“Pearl
of the Month”
Pertinent
comments on the practice of fee-for-service dentistry.
by Michael Perry, D.D.S., President
The Challenge of Leadership in
Private Dental Practice
There are fundamental characteristics most dentists share.
Dentists tend to be: analytical, compassionate, introverted,
and linear thinking. These are attributes which often create
an aptitude for being an effective doctor and micro surgeon,
but not necessarily the leader of a dental practice in todays
marketplace. Indeed, in those practices in which I have consulted,
leadership was the most common issue challenging the owner/dentist.
My father practiced pedodontics for 44 years. My clinical
career overlapped his for about 15 years. Observing my dad,
his colleagues, my clients, and in my own practice experience,
I have seen 3 basic styles of private practice leadership:
1) the authoritarian (military) model, 2) the family model,
3) leadership by facilitation.
Ive met very few dentists who declare or are even aware
they are utilizing one of these specific styles. For better
or worse, the vast majority adopt one style by default.
During the 60s and 70s, most dentists were men
and were typically the unquestioned authority in their practices.
They gave orders concerning every detail of practice operation
and employees complied. A diminishing percentage of dentists
still use this model.
In the 80s and 90s, a greater variety of private
practice types evolved including those with tiered management
-- which often separated the dentist from a significant portion
of business decisions. This evolution, dentists fundamental
characteristics, and their lack of management and leadership
training created, in my view, the family model that commonly
exists today. In the family model, leadership is often performed
via consensus and relationship dynamics within the practice
are a significant force in decision making. Some dentists
have made the family model work to create their version of
success. In general, however, I do not see this model as effective
in todays marketplace.
Max DePree in his seminal book, Leadership is an Art states:
Everyone has the right and the duty to influence decision
making and to understand the results. Participative management
guarantees that decisions will not be arbitrary, secret, or
closed to questioning. Participative management is not democratic.
Having a say differs from having a vote. This statement
catches the essence of leadership by facilitation -- the optimum
style, in my opinion, for todays private practice.
Leadership by facilitation is the art of moving an organization
toward a declared purpose. In a dental practice, it is the
owner/dentists responsibility to define and declare
his/her purposes for being in practice. A purpose could be
the overall mission of the practice or a more specific one
such as the level of service and profitability in the hygiene
department. Employees are respected and receive a say in defining
a purpose, but they do not receive a vote.
Once a purpose is defined, the dentist engages in a participative
process with employees that leads the practice toward that
purpose. This facilitation revolves around the
question: how can we move as effectively, efficiently,
and enjoyably as possible from where we are now toward the
purpose Ive defined? The answer to this question
always creates an action plan. Employees continually participate
in answering this question and are then responsible for playing
their respective roles in implementing the action plan.
I have talked with many dentists who would like to change
the way they lead their practices, but feel trapped in their
current circumstances with their employees. Changing a practice
which utilizes a family style of leadership to a one utilizing
leadership by facilitation can be a challenge, but is well
worth the resources and effort to achieve it. In my own experience,
making that transition and running my practice via facilitation
has been one of the most freeing and effective experiences
of my professional life.
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