I'm facing a situation in which I'd appreciate some experienced advice. I'm a dentist and like most dental offices the work staff is primarily female. We're going through a bout right now of 2 staff being out due to maternity leave, one staff recovering from surgery, another going through a messy divorce. Just general life things. Unfortunately, that's putting us in the position of everyone putting the gas peddle to the floor in order to continue good, productive business. Fortunately, I have a staff willing to do that. But not unlike anything else, you can only do that for a time before things start to break down. I'm beginning to see some early signs of this-tempers grow short more quickly, people feel overwhelmed, some early signs of burn-out. I'm looking at late summer before everyone gets back to regular schedules. How do I nip this before it becomes a real problem and still continue to grow and thrive the business? Any thoughts would be appreciated.

esanthony's picture


Good question! I had 40+ women (and 4 men) working in a mfg facility where I was COO. Like it or not, women still seem to statistically miss more work for personal reasons than men. (Disclaimer - this does not apply to all women by any means)

In times of increased production or vacations I hired temps. I would imagine that there is something a GOOD temp could do to help out in your office and reduce the load. This accomplishes two things. First it does not threaten your employees (you aren't giving away their job). Second the temp has no misconceptions, he or she knows they are there for a limited time.

Also when times got tough I would order in lunch for the whole crew.

But most importantly you must SHOW you sincerely appreciate how hard they are working for you. This can be in whatever way is most effective for them, time off, bonuses, lunches, etc. And don't let a day go by without thanking them for being there.

One way you can show them is by using the one-on-one technique Mark and Mike are always talking about. It will impress your employees that no matter how hectic it gets that you make time for them and you will most likely be able to find and deal with hidden problems before they surface. You can find a form and instructions sheet on the website. USE IT, IT WORKS. I had always done less formal type meetings but Mark and Mike have nailed it as an art form. The effectiveness of my one-on-ones has skyrocketed in the last month since I started using their format.

Gary King's picture


I agree with Eric's reply and I am guessing that temps are not a big option. When faced with similar situations (abeit not the duration that you face) I have have had best success by making sure to acknowledge the situation openly and when possible with humor. Also positive feedback directly to the point of how they are handling the difficult circumstances. Perks are great, even small ones --- have a message therapist come in and give back rubs at lunch! Engage the employees by asking how they would like to get through the tough times (different scheduling, personal time credit, etc)

This has the possibility of being a big team building process. Difficult shared experience has that effect.


Mark's picture
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I'm glad you posted your question! I think many corporate managers fail to realize the scope of "management"... It includes professionals like yourself as well, who went to school to be technically and professionally proficient, and medically knowledgeable. But probably not a lot of management training in dental school (though I know they do more than they used to). Just the IDEA of all the dental expertise, combined with managing a say nothing of running a business.


Okay, so what to do. I have two suggestions. One you'll like, the other you won't. Right ain't always easy. As the Cadet Prayer reminded Mike and me, "Make us to choose the harder right rather than the easier wrong, and never be content with the half truth when the whole can be won."

Before I go any further, though, I want you to know that I've USED these recommendations several times successfully. I've had 2 medical practices/chains as clients, and one large dental group as well. Total physicians and dentists involved in work my firm has done is probably close to 250.

Okay, two suggestions:

1. Communicate more. The PURPOSE of this is to talk about what the practice is going through.

Now, don't take that purpose at face value. It comprises many facets. It means explaining repeatedly about why things are the way they are. Talk about - repeatedly! repeatedly! - about why people are out, and give examples of how their being out creates issues at the office, and how it's still worth doing.

In every case, remind those still at work about WHY you give the time off you do, why time with newborns is important. If staff listening are young females, tell them their time will come. If they're older women, remind them of what you did for them, or what other employers years ago DIDN'T do for employees. Say OUT LOUD that you care about them and their families, and you're trying to find out the right way to help everyone balance LIFE, which, as the commercial says, sometimes comes at you pretty fast.

This reminds them of WHO they're putting the pedal to the metal for: their TEAMMATES, not just you. Put slightly differently, THE PRACTICE they all work in. Admit publicly that the practice is bigger than you, and use this as an example. I don't know you, so it's hard to be pitch perfect with some of this, but even if you are a slave driver, or normally nurturing, this will work. IF YOU REPEAT IT. And then say it again.

Say something seven times and half your people will say they heard it once. Horstman's Law of Organizational Communications.

And here's a neat secret. The next time this kind of scheduling pain happens (even if it's because you fire someone or your hygienist quits, God forbid), they will REMEMBER why EASILY, and the pain will be lessened. I admit only 70% of the value of my approach will be fully realized during this time.

Take individuals to lunch. Sorry if this is a time for you to be alone - either it's about you or it's about the practice. Get over it, and take a staffer each day of the week. Tell them it's a chance for you to treat them, and to talk about work and what's going on. Repeat the why again. Ask how they're doing. DON'T TRY TO SOLVE THEIR PROBLEMS! This is about communication. After a few weeks of this, themes will emerge. There will probably be small irritants that become obvious that you can, as leader/owner, make magically go away, if even for a short period.

Ask them at lunch and at other times for suggestions about what to do differently to ease the load. Tell them that most large organizations use situations of change and stress and even crises to get rid of dumb stuff (and trust me, you've got that too). A recent book suggested using a created crisis to facilitate de-silo-ing an organization. (This is the old "build a burning platform" theme, and I've used it, and it works.)

Tell them thank you specifically and directly at lunch. Use the principles of feedback if not the actual specific model. Talk about the work you SAW them do. Use their names and talk about specific patients they helped, costs they saved, minutes they stayed after, kind words they shared with patients, charts they shelved at the end of the day.

Bring in lunch one day every other week for a mandatory meeting (pay them if you normally don't over lunch, it's only two times a month) to talk about how things are going. REPEAT why everyone is doing this (out of respect and appreciation for their teammates). In advance of this, call those that are out and ask how things are going, and that you want to give staff an update. (Careful you don't send a hurry up message.) Ask for input, let them vent a little (you don't have to solve every problem). If you're not regularly asking for input, you're seen as STUPID. Sorry, but you are. You don't know their jobs as well as they do. Yes, you COULD do their jobs perhaps better than they can, but you couldn't TOMORROW, and certainly not do your job at the same time. They know stuff, and giving them a voice in times of stress honors that.

It's as simple as, "What could we do differently to make things a little easier?" "What are we doing that you don't think makes a lot of difference, but maybe takes some time." When they answer, don't you DARE tell them why the way they're doing it now really is the best way... EVEN WHEN IT DANG SURE IS. This is brainstorming... and so anything goes. Say thanks, and write it down. If the first time you ask you only get one lame idea, say thanks, let the awkward pause hang, and then say, "well, okay... I'll keep asking... that's good for now." And move on to the next agenda item.

Repeat the individual thank you's/feedback principle at the group lunch. NO SHOTGUN "Good job team!" speeches. Take the time to have written down things you've noticed, and read the dang notes if you have to.

During the day, take a moment to STOP and say thanks. The fool proof way to do this is to wait for someone to be done with something, and ask them to stop for moment. (The feedback model interspersed every few days is great, too). Make sure they truly stop moving. Make sure your shoulders are square with theirs. Then say, "thank you for all your hard work. I notice, and I appreciate it. Thanks." That's all it takes to be a champion boss, most days.

Okay, now for the hard part.

2. See less patients. The simple truth is, if you have less staff in, and you're not paying them full pay while they're out, and you're trying to keep up the patient load*, your margins have gone up, and even your most loyal staff members at times see you as making profit on their backs. They might let you... but when folks come back from their absences, their will be subtle resentments that will possibly lead to attrition. [* - Don't for a second think that they believe you that you're "keeping this grueling schedule for the patients." You've taken vacations before, and perhaps taken time off in the middle of the week. They don't see it the way you do... and they know the patients that are recurring WILL tolerate a little slip of their regular cleanings and check ups.]

When you try to keep up the previous patient load, there's a subtle message sent that we can do without those other folks, or that everyone wasn't working as hard as they could have before.

When you put 1 and 2 together, you sit down and explain why you're cutting back a bit - to make sure you "still have room for emergencies, and to keep everyone's head from exploding...we need (those that are out), and I don't want us to forget that. I need each one of you to do what we do, and I don't want to sacrifice tomorrow for today.

There are a lot of patient load things you can do, but I've learned that every practice has its own way of interacting with and scheduling patients... so, whatever you do, cut back. Maybe it's just you, maybe it's guaranteeing the hygienist's pay even with one less patient every other day... but: LESS PATIENTS.

Talk More (why we're doing this, what can we do better, and thank you thank you thank you), and See Less.

Will it work with just suggestion #1? Yes, mostly. But beware if you ever let slip how well the practice is doing financially. The fact is, unless you have open books, you have a completely different relationship with money than your staff does. They think you are RICH, sir. they are MUCH less tolerant of you talking about money, or what you don't have, or the trip (to the Caribbean??) that you have to postpone (they've never been). If your spouse is involved in the practice, special attention must be paid there. A spouse as an office manager who were to say to a staffer, "Do you not understand how tight things are?" will NEVER be forgotten, and will ALWAYS be at the front of others' minds on Friday at 4:30 when there's an hour of work to do.

I hope this helps. Please don't take offense if some of this doesn't apply to you - just dredging through my experiences.

Please let me know if this helps.


Tim G's picture

Mark, Gary, Eric--Thanks for the terrific advice. Nowhere else could I get such terrific and diverse knowledge.