Why your practice meetings are a waste of time…(and what to do about it!)

Practice meetings eh? Don’t you just love/hate them?! So much expectation that this time, the team will (willingly) put their shoulders to the wheel of change ~ while offering you a standing ovation for your innovative thinking. Yep, in your dreams…

What actually happens is (more often) something like this: the team slowly gathers in the patient lounge, the front door is locked with a post-it on it saying, “Closed for staff training”. The phones, however, keep ringing, punctuating the meeting with messages left on the answerphone. An old flip chart is found with notes from the last meeting still on it and the hunt for working marker pens starts. Everyone cradles a mug of hot drink while waiting for the dentists to arrive who are either running late or making a quick call on their mobile.

Eventually, (20 minutes late), the principal shows up, clutching some paper notes (and probably the work-book from the course he/she went on last weekend.) He or she announces the latest “big idea” and asks the team what they think. As he/she looks around the room he/she notices that many of the team, especially the younger ones, have discovered a new fascination with their shoes. Nobody wants to say anything until the senior nurse pipes-up, saying something about, “how on earth is this going to work, what with most of the girls struggling with child care and nobody wanting to go to the dentist on a Saturday” etc etc.

Nothing creative, constructive or useful happens, and as the meeting breaks up the team reassembles in small groups, the nurses in the staff room the receptionists around their desk and the associates in a surgery to work out what these changes are going to mean for them. The next day the principal walks into a practice full of sullen team members and one letter of resignation.

Sound familiar?

The meeting has cost the practice a whole session of fees not being earned, around £2k-2.5k between the principal, 2 associates and hygienist. There’s also the cost of recruiting to replace the person who resigned and even now, no-one knows what’s happening next or who is expected to do what. So they wait, hoping it will just all go away.

For better or worse, practice meetings like this one expose the principal’s (lack of) leadership skills to the rest of the practice and this is why the meeting becomes something counter-productive or even destructive. I don’t buy the idea that leaders are born, I think all of us can learn a few basic leadership skills, certainly enough skills to avoid meetings like the one I describe. (See: https://www.amazon.co.uk/Leader-Who-Had-No-Title/dp/1849833842)

I think dental practice whole-team meetings have a very limited list of functions and it is these:

  • To update the team on what’s happening and why
  • To tell them what’s in it for them
  • To ask for constructive feedback
  • To tell them when the changes are to take place and their role in making this happen
  • To remind them who they are accountable to
  • Thats all.

The quality and atmosphere of the meeting will depend on the principal’s leadership skills and style. I have noticed four types of leadership style amongst dental principals: numbers 1 and 2 work hardly at all, number 3 works a bit and number 4 works well (but is rare!).

1. The Naive Leader style is innocent and trusting. Naive leaders believe that because their team have been hired, given job descriptions and a monthly salary, they will carry out the work and the naive leader’s wishes. They are hands-off leaders who ask for things to be done and then are genuinely surprised when this doesn’t happen. Their practices are chaotic and in frustration, the leader often evolves into….

2. The Democratic Leader. These folk believe that collaboration is the answer. Getting the team to “buy in”. They seek the views of everyone (lots of meetings that go on for hours) on everything including: uniforms, fees, decoration, Denplan etc, making sure everyone has a voice and is heard.
Then they wait for the outcomes to be implemented and supported. This creates a sort of dumbed-down, Marks and Spencer’s type practice: the sort of place that the team would choose if they weren’t getting free private dentistry where they work. These practices are full of power struggles, arguments and the team split into cliques. The powerful stay (or those that have the ear of the principal) and the weak leave.

3. The Benign Dictator has usually tried democratic leadership and found that it got them nowhere, rejecting it in favour of autocratic leadership: “this is how it is going to be done”. They have stopped caring whether anyone “likes them” anymore and their previous experiences have made them un-trusting, over-bearing and likely to micro-manage the practice in order to get anything done. Their practices are either over- systemised, or have no systems, because the principal pops up everywhere telling folk how to do it!
This style stifles initiative and encourages dishonesty and duplicity. These leaders often generate a practice with high staff turnover as the team resents the continual close inspection of their behaviour. Most benign dictators continue in this way (it works better than naive or democratic leadership) whilst a few realise its limitations and get fed up with the continual recruitment.

4. The Inspirational Leader. These leaders are driven by their own core values and the values they wish their business to reflect. They tend to hire people with similar values and so communication within their team is easy. They have a clear vision for the future of the practice and share this frequently and openly with their team, who love where the practice is heading (those that don’t have already left). The team measure themselves against progress towards this vision. These practices are fully-systemised (with systems built by the team) and are creative places where the teams understand that they can develop themselves within this environment.
There is room for creativity and the principal becomes the employer of choice in the area with folk regularly leaving their CVs in the hope that they might find a job there. Some team members grow beyond the business and leave to find a business that will support their next growth phase.

While you are developing your own, effective leadership style and in order to avoid any more toe-curling practice meetings, I suggest that you run your meetings like this:

  • Always have a (short) agenda (better to have lots of short meetings than one long one) and give everyone a copy the day before
  • Start and finish on time, every time
  • Have a flip chart and sit around a table if possible
  • Actively chair the meeting, keep the pace fast, limit discussion, summarise points made, agree actions and a time line
  • Write up what was decided on a flip chart, who doing what by when and circulate confirmation of this to everyone on the same day as the meeting
  • Agree the next meeting content and date
  • Make it business-like, save the fun (cake or cocktails) until afterwards.

And if you are not yet ready or willing to become an inspirational leader, then the benign dictator leadership style is still far more effective than the naive or democratic leader! As a Chinese proverb points out, “People are longing to be lead!”

If you would like some help with developing your leadership style, please contact me for a chat.

Best wishes,

Simon
e. simon@nowbreathe.co.uk
m. 07770 430576

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