Practice Management

Leadership Within The Emerging Complex Entity Called “The Dental Office”


Ron Weintraub


November 18, 2015

November 18, 2015

Typically, an evolving contemporary dental facility is dramatically different from the norm of five to ten years ago as predicted from a healthcare and business perspective. “Change brings opportunity” according to businessman Nido Qubein and change is what we need in the leadership of the current emerging complex entity of the modern dental office.

THE NEED FOR EFFECTIVE LEADERSHIP STYLELarge multi-provider entities often include a complex support group of administrators and treatment professionals. In addition, some larger entities offer specialty services in-house that, more often than not, require a leadership style that can deal with the burgeoning numbers. Among the departments are the following:

Administration1. Office Manager2. Treatment Coordinators3. Re-care Coordinators4. Back-Up Coordinator (sometimes counter-productively referred to as the floater).

Professional1. Restorative Hygienist2. Re-care Treatment Hygienist3. Level 1 and Level 2 Clinical Assistants4. Denture Therapist

This level of staff/employer interface requires a team approach to patient care, and a successful team needs a designated team leader. It behooves us to have the owner/operator dentist delegate the various responsibilities in the role of team leader being careful not to deflect from his/her crucial clinical responsibilities. The structure and protocols of the office should be such that the leader (dentist) uses the art of appropriate delegation and as the practice leader, discharges responsibilities.

Based upon their behaviour, different types of dentists apply their leadership style to the variety of challenges presented in carrying out the mantel of leadership. For example, micromanagers operating strictly as a boss as opposed to a leader must be constantly reminded of the appropriate role as a leader. We often provide a strategically placed chart in their private office as a reminder of the characteristics of a “Boss” and a “Leader”.

ONE STYLE OF LEADERSHIP:  THE ABDICATOR PERSONALITYOne ineffective leadership style we don’t recommend is the “Abdicator”. This designation carries with it significant long term danger for leaders of the practice. The risk lies in the fact that such leaders are not sufficiently knowledgeable of the operation of the office beyond the confines of the clinical area that they see as their domain. When issues arise, “Abdicators” commonly respond “I know nothing about this matter; just have Zelda/Ruth/Carey look after it and please don’t bother me”. 

The hazards of this scenario are overly empowering by giving long-term employees, who are knowledgeable in connecting with patients, carte blanche to decide what is the best interest of the practice. Often the decisions coincide with what may appear best for the individual personality and skill set of the particular staff member. Procedures tend to get institutionalized into forming a “that’s how we always do it” dental office.

Often, most of the on-going indigenous protocols are unwritten and recorded only in the mind of the incumbent administrator. Should he/she become ill or leave for some reason, no formal description is in place for new hires to build on. It’s a case of them “not knowing enough to know what they don’t know”. Their concept of the expected contemporary norms of customer service may well be years out of date. All information with operational problems is filtered through the overly delegated office staff and leads to justification for the status quo.

STRATEGY TO MOTIVATE AND IMPROVE ISSUES: PERFORMANCE METRICSAn effective leader’s introduction of performance metrics into the everyday operation goes a long way to motivate and ameliorate many issues. The purpose of performance metrics is to quantify and observe the various functions required in job descriptions and the particular task required of the function; for instance, for the Re-care Coordinator, the sheet or computer page has a section on any given date listing the following:

a. The number of calls made to attempt to maximize the hygiene schedule;b. The number of patients actually reached and as a result, those who booked their appropriate hygiene visits;c. Those who said they would call back, thus giving a list of potential fill-ins for short term cancellations;d. Patients who indicated they would not be returning and reasons for not doing so provide an opportunity for the hygienist to contact and recapture the former patient.

Established performance metrics are quantifiable based on expected work outputs and serve as a self-motivating document for the Hygiene Coordinator. It allows staff to show that they were working hard and were able to fill the schedule for the weeks ahead. In addition, it allows leadership to complement the Hygiene Coordinators when they do an exemplary job and to find ways of rewarding them. In addition, it sets the standard for what is expected from the next person who accepts the responsibility of the Hygiene Coordinator role.

Leaders’ use of performance metrics creates a concrete database that is readily available for evaluation, thereby producing an empowering effect and positively affecting the ongoing growth of the success of the practice. Consequently, the ability of leaders to accept accountability and praiseworthiness of the team lies in the adoption of an effective leadership style.

Ron Weintraub is a founding partner with the Bayview Village & Downtown Dental Associates and brings over thirty-five years of knowledge and experience in the practice of general dentistry to the Professional Advisory. Large companies such as Patterson Dental, Ash Temple Ltd, Henry Schein Arcona, & the former Canadian Dental Co. have benefited from his insight. As owner of Innovative Practice Solutions, Ron advises dentists on practice enhancement, practice purchases, sales, location evaluations, associate buy-ins, and business mergers. Dr. Weintraub can be contacted at (905) 470-6222 Ext. 221 or