Staff Accountability

At times, a practice owner or team leader is utterly surprised when they realize that an iron clad system is not being utilized by the team. How did this happen? How long has the system been out of use? The consequences of unfollowed systems are numerous. First, team members can be confused, leading them to spend too much time seeking clarification from others. Second, team members can become inefficient as they use outdated or previously unsuccessful systems. Finally, unfollowed systems can create discord on the team when some diligently follow the protocols while others seem to be slacking. Listen in today as Dr. Kuba and Bethany discuss staff accountability! 

Previous Episodes Worth Revisiting: 

Task Management – The Art of Getting Things Done  

The Highs and Lows of Family Members as Employees

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Transcript

are you looking for a podcast where you can hear from real people regarding their real dental drama if so then
0:09
you've come to the right place join hosts Bethany Penny and Dr reena Kuba as
0:15
we dive into the solutions we've created and the mistakes we've made while
0:20
managing dental drama let's get started so I would like to talk today about um
0:28
kind of the bread butter bolts foundation of dental
0:35
drama every day everybody listening can uh you know will relate to this um this
0:41
is why we kind of created this podcast um but team members
0:47
accountability you know we we're trying to steer our ship in one direction and then suddenly
0:54
we are being blown away to another direction and before we know it we haven't even realized we're off course i
1:01
was trying to go to Hawaii but somehow I am in the Bahamas i don't know what just happened there
1:08
um and so you know it's just easy to kind of humb look at the waves look at
1:13
the oh look at all these new patients look at our dentistry we we we hit gold this month humb life's good whoa where
1:23
the hell are we um and so I you brought up an example that I would like to talk
1:30
about with one of your clients that you mentioned this but I just laughed when you mentioned it because I was like "Oh
1:36
been there done that i'm probably in it right now and don't even realize that I'm not in the right course." So now I'm like "Oh I better stop and re-examine
1:43
and look at look at my compass." Um because I'm assuming we're off to Hawaii we go um I need to make sure we're not
1:51
in the Arctic somewhere so the topic is staffing and
1:56
accountability and I guess you went into a client of yours it's a well-established client you're there
2:02
every month how the hell did this happen you know what fish were we frying that
2:08
this one just like got burnt on the back burner that we weren't even aware like the kitchen was hot um I'm imagining a
2:15
episode of Chopped now you know like you're in there going "How are you you're on Chopped you know you got to move and how did you let your stuff burn
2:22
like didn't you practice for this and yet not calling the kettle black I'm
2:27
like oh you'd think I'd be doing this for a while that my team is always accountable we are always swimming
2:34
floating steering to Hawaii and yet so made me feel kind of like okay start
2:39
with the example and then we can yes because this is you know wellestablished client excellent practice you are you
2:47
know and yet you stumbled upon this and you're like Okay I really I stumbled
2:53
upon it is the exact right word because I'll I'll kind of explain the scenarios
2:59
so it'll it'll make sense so in this particular client's office it is consistently clear communication very
3:07
clear expectations we have regular meeting times training times i'm in there on a
3:15
monthly basis and I'm bringing things to the attention of the team members or to the practice
3:20
owners and so this one took me by surprise in
3:26
the meeting i was like flabbergasted for a moment and I was like I don't know how to recover from this because I had
3:33
noticed some things when I was basically there's a document that
3:38
was created a couple years ago a financial arrangement document and this
3:44
document was pivotal for multiple reasons i won't divulge all of the reasons why it's pivotal but it was key
3:53
in this trajectory that we were trying to take this practice so much so that
3:58
when I look back at notes like we had talked about at every single meeting the do doctor was making iterations or or
4:05
edits to this document to make it more usable this has been it was a big deal
4:11
it's a big deal really big deal and so I started doing some auditing because
4:19
I couldn't figure out this particular number that I was looking into i don't I was like I don't understand why this
4:24
number's off and so I went and just audited some patients accounts looking for this particular
4:30
document and I was like "Wow that's weird this financial arrangement document is missing." Like hm that's odd
4:38
but in the midst of all of this there's been a software change and so I'm like maybe I'm not looking in the right places and so I got one of the business
4:46
team members will you just be a second set of eyes for me are you seeing this document she's like no I don't see that
4:53
document and looked at multiple patients charts i was like that's weird i'm going into this meeting
4:59
thinking it's me i am looking in the wrong place i can't find this document what in the heck something wrong with me
5:07
much to my surprise when I brought this up it's like hey just FYI I'm not seeing
5:12
this document like I just want to make sure that we're all still on the same page with that and where are we storing
5:18
this document so I can find it because I couldn't find it and so the team's like
5:24
"Oh well no we haven't been doing that document because of the software change
5:29
we we felt like the document in the software it basically covered
5:36
that." And I still like I'm like my mind is like I can't I can't wrap my head
5:42
around this because we spent two years developing this document and we talk
5:48
about it so much and it's pivotal for so many different reasons and so I was like "Wait what?" Like I maybe I missed a
5:56
meeting was this collectively decided and I just didn't know it and they're like "Well no i mean it was like who
6:02
decided who decided that the software's version was the equivalent of the sheet
6:07
that this doctor created and edited and got feedback on and tweaked and then sent out the new version and said "Hey
6:13
guys this is like I can only imagine how that process played out." And somebody decided "Oh but we don't need that
6:21
anymore yeah and and then the rest went along with it it seems well and not everybody because I could tell that
6:27
they're like my rule followers on the team like I could hear them saying like "Well I'm still doing
6:34
it." And some of the business team members are like "Well we still need it." You know so I could hear the
6:40
rumblings so it's like some people just assumed and then maybe spread that so
6:46
there's clear confusion over this and it was a moment for me where I was smacked
6:54
in the face with this systems are so hard to implement
7:02
something as clear as this something as as pivotable pivotal as this something
7:07
as like this is an office that is so clear in its expectations and here we
7:13
are with a confused team and so it was a reminder for me of how easily things can
7:21
just go off the tracks if it's doing it in this practice
7:26
how easy it would be well then that makes me think of like the basics of like a consent form you know like even
7:33
you talking about this and I don't have whatever document you're talking about in my practice but it it makes me go are
7:39
we sure we're getting all our consent forms signed are we sure we're getting our treatment plan signed are we sure we're getting our HIPPA form signed like
7:46
what what rogue decided one day that they didn't want to do it or you know it made sense to them and then they
7:52
probably con consulted with another team member and was like this makes sense to you oh no we we don't need that anymore
7:58
and just went rogue like I can so see that happening very easily so then I start going okay are they blaming the
8:05
software but to your point not everybody is doing it so some people are some people aren't then then when as you're
8:12
telling me this I'm like I don't understand how this could go off the rails is it a new person was a new
8:18
person brought in did a Was it one person that used to do this and that person retired and now the rest of the
8:24
team took over like how does this happen yeah I know and they're blaming the software so but still like how are some
8:31
of the team members doing it and the others not like I I'm just Yeah kind of confused well and to your point there
8:38
were no this is no new people at this point so this was not like a staff change and somebody new came in and
8:44
didn't know that like this is all the same staff but I think there's something
8:50
really important here that we need to look at which is there was a software change now a software change in a dental
8:58
practice is a big deal it changes your daily grind
9:03
like every click you make is different in a day and that can create some chaos
9:11
now it may not be software change in a practice but it could be we Sally left
9:18
she moved out of state and Susie replaced her and that created a moment of chaos
9:24
or our doctor decided good for her she decided to take a two week vacation and
9:29
we were shut down for two weeks and we came back and we forgot what we did you
9:34
know um it could be we had this huge influx of new patients we don't the
9:39
practice down the street closed down and all of a sudden we were bombarded with all these new patients insert any level of chaos into
9:49
the practice and then it can throw us off and we just forget in that
9:56
moment what we're doing why we were doing it so in this particular situation I do
10:02
think that brief moment of chaos those couple months of software software
10:08
change just we forgot the importance of some things and so I think it just
10:15
reminds us that if your practice is in constant chaos I have plenty of clients that bless their hearts they're just
10:21
something chaotic is happening every month and they're in constant like
10:26
rebound mode trying to get out of that and systems are very hard to implement in that type of scenario or systems are
10:34
hard to keep in that so then what is your what is your suggestion for that
10:41
um lots of communication so in this practice that I'm talking about there is
10:47
regular communication but we hadn't talked about this
10:53
financial arrangement document in months because in my mind it was set it was
10:59
already like we've spent two years talking about this thing but we had a massive change and and I think also with
11:06
change we end up trying to put out a bunch of different fires and so we're
11:11
not even focusing on the basics at that point we're just focusing on settling
11:18
yes just like control the chaos and bring it back to a level of normal and so I do think it's important that in our
11:26
whatever the typical communication is whether that's a monthly staff meeting whether that's a morning huddle where we
11:34
address everything whatever the case may be we need to have some level of um
11:41
consistency in going back and reviewing systems so are we going back and looking
11:47
at um you know business systems do we incorporate one of those into each of
11:54
our monthly staff meetings like hey we haven't talked about in a quarter we
11:59
haven't talked about how we're handling cancellations no shows reminders appointment reminders so every quarter
12:07
we're going to go back and revisit that or hey we haven't talked about um you
12:13
know consent forms all of our health history consents uh posttop instructions
12:18
so we're going to talk about that in the second month of every quarter you can kind of get the idea that sounds awful
12:26
like that sounds so tedious i know to me which is weird then I'm like "Okay this
12:32
is why I've got you because you you're the second set of eyes that are coming in and you're not um but I I I can just
12:38
imagine right now if I went to my team and I was like "Okay guys let's let's talk about our you know our protocol for
12:44
insert whatever." I mean it's hard enough to do even emergency training i know which is why you know at least in
12:50
Texas they require that once a year but to me I'm just like God that's so tedious like I just don't want to do it
12:55
i know it really is the nitty-gritty of running a practice but it's interesting
13:02
i I think from my vantage point like when I get incorporated into a practice new
13:09
fresh I'm seeing the results of inconsistency so I'm like "Oh my gosh."
13:16
Like wow our production per patient has dipped the last three years we're on a
13:21
decline with our productivity per patient yeah your production have stay has stayed the same but you're trying
13:27
you're having to see you know 100 more patients every year to be able to keep that same production like oh wow what is
13:33
off and when we start to go back and dig it's all these little systems that have
13:39
gone off the rails like "Oh wow we're less productive per patient because our treatment acceptance has been declining
13:45
over the past 3 years why what happened to that financial arrangement document that we used to do 3 years ago that got
13:52
people to move forward with treatment where where I thought we were doing that oh we haven't been doing that for 3
13:58
years what?" So I can see it from a different vantage point and I know that when we get off track if we are off
14:05
track long enough it leads to a negative result and so it does feel like oh this is so tedious and the frequency can
14:14
be tailored to the needs of the practice or the needs of the meeting frequency
14:19
but to me we've got to have some level of coming back and revisiting what are our systems on this and and I feel like
14:26
that's how it ends up happening is you you stumble ass backwards on something where you're like wait what where is
14:32
this or why is this so maybe that's another thing like maybe all the assistance before
14:38
Well I was going to say before treatment but the treatment may not be there if they didn't get the financial arrangements worked out and the patient
14:44
ever scheduled at some point maybe that needs to be like who who else could have caught this if it wasn't you um and I
14:51
mentioned this in a podcast you know recently but it was you know you and I talked about um starting to boost
14:58
Facebook posts for marketing and then something happened where it made me
15:04
think about it randomly and I'm like "Okay guys are we still doing this?" Or whatever question I asked we never
15:09
started doing it like somebody dropped the ball and I'm like "Oh for I'm I'm assuming for the last 5 months like we
15:14
spent a lot of time talking about this and who was going to do it and how they were going to do it and the training for it and it just never got done." And so
15:21
I'm like even with all that clear communication I stumbled ask backwards into what do you mean we're not doing
15:27
this and so I guess that's kind of the point of this podcast is how do we follow up I guess maybe on these things
15:34
and how can we minimize the number of things that go off the rails that we didn't know um and so I think what
15:41
you're saying is is maybe intentionally proactively maybe sit down and kind of
15:47
create your reminders it's um there's a dental compliance I forget what he's
15:52
called dental compliance is company yeah a tank like that's what he does every year every month he is getting together
15:58
with the team to go "Okay let's go over your uh drug kit like what do you have in there okay this month we're going
16:05
over your radiology binder this month we're going over your HIPPA binder did everybody sign what they needed to sign
16:10
this month we're doing so like that's what as an owner I'm paying you Tank
16:16
whoever else to come in and help me because there's just no way I can keep up with it that if you don't have those
16:21
resources um if you can afford it and you're not investing in it shame on you if you
16:28
can't afford it yet then that's all on you best of luck to you friend but maybe
16:33
that's where you're sitting down on a day and going "Okay I'm going to make a list of all these systems and things that I need to be doing and going ahead
16:39
and putting it in my schedule planning it out for the next couple of months like what are we going to revisit?" I
16:45
know we talk about every year about revisiting our policy manual every year we talk about revisiting our paperwork
16:52
um because inevitably things will change and the paperwork's outdated we're like we just had that the other day we
16:57
discovered that our um our sheet for whatever it is that we've got still has
17:04
operating room privileges well I quit doing that after co I haven't gone to the operating room since 2020 and so we
17:10
need to update our form and we just kind of quit looking at that right um so I
17:17
think looking you know thinking about all that I think the second takeaway I would say what you just mentioned is the
17:23
anytime you've got a moment of chaos so anytime something major changes a staff member changes and or even if it's um
17:31
the staff didn't change but what if like sweet Sally's grandma passed away or
17:36
sweet Sally's going through a divorce that guaranteed personal life will impact professional life yes and so if
17:44
you've had that or me like being out almost the whole month of February I haven't been there i was helping aging
17:50
parent with all of these like health issues so now like a lot of the things that maybe I was taking care of I need
17:55
to go back and say like what what was my system and routine because I'm off my game right now um so just kind of being
18:03
aware of those moments of we've had transition and so to assume that your
18:09
systems are a still working b still being executed appropriately is is a
18:16
very dangerous way to proceed absolutely and to me it's all about when you start really thinking
18:24
about everything that requires followup it can be overwhelming and to me it's use the systems that you
18:31
have in place you don't have to reinvent the wheel if you have a monthly team meeting that is your spot now it's just
18:39
a matter of plugging in the topics look at the year and go I've got 12 monthly meetings okay what are all the systems
18:46
that I want to make sure to follow up on i'm going to plug in one of those you know each month throughout the year
18:53
there's so many great resources now one of the uh real basic things that I
19:00
utilize with my team is we each have an Outlook account an Outlook email and on
19:06
that there's a fantastic task list i can pull up my task list at any time my team
19:13
can add to my task list so they can go and put a a reminder for me on there they can set a due date reminder i can
19:20
add to my team's task list hey so and so you know do this put a due date uh there
19:25
can be reminders set up for that um but I can also view they can view my task
19:32
list I can view their task list there's multiple like there's one for each of my assistants it's such a great platform
19:40
for us being able to communicate on a regular basis so even beyond like adding
19:46
system review into the annual plan it can even be "Oh shoot have we done our
19:54
CPR when's our CPR certification due and who are we using for that?" Oh sweet
20:00
Sally I'm adding a task to your task list and Sally knows she needs to look at that task list on a daily basis go
20:05
figure out when our CPR is due um if due set up the CPR class and loop me back in
20:12
so even just setting up ways to be able to pass off tasks as random little
20:17
things pop into your mind oh shoot have we done that rather than having to call a meeting and figure out you've just got
20:23
a platform to be able to communicate those kind of tasks with it doesn't have to be Outlook practice management
20:29
softwares have tasks that you can task list that you can utilize whatever the case may be set up the system so that
20:36
everybody knows to be checking their communication is the point find your way of communicating um okay so I'm going to
20:42
take this in a little different direction now so what if it is somebody who it it just like this we're going to
20:48
blame the software here but accountability is a is a sticking point for for dental drama right and so um I
20:56
think kind of have we determined for this scenario we don't think it was like
21:03
a staff member just going this was literally the software somebody probably
21:08
just kind of being a little dumb yeah and they're like "Oh this is making some assumptions." They made assumptions
21:13
because in the software it at the bottom of the treatment plan it
21:19
lists four op one sentence about each of the four options that are fully
21:25
represented on the financial arrangement document they looked at it they're like "Oh that's the same
21:30
information." Now let's the the document that was created
21:36
was a two-year process of iteration so to look at the four sentences on the treatment plan and go "Oh yeah there
21:41
there it is that's the same thing." It's a little bit mind-blowing to me but whatever i get it they thought it was
21:47
the same information and that the financial arrangement document would be a duplicate of
21:52
that so they didn't want to do duplicate documents which I think happens all the
21:57
time absolutely um and that's where I guess for me um I think we've
22:06
got you need to go back and look at your team members I guess is what I would say because the whole um you know again
22:13
knocking on my head right now I don't think we've got said people now but I
22:19
feel like last year when we had um what was it at least two more employees and
22:25
we were constantly going we talked about this we had a three-hour meeting about this we had a follow-up email like the
22:32
communication couldn't have there's nothing more we could have done from au communication standpoint it turns out
22:37
that it was one person who thought she was being more efficient and she would
22:44
be the one I could almost see being like "Oh you know it's the same page here i'm going to save the doc paper you know the
22:51
doc doctor from having to do this other sheet look it's right here." and just carry on thinking she was doing
22:57
something smart and the rest of us are like "No no no back up." But trying to
23:02
catch her going rogue because she thought she was being efficient um and then we had another one that was lazy
23:09
she don't want going to do it i don't want to fill out that form so this form has it i'm not going to do it and and that's that so I think in our case now
23:18
we are to where I get nervous cuz we we don't have the extra person and I've
23:23
always been kind of an extra person mindset and since what last September October whatever it was we've not but
23:30
dare I say I think we're still going to Hawaii i need to stop and I guess look back at that but it's almost like the
23:37
fewer cooks in the kitchen yep made the difference because now the communication
23:42
is easier there's not like if one person was confused and going "Oh could this be
23:47
the replacement to that and she only has one other person to turn to and that
23:52
person's going to go what if that person goes yeah we don't need that other sheet." Well there's still like the
23:59
manager or myself there's very few people there that we can very easily go quickly notice and go "Wait I did what
24:05
did y'all do with that?" Nope this is not at all the same versus when there were four people up at the front now
24:11
you've got two others maybe three of y'all are going "Oh yeah that makes sense to us this is what we're going to do great." And like "Yeah changed the
24:18
direction without checking with the captain if that was okay to do." Um so it might just be a numbers thing for one
24:25
but I think more to the point for us it wasn't just numbers it was the quality of the people making these changes and
24:31
the reasons they were making those changes and we don't have that now yeah um and I think the people that we've got
24:36
now are going there's a method to the madness here and so if we're about to
24:42
make this change we better at least fine if you don't want to seek the opinion if
24:48
you're going nope I'm the expert of the front desk doc said that we can make our
24:53
decisions but at least if you're communicating that this is what you're doing and and we've got that now yes so
25:00
we don't have any rogue players at the moment now again that that's my assumption i guess I need to maybe make
25:07
sure we're not in the Arctic and I'm not sure um but I don't think we
25:12
are right uh but I think it's also um a
25:17
smaller group i could I get myself in trouble now because I don't have the extra people right so if somebody gets
25:23
sick and is out or somebody's husband moves I'm going to be up a creek but for now I think we are still going to Hawaii
25:30
yeah i think you bring up a super solid point here that needs to be mentioned um
25:35
clearly on this part of system execution is looking at do I have people
25:42
that can execute the system and there's a million different reasons why they might
25:48
might not be able to it's it's too complex of a system and they they're
25:53
never going to get it which we've had those situations before um they think
25:59
they're smarter than the system and so they're going to constantly be breaking the the rules so to speak and doing
26:04
their own thing uh they're forgetful or they have their own dramatic life that
26:10
they're on reset every day like every day they come in they've just experienced you know World War II at
26:16
home and so they're coming in and they're having to reset every single day or is it the doctor communication does
26:23
it start at the dock did you say one thing but you're doing another yeah and so that's where I've been guilty of that so many times i'm like "No this is what
26:29
we're going to do." And then an exception a quote exception comes up and I'm like "Well," and so now I've thrown
26:36
us off course because now people are like "Oh if there's an exception then maybe this is an exception that's an exception that's a so like sticking to
26:42
the protocol." Yeah um and and so it could be any any of those scenarios
26:48
throw you off it really could be and so to me the communication and setting up
26:53
the clear expectations is on the practice owner like you have to ensure that that is you've got a clear course
27:01
and that communication is being very like we're going in this direction we're rowing in this to this destination and
27:07
here's how we're going to do it that to me is on the onus of the practice owner the follow through is let's make sure
27:14
you got the right shipmates on the on the boat and when they start going off
27:22
course that you have protocols in place to huddle back up and go no no no no
27:27
remember this is what we talked about here's the documentation of what we talked about so not just we had this
27:34
team meeting where we were all there and we all discussed it who took notes on that who who has a document that shows
27:41
no this is what we decided upon cuz that's can that can also create some
27:46
chaos which is what I asked this team I was like but what meeting did we talk about this when did we when did we
27:53
collectively decide that maybe I missed that meeting which I was honestly asking there was no documentation so
28:01
we've got to have because our memory fails us even as the practice owner our memory can fail us let's go back to that
28:08
meeting where we discuss that and let's look at the notes and make sure that we are all on the same page which is then
28:13
now another point did you take notes exactly and who read the notes who took the notes like did they put down what
28:18
they thought they heard did they like Yep that's a whole another tedious thing to do yep you got to make sure that
28:25
you've got somebody assigned to take the notes that that person is capable of taking accurate notes and then how are
28:32
we disseminating those notes afterwards because it's one thing to all hear it and oh great Sally our notetaker took
28:40
tedious notes thank you Sally but nobody ever looked at the notes i think that's almost a thousand% like nobody nobody
28:46
ever looks at the notes like and we do our due diligence to print them we put them in a binder sometimes we'll email them sometimes we'll post them and I
28:52
think it's all a waste of paper but at least I've still got something to say go back to that yep go back to that yeah
28:59
yeah and if you've got one of your team members that is just a naturally
29:05
inconsistent person like my husband's one of these people it's amazing every
29:11
day looks different for him you know where he puts his keys is different where how he packs the lunch is
29:16
different what time he leaves the house is different it drives me absolutely baddy but for him it works he would be
29:22
the guy that it's like you roll out the system you're like "Yeah let's do it." And he's going to be your cheerleader
29:27
he's like "I love the system let's do it and then never implements it okay well that person you may have to say "My
29:33
expectation is those notes are disseminated." Your job is to go and
29:38
review those notes every time everybody else can get away without reviewing it because they remember it and they're just natural implementers you buddy you
29:45
got you got to go back and read the notes okay so find your person that has trouble implementing systems and then
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you're communicating specifically with that person and going "Hey I'm actually doing the notes for your benefit." So
29:56
read them and read them multiple times a month if you have to or make your own like rewrite them in the color that you
30:02
want on the paper that you want and keep that paper in your pocket like Exactly yeah um so yeah accountability anything
30:08
else that you can Well I think I kind of disappointed myself here in this episode cuz I thought it was going to be more meaty drama like it was sweet Sally that
30:16
was like I'm not doing this so I may have teed us up for like drama and there was none oh there's plenty of drama
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associated with this so especially when the you got the great implementer paired
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with the one my husband paired with my husband that creates real good drama on the team ooh so to be a fly in the wall
30:35
in your house oh it's fun it's It's dramatic all the time
30:41
thanks for joining the conversation today we hope that you are comforted in knowing that you are not alone but we
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also hope that you're walking away with some really great tips and tricks to try in your
30:54
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rooting for you today as you manage your dental drama