Thursday Troubleshooter: Why don't the rules apply to the new hire in this dental practice?

This dental front office manager is frustrated that the new hire who was supposed to help her is now assisting in the back. In addition, she's getting preferential treatment and the rules don't seem to apply to her. What can she do?

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QUESTION: I’m the practice manager of a two-dentist three-hygienist practice. We hired a recent grad as a front desk reception/scheduling coordinator to replace a full-time person. After a few weeks she decided she wanted to work in the back as an assistant. The owner and I agreed to "share” her, even though there really wasn't a need for another assistant.

The change did not happen in my favor. She was moved to the back to learn and removed from her desk duties, which were passed on to me. I handled the front desk alone for two months. I requested help from the second assistant and asked if we could go back to sharing her. The owner told me she doesn't like working in the front.

Then I found out he gave her a raise without my knowledge, and wrote off a $600 balance from her mother's account. She also tried to change codes on her mother's account to decrease the fee without my knowledge. This has never happened before as I do salary and write-offs. I feel there is a significant lack of transparency here.

This person is supposed to report to me, yet she reports to the dentist. I blame him for allowing her to manipulate him and change the way things are done. We don't have this issue with any other employees. I’ve brought this to the dentist’s attention, and he said he thinks I’m treating her unfairly because she’s working in the back. I just want to run the office the way it should be run without the owner usurping my authority. Please help.

ANSWER FROM JUDY KAY MAUSOLF, Founder of Practice Solutions, Inc:
You have several different issues. I would suggest that you as the practice administrator (PA) schedule a meeting with the doctors to discuss the following topics.
• Staffing for the front desk coordinator position—Evaluate current needs and discuss what to do now that the new hire is working in the back.
• What are the doctors’ expectations regarding who the team should go to with suggestions, questions, or concerns?
• What is the process for giving a team member a raise?
• What is the process for employee family member write-offs and adjustments?

It’s important to shift the conversation from being about what you and the new hire want to what supports the practice standards. Right now it feels like it’s a battle between you and her. Instead, establish standards together with the leadership team that are the same for everyone. Otherwise you divide the team. I recommend the following strategies to my clients.

A united leadership is the most important strategy to build a happy, healthy, and high performing team. Without it performance expectations will be ambiguous and the team will conform to whatever are the lowest expectations.United leadership starts with getting the leadership team aligned. This team is made up of owner/partner doctor(s) and the PA. I suggest the leaders schedule weekly meetings, and the PA become the designated point of entry to the leaders. Team members should bring all questions, requests, or concerns to the PA, who will then share them at a meeting with the leaders. The leadership team will discuss and come to a solution. The PA should then meet with the team member(s) within 48 hours to share the leaders’ decisions.

It’s also important to have a defined decision-making strategy. I coach leadership teams to use what I refer to as WOW decision making. WOW stands for weed out weeds.” A weed is anything that destroys relationships or makes a patient feel unwelcome or uncomfortable. WOW decision making gives leaders a positive and proven decision-making strategy. The results are consistent and fair decisions that support the team, patients, and practice.

WOW decision making is based on the following four fundamentals:
Patients, Practice, and Team! What is in the best interests of the patients, practice, and team, not just any individual?
Practical! What makes sense? Is something realistic with what you have available regarding time, money, or people?
Precedence! What precedent is being set? If something is done once for one team member, it becomes the expectation for entire team. If it is not across the board, it will feel like favoritism or inconsistency.
Passion! Are the leaders passionate enough about their decision to defend it, even to the point of losing a patient or team member? I suggest not implementing anything that the leaders think is just “nice to do.” “Nice to do”won’t be worth defending if the practice could lose a patient or team member.

Setting clear standards for the team will clarify expectations in the future and eliminate the chafing of who is right and who is wrong based on different opinions. Remember that if there aren’t clear standards established it is just an opinion.

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