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The Guerilla Practice Sale: How to avoid a crying, angry, surprised staff Dr. Rhonda Savage

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by Rhonda Savage

When I bought my first practice, I walked in, with a tray of steaming hot lattes. The team members were crying. One front desk person thought, when she saw the tray of lattes: “Hey, this might not be bad!” However, this wasn’t the group consensus! One dental assistant left the practice that first week. She felt betrayed. A transition can be a very hard time for some staff. It’s not easy, even if it’s a planned transition. Transitions are hard for the team members and difficult for the new doctor. Plus, if you’re the selling doctor, you might have seller’s remorse.

It’s unrealistic to think that a major change like this will be something everyone can live with; but it is realistic to consider a strategy, create an action plan and be prepared when the transition happens. Staff retention can be good or bad; much depends upon your approach, your willingness to prepare and your follow through as the new doctor. Let’s talk about the “Rules of Conduct” in this landmine of potential problems. This article will address the following topics:
  • How to earn the trust and respect of patients and staff when you’re the new person on the team.

  • How to establish yourself as a leader in the practice, instilling a climate of ownership so every person feels like they’re accountable and responsible for the success.

  • How to create a practice where change and innovation are not met with fear, but instead, are understood as ways to set yourselves apart from the competition.

  • As the selling doctor: What are your responsibilities?
The first question we should address is: Should you keep the team? Some say, “Fire them all, right away.” I would disagree. The team can and should help with the transition. Should you keep someone who’s disrespectful? No, but this is a qualified no. Read on for the answer.

As a young, eager new practice owner (the former doctor worked on a limited basis for six months), I made all the mistakes. I jumped in, excited, and began talking about adding hours and expanding days. Staff began to shift nervously, like a herd of antelope, ears up, eyes darting. I wanted to implement new technology. Nostrils flaring, the team members thought, “Am I going to have to change?” I was impatient; I wanted it all and I wanted it now. I didn’t communicate well. And, I didn’t understand the business of the practice. There was no plan. I was running this practice like it was all about me. I quickly learned that it couldn’t be like that.

Whether you’re coming in as an experienced doctor or a younger dentist, this applies to you. As a doctor, you cannot get where you’re going or accomplish everything by yourself. What you do need to do is to come into the new situation well prepared as a leader.

Here’s how:
  1. Come in with a well-written office policy manual. One resource is Bent Ericksen and Associates.* Google it, take classes from them and learn about employment law. Quite frankly, you’ll sleep better at night. Spendy? Yes. But you’ll save in grief and mistakes; well worth the value and it’s based upon your state laws.

  2. Decrease the fear of the team with confidence, friendliness, great listening skills and saying, “I need your help!” Bottom line in guerrilla practice transitions: It’s all about leadership. If you don’t feel confident, fake it. Don’t let your ego, however, get in the way of listening to the team. They know stuff.

  3. Work with a great coach. You can save yourself costly mistakes. I hired one of Linda Miles consultants and put great systems into place, after I’d made my share of mistakes.
There is an awareness that comes with mistakes. One I learned was that leadership is earned. Trust is given slowly. Leadership, communication skills and knowledge of business systems are not taught in dental school, nor are these skills part of most office manager’s training.
To earn trust, there are a number of areas that you should consider:
  • Follow through consistently. Always do what you say you’ll do.

  • Be the first one to work, or nearly so and come in “on top of the world.” Think your happiest thought before you walk in the door. Watch Sean Achor on YouTube: The Happiness Advantage.

  • Have a team meeting and let them know your vision and goals for the practice. Start with a values exercise.

  • Develop a system of daily coaching. Let the team know you’re open to coaching also. Your team members need to know daily what they need to change. With that said, do praise and appreciate what they do well. Look for the good. Also, be careful that you aren’t micromanaging; management is a balancing act. Micromanagement will drive the morale of the practice down. Don’t coach when you’re angry, but do let people know, if possible, that day what they need to change. Use a dialogue format rather than a berating format. Ask for their thoughts on the situation.

  • Make certain you’re listening to them. Involve them in dialogue so they don’t feel threatened. Listening means you don’t answer your cell phone, do not look at your computer and leave the paperwork on your desk alone. Paraphrase and ask clarifying questions: “So if I’m hearing you correctly…” or, “Just to make certain I understand what you’re saying…”.

  • Clearly define your expectations. Train your team members to ask you clarifying questions.

  • Learn the business systems of the practice so you can hold them accountable.

  • Talk about accountability systems. Your team members need to know how to read their reports. You need to have them regularly sit down with you to give them feedback, plus praise and appreciation for what they’ve done well. The front desk should not be a mystery to you.
These steps are foundational steps to earning respect. Let’s step back now to the initial questions:

How do you earn the trust and respect of patients and staff when you’re the new person on the team?

Let them know who you are, what your values are and how you envision the future of the practice. Ask for their thoughts. Lay down your expectations as a team and hold all team members to the same standards.

Put yourself at a higher level of accountability. Don’t send the wrong message, like: “I come late but hey, I’m the boss!” Ugh. You say, “Don’t be on your cell phone” but “I’m not giving up mine!” Double Ugh.

How can you establish yourself as a leader in the practice, instilling a climate of ownership so every person feels like they’re accountable and responsible for the success?
  1. Ask for their help.

  2. Lay out a plan.

  3. Start slowly with changes. Implement changes over time. Involve them in the change process (but always keep changing).

  4. Develop goals as a team.

  5. Be clear about expectations.

  6. No excuses from you. The staff doesn’t care!

  7. Treat patients with respect.

  8. Start slowly with patients, if possible, regarding treatment needs; you must earn trust and trust comes with time.

  9. It can’t be about the money, or the staff and patient will feel it.

  10. It’s not just about you.

  11. Don’t burden them with your debt issues. They need a sense of practice goals; long- and short-term.

  12. Establish leadership meetings with your office manager, selling doctor and/or any associates.

  13. Don’t be a friend or a dictator. Staff need and want fair, firm, consistent leadership from you.

How can you create a practice where change and innovation are not met with fear, but instead, are understood as ways to set yourselves apart from the competition?

Everything above! You cannot expect to be perfect, nor have expectations of team members to be perfect. Instead, create an atmosphere where it’s OK to make a mistake. The goal is to not repeat the mistake. If you make a mistake, throw your arms in the air and say, enthusiastically and loudly: “How fascinating!” Do this, grin and move on. Give your staff permission to do the same thing.

As the selling doctor, what are your responsibilities?
  1. Never say anything negative about the buying doctor.

  2. Ask for their help.

  3. Move your stuff out of your office and have it cleaned up and ready on day one.

  4. Support the doctor by letting the team know that to disrespect the new doctor is to disrespect you.

  5. Have the new doctor’s credentials ready and endorse them to the team.

  6. Talk up the new doctor to patients.

  7. Do not gossip about the practice or the new doctor in the community.

  8. Support the new doctor with training on the business systems and diagnosis. Be a supporter, but not a coach, unless you’re asked.

  9. Defer leadership decisions to the new doctor, but if you’re staying on, make certain you two are on the same page. Don’t let staff do the “mom versus dad” thing.

  10. Introduce the new doctor to the community.
You might well be doing all this stuff, but I know I wasn’t! Right out of the Navy Dental Corps, as a former dental assistant and front desk, I’ve made every mistake there is to make. Hang in there! You can do this!

*Dr. Savage has no financial interest in the companies mentioned.

Author's Bio
Dr. Rhonda Savage a former dental assistant and front office staff, graduated with a B.S. in Biology, Cum Laude, Seattle University in 1985. She then graduated from the University of Washington, School of Dentistry in 1989, with numerous honors. She served on active duty as a dental officer in the U.S. Navy during Desert Shield/Desert Storm; awarded the Navy Achievement Medal, the National Defense Medal and an Expert Pistol Medal. Dr. Savage was in private practice for 16 years. She has authored many peer-reviewed articles and has lectured internationally. She is a past president of the Washington State Dental Association and is an affiliate faculty member of the University of Washington, School of Dentistry. Dr. Savage is the CEO for Miles Global, an internationally known consulting business. A member of the National Speakers Association and the Institute of Management Consultants, Dr. Savage is a noted speaker on practice management, women’s health issues 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 rhonda@milesglobal.net, or call 877-343-0909.
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