7 Reasons for Performance Shortfall in the Dental Practice

How many times have you woken from a sound sleep with an employee’s performance issue dancing on your head? As your heart races, you think dark thoughts like, “She hates me,” “He needs a therapist,” or, “There’s nothing I can do. … I’ll just have to live with the problem until I sell the practice!” This is an example of “stinking thinking” because it doesn’t give the leader any options to upgrade performance and it doesn’t allow the team member the benefit of being coached to new levels of success.

For those of you who really want to help, mentor, coach, and train your team members toward continuous improvement, I have some good news. There are only seven reasons why a staff member experiences a performance shortfall. More importantly, only one out of the seven is “unfixable.” In the chaos and confusion of helping someone who is struggling, it’s nice to know there’s a reason for the problem and that you have the tools to address it.      

Let’s use an example — a fictional circumstance that could never really happen in your practice, ahem — to explain the seven reasons.

Emily, your financial coordinator, is organized, focused, and productive. She loves communicating with your patients during the treatment conference and has tremendous success in working the e-claims system. But when it comes to collections calls, she experiences very little success, waits until the last minute, and avoids this task above all else, What’s happening with Emily?

Lack of task clarity

Does Emily know the guideline for collections? How many days is she supposed to wait before making contact about a missed payment? Does she have model verbal skills that can support the phone contacts? Does she have sample letters and online pay notices? Or have you just said, “Make calls and collect money”?

Lack of task priority

Is there a job description that lists all the outcomes and tasks in priority order, based on the vision, goals, and strategies of the practice? In the absence of preset priorities, a person will always default to what they’re confident in (what they do best) as the priority. Emily loves patient interaction and processing insurance; therefore, she will always do those things first.

Lack of competence

I’m not suggesting Emily is incompetent! The definition of competence is whether Emily has the innate abilities, transferable skills, complete training, and the practice to master the skill. That is what creates competence, and it’s the coach’s responsibility to make that happen.

Real or perceived obstacles

What is the elephant in the middle of the room? Whether real or valid, an obstacle is an obstacle. If Emily thinks there is no time to make the calls, this concern must be addressed and solved before she can move on.

A perceived reward for failure

This one is fun! There are two types of rewards for failure. The first has to do with someone else taking the monkey off their back so the staff member doesn’t have to worry anymore. If Emily’s lack of collection calls has been answered by the dentist taking on the problem, congratulations: You have rewarded failure! The other is a bit more delicate. Everyone craves attention — good or bad. If the only meaningful conversations you have with your team are those of correction, then subconsciously your team will create situations that will need to be addressed.

Lack of performance feedback

Mumbles, grumbles, or telepathic good wishes don’t count. In many instances in the dental practice, a team member is given a task and gets no communication until there is a flaming disaster. If you want Emily to succeed, catch her in the act of doing a “right or almost right” collection call and give her positive feedback.

A role/person mismatch

The great news is, if you’ve reviewed Points 1–6 above with Emily and she’s still unsuccessful at collections calls, then the mystery is solved: You have a role/person mismatch! This doesn’t mean you have to terminate poor Emily! You may need to redefine a job description that’s win–win for both her and the practice.

When you know you can help a floundering employee, you will sleep at night. Your practice will also run at a much higher level, because you coach team members to new levels of success.