

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Staff Management & Motivation

A few years ago, Doug wrote the following article for an orthodontic publication. The principles and ideas still hold true today, and are offered for your reading enjoyment.


How to Create It and How to Sustain It

The benefits and rewards of teamwork are many... a positive and enjoyable work environment, being enriched and fulfilled in your work, having fun, greater financial rewards, practice growth, patient satisfaction, and, most importantly, waking up every morning and looking forward to going to work! The questions often asked by doctors and staff are how do we create this type of teamwork and how do we sustain it. The following thoughts, ideas and suggestions come from years of observing, studying and learning from some of the most successful teams in orthodontics, sports, manufacturing, schools, YMCA’s and other organizations across the country.

Create a Team Vision

First and foremost, a successful, winning team must have a vision of success. A vision is much more and entirely different than goals or objectives. The vision is the big picture – what we’re about and why we are in business – and is often built around the personal and organizational values of the team. The vision speaks to what’s important to the doctor and staff and most often includes principles such as quality, success, getting along, open and honest communication, mutually respecting, appreciating and supporting one another. The vision is the basis and the foundation from which the team can build. It becomes the FOCUS. Often in life we focus on what we don’t want rather than what we want. Focusing on the vision is far more effective, positive, fun and rewarding. Without vision, teams have a difficult time fulfilling their dreams and goals. When problems and challenges arise, they have nothing to fall back on, refer to, or use as a guide. Team visions are phenomenal resources and absolutely necessary in order to create and sustain a winning team.

Two years ago, I had the wonderful opportunity to work with an extremely successful practice in the Southeast. This doctor and his team had built their practice based on a philosophy of providing exceptional quality care and treatment results. They had a Mission Statement that spoke to these things – great patient care, and quality orthodontics. Their teamwork however, was the weak point in the practice. One of my first responsibilities in this practice was to facilitate a process where we brainstormed and discussed what was important to this team – what values and principles needed to be identified and improved in order for this team to grow and succeed. The following is the vision that was developed by this team:

Team Vision
Together, our team creates a work environment that is relaxed, efficient and fun!
With positive attitudes, we support, respect and appreciate one another.
We are proud of who we are and what we do,
fulfilled in our jobs, and well compensated for our excellent work!

This team continues to use this vision as a tool and a guide to solve problems, focus on what’s important, and sustain the type of work environment that is fun and rewarding.

Discuss what is important to your team, create a vision, write it down, continually discuss it, focus on it and use it as a tool to guide your team.

Take Responsibility

A mentor of mine once told me...

Losers have excuses (or reasons). Winners don’t need any.

Obviously, if we are going to create and sustain a winning team, it is necessary for everyone on the team, particularly the doctor, to abide by this philosophy. We all need to take personal responsibility of our own success and the success of our practice. We all need to understand and believe that excuses, buck-passing and ‘that’s not my job’ mentality, have no place on a winning team. Winning teams and winning team members take responsibility. When something goes wrong, they fix it. They don’t waste time blaming others or making excuses, they take care of it. Life is too short and our work is too important to blame other people, pass the buck or make excuses. Extraordinary teamwork requires this from everyone. Catch yourself the next time you give a reason or an excuse for doing something incorrectly or not doing something you were expected to do. Refrain from giving a reason or excuse. Fix it, and move on!

Hire the Right People, Provide the Necessary Coaching, and Know When and How to Fire

Hiring the right people – I have always said to hire the personality and teach the orthodontics. Personality is the most important asset a person can bring to your practice. The Carnegie Foundation for the Advancement of Teaching concluded that 15% of one’s financial success is due to one’s technical knowledge. 85% is due to skill in human engineering, to personality and the ability to lead people. Look for people who are people oriented, friendly, organized, self-starters, enthusiastic and excited about the opportunity to work with your team. Spend the time and energy to improve your interviewing skills, check references, and involve the team in the interview process.

Once you have spent the necessary time and energy to hire what you hope are the ‘right people’, the next step is to provide the coaching necessary to help these people to succeed. This is an ongoing and never ending process, and is absolutely critical to creating and sustaining a winning team. Coaching comes in many forms and is most often provided one-on-one or in a group setting. It can sometimes be delivered by other team members, but is typically more effective when provided by the doctor.

Tips for effective coaching...

Coaching Tip #1 – Come from and focus on the vision. The team that has done a good job of developing a team vision will find coaching to be far easier and more effective. It is easy to tell a team member... In order for us to deliver on our vision of success, taking great care of our patients, and having an extraordinary team, I need you to... (state whatever it is that you need).

The office mentioned earlier that now has a team vision, was able to utilize their vision recently to help resolve a problem. The team was experiencing gossip, which was resulting in rumors that were both incorrect and damaging to the team. Having the Team Vision helped the doctor immensely. He was able to say to his team, in a caring way, without making anybody wrong, or placing blame... Look, there has been some gossip recently. Some things have been discussed which are not accurate and are damaging to our team. These things – gossip and rumors – are not healthy to our teamwork and not consistent with our Team Vision. In order for us to sustain the quality team we have worked so hard to create, it is necessary for all of us to stop the gossip. If we have an issue with someone else, we need to go to that person. If you are not comfortable with that, come to me and I will help you to resolve it. The doctor utilized the vision as his tool and his guide to help the team to focus on what’s important and to sustain a high level of teamwork.

Coaching Tip #2 – Tell people what you want and need, not what they are doing wrong. What we say and how we say it will, more than anything else, determine our levels of success (or failure) in coaching. It is more effective (and easier) to tell people what you want and need than it is to tell them what they are doing wrong. You were late to work three times last week makes the other party wrong and puts them on the defense. By doing this, we have given them the opportunity to argue (No, I was only late twice), defend themselves, and/or give excuses (My child was sick, the cat died, the tire was flat, my latte spilled and I had to go home and change my clothes).

When a team member’s behavior or attitude is inconsistent with the vision of teamwork and they need to be coached, do it in a positive way. It is far more effective to say... In order to achieve our vision of success, teamwork and taking great care of our patients, I need you to be here on time, at 7:50 every morning. Notice how positive this is. We are clear with our communication and expectations, without making them wrong.

Knowing when and how to let someone go. Firing staff is never easy. However, as Harvey Mackay wrote in his book Swim with the Sharks Without Being Eaten Alive,

It isn’t the people you fire that make your life miserable, it’s the people you don’t.

When you have hired what you thought were the right people, and have done your best to provide the necessary coaching for them to succeed, and things are still not going well or working out, the worst thing you can do for that employee and the practice is to keep them on board. They typically are not happy, not fulfilled, and know they are not meeting your expectations. Do the right thing and let them go. You owe it to yourself, your practice, your patients, and to the employee.

Set Goals and Monitor Results

Hazy goals produce hazy results. Clearly define your goals. Write them down, make a plan for achieving them, set a deadline, visualize the results and go after them. – Barbara Smallwood and Steve Kilborn

Every successful orthodontic office has clearly defined goals. Some of the goals may be short term (3–12 months) others may be longer term (3–5 years, or longer). Successful teams need something to shoot for – they need targets. They want and need to know that they are accomplishing something, and need to know what that something is. Examples of short-term goals, typically set by the doctor and staff in January of each year:

  • Increase production by 10%,
  • Reduce overhead to 52%,
  • Web site designed and in place by May 31,
  • Increase conversion ratio from 59% to 70%,
  • Decrease the number of emergencies per week from x to y,
  • New computer system and digital imaging in place by November of this year,
  • New patient packet designed and in place within 90 days.

These are clearly defined and measurable. They are also realistic and achievable. Far too often, people go to work not really knowing or understanding the big picture. Highly successful teams understand the big picture, they helped paint it. They know what they are about (vision) and know their targets (goals). Without goals, teams struggle with their day-to-day frustrations, and seldom seem to get anywhere. Setting goals help to create the excitement and fulfillment in our work. They give us a greater sense of purpose, and meaningfulness in our work.

A doctor client recently set the following longer-term goals – to double our practice in the next 7-10 years and to build a new facility in 5 years. His chances of achieving these goals are far greater now that he has set them and communicated them to his team. He has already visualized these goals. In his mind (and in my mind) he has already achieved them. It’s a slam-dunk! This doctor by the way has just begun his fourth year in practice and has already quadrupled the size of this practice from where it was when he purchased it 3 years ago. He thinks big, he gets his team excited and rallied behind him, and doesn’t allow negative thoughts or negative people to get in his way.

Celebrate Your Accomplishments and Have Fun

Great teams take time to celebrate and reward their accomplishments. Take a trip. Attend a CE course or a meeting out of town. Set money aside every week in a CE account to pay for these things. Sustaining a great team requires having fun together. These types of trips and meetings combine fun and learning. They also provide a wonderful opportunity for team members to get to know one another on a more personal level.

It is not just the doctor that needs to acknowledge his team, but the team needs to acknowledge and appreciate each other. Everyone needs to reward, acknowledge and recognize their teammates and their doctor. Pats on the back, personally handwritten thank you notes, and words of thanks and appreciation go a long way.

Orthodontics is a wonderful profession. Working for a great practice with great teamwork makes the job even more rewarding. Ask yourself, and ask your team – How are we doing? What can we do to improve our teamwork, improve our work environment, and have more fun, and a greater sense of fulfillment and enjoyment at work? Asking these questions is one of the first steps in Creating and Sustaining Great Teamwork!

Professional Business Management is a national professional practice management consulting firm.
Consultant Doug Aiton’s results-oriented consulting has helped hundreds of practitioners and their staff to achieve their goals,
enjoy their work, and be more fulfilled in their profession.

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