Do you want to revamp the culture of your practice but just don’t know where to start? Registered dental hygienist and corporate consultant, Amber Auger, lays out the fundamental steps of culture transformation and what it can do for your dental business.
Are you finding that despite all of the time, skill, and effort you’ve been investing in your dental practice, there are certain roadblocks that are keeping your team from reaching its highest potential?
Maybe there is unresolved conflict between your team members that leads to a stressful work environment. Or perhaps you or your team members are experiencing burnout, and you’ve noticed there’s a higher turnover rate than you’d like to see.
Your practice is a reflection of you, so it’s no surprise that you want it to be functioning at its best. Even if your business is thriving financially and your patients seem to be happy, there might still be dissonance within your team. It’s almost like a vibrant garden that sprouts the most colorful plants, but tangled roots lie underneath the soil – eventually, the disarray will seep to the surface.
While there might not be a quick fix or one-size-fits-all solution, there are certain tried and true principles that can help get your team right on track for success. In this interview, Amber Auger, MPH, RDH, addresses what makes up the culture of a dental practice. She gives advice on how to shift the culture when you notice warning signs indicating that it’s time to renovate your “garden.”
Amber Auger, MPH, RDH is an accomplished dental professional and preventative dental therapy advocate. She is a sought-out international speaker, podcast host, dental marketing strategist, published author for several industry-leading publications, and the recipient of the 2019 Sunstar/RDH Award of Distinction. Amber is also the founder of Thrive in the OP® and the Functional RDH®.
This is the fifth blog post of a 6-part series where Amber will share helpful insights from a distinct viewpoint on how dentists can enhance their business success.
Making a Cultural Shift
Q: What factors comprise the culture of a dental practice?
- It all starts with leadership and how you engage with your team. You might hire a professional for his or her skill set, but how are you taking those skills and talents and all of those great things that live inside of the clinician or team member and fostering them to improve? It's great to hire somebody for their potential, but it's very easy for them to fall short of expectations if they're not being led and held accountable. They need to have opportunities to foster and grow those skills.
- The next factor is respect, especially when it comes to handling conflict. How are you supporting team members? For me personally, that is so important for a clinical practice. I've seen really amazing clinicians who move on from a practice because of lack of respect, and that's often why I’ve moved from one clinical role to the next.
Maybe you see something that wasn't billed out on a patient and you bring it up to an office manager. How is that received when you find an error? Is it received with: “Thank you so much for noticing! We will make sure that's resolved. Let's talk about that at the team meeting.”? Or is the response: “At the end of the day, you signed your production list. Did you not notice? That's your fault for missing it.”? That doesn't really feel great. We're a team, right? So how are you handling those situations?
3. And then, what are you doing outside of the office to build culture? Do you enjoy hanging out with your team members? You don't have to be best friends, but by actually stepping out of the practice and getting to know somebody outside of work, it really helps understand how they operate inside the office and what their values are. You could also do team assessments or personality assessments to gauge how you interact with your team members. It’s often the little things that make a huge difference.
Q: What are some indicators that practice owners might want or even need to change the culture of their practice?
I would say if you're seeing team members who are disengaged, that’s a good indicator that something needs to change. One thing that I see often is having high-performing team players who are on the same team as team players who want to clock in and clock out without accountability. That dynamic can really destroy your culture.
So you have to look at how you are holding the entire team accountable. How are you mixing that high-talent team member with somebody who might need some coaching and then creating an environment where you're all open to learning and improving together?
If you have team members who are coming into work late, disconnected, and not giving their full effort, those are key warning signs that there needs to be a conversation and a change in the culture.
The worst case scenario that you want to avoid is having a “type A” team player who is bringing in amazing revenue and creating office rapport, who then leaves because of somebody who's not invested in the culture of the practice and even contaminates the practice. Gossiping and coming in with a poor attitude will quickly contaminate the practice. You should analyze if your culture is compromised because that is truly what happens if you put a beta fish with a bunch of goldfish. It is not going to go well. So the key is making sure you have the right fish in the right bucket, if you will.
Q: In your experience, what are some common challenges that dental practices face when trying to change their culture?
It's always hard to move from one way of doing things to another. It takes active work to be a leader. It takes self-awareness, emotional intelligence, and personal accountability to want to lead well. I think practice owners are exhausted with what they have on their plates. So in order to achieve this, practice owners should have their own coaches who are mentoring them and keeping them accountable. They should also learn how to delegate.
What I see in many practice owners is they are amazing and skilled providers trying to run a practice all by themselves, but they’re forgetting that they are supposed to be leading the team and delegating these small tasks out. But if they don't trust their employees to do that, the culture will never be able to expand in a way that is going to be a joyful culture, which is the type of environment required to provide excellent dentistry.
Q: Which members of the team are responsible for implementing changes?
Every single team member is responsible for implementing changes because in order for a culture shift to happen, every team member has to actively be accountable for how they perform. And that can be as simple as what conversations they're bringing up at the lunch table or how they resolve any conflicts they might have with another team member. All of those things require 100% commitment from the team.
Q: What is the role of leadership in creating and maintaining a shared vision that will lead to cultural change?
Dr. Lon McRae, a mentor of mine who practices in Idaho, is – in my opinion – the top example of how to run an amazing dental practice for so many reasons. Number one, he has ample integrity. He is constantly communicating to the team what the vision is, where they are in terms of staying consistent with their values, etc. There are no secrets in the practice. They know what their production is and the percentage of production they're going to make. There's an overall incentive to want to keep growing and that's the big key.
Are your team members just there for their hourly rate, or are they truly invested in changing the culture of your practice? Are they stakeholders in your practice where they're committed to its success? When I work as a hygienist, I personally work on hourly plus commission. I'm invested as a stakeholder, so the more I produce in my chair, the more money I'm going to make personally, which is fantastic. Does that mean I'm over-recommending treatment? Absolutely not. But I do think twice about pushing off a patient’s full mouth series if they’re wanting to postpone. I'm now more accountable because I want a piece of that production. And now I'm going to work harder to educate the patient on why they need that treatment based on their specific dental risk.
What Dr. McRae does as well is hold weekly 90-minute meetings. Now that could seem excessive to people. But once a week they're focusing on different areas of the practice. He does cosmetic dentistry, sleep dentistry, and a lot in the community. So each week there's a different pillar to address. These 90-minute meetings are lunch meetings, and he provides food for everybody in the practice. How do you think that makes the team feel? They feel heard. They feel valued. They feel supported. They feel like a part of a greater mission, not just a dental office. They’re now invested in their community.
There's this vulnerability from the leadership team that creates a stable environment. And when you have a stable environment, for these clinicians, you're able to exude excellence because when somebody is not worried about their job or about what their coworkers say, they’re showing up better mentally and physically. There's less cortisol pumping through their body, the day is less stressful, there's less burnout, and you're more likely to create an environment where that energy exchange is felt by your patients as well.
Q: Is there value in documenting a mission statement or shared cultural values that can be shared among the team?
Oh, definitely. That's a necessity of establishing what your practice stands for and what its core values are. If the team doesn't know what success looks like, you can't achieve your goals. So you have to come up with those shared values and objectives as a team.
You can ask questions like: What kind of services do we want to be adding? Is sleep apnea important to us? What type of CE can we utilize to learn about sleep apnea so we can integrate this chairside? As we're adding something new, are we going to be the team that's focused on building a protocol for the 20% of patients who it doesn't work for and getting stuck in analysis, or are we committed to building a protocol that is going to work for 80% of our patients? We know that it might not work for 20%, but let’s target that 80% because that is what success looks like.
Another benefit of having a mission statement that reflects your cultural values is that you can use it as a filter through which to evaluate new staff candidates. Not every candidate will fit on your team, and that’s perfectly fine! It’s better to find that out in the early stages of the hiring process rather than setting yourself and your new hire up for failure. Having a written mission statement will allow you to weed through those candidates that might not share your same values, ultimately fast-tracking the hiring process.
Another way to choose candidates that resonate with your practice is by conducting working interviews. Many people can perform well during a face-to-face interview, but you want to make sure that your future staff members can integrate well with the rest of the team. It’s advantageous to see firsthand how your candidates interact with patients that might be a little more demanding or how they handle any other challenges that arise. Working interviews will give you a clearer idea of how well your candidates fit within the culture of your practice.
Q: Can you share some actionable steps that dental practices can take to make a positive cultural shift?
I would start with maybe adding some sort of team bonus structure into the mix of things. You could incentivize hitting a certain quota by providing a paid vacation. You could add specific benefits like free dentistry up to “x” amount of value per year. These things are really important because the way that you make your employees feel is a complete reflection of how committed they're going to be to your practice's vision, mission, and overall success.