Levels of engagement: How the work culture in dentistry can avoid aura of meaninglessness

March 16, 2016
Dorothy Garlough examines how the work culture in dentistry can avoid the aura of meaninglessness.

Work culture can avoid aura of meaninglessness

Dorothy Garlough

Last month, we spoke about workplace engagement and how there is compliance in offices with a culture of control. However, in an office where there is autonomy, engagement is the outcome. The intrinsic rewards obtained in an engaging culture are what drive ultimate success within the dental office, both financially and in personal satisfaction.

But how do we know how engaged we are? Two renowned professors, Walter Tymon and Kenneth Thomas, have developed a Work Engagement Profile that rates workers as high-range, middle-range, and low-range. The people who experienced high-range engagement enjoyed key intrinsic rewards regularly and intensely. Subsequently, these people were engaged and energized in the workplace.

The middle-range grouping of 50% had a less intense experience, and less frequently. In other words, rewards were somewhat positive but limited. This group thought their work had meaning when they stopped to think about it and had some autonomy, but they also had to live with others' decisions; they felt somewhat challenged but perhaps not as much as they would like. They also thought they were competent at most of their tasks. In the end, they were somewhat engaged and believed they put in a "fair day's work."

People who scored in the low range were unhappy with their work on many levels. They felt that their work was meaningless and therefore were not engaged. Or they might have had no autonomy, making them feel helpless and hopeless. With no influence, they knew they could not partake in decisions that could lead to needed change. There was no sense of empowerment, and living with those feelings acted as a drain on motivation. Over time, they would likely grow resentful of their jobs.

Research findings support the benefits of intrinsic rewards for both employers and staff members. Employers remark that those who feel empowered in the office do better work and have better concentration. Another benefit of intrinsic rewards is that there is better staff retention. Engaged and contributing staff are good employees ... highly energized and self-managing. They are also walking advertisements for the office, perhaps recommending the office to other recruits or possible clients.

So how can a dentist and office manager build a culture in the workplace that is a high-engagement culture? Based on studies by Tymon and Thomas, an office can follow seven guidelines to building such a culture through intrinsic rewards:

1. Define vision-In dental offices, the purpose behind "why you are here" needs to be more than just profit. Defining why you do what you do and whom you serve will drive the "why you are here." Keeping an eye on this sense of meaningful contribution will add the value required for the self-management process.
2. Promote intrinsic motivation in training-It is the norm that dentists and dental office managers recognize their own fulfillment through intrinsic rewards but often don't see this as important for staff. Yet, if the office is to build a culture of engagement, intrinsic rewards need to be included in training. It stands to reason that management is more effective at promoting the value of workplace engagement if they are managing and understanding their own intrinsic rewards well.
3. Focus dialogue around the office's vision as well as competence and progressive initiatives-Dentists and office managers need to align their messages-that the office stands for doing work that matters and they stand for doing it well. When approaching any new initiative, process, or work project, leaders can promote the importance of contribution by focusing on the following questions:

· What can we do that is important?

· How can we think creatively to achieve the desire outcome?

· What process is in place to ensure competence?

· How can we ensure that we are on track, leading to the accomplishment of the purpose?

These questions bring employee contributions to the foreground and highlight the intrinsic rewards.

4. Enlist the "middle"-This large group needs to have autonomy built into their positions. By moving staff from being somewhat engaged to highly engaged with intrinsic rewards, an office can create a majority of highly engaged staff. These motivated and energetic workers will create a tipping point to achieve a high-engagement culture.
5. Measure intrinsic reward levels-Assessment of the staff's connection to their intrinsic rewards is important to determine if you are on track. In addition, it can enable the leaders in the office to know what needs to be done to improve engagement. Self-assessments, anonymous surveys, engagement profiles, and conversations are means by which an office can keep a pulse on the level of enlistment from their staff.1 These assessments will also pinpoint if any of the intrinsic rewards are low. If they are, this gives you the opportunity to address them, and it is important to do so. Over time, these low rewards will drag on the success of engagement.
6. Recognizing and promoting the following: 2

• Meaningfulness

- Freedom: opportunity to be passionate in a nonjudgmental environment

- Determine what individuals are passionate about

- An electric vision: identifying clearly what can be produced

- Relevant task: understanding the connection to the vision

- Whole task: responsibility for an identifiable product or service

• Choice

- Autonomy: the freedom to make relevant decisions

- Trust: knowing that an individual's self-management is working

- Security: no fear of punishment for honest mistakes

- A clear purpose: understanding what you are trying to accomplish

- Sharing of information: access to relevant facts and resources

• Competence

- Knowledge: acquired through education, experience, and insights

- Positive feedback: information on what is working

- Recognition: credit when credit is due

- Challenge: opportunity to work at tasks that both stretch and satisfy you

- Standards: high standards that do not force rankings

• Progress

- A collaborative climate: workers engaging together through consensus building

- Reference points: marking each stage as you advance toward the goal

- Celebrations: gatherings to acknowledge successes

- Access to clients: interactions with those who have used your services

- A dashboard: measurement of improvement

7. Adopt a change and implementation process that is itself engaging-In 1981 Jack Welch came to the helm of General Electric and used what he called the Work Out Process to foster high levels of engagement.3,4 The genius of this process helped turn the company around, turning it into the top company in the world in a few short years. Today, similar processes are being used in other organizations. Creative training workshops encourage employees to identify challenges and spark ideas on what could be changed for the good of the company. These recommendations and diverse competencies and experiences result in a rapid sense of progress. The result is not only workable solutions but also a sense of excitement among employees, which often serves as a significant turning point in an organization's culture.5

The beauty of intrinsic rewards is that they are a sustainable means of motivation.4 Staff doesn't experience burnout and claims more positive feelings with fewer negative ones. They are satisfied that they are developing professionally and have a healthier outlook with less stress. It is a win/win for both the doctor and the staff, and it is affordable. It doesn't depend on huge investments of money, although it does depend on an investment in the culture of the office. So, go ahead and ask yourself, "What is the culture in my office?" RDH


1. Dale Carnegie Training. Enhancing Employee Engagement: The Role of the Immediate Supervisor. Dale Carnegie Training website. http://www.dalecarnegie.com/white-papers/improving-employee-engagement/. Accessed January 27, 2016.
2. Thomas KW, Tymon WG Jr. Work Engagement Profile. Sunnyvale, CA: CPP; 2009.
3. How Jack Welch Runs GE. Business Week website. http://www.businessweek.com/1998/23/b34581001.htm. Updated May 28, 1998. Accessed January 27, 2016.
4. Welch J, Byrne JA. Jack: Straight from the Gut. New York City: Warner Business Books; 2001.
5. Pink D. Drive: The Surprising Truth About What Motivates Us. New York City: Riverhead Books; 2009.

Dorothy Garlough, RDH, MPA, is an innovation architect, facilitating strategy sessions and forums to orchestrate change in both the dental and corporate worlds. As an international speaker and writer, Dorothy trains others to broaden their skill-set to include creativity, collaborative innovation and forward thinking. She recognizes that engagement is the outcome when the mechanisms are put in place to drive new innovations. Connect with her at [email protected].