Managing People as a Dental CEO: Leadership Masterclass with Scott Leune
This episode of the Shared Practices Podcast features a discussion between Dr. Scott Leune and Richard Low. The central topic focuses on the concept of being a dental CEO, specifically the management of operations, expenses, and people within a dental practice
Key highlights include:
- Three Pillars of a Dental CEO: Dr. Scott Leune teaches us that the dental CEO manages operations (scheduling, diagnosis), expenses (financial control), and people (staff performance and satisfaction).
- People Management: Scott emphasizes that effective people management depends on regular audits, clear metrics, and fostering accountability through well-designed systems.
- Checklists: The discussion focuses on simplified checklists as tools to enhance consistency, accountability, and employee training within the practice.
- Meeting Cadence: Scott underscores the importance of structured daily, weekly, monthly, and quarterly meetings to ensure clear communication and alignment on goals.
- Change Management: Dr. Leune advises addressing staff resistance to change by starting with temporary trials, conducting follow-ups, and reinforcing decisions through decisive leadership.
- Dental CEO Skills: Scott believes leadership is a learnable skill, built on structured tasks, a dedication to continuous improvement, and the use of effective systems.
Here is the full transcript of the video
Richard Low:
Welcome to the Shared Practices Podcast. We are back for potentially the final episode, we’ll see how this goes, around the conversation of being a dental CEO in single office, larger office, or even on a larger scale than that. What does it mean to think like a CEO and apply that to a dental office? Scott, welcome back. I’ll let you just recap real quick this framework of these three pillars, before we get into this last pillar today.
Scott Leune:
Yeah, if you haven’t heard the previous few episodes, you need to stop this episode and go listen to those, because we dove in pretty cool detail on some of those. But there’s three main pillars that a dental CEO has to manage and keep healthy. The first pillar is called operations. That’s the day-to-day activities that people do to create collections. So that is scheduling, that’s case acceptance, it’s diagnosis. The second pillar is managing expenses. That is how we spend money, primarily. So we manage the first pillar, operations, to create the collections, and we manage second pillar, expenses, to make sure we don’t go spend it all away. And then, the third pillar, which I think we’re going to dive into today, is managing people. So we manage operations and we manage expenses and we manage people. And kind of the habits we have day-to-day as a CEO become the glue to keep those three pillars strong and intact. But I think we’re talking about people today, is that correct?
Understanding the CEO Mindset
Richard Low:
Correct. Yeah. And as we record these topics and episodes, it leads itself to, oh wow, there’s a whole lot more we could talk about, but I think talking about managing people within this framework of being a CEO versus being a manager, I guess, that’s the first place my brain goes is, is there a difference in thinking about managing people as a CEO versus thinking about managing people as a manager, as an office manager? And sometimes, the dentist has to fulfill both roles. Maybe the office doesn’t have an office manager and they have to be the CEO and the manager on a day-to-day basis.
Scott Leune:
Well, I think that what we want is we want people accomplishing what they’re supposed to accomplish every day, and we want them to be happy about it, to the point it’s fun to work there and we retain everyone. But the reality is, if we were to be ruthless and say, well, if we could only pick one of those, which one would it be, performing at the level we need, being happily, and retaining? Obviously, I think performing is the most important. Even if we had people that were unhappy and even if people quit, if everyone’s still performed, we’d accomplish our clinical and financial goals. Now, obviously, I don’t want to have unhappy people that quit, but let’s make sure that we say the priority here of managing people is that we have an outcome that is positive, an outcome that looks like success, a clinical outcome, and a financial outcome that says, “Hey, we are doing really good.”
And that has a lot to do with managing. So when I think of managing, I think of providing an environment for the day-to-day operations, where there’s accountability, there’s organization, there’s also praise and validation, but it’s like, can we manage what people are doing and hold them accountable, so we achieve the final result we want? And then, outside of that, we have the winds of change that happen in the practice, the winds of drama, the winds of people moving away and having to replace someone, the winds of changing systems and managing the pains of change. And that has a lot to do with, okay, me, as a leader, can I lead people through these strong winds that blow us left and right and still ensure that the management side is healthy, our final results are good every day? Am I making sense?
Richard Low:
Yeah, absolutely. That first point of, at the end the day, this is a business, and in order to operate, we have to collect and deliver what we’ve agreed to deliver to our patients, that framework is important to revisit for the people-pleaser dentists in there. I think some dentists fall naturally into, “I have no problem having difficult conversations. I have no problem holding people accountable. This is my business, this is my livelihood, and a lot’s on the line.” There are other dentists who feel like, “I really want a good culture, and that’s a huge priority. I don’t want to rock the boat. I want friends. I want everyone to be happy.” The longer I’ve led, I’ve realized that, sometimes, leaning that direction too much and prioritizing friendships or culture over performance can lead to difficulty making the decisions that need to be made.
There’s people on both ends of the spectrum, people who are not focusing on the culture, on people being happy, on retention at all and are therefore burning people out and losing people. And there are people who are overemphasizing those kind of softer people-pleasing aspects and missing out on the level of accountability and realism they need to have as business owners. So hopefully, we can sync, but we have to choose those priorities. So let’s talk about performance. How do we ensure that we’re delivering and that we’re managing the people who are producing the dentistry that are part of our team? How do we start?
The Role of Metrics in Accountability
Scott Leune:
Well, we have to, as much as possible, measure performance, because that is the least amount of work for the CEO to do. So in a really, I guess, simple example is it’s much easier for me to look at some number that says what percent of the time do hygienists reappoint patients for their future visit. They’re supposed to reappoint everyone. So if I can just look at that number, that’s a lot quicker than me, by hand, listing or looking or auditing or tracking, are they doing it or not? Numbers are meant to give us a quick snapshot, so that we can make a judgment with very, very little work.
Discover Practice Management Mastery Seminar
But of course, the number alone, without the action after that, becomes not so valuable to us. One aspect of making sure that we’re understanding, are we healthy or not, is identifying the numbers that we need to look at.
And these numbers are typically looked at once a month. There’s some things we might dive into once a week, but usually, what you’re just doing is you’re having a monthly report card of how the practice is doing. And you’re looking at, “Okay, are we reappointing patients? Are we scheduling patients on the phone? Are we answering the phone? What percent of our dollars that we’ve diagnosed are actually being accepted and scheduled? What percent of our exams result in the diagnosis? What are we producing per day on average in hygiene? What are we doing at per day on average on the doctor’s side?” There’s these kind of bank of numbers that we can look at, and I’m going to look at them as a CEO to tell me very quick, what’s healthy, what’s not, what’s getting better, what’s getting worse.
And everything that’s healthy or that’s getting better, I’m just going to ignore, I’m not going to go change right now. I’m going to focus on the few that are a little bit sick, and that’s when I then try to fix or implement something new. So this initial process is really evaluating the operations. That’s kind of one layer of managing people. “Can I evaluate our performance?” And that performance could be as an office, but you can always drill down to the person. So that is a kind of bigger picture like how are we doing that has to be done as a CEO in managing people, but we also have the deeper picture that says, “Well, how is this person doing?” And that is not just looking at a number, but that is primarily driven by auditing. Now, you had mentioned you were surprised I talked about auditing. So auditing is kind of one of those incredibly important things that, for whatever reason, hardly anyone is doing in dentistry.
Auditing as a Tool for Accountability
Auditing is quality control. Auditing is making sure that things are done right. Auditing is a mandatory ingredient in having a culture of accountability. I am going to audit things as CEO. I’m going to listen to some phone calls, not that many, but I’m going to listen to some phone calls. I’m going to walk through the practice, not all the time, but I’m going to walk through the practice to make sure the light bulbs are working and my hygienists are saying the right thing and my treatment coordinator is saying the right thing and the restroom is clean and beverage bar is stocked. I’m going to audit charts, not all the time, not a lot of charts, but I’m going to audit charts to make sure we have consent forms signed and HIPAA forms signed, and we’ve collected the money and there’s no funky write-offs happening. Those audits take minutes, not hours, not days.
They take minutes. But the spending the minutes on the audit might be the most valuable minutes of my day as a CEO, because when I find something wrong, I get to reinforce the fact that we have a culture of accountability. When I find something off, like we forgot to get a consent form signed, it’s my opportunity to positively go to the assistant to forgot and say, “Hey, I found that we forgot to, in my audits I do every day, I found that we forgot to get this consent form signed. Please contact her and get the patient to sign the consent form right now.” That is a reminder to that assistant that there is accountability, to ensure that that assistant performs at their highest level, that they don’t forget things like that. So auditing is an incredibly important part of people management. And stop me whenever you want here, because I can go on for hours on this.
Richard Low:
And actually, I will. So I think Tuan fliegenfischen, I always forget how to say his last name correctly, but he once talked about this sense that humans, in general, default to preserving energy. One of the things that we do as a species is, what is the least amount of work that I can go from point A to point B without causing problems or risk? And that we shouldn’t resent people for that natural tendency. There are some people that are kind of like natural self auditors, but the majority of people are almost built to say, “Okay, how can I get here without expending a lot of energy?” And that is efficient, because then, we have more time, energy, effort to spend elsewhere or to have available. So what that means is, if you’re not auditing, people will begin to let things slip, because it’s more work, it’s more energy to expend, to do these extra things, to do it right, to check ourselves, to audit ourselves.
But when we’ve set the expectation and the standard that we will be looking at these things, it changes expectations, it changes behavior, because people know, “I’m going to get checked, my work is going to get checked. And we are the same way. I think a lot of our resentment and frustration, there are contexts in our life that we do this. It might not be at the dental practice, it might be in other areas, but we tend to find shortcuts and take shortcuts. I like the reframe of, sometimes, the natural resentment that can get built into or resistance around checking on people’s work and really just this is part of human nature and this is part of the deal. We need it ourselves. That’s why we need coaches. That’s why we need metrics, sometimes, there’s mental baggage around this for dentists.
Scott Leune:
Well, I kind of love the analogy of a personal trainer. We,, as a CEO are like a personal trainer. We have to build an environment around our client, our employee, that they become the best version of themselves. Naturally, someone that hires a personal trainer, naturally, they don’t want to do 50 lunges. They naturally don’t want to lift as much as they possibly could. They are naturally going to do less. And the reason why they hired a trainer is so that they could get the support and the accountability to elevate them to a higher level. So they can get fit. And that trainer is going to measure them, they’re going to track them, they’re going to audit their form, they’re going to make sure they’re showing up and doing everything they’re supposed to do, and they’re going to do so in a positive way. But that’s definitely measuring, tracking them, and auditing them, right?
And so, we are, in a positive way, going to measure, track, and audit our people, so that they perform more than just the minimum that human nature sets them up for. And even if we don’t like the thought of auditing or having accountability, the minute we signed up as a CEO, we threw that out the window. We have to develop the skill to lead people this way. That’s the requirement of us being a leader of a CEO is to bring a culture of accountability, and auditing is the laziest way I know how to do it. It’s the least amount of time, the least amount of conflict, it’s the least amount of work, but we have to do it.
Power of Checklists
Now, how can we make sure though that our people know what to do every day, so that, when we check them, they didn’t forget things? And that is where this whole concept of just simple intelligent checklists come into place.
If we’re going to go audit things, that means we know it’s supposed to be done this way. From A to Z, these are the steps of doing it. Well, those steps from A to Z need to be on an intelligent simplified checklist, so that the team members that are doing it are going to audit themselves before they let the patient go. They’re going to make sure they did reappoint the patient, they did take that post-op x-ray that we need, they did get the consent form signed, so that they’ll pass the audit with flying colors. And that checklist forms not just the foundation of reminding them what to do every day by kind of giving them a self-audit, but it also forms a foundation of training the next employee.
They bring someone in, and having it written out like that makes training way more effective and take a lot less time than kind of not having that. So the ingredients we’re saying here is that we start with checklists, and then, that checklist enables training to happen, that checklist enables a self audit to happen. We, as CEOs, go spot audit, and we also track the numbers that tell us if we’re performing. And that tracking and that auditing takes minutes a day. It does not take hours. It is very little time.
Richard Low:
The first thing that comes to mind here with the checklist, we’ve talked about this before, people have heard this before, there’s books written about this, and I think, a lot of times, this doesn’t happen or this happens in a digital format. So I have opinions around this that I’d love pushback or your thoughts on it. I really think checklists need to be a physical thing, whether that’s a paper or at least that’s my preference, is that, when checklists are physical, whether it’s a laminated form, whether it’s a spreadsheet that’s printed off, or a day sheet that’s printed off, with signatures or accountability in that way, the nice part is that it is visible, not only by that person and that act of checking this off or signing this off, but also, when the dentist or the manager comes around, it’s very apparent and a discussion can be had about this physical object. So I wanted to get your opinion on the physicality of checklists and if that’s important to you or if you think a digital checklist works just as well as a physical one.
Scott Leune:
My favorite checklist is a physical sheet of paper, one sheet of paper has an entire month’s worth of tasks on it for a particular employee. Only in offices that have a checklist culture, they’re kind of advanced, they heavily rely on it would digitizing it maybe makes sense, but the problem with digitizing it is it takes more steps. You have to log in, you have to scroll, you have to find, you have to check. It takes longer. A physical form is the fastest. It’s also a physical reminder it needs to get done. It’s sitting on your counter. You see it there. Because it’s so fast and convenient, it gets used. That would be my preference. Now, there are programs out there, for example, Asana is one of them, where you can create checklists, and you might think, “Okay, well, if it’s all digital, I, the CEO, can log in and see what everyone’s done and not done.”
The problem is it’s not accurate. They have or have not done, because they have or haven’t logged in, not that they have or haven’t done. And I don’t even need to micromanage them doing the checklist. The checklist is for them to remember to get stuff done. I’m going to grade them on the audit. I don’t need to micromanage the checklist. I might as well do all the work, if I’m going to check every box that they’re checking off. I might as well do it. So I’m just going to take a sample in an audit to tell me if it’s being done or not. Of course, if I also have eyes and ears and as I’m doing my office walkthrough audits, I can see if people are using checklists or not. I can see if my assistant’s doing it or not. I can always have a moment where I might reinforce something, if I notice something, but I don’t need to track it digitally. I just need to perform a simple audit.
Richard Low:
I appreciate that, because the specificity of one team member, a month’s worth of tasks, a physical checklist, there’s a lot of decision-making around this, and that’s a very concrete goal of, “Okay, can we have, for every team member, one month’s worth of checklists on one single page?”
Scott Leune:
Yeah, it’s something I teach… I’ve got this super intense seminar, the Practice Management Mastery course. It’s probably, of everything I’ve done in my career, it’s probably the highest quality thing, the most impactful thing I’ve ever done. And in that seminar, there’s like 400 pages of stuff I talk about, but I dedicate a significant chunk of time to teaching how to build these checklists, to have these audits, to have accountability. Because what I know is that the vast majority of pain points dentists feel, that really kind of burn them out, have a lot to do with a lack of accountability, has a lot to do with a lack of organization, a lack of consistent performance.
When we can fix consistency and organization with accountability, then suddenly, a whole lot of pain points go away. And I think that dentists are searching, many times, for the easy, magical silver bullet that says, “Oh, here’s how to get rid of collection problems. Here’s how to get rid of staff drama.” That magical silver bullet isn’t in the shape of a bullet. It’s in the shape of checklists and audits. And it’s hard to see it in the beginning. And so, it’s a very important thing I focus on, on top of a lot of other things, in my big kind of big training seminar.
Richard Low:
This is something as well in our analytics-based practice management course that we’ve run in the past that, absolutely, we also have checklists. Our coaches work with offices to build checklists and roles. It’s a process to do it right. You mentioned in the walkthrough you mentioned a few different things that I think can begin to form the basis of dentists’ own checklist or the CEO’s own checklist. So there was listening to phone calls, there was walking through and the physical appearance, as well as what is being said in the office. There was a chart audit.
It would seem like, if one of these is missing or is wrong, as we walk through, then that would be an opportunity to revisit their checklist and talk about the issue that was missed or check, did they say that they did this thing, even though the bathroom’s dirty or even though this thing that was their responsibility didn’t get done? Other than those five, are there any other key areas to think about in that daily audit of the office and of the things that we need to look at, whether that’s financial, money going in and out, or metrics? What would be any other components to the dentist’s daily audit of the practice?
Scott Leune:
Yeah, what you’re talking about now is kind of a, I would say, it’s a different topic. So we’re in the topic of team management, and there’s certain things we look at and we track and audit to help manage the team to help get accountability to the team. But as a CEO, we ourselves need to get the job of a CEO whittled down to steps, to a checklist, to, “Here’s what I do every day, every week, every month to be a CEO.” And on that list, which could probably be a whole nother episode, but on that list, we would have these audits that we’ve talked about, but we might have also other audits like, “I’m going to audit the day sheets. I’m going to audit the write-offs and the adjustments every day. I’m going to balance the deposits to make sure that no funny business is happening there. I’m going to look at my marketing results every month, make strategic decisions about that.”
There’s other things we’re looking at that don’t necessarily directly impact managing of an employee, and that is a whole nother kind of angle. As a CEO, can I put my entire job onto a checklist? Absolutely we can, but in that, we have managing operations, we have managing financial, we have managing people. Our checklist is the glue of that stuff. Well, managing people, we’ve talked about, well, here’s how we measure certain things with people. Here’s the fact we need to audit people and we need to give them checklists, but we also need to talk about, well, how do we manage them from a communication standpoint? What about from an office policy standpoint, culturally? There’s other aspects of managing people. What if we’re going to change something? How do we manage the pain of change to get people to not push back against it? Right? That’s probably something we need to focus on, maybe right now, if we have time, that is separate from what does it mean to be a CEO, globally speaking?
Richard Low:
Well, and I think that where this came from was I think about self-management, managing of this person, of me as the CEO, as one of my challenges in particular, as I want to help myself manage other people. So my brain goes there quite often. I’ve jumped to that multiple times within this series, as that’s something I’m anxious to visit, but I think it deserves its own possible episode. I’m not going to add a pillar to your pillars, but managing the CEO could be its own little adjunctive cap to this whole thing. I also, to lead back into this conversation that you’re talking about, I think that, a lot of times, when people think about auditing and managing people, they think about monthly or quarterly reviews, but they’re not doing the daily things.
The checklists aren’t clearly in place. There isn’t appropriate expectations, and so, a lot more pressure gets put on a monthly check-in or a quarterly check-in and evaluation. It seems like, if you’re doing a lot of little audits along the way, there’s a much better sense, there’s much more concrete data of the performance of a team member, that leads into kind of a natural check-in conversation on a monthly or quarterly basis with a team member.
Scott Leune:
I don’t want to judge someone’s performance on a quarterly, semi-annual, or annual basis, when I didn’t help them along the way. So that’s like judging them at their worst. I want to turn them into their best, and then, I don’t need to judge them that often. And turning them into their best is building this environment of accountability around them to where they become the best version of themselves. They might be an insanely good scheduler for me in this environment. They might suck for someone else that doesn’t have the environment, because this is a person that’s normal, that they thrive if they’ve got an environment of accountability, of boundaries and support and training and auditing and frequent communication. They turn into the best version of themselves. I think doing reviews twice a year is important, and those reviews are going to be mostly validating how good they’re doing for you. And it’s going to be listening for feedback.
It’s going to be a very positive moment, because all the negative moments got corrected before then. Every now and then, of course, you could have a negative review of something, especially if something recently happened, but usually, those are very positive moments of validation. So daily kind of auditing and weekly auditing kind of keeps everyone inside the boundaries of health. Imagine you’re trying to eat right on a meal plan. Every time you ate wrong, someone said, “Oh, let’s throw that away and let’s put this in your hand instead.” You would eat right all the time, right? It’s these little moments, these little things of, “Let’s just stick in the boundary.” What we don’t want is fall off and fall into the deep end here, like we’re just doing the wrong thing for a long, long, long, long time and no accountability. That is how most dentists start getting burned out by managing their business and trying to get through the day.
So these frequent audits is the laziest way I know to have a super healthy practice, but you know what? We have to have good communication. I might put it this way, a very strict disciplined cadence of meetings. This is pre-scheduled communication, so that everyone knows it’s coming, it’s they’re available, everyone expects it. Sometimes we don’t need the meetings, but because we have the disciplined cadence, every time we did need the meeting, it actually happened. And so, meetings are usually a waste of time for many people in the meeting, but incredibly important for some. And it’s always important for the owner, because it is the best use of your time to be able to get messages out and influence and listen and impact in a short amount of time to everyone, is a really good use of your time. The dental assistant might be bored three meetings in a row, because nothing we talk about impacts her and she’s good and she’s got no problems.
But that fourth meeting, she needed that one. And only because we had them once a week did she get the fourth one, right? We have to have this strict cadence. By the way, a meeting should have a strict outline. A morning huddle should be an outline. A weekly meeting, a touch base meeting should be an outline. A monthly general office meeting should be a specific outline. A quarterly strategic planning meeting should be a specific outline. It’s always going through the outline, because the outline holds us as a practice accountable to staying on task, to getting done, from a communication standpoint, the things we need to get done in that meeting.
Structured Communication and Meeting Cadences
Richard Low:
I don’t think I’ve ever met a team member who communicated, “You know what? There’s too much communication in this office.” In fact, a very consistent piece of feedback at every level of every organization I’ve ever been in is the communication needs improving, that people are getting mixed messages, or someone is finding out about an important thing, but other people aren’t finding out about that in a timely manner or that whatever the case may be, communication is not standardized and is not frequent enough and is not effective enough. We’re not in an email environment in a dental office. We’re not in a text environment in a dental office. We’re not in a remote work situation. We’re in the same building operating together. And so, it seems that the most efficient way to do that is a cadence of meetings, that is set up and structured and regular and non-negotiable. Yes, it might dig into a little bit of time that might’ve been used to produce dentistry instead. Talk to me about daily, weekly time that would be dedicated to this cadence of meetings.
Scott Leune:
Absolutely have to have a morning huddle. That has some very specific purposes. We could maybe go in, at some point, some other meeting time or some other podcast maybe. But morning huddle is insanely important. That’s going to happen before you see your first patient. It’s going to take no more than 10 minutes. Got to have a morning huddle. You’ve also got to have typically some sort of check-in with the office manager and the front office on a daily basis, so kind of like a front office huddle. Because there’s a lot of complicated things that happen in the front office and a lot of problems to solve every day. So you want to have everyone aligned on what to do and what to expect. There’s also going to be a weekly meeting, that could happen in the practice, that would be short, like a half an hour touch-base.
That meeting is going to kind of be one of the ingredients to get our quarterly strategic plan done. So maybe let me start with a quarter. We’re going to have a quarterly strategic planning meeting, a big freaking meeting, and that is where we’re going to list everything that’s not working and we’re going to prioritize what we’re going to change for the next three months. Those changes for the next three months become our monthly implementation project, and we’re going to have a big monthly meeting to make sure we’re going to get that implementation project done. And we’re going to have weekly touch-bases, small little meetings, to give us progress on that project, to deal with all the pushback or all the confusion in getting those new things implemented. The morning huddle is going to also serve as a daily reminder of the monthly implementation project. So you can see that every meeting I’ve listed so far touches on the quarterly strategic plan.
Every meeting, we’ll talk about the big plan that we’re trying to get done this quarter. In addition to that, all those meetings will have their own individual categories of things to talk about as well. A daily huddle is going to talk about the fact that, “We’ve got a patient double booked here, we’ve got an opening there. We need same day dentistry, and these three people owe us money, and let’s make sure we collect from them today. And oh, by the way, we’re under our goal for the week, so we need to activate new tasks to get us up to the goal.”
That could be a morning huddle that’s totally different than what we might say in a weekly meeting, but all of those meetings are going to have the theme of getting our implementation projects done. They’re also all going to be a platform for people to talk, to ask questions, to get clarifications. It’s going to be a platform for the owner or the office manager to give validation and praise and to kind of influence people. And then, of course, like I said, each meeting is going to also have its own little category of things to talk about.
Richard Low:
Okay. I love this. You’ve mentioned specific lengths for… I think, sometimes, not having done these before or not having made decisions around these, dentists get hung up on like, “Okay, how do we format this? When do we put this? How long should it be?” You said 10 minutes non-negotiable daily huddle, 30 minutes once a week weekly meeting. Do you have any preference of where that meeting goes? I find sometimes end of the day can get weird, depending on the day or the week.
Scott Leune:
Yeah, usually, usually, you’re throwing meetings around lunchtime, so 30 minute meeting is right in the middle of the hour lunch. It’s not a very focused meeting, where we’re making massive decisions. It’s a regrouping kind of touch-base meeting, so having full attention of everyone in every moment’s not that important. When you’re looking at a monthly meeting, that thing’s probably an hour and a half. You might block out a half an hour for lunch and an hour and a half for this monthly meeting, so you got two hours there of no patients. And then, the strategic planning meeting, that’s probably a half a day, and that may not be with your entire practice. It may just be with leaders of your practice, if you’ve got a large organization. Or if you’ve got a small organization, it’s going to be a half a day off for your entire practice.
Don’t get stuck in thinking that this time is lost dentistry. This time is maximize dentistry. This time is maximize collections, maximize organization and accountability, and without these meetings, you start having the screws fall off. With these meetings, you do much better. You see, having a successful dental practice means that there’s a chunk of your time where you’re going to produce. And that production needs to be as efficient and quality as possible, but in order to have that stay efficient and high quality, we have to have supportive time to stay organized and to have accountability and to have communication. If we are breaking one of those two things, it’s not going to work. Most offices don’t have anything dedicated to supportive time, so no wonder they feel like they’re in a rat race, spinning their wheels trying to get through the day and only to be exhausted and not producing that much and overspending, no wonder. We have to have both. We have to have a balance of it. We have to have plenty of supportive time to ensure that the super important productive time is efficient and high quality.
Richard Low:
This is great. I think this is a mindset shift and a culture shift and something that just needs to be that non-negotiable. We just bake this in. We just schedule them out for the whole year, these time slots that are not moved or changed, unless the office shuts down or the power’s out or whatever. This solves the majority of communication issues. You talked about then office policies and other things, that change management. Is there anything to address, once again, these could be whole episodes out of themselves, but at a high level, the communication around office policies, deciding office policies, the communication around change efforts, we just talked about that hierarchy of quarterly into monthly around change, the monthly focus on this, what high level pieces are there to this before we wrap up the discussion?
Managing Change in the Practice
Scott Leune:
Well, for office policies, you got to have a policy manual, and having one built takes you, the owner, through the process of deciding on the policies. And the policies you decide on, when you decide on them, you need to understand that they’re going to be non-negotiable. So when you say this is your time off policy, you need to be willing to fire someone for breaking it. So those policies you create need to have enough flexibility in them that you can have that non-negotiable stance and people not get fired, but they need to be strict enough that you’re not damaging your business. You have to stand by the policies. You have to uphold them and keep them true and healthy and strong, because they form the boundaries, the rules, the laws of your land. They form the boundaries of where people can work and where they can’t cross.
Right? And when you have people crossing some of these boundaries, then it really damages your practice. So hire a company to take you through the process of building a policy manual, and when you make those decisions, make them with the mindset that you will fire someone if they are breaking them. So that’ll kind of keep you honest into making them not too strict, but obviously, they need to be strict enough that you’re protected. When it comes to change management, that’s taken care of a lot in this whole strategic planning cadence.
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Then having a monthly implementation project, what that does is it turns change into part of the culture of the practice. Every month, we’re changing something. Every day, we’re talking about it. It becomes normal. Now, there is pushback and disagreement on the decision to change. So here’s a little tip.
Let’s say you want to change the payment option form you show patients when you present finances. And your treatment coordinator says, “No, I don’t want to do that. I like what I do. I’m not going to change. It’s the wrong thing to do.” And you’re like, “Well, no, I think we should do it. I learned it here and I want to try it out.” And the treatment coordinator says, “No, that’s not something we need to do. I do not want to do it.” What do you do? You say, “Okay, treatment coordinator, tell me the reasons why you don’t.” Let the treatment coordinator communicate. You might learn something, you might agree after that, but let the treatment coordinator communicates.
And internally, you’re like, “No, I still want to do it,” internally, you’re thinking that to yourself. Here’s how you handle it. You say, “Okay, treatment coordinator, I’ve heard you. You don’t want to do it, because of this and because of that and because of this thing here. All right. Well, I’ve made a decision. Here’s what we’re going to do. We’re going to use the new form for three months, and then, you and I are going to meet again and talk about it and then, decide what to do. That’s my decision.”
And then, you’re done. So what you’ve said is, “Look, I own the place, I am going to make the decision, but also, I heard you. And because I heard you, I’m not saying this is permanent. We’re going to do it for three months, that’s reasonable, and then, we’re going to talk about it again.” You can do that with assisted hygiene. Assistant hygienist says, “No, I don’t want to do assisted hygiene, because this, that, and the other. I’ve done it before. It was terrible. Da da da da da.” You’re like, “Okay, I hear you. You don’t want to do it, because of this and that. I’ve made a decision, we’re going to do it for three months, and then, after three months, we’re going to see how it was and you and I are going to talk about it.”
And then, that becomes part of the strategic plan, and then, that becomes a monthly goal. And then, it’s talked about every single day in the morning huddle, and like that, you blow through a ton of pushback that can occur. You see, pushback happens a lot more when the CEO doesn’t have any strength. They just fall backwards. But you’re the CEO, you’re the owner, you’re the office manager. Your job, many times, is to disagree, for the right reason, or to do what you think is the right thing for your vision. And you may not always be right about it, but your job is to make that happen. And so, this is a very good kind of way or strategy, it’s respectful, but it still gives you the power to do it.
Richard Low:
I love the policy of, anytime you’re making a change that impacts people, you want to hear their feedback on that change, so that every person, even if they’re someone who’s quieter or doesn’t usually push back and volunteer information, there is buy-in, because they’ve felt heard. And that’s what you’ve talked about here, because then, as you make that decision, it’s not that you’re making the decision without information or without consideration. They feel, “Okay, he’s at least seen the consequences or she’s at least heard my opinions on this before making this decision. It is what it is and we’re going to move forward.” So much of this episode and what we’ve talked about today has been around concreteness and expectations, so that we can circle back to data, to results, to auditing, to a format of a cadence. And so much of managing people, sometimes when we don’t have clear concrete expectations and systems, is just around emotions and the fires that get put out.
We’ve done whole episodes and series’ in the past on things like crucial conversations, and one of the very first steps of a crucial conversation before you even go into it is what is the concrete facts surrounding the situation versus the story I’m telling myself that’s creating all the emotion. Giving yourself as much concrete data and accountability and structure gives you the power to manage and not have emotion and the waves of just kind of the daily chaos run the practice. So I’ve really enjoyed this, because it just gives so much teeth to the power of that dental CEO to manage people without feeling burned out by drama and emotion.
The Role of Coaching in Leadership
Scott Leune:
Yeah, and there’s another kind of secret sauce here. When a practice hires a practice management coach or business coach, the coach can, many times, take the bullets for the owner. The coach can be the one saying, “Hey, guys, I want to try this, and here’s why.” And also, when the coach says it, there’s way less pushback from the team. When someone on the outside says it, there’s not this emotional history with that person, and so, there’s not these negative tendencies that can occur. So a lot of times, when a coach says something, the team agrees, they want to implement it, or if there is pushback, the coach takes the bullets and the owner’s like, “Well, Scott wants us to try it, so let’s just try it. But look, guys, if it doesn’t work, let’s not do it.” The owner can be on their side sometimes.
So when I’m coaching my clients, there’s so much value in having the team implement things faster, while I also take the bullets for the owner. Coaching, I argue this all the time, the cost of coaching is negligible, considering the speed and the impact of the implementation. For dentists that are weak at implementation, coaching might be the only way they can get change anytime soon. For dentists that are strong at it, coaching will speed it up and get it to a much bigger level. But let’s not forget that, if you have a coach, you can ask them to have these crucial conversations if you’re not skilled at it or ready yet. You can ask them to hold your team accountable. You can ask them to try to get change accepted. They should be the ones doing it. They’re going to have a better shot at getting it, and they’re going to take the bullets for you. And that way, you get to sit there in a clean way without disrupting your relationship with your team, and you get to watch these things happen without you lifting the emotional weight of it.
Richard Low:
I love this, and it reminds me of, I got into meditation as a practice and I told my wife about the benefits of this and tried to convince her of this, and there was never really a desire to experiment or to try this out, and then, her good friend is all in and tells her about it. And all of a sudden, she’s willing to try it out and listen to some meditations as she’s falling asleep. That third party sometimes adds authority or interest or a willingness to be open to new ideas versus the same person that we’ve been in the trenches with day in day out, who’s been experiencing the same things as us and they see things differently than we do.
That can be overcome by the coach taking the bullets, as you said. So I love that final point here. Anything to wrap us up? I think there’s a whole nother episode of the capstone of managing ourselves as a dental CEO and simplifying this role. I do want to revisit that. I really want to have that conversation, but I’ve really enjoyed talking through this framework and these pillars. So I’d love for you to wrap us up here.
Scott Leune:
Being a good CEO, especially managing people, it’s a learned skill. It’s something that you work on, you practice, you perfect, you get organized with, you study, you have an outline, you have your checklist. It’s a series of tasks. Don’t think being a good CEO is a personality trait. It doesn’t mean you’re charismatic. It doesn’t mean you’re a leader kind of alpha person or anything like that. It is a series of tasks that you perform, and almost all of those tasks, you need practically no skill to perform. Just showing up at the task is all you need to do. Some of those tasks, you do have to develop skill to become better at it. But I’ll tell you, being a CEO of a dental practice is a fraction of the skill, a fraction of the work, as learning how to do a dental procedure. It’s not that complicated.
It’s just we weren’t built this way from the beginning. We were never taught this in school. No one kind of walked us through and held us accountable to learning how to be a CEO. So it has to be either a self-taught thing, self-practice thing, or you need to bring a coach on to coach you and hold you accountable to becoming a CEO like this. But it is not complicated. You’re not born with it. This is just a learned series of tasks, and it will have a dramatic impact on your life. A domino effect of positivity will happen when you can improve your effectiveness as a CEO.
Richard Low:
I love it. Please, if anyone somehow listened to this episode without listening to the others, this has been a comprehensive education in thinking high level, and now, we’ve got so much we can dive into in future episodes, including this next episode. Thank you, Scott, for walking us through this process.
Scott Leune:
Awesome. Thank you, everyone.
Richard Low:
Awesome. We will talk to you next time on the Shared Practices Podcast.