Ep. 28: Improving Employee Initiative & Responsibility
You may wish that your team members would care more about the practice, have more initiative, and take on more responsibility—but what can you actually do to improve these things? In this episode, Jeff Blumberg gives nine things you can do to improve employee initiative and responsibility in your dental practice.
Topics:
1:38 – Communicating with your team members
3:19 – Proper division of labor is essential
6:07 – Using statistics to rate employee performance
10:28 – Should you share “the numbers” with your team?
11:40 – What is your mission statement and is your team really on board with it?
14:43 – Continued learning and training for your team
19:09 – Have you clearly communicated your expectations?
23:20 – It starts in the interview process
26:11 – Things that can create a toxic environment in your office
Links:
Download list of statistics to track - https://www.mgeonline.com/dental-office-statistics
Team training video courses - https://ddssuccess.com
Learn more about MGE - https://www.mgeonline.com
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Questions From This Episode
What's the first step to getting employees to take on more responsibility?
Actually ask them. Most owners assume their team won't want more, but the vast majority of people are receptive to a direct conversation about taking on more ground, as long as you're not asking someone to do something that doesn't suit them, like turning a detail-oriented bookkeeper into a treatment coordinator.
Why does dividing labor matter so much at the front desk?
When two or three people share every task, from scheduling to insurance filing to collections, nobody is actually accountable for any of it. Giving each person a specific area they own, and holding them responsible for both the wins and the setbacks in that area, is what makes growth expectations possible in the first place.
What's the right way to measure an employee's performance?
Give them a statistic that actually reflects what they do, not just an activity count. For a scheduler, that means production, not percentage of appointments kept, since a scheduler could hit 110 percent by refilling a canceled implant case with a cheaper procedure and still be hurting the practice long term. The statistic should track the outcome, not the busywork.
How much of the practice's numbers should actually get shared with the team?
Share production, collections, and new patient numbers so the team can see whether the practice is genuinely growing, since that's the visible result of their combined effort. Profitability is the one number worth holding back, since it tends to create friction rather than motivation.
When should expectations and mission actually get communicated to an employee?
As early as the interview process, not months in. Laying out pay, hours, responsibilities, how performance will be measured, and what the practice's mission actually is before hiring avoids the kind of mismatch that quietly wrecks associate and partnership relationships down the road, where each side ends up with a different idea of what has to happen before a conversation about equity even starts.
Episode Transcript
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I want to start this week's episode with some questions I get asked often, especially from newer clients. They go something like this: how can I get my team to take more initiative? Is there a way to get my staff to take on more responsibility? How would I get my staff to care more about the practice? There's a number of different ways that question gets asked, but conceptually, they're all the same question. So that's what I want to talk about in this week's episode: nine ways to improve employee initiative and responsibility. My name is Jeff Blumberg, and I'm your host.
I want to start by bringing us back to the mission of this podcast specifically. We do a ton of training at MGE, we teach a whole system for hiring, management, efficiency, and so on, and that can take months to learn, and it's genuinely the way to build long-term sustained success. But the mission of this podcast has always been to give you something you can start applying right now, something you can listen to today and use in the office tomorrow. We're not going to solve everything in one episode, but the points I'm about to cover are things you can implement immediately to improve employee initiative, responsibility, performance, efficiency, and retention. Let's jump in.
What's the first thing you can do to improve employee initiative? This may sound almost too simple: ask them. Have an actual conversation. It's genuinely shocking how little real communication happens between owners and their teams. People maintain a professional relationship, which I agree with, but they don't actually talk to their team, don't exchange ideas, it stays very sterile. Have you ever actually sat down with someone and said, I'd like you to be able to handle this, or I'd like you to take on more ground from your current position? You'd be surprised, despite whatever bad experiences you've had with employees in the past, most people are genuinely receptive to this and want to grow. There are a couple of qualifiers though. You don't want to ask somebody to do something they're not suited for. If you have a bookkeeper who's meticulous, high attention to detail, doesn't make mistakes, but you just can't see them selling, that's not their makeup, and while you can teach almost anyone the mechanics, if it's genuinely not something they want to do, I wouldn't turn that person into a treatment coordinator. But assuming someone is suited for more, it's not difficult to get them to take it on just by asking. You might attach some kind of reward to it too, extra compensation or an incentive tied to the added responsibility.
Which brings us to the second point: division of labor. Look at the conventional front desk in the average dental practice, you might have two or three people up there with no clear division of who's responsible for what, and that creates problems in a number of ways. If I have three people at the front desk and there's a hole in the schedule, who do I actually talk to? It's not that they don't want to be responsible, it's that no one has actually made them accountable for anything specific. Even with just two people up front, you can divide labor: one person might be the office manager and financial coordinator, another the scheduler and receptionist, your hygienist might be in charge of the hygiene department. If somebody doesn't have a specific area of the organization they can call their own, you can't reasonably lay expectations of growth on them, it's simply not possible. You can't walk up to three front desk people and say I want to collect an extra $20,000 this month and expect any one of them to feel responsible for making that happen. I ask this at seminars constantly: if everybody is responsible for something, who's actually responsible? The answer is always nobody. So divide the labor. Each person should have a specific sphere of activity they're responsible for, and they're responsible for the good and the bad. If you're my financial coordinator and we usually collect $100,000 and you collect $130,000 one month, you'll make sure I know about it, and you should. But then the next month collections drop to $70,000, and suddenly it's tax season, or the holidays, or people just don't want to pay, in other words, the responsibility has moved somewhere else. That's human nature, people are happy to own the good outcomes and quick to deflect the bad ones. Being responsible means owning both. It doesn't mean sitting there thinking you're a terrible person, it means looking at what happened and figuring out how to fix it: we did $70,000 this month, here's what happened, here's how we get to $120,000 next month.
That brings us to the third point: they need a statistic. You've probably heard the idea of managing by statistics, we teach it extensively in the MGE program. Most people think managing by statistics just means graphing a number, which is good as far as it goes, but you're supposed to actually act when the graph moves a certain way. More importantly, the statistic you give someone should actually represent their productivity and what they do. Take a scheduler as an example. We've made someone the schedule coordinator, that's their area of responsibility, now what statistic do we give them to judge whether they're doing a good job or a bad one? There's one option I really don't like, and one I do. The one I like is production, because that's the actual point of having a scheduler, to keep the schedule filled productively and efficiently. If it's not being filled productively and efficiently, why do you have a scheduler at all? You'd need a different one, or better training. The one I'm less enthusiastic about is percentage of appointments kept. It's a nice piece of data, similar to how many hours you were open today, but I wouldn't build a whole management system around it. Here's the problem: say there are 10 patients on the schedule and one cancels, dropping you to nine, and the scheduler fills that opening with two other patients, they're now at 110 percent for the day. Sounds great, except what if the patient who canceled was coming in for three implants, and they backfilled that slot with a denture reline and a composite? That tells you nothing about quality, and it doesn't help the practice long term, even though the percentage looks fantastic. You can absolutely keep that statistic as a secondary data point, we have clients who do, but it shouldn't be the core statistic you manage a scheduler against. Same logic applies elsewhere: production for a hygienist, collections or collections percentage for a financial coordinator. The statistic has to represent what the person actually does. If a scheduler's numbers keep production trending up and the schedule is being run intelligently, that's a scheduler worth retaining and compensating well. If they're hitting 110 percent on appointments kept while your production is declining and your costs are climbing, that's not actually working.
We cover a lot of different statistics in one of our seminars, more than I can get into here, but as a starting point, there's a download on the episode webpage with a few core statistics worth tracking in your practice. Feel free to grab that. If you have questions, you can always email me directly at jeffb@mgeonline.com.
There's a second layer to statistics worth mentioning: the overall performance numbers of the practice. I've talked before about whether you should share your numbers with the team, and I'm a big fan of it, for certain numbers. I wouldn't share profitability specifically, that can spiral out of control fast, but I would share production, collections, and obviously new patients. The reason I like sharing these numbers is that it lets the team see whether the practice as a whole is actually growing, whether it's collecting more, producing more, helping more people. That's the visible result of their combined effort, and it lets them share in the success. Some owners are leery of this because they've had an employee accuse them of just caring about the money, which isn't true, sure you have to make money, but that's not the only reason you're there. Don't let one bad experience sour you on something that's genuinely worthwhile. There's nothing wrong with running a productive, highly viable practice, and if there are incentives tied to collections for the team, sharing the numbers lets everyone see how they can help move that forward. I'll get into structuring bonus plans like that in a future episode.
Next point: make sure your employees know they don't just have a job. The employment market right now is genuinely unusual, there are more people looking for employees than employees looking for work, and inflation has been climbing fast. I did an episode not long ago on inflation sitting at 7.5 percent year over year in January, I'm recording this one on March 10th, and this morning's report put it at 7.9 percent. That qualifies as off the charts, and who knows, it could be worse next month. So you'd think it's all about money for people right now, and money is certainly part of the equation, people do have to make a living, but it isn't the only reason people show up. Work becomes drudgery after a while if that's all it is. I know plenty of genuinely wealthy people, and some of them are among the most miserable people you'll ever meet. People need a mission to keep them going, they need to know they're actually making a difference. So your team needs to know what the mission of the office actually is, and if you don't have one clearly defined, you need to figure it out and make sure they know it too. How are they making people healthier? How are they improving quality of life? That's one of the genuinely great things about dentistry, it does improve quality of life, and it contributes to better systemic health and longevity, people with a healthy mouth can live longer. That's worth keeping in mind constantly, when you're scheduling somebody, collecting money, closing a case, there's the mechanical side of all of that: getting financing arranged, getting signatures, watching the numbers land on the stat graph. That's the what and the how. But the why is extremely powerful. Why does it matter that this patient gets this treatment? Why does it matter that they show up for this appointment? If you know that showing up is genuinely connected to their quality of life and potentially their longevity, that makes it matter a lot more that they don't cancel and that they get the treatment they need. And it's true, that's the best part of this work. Make sure your employees are thinking with that in mind, especially when things go right with a patient, which happens constantly: someone gets veneers and is thrilled, someone who could barely eat gets an All-on-6 and their life changes. The whole team should hear about that, not just the person who happened to check that patient out that day, it's worth sharing in a staff meeting.
The next point is training, or really, education. A couple things on this. First, training is genuinely a benefit in your practice if it actually increases someone's ability, it's not a drag, unless the training itself is pointless. My father-in-law worked in software right before the dot-com bubble, and he went to a team-building retreat where one exercise had everyone lie down in a long line and try to roll over together. He thought it was the dumbest thing he'd ever done. I'm not even weighing in on whether that particular exercise was good or bad, the point is that education has to actually improve someone's ability to count as worthwhile. Real training also improves marketability. We've had people complete our MGE office manager program and put it on their resume, and it makes them noticeably more desirable hires, we've had prospective employers call to verify someone actually completed it. Training should never feel like a drag, it should make people more efficient, improve their performance, and be genuinely workable. If you have an employee who's resistant to learning or improving, that's a real red flag, because otherwise how are they going to grow into more responsibility? Business changes constantly, look at how differently we're doing things now compared to two or three years ago. Someone who doesn't want to learn new things is going to become a problem eventually, and that applies to your clinical staff too, certifications for assistants and hygienists included. If you're investing a meaningful amount in training someone, you can always talk to an employment attorney about some kind of agreement where they commit to staying for a certain length of time afterward, that's one of the real risks people cite with training, spending the money and then having the person leave. That risk is real, but if you avoid training altogether because of it, you're never going to grow. Increasing your employees' ability is one of the keys to all of this.
One last thing on training: some of the simplest, easiest changes you can make in your office start with just walking through a broken process. Say your new patient onboarding is falling apart, patients come in, get their exam, are told to come back for a treatment presentation, and then never show up. Walk through that entire process with your team, have someone play the patient, and you'll usually find exactly where it's breaking down. That might take an hour of your time, and you'd be surprised how much it changes. We have an online training platform, DDS Success, with training built for the financial coordinator, the receptionist, the scheduler, and simple resources like that can make someone's job dramatically easier without being expensive. You can also scale training investment with an employee gradually, a little up front, more once they've proven themselves. Obviously training isn't a fix for someone who's completely non-productive, remember, training is a benefit, not a rescue plan, but if someone's struggling in a specific area, that's exactly where education helps.
Which brings me to the next point: expectations. I find this is wildly missing in a lot of practices, and it ties back to how I opened this episode, employers often just don't talk enough to their employees. When you hire somebody, or when you're managing one, how clear are your expectations actually being made? Say you've hired a schedule coordinator, are you really explaining what success looks like? Here's what I expect you to schedule in production each month, here's how I expect the schedule to run. With a treatment coordinator: I expect to hand you a case after I've presented the cost, and I expect you to get 80 percent of those patients to commit to paying for the full plan. Are you laying out expectations clearly enough that you can actually judge later whether someone is meeting them? Because if the expectations aren't clear, or you have them clear in your head but haven't actually communicated them well, that mismatch causes real problems.
I see this most often with associate hires. Say you bring on an associate and tell them, if this works out, maybe we can talk partnership down the road. That sounds encouraging, but it's completely undefined. You haven't spelled out what actually has to happen before that conversation can start: how much time needs to pass, how productive does the associate need to be, what would they actually pay to gain partnership? Because you haven't spelled it out, the associate forms one idea of what that means, and you have another. Six months go by, and in the associate's mind, that was the timeline before partnership talks could start, while in your mind it was closer to a year. Then one day the associate asks to grab lunch and says they think it's time to start talking partnership, and you're caught off guard, you were thinking a year. That's exactly when the conflict starts, and I've watched genuinely good potential partnerships fall apart simply because this wasn't spelled out early. I've seen the same pattern with regular employees too, if expectations aren't spelled out, they don't know what you actually want, and most people, being fundamentally good people, will try to deliver what they think you want. But if you never told them, how would they know if they're succeeding?
One key with expectations: they have to be realistic. This is a bit of a leadership lesson. Some of the better executives I've worked with, and I've always operated this way myself, follow one rule: never ask somebody to do something you wouldn't do yourself. If I tell someone I need them to do X, Y, and Z, I need to know two things, that X, Y, and Z is actually achievable, and that I would do it myself if I had to. If you're asking someone to do something you believe either can't be done or that you yourself wouldn't do, that's genuinely poor leadership. You also have to understand what's realistic from a business standpoint. If you've got three doctors, six hygienists, eight assistants, and one person at the front desk, and you tell that one person you want everyone booked solid, they're probably not going to be able to pull it off, and it's not because your front desk is bad, it's because they're completely overwhelmed. More may be achievable than you'd think in a lot of cases, but you have to actually understand your business deeply to know the difference, and not understanding your own business well enough is exactly where owners get themselves into trouble.
Ideally, all of this, the statistics, the expectations, the mission, starts at the very beginning of the interview process. If you sit down with a candidate and lay it all out up front, here's what I'm looking for, here's the pay, here's the hours, here's the responsibilities, here's how I'll rate your performance, here's how you'd earn a raise, here's the mission of this office, here's the training I'll expect you to complete, and you do all of that during the interview, then if someone has an issue with any of it, it comes out right then and there. You don't waste time hiring someone only to find out a month later they don't want the X-ray certification training you expected, or they don't want to work one Saturday a month, or they didn't realize scheduling was part of the role. You want to know that before you hire them, not after. That should absolutely be part of the hiring process, almost a checklist you run through during every interview to see how a candidate reacts. Some people will push back on parts of it, and that tells you something valuable. Others will genuinely light up when you bring up the mission of the office, people you might not have expected to connect with it, and that often turns into a great hire. Doing this from the start eliminates a lot of surprises down the line, and combined with having a real system for growth and advancement, it contributes directly to retention, especially with ambitious people, because if you're hiring ambitious people, you have to keep the practice growing so there's somewhere for them to go. Let them know from day one what to expect and where the practice is headed.
The last two points I promised, since I said I'd cover nine total. First: we're quick to point out when someone makes a mistake, but we tend not to acknowledge it enough when someone does something genuinely well. I've been guilty of this myself. Make a point of it, and it doesn't need to be a big production, it just needs to actually happen. If your scheduler beats their production target by $20,000 this month, say so, tell them that's genuinely impressive. That lets them see that the effort they put in created that result, it reinforces that they're the one who made it happen, and it validates their importance to the team.
The final point: nip problems in the office in the bud, quickly. If there's staff conflict, or a non-productive person creating friction, deal with it fast. Say you've got ongoing conflict between your dental assistant and your scheduler, and it just keeps dragging on, and you tell yourself it's not your problem to get involved in. Eventually it becomes your problem, and it will lower overall office productivity and morale in the meantime. Worse is when you have someone who's genuinely non-productive. Think of it like a tug of war, six people on each side of the rope. Everyone is expected to pull as hard as they can, some pull harder than others, sure, but the expectation is maximum effort from everyone. If you've got someone who's just not pulling their weight, effectively sipping coffee and twanging the rope while everyone else strains, the rest of the team absolutely notices. That creates a real problem, and if the team genuinely wanted to fully take ownership, they'd want that person handled, either they get their act together or they leave. Most employees won't say that outright because they don't want to get a coworker in trouble, but think about the message you're sending by letting it slide. Say you have a hygienist who isn't very productive, is unpleasant to the rest of the staff, doesn't help present treatment, and patients don't particularly warm to them, though the hygienist herself will insist patients love her. If your response is that it's hard to find hygienists right now so you'll just deal with it, think about what that tells the rest of the team. First, that you're not protecting them, it's apparently fine for this person to be unpleasant and underperform relative to everyone else. Second, that this kind of behavior is simply acceptable in your office, that it's fine to be rude, to be short with people, to snap at teammates for no real reason. Once you send that message, don't be surprised when your receptionist starts blowing up too and you ask why, and the answer is, well, the hygienist does it. It spreads through the office fast once it takes hold. As the executive, whether that's you as the doctor or your office manager, you can't let someone sit there unaddressed if they're not doing their job. It's not just bad for the practice and stressful for you, it actively poisons the rest of your team, and most of them are too nice to ever say something about it directly, so you have to be the one to confront it. The same logic applies to patients. If you have a patient who's genuinely nasty to your team, that creates a toxic environment too, and it shouldn't be tolerated, that patient needs a direct conversation, and if it doesn't improve, you may need to dismiss them from the practice. That's your call, and worth checking with your malpractice carrier and reviewing your state's dental practice act before you do, but these things matter enormously for office environment. A lowered, tense, unpleasant office environment doesn't just make it harder to attract new employees, it makes it harder to keep the ones you already have, because work becomes a genuine drag. You might be avoiding the discomfort of letting that hygienist go, but don't be surprised when your scheduler quietly takes a job down the street where they don't have to deal with someone like that every day. Handling it can save your entire office.
And this applies to you too. You can't be nasty when it isn't warranted, you have to look honestly at how you handle people as the boss. If you're going to hold your team accountable, you have to hold yourself to the same standard, or a higher one. If you're going to give someone a hard time about being late, you can't be late yourself. I've personally visited well over a thousand dental offices and small businesses across the country as a consultant, and I remember walking into one practice years ago where the doctor threw things at his assistant and yelled at her because she'd ordered the wrong x-ray film, or the wrong developer, this was a long time ago. His staff did not look happy to be there. Take an honest look at how you handle people, and ask yourself whether you'd be okay being treated that way yourself. If the answer is no, that's something worth changing, because ultimately, you're in a service business, and your team is one of the most valuable assets your practice has. You can't afford to ignore that.
That covers all nine points in detail, I hope it helps. As I mentioned, the training we do at MGE goes much deeper, a client will typically go through eleven days of training just on statistic management alone, we do a lot of education on this so that a doctor genuinely understands what they're doing when it comes to managing their practice. Really knowing what you're doing puts you in the driver's seat instead of feeling like you're just reacting to whatever's happening around you. If that's something you want, I'd recommend looking into it further, we offer a free consultation, and you can find that link along with the statistics download on the episode webpage, or visit us at mgeonline.com or call (800) 640-1140.
That's all I have for you this week, folks. I hope it wasn't too much, I don't think I stayed under my usual half hour on this one, so call it practice success in thirty-five minutes or less this week, sorry about that. I wanted to make sure I covered all the bases. I hope this helps, and we'll see you back in the next episode.