Doctors purchase state of the art equipment, build modern facilities, buy computer systems and take extended vacation-oriented continuing education. At the same time they attempt to cut operating costs by withholding salary increases, offering minimal or no employee benefit packages, and providing only token education and training for their employees. It is critical for practices to differentiate and distinguish themselves in a service-oriented competitive marketplace by maximizing the potential of the people that use and operate these very costly investments. Human potential is the most overlooked asset and underutilized resource of many organizations.

Capital investment does not relinquish the responsibility to select and train the right employees. The investment of $10,000, $20,000, $30,000 and more in equipment, computers, and doctor-only training without budgeting adequate time and dollars for employee training only thwarts or sabotages the real potential of the practice. This is the equivalent of buying your dream luxury car and then becoming budget conscious by deciding not to buy the fuel that runs it and postponing oil changes and routine maintenance. Besides, new equipment and attractive facilities do not enhance patient relationships. People do.

The Job Analysis

Hiring the right employee for your business requires more than a well-written resume, a casual interview and intuition. The best employee for one position in one practice may be a nightmare for another.

Successful selection requires an understanding of the dynamics of the position and how the employee filling it will interact with other employees and patients, and how she/he will perform the necessary tasks. Successful selection looks not only at the job skills required to complete tasks but which performance factors may influence how well an employee performs the job. Begin the selection process by identifying a profile of the type of person you feel you need in your practice and determine the communication and learning preferences you feel are necessary to be successful in the job.

The Heart of the Dental Business

Oversimplifying the complexity of human behavior is dangerous. But any tool that allows you to focus on what is most important will help you become more effective and more successful in your interactions with employees and patients. Improved understanding reduces stress, avoids conflict, improves decision-making ability and helps people become more persuasive and influential. It helps people disagree without being disagreeable.

For years philosophers and psychologists have observed the different styles of people. As far back as 400 B.C. Hippocrates observed behavior, noticing that we exhibit similarities and differences. We, as humans, are the same yet unique. Continued observation proved that humans exhibited behavioral preferences and these preferences were observable, giving birth to what is known as a "behavioral language."

Each person, through nature (genetics, heredity) and nurture (environment) develops a unique behavioral design. In the 1920's psychoanalyst Carl Jung asserted that people tend to use a blend of behavioral preferences, or styles, but over the course of time, one style dominates. One very helpful model is based on the psychology of Carl Jung and William Marston. Their work developed a working model, D-I-S-C, that measures four behavioral factors. A person's behavior, or style, is the sum of the highs and lows of all four factors.

These styles affect the way we communicate and learn and make decisions. Your behavioral design then is a "doorway" of communication. It displays itself in every relationship and interaction. There is no right or wrong style. There are just different styles.

Imagine four strangers in a foreign country. They approach one another requesting help with directions. One speaks only Spanish. Another speaks Japanese. Another Russian, and another French. The language they speak is not right or wrong. The strangers are neither good nor bad people based on the language they speak.

But how will they communicate with one another? How will each stranger respond to their inability and the inability of the others to verbalize and respond effectively? Will the language barrier result in frustration, disappointment, anger, rejection, or withdrawal? Or will other non-verbal tools of communication, such as tone, pace, gestures, and posture nurture an atmosphere of openness and friendliness as the strangers attempt to help each other find their way? Will one consider him inadequate for not being multi-lingual while another considers the other strangers as rude or inferior for not understanding his language?

For doctors and staff members to develop loyal and trusting relationships, they must recognize more than their own preferred style. They must learn to understand the strengths and weaknesses associated with their own style as well as understand the styles of the people they deal with, and learn how to adapt to those other styles.

Fitting People To The Job

An employment assessment tool that helps employers and employees identify and compare people's perceptions and attitudes toward the job is The Work Environment Analysis. It measures the behavioral style that each person feels is necessary to be successful in the job.

One way to utilize the Work Environment Analysis is to have the key people in your practice complete a twelve-question assessment. Key employees may include both top performers and non-performers alike. Selecting employees who resemble other successful employees is important. But it is equally important not to select employees who may be similar to those who didn't work out. In other words, don't repeat the same mistake twice.

Comparing the results of the analysis for similarities and differences, a basic profile is developed for each position in the practice. If differences exist, it is important to discuss why each person expressed their particular preferences. Specifically, you want to identify three areas:

1. Differences of opinion about how a job should be performed.
2. Potential areas of stress between the style of the employee and the demands of the job.
3. Anticipate potential conflicts between co-workers, supervisors, management and patients. It is important that the key people in the practice agree on a consensus profile prior to interviewing new candidates, making promotions or changing job positions.

In a recent management group of fourteen independent, successful private dental practices, sixteen dentists completed a Work Environment Analysis for the front desk/receptionist and chairside assistant positions. The composite graphs of the profiles for the dental receptionists were very similar; the profiles for the chairside dental assistant were markedly different. There was little consistency between one dentist's perception of the dental assistant position and the next. Patterns differed as well as style preferences.

Selecting employees whose communication, learning or decision making processes differ from the dentist or co-workers may result in conflict, lost productivity, or turnover. These conflicts may have nothing to do with the skills and competencies of the employees but how they perform the job and the methods they use to complete their roles and responsibilities.

Peggy vs. Sue

You have two chairside assistants, Peggy and Sue. Both are extremely competent, reliable and conscientious. At first, all was going well and you felt pretty good about your employee selection. But things are now beginning to get a little tense.

Peggy leaves each day at noon to pick up her child at day care. She returns at 12:30 to help with the clean up and preparation of rooms, and sterilization of instruments. But by the time she returns Sue has almost everything completed. After a few months this begins to bother Sue. Why does Sue have to clean up everyday and wait to eat lunch while Peggy gets to leave on time?

When Peggy returns, she has time for lunch. Peggy wonders, "Why can't Sue go to lunch and wait until I return?" Sue wonders, "How can Peggy leave each day with so much to do? Doesn't this bother her?"

Now, the doctor couldn't care less when the instruments are sterilized and the rooms are cleaned as long as everything is ready to go prior to the arrival of the afternoon patients. So what's the big deal?

At the heart of the issue is a difference in how Peggy and Sue handle tasks. Both are good at multi-tasking. But Sue has to complete whatever she starts before she undertakes anything new. She has trouble resting if she knows her work is undone. Peggy, however, can begin a task, put it aside and then come back later to finish it. Both are good people. Both reliable. Both conscientious. By the time the first patient arrives, both are always prepared. But how they prepare themselves differs, and that is the problem. Using employment assessment tools can help anticipate such conflicts and prepare for the communication skills necessary to improve relationships and teamwork.

To prevent or minimize conflicts like this in your practice, interview questions should be designed to:

Validate a candidate's answers

Anticipate when and what conflicts might arise

Identify strengths and recognize potential weaknesses

If multi-tasking is a priority in your selection process, some examples of questions would be, "When faced with a deadline and several tasks need to be completed, how do you prepare?" Or, "How do you prioritize which tasks you complete first?"

Summary

Assessment tools, like the Work Environment Analysis, can help identify or verify performance factors. These factors are people's preferences in how they relate to other people, tasks, and their environment. Performance factors may include communication skills, interpersonal effectiveness, ability to multi-task, dealing with conflict, teamwork and taking initiative. Employers generally hire people based on specific job skills such as education, experience and training, but fire based on performance factors -- how they got along with other people.