The seven most dreaded words a dentist hears during a workday are: “May I speak with you after work?” Does this mean the employee is quitting, needs maternity leave, or wants a raise? Whatever the situation, the doctor hopes they will handle it well.

For the employee who feels the need to ask for a raise, it often takes days or weeks to muster up the courage to ASK! With the slower economy of the past few years, raises have been few and far between. Some dental employees have not had a raise in two or three years yet they feel they are working harder than ever to maintain practice goals. They report going above and beyond the call of duty to keep the schedule full and to work in emergencies.

The best way to ask for a raise is to keep a record of the date of the last increase in pay along with the history of all you have personally done for the patients, practice, and coworkers since your last raise. What CE or online courses have you taken? What above-the-call-of-duty projects have you done recently? Examples might including: volunteering for community activity/service which promoted the practice; working on the marketing committee which met during lunch six times in the past six months; developing on one’s own time the in-school program for elementary schools; and/or participating in the reactivation process of inactive patients. You might say, “I personally called forty-five patients and rescheduled seventeen of them as well as getting four new family members by asking about family members who might not be seeing a dentist.“ Dentists are busy taking care of patients and running a business, so they are often NOT thinking about someone’s last pay raise nor what each employee has done for the practice since that pay raise. Don’t go to your doctor with the “I-need-a-raise-because-I-DESERVE-it” attitude. Go with an attitude of gratitude and show your personal value to the practice. Does this guarantee a raise? No, but it greatly increases your chance of its being considered. It also lets your employer know you are not only assertive but you value yourself.

Every practice has a tremendous ability to succeed far beyond the owner’s expectations. In consulting for over thirty years, I’ve learned the true secret to success is to build a structure, or a foundation, known as the cornerstones. The same is true in every practice, large or small.

The first and most important part of the foundation is COMMUNICATION.

From the doctor to the employee, from employee to co-worker, and from all to the patient. Knowing very little about one’s services and less about the benefits to the patient is the downfall of many professional practices. In his book, Everyone Lives By Selling Something, the author Alan Lord clearly defines this weakness in most businesses as one’s inability to connect customers with the product or services on the shelf. The same is true for dental practices and includes the inability of the doctor to clearly define the mission or goals of the practice to the workers. When the communication within a practice improves, the likelihood of workers enjoying their environment is greatly enhanced.

The second important cornerstone of success is ORGANIZATION.

Some people are totally disorganized which causes stress for others as well as low productivity for all. Looking for things that could be found in seconds versus minutes or hours is one of the key reasons why some practices are not only less productive but also less profitable. I truly believe it is the top 20 percent of efficiency and organization that creates another 40 percent of productivity. Going home “happy tired” versus “stressed-out tired” will be the workplace of the future and one that is highly organized. Some workers are born organized and others struggle with it. I find that some employees need simple organizational plans to accomplish more each day. Outlining these plans step by step, prioritizing the lists by due dates, then color-coding or computer tracking memos will help.

The third cornerstone is MOTIVATION.

Often employers and employees lack motivation to move their practices to the next level. At meetings, they continue to discuss what needs to be done but the motivation necessary to turn great ideas into finished projects through teamwork and delegation is not there. Motivation is a gift we give ourselves. We can’t look to others to motivate us. How a person thinks, who they spend time with, and what they listen to often shape their level of natural motivation. It isn’t the daily challenges that come to a person during the day that causes their stress. It is how one chooses to deal with the issues that come their way. If they process responses through a negative filter, they will have negative results. The opposite holds true for the optimistic people of the world. They process everything, even obstacles and challenges, through a positive filter, which brings positive results. We all enjoy being around positive, motivated individuals as they give us energy. Negative people are referred to as “joy robbers” who drain our energy!

The last, but certainly not least, is the fourth cornerstone for success in business, which is APPRECIATION.

Appreciation for one’s work, co-workers, patients, and the opportunities for being able to contribute is having “an attitude of gratitude.” So many employers are not appreciated by the people they hire, even when the employers go out of their way to create a good work environment for the employees. Some employers do not appreciate their employees. These employees usually end up leaving when there is little, if any, praise and respect for the workers. If a practice has good employees, they should be treated like gold. In today’s world, attracting and retaining good employees is not an easy task.

Most important to success is an appreciation for patients. Let them know you appreciate their business, so when they need your service, they think of you first and only. This type of patient loyalty is found in practices that have strong leadership, effective communication, praise, and appreciation for employees and employers. The trickle-down effect is obvious in a happy practice where the levels of appreciation and respect are strong.

New Associates

The success of any associateship or partnership depends greatly on the acceptance of a new member to the practice by the entire dental team. Well-organized, happy, solo practices can go through tumultuous changes that can play havoc on anticipated growth when another person is added to the team. Unknowingly and most often unintentionally, sabotage of these relationships can become apparent before the ink is dry on the agreement.

The Dentist’s View

“My associate has been here for a year. I would have thought by now he would be more productive. My overhead is up, my stress has increased, and I’m not sure this is working.”

The Staff’s View

“We liked our practice the way it was before. We had to give up our Fridays off, our patients are loyal to our senior doctor, and, frankly, we wish we could be a happy work family without this added stress.”

The Consultant’s View

An associate dentist needs the full support of the senior dentist and the entire staff in order to become a passive income center. He or she must be properly introduced to the patients and staff. Sitting down to discuss WHY the practice is bringing in a second dentist is key to the success of the arrangement long-term. What benefit will the associate provide for the patients? What benefit will the associate provide for a healthier business, and finally, what benefit will the associate provide for the senior dentist and staff? Until the “whys” are identified, the relationship is doomed.

The senior dentist should sit down with the team. The script should go as follows: “Thanks to your dedication and hard work over the years, we have built a patient base that requires another dentist. The benefit to the patients will be more available appointments and additional services. The benefit to the practice will be higher revenues if we support this new dentist in developing a highly successful two-doctor practice. The benefit to me is someone to cover on days I am not here, a colleague to consult with on patient or management issues, and increased net profit for the practice by increased revenues. The benefit for you is additional room for growth in your compensation packages as the practice develops.”

The associate dentist’s ability to produce more revenue depends on scheduling, staffing, and support issues. If the team and senior dentist have feelings of wishing they could go back to “the way things were,” no wonder the associate looks for opportunities elsewhere.

The Dentist’s View

“My associate tends to be one of the staff. She goes to lunch with them and never consults with me in regard to practice issues. I wonder whose side she’s on. I feel like I’m the odd man out. I thought bringing an associate into my practice would be a plus. Now I’m feeling even more left out of my own office. “

The Staff’s View

“Our senior dentist is acting very jealous of the relationship we have with our new associate, Dr. Karen. He gets really mad if he sees one of his patients on her schedule. We are caught in the middle. Why did we bring this second dentist into the practice if our senior dentist can’t share the patients and be happy we like her?”

The Consultant’s View

One of the major problems with interpersonal relationships within a two-doctor practice is that the second dentist is typically closer in age to the staff. Staff members often want to confide in the younger dentist about the practice or their senior doctor. This can be the kiss of death to the doctors’ relationship. While it is fine for the associate to go to lunch occasionally with the team, a hard, fast rule must prevail: If the conversation turns into a gripe session, the associate must let the staff know it is totally unfair of the associate to discuss with the team the practice or senior dentist’s faults. The associate needs to offer to arrange a meeting with both doctors and staff to discuss the issues fairly. Likewise, the senior doctor cannot ever discuss faults of the associate with any member of the team. Practice problems should be aired in a group situation. Personal intervention should take place privately.