Are your dental team members lone 'silos,' or do they take 'team' seriously?

It's important for dental team members to understand the responsibilities of each other, and how they can work together to make the practice run more smoothly

Mckenzie Silos

General Motors CEO, Mary Barra, and the company she runs are taking a beating over the ignition switch fiasco that, as of this writing, has led to considerable fallout for the corporation that taxpayers bailed out just a few years ago. As Ms. Barra faced scrutiny during hearings on Capitol Hill, during her testimony she lamented the “silos” in the organization and a “culture” that was focused more on cost. No question, GM is a huge company, and what we are witnessing is yet another example of what system failure looks like on a titanic scale.

Mckenzie SilosBut culture and communication are serious issues that can lead to serious outcomes in every organization and every business, regardless of their size. The dental practice is no exception. Individual employees commonly carve out their niches. Beth is responsible for one area. Emily takes full ownership of another, while Mike is in charge of his. So what’s the problem? There’s a delicate balance between taking ownership of your responsibilities and building walls or silos, as the case may be.

The “silo effect” occurs in the workplace when individuals are focused almost exclusively on their own areas. Think of farm silos – they stand next to each other, each performing individual functions, but they have no link between them. That’s not a problem out on the farm, but in the workplace it’s a different story. The silo effect is another way of describing that old workplace problem of the right hand not knowing what the left hand is doing. Each person is performing his or her job, with little attention paid to the big picture, or how each system intertwines with the others, or how a seemingly wise decision at one point in the process could have catastrophic outcomes in another.

The silo effect can occur in the dental practice when there is a lack of communication or common objectives among the different areas – the clinical staff and the business staff, the doctor and the hygienists, etc. Individuals have tasks to achieve, but there’s minimal focus on overall goals or teamwork.

The business employee unknowingly schedules the emergency patient at a time that puts significant strain on the doctor and assistant. The doctor recommends that a patient pursue an extensive treatment plan, not realizing that the patient carries a significant balance on his account. The collections coordinator is told to increase collections, but is frustrated by the doctor’s actions, saying, “I can’t control accounts receivables when the doctor is recommending costly treatment to patients with outstanding balances.” Meanwhile, the doctor wants to increase treatment acceptance and is now offering more elective procedures, but there’s no effective communication between the silos.

The hygienist provides care to the patients who show up, but her production continues to fall short. She has been told that she needs to see more patients and if she does she will get a bonus, but she can’t achieve that without help from the others. No one is willing to help confirm appointments – it’s not their job, they say – so the hygienist can’t increase her production or the practice’s production.

Resentment builds on all fronts, including with the business staff. They may be saying, “I have enough to do with my own job. I can’t be sitting on the phone all day. Let her make those calls. After all, she’s the one who will get the bonus, not me.” Each person is so focused on his or her individual duties that it seems no one has any concept of the bigger picture and in many offices, that bigger picture has never been painted.

Consequently, the collective interests of the practice as a whole suffer. If there are common goals or a common purpose, they don’t have a chance in this environment until the silos are torn down and individuals focus on how they fit into the shared success of the office. That begins with the doctor creating and communicating his or her vision and goals for the practice.

For some, this is a significant hurdle. After all, dentists are not trained to create visions or develop goals for systems that they barely understand themselves, let alone lead teams. Dentists are trained to treat patients. It’s certainly no wonder that for many doctors the sentiment is, “If I’m doing my job and the rest of the staff are doing theirs, what else do you need to do to be a team?”

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Sally MckenzieSally McKenzie is CEO of McKenzie Management, a nationwide dental management, practice development, and educational consulting firm. Working on-site with dentists since 1980, McKenzie Management provides knowledge, guidance, and personalized solutions that have propelled thousands of general and specialty practices to realize their potential. She can be reached at 877-777-6151 or

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