High Cost of Doing Nothing Part 2: Underperforming Staff

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All too often, dentists choose to ignore underperforming staff instead of addressing the problem. Why? Because doing nothing seems like a better option than going through the time and hassle of correcting the situation. But ignorance is not bliss.

High cost of doing nothingWhether your employees are texting during work hours, slacking on the little things, stirring you-know-what among staff or committing major errors, your under-performing employees, to put it harshly, are stealing from you. The focus and energy these employees sap from the practice deprive you of much more.

You can not be as effective in your role when you are worrying about whether your staff is doing their job. Add to that the internal conflict that can develop when an employee doesn’t pull her own weight or “gets away” with it and others have to pick up the slack. The rest of the team begin to resent it and factions form. The next thing you know, trust and teamwork has eroded and you have a full blown dysfunctional team.

When all you wanted was to avoid all the hassles, you end up spending more time managing the inefficiencies and conflict.

Enough already. You can no longer afford to work with people who are inefficient, ineffective, and cost your practice time, money and negative energy.

The first step is to admit your role in allowing it to occur, take a big breath, then set out your plan for a course correction.

          Use this step-by-step approach to do away with under-performers

Define your expectations:
Expectations are reasonable only when they are clearly conveyed and that is where you should begin. Before you decide to let anyone go, apologize for your lack of leadership. Then clearly convey your expectations and give your staff the opportunity to demonstrate their ability to change and perform at a higher level.

There are a number of areas that come up often in discussions with dentists and may have been overlooked in your employee manual. While they may seem like a no-brainer, you simply have to spell it out for them. These details have to do with work ethic, performance, code of conduct, and dress code. Bring your group together and discuss them along with other important expectations. Here’s a partial list:

-Dress and personal hygiene
-What is and is not appropriate to discuss with patients
-Cell phone use during work hours and breaks
-What to do when there is down time
-Calling in “sick”: advance notice and when it is appropriate NOT to come to work
-Showing up on time and being prepared before the work day begins
-Unacceptable behavior with fellow team members (ie: non-communication, triangulation, favoritism, tattling, passive-aggressive behavior, raising your voice)
-Responsibility to identify, call attention to, and catch errors before they happen – no matter who’s job it may be

Once these expectations are clear, everyone must agree upon them. You must also outline the consequences if the expectations are not met and emphasize that you will hold each person accountable.

Follow through with consequences:
Whatever your approach, stick to it. For instance, if you establish a one strike rule, one violation equals one strike. That’s it. You formally put them on notice, in writing, and monitor improvement with a specific deadline for a follow up evaluation.

Cut them loose:
Seriously. Fire employees who don’t get with the program. Get rid of the bad energy, increase your chances for a healthy and productive team. Your documentation will provide the support and justification for letting them go and it will demonstrate to the rest of the team that you are committed to a higher standard.

Provide lots of positive feedback and recognition:
Start establishing a culture of excellence by continually recognizing those who are performing at a high level.
-Verbally mention their performance in the moment, in front of patients and co-workers.
-Take time during team meetings to call attention to a team member’s exemplary work.
-Plan on recognizing high performance with unexpected recognition such as a gift card, or one time bonus to show appreciation to the group or individually.

If you aren’t getting your money’s worth, make a change in the way you address staff who aren’t living up to your standards and expectations. Start today because there IS a high cost for doing nothing.

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Doc, I Want a Raise!

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Brush them!A recent poll conducted by Real Money magazine reveals that 71% of the respondents want a raise this year. The clients we work with will often give us two perspectives;

1) A call from a dentist wanting help with performance reviews. It’s time for raises and the staff is pressuring the dentist for a review. Or the dentist is panicked because she promised reviews six weeks ago, but has been avoiding it because it takes so much time. Or the dentist feels reviews and raises just create trouble and is tempted to just give everyone an across-the-board raise to get it over with.

2) A call from a team member wanting to know how to get her (or his) dentist to do performance reviews. She might complain that he keeps rescheduling them, and she needs some valuable feedback. She may feel she is entitled to earn more money because she believes she’s carrying a big load. Or the dentist promised a review after six months but she’s been working there ump-teen years without any feedback.

Here are some thoughts from Sandy Roth about this timely topic:

I’ve written several essays on the issue of compensation and performance evaluations. By now you know that we encourage our clients to compensate staff based on merit and work performance, not length of service or time of the year. For that reason, it is essential to establish a system of reviewing the performance of every member of the team at regular intervals. But how do you structure such an evaluation? And how can these evaluations be done without becoming a huge burden for the
dentist?

The process can be made simple if the preliminary work has been done. We can’t talk about evaluations without mentioning that a Statement of Performance Expectations must be in place for each employee. A Statement of Performance Expectations is quite different from a traditional job description.The job description was a union invention which outlined exactly what the employee was expected to do and thus guarding her from having to do anything more. This mentality makes no sense in dentistry, where each person is expected to grow and change as the needs of the client and practice change.

Whereas a job description outlines the employee’s tasks and limits the scope of her influence, a Statement of Performance Expectation widens her sphere of influence by suggesting ways she might have a greater impact on the success of the practice. When a Statement of Performance Expectations is appropriately in place for each employee, performance evaluations are a breeze.

The next step is to involve each employee in her (or his) own evaluation. The process is amazingly simple and wonderfully healthy. The employee begins by evaluating her own performance, using the Statement of Performance Expectations as a guide. Simultaneously, the dentist (and in more sophisticated teams, other team members) evaluate the team member’s performance, using the same guide. The employee, dentist and other relevant team members all participate in the Performance Review meeting, during which each of the participants contributes his or her perspective on the employee’s impact on the success of the practice. This meeting is held discussion style and everyone gets an opportunity to contribute.

At the conclusion of the meeting, new goals are set, new expectations are identified, new training and learning opportunities are planned, and supportive commitments are made to the employee. Finally, the next Performance Review meeting date is set.

The following structure outlines some of the categories of expectations which you might want to consider. Use this list as a starting point and add your own ideas. For each area, identify first the expectation then the actual level of performance or mastery.

Evaluation of Clinical Effectiveness or Administrative Accuracy/Efficiency
Clinical Acumen – Diagnostic Skills – Clinical Intervention Skills – Clinical Information Skills – Clinical Strategy Skills – Clinical Collaboration – Information Transfer – Administrative Efficiency and Accuracy – Record-keeping and Tracking

Evaluation of Client Relationship Effectiveness
Listening Skills – Questioning and Learning Skills – Other Communications Skills – Ability to focus on the patient – Sensitivity to patients and their issues – Ability to develop and advance healthy relationships – Ability to transfer information to the team – Ability to handle difficult patients – Social skills – Feedback from patients

Evaluation of Team Participation
Listening Skills – Questioning and Learning Skills – Other Communications Skills – Collaborative Skills – Conflict resolution skills – Respect for others – Finesse

Evaluation of Practice Alignment
Alignment with practice vision – Problem-solving skills – Willingness to commit to the success of others – Planning and strategizing skills – Ability to spot trends and stay aware of changes – Growth patterns/Personal commitment to learning

Please note that some evaluation points are duplicated under more than one evaluation category. It is not unusual for a team member to be extremely effective with patients and out of whack with the rest of the team. These differences are worthy of notation.

Obviously, the expectations will be different for each member of the team, depending on her (or his) role and level of responsibility, and, of course, not all team members will have clinical responsibilities. So, you must individualize the Performance Evaluation categories and items to reflect the expectations of the individual team member.

Don’t fall into the trap of believing that every team member should have the same expectations and evaluation criteria. Although they are entitled to equal respect and attention, no two team members are the same, nor will they ever be. For that reason, the Statement of Performance Expectations as well as the evaluations for two team members who occupy essentially the same position will necessarily be different in some significant ways. The important thing is to set a time for evaluations and involve everyone in the process.

If you haven’t yet created Performance Expectation Statements for your employees, it is not too late. ProSynergy’s Hiring Kit is packed with information to help you learn how to create, even remedially, great relationships with your staff.

Top 5 professional habits you should commit to in 2014

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With every new year, comes an overwhelming amount of commentary on new year resolutions and goals. A lot of them are common sense no brainers mixed with an equal amount of recommendations we know are unattainable. Reflecting upon 2013, I would like to shift the conversation to some things I believe have become overlooked.

I have discovered that many people have forgotten the basics. It annoys me when the professionals I work with don’t afford me these common courtesies. If you want to gain respect from your colleagues, patients, customers and employees and you want them to offer you the same respect in return, it is absolutely essential that you follow these very basic rules of business etiquette in 2014.

Here are my TOP 5 No-Brainers every business professional should commit to in the new year:

Number 5: Don’t interrupt.
Of course, there are some exceptions to this rule and if you made it through high school, you can surely figure out what those are. I’m talking about people who cut you off in mid-sentence because they believe what they have to say is more important than what you are expressing. It indicates they are not listening. It comes off as rude, disrespectful and confrontational. If you are guilty of this, listen more, talk less. If someone else violates this rule, let them know you weren’t finished with your thought.

Number 4: Do what you say and say what you do.
If you tell someone you are going to do something, don’t just talk about it. Do it! If you aren’t sure you will follow through, don’t commit to it. How many times have you been disappointed by someone who has said they were going to do something then dropped the ball? And it adds additional insult when they don’t give you the courtesy of letting you know, which leads me to 4a:

4a) If you commit to something then discover it was unrealistic or you can’t follow through, own it.   It’s as simple as saying you’ve discovered you’ve bitten off more than you can chew or your time commitments have gotten the best of you. You will continue to earn respect from your peers, co-workers, and employees when you are honest with them about your shortcomings.

Number 3: If you change your mind, say so.
Everyone has that right. But changing your mind and not telling us is not OK. People will have different expectations and you will inevitably disappoint them – possibly make them angry – if you don’t tell them your thinking has changed. We will continue to think you have your original mindset unless you tell us otherwise.

Number 2: If you are in a meeting or conversation, DO NOT LOOK AT YOUR CELL PHONE!
We’ve all been on the receiving side of someone who shifts their attention from us to their “next-best friend”. Why would anyone think this is appropriate? This is rude and disrespectful. Period. But it is occurring at epic proportions these days. Just because others engage in this behavior doesn’t mean it’s OK. It says they could care less about what’s happening outside the edges of their smartphone screen – so why should we? Business owners and CEOs can often be the biggest violators of this. Regardless of how important someone is, your time is equally important. If someone does this to you, stop talking until they look up and tell them you’d be happy to continue when they aren’t pre-occupied. Let’s shut this behavior down in 2014.

Number 1: Reply to emails. And do it in a timely manner.
Just like the sign in the public bathroom stall that says; “please flush after use”, this is so basic that I shouldn’t have to mention it. That being said, a large percentage of the emails I send out go unanswered. If email isn’t your thing, tell people up front or simply don’t give out your email address. Otherwise, people expect an acknowledgement or reply – THAT’S WHY WE SEND EMAILS! If you don’t reply, it’s the same as saying you don’t care or the sender isn’t worth your time. Your lack of response indicates your lack of interest which erodes your credibility, regardless of your position or role in any business.

Are you starting to see a pattern here? Every one of these has to do with professional courtesy and respect. And if we want people to respect us and behave in a certain way, we have to commit to that behavior ourselves. That is the hallmark of a leader. And yes, these are basic. That’s where we have to begin to build a solid foundation of professionalism, gain respect from others and to further develop our effective communication skills.

Do you have something you would like to add to this list? Let’s start a dialog and spread the word in 2014.

The Dying Bamboo

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Recently, Sandy and I had dinner with a dentist and his wife before we visited their practice for observation. The restaurant was in the airport hotel where we were staying.  We were greeted and seated immediately and as we settled in, both of us noticed the centerpiece; a trendy looking slate stone vase that held a single bamboo shoot.  Sounds like a great concept, right?  If only the bamboo wasn’t falling over and the leaves weren’t yellow and wilted.  It was downright sad.

Immediately, this symbol of good luck became a depressing sign, so we removed it from the table.  It might also have been a sign for the lack of attention the restaurant received from the management and employees. As the dinner progressed, I noticed the bread was stale, the water glasses sat empty without a refill, and the meals were plated with little care. I began to wonder whether the food prep area was sanitary. Was the walk-in refrigerator temperature to “code”? Did the employees wash their hands? I didn’t have high expectations for the meal. Luckily, our server was decent and our food was acceptable but the experience was less than what I expect from this type of restaurant. I left underwhelmed.

What we discovered were telltale signs that no one was paying attention to the details. If those details weren’t being tended to, what about the things that really mattered?  In their book,“In Search of Excellence,” Peters and Waterman make the following observation:

“When there are coffee stains on the tray tables, passengers wonder about the quality of the maintenance of the airplane’s engines.

These signs undermine confidence. The same is true in your practice. For example, on a recent consultation visit to an upscale cosmetic practice, I immediately noticed something that seemed out of place. The sign in front of the building and the landscaping was top notch. The reception area was gorgeous and it was obvious an interior designer was consulted. The environment was warm and the sounds were soothing. Then I saw it. The spot on the carpet. It did not belong. When I asked the group about it later in the day, most of the team had no idea what I was talking about. Two staff members did recall the spot and said that it had been there for as long as they could remember. No one seemed to feel it was a big deal. That spot was as significant as the dying bamboo centerpiece.

Point 1: Patients have no way to judge your clinical abilities and the indicators they will use to gauge your expertise are the physical plant, the environment you create and the way you engage your patients in the process. If the little details aren’t tended to, your patients will wonder if the things that truly matter – proper diagnosis, clinical expertise, sanitation standards – are also being overlooked.

Point 2: Your team must be vigilant all the time. Create a culture where your staff is encouraged to pay attention to the little things – the stain on the carpet, the full trash can in the patient’s bathroom, a patient’s concerned look or the negative comment he or she might make on their way out. Everything matters. Patients notice. You can’t let down your guard.

Over the course of the next several articles, we will review the physical plant and environment and shed light on those areas you may want to pay more attention to in your practice. If there is a specific area you would like for me to address, please comment below or email and let me know.