In this series of essays, we are having a serious look at the notion of team. In the first installment (What is a Team?), I introduced a definition of team and then addressed Trust in the following article. Today, we will turn our attention to what we call The New Boss.
Yes, the boss is usually the dentist — the one from whom all things come and to whom all things go. But this strategy means the dentist must give all the permissions, pose all of the questions, provide all of the answers, diagnose all of the problems and be continuously responsible for all of the solutions. The result of this approach is to simultaneously burden the dentist while depressing the impact of the staff and team. A number of things follow:
- the staff rarely gets to use their basic skills
- the staff is unlikely to develop any new skills
- the culture of the practice centers on blame and cover your assets
- people are more compelled to be right than to do the right thing
- mistakes which results in learning are never made so learning doesn’t occur
- the dentist is overwhelmed by yellow sticky notes, charts to complete,calls to return, problems to sort out, strategies to develop, etc.
- team meetings become gripe sessions because staff members neither accept responsibility or hold themselves accountable
- staff turnover is high; the culture does not attract high achievers and if one should stumble through the door, he or she is unlikely to succeed
Thus, when the Big Kahunah is always in charge, a team cannot develop. In order to move beyond this oppressive model, a group of people must coalesce around a common goal or purpose. This becomes the new boss. Consider the following model:
The centerpiece of this model is the purpose of the practice, which I believe is best understood in terms of the promises which are made to the patients. The first step in building a team (as opposed to assembling a well-meaning group of individuals) is to determine the promises the members are able and willing to make to the patients on behalf of the practice. These promises define the essence of the practice and provide guidance about what is right in given circumstances. These promises must be fully operational, not airy fairy. Function is what is important here. What do we do, why and how form the promises of the whole.
From this point on, each member of the team derives the authority to act on behalf of the practice by his or her commitment to represent and uphold the promises to the patients. The dentist needn’t be consulted at every turn and permissions are not required. Authority comes with the territory and is automatically given as a result of team “membership.”
But with authority comes a full responsibility to act on behalf of that purpose. Indeed, each member has an obligation to act in congruence with the practice purpose and mission because representing the purpose is not optional. One cannot choose to act or not. One must. Simultaneously, however, each member also has an accountability to the purpose of the practice and thus to each other member of the team. Authority carries both responsibility and accountability.
In this model, every member of the team (although perhaps not necessarily every employee) participates in creating the promises and thus the purpose. Every member is obligated to represent those promises and is accountable to every one else for the way in which his or her actions impacts the practice. Every member means every member, the dentist included. Indeed, a real team doesn’t function when key players operate on their own agenda, on their own timetable and at their own whim.
It is easy to see why trust is such a key element. In its absence, accountability becomes blame, and blame can destroy a team. On the contrary, accountability is the process in which people review their decision and actions with an eye toward evaluation and modification. Feedback is essential and the key question is what might have been different and better.
Thus, the new boss both relieves the dentist of a role and burden he or she cannot shoulder alone while it simultaneously distributes power to those whose actions and attitudes can most benefit the practice.
