Thursday Troubleshooter: I feel threatened by the second dental assistant

The second assistant is threatening my job

Jun 13th, 2013
Trouble 6 13

QUESTION: What should an assistant do when her boss/dentist/owner plays favorites with the new overflow/second assistant? He requires me to give her my clients when the front office does not fill her schedule. I have talked to him many times about this behavior. I recently asked to talk to both of them. I asked why the doctor and assistant feel like I’m not not using her to her fullest. The second assistant did not say much in our meeting, she let the doctor talk. I know the assistant tattles to one of our front office people and the doctor when she feels she has been wronged, but she doesn’t come to me. I find this VERY irritating since when she first started she told me, "I’m not here to take your job, and if you ever have a problem with anything I do I want you to be able to talk to me about it and not go to anyone else." What is it going to take to get the doctor to see that I am NOT responsible for the lack of patients in the second assistant’s column? For someone who keeps saying that she is not here to take my job and she is my partner, she sure acts just the opposite! What do I do?

ANSWER FROM ART McCRACKEN, Synapse Point Consulting:
I see three things here:
1. This is only one part of the picture, and only one party is verbalizing the complaint. There are always two sides of the coin.
2. The new dental assistant has nothing to do with this, so drop that notion.
3. Effective communication is absent. This may or may not be a cultural norm of the practice.

Again, we're getting one perspective here, but from that perspective it appears that there is a significant breakdown in communication. It sounds like goals haven't been clearly defined and adopted, roles remain undefined, and the systems of troubleshooting and communicating are weak.

It's obvious you feel threatened by the new assistant. If the doctor has an attachment or seems to be more engaged and protective of the new assistant, it may be because he is working with someone that is meeting his previously unmet expectations. The doctor may not be clearly communicating what those expectations are, but may also feel as if he shouldn't have to.

Each of us has our own way of defining success. When there is confusion and contention in an organization, it's usually linked to the unclear communication of expectations of its leaders.

Here's a solution. Rather than complain about what's broken, own the solution and become the fix. If that means you ask the doctor to better define his expectations so you are clear about them, then do that. The more you try and convince others of how you've been victimized, the more it will taint the culture of this practice. If that type of behavior is allowed by the doctor and accepted by the team, then you can look forward to much more of this sort of thing happening in the future. The practice might not be a fit for you if you are looking for a high performing culture with people who respect each other. Best of luck!

There are two issues here
1. Lack of effective communication
2. Being a victim, or being personally strong

Many people are not good communicators. As a leader, a dentist MUST learn how to be a good communicator, and thus a good leader of his practice. You can help the dentist become a better communicator and leader by being strong in your questions and how you move the conversation with the dentist.

You only present your side, and I have no way of asking the other side what was said at the meeting. If that could be done, the sense of a bad meeting might be turned into a good learning experience for all parties, especially the dentist. In my opinion, it is the role of the dentist leader to effectively address concerns of team members as individuals, as well as how they interact with other team members and their boss. But the dentist cannot read the minds of his team.

You did act proactively to meet with the dentist and new hire. But what was the outcome of that meeting? What was written down? What will be the follow-up? What were the ground rules of the meeting before it started? My recommendation is to sit down with the dentist when you will not be interrupted and ask a simple question, “Do you want me to work with you now and in the future on a full-time basis?” If the answer is no, then you know to look for work elsewhere. Period. The end.

If the answer is equivocal or not a straightforward yes, here’s what must be discussed and written down, with a follow-up reevaluation time set in not more than 30 days. You should work on a 30-day trial basis, and this agreement should be signed by both you and the dentist and placed in your file.

· What are you doing or not doing vs. the new hire? Be specific.
· What can be done to get you up to the level of skills (personal or clinical) that would make the dentist say, “Yes, I want to work with you now and in the future” with no hesitation. Be specific.
· Agree that there will be open communication between the dentist and you on an ongoing basis as you work through what needs to be improved.

If the answer is “Yes, I am in 100% with you working with me now and in the future,” then you and the dentist must both address your fears.
· Ask, “Why are patients being put onto the new hire’s schedule and taken off mine?” Get specific. If the dentist says, “I did not ask for that to happen,” then you and the dentist must immediately tell the appointment scheduling person that patients are not to be moved out of your schedule if the doctor’s schedule is light. The dentist, not you, must speak directly to the scheduling person.
· Write down what was discussed at the meeting. Both of you should sign and agree as to what was discussed, and each of you should get a copy.
· Set a specific formal review to see if your fears and concerns are still ongoing. It should be in no more than 30 days.

The new hire is just that, a new hire. If that person was hired to replace you, then get that in the open and find a new job. If the new hire is not to replace you and your issues are addressed, the issue of how you and the new hire are to work together becomes a conversation between the doctor, you, and the new hire. Openly address the “busyness” considerations around keeping this extra assistant. It is only fair for the new hire to know the parameters of her employment.

ANSWER FROM SERENA WIXOM, Advanced Dental Consulting:
There seem to be several problems at play. With limited information regarding the nuances of the intrapersonal dynamics of the dentist and team, it’s a bit difficult to pinpoint a single solution.

The first thing I see is that the doctor is not taking an active, effective leadership role in the practice. There is a fine line between being the boss and being a friend. It’s best for the practice that the dentist/boss/owner maintain a professional relationship with all members of the team. If the meeting with the dentist and assistant doesn’t resolve the situation, perhaps bringing in a professional facilitator may be helpful for all involved to come to some understanding and solutions.

The second problem is the schedule not being full, thus causing this behavior. It is commonly the responsibility of the front office to keep that schedule full. I’ve found an effective way to keep the schedule full every day is to confirm two days prior to an appointment. If there is an opening in the schedule, it is best to call patients scheduled at or around the same time on other days to see if they’d like to come in early. Next, call patients off the quick fill, ASAP, or unscheduled treatment plan lists. Let them know that you are thinking of them and ask if you can schedule an appointment. Chances are that someone will fill that opening.

Do YOU have a tough issue in your dental office that you would like addressed?

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