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June 9, 2008

By Rhonda R. Savage, DDS

The greatest challenge you will face as a female dentist is that of leadership. Do female dentists have different leadership challenges than male dentists? In consulting with practices, I have found a split in staff perceptions about working with female dentists. Most say they would never work with anyone but a female dentist. But others say they would never work with a female dentist again. What do patients think? Patient surveys in a number of female practices mark us high on qualities such as honesty, cooperation, and caring, as well as toughness. Women in general are much more congenial and team builders. We're wired differently, and we socialize differently. With women, we see similar communication patterns and behavioral models — behavioral models that are ingrained into us at birth.

The most important thing in leadership is to know what you're good at, and equally important, what you're not good at. Surround yourself with people who know more than you. I've had terrific male and female mentors. Some people think that mentors are people who sit down and give you advice on how to succeed. I don't think that's the way the best mentors work. I think the best mentors are those who show you how to succeed by modeling it themselves and by being supportive of others. When we turn around and become mentors ourselves, we are doing something good that then becomes essential for our own existence. Mentoring should work in two directions. As leaders and CEOs of our practices, we can encourage our staffs and our colleagues to reach higher than they thought they could. We should also seek out mentors for ourselves, so we can continue to be challenged and grow beyond our comfort zones.

Mentoring can go both ways ... younger and older. While my daughter, Kaitlyn, is significantly younger, I value her opinion and ask for her feedback constantly. Kaitlyn and I love to watch movies together. I told her about this article and she said, "If we were to give this scenario a movie title, it would be 'The Secret of My Success.'" I'm going to rename this movie-in-progress to make it "The Secret of Your Success." How are women successful in working with women, and what holds us back? There are five issues that usually cause conflict in an all-female office, and they are:

1. The formation of cliques
2. Gossip in the office
3. Lack of clearly defined expectations from the doctor
4. Poor communication
5. Unmotivated coworkers

How do we deal with these issues? The secret of your success is leadership! First, realize that leadership is probably not something that you were born with. Leadership is developed over time. Leadership takes a concerted effort by surrounding yourself with mentors, taking leadership courses, learning about dentistry from the masters, and developing a great book list (the secret then is to read the books). Where do you find time for all this if you're busy juggling, like me?

Your kids need mothering, your partner needs loving, your parents need help, your career needs energy, and your friends need your ear. Throw into that mix the dry cleaning that needs to be picked up, the groceries that need to be bought, the meals that need to be prepared, and the house that needs to be cleaned. How do we survive, much less prosper? We need to divide our lives into core tasks. We cannot do it all. The day of the "supermom" is dead. It's impossible to do all we need to do as CEOs of our businesses without the delegation of tasks. In your office, this means you need to hire well, train your staff, trust them to do as you've trained them, and then most importantly, you need to praise them!

Obviously, time management and delegation of duties are key. Depending on your situation, oftentimes a consultant can help you design a list of things to do to get your practice running the way you want, and to get your staff on board with the changes. Without the staff on board, you will not be successful in implementing the changes you need for your practice success. I stress "practice success" because at Linda L. Miles and Associates, we are pro-practice vs. pro-doctor or pro-staff. If you focus on your patient as the most important part of your practice, you will have the key to success. If you focus on hiring, training, trusting, and praising your staff, you will find that the main conflicts between female doctor and female staff are resolved. This takes us right back to leadership!

Here are three key elements to "The Secret of Your Success"

1. Learn the basics of practice management.
2. Be excited about change.
3. Acknowledge your office's successes with celebration so you all can enjoy the feeling of success.

Learning the basics of practice management

Change is uncomfortable for most people and is best implemented slowly, over time. Too much change all at once is really worse than no change at all. When I bought my first practice in 1992, there were so many changes I wanted to make! I knew what I wanted the practice to "look like" as I'd been a dental assistant for four years, a front office person for two years, and a U.S. Navy dentist for three years. I brought a practice-management consultant on board from Linda L. Miles and Associates in 1993. I implemented all the changes slowly over the course of the year. The systems stayed in place until 2003, when I sold that practice and opened a new office simultaneously. I implemented all the systems and within three months, I was as busy and productive as I had been in the old practice with less marketing! There are many great consultants available to practices today. If you're interested in consultants and coaching, check references and make sure your philosophies match before engaging in their services.

Basic numbers for your practice include:

• Production less fee adjustments
• Collection less fee adjustments: 98% (collection divided by production)
• Accounts receivable: Watch your 60 to 90 day and over column. Tackle AR patient issues early on. Phone the patient, politely and with concern. Ask if there's a problem. Document the reason and ask for regular monthly payments due on a certain date. Follow up within two days past due to ask again if there's a problem.
• Number of days worked
• Number of hygiene days worked; number of hygiene open chair units, and number of scale/root planing on a monthly basis
• Know your overhead numbers: staff salaries, supplies, and laboratory fees

Know how to run a profit and loss statement. Check your total monthly deposits noted on your bank statement and compare these numbers with your month-end closing documents produced by your dental practice software. Embezzlement happens in more than 80% of dental practices. According to the 2006 ACFE Report to the Nation, the median loss to a dental practice is $160,000 and the embezzlement happens slowly, over a typical course of 18 months or longer. The most common person to commit fraud of this nature has been with the practice a long period of time and is a very trusted employee. Trust and opportunity exist because most practices do not have division of duties. Dentists who have a relaxed attitude and do not provide oversight are embezzled more often. Interestingly, those doctors who do know their numbers and run an organized practice are not only more protected from embezzlement, but they are also more profitable!

It doesn't take a consultant to make a great practice; it takes a dedicated dentist. Setting aside time each week and each day to study your leadership skills will determine your success. I know this is easier said than done. It's much like diet, exercise, and eating healthy. Sometimes what's simple isn't easy to implement.

Besides books, courses, and mentors, there's also involvement in organized dentistry. Organized dentistry, through your local, state and national levels, offers opportunities for involvement — leadership training on the job! Speaking opportunities enable you to communicate better with your patients and your staff. Toastmasters International is one speaking group that is inexpensive, easy to locate, and is a positive support group that can coach you to better speaking skills.

Find a mentor! Your life will never be the same. Learn from your mentor. Don't feel guilty! They will learn by teaching and will benefit just as much as you do!

Be excited about change

How can you be excited about change when just the thought of change may make you nauseated? If we look at personality profiling, approximately 50% of us are resistant to change. If you're in that personality category, you're in the same 50% category as your patients and your staff. For some patients, that may mean loss of financial security because they have to put their savings into necessary dental treatment. As a dentist, you may be resistant to change because change may cause you to lose your security. And loss of security for most means financial loss of some sort ... loss of a job, or loss of funds in your income as a dentist. That loss may be attributed to the need for additional staff, new technology, or simply the need to take time off from work. Many articles have addressed change, and how to change. I would simply urge you to become used to change, because it's inevitable. Consider conditioning your staff to change. Introduce it slowly over time, but be excited about it! Don't spring a new software program on your front office to be implemented next week! Involve them in the decision-making process and the change. Trust their opinions and respect their feelings, but move forward.

Acknowledge your office's successes with celebration

Have annual retreats to celebrate the past year's successes together. Staffs thrive on challenges and rewards. They need to know where they're going and that it's possible for them to get there. Setting measurable goals is the first part of the equation. Celebrations for success can involve the patients and become part of the enthusiasm for the team.

Small ongoing celebrations are particularly important for female staff. They need to feel appreciated and that their work is of value to the practice. Women especially need daily appreciation. To occasionally give a gift to a female employee without commending them for a job well done is a meaningless gesture. They need daily acknowledgement of their contributions to the practice. This is simple to say, but hard to do! I know. I've done it the wrong way. If you walk in, focused on your day, and say to Kathy, "I've got this statement from our supplier and it doesn't make any sense; can you check into it?" and then you walk away ... you've just offended her! If you don't greet her with "Good morning, how are you?" you've slighted her personal value.

There are so many nuances! Again, as with leadership, communication is a tool that should command a lifetime of study. There are many models for rewarding your staff. Linda Miles has developed her signature "Trip Kitty" fund that rewards staff through a combination of the team and doctor's efforts. It's a win-win situation. For more information regarding the "Trip Kitty," contact me at rsavage@harbornet.com.

In conclusion, I would challenge you all with a quote from William Butler Yeats:

"Education is not the filling of a pail, but the lighting of a fire."

We have the ability and the need to light the fire in our staff, those whom we mentor, and those who look to us for leadership. I look forward to learning with you in the future years and to sharing the secrets of leadership.

Rhonda R. Savage, DDS, began her career in dentistry as a dental assistant in 1976. After four years of chairside assisting, she took over front office duties for the next two years. She loved working with patients and decided to become a dentist! Dr. Savage graduated with a BS in biology, cum laude, from Seattle University in 1985. She then attended the University of Washington School of Dentistry, graduating in 1989 with multiple honors. She was in active duty as a dental officer in the U.S. Navy during Desert Shield/ Desert Storm and was awarded the Navy Achievement Medal, the National Defense Medal, and an Expert Pistol Medal. Dr. Savage has been in private practice for 16 years, has authored many published peer-reviewed articles, and has lectured internationally. She is active in organized dentistry and has represented the State of Washington as president of the Washington State Dental Association. Dr. Savage is the CEO for Linda L. Miles and Associates, an internationally known practice management and consulting business. Dr. Savage is a noted speaker and lectures on practice management, esthetic dentistry, women's health issues, periodontal disease, communication and marketing, and zoo dentistry. You may contact Dr. Savage by e-mail at rsavage@harbornet.com.

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