TEAM DYNAMICS
Adhering to the Top 6 Principles
for Leading a Team
There are probably as many approaches to getting the right people on our team as there are practices. Most of us come to how we hire, fire, and review our staff through trial and error. Leaders who develop high performance teams, however, all eventually seem to converge towards a similar approach and the same set of key principles and disciplines. Their styles may differ, but the principles are the same.
The Key “People” Principles for Practice
So, what do successful practices do to get the right people on their team and get the wrong people off their team and everyone performing at the highest level? And what “Team Disciplines” do we need to put those principles into practice?
Key “People” Principle #1
Successful practices with great teams hire and retain “good heads” & “good hearts”, not necessarily just “good hands”.
So, who are the people with “Good heads”?
Quick learners who can figure things out for themselves.
We give a lot of autonomy to our employees and expect them to handle all situations with intelligence and professionalism. We hope they can learn quickly and solve situations on their own without constantly having to ask someone else, “what should I do?”
Who are the people with “Good hearts”?
Compassionate people who naturally know how to support and encourage others.
They are the assistants who are not going to upset the patients, parents or other staff in our practice, because somewhere in their upbringing, they learned what it means to treat others with compassion, courtesy and respect.
Who are people with “Good hands”?
The people who have the technical skills needed for their position.
When a practice needs an additional employee, it’s natural to think that we need only the well-trained staff who could step right in and help us treat the patients immediately. However, practices that over-value and hire only trained assistants may discover that these are the same people who later create interpersonal problems with the other staff and patients.
When hiring, it’s great if we can get all three, but it is essential that we get the first two. “Whether someone is the ‘right person’ has more to do with character traits and innate capabilities than with specific knowledge, background, or skills.” We can usually train the staff to perform the skills needed to do well, but we can’t train people to have “good heads” or “good hearts”.
Key “People” Principle #2
Successful practices with great teams don’t hire people and then figure out how to motivate them; they choose self-motivated people who share their core values and assist them to become even better.
Successful practices understand that we don’t motivate anyone. We can lead, we can inspire, but we can’t motivate. Motivation comes from within - a personal trait that someone brings to the practice that we can channel towards quality care and outstanding customer service.
Nothing can be more exasperating than trying to motivate an unmotivated person or to get a reluctant employee to embrace the practice’s values of clinical excellence and outstanding service. We need staff who, by their very nature, are self-motivated, share our core values and strive for excellence in all that they do. Then, we can focus on inspiring and leading our team to continually improve, rather than trying to convert the staff to our way of thinking.
So, with these two principles as guidance, what discipline must we exercise when we’re hiring?
The Hiring Discipline
When in doubt, don’t hire (keep looking).
Leaders who build great practices understand that the primary ingredient to having an exceptional practice is the ability to get and keep the right people. So, for a practice striving for excellence, hire for excellence and only hire if the applicant has what it takes.
The more cohesive the team, the more rigorous we need to be in the hiring process. We don’t want to ruin what we already have. The discipline is “when in doubt, don’t hire” - keep looking until you find someone who is self-motivated, shares your core values and is willing to become part of a dynamic team.
But what if we find that we have the wrong person on our team? After giving the employee ample opportunity to improve, then what must we do?
Key “People” Principle #3
Successful practices with great teams are willing to dismiss any person who interferes with their ability to become an exceptional practice.
There are some people who shouldn’t be working in a professional office. They’re simply the wrong fit for what wish to accomplish. Often, they are either not “good heads” or “good hearts”, or they are not internally motivated to always do their best.
We can spend an inordinate amount of time teaching proper interpersonal and professional behavior to someone who just doesn’t understand. Staff members must know how to treat others before they enter our practice, because they rarely learn it after; and certainly, we’re not the ones to teach it to them. If we are reluctant to accept this fact, we can spend months or years wasting our time and energy on the wrong people.
So, what discipline must we exercise when we are considering firing someone?
The Firing Discipline
When you know you need to make a staff change, ACT!
The moment we feel the need to tightly manage someone, we’ve made a hiring mistake. “The best people don’t need to be managed. They need to be guided, taught, and led, yes, but tightly managed, no!”
Too often, we spend a great deal of time tightly managing a staff member who is under performing or has behavioral issues. Perhaps we think that we would have difficulty finding a replacement or we dread the thought of training some new. But if numerous discussions with this person are unsuccessful in improving performance or behavior, then we must act.
To the patients, the staff and doctor are the practice. If we don’t follow through and dismiss a poorly performing staff member, the reputation of the practice will suffer.
The Key “Performance” Principles for Practice
Now that we discovered the top principles to have the right people on our team, what do successful practices do to lead that Team to high levels of performance?
Key “Performance” Principle #1:
Successful practices with great teams have regular coaching sessions that provide an opportunity for everyone to continuously improve their attitude, behavior, job performance and value to the practice.
To have a Championship Team, we must be willing to encourage the good performance and confront the poor performance of our staff. The foundation of this ongoing process of coaching staff is an effective performance review process. Regularly scheduled coaching sessions are an absolute necessity if we expect to build the team we want. Staff performance reviews lay the groundwork for what we expect; it’s an opportunity to be clear about what good performance looks like.
What do we want to achieve with the regularly scheduled performance review process? We want:
- Continuous improvements in technical skills and job performance (front desk, chairside, financial),
- A positive lasting change in interpersonal behavior,
- An opportunity to coach the staff leaders of our practice, and
- A process to identify anyone who may be wrong for our practice.
Therefore, an effective staff review should include an evaluation of their job performance as well as a peer assessment of their performance as a member of the team.
Occasionally after several reviews, an employee does not improve - specifically, they may have not learned to perform well in their position, or they may have persistent problems with their behavior. What should we do then? How much progress do we have a right to expect?
Key “Performance” Principle #2:
Successful practices with great teams expect "measurable progress in a reasonable time" from anyone who has been presented with a realistic behavioral or performance objective.
During the performance review conference, several personal development goals should be proposed for each staff member. These performance and/or behavioral objectives are expected to be achieved by the next progress review. When agreement is reached on these realistic goals, we have a right to expect measurable progress in a reasonable time.
If the staff member fails to make measurable progress after 6-12 months, we’ve given the person every opportunity to change. Therefore, we now can be rigorous and “dismiss any person who interferes with our ability to become an exceptional practice.” (People Principle #3)
But enforcing high standards performance and behavior cannot always be reserved for a formal performance review. As an effective leader, we must be willing to address any issues of cooperation, communication, commitment, accountability and inattention to results each and every day. These problems cannot be ignored or tolerated. Sometimes, that may take the form of a gentle reminder of “how we treat each other here” or a more direct discussion with team member.
Therefore:
Key “Performance” Principle #3
Successful practices with great teams consistently confront anyone who is not meeting the standard of performance needed to remain a member of an exceptional team.
One of the essential skills of a leader is the ability to hold team members accountable in a face to face discussion – it’s the ability to “confront” the issue when someone is behaving in a way that is contrary to the standards we have set. We are the ones who benefit or suffer from the performance of our staff. And, our team’s level of performance and behavior is directly proportional to our willingness to hold staff accountable.
In this context, to “confront” doesn’t mean to be “confrontational”. We are using the term to describe a “face to face discussion” which deals with something unpleasant head on, as in "We must confront this issue."
The book, Crucial Accountability, presents an effective way to have a face-to-face accountability discussion that is candid, open, honest and respectful in which problems are resolved and the relationship benefits. At the heart of most team problems lies the inability to hold “crucial confrontations”. If you ignore them or handle them poorly, the costs can be high. (emotional, mental, financial).
Sometimes the problem with performance is not about having the wrong person. It’s more about matching the right person to the right position - that is, finding the job in our practice that allows that person to use their strengths for the good of the practice. So, before we decide that an otherwise good employee needs to be dismissed for poor performance, what should we do?
The Performance Discipline
Match your team members to the roles in which they can do their best work.
The best front desk person doesn’t always make the best financial coordinator. The best clinical assistant doesn’t always make the best clinical coordinator. And conversely, sometimes a mediocre clinical assistant makes a wonderful treatment coordinator, or a mediocre front desk person can make a great insurance coordinator. Our goal is to make certain that the right person with the right personality and strengths is in the right position.
We should strive to identify staff strengths (through personality testing and performance reviews) and put them into the positions in which they can shine. Often, if a person has a good “head” and “heart,” we can find a place for them. But be careful. Some people have “good hearts” but lack the mental acuity to work in an professional office. Others are very bright, but don’t know how to relate well to others. For the type of practice, we want, we need both good “heads” and good “hearts” and a great training program to prepare them for the task at hand.