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Helping your doctor manage the practice

By Dr. David Black  bio

A lot of contemporary literature I have seen in recent months has emphasized the need for leadership by the doctor instead of management.

This literature defines the difference between leading and managing as having the team follow a leader versus managing as a function of supervising day-to-day operations. The reason for this emphasis is that the doctor is the primary producer in the office and often does not have time during the day to manage the team.

That lack of time to manage does not negate the need for management of the team. This does not relieve the doctor’s responsibility to manage, but it does make it more important for the office manager to have a major role in the day-to-day operations of the office.

One of the mysteries of managing I never had an answer for was the intangible things that would make team members seemed engaged and satisfied with their job. Some doctors have huge turnover, while others keep team members for years and years. I was one of those doctors who retained my team for many years, but I never really analyzed what was different in my approach that helped me keep my team when others have to constantly replace and retrain new employees.

I recommend a great read, “The Three Signs of a Miserable Job,” by Patrick Lencioni, written back in 2008. This book gave me some wonderful insight into the difference in enjoying your job, being engaged and fully vested in the job, and being miserable and wishing you were working somewhere else.

In an office that has an office manager, most of helping the team members enjoy their work, and being productive falls on the office manager. The doctor must set the tone of encouragement and must participate in the process, including supporting the office manager and helping the manager feel important and reinforced and empowered.

There are three areas of practical and emotional support that will affect whether employees are happy, engaged and productive.

Visibility: Do they feel they are invisible—no one knows them or what they do—generic or not special?

Relevance: Do they feel they matter or their job matters … to anyone?

Measurement: Do they have a way to tangibly measure daily progress?

My team of seven employees had 140 years of experience in my office. I was very busy, and my team had reached the point of what I call self-directed. I did not have a designated office manager, but everyone knew their roles, helped each other and were fully engaged in the operation of the office.

Not all doctors are that lucky. Most would be smart to have an office manager instead of taking on that role in addition to the clinical demands.


People react positively to you showing interest and concern for their life and situation. Do you know about your team member’s personal life, their children, their hobbies, their life concerns?

To make contact with your team member, you need to realize the employee wants to be understood. This is a time-consuming job that is difficult for the doctor to accomplish during office hours. This often takes lunches, team meetings, acknowledging birthdays and special events. It is more manageable for an office manager to do this than the doctor.

I sold my practice and worked for a young doctor who was interested in the administration of the practice and acquiring additional practices. I had 40 years of experience and had marketed myself as a superior clinician in certain areas. I had created a niche, but when I became one of 10 doctors in a big group, I felt I had become invisible.

I relate this to employees who are not recognized, who no one tries to know or understand, and they feel invisible to their boss. A good manager will show genuine concern about a team member’s life, or they will disengage, like I did.


Do your employees feel they matter, or does their job matter to the management, the patients or the other team members? Team members need to feel this connection to feel fulfilled. We all need to be reminded almost daily that we are important.

Reflecting how I engaged my team, one thing I remember is that I would thank my chairside assistant and my front desk team almost daily for a good day and a job well done. This was not a contrived display on my part. I sincerely was thankful for the job they did.

If your doctor is not warm and fuzzy, you as an office manager may need to take on that job. Most of us need to be reminded we make a positive impact on someone.

We need to be reminded of who we are helping. Is it the doctor, is it the patients, or is it the team members? A good manager will help the team understand who they are helping. Sometimes it is only the boss who is being helped, but most of the time there will be many people who the member is helping.

We also should understand how we are helping. Is it making it easy to make an appointment, clarifying a statement, helping work with an insurance company, or pitching in with a procedure?

An example from my life is the jobs my twin grandchildren have. One works for Chick-Fil-A and the other for Subway. They both make the same hourly wage, but one loves the job and the other does not.

When I asked what the difference was, one said she loved the people and the way they made her feel important. The other said there was little training, the manager was hateful, and she only tolerated going to work.

Both prepare food, both operate the cash register, both clean the tables, but one was made to feel important and part of a team. Same type job description, totally different management.


To stay on task, an employees need to have a way to gauge their own progress and level of contribution for themselves. If this is ignored, performance will fall off. These should not be things that are big picture things, but rather something that can be measured daily.

I had several goals for different team members. My hygienists were charged with finding one previously-diagnosed procedure to schedule from their eight patients they saw each day. This allowed me to have two procedures put on my schedule each day. I personally tracked production, collections and new patients daily. My scheduler was charged with keeping a full schedule, and my chairside was expected to make the flow in the operatories smooth.

All these things can be tracked daily, and I could give daily feedback to the team.

If you compare dental team members to salespeople, the latter know each day whether they have met their goal. They are motivated by winning. Dental team members can have a similar drive if they have an identifiable goal and they know if they did it each day.

As a manager, whether a doctor or office manager, you can work this system by asking:

  • Do you really know your team members?
  • Do you know who their work impacts and how it impacts whom?
  • Can your team measure their own progress or success?

Then, you can implement your plan by:

  • Having employee assessments to confirm answers to the three questions.
  • Planning to correct inadequacies around the three questions.

A story of how this works in real life is one of my last hires in my own practice. I had hired a young lady, and she had worked for me a couple years. We had a need for an additional employee, so I asked her if she knew anyone who was just like her.

I had learned about her family, her attitudes, and her work ethic. I knew enough about her to know I wanted more employees like her. We hired her best friend, and I attribute this great hire to the fact I knew my employee and had spent the time to know her.


I didn’t realize at the time that I was using these three intangible factors to create a strong, engaged, effective team. Luckily, I had a wonderful group of employees who I really cared for, including how their personal lives were going. It helped me have great job satisfaction and a successful practice.

Little attention is given to these “soft skills,” but I believe they were an important part of my success.

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