From office manager to practice leader

Jan. 29, 2008
Today's office manager is a leader in the practice as more dentists relinquish sometimes tightly held management responsibilities to focus on delivering exceptional dentistry.

Thirty years ago, most dentists relied on a single front-desk team member who was in charge of "doing it all." As dental practices grew from producing $40,000 to $60,000 per month, another person was added to the front desk to be responsible for some or all of the four areas of practice management that the doctor used to handle. The roles and responsibilities of the front desk team became more clearly defined.

In most one- and two-doctor practices today, the practice manager sits at the front desk three out of four days and devotes about 25 percent of her time to management functions. As practices approach $80,000 to $100,000 per month, the role of office manager officially becomes a full-time position. Today's office manager is a leader in the practice as more dentists relinquish sometimes tightly held management responsibilities to focus on delivering exceptional dentistry.

The Characteristics of Practice Leaders

Successful office managers, those that truly become leaders within the practice, share seven characteristics. The first characteristic is that they have basic dental knowledge. It is very difficult to fulfill the responsibilities of an office manager without a clear understanding of dentistry, including technology, scheduling and production.

The second characteristic is total loyalty to the doctor and practice, an area where many office managers fail. When an existing team member is promoted to office manager, she must act in the best interest of the doctor and practice. If she wants to be "one of the girls," she cannot successfully assume supervisory responsibilities or her loyalties will be divided, which can negatively impact not only her morale, but that of the team, doctor and practice.

The third trait is the ability to be fair to co-workers from management's perspective. Successful office managers are able to objectively confront uncomfortable issues with team members who used to be their peers.

The fourth characteristic among successful office managers is that they are business minded. They understand profit and loss statements and the key aspects of running a business. As leaders, they are able to evaluate existing systems and programs and recommend changes that will help the practice meet its production goals. For example, they could recommend implementing a financial policy to reduce A/R, or a program such as outside patient financing to increase case acceptance.

Next is a shared ability to keep important information confidential. Financial and employee information, while terrific gossip material, is not appropriate to share with other members of the team without the doctor's permission.

Successful office managers are honest. They set the standard and become role models, which means they consistently display exemplary behavior. For example, they don't surf the Internet during business hours, they don't take personal calls or bring an unpleasant attitude to work.

And finally, office manager leaders are professional in appearance and behavior in and out of the practice. They "wear their rank well," which means that they view and use their responsibility as a leader with humility, never abusing the leadership position the dentist has given them.

The Transition from Team Member to Team Leader

When the practice's growth requires a full-time office manager, it's best to promote from within. Why? Because team members have valuable knowledge that will take someone from the outside months or even years to acquire. Of course, some practices have had tremendous success hiring from outside of their practice, and even outside of dentistry. But for the majority of practices, one of their own should be chosen to transition from team member to team leader.

The most critical key to success is the way the promotion is presented to the rest of the team. As a management consultant, this is one area we work on really hard. It doesn't matter if that person is someone from the team, is the spouse of the doctor, or is someone hired from outside. If the doctor is hesitant to formally introduce and clearly outline the new office manager's responsibilities to the team, the chances for success will be significantly undermined. When a formal announcement is done properly, the new office manager will be immediately supported with the respect the position deserves.

During the announcement, the role and responsibilities of the office manager must be clearly discussed so there is no confusion. Many dentists are not comfortable relinquishing authority, and this can stifle growth and sabotage the new office manager's success.

The Four Levels of Authority

In addition to an announcement, the success of the office manager is determined by the level of authority she receives. If too much or too little is given, it can lead to problems and stress. There are four levels of authority given to office managers:

Level One: The office manager is responsible for getting all the facts and the doctor decides the solution or course of action.

Level Two: The office manager is responsible for getting all the facts and together with the doctor decides the solution or course of action.

Level Three: The office manager is responsible for getting all the facts, deciding the solution or course of action and reporting back to the doctor the results.

Level Four: The office manager is responsible for getting all the facts, deciding the solution or course of action, and no further reporting to the doctor is necessary.

Levels one and four are very dangerous for both the doctor and office manager. With level one, too little authority is given. With level four, too much authority is released. The most effective practices use level two or three, with more teamwork and shared authority.

The Four Areas of Office Management

Depending on the personality and needs of the doctor, the office manager will be responsible for some or all of the four areas of office management. These four areas are personnel, budget and finance, marketing, and facility and technology updates. Most doctors are happy to relinquish authority in the areas of personnel, marketing, and facility and technology. These are often not strengths of the doctor and, because he or she is the top producer for the practice, his or her time is better spent delivering dentistry. The one area that doctors are most reluctant to let go of is budget and finance.

For successful office managers to excel in the areas they are given authority over, they must seek expertise through all available resources. The American Association of Dental Office Managers (AADOM) is a great resource for tips and programs to improve your practice. Office managers should visit the site at American Association of Dental Office Managers. Look both inside and outside dentistry for seminars on personnel and training. Tap into the free resources provided by companies, including equipment manufacturers and financing partners. For example, CareCredit, the leading patient financing program endorsed by the AADOM, provides free morning huddle topics, consultant advice, scripts, and training on exceptional patient communications skills on CareCredit.com. Also, seek additional insight and proven techniques from industry experts through publications, articles and case studies.

To help you get started, go to my Web site at Linda Miles and receive a 10 percent courtesy on my "Women Working With Women" DVD or the new CD series from our recent Practice Administrator workshops. (Please join Dr. Rhonda Savage and me at our next workshop on Feb. 8 and 9 in Sarasota, FL).

There has been significant research conducted to determine if leaders are born or made. Even if you're not a "born leader," making the transition from team member to team leader simply requires the right attitude, the right announcement, and the right authority.