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Practice Growth in 90 Days Rhonda R. Savage, DDS, CEO, Linda Miles and Associates

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by Rhonda R. Savage, DDS, CEO
Linda Miles and Associates

On a scale of one to 10 (“one” being completely unwilling and “10” being absolutely willing), how willing are you to change? If your answer is a four, that’s not good enough! This article is about leadership, a topic of which we rarely receive training while in any dental program. Dentists and practice administrators who read this should come away with some tools that will help empower your team, and comfortably allow you to discuss their goals, give input and hold them accountable. As a team member, you will learn how to give valuable feedback to your office manager or dentist. For dental offices to grow, you need to be able to comfortably address the things that aren’t going well as well as address the areas that are going well! Team members need to be able to express their concerns for the practice to grow.

Let’s use broken appointments as an example when addressing leadership. Broken appointments can inadvertently happen because of what we do and don’t do in the dental practice. If you run late, change your patient’s appointments, have misguided communication, don’t have clear financial policies or don’t create value for the upcoming appointment, you’ll experience more last-minute cancellations and broken appointments. It takes leadership, teamwork and training to change these problem areas, all of which must begin at the top.

Did you know the U.S. military dental departments also have problems with broken appointments? As a U.S. Navy Dental Officer, attached to the Fleet Marine Force in Camp Pendleton, California, during Desert Shield/Desert Storm, I learned first hand what it took to change an organization. The troops were expected to be at an 80 percent level of dental readiness. This meant that 80 percent of the men and women needed to be free of potentially debilitating dental problems. Instead, they left our country with a readiness level of 30-35 percent. The Marines deployed for the war at a low level of dental readiness, which led to many dental problems overseas where facilities and dentists were limited or unavailable!

After the war, the Commandant of the Marines issued a directive that all Marines would be at 85 percent dental ready. I reported this to the Colonel in charge of my unit. The man had the eyes of a killer – direct, cold, steel-blue eyes that made me sweat! He told me, “I want you to open your clinic on Saturdays and take care of my men.”

Swallowing, I carefully replied, “Sir, I could do this for you. However, your men fail 38 percent of their regularly scheduled appointments. Why should I ask my people to work extra hours when your men don’t make their appointments? I’ll have a ‘stand-down’ for your troops. We’ll get them in and out during our regular day, but Colonel, if you don’t care, I won’t care, and quite frankly, neither will your troops!” Eleven months later, I received an award in front of the entire command for having the colonel’s troops at 92 percent dental ready! When the Colonel cared, no one failed Lt. Savage!

As a leader in your practice, you set the standards for the level of passion, enthusiasm, energy and willingness to change. Here are six tools to facilitate change and hold team members accountable for their responsibilities:

1. Invite your team members to set their own goals
Many practice management groups encourage yearly performance reviews. A yearly formal review is important. However, to facilitate change, you’ll need a system to focus on short-term goals and provide oversight, guiding your team member’s progress.

To begin, ask some basic questions: What are your objectives for the next 90 days? What are your plans and priorities? What is it that you hope to achieve? How do you plan to go about achieving your goals? Then, once you’ve mutually agreed upon the employee’s goals, you sit down every 90 days and review their progress. The review process is actually a 90-day cycle, finishing at the end of one year with a formal review.

By establishing their own goals and coming to a mutual agreement, team members “buy into the process.” You’re not dictating their goals. It’s important that we emphasize the importance of the goals being mutually agreed upon. The team member might overshoot what they are able to accomplish. Or, their goal might not be the most important priority for the office. As an example, the team member’s goal might be to reorganize the filing system. This goal might take second place, however, to the need for a focused reactivation effort of your patient base that will fill your hygiene schedule.

2. Come to mutually agreed upon goals by asking questions
What goal do you personally want to work on in the next two-to-three months?
  1. Why is this goal important to you?
  2. How will it help your co-workers?
  3. How will it help the practice and the patients?
The goals should be specific, realistic, and measurable plus have a specific time frame. In addition, ask your employee:
  1. What do you need to accomplish this goal?
  2. Let me know my role in supporting your goal.
You’ll be surprised at the goals your team members come up with! The more your employee feels he or she has set their own goals, the more likely that person is to do everything he or she can in order to reach them! After all, your employees decided upon the goals themselves and they want to have your approval. Because they can do things their own way, they’ll do their utmost to make certain it makes good sense.

3. Evaluate potential problems
There are two potential problems with this system. The first is that people can bite off more than they can chew. If so, the boss often doesn’t need to say anything. The employee will bring it up because it will be obvious. One word of caution: if you and your team member agree upon the goal and they do not have the time needed to achieve the goal, the task will become a burden. This is not fair to the team member. Be certain to carve out the adequate, agreed-upon amount of time needed to accomplish the goal.

The other is the doctor’s tendency to interfere too early. Resist the temptation! This takes patience. The system works best when you don’t interfere. Your team will be headed forward in a constructive way, toward the agreed-upon objectives. As a practicing dentist, I know from experience that we are detailed oriented and tend to micromanage. If you want self-starters who have an “ownership mentality” vs. a “clock-puncher mentality” you’ll need to step back and not micromanage!

4. Accountability
Accountability is so important in a team setting! It’s not enough that your team members develop their own goals. You must, as the leader, give them feedback on how they’re doing or their work is devalued and can become meaningless.

As an example, ask your front office team to give you monthly reports at the close of the month. Include a summary of production and collections, the Accounts Receivable Aging report, the past due insurance report and the new patient report. If you request these reports but then do not follow up with feedback, your team member will not feel their work is valued. Remember these words: “What gets measured, gets treasured!”

Each team member should have designated responsibilities and be held accountable for their work.

Dental assistants should have designated duties regarding laboratory cases and supplies, as well as equipment maintenance, sterilization and OSHA. Hygienists need clearly defined duties to perform during down time: helping with recall, sterilization and ordering. If someone slacks on their job, it’s important to hold that individual accountable, and quickly!

5. Hold annual motivational performance reviews
The performance review time is not a time to address something that happened three months ago! A well-done performance review includes a self assessment and the doctor’s assessment (If you would like to see a copy of our personnel assessment form, please e-mail rsavage@harbornet.com). If your practice has an office manager/practice administrator, this person should be also involved in the review process.

Performance reviews should be timely and held in the anniversary month of the hiring of the team member. Ask your staff person these questions:
  1. Are you happy?
  2. Are you being challenged?
  3. What skills, ability or training can I give you that will better enable you to do your job?
Consider separating the discussion of merit increase from the review process.

Merit increases should be based upon attitude, contribution to the practice, willingness to volunteer for projects and the health of the practice. A motivational merit increase is one that is tied to performance and is given after the goal established by the doctor and team member has been accomplished. When the staff person knows where the raise came from and when the next one will come, it will be motivational!

6. Evaluate yourself and ask for your team’s involvement
As a leader, you do live in a glass house. Hold yourself to the same standards that your team is held to. Ask yourself the following questions:
  1. Are you happy?
  2. Are you being challenged?
  3. On a scale of 1-10, what is your level of passion and enthusiasm toward dentistry?
  4. Are you on time for work?
  5. Do you put patient care first and foremost during your day?
Ask your team members to give you feedback on these two questions:
  1. My goal is to be a better time manager. What do I do on a daily basis that wastes your time or the time of the patient?
  2. If this were your practice, what would you do to decrease my overhead and increase the production?
Leadership is a tough subject and one that has little coverage in dental school! To learn about leadership, I would challenge you to read a book a month on leadership and better communication skills! Team members need and expect clear, fair, consistent leadership.

So, how willing are you to change?
Change equals risk. It’s not easy to change, yet it is through change that our staff will stay motivated and enthusiastic about dentistry. We know that the higher the morale in the practice, the greater the productivity! Successful offices, even in today’s times, have been experiencing stability and growth. The six tips above are meant to empower your team members. Hold all team members accountable. Have reasonable, clearly defined goals and expectations for each person on your team.

Author’s Bio
Dr. Rhonda Savage began her career in dentistry as a dental assistant in 1976. After four years of chair-side assisting, she took over front office duties for the next two years. She loved working with patients and decided to become a dentist. Dr. Savage graduated with a BS in biology, cum laude, from Seattle University in 1985; she then attended the University of Washington School of Dentistry, graduating in 1989 with multiple honors. Dr. Savage went on active duty as a dental officer in the U.S. Navy during Desert Shield/Desert Storm and was awarded the Navy Achievement Medal, the National Defense Medal, and an Expert Pistol Medal. While in private practice for 16 years, Dr. Savage authored many peer-reviewed articles and lectured internationally. She is active in organized dentistry and has represented the State of Washington as President of the Washington State Dental Association. Dr. Rhonda Savage is the CEO for Linda L. Miles and Associates, known internationally for dental management and consulting services. Dr. Savage is a noted speaker who lectures on practice management, women’s health issues, periodontal disease, communication and marketing, and zoo dentistry. To speak with Dr. Savage about your practice concerns or to schedule her to speak at your dental society or study club, please e-mail rsavage@harbornet.com, or call 877-343-0909.

This story, originally published in the KISCO Perspective Newsletter, is reprinted with permission.
Dentaltown Magazine
September 2025
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