By Amy Morgan, CEO, Pride Institute
Victoria, a California dentist, asks, "How should I train a new staff member when I don't know exactly what she's supposed to be doing and I have so little time?"
The founder of Pride Institute, Dr. Jim Pride, used to tell the story of how he hired his first staff member, Elaine, when he was a young dentist beginning clinical practice. Although Elaine had no dental experience, Dr. Pride hired her because of the excellent customer service skills she displayed working at a local bank. On her first day at the practice, Elaine arrived wearing full nurse's gear, including the hat (this was in the '60s). Pad in hand, Elaine asked Dr. Pride what he wanted her to do. He thought for a moment, then had her write "Work." When she asked, "How?" he responded, "Hard." (Dr. Pride advanced his skills before creating the Pride Institute.)
If you're training your most valuable asset — your staff — by crossing your fingers and hoping for the best, you're doing what Dr. Pride did. Women dentists often feel uncomfortable training staff for the following reasons:
• They haven't clearly defined what they want their staff to do;
• They haven't performed many of the nonclinical tasks themselves, so they feel uncertain teaching them; or
• They feel that they lack the time to train.
When staff members enter the practice, they haven't struggled yet with performance shortfalls and are enthusiastic and willing to learn. If you capitalize on their initial enthusiasm during the training phase, you won't need to invest unpleasant time later in correction, counseling, confrontation, and termination. If you dread confronting and firing staff, the antidote is to train them. Two basic tools that make training easier are a job description and training plan.
The dental offices I encounter overwhelmingly have either no job descriptions or flawed ones. Massive listings of duties with no priorities, clarity, outcomes, and explanation of why tasks are performed make for flawed job descriptions.
An excellent job description starts with a list of ideal outcomes of the position — not the tasks. Outcomes tell trainees why their tasks are important. For example, assume you're hiring an appointment coordinator. The flawed way to start your job description is with a laundry list of tasks, such as:
• Pick up the phone in three rings.
• Make coffee.
• Take out the garbage.
Instead, begin by explaining what you are striving for, i.e., outcomes, such as:
• Patients committed to and showing up for their appointments
• A schedule that meets production goals, provides balance and efficiency, and ensures a quality experience for both patients and staff
When staff members know the whys, their tasks become important.
Job descriptions next contain the knowledge, skills, abilities, and attitudes required for success in the position. Avoid Dr. Pride's generality about working "hard." Instead, be specific about the organizational, computer, customer service, teamwork, and other skills that a staff member needs. For the appointment coordinator, for example, your list might include:
• Calmly and efficiently juggle many things — handle patients, file documents, answer the phone, etc.
• Master computer software programs.
• Exhibit excellent communication, listening, and relationship-building skills to deliver exceptional customer service.
• Be willing to help other team members beyond one's own job description and actively participate in staff meetings and projects to improve the practice.
After indicating your ideal outcomes, as well as the knowledge, skills, abilities, and attitudes expected for success, then list the duties required. Ideally, prioritize the tasks based on the vision and values of the practice (greeting arriving patients, for example, might get priority over filing charts). For the appointment coordinator, this section might include tasks such as:
• Handle no-shows and cancellations.
• Acknowledge patients within one minute of their arrival.
• Fill pre-set times for production blocks in the schedule.
Once you have completed an effective job description, you can easily customize an on-the-job training plan for new staff members (as well as veteran staff needing additional training). Review the job description with your new staff member and diagnose the person's specific training needs as you go. When explaining the outcomes, as well as the knowledge, skills, abilities, and attitudes expected of someone to achieve those outcomes, you can co-analyze the person's current status and define any performance gaps. For example, a new appointment coordinator such as Dr. Pride's Elaine, because of her inexperience in a dental office, would lack competency in scheduling dental appointments. This is a gap, i.e., a deficiency in the trainee's knowledge, skill, or both. Therefore, Elaine's training goal would be to learn all the aspects of scheduling, and then apply the knowledge until she masters the tasks.
When defining the training goals for a staff member based on the performance gaps uncovered, ask yourself and the employee three essential questions:
• What do you want the employee to do differently after the training period, stated in objectively measurable terms? For example, at the end of a four-week training period, the employee will be able to schedule every day with all pre-blocks for major procedures and new patients filled, with a balanced mix of procedures, production goals met, etc.
• What tasks can the employee currently do, and with what degree of consistency? Remember to consider the employee's transferable skills, i.e., skills learned at previous jobs that can be applied to the new position. For example, an appointment coordinator who has worked in the insurance industry will have a familiarity with insurance terms, computers, and organizational basics that will assist the person in learning the new skills required.
• What are the performance gaps that need to be filled through training? Always describe specifically the performance gaps, standards the employee needs to meet, and tasks the employee needs to learn in order to meet your standards. For example, it's not enough merely to tell the trainee to answer the phone and "interview" all prospective new patients. It's vital to state clearly what a successful new-patient phone call sounds like and the results it creates.
After reviewing the job description with your new employee, you can create a written training plan based on the competencies the trainee will need to acquire for the position, transferable skills the person has that will aid in developing those competencies, and benchmarks the employee will need to meet in order to demonstrate mastery of the assigned tasks within a forecasted time. New staff members will learn tasks by a combination of methods, including being shown by others, shadowing others, reading manuals, role playing, practicing the skills under supervision, then practicing them unsupervised until they are integrated. There's no greater feeling for the doctor or staff member than to mark off a competency on the training plan as mastered.
Designing job descriptions and training plans might sound like an awesome amount of work, but imagine how much more time it takes when staff is given no guidance and merely told to "work hard." How many years does it take, if ever, for staff to master their jobs when they must learn from your disapproving body language and trial and error? Once your job descriptions and training plans are in place, you'll never again have to dread that knock on the door when a staff member says, "I'm moving to Hoboken" (assuming you're not located near Hoboken), or "I'm going back to school." You will have a system in place for training the next staff member. Like eating spinach, you've just got to do it. The results will be amazing.
Amy Morgan is CEO and lead trainer of Pride Institute, the practice-management firm helping dentists better their lives by mastering the business side of their practices. For information on Pride's seminars, its acclaimed management program, and Morgan's flagship courses, call (800) 925-2600 or visit www.prideinstitute.com. E-mail your questions to [email protected], and Morgan will address as many as possible in this column.