TEAM BUILDING - The Obstacle to Exceptional Teamwork

WE are the biggest obstacle to exceptional teamwork!

We blame our staff for not getting along with each other, not treating patients well, and making too many mistakes.  We believe that “If only my staff would improve, my practice would improve!”

But when we do, things rarely get better.

I felt the same way until it finally dawned on me. They were MY team!  I hired them, I trained them, and I kept them around.  Therefore, I must accept responsibility for not doing my part to make things better. And if I don’t change, nothing will change!

If I could figure out how to transform them into a more productive and harmonious team, then the day would go smoother, productivity would improve, and more patients would leave raving about the practice.

But if I couldn’t, then the practice would never reach its full potential. And I’d continue to be frustrated by staff bickering, periods of disappointing production, and a patient experience that may be good, but definitely not great.

Any great team needs three things:

a great coach, great players and a great game plan.

And for me to have an exceptional team, I had to take steps to develop all three.  Here’s the path I took.

STEP #1 – Personal Leadership

A great team needs a great coach

Leadership is the art of getting people to want to do, what must be done

– Jim Collins

To become a better “Coach”:

a. I had to become a student of Leadership.

I started by reading leadership books, watching videos, listening to podcasts, taking online courses, and getting coaching myself. I saturated my mind with the perspective of a leader so that, when issues arose, I’d have a wealth of knowledge to draw from to respond appropriately.

Fortunately, many men and women have spent their entire lives studying Leadership & Teams.  There are so many books on these subjects that it’s impossible to read even a small number of them.

But, running a busy practice, I didn’t have the time!

Instead, I bought a subscription to getAbstract, which has 5-page summaries of more than 20,000 business books.  I began reading summaries on leadership, team development and a number of related topics. From each, I gleaned the best insights from these authors in only 5-10 minutes, either by reading the pdf or listening to the audio summary.  If I found a particularly great book, I’d read it in its entirety.

Two such books were:

• Crucial Accountability: Tools for Resolving Violated Expectations, Broken Commitments, and Bad Behavior, Second Edition by Kerry Paterson, et al.

This book is indispensable when dealing with the staff issues. It has a great model of how you approach difficult staff discussions and should be read by everyone in clinical practice.

• The Advantage by Patrick Lencioni

Which is a condensation of his many books on teams and team development. He’s the author of The Five Dysfunctions of a Team, The Ideal Team Player, and several other books on leadership and teams.

I also spent time listening to audios and watching YouTube videos by authors like Jim Collins, Sheryl Sandberg, Simon Sinek,  Lolly Daskal, and John Maxwell.  They became the voices in my head. Hearing them talk about leadership guided me in moments when I had to make a quick decision about how to handle a staff issue or promote team development.

b. We built a Cohesive Leadership Team

No one can do this alone.  We can’t be successful unless the doctors and office manager form a cohesive leadership team, aligned around a common set of principles & standards.

In our case, the other doctor & I committed to each other and to our determination to build a harmonious & productive staff team. We both wanted to enjoy our time in the office, free from petty squabbles and inefficient systems.

Fortunately, we had a Practice Administrator who shared the same values and was “on the same page”. Together, the three of us formed the “Leadership Team” who met regularly to plan the practice’s progress and provide a unified front to the staff on acceptable behavior & performance.

With high standards, our message was simple. This is where this practice is going, this is what we must do, and this is how we must behave in order to get there.

c. We constantly communicated and reinforced our message to the staff.

Saying it once is not enough. For a message to be received, it has to be repeated. How many times?  Well, one author suggests that a leader should repeat it until your team can do an impersonation of you!

Also, the Leadership Team’s personal behavior had to become the model of our behavioral standard. Otherwise, we wouldn’t have the “moral authority” to insist on that higher standard with our staff.  So, if we expect that they are not late from lunch, we can’t stroll in late either. If we expect them to not to use their cell phones for personal calls during the day, we shouldn’t either.

STEP #2 - People Development

A great team needs great players

“Leaders who can identify, hire, and cultivate employees who are humble, hungry, and smart will have a serious advantage over those who cannot.”
― Patrick Lencioni

We can’t micromanage every interaction that our staff has with each other and the patients.  We can’t achieve a “remarkable” patient experience without having exceptional team players knowing how to handle each situation with excellence.

a. We had regularly scheduled coaching sessions.

Just as a basketball team has to use every game to get better, we had to set aside time to coach them.  To that end, we became more consistent with our Periodic Performance Reviews to help them develop their skills and behavior.

We held these reviews three times a year during which each employee was given three goals to achieve by next time.  The reviews provided an opportunity for everyone to improve their attitude, behavior, and job performance.

With these coaching sessions, we were able to make rapid progress. With each employee achieving three goals every four months, our team of 15 could make 135 specific improvements to their behavior and performance each year.

b. We developed staff leaders

During these coaching sessions, we were also able to identify staff leaders who could reinforce our message even when the Leadership Team wasn’t around. They could act as leaders “on the court”, someone who could encourage and guide their teammates to make any necessary adjustments during the “game”.

They also could relieve the burden of running the practice.  Tasks that the doctors were performing could now be reliably delegated to a staff leader.

c. We learned how to hire well and train well

As we grew, we needed to add new members to our team. The best applicants only want to join a great team. So, the better we became as a team, the easier it became to hire the best people.

We developed a selective hiring process that could screen and select the best applicants. The staff was deeply involved in the interview process and helped guide the final decision. Since they had a voice in the selection, they were fully committed to welcoming and training the new employee to be a productive member of the team.

Through the Periodic Review Process, we were also able to identify those with behavioral or performance issues. We became more rigorous in dismissing employees who weren’t willing to meet the new standards. Unless we were willing to get these people off the team, we would never have the outstanding team we wanted.

Step #3 – Practice Operations

A great team needs a great game plan

Systems permit ordinary people to achieve extraordinary results.

- Michael Gerber

A team must know “the plays” to work together as a unit.  They need well designed systems and procedures to streamline practice operations and virtually eliminate mistakes.  Well thought out processes guide the staff to execute their responsibilities efficiently, effectively and error-free.

a. We held frequent meetings to plan and implement more effective office procedures.

For us, system design and training became a priority.  We held frequent meetings to plan and implement improvements in all areas of practice operations, developing written protocols for all the essential administrative and clinical procedures.

As we met, we were able to identify reoccurring problems and brainstorm the best solution for each.  The staff learned to the see the practice as an integrated whole, with each member dependent the others to do their best work.

Over time, we systematized the entire practice! The doctors and staff decided on the best way to handle all the critical processes, such as incorporating New Patients, filing insurance, adjusting archwires, monitoring hygiene, etc. The protocols became the “game plan” for “how we do things here”.

b. We then trained and cross trained the staff

The written protocols became the training manual for all current and new staff.  Now everyone was literally “on the same page”. The protocols could also be tweaked and updated as needed.  Or when things did go wrong, the staff could go back, see what step in the process was missed and do better next time.

With protocols in hand, cross training became much easier.  We proceeded to cross train a backup person for every critical position. That way if someone was out, another could step in and the practice would run smoothly.

For example, if the Treatment Coordinator was sick, the backup TC could move from her position chairside to serve as the TC and the lab person could step in as a chairside assistant.  Similarly, if the financial coordinator was out, another cross trained administrative or clinical person could fill the role, and someone else might handle the backup person’s duties & tasks.

c. Finally, we committed to continuous improvement

All of this didn’t happen overnight. It took two years to get the fundamentals in place and the team on the path to excellence.  There were many setbacks which required persistence and patience.  But eventually, a culture developed - we became a practice that was constantly improving.  And we now had teammates who supported each other and took pride in their work.

We realized that we were not competing with other practices; we were competing with ourselves.  We're only “competing” with who we were yesterday!

So, we didn't have to worry about any other practice because no one else was going to be willing to devote the time, energy and thought to constantly move forward as we were. As a result, our single greatest Competitive Advantage became an exceptional team executing effective systems.   

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Competition is tough. Hard work and good intentions will only get us so far. A beautiful office, the latest technology, and a “friendly” staff have become the “price of admission”, a minimum standard that every patient expects.

To grow and thrive in today’s environment, we need great people, well-trained in great systems to deliver an outstanding patient experience.

An outstanding patient experience, which was once a luxury, is now a necessity. It generates “raving fans” and 5-star reviews. But we can’t consistently deliver that experience without an exceptional team lead by an outstanding coach with a great game plan. And WE must be the one to initiate that process.

So, exceptional teamwork starts with us, not them! We are its biggest obstacle!

But if we’re willing to take full responsibility for our team, the rewards are enormous. The day goes smoother, productivity increases, and we enjoy our time in the office so much more because we're surrounded by such an exceptional team.