Dental Team Management

 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.

FIGURE 2-1 Functions of an administrative assistant.

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:

• Conceptual skills
• Human relations skills
• Administrative skills
• Technical skills

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.


image Practice Note

Human relations skills help you to understand people and allow you to interact with them.

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:

• Respect the dentist and the practice concepts. Being respectful of a dentist employer means not circumventing him or her with issues or concerns. If an administrative assistant has an idea to improve the practice, discuss it with the employer. If there are problems with a task or a staff member, share these concerns. Believe in the dentist and the practice, and support the objectives that have been defined. If a person stays in a practice in which unethical conduct occurs, he or she is essentially supporting this type of practice; thus, one’s personal ethics become questionable.
• Maintain frequent communication. For people to follow someone, they must know who that person is, what he or she represents and can do, and what his or her vision is. To do this, the administrative assistant must tell and show the other members of the staff what he or she is about. In other words, the administrative assistant should disseminate ideas in meetings and during day-to-day interactions with the staff and cultivate relationships outside of the office to have a network of contacts from whom to draw information when a task needs to be performed. Written and verbal communication must be continuous and supportive. These individuals must take time to communicate positive responses to the staff. The attitude presented to others affects their performance both positively and negatively. The staff must know that the administrative assistant possesses the skills and knowledge necessary to lead them in their daily workload and that the administrative assistant is also capable of performing the assigned tasks. Frequent communication does not relate to staff interaction only; it must also be practiced with patients. Patients need to understand relevant issues that relate to their dental care, and they must receive frequent communication from and about the office.
• Utilize feedback. Administrative assistants must be able to recognize nonverbal cues, use feedback as a positive source of communication, and transmit feedback between management and staff.
• Make ethical decisions. To do this, one must gather facts and analyze problems, develop alternatives, determine the ethical issues involved, brainstorm with staff members, determine what actions should be taken and whether they are practical, and evaluate the results of the decision that was made.
• Avoid unnecessary delays in decision making. Sound decisions should be made as soon as possible; if conflicts go unresolved, greater problems may be created.
• Delegate authority. The administrative assistant can demonstrate his or her confidence in the staff members by allowing them to assume responsibility and provide freedom for them to work.
• Identify constraints within which work must be done. Time limits on production needs must be established, and staff members must be allowed to develop their own approaches within the defined framework.
• Exercise self-control. Emotional outbursts do not lead to constructive management. The administrative assistant should never “talk down” to staff members.
• Make time available to staff. The administrative assistant should not be too busy to listen to a staff person. This does not mean dropping everything to listen, but time should be made available for staff input.
• Build and develop strong followers. One of the hallmarks of a successful administrative assistant is that he or she surrounds himself or herself with action-oriented, dedicated followers. By showing confidence in the followers’ abilities, providing challenging assignments, and being genuinely concerned, the administrative assistant garners respect, loyalty, and commitment while inspiring high-quality performance. In essence, the administrative assistant makes it easier to delegate and free himself or herself to devote more energy to issues that require his or her time. The key to this characteristic is for the administrative assistant to be genuine and honest in his or her delegation rather than only delegating duties that involve no challenge or that are not recognized.
• Be visible. An administrative assistant cannot hide behind a desk and be a leader. There is nothing arrogant or inappropriate about letting others know what the administrative assistant and other members of the staff have accomplished. The administrative assistant should share a complimentary memo with the staff or patients when significant achievements have been made. He or she should participate and encourage staff members to participate in activities that place the people and the office in the spotlight. He or she should be cautious to not take on too much, and he or she should complete what is taken on with quality and panache.
• Learn from mistakes. Everyone makes mistakes, so they should not be agonized over. However, it is important to find ways to avoid making the same mistake again or assigning the blame to others. Some individuals consistently blame others for their mistakes. This characteristic will not be present in a good administrative assistant. Leadership is about accepting the mistake, moving forward, and not wallowing in the past.
• Expand the leadership role. An administrative assistant or office manager must extend the leadership role beyond the dental office. Make an effort to become involved in other professional or business groups that will provide valuable information for the office and offer the opportunity to place the office in the spotlight. Specifically, the administrative assistant will want to participate in the American Association of Dental Office Managers, AADOM ( This organization provides an opportunity for networking and support with educational webinars, access to foundations of dental practice management, study clubs, a newsletter, a magazine, and an annual conference specifically designed for business office personnel.

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.


Box 2-4   Suggestions for Creating Positive Staff Interactions

• Help others to be right rather than wrong.
• Whenever possible, have fun.
• Be enthusiastic.
• Seek ways for new ideas to work rather than reasons why they will not.
• Be bold and courageous; take chances.
• Help others to achieve success.
• Maintain a positive mental attitude.
• Maintain confidentiality.
• Verify information given to you before you repeat what you hear; avoid gossip.
• Speak positively about others whenever the opportunity arises.
• Say “thank you” for kind gestures or a job well done.
• Express a happy attitude in your nonverbal communication.
• If you do not have anything positive to say, then do not say anything.

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:

• Behave as owners of the job and the company
• Behave in a responsible manner
• See the consequences of the work they do
• Know how they are doing and how they are valued in the practice
• Are included in determining solutions to problems
• Have direct input into the way in which the work they do is done
• Spend a good deal of time smiling
• Ask others if they need help


image Practice Note

To be successful, the dentist must be able and willing to recognize the value that each employee brings to the office.

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.


Box 2-5   Concepts to Empower Employees

• Create a communication process that is complete, consistent, and clearly understood by all members of the staff.
• Ensure that all employees understand what is expected of them in their respective job positions.
• Provide each employee with the appropriate training, information, and materials to successfully accomplish their job duties.
• Clearly define and establish evaluation instruments for the responsibilities for each job.
• Create controls that are guidelines that allow flexibility.
• Encourage and practice behaviors that promote encouragement, support, and clear feedback to employees.
• Encourage and promote a sense of responsibility in each employee.
• Encourage and promote continuing education and credentialing.
• Create opportunities for staff members to work together in teams.
• Make it easy for people to praise each other. Make the office one that recognizes and acknowledges praiseworthy actions.
• Listen to employees at all times. Make the office systems listen to the employees.
• Trust the employees.

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.


image Practice Note

The staff meeting provides an opportunity to define and review the goals of the practice.

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.


Box 2-6   Guidelines for Holding Effective Team Meetings

• Notify each staff member of the time and place of the staff meeting. The use of e-mail will ensure that all parties are sent the information.
• Request a return reply for attendance.
• Determine the priority of agenda items.
• Obtain suggestions for these items from staff members.
• Provide a copy of the agenda to each staff member, and adhere to the agenda items.
• Review accomplishments.
• Determine goals and things that need to be changed.
• Establish a method for accomplishing these goals.
• Review outcomes of the meeting.
• Provide keyboarded minutes to the staff.
• Maintain a strict meeting schedule.
• Do not allow one person to monopolize the meeting.
• Do not turn the meeting into a gripe session.

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:

• Make time available as soon as possible to discuss the problem. A delay may result in additional conflict, or it may be interpreted to mean that the administrative assistant is not interested in listening to the problem.
• Listen patiently to all of the issues, and keep an open mind. The administrative assistant can gain the staff member’s confidence by encouraging the staff member to talk and by indicating that there is an intention to provide fair treatment.
• Determine the real issue. Frequently a complaint is made about a problem when in reality a deeper concern is the real issue. For example, a person may be complaining about unfair work assignments when actually the source of the problem is a personality clash between two staff members.
• Exercise self-control. Avoid arguments or expressions of personality conflicts between the complaining parties. Emotional outbursts generally do not lead to a constructive resolution of the problem. Should such an outburst result, it is wise to terminate the meeting until a future meeting can be scheduled so that the problem can be discussed in a calm manner.
• Avoid a delay in decision making. A dental office is a relatively small business organization, and allowing a conflict to go unresolved can cause undue stress on the entire staff. If it is necessary to delay a decision, let the persons involved know the status of the problem.
• Maintain a record. Documentation of meetings or discussions is helpful should future conflicts arise over the same problem. It is impossible to recall all of the issues about an incident; therefore, information should be retained in an employee file or another appropriate area for future reference. This memorandum should be presented to the employee, and the employee will then sign it to ensure credibility.

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.

Barriers to Staff Communication

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Mar 21, 2015 | Posted by in General Dentistry | Comments Off on Dental Team Management
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