Practice Note
Individuals can develop their natural skills into sound management skills through experience, effort, and learning.
An employee should be delegated all tasks that are legally delegable to his or her role and for which he or she is properly qualified. Employees cannot work to achieve their maximum productivity if they feel that they are not given responsibility for which they are answerable.
Responsibility denotes duty or obligation. It also denotes follow-through and the completion of a project. An employee who is to become a valuable member of the dental health team must be delegated responsibility. If responsibility is withheld, then it is assumed that the administrative assistant or employer does not feel that the employee is capable of the task; the retention of this employee should be carefully considered.
Respect is consideration or esteem given to another person. Each member of the dental health team must respect the others’ education, skills, and values. To not have respect indicates a lack of confidence and again reflects a poor attitude toward another person’s capabilities. Each member has a major role on the team and should possess expert skills and credentials that warrant respect.
Rapport is a mutually trusting or emotional relationship that exists among the office staff members. Each dentist sets the tone for the rapport in the office. A good rapport in the office is effused into the patients who recognize how well the team members work together during tense times and how they enjoy each other’s professional friendship.
Recognition is a type of achievement. A person can be recognized for a task well done or for special achievements. Recognition can come in the form of verbal praise, a sign placed in the office that recognizes an individual’s employment and credentials, a monetary gift, or a gift certificate.
Remuneration is a monetary recognition of achievement. Most employees say that they are willing to work hard if they are compensated for their efforts. Remuneration should be based on education, merit performance, longevity, and cost of living. Dentist employers who affirm that their employees have worked with them for many years with repeated job satisfaction reviews are those who delegate responsibility; who create good rapport in the office; who respect, trust, and recognize their employees; and who provide compensation commensurate to other small business and allied health employers.
Functions of an Administrative Assistant
Because this textbook deals primarily with practice management, the role of the administrative assistant will be discussed in detail.
The basic functions of an administrative assistant in a dental office are shown in the schematic drawing in Figure 2-1. Some assistants may interpret this diagram to mean that their job is “a vicious circle.” In actuality, many of these functions overlap, and the basis for each depends on planning. Sound planning before beginning an activity may eliminate the need for crisis management or handling one crisis after another.
Planning involves identifying what is to be done in the future. The goals and objectives discussed earlier are vital to planning. The administrative assistant will be involved in long-range planning as well as daily planning.
Organizing involves determining how the work will be divided and accomplished by members of the dental team. After procedures have been identified and tasks enumerated for each procedure, the administrative assistant is required to assign the duties to specific staff members. It is essential that the dentist give this authority to the administrative assistant. Without this authority, the administrative assistant cannot manage effectively.
Staffing includes the recruiting, selecting, orienting, promoting, paying, and rewarding of employees. Cooperation among staff members will be necessary as new employees are integrated into each technical area of the office. Staffing also involves instructing, evaluating, and educating employees as well as providing opportunities for their future development. In addition, the administrative assistant is responsible for recommending an appropriate system of pay and a benefit package.
Leading involves directing, guiding, and supervising the staff during the performance of their duties and responsibilities. It consists of exercising leadership; communicating ideas, orders, and instructions; and motivating employees to perform their work effectively and efficiently. This is really the “people” function of management.
Controlling is the function of management that deals with determining whether or not plans are being completed and, when necessary, making decisions to modify plans to achieve specific objectives.
Basic Skills of an Administrative Assistant
At this point, one may wonder what basic skills are required to function as an administrative assistant and to perform the administrative role effectively. Although many skills are needed, a few of the most important ones are the following:
The relative importance of these skills varies according to the type of office; the type of practice (i.e., general or specialty); the job being performed; the staff being managed; and the involvement of a practice management company if one is used.
Conceptual skills involve the ability to acquire, analyze, and interpret information in a logical manner. These skills help one to put an idea or concept into perspective and to perceive how this idea would affect the whole practice.
Human relations skills help with the understanding of people and with effectively interacting with them. These skills are vital in a health profession and include communication, motivation, and an ability to lead.
Administrative skills are those that help you to use all of the other skills effectively when performing administrative functions. These include the ability to establish and follow policies and procedures, to process paperwork in an organized manner, and to coordinate activities in the dental office.
Technical skills include understanding and being able to effectively supervise the specific processes, practices, and techniques required of specific jobs in the business office. This is the use of all of the knowledge of dentistry and business, so that the day-to-day operations of the office may flow smoothly.
The Ethical Administrative Assistant
In Chapter 1, several characteristics of an effective leader were listed. In addition to these characteristics and the basic skills that the administrative assistant should possess, the professional attitude and ethics of this person have a significant influence on the staff. The following suggestions may identify some attributes of an ethical and caring administrative assistant:
Staff Communication
Communication is an essential element of management, and it becomes a vital link for establishing meaningful relationships among the administrative assistant, the dentist, other members of the staff, and the patients. The basic definition of communication is understanding and being understood by another person. As Bob Adams states in his book, Streetwise Managing People: Lead Your Staff to Peak Performance, “Quality Communication = Positive Interaction.” When an office staff employs positive, constructive communication, it is sending a consistent message. The relative success of a dental practice is measured by the ability of the staff members to communicate with each other and with their patients.
Communicating with staff members is in many ways like communicating with patients. Information is being transmitted between people and therefore understanding should occur. However, when communicating with staff members, the status of the individuals involved have changed, and thus the channels of communication may be more complex. To achieve quality communication, consider following the simple steps suggested in Box 2-4.
Channels of Communication
As a dental practice increases in size, the channels of communication become more complicated. Both formal and informal communication exist. A formal communication channel is dictated by the type of management that exists in the practice. Formal communication may be downward, upward, or horizontal.
Downward communication is exemplified when a dentist issues an order or mandate that is disseminated to the staff member at the next level. Downward communication includes instructions, explanations, and communications that help the employee to perform his or her work. These instructions may be given to the business or clinical staff. If a management company exists, there may be two-way downward communication from the dentist to the management company and from the management company to the dentist. In this case, too, the management company may give instructions to the business staff within the office.
Upward channels of communication are vital in a formal setting. Employees should be free to express their attitudes and feelings. This type of communication reverses the flow of information and is generally of a reporting nature. It may include suggestions, complaints, or grievances. A lack of upward communication may result in dissatisfied employees.
Horizontal communication is essential for a larger organization. This type of communication involves the transmittal of information from one department to another. This type of communication exists within large offices, clinics, hospitals, and dental schools. Likewise, it could occur in a dental office between the management company and the dentist.
Informal channels of communication can also be referred to as the “grapevine.” This form of communication is often feared by administrative assistants; however, if it is handled effectively, it can provide the assistant with insight into staff emotions. Frequently the grapevine carries rumors, personal interpretations, or distorted information. Fear often causes an active grapevine. It becomes the responsibility of the administrative assistant to listen to the grapevine and to eliminate rumors by explaining the actual facts. Thus, the administrative assistant develops skill in the handling of tension created by the grapevine.
Empowering Employees
In Chapter 1, empowerment was defined as “putting power where it is needed.” Just as the dentist leader has empowered the administrative assistant or office manager, this person should also provide the staff working in the business office with the power and authority to accomplish office objectives.
The dentist who gives employees the power, ability, and permission to accomplish office objectives and to perform legal tasks independently will have the edge over the competition. To be successful, the dentist must be able and willing to recognize the value that each employee brings to the office. In Bob Adams’ book, Streetwise Managing People: Lead Your Staff to Peak Performance, the author declares that “empowered employees attempt to work above and beyond their anticipated capabilities.” To empower employees, he recommends the creation of an environment in which staff members do the following:
Many concepts that Adams introduces seem to show common sense. When applied to a dental practice, these concepts seem to fit like a glove. Box 2-5 lists concepts that can be adapted easily to any dental practice to empower each member of the staff to become a meaningful member of the dental team.
Conducting a Staff Meeting
Two types of staff meetings commonly occur in the dental office: (1) morning “huddle” meetings and (2) routine team or staff meetings, which occur at least monthly.
The “huddle” meeting occurs once a day, most often in the morning, before the day begins. It lasts about 10 to 15 minutes and serves as a time to review all of the patients for the day and to discuss preventive and restorative work that needs to be done, emergency times, patient concerns, and any radiographs to be taken. During this time, patient management problems can be addressed, staff assignments can be made for assorted expanded duties, and business activities can be reviewed. Some offices have such a meeting twice a day and review the morning patients before beginning the afternoon assignments. Such meetings provide the opportunity to adequately prepare for patient treatment and to ensure that the entire team is tuned in to rendering patient care.
Regularly scheduled staff or team meetings should become a routine part of the dental practice, and they should occur at least once a month. These meetings are an effective means of keeping communication channels open. The staff meeting provides an opportunity to define and review the goals of the practice and to help motivate the staff. Although criticism may be part of a staff meeting, such a meeting should not be designed as a gripe session. The time and length of the staff meeting will vary according to the needs of the staff. Some offices schedule an hour per week or month, others close the office for a half or a full day for a retreat session, and still others find breakfast or lunch meetings to be effective. It may be worthwhile to consider having a different staff member head the meeting so that all persons may take responsibility for planning and executing the meetings.
An agenda may be used when planning a staff meeting. The agenda, in combination with the list of rules presented in Box 2-6, expedites the business objectives of the staff meeting.
Managing Conflict
Some administrative assistants become defensive and irritated when confronted with a complaint. These individuals may feel that a complaint reflects on them personally. Conflicts are normal between an administrative assistant and an employee or between a patient and a member of the staff; however, concern should be raised if numerous complaints arise, because this may indicate a serious problem.
Regardless of the nature of the complaint, the administrative assistant should review the details of the complaint and seek to resolve the problem quickly. Steps taken to resolve the problem may include the following:
It is not easy to resolve conflict, and most of us wish to avoid it. However, conflict will arise whenever two or more people are working together. The administrative assistant must try to be fair and objective. If these suggestions are followed, at least an attempt to resolve the complaint in a professional manner will have been made; this may avoid minor conflicts that can escalate into major crises.