Is the ‘silo effect’ putting you and your practice out to pasture?

That’s not a problem out on the farm; however, in the workplace it’s a different story.

This silo effect can occur in the dental practice when there is a lack of communication and common goals among the different areas — the clinical staff and the business staff, the dentists and the hygienists, etc. It is perhaps a new twist on the old workplace problem of the right hand not knowing what the left hand is doing.

Each person is performing his or her job with little understanding of the big picture or how all of the systems are intertwined. Individuals are given tasks to achieve, but there’s minimal focus on overall goals or teamwork.

The business employee unknowingly schedules the emergency patient at a time that puts significant strain on the dentist and the assistant. The dentist recommends a patient pursue an extensive treatment plan not realizing that the patient already carries a significant balance on his account.

The collections coordinator is supposed to increase collections, but is frustrated by the dentist’s actions. “I can’t control accounts receivables, when the dentist is recommending costly treatment to patients with outstanding balances.”

Meanwhile, the dentist wants to increase treatment acceptance and is now offering more elective procedures. Yet, there’s no effective communication between the various silos.

The hygienist provides care to the patients who show up, but her production continues to fall short because of cancellations and no shows. She has been told that she needs to see more patients and if she does she will get a bonus, but she can’t achieve that without the help of others. No one is willing to help confirm appointments — it’s not their job everyone says — making it rather challenging to increase hygiene production.

Resentment builds on all fronts, including with the business staff. “I have enough to do with my own job. I can’t be sitting on the phone all day. Let her make those calls.” Each person is so focused on his/her individual duties that it seems no one has any concept of the bigger picture. In addition, it appears that in this office, that bigger picture has never been painted.

Clearly, the collective interests of the practice as a whole are suffering. If there are common goals and a common purpose, they don’t have a chance in this environment until the silos are torn down and individuals focus on how they fit into the shared success of the entire office.

That begins with the dentist creating and communicating his/her vision and goals for the practice. For some, this is a significant hurdle to overcome. After all, dentists are not trained to create visions or develop goals for systems they scarcely understand, let alone lead teams.

Dentists are trained to treat patients. It’s certainly no wonder that for many dentists the sentiment is, “If I’m doing my job and the rest of the staff is doing theirs, what else do you need to do to run a practice?” You need a team, not silos.

Teams are driven by a common purpose, common goals and objectives, and are fueled by mutual respect and trust. They also must be nurtured over time and they must be rewarded for a job well done and redirected when they veer off course. How do you get there? As they say, every journey begins with the first step.

Team development occurs when a team pauses to examine itself, identifies opportunities for improvement and commits to action. Over time the members of the team work through various aspects, including:

• Improving communication skills and establishing dialogue.
• Evaluating strengths and weaknesses.
• Defining staff members’ roles and responsibilities.
• Assessing individual roles in the group and understanding how each contributes to the overall practice objectives.
• Developing specific team processes such as decision-making and conflict management.
• Improving problem-solving strategies.

One of the most critical steps toward creating a team is making sure everyone understands his or her role and how he or she fits into the larger practice picture.

Step No. 1: Communicate, communicate, communicate

You simply must express your practice goals and objectives to your staff. It is said that some two-thirds of employees do not know their employers’ goals or business philosophy.

Open the lines of communication with your team. Encourage ongoing discussion, feedback and problem solving from everyone. While you’re at it, make sure that every employee has a job description and understands his or her role.

Step No. 2: Detail job duties and expectations

Define the job that each staff member is responsible for performing. Specify the skills the person in the position should have. Outline the specific duties and responsibilities of the job. Include the job title, a summary of the position and a list of job duties. This can be the ideal tool to explain to staff exactly what is expected of them.

You’d be amazed by the number of employees who have little more than a vague idea of what the dentist expects. Too many are out there in their silos trying to figure it out on their own.

In addition, when job duties and expectations are not clearly defined, employees don’t take responsibility for their actions. The result is that the practice doesn’t have systems in place to solve problems and individuals waste valuable time backbiting, gossiping and wallowing in frustration.

Step No. 3: Ask the difficult questions

Resist the urge to be satisfied with simple answers. Look below the surface. Ask yourself every day what can be improved. Which system is not delivering the results it should? Why? What needs to be changed, adjusted and improved?

Remember, building a stronger team and better practice requires that you routinely question the way you and your staff do things. It is essential to improving problem-solving abilities in yourself as well as your staff.

Step No. 4: Encourage leadership as well as partnership

This may require that you let go of some of the very beliefs and behaviors that enabled you to achieve success in the first place. Where you’ve insisted on control, you may need to step aside and provide the opportunity for employees to step in and take a leadership role in order to improve specific systems. It likely means that everyone needs to be open to adopting new mindsets and skill sets.

It requires changing and adapting in order to realize the vision that you have for your practice, and it requires encouraging others to take risks and grow as professionals. All of this begins with taking an honest look at each person’s strengths and weaknesses.

Encourage each member of your team to identify two or three of his/her greatest strengths and weaknesses. Ask each of them to work with each other in doing this and gather feedback from others on the team who will be honest and constructive.

Next, ask all members of the team to identify the three or four critical activities that are essential for their success in their role on the team and what tools and/or training do they believe they need to achieve that success. Use the information you gather as a cornerstone in developing an ongoing staff development plan.

Step No. 5: Show courage

Insist that employees set an example for one another. Individual employees seldom realize how their actions affect the behaviors of their teammates. Employees both consciously and subconsciously look to each other for positive or negative behavior examples.

If one person continually blames others when things go wrong, so too will others on staff. If one employee routinely comes in late, others will be more likely to do the same.

Negative behaviors reinforce the silos. Don’t ignore them; address them. Address the issues that don’t make you popular: problem employees, showing up on time, following the dress code and office procedures, treating each other and every patient with dignity, respect and patience.

With time, the silo walls will crumble as individuals discover the satisfaction of reaching goals, realizing a vision and having the pleasure of being a part of something bigger than themselves — namely, your team.

About the author

Sally McKenzie is CEO of McKenzie Management, which provides success-proven management solutions to dental practitioners nationwide. McKenzie is also editor of The Dentist’s Network Newsletter at www.thedentistsnet work.net; the e-Management Newsletter from www.mckenziemgmt.com; and The New Dentist magazine, www.thenewden tist.net. Reach her at +1 877 777 6151 or at sallymck@mckenziemgmt.com.