The pack mentality

Aug. 1, 2004
My hygienist is not a team player. She usually arrives for work about two minutes before her patient is to be seated and regularly misses the morning huddle.

by Dianne Glasscoe

Dear Dianne,

My hygienist is not a team player. She usually arrives for work about two minutes before her patient is to be seated and regularly misses the morning huddle. Often, she asks other team members to help her, yet she rarely offers to help them when she has down time. This hygienist has been working in my practice for 18 months, yet she hasn't formed any real friendships with the other staff members.

However, she does have some wonderful redeeming qualities in that she has excellent clinical skills and patients compliment her regularly. She has a strong work ethic and rarely misses work.

My other staff members resent her, and the stress that it creates wears on me when they complain to me about something she did or did not do.

How can I bring my team together to work in harmony and help this hygienist see that she needs to be a team player?
Concerned Doctor in Colorado

Dear Concerned,

Most solo dental practices have small numbers of staff members that work in close proximity to each other. When a little seed of resentment takes root and is allowed to grow, it can choke out the camaraderie, harmony, and positive growth. Dissension in the ranks creates an unhealthy, unhappy practice atmosphere.

However, there's more to this picture than meets the eye. The first problem you describe is an employee who "regularly" misses the morning huddle. The non-verbal statement this employee is making is that she does not consider the morning meeting important. How important is it to you as her employer? You, as the leader of the practice, must set the tone.

If you feel attendance at the morning huddle is important, you must spell that out in no uncertain terms to all staff members. There should be consequences for tardiness or missing the meeting.

If you have tolerated this behavior for the last 18 months of her employment, the non-verbal message that the other staff members hear is that this employee is "special" and is excused from doing something they are expected to do. That fosters resentment.

Frankly, some morning huddles are worthless. In my observations of many dental practices, I've seen employers who tell their staff members to conduct the meeting sans the doctor.

In other situations, there are doctors who are routinely late as well. In some morning huddles, one person does 95 percent of the talking, and nothing meaningful comes of it. Doctors in the above situations are clearly lacking in leadership qualities, and their practices would be better off not having morning meetings.

Also, please remember that if staff members are required to be at work at a certain time, they must be paid for that time. For example, if your policy is to have the morning meeting at 7:50 a.m. and staff members are expected to attend, you must compensate them for that time.

However, a well-organized morning meeting can be beneficial. This is an excellent time to spotlight any new patients, mention any patient concerns that should be shared, and bring the whole group together as a cohesive unit. This is especially true for large practices with multiple doctors. In such practices, the morning meeting might be the only time during the whole day when everyone comes together. Some offices have a "thought for the day" — an inspirational or funny saying — which adds a nice touch.

Us against her

You mentioned that other staff members complain to you about the hygienist. There seems to be an "us-against-her" mentality. How unfortunate for the hygienist and you! I wonder if you have had trouble keeping a hygienist in the past.

In every office, a pecking order exists. Usually, a dominant personality will lead the pack and the others fall in behind. You may have a staff member who keeps the other staff members inflamed with negative comments. A staff member who runs to the doctor complaining about a coworker should be viewed with suspicion. Such people are team destroyers. One gossiping staff member can do great damage to the practice morale.

Furthermore, there is a long-standing rivalry between hygienists and clinical assistants that stems from a jealousy over hygiene wages. While the playing field should be level for all team members (including the doctor) regarding patient care and practice profitability, hygienists are producers in the practice. Just as your education equips you to be a restorative (or other) specialist, hygiene education equips hygienists to be preventive care specialists. They deserve to be paid more.

The bottom line is this: If an assistant wants to be a hygienist, let him or her go to hygiene school. If a hygienist wants to be a dentist, let him or her go to dental school. Each member of the team should respect their co-workers for their different levels of expertise and contribution to practice success.

How wonderful it is when people come to work, attend to their responsibilities, refrain from gossip, and keep their noses out of everybody else's business! A doctor with such a team is truly blessed!

In my opinion, no greater compliment can be paid to a staff member than when a patient praises him or her. The fact that the hygienist has a good work ethic and possesses excellent clinical skill is more important than petty jealousies that exist. After all, patient care is what is most important. Could it be that the reason this hygienist doesn't seem to fit in with the group is that she feels resentment from them and has built a wall around herself for self-preservation? Most people can sense when others do not like them.

Your current situation is not uncommon. But what should you do to restore harmony?

The answer to this and many other staff management problems can be summed up in one word — leadership. Unless you employ an office administrator, it is up to you to come to an understanding of the problem and develop a solution.

Regular staff reviews give you and each staff member a time to sit down and honestly look at job performance against a set of pre-established criteria. One of these should be "arrives at work promptly and attends the morning huddle."

Another criterion could be "offers help to other staff members when time permits." Your hygienist probably does not know why the others resent her, although I'm sure she knows the resentment exists. If there have been no repercussions for her tardiness, she probably thinks it is not a priority.

Establishing harmony among your group may be impossible if there is a "bad apple" among them. This could be a staff member, possibly of long standing, that has had relationship problems with many former staff members. Employees who are always looking for some deficiency in their co-workers are very insecure. Their self-image is poor, and they seek to look better by making others look bad.

Management by default rarely works. I urge you to take a strong leadership stand and be proactive when you see resentment "weeds" springing up among your staff members. This stand may include bringing a complaining staff member and the co-worker together for dialogue with you as the mediator. In my work with staff members, I admonish them to take their concerns about a co-worker to that person specifically. Do not involve other co-workers.

Conducting biannual staff reviews should help you give your staff members the feedback they want and deserve. Bent Ericksen and Associates (1-800-679-2760) is a good source for all kinds of human resource materials for staff management. Your staff members will respect you for being honest but not micromanaging. Be careful as the leader to look beyond the surface problem. In most every case, there are undercurrents that you may miss if you are not sensitive and astute.
Best wishes,

Dianne D. Glasscoe, RDH, BS, is a professional speaker, writer, and consultant to dental practices across the United States. She is CEO of Professional Dental Management, based in Frederick, Md. To contact Glasscoe for speaking or consulting, call (301) 874-5240 or email [email protected]. Visit her Web site at