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Women Working With Women - Inner and outer circles

July 1, 2003
You are the new employee in the practice, but you do not feel included or accepted. No one says hello in the morning or invites you to lunch.

You are the new employee in the practice, but you do not feel included or accepted. No one says hello in the morning or invites you to lunch. You hear whispers behind your back when you try to interject ideas at staff meetings based on the wealth of knowledge you bring from your years of dental experience. When you ask the team members simple questions, they roll their eyes like you should already know the answers. Sure, every practice is different, but you feel like a duck out of water. You know now why they have lots of turnover here. No one makes you feel welcome. You figure if you feel this way, then the patients must also.

... You are a young, new employee who learns after a day that the majority of your co-workers are your parents' age. To make matters worse, the dentist is older than your mother! The more you listen to social chatter during lunch, the more you realize that you have almost nothing in common with anyone in the office.

... You are the only person on the team who remembers the Beatles! Hearing your co-workers talk about their dates or the places they go in the evening makes you feel like you live in a different time capsule. Why don't these young co-workers grow up and get a real life?

... The dentist feels like she is the only person on the team who has goals or a vision of where the practice needs to be in five years. Talking about the future of the practice or current figures at staff meetings makes everyone yawn and reach for their second donut. What must the doctor do to motivate a group of individuals who are obviously interested in only two things — quitting time and their next paycheck? Every time the dentist walks into the staff lounge, the talking stops. How can the boss feel so left out in her own practice? Why should she continue to sign her employees' paychecks when they only make her life miserable?

... The business team members have the easiest job in the office. All they do is sit on their chairs all day rolling from spot to spot, talking on the phone, and making the schedule impossible for us to see all these patients. Have you noticed how the doctor thinks they are so wonderful? Who died and put them in charge anyway? The dentist expects us to go up and file their charts when we're not busy. When is the last time they got off their wheels and came to the back to help us? They scheduled all these people, and we'll be here until 6 p.m. trying to see them. Isn't there a scheduling course we can send them to? We'll take up a collection and pay for it ourselves!

... Those assistants and hygienists think they have it so bad. There are four of them and only two of us! When they see their last patient of the day, their responsibility to this practice ends. Ours never ends at this desk! Did you see how the assistants try to look busy when the dentist is looking? They waste more time in a day collectively than we have to spend. Everything that goes wrong in the business is our fault. Don't the clinical people here, including the doctor, know that running a practice is a total team effort? Because hygienists and assistants are scarce, they can get by with murder. But let us step out of line just once here at the front desk and there's a double standard.

... That associate dentist is just never going to be productive. She is so slow and her communication skills are a minus 10. Doctor Senior would die if she heard how Doctor Junior talked to the last patient. We don't do composites like that in this office. And those margins on her last crown were bad. The crown fit like socks on a rooster. I just wish we could go back to being a one-dentist practice. It was so nice before, and we even had Fridays off.

The above scenarios are based on actual statements that were made in practices where inner and outer circles prevail. The distinctions between inner and outer circles can be ever so slight or totally blatant. They are very destructive and are the reason many good employees leave a practice. When these circles are not recognized for what they are and nipped in the bud, they can translate into thousands of dollars of lost monthly production and hours of wasted time.

Until the work environment is improved, management systems will not be as efficient as they should be. Spending time addressing the problems in an office is counterproductive and stressful. Sometimes it is the front office against the back office. Other times it is the long-term vs. the new employees who represent change and bring a burst of enthusiasm. Occasionally it is an age factor or an ethnic or values difference that causes the friction. The saddest situation of all is when the entire team is on the inner circle and the poor dentist is on the outer circle all alone.

Having a caring, accountable team that spotlights one another's strengths rather than weaknesses is the key to success. In the ideal work environment, team members can go to work every day feeling good about the patients they will see and the numbers they will help produce. In the perfect office, co-workers are like dear friends, the boss is appreciative, and each team member is excited about all that can be learned in the wonderful profession of dentistry!

Working through the inner and outer circles is easy if you follow these guidelines:

1. Understand that the problem exists. Some dentists deal with problems by ignoring them, hoping they will get better on their own.

2. Outline the problem, the solution, and the anticipated outcome. Results in the form of a positive outcome will take place only when the lines of communication are open and exchanges are made in a safe environment. Everyone who wants the workplace to be more harmonious will participate.

3. Reward the group for realizing they were all part of the problem and congratulate them for being part of the solution. Whether it is a covered dish luncheon, lunch out, a one-hour shopping trip at the end of a short workday with a $50 bonus, a cookout at someone's house, or dessert brought in after lunch, celebrate the outcome! Take your team members to national dental meetings and offer additional training to those who exceed practice goals. You, your family, and your patients will notice the difference.

Learn that it is OK to be different. In fact, it is good to be unlike everyone else. Learn that tolerance and acceptance eliminate problems and help you blend your behavior with those around you. The inner and outer circles will be a thing of the past!

In the new 2003 seminar, Women Working With Women (From Sabotage to Support), Linda Miles and Gina McMeans will address these and many similar issues that management consultants deal with on a regular basis. Ms. Miles addressed the 82nd annual AAWD Meeting in Nashville, Tenn., in July.

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Linda Miles, CSP, CMC
Ms. Miles is a certified management consultant and sought-after speaker. Visit for a listing of dates for the 2003 Women Working With Women seminars. You may contact Ms. Miles at (800) 922-0866 or [email protected].