The Dental Billing Podcast

From Dental Assistant to Dental Office Manager

• Ericka Aguilar • Season 7 • Episode 5

Share episode

Ever wondered how a seamless transition from a clinical role to office management is made? This episode is your golden ticket, packed with advice from my personal journey managing multiple dental practices. Anchoring this episode is a deep dive into the importance of understanding management principles within the dental industry. We'll share the challenges and triumphs from my adventure in the realm of dental office management and provide you with practical insights. If you are new to the office management scene, this episode will be your guidepost. 

Transitioning to the structure of a dental practice, we examine the pivotal role of the billing department. An efficient billing department is a linchpin to a practice's financial success, and we discuss how an office manager can ensure this by identifying and filling performance gaps. The focus then shifts to an often overlooked aspect – the psychology of patient experience. Why do some patients willingly spend more at certain practices? The key lies in creating an exceptional patient experience, and we recommend eye-opening reads like "Unreasonable Hospitality" and "The Nordstrom Way" to further illuminate this aspect.

Lastly, we delve into the meaty topics of accountability, psychological safety, management styles, team dynamics, and their impact on a dental office. We shed light on the importance of fostering a psychologically safe environment and how doctors can support their managers' decisions. This episode will empower you to navigate through the stages of team dynamics and shape both team performance and patient experience. Whether you're an established manager seeking fresh insights or a new office manager finding your footing, this episode offers invaluable resources and strategies for enhancing patient experience and boosting your bottom line. Tune in for a journey packed with insights, inspiration, and practical tips for creating a successful and fulfilling dental practice.

Want to learn Dental Coding and Billing? Join here:

https://tr.ee/efzYrY7mp-

Would you like to set-up a billing consultation with Ericka or Jen? We would love the opportunity to discuss your billing questions!

Email Ericka:
ericka@dentalbillingdoneright.com

Email Jen:
jen@dentalbillingdoneright.com

Perio performance formula:

(D4341+D4342+D4346+D4355+D4910)/(D4341+D4342+D4346+D4355+D4910+D1110)


Want to know what your fee should be for D4346? Send Ericka an email to ericka@dentalbillingdoneright.com


Speaker 0:

Hi friends, welcome back to another episode of the Dental Billing Podcast. Today's podcast is going to be very different from our normal conversations around dental billing. We're going to go off the beaten path and we're going to talk about dental office management. Before we dive into that topic, I want to give a big shout out to all of our listeners in Germany. Our podcast is now in 32 countries and Germany comes in at number two with the second most downloads to the Dental Billing Podcast. So shout out to my listeners in Germany. I hope I get to meet you guys at some point. Thank you so much for your support and I hope I continue to provide content that you find valuable and that is for everybody all of the returning listeners and to those of you that are new to the podcast. Thank you so much for giving me an opportunity to serve you and hopefully you find value in these episodes. That's what I strive to do. Now, going back to today's episode, this is a dental billing podcast.

Speaker 0:

However, a lot of you don't know what led up to me becoming a dental billing coach or dental billing consultant and what I did do previously to, when I worked with offices to help them make certain transitions, implement new ideas. Most of what I did prior to becoming a dental billing coach. I did a lot of general practice management consulting and there are a lot of companies out there that are much bigger. I am an independent consultant. My sole focus now is dental coding and billing because I'm really really good at it and typically, after working with me, offices will see a significant increase in insurance reimbursement and for the perpetuity of owning that practice, my average client increases collections about $13,000 per month just after working with me. I'm trying to promote friends. I'm trying to give you some perspective, so that's what I do today. This has been a very big shift from what I did previously.

Speaker 0:

Now, previously, going back to the general practice management consultant that I was, I would work with an office and we would shift through the various areas of the program. What a lot of you don't know about me is that my formal education is in human resources, and part of the package that I offered pre COVID was HR support, and I love HR. However, it was not where I lit up in my program. Where I would light up and where my client would light up is when we got to the coding and billing element of my consulting package. So when COVID hit, it allowed me to regroup and rethink what type of coaching and consulting I wanted to offer, and I've always loved working with the billers. That's really where I would light up.

Speaker 0:

Now, why am I talking about all of that? Because I want to go into this episode with some history, with some context. When I would host trainings across the nation, we had multiple, we had team case acceptance, we had coding and billing mastery, we had office manager boot camp and since I've decided to just focus on dental coding and billing, I have not revisited the other programs that I offer. I used to do an office manager boot camp. That was an intensive, day long boot camp and it really was nothing to do with dental.

Speaker 0:

We would discuss about dental teams, but the principles of management have really nothing to do with dentistry. Management principles can be applied to any industry and their universal Dental coding management principles not only makes you a better office manager, but it also makes you a better employee and understanding how to navigate as an office manager, through all the things that we need to understand outside of dentistry, because dentistry is a very niche industry. We need to understand not only the components, the moving parts, of a dental practice, but then, as office managers, we need to understand the business side of dentistry, and what I see a lot of is a lot of dental assistants that have been with their dentist for many years getting promoted to the front office and they're completely lost. And rightfully so, because you're going from the clinical world, understanding the setups and understanding the clinical side of dentistry very well, and now you're transitioning over to the business side of dentistry. And this is where it gets sticky, because on the business side of dentistry, as an office manager and I want to say bonafide office manager, because a lot of people have that title for the wrong reason and I'm not going to get into that today. However, I do want to emphasize that when you make that transition from dental assistant to office manager, there are things that you need to understand, and my hope for you in this episode is to give you some bits and pieces to help enhance your career for those of you that are new to office management, your position as an office manager.

Speaker 0:

So, going back to my background and my formal education, which is in human resources, why did I choose human resources Storytime? I got to tell you a backstory in order for you to understand why I chose HR as my major and why I pursued it. Now, keep in mind I've only ever used my HR education in dentistry, so all I know is applying this education to dental teams. Now, with that being said, I worked for a dentist who had multiple practices and he moved to Dubai and took me and had me sign, explained what I was signing, obviously, but I signed a power of attorney and was left in the capacity of acting owner as he moved and transitioned his life to Dubai. I still have that power of attorney and I still look at it from time to time, because I do have to say that was probably the most pivotal part of my career running multiple practices and running it as acting owner.

Speaker 0:

I really want to give props to my doctors out there running your practice and keeping up with your CE and all of the team stuff and all the things and moving parts you have to deal with in addition to providing quality dentistry to your patients. That is so I mean. I was running multiple offices. I did not have to keep up with CE or provide the dentistry, but, wow, it was an experience that I will never forget and I will forever be grateful for and I will always say, I've always said this it was the best experience and the worst experience at the same time, and I know that some of you get that.

Speaker 0:

So, going back to why I chose HR, I had a lot of decision making to make as acting owner and I didn't take that lightly. So I decided that I was going to go to school to learn how to make these very important decisions as acting owner. So, as I decided, when I went back to school, my professors not only became my instructors, my educators, they also became my mentors. And I want to give a shout out to Professor Kilgore because he was probably the most influential professor I had and I learned so much from him because I was able to take what was happening in the offices and bring it to my professors and get coached on the proper way to address certain situations, Things that I would have never thought of and liabilities I would have put the business in had I not had that mentoring and coaching from my HR professors. So definitely wanted to give a shout out to Professor Kilgore. He helped me in so many situations and you are also going to benefit from my interaction with Dr Kilgore and his way and style of management very, very influential on my education and then taking that into my career. We're going to talk about some of the things that I learned from him.

Speaker 0:

So, first and foremost, as we talk about dental office management, I want everybody to understand that we have two roles as managers, and these two roles can be very difficult, almost like walking on a tightrope and it's a very fine yet defined line that we must follow. The first thing that we need to understand as office managers is that we are here to protect the business first. So protecting the business from the employees while, at the same time, protecting the employees from the business. So I want you to think about that for a second, because that can sound a little confusing. So what do you mean? Protect the employees from the business? How do we first protect the business from the employees and then protect the employees from the business? So a couple of examples.

Speaker 0:

So let's talk about protecting the business from the employees. That simply means minimizing any potential liability, right? So let's say that you have an employee who came to you asking for an exception to a policy. Within your handbook, making that exception for that one employee would not be considered protecting the business from the employees, because now we have the other employees who may get upset. In fact, you could lose people that way and in this climate, we definitely don't want to lose people.

Speaker 0:

So protecting the business from the employees is first and foremost. As an office manager, however, we also need to protect the employees from the business. So let's get an example of that. Let's talk about making sure that your employees are getting their breaks and their lunches uninterrupted, so that they can decompress and come back refreshed, because that's the purpose of the break and the lunch is to allow the employees to decompress and not prevent overwhelm or burnout, but it is definitely going to help that we don't get to overwhelm and burnout quickly. So those are two examples of protecting the business from the employees and protecting the employees from the business Making sure that your employees are following the policies while, at the same time, allowing them to have what they're entitled to and making sure that nobody is interrupting them during their break times, because that's the point.

Speaker 0:

The point is to have uninterrupted time. So your job is to enforce on both of those ends. So that's why I said this is like walking a tightrope, because you really have to understand the difference between the two and how each of those apply. I mean, some of the things that office managers need to understand and I really want to spend some time talking about each of these is overseeing the business operations. I have met office managers friends that have nobody to manage, so they are the doer of all things and wearing all hats, and I don't understand how an individual can be called or given the title of office manager when, technically speaking, you need at least two or more full-time employees to technically be considered an office manager. I don't know what the state law says in your state, but in California they require that you are overseeing the work of two or more full-time employees. So it's important that we understand those things as we accept the role of office manager. Are we really an office manager? Are we just getting a title for the sake of getting a title? So really, really important there Some of the things that we oversee as business managers. We're going to oversee the business operations. That is going to include key performance indicators, kpis.

Speaker 0:

If you are an office manager, it's very important that you know you're managing a business. You're managing a corporation and, like any corporation, we have numbers we need to monitor because, as the manager, you need to understand, at the end of the day, from a numbers perspective, was this a successful day? What does a successful day look like according to your doctor? Some of the things that I consider when I'm looking at a successful day is did we hit our numbers? Did we hit our goals? What is your daily production schedule goal? How are we scheduling to goal? Do you have strategy to meet that goal? Are we executing that strategy? Do we have key performance indicators that keep us on track? What percentage of our patients today showed and what percentage did not show? And you know, maybe take the average over the week. This week was a good week because only 2% of our patients did not show, but they all rescheduled.

Speaker 0:

These are the things that we need to be thinking about so that we can serve this information up to our doctors. Or we can serve this information up to our doctors with the solution or a suggestion to make a shift, so that we can improve on things, but if we don't know what our key performance indicators are for the various departments that we have in the front office, then we are not going to successfully navigate this ship. So what are the departments that we have in the front office. We have office management. So we have management, or let's call that the executive department, because the office manager is considered a mid-level manager. So we are not decision makers, we are information givers, unless our doctors like my doctor basically wanted me to make most of the decisions. I became the decision maker for most things, but overall, top level, we are not the decision makers. This is not our business and we need to understand that. Our job is to serve up information to our owners, to our doctors, so that they can make better decisions, navigate the ship as needed. So the departments are the executive department. Then we have our sales department, which is going to be treatment coordination.

Speaker 0:

So what is our case acceptance looking like? What is our current case acceptance percentage? And every office has a different way of measuring this. Some offices measure it with like dollars presented versus dollars accepted. I have offices that have measured this in so many different ways. I have had offices say we consider scheduled accepted even though they have not paid for anything. There's just scheduled. So they'll allow that to be included in the case acceptance percentage because they know that their patients show. They have such a low no show rate that they trust their patients to include the patient scheduling for that treatment to start in their case acceptance percentage. So it just depends on how you define case acceptance in your office and you don't have to go based off of industry standards. You can run your office the way you see fit because you know your patients better than any consultant is ever going to know your office. So consultants come to the table with industry standard numbers but sometimes we need to tweak those numbers because your office may operate better than the industry standards and that just happens to work for your office.

Speaker 0:

So, going back to the departments, then we have our scheduling department and there are key performance indicators for the scheduling department. Then we have our billing department, which you guys know I am super passionate about because I do firmly believe that the billing department is the one that controls the income to the practice. You have seen it, you have felt it as owners. When your bank account reflects higher numbers because the checks are bigger, because you have a good biller, there you go. That is the definition of I don't want to say completely controlling the income of the practice, because that would take away from the team case acceptance. That happens because we all know that insurance income is not the driving force for a dental practice it's usually 30 to 40% of total income but we can definitely tell when we have someone who knows what they're doing, because we feel it in the bottom line.

Speaker 0:

And I have been an owner in two practices and I have experienced this myself. I did not do the billing in either of the practices that I was a partner in because I was busy doing everything else in the ownership level and the executive level, such as recruiting. We were going through so much change, renegotiating the lease, I mean you name it. That's what we were going through and I could not dedicate enough time. So I hired a biller, I hired someone who interviewed very well and completely flopped and I felt that in our insurance income. And then I hired someone who really knew what she was doing and the income went up and as an owner, that's really going to be the benchmark. And for me, when I would check up on her billing, it was more of a compliance audit making sure that we are using the right codes, making sure that the doctor's clinical notes match the codes that were put on the claim, making sure that the assistants were taking proper X-rays. There was just so many things going on. But that, to me, is top level, owner level responsibility.

Speaker 0:

When you have team members, you want to make sure that you trust but verify their work, and so the billing department is one of those departments that we definitely I feel definitely gets overlooked a lot of times and really we're not paying a lot of attention to what's going on in that department. But again, another department that has key performance indicators that tell you if it's running successfully or if it's running poorly, or are we just kind of basic and mediocre? What opportunity, what gaps need to be filled? And that's really as an office manager, where you are coming in and looking at all of the things and saying, okay, we have gaps we need to fill, and those gaps are going to require coaching from you as the office manager. They're going to require depending on your management style, and we're going to talk about the four different styles of management and you can determine which style you fall under. But really that's why we want to understand those KPIs. So if you are an aspiring manager or you are a manager, I would highly recommend that you have a dental practice organizational chart and also refer to as an org chart, and this is going to break down the dental organization so that you can see the different departments and then you can start inserting the different positions in each department and then you can break down each position so that you understand what outcomes you are anticipating. It is a very detailed chart and you can make one yourself. I think Canva has some fillable organizational charts, but I highly recommend all office managers understand what an organization, dental practice or chart should look like and have one up in your office to remind you of the different departments that you have within the practice that you are ultimately responsible for and then find those KPIs so you know what a successful day looks like for each of those departments.

Speaker 0:

Okay, so we're also as managers, we are also managing the patient experience. We all know how important the patient experience is and if there's some things that I can mention here about the patient experience, the patient experience has a direct impact on the income to the practice and there are a couple of books that I recommend and I have recommended in the past. Some of my clients have read these books together with their team, kind of like a reading club or book club, internal book club. You do have to get the buy-in from the entire team. Not everybody loves reading as much as I do. I love learning, I love reading, so this kind of stuff really lights me up. But when you read these books like Unreasonable Hospitality or the Nordstrom Way, you start to understand the psychology behind a sale and just in general as a consumer right as a consumer.

Speaker 0:

We walk into an establishment, we have a subconscious spending threshold and that spending threshold is impacted by so many things and it's subconscious, so we don't have any control over this. However, where you see it reflect is when someone has an excellent experience. So think about Disneyland and think about what they charge. Why are people willing to pay for Disneyland? Because of the experience. Not because Disneyland is fancy, not because Disneyland is the state of the art. It's not because of any of that. It's because of the consumer's experience. We're willing to spend top dollar in a down economy for the experience. So if you take that concept and you transfer that into a practice, what you will find is that the better the experience, the more the patients are willing to spend. And it doesn't. We're not talking about having the latest technology in dentistry. You could get a patient to spend their hard earned money in your practice just by having an intentional experience with the patients. And if you feel like you have a team that would not be willing to provide an exceptional experience, I'd get some ads out ASAP, because you would be amazed at how much we have driven income to practices up just by focusing on the patient experience.

Speaker 0:

And as the office manager, you are the accountability piece to all of this. What happens to teams when they know that they understand their role, they understand the outcomes they need to have, they understand that you are going to be checking in and having those coaching discussions with them. That's called accountability, my friends, and this is the missing element in most offices that we work with. You have to be willing, as a manager, you have to be willing to have the difficult conversations. You cannot be the enabler, and there are things that cannot be swept under the rug. There are difficult conversations that you will have to have and I'm going to give you some strategies on how to have those conversations without making it about the person rather than we're just going to stick to making it about the policy, right? So again, accountability for that patient experience. We manage and oversee the collections.

Speaker 0:

Employee engagement are our employees engaging genuinely with the team with their peers, or do we have what I refer to as artificial harmony in the workplace? That's another area we need to be very mindful of is how is our team clicking? Are they clicking together at all, or do we have artificial harmony within the practice? Artificial harmony is something that just kind of seeps into teams because everybody wants to play nice and nobody is willing to have a hard conversation, because everybody is wanting to avoid conflict and they avoid it at all means. So this is going to silently destroy team morale. Because of this artificial harmony that is just going to seep in, people are going to start talking about their disagreement or they're not going to feel safe in speaking up in a meeting. They're not asking questions, they're just kind of going with the flow.

Speaker 0:

And when you start to sense that you have this type of artificial harmony within the practice, that is probably because as managers, we're just not having the right conversations, we're not encouraging relationship, trust to be built within the team. And we need to be very, very mindful because when you have artificial harmony that seeps into your team, it's fixable. It just takes time and you need the team to be willing to participate in fixing that and understanding that when there is artificial harmony, that is usually because there is no psychological safety among your team. And I know now we're getting deep into management principles, and that's what I was talking about earlier is these are management principles that you need to understand as an office manager of any business, because this is a biggie.

Speaker 0:

Artificial harmony is very prevalent in dental offices because we have small teams and nobody wants to have conflict, nobody wants to rock the boat, so everybody's playing nice, but deep down there are things that bother them, that cause them to drag their feet into work. It turns people into paycheck employees where they're just showing up because it's a safe paycheck. But I'm not going to go all out and give my all because I don't necessarily agree with how this office is run, or I don't necessarily agree with this decision that the doctor made without confiding in the team. I feel unheard and therefore I don't feel psychologically safe here. And psychological safety is the responsibility of the manager. Right, because you are there to advocate for your team. You are there to make sure that they have everything they need to be successful, right?

Speaker 0:

One of my professors in fact I spoke about him shortly, professor Kilgore used to always remind us that our weakest link in the chain is a direct reflection of our management style and that really impacted me because I took that into my management career. And if there is somebody who is making repeated mistakes and all you're doing is writing that person up or all you're doing is having a kind of you need to or I already explained, I already told you that is not management, that is not leadership, that is authoritative and people don't respond to authoritative management. It actually causes people to leave because people don't leave businesses, they leave managers. Think about that for a second. People leave managers, they don't leave businesses. I didn't leave the last job. I quit because of the company. It's a very large dental DSO and I'm talking from back in the 90s.

Speaker 0:

I will never forget an experience I had with an office manager who asked me to sign narcotic prescription because the doctor had already gone home and forgot to sign the prescription pad and I said no and I told her that that was illegal and I would not do it. And two weeks later I was brought before management her and upper management and HR and I was told that I was in subordinate and they wanted to write me up and I quit because I didn't agree with the manager asking me to sign a prescription pad and she knew it was illegal. I knew it was illegal. Therefore, I left because of the manager. Everybody else on the team was. We were great. We got along very well. In fact, the managing doctor and I got along so well that he went to HR and he requested that I get brought back, and they did. They actually terminated that manager after hearing the entire story and they did bring me back, but that is an example of how a manager can cause good employees to leave a practice.

Speaker 0:

Understand that this principle of psychological safety within your team is your responsibility and it is also the doctor's responsibility. We can't have doctors who undermine us when we are given the authority to make decisions as far as enforcing policies. As an example, this happens all the time and I used to get a lot of phone calls about this. When someone will request vacation time and the office manager is following the vacation policy and has to deny that request due to policy, the employee goes behind the office manager's back and asks the doctor and doctor grants that vacation. That just undermined the office manager. Doctors, if you're listening, don't do that. Have a conversation with your office manager before you make that call or, better yet, ask the employee what the office manager said, thereby redirecting them back to the office manager, because you put this person in this position for a reason. The last thing that I would hate to see is the office manager throw their hands up in the air and say well, go to the doctor, because you're going to do that and he or she's going to grant that anyways. Why are you asking me?

Speaker 0:

I've seen those situations over and over and over again and it drives me nuts, because I really feel for the office managers who have good intentions and want to manage the office, but they are consistently undermined by the authority of the doctor, who allows the employees to go to them rather than just redirect that employee back to the manager and let them know. Well, what did the office manager say about that? Did you ask the first of all? Did you ask the office manager? Did she or he ask you to come and ask me? Well, no, she said that I, he or she said I could not take the vacation. Well then, I'm going to have to back that up. I'm sure she said that for a reason and I'm sorry. I know that. It seems that it would be a hard conversation to have, but I promise most people don't like change. They also don't like being told no, but it's usually getting denied.

Speaker 0:

Vacation time is not going to be a means to go look for another job and if it is, if it's that important to the employee, see if you can work something out with your office manager. Just don't undermine your office manager. That's just extremely important. So, going back to your psychological safety here, this is where your team feels that they have the support of each other. So they have a sense of freedom to communicate without being judged. They're not going to feel like everybody's thinking that was a stupid question or they're not quiet in team meetings. That's really where you're going to see whether or not there's an artificial harmony going on here. So if your team is I mean, really silent during your meetings and you're the only one doing the talking, that is a hard sign of artificial harmony.

Speaker 0:

So how do you fix artificial harmony? So some of you might be listening to this going oh my God, erica, I have artificial harmony. I wouldn't doubt that. A lot of offices do have that. And let's talk about how to fix artificial harmony and provide psychological safety to your team. First of all, we need to recognize that it does exist. If it does, let's deal with it.

Speaker 0:

And the way to deal with artificial harmony is through bringing your team to build up relationship trust, which is a belief that they can rely on each other and on the integrity of one another. So they need to understand that. Hey look, I know that so-and-so has my back. We're a cohesive team and I know that I can openly communicate with my team members without judgment, without fear of judgment. And how do we do that? So we want to understand that relationship building is a matter of encouraging your team members to get to know one another. It's encouraging them to befriend one another. It's encouraging them to have productive conversations.

Speaker 0:

Conversational turn taking in meetings provide humor. Let's get people laughing, let's start telling jokes, let's ask questions, let's get curious about one another and be respectful of the rules, like no phones in a meeting. Let's be respectful of one another. It is going to take time and it will require you, as the manager, to encourage this. Maybe we start taking our team out to lunch. Maybe we do some type of activity where we put team members in a room for five minutes and tell them ask certain questions. There are so many things that we can do to do relationship building and trust building, and you'll see over time, as people get to know each other and start to like one another, it's very hard to have a disagreement with someone that you like. You take a different approach to that conversation, and that's another way that you can tell artificial harmony exists is how people are approaching each other on certain topics.

Speaker 0:

Okay, so now that we understand that artificial harmony is real, psychological safety is real, let's talk about the difference between micromanaging and macro managing. So micromanaging is typically going to be when someone is excessively involved in the details of a task, almost to a controlling point. And come on, friends, you guys are my coworkers, we've all worked with that manager or that doctor, and are we still there? No, we are not, because this type of management style, micromanaging, decreases team morale and it hinders practice growth. So in their journey to control, they are actually losing good people, or if people stay, they're not going to be the best version of themselves. They're just going to show up because, once again, like I said earlier, it's a safe paycheck. It's almost like a guaranteed paycheck, especially if you're going to endure that kind of abuse, because micromanagement is a form of abuse and it does not provide the parameters that we need to have for psychological safety. In fact, it is the exact opposite of providing psychological safety in a practice.

Speaker 0:

Let's now talk about macro management. Micro management is the complete opposite of micromanagement, as you would have guessed, but macro managers provide guidance, they take a more collaborative approach, they encourage autonomy and they enhance their peer-to-peer support network. In other words, they encourage their team members to support each other, and that is the kind of manager that we want running the show, because when we have happy employees I know you've heard this before, but happy employees are going to equal happy patients, because happy employees are going to exude that happiness, the patient is going to feel that vibration and the patient is going to feel that energy. All right, there are four management styles that I want you to be aware of and I want you to think about the type of manager that you are. The first one that I'm going to start with.

Speaker 0:

We kind of touched on a little bit as we talked about the micromanager, but it's the authoritative manager. These are the old school managers. I don't really see much of these managers much anymore, but I still, once in a while come across an authoritarian and they're always frustrated because their team never does enough. Nothing's ever good enough, and they're the type of manager that gets very, very, if any, low results from their team, because their leadership style is to point the finger, say things like I already told you you should have known why did you do this, what were you thinking? Things like that. So authoritarians are still out there.

Speaker 0:

In today's employment market, I don't think very many people are tolerating that type of management style anymore because there's so many options. Nobody has to put up with that behavior. Then we have the participative manager. The participative manager is the manager who's going to roll up their sleeves and when we have a project like we need to get our account receivable report under control, the participative manager is going to roll up their sleeves and get in there with their team. They're not going to delegate, they're actually going to get in there with the team and see that project through to fruition. And that is that type of manager tends to get very high performance from their team because they are willing to get in there with their team.

Speaker 0:

The next style that we have is the delegator, the office manager who delegates. Now that we are talking about the difference between delegating and abdicating. I want you to understand the difference, because what I find is that we don't truly have delegation In some cases we have abdication. And here's the difference between the two. Delegating means that you are retaining the responsibility for the outcome of that project. So let's just say that you need to deliver a report to the doctor by 5 pm, but you don't have time to gather the information. You are going to delegate the gathering of the information to a team member and then you're going to ask them to return that information to you, say by three o'clock, so you have time to review it. That is delegating. You are retaining the responsibility for the result because you are not going to be able. Ultimately, the responsibility was given to you. What I see a lot of is abdicating or abdication, which is relinquishing responsibility. So I am offloading this task to you and then you are going to meet with the doctor to deliver those results. That is abdicating. That is not delegating. So when you are retaining the responsibility of the outcome or the result, yet you are delegating some of that, you are delegating some of that project to someone to help you get that result, then that's delegating. So understand that the delegating manager knows that they are still fully responsible for the outcomes and the results. However, they're going to utilize their team to help them achieve results and that type of manager is also very successful with high performing teams, assuming they are delegating and not abdicating.

Speaker 0:

Okay, finally, we have the enabler. The enabler, the manager who never wants to have a hard conversation. The manager who people have stopped going to because that manager gets no results. In fact, they're not really managing much. They just kind of stay in their office. They just bury themselves in paperwork. They are not engaged with the team. They really don't know what's going on in people's lives.

Speaker 0:

This is between the authoritarian and the enabler. It's the complete opposite of the authoritarian, because you get the same result as the authoritarian. You don't have a thriving environment, you don't have engaged employees, you have people who are just the morale is very low because we have that manager who, for some reason, is not managing. They're hiding, if you will. So those are the four types of managers and if you want to learn what type of manager you are, or maybe you realize your management style isn't what you would like it to be, the good news is, friends, that, as you learn the principles of management and you apply them to your career, it will make you a better manager, which will in turn give you a higher performing team, because, at the end of the day, that's what we all want. We want high performing teams.

Speaker 0:

And then the question becomes how do we do that? How do we get our teams to go from underperforming to thriving? There are four concepts to team dynamics that, as an office manager, you need to understand, and I don't mean to sound like an authoritarian there. However, I do find that it is very important for you to understand that your team goes through four stages before it becomes a high performing team, and those stages are managed by the office manager. So the first area that we want to actually let me just tell you the four it's forming, storming, norming and performing. So we have to know, as office managers, how to navigate through these stages. So when we have a forming team, this is when the team is being very nice. Nobody wants to step on anybody's toes. We are a new team and we are just starting to gel, so everybody's still getting to know each other. There's a lot of excuse me, thank you. There's just a lot of pleasantries being exchanged, nobody's really getting to know each other just yet.

Speaker 0:

And then we get to the storming phase, and this is the phase, in my opinion, where most teams stay stuck because the office manager has no conflict resolution abilities. And when we are storming, we are having conflict. Actually, there's a lot of conflict going around, and by conflict I don't want you to think that I'm talking about arguments and people walking out. When I say conflict, I mean we're getting to know each other. We're getting to know who's a morning person and who's not, and who needs five cups of coffee. We're getting to know each other. So there is conflict going on, but it shouldn't be to the extent where it's extreme. And I also want to remind everybody that without conflict there is no growth. So this is the most important stage of the four dynamics to teams. So this is where we're going to see explosive growth through the conflict, because of all of the things that are happening as we get to know each other.

Speaker 0:

Storming is also where we can identify as managers, where our individual team members need coaching. So the idea behind office management is to get your team on autopilot, to get them to the point where now you are just overseeing. So through the storming phase, you are very hands-on in training and in coaching. So we have a team that's getting through conflict because they're getting to know each other and that might require you to come in with your conflict resolution hat, but for the most part the team should be okay. What you want to do is take your team from storming into norming and as the team starts to norm out, that means that we have gotten to know each other a little better. So things have calmed down in that arena. I am meeting expectations in most of the areas within my role because I understand my role and the office manager has coached me to understand what a perfect day looks like for my role. So we're able to understand and norm out a little bit better. But that's going to require a lot of hands-on from you as the office manager.

Speaker 0:

And finally, success to an office manager looks like a high-performing team. Actually, that is an office manager's goal when we have our team within an environment that has psychological safety, because that is a key component to a high-performing team is making sure that your team feels safe, that they can communicate with you, that they can communicate with their team members, they can ask questions and meetings and not feel judged and there is no artificial harmony. People are willing to have conversations that might have been avoided when there was artificial harmony within the practice. That is. Your ultimate goal as an office manager is to get to an area where we have a high-performing team because, just as my professor, professor Kilgore, said, your weakest link in the chain is a direct reflection of your management style. So when we have people on our team who are flipping and flopping like fish out of water, that is on you.

Speaker 0:

That is not to be taken lightly and that is the biggest flashing red light that that individual needs coaching Coaching from you or coaching from a team member that you assign to coach that individual. But if you and your doctor have decided to keep somebody on a team, you decided to pick this person, you decided to hire this person. There was probably merit there and now it's a matter of skill set. As long as that individual has the willingness to train, that's all you need. But when we're training and the individual does not have the willingness to be coached, you got to get that person off your team. You've got to get that person just off of your team as soon as possible, because uncoachable people do not belong on your team. You can only have high performers when everybody is willing to be coached. Everybody has to be willing to learn something new. That is just how it works with high performing teams. So, as you grow into your management role, one of the tools and this is going to be my final thought before we close out, your best friend is your handbook, and I hope that you have a handbook to use, because that is your guiding light to having difficult conversations.

Speaker 0:

When an employee is, say, for example, coming in late on a regular basis and you need to have a conversation with this person, it is not about them, it's about the policy. So of course, we want to know if there's anything that we can do. Is there something going on that we can help or assist them with? I've had situations where suddenly, my employees are coming in, my employees coming in 30 minutes late consistently. Is this a time to consider writing this person up, or is it first an opportunity to learn about what's going on in their life? In her case, I learned that she no longer had anybody to drop off her child at school and her child had to be at school the same time our office opened. So you can imagine how stressed out she was every morning and it was a simple fix. She was a good employee Prior to that. We never had any issues years of loyalty with us and after speaking to my doctor, we agreed that we would move her time to an hour later and she was very happy with that because that relieved the stress in the morning and, friends, she was super stressed out.

Speaker 0:

So my handbook is your guiding light to being an office manager. When an employee asks me something that is outlined in the handbook, I always remind them to look at the handbook and see what the handbook says about that. If they want to discuss that matter further, then I'm always open to having that conversation and considering other factors, such as I would like to take a four week vacation. I want to know how much time you need because I need to go somewhere for a month. That may not be in my handbook and that may not be a request I can accommodate, but my decision will be made based on the policies Now, policies and procedures that are outlined in the handbook. Now, does that mean that we can't make some exceptions when it is necessary to? No, it does not. However, you don't want to make that a norm within your management style.

Speaker 0:

So I hope that this episode was helpful for you. This was a very fun episode for me because I have always loved working and managing dental practices and I loved working with my teams and getting to know them and really having them become extended parts of my family. So I hope that this was very helpful for you and if you have any questions and you would like to, if you have any questions about anything we talked about today I am here for you. You have my email address. You have a number where you can text me. I don't check that number all the time, so sometimes it takes a few days for me to get back to that, but you have all the things you need.

Speaker 0:

I'm here for you. My email is in the show notes. Friends, go pick up a couple of books the Nordstrom Way, also Unreasonable Hospitality. Those books are game changers and if you just take some of the concepts that fall within those two books, I promise that will elevate your patient experience and by elevating your patient experience and the experience that your team has as an employee within your practice, I promise you'll see the bottom line increase. All right, friends, I really enjoyed having you in this episode and I will see you in the next one.

People on this episode

Head Shot

Ericka Aguilar

Host