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Accountability in Dental Practice Management: If You Aren’t Seeing the Results You Want, Look to Yourself First

In my work with dental offices across the country, I’m constantly talking about the importance of accountability in running your business.

The truth is there’s nothing new to learn here, no magic pill that will suddenly make you successful or rich. But putting these simple accountability measures into impeccable practice is the difference between an office that successfully brings in new patients and generates healthy income, and an office that struggles to keep the doors open.

When you’re willing to hold yourself, your staff and your patients accountable, you will see your practice begin to grow.

Use Your Mission/Vision to Hire the Right People
I talk a lot about mission/vision with my high-level clients because it is so important. Mission/Vision [How to Build a Million Dollar Practice] is essentially your roadmap for the practice: it’s impossible to strategically build a structure for your dental practice when you don’t have a direction of some sort.

It’s vital that you have a clear picture of the office values, core beliefs and goals for your patients. This can include everything from how you want your employees to treat one another, to your policy on offering payment plans for patients who can’t afford treatment, to your vision for your retirement. This is your business – what do you want it to look like?

If you haven’t crafted a Mission/Vision yet, that is your first step. Take out a pen and paper and work on this right away – it will shape every choice you make for the business from now on, including how you hire and fire employees.

If I know what an A-level employee looks like according to my Mission/Vision standard and I have someone who’s not playing up to my expectations, now I can use accountability and my Mission Vision as a clear measure. When they’re also aware of the Mission/Vision, it won’t come as a surprise to them when I sit them down to have a conversation about their performance.

When an employee receives coaching or reprimanding from me, he or she will either accept the adjustment and improve their work ethic or not. If someone knowingly acts outside of my Mission/Vision, how many strikes do they get before I let them go? Ultimately, I can only say to them, “You get to decide whether you want to stay here as an employee and do what’s expected.”

The choice then belongs to them as to whether they’re going to play within my Mission/Vision standards or not. Over time, their behavior will prove if they’re reliable, responsible and accountable... if they’re not, then I have to let them go, and they’ll know exactly why.

When you get to the point where you have a team filled with proven employees, you don’t have to monitor day-to-day office routines as much. That’s when you’re working like a CEO Dentist.

Structures for Accountability in the Office
Accountability is so important for success in the office space, and there are specific structures you can put in place to create a sense of loyalty and responsibility within your team.

Most often an employee doesn’t do what’s expected because he or she never really bought into where you were going – the Mission/Vision – in the first place. They took the job because they needed income, but they’re not “all in.” Usually you can catch on as to whether an employee is “all in” within a matter of 30 days (or less), but once you put accountability structures in place, you’ll be able to see where they stand much more clearly.

The Action Board
Rarely have I seen such a simple tool make such a profound difference in the productivity levels of a dental office and you can easily put this tool into place right away.

Essentially, an Action Board is a white board, chalkboard or large sheet of paper that all team members can see. In a team meeting, we clearly outline on the Action Board what project we’re working on and what our expectations are for the project. We document what it is, who’s responsible for what, and what the deadlines are. Working backwards, we come up with a timeline that everyone agrees to and possibly even checkpoints, when appropriate, to gauge our progress.

The Action Board is a tool that will come in handy in managing specific goals or projects (examples might be the development and execution of a marketing campaign, the implementation of a community outreach program or posting regular website updates). Each project on the Action Board gets what we call a “Champion,” a member of the office team who acts as a go-to for all project-related updates. We also assign a completion or “by-when” date to Action Boards items so that you can accurately assess whether the work is being done on schedule. The Action Board works because each team member is making a public, voluntary commitment to their role in the project. Everyone knows whats happening and who is responsible. There is no place to hide.

Day-to-Day Accountability
The other side of accountability is day-to-day office routine. Success in this area demands clear systems and procedures for the daily tasks that must be completed by each team member.

For example, let’s talk about the front desk manager who has to answer the telephone during work hours. If that person has been well trained in her job, meaning I’ve invested time and money in teaching her how to do it, I can expect that she will. However, if I’m spot checking and we have frequent follow ups to see how the performance is going, she knows that she will be held accountable for her behavior.

In practice, this looks like holding private meetings (Growth Conference) with this employee once or twice a year. Sit down with her, go over her roles and responsibilities and talk about the areas that need improvement.

You might say something like, “Since I hired you and I want you to be successful, let’s work together to improve your performance. I’ll coach you through it. Here’s how I want you to answer the phone...”

If this person is continually bastardizing the system despite frequent check-ins and trainings, you have the wrong person. These accountability meetings will show you much more quickly that it’s time to find someone new.

Know Your Numbers
Another tool we use is the Key Business Indicators Scoreboard. This is a dry erase board to track the base metrics of your practice. Production collection numbers, patient retention data and pre-appoints all go onto the Scoreboard. Additionally, this tool can track whether patients are coming from internal or external marketing and measure how effective you and your staff are at presenting treatment options and having patients accept and complete treatment.

Knowing the numbers allows you to monitor the growth of your practice... but without that sense of accountability, it’s easy to lose sight of business goals.

Set Up Expectations with Agreements
In the CEO Dentist training, we talk a lot about “promises and agreements.” Sometimes these are written agreements that every member of the team signs, but often these agreements can be verbal.

It’s important to outline to your team how you expect them to behave with the patients, with each other and with you because this will set the tone in the office.

For example, I like to have my teams sign an agreement that outlines what happens when there is an upset, or disagreement, among team members. The agreement essentially says, “If I have an upset with someone, I agree to go directly to that person. I will not talk to anyone else on the team because that will cause unnecessary conflict within the office.”

If anyone breaks a promise like that, the agreement clearly states that a breach is grounds for dismissal. Why? Because integrity is our highest priority in the office, and if we allow employees to act outside of integrity, we can’t expect to offer our patients the best dental care in the business. It’s all related.

Look to Yourself First
All of these systems and structures are incredibly powerful in creating integrity and accountability within your business, but ultimately it comes down to you. You have to set the tone as the leader and the culture of the practice has to be one of accountability.

When a CEO Dentist says he is going to do something, he does it. On time and impeccably. Anything short of that in our culture is not the way we do business.

If you, as the head of the office, continue to tolerate bad behavior in yourself or in your team, it will continue to happen. If you stop tolerating it, it’s true that you may lose some employees (they may leave or you may have to let them go) – but you will also create an opening for someone who better fits your needs. It can be hard to draw a firm line, but it’s critical.

Whatever your goals in your practice, it will always come down to what the leader does. The staff is going to follow your behavior and expectations and you get to set the tone.

What changes could you make in the way you run your practice to build more structures for accountability? Leave a comment in the area below to add your thoughts.

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