The Hardest Thing

March 1, 2007
Do you have advice for women dental managers/bosses/clinicians? It’s been the hardest thing I’ve ever done.

Dear Dianne,

I have been a dentist for 20 years. Sixteen of those years, I was a part-time associate while I raised my three children. I have owned my own practice for three and a half years, and the biggest challenge for me is being the boss. I think it really is tied to a woman managing seven other women in a small atmosphere such as a dental practice. I recently had to let a long-term employee go because she was so negative, gossipy, and power-hungry that she was constantly causing me (and the others in my practice) stress.

Do you have advice for women dental managers/bosses/clinicians? It’s been the hardest thing I’ve ever done. Thank you.

Patricia McConnell, DDS

Hi, Dr. Pat,

As a consultant, I find the top three areas that give doctors in private practice the most frustration are staff management, third-party payment issues, and broken appointments and cancellations - in that order.

I bet you found management issues a lot easier when you were an associate. Trust me, your male counterparts do not have it any easier when managing a mostly female staff. Often, they are clueless on how to deal with everyday issues. I believe you, as a woman, have insight into the female psyche that men will never understand. That’s a plus for you.

But being a woman boss has its downside, too. Many women staff members presume incorrectly that a woman boss does not possess the same authority as a man in the same position. I have observed staff members in several female doctors’ offices address the doctors by their first names. This is rare as hens’ teeth in offices with male doctors. An example is one of my client offices with a female doctor. I was appalled when I did my first site visit and observed that the staff members all called the doctor by her first name. It shows a lack of respect. This doctor possesses wonderful clinical skills but commanded little authority. When I privately asked one of the staff members if she addressed the former doctor by his first name, she said, “Oh no, I wouldn’t feel comfortable with that.” Comfortable - now that’s an interesting word. Was her “comfort” in addressing this doctor by her first name related to a perceived authority level that everyone in the office is equal? I think so. Plus, this doctor allowed her authority to be challenged by allowing the first-name basis. When I asked the doctor how she felt about their calling her by her first name, she said it started with her chairside assistant, and then the rest of the staff members joined in. Yep, just like kudzu vine, bad habits spread like crazy when they are not clipped. She thought that in the interest of having her staff members like her, if they wanted to call her by her first name, it was OK with her. This is inconsistent with being a leader. At the least, staff members should respect the position and education of the doctor by addressing her by her professional designation.

I will also mention appearance. When I walk in an office and see everyone including the doctor dressed alike, I can almost promise a lack of respect. The doctor should look different than staff members. Patients should have no problem discerning who the doctor is.

While I’ve known a few soft-hearted men, generally men see life situations differently than we do. I think it has something to do with the emotional side of being female. While women are sometimes characterized as bitchy, like-minded men are characterized as grouchy. The term “bitchy” has more to do with being short-tempered and nit-picky. Sure, we women have to deal with our monthly menstrual cycles, and we know how that can affect our moods. Nevertheless, our physiology is not an excuse for poor intersocial behavior with coworkers and patients. Bitchy becomes the norm for some people. If it’s the boss, the result is continual staff turnover. If it’s a staff member, there is continual staff conflict.

Another term closely related to unpleasant female behavior is “catty.” I never really knew what that meant until I got a cat. Abbie is a female, black and white, domestic shorthair. When another cat comes on her turf, the hair on Abbie’s back and tail stand straight up and out come the claws. Oh, such growling and hissing! It’s all such a silly display. Cattiness can also be related to the independent nature of cats. Sometimes they want your affection and let you know it by rubbing against your leg or begging for attention in other ways. Other times, they do not want you to touch them. They prefer to give you permission to pet them. People are not cats and should not behave like them. If you have a catty staff member who is always growling and hissing at other staff members, it’s time to part ways.

Another aspect of females is that we like to be buddies. Generally, we are social creatures. But understand that if you socialize outside the office with your staff members, you will have a hard time treating them as subordinates in the office. Plus, you risk showing favoritism. Further, never under any circumstances participate in gossip about anyone with your staff members. They will mistrust and lose respect for you, just as you mistrust and lose respect for gossiping staff members.

Here are some basic rules of being the leader in your practice.

  1. Lead the way in appearance. Keep long hair tied back. Dr. Harry Wong, noted educational speaker and writer said, “As you are dressed, so shall you be perceived. As you are perceived, so shall you be treated.” And please, no visible cleavage or other provocative appearance.
  2. Respect your staff by treating them as you would like to be treated if you were a staff member. For you to get respect, you must give it first.
  3. Respect your patients. Express your love and appreciation for your patients through the care you deliver and the way you interact with them.
  4. Learn to pick your battles. Nobody is perfect.
  5. Praise in public, criticize in private. Behavior that is rewarded is likely to be repeated. Praise often.
  6. Fire with impunity those who do not thrive. It’s an unpleasant task but often a necessity for the good of the practice.
  7. Have a well-written policies and procedures manual. Conduct yearly performance reviews. Staff members need feedback.

There is more to this subject in the way of leadership styles, learning styles, personalities, etc. But I don’t think that leading your practice has to be complicated or unpleasant if you follow the basic principles I’ve outlined in this column. If you continue to struggle, get a consultant to help you.

Practice ownership is a privilege that you worked hard to accomplish. No doubt you’ve taken lots of physical, emotional, and financial risks to be where you are. I admonish you to lead your team by your outstanding example so you may accomplish what you set out to do - take care of your patients’ dental needs, wants, and desires in the most excellent way.

Best wishes,

Dianne Glasscoe

Glasscoe is a speaker, consultant, and writer for the dental industry with more than 30 years of experience. She is CEO of Professional Dental Management, Inc., in Frederick, Md. You may reach her at (301) 874-5240, [email protected], or visit www.professional