Content Dam Rdh Print Articles Volume37 Issue6 1706rdh C1

Fearless accountability: Trust-based peer accountability in dental offices is linked to a commitment

June 1, 2017
Dorothy Garlough, RDH, explains how dental offices can establish accountability in a painless way.

By Dorothy Garlough, RDH, MPA

The 360-degree assessment carried out by everyone in the office proved to be a disaster. The assessment was supposed to offer constructive peer feedback, highlighting everyone’s strengths and weaknesses in a positive framework. Instead, one person saw it as an opportunity to lambaste other staff members in a personal and cruel manner.

It was anonymous, you know. No one - not even the doctor - would know who wrote that another staff member should wash her hair or iron her uniform, that she was too friendly with the patients, that she was unfocused, or that she shouldn’t floss her teeth at the office. It was just too easy to spew mean-spirited remarks. In some warped fashion, this behavior made the evaluator feel superior.

It is clear that this staff member abused the 360-degree assessment. In my view, I was working with a dysfunctional office. The staff claimed to be a team, but they didn’t have a clue about how to work together cooperatively to achieve shared goals. Bad behavior was rampant in this office: snide remarks about others were common, some members were excluded from “team” activities, competition was high, and collaboration was low. It was not a safe environment - it was a war zone where some employees had to be watchful of the next dagger that was coming their way.

The 360-degree feedback tool has become popular in business environments in recent years. With this tool, each employee gets feedback from various perspectives (i.e., subordinates, peers, and supervisory), as well as a self-evaluation.1

The purpose of the 360-degree assessments is to offer:

  • Blind-spot analysis - What do others see about us that we don’t see about ourselves?
  • Evaluating opportunities - Do we recognize and appraise opportunities wisely?
  • Communicating effectively - How clear are we at communicating?
  • Innovation and risk-taking - Do we see failures as opportunities to learn?
  • Problem-solving and decision-making - Do we use processes to find solutions and make smart choices?
  • Planning and collaboration - Are we tapping into the creativity of others?
  • Managing conflict - Do we have the skills to defuse conflict and arrive at solutions that everyone can live with?2

Last month, I wrote about how peer accountability within organizations leads to higher engagement and results. Not wanting to let the team down can be a motivator for staff members. In a “real” team, conflict is even encouraged.3 But there are respectful ways to disagree and dispute, and then there are disrespectful ways. The method above was not helpful or healthy for the office.

I believe 360-degree assessments can be beneficial, but it is better to have face-to-face feedback so everyone can be honest and discuss the feedback maturely. It is also important to voice dissenting views; otherwise trouble can fester, possibly resulting in greater pain and irreparable damage.

No assessment tool will work, however, if there is distrust among team members. Do you trust that everyone on your team has the highest good of the organization in mind? Are you confident that fired-up emotions will evaporate after coworkers disagree with one another? Do you trust the leader? Will she be fair and open-minded, even if you challenge her?

We will only ever achieve a healthy team if we are fearless in exposing our vulnerabilities. None of us has all the answers. Only when we feel safe to say, “I don’t know,” “I need help,” “What do you think?” or “This isn’t my strength,” can we effectively tap into the commitment of everyone.

Vulnerabilities need to be modeled foremost by the leader.3 Others will only come forward to share their own when a safe environment for doing so has been established. It takes strength and courage to acknowledge shortcomings. A real team acknowledges vulnerabilities because it can strengthen the team. This becomes a part of the culture.

Three effects occur when a team acknowledges individual vulnerabilities:

  1. Trust rises through open and honest communication.
  2. We tap into other team members’ strengths.
  3. Commitment builds within the team. Only when we can voice our opinions and know that they are at least listened to - if not acted upon - will there be commitment in the team.

Sure, team members may comply if they are told to do something, but there is a difference between compliance and commitment. Compliance doesn’t tap into buy-in; it means doing something because you know you should, because you have been told that it is the best action to take, or because you have to do it. Think of our patients: they will comply with home-care instructions to improve their periodontal status, often reluctantly, but when they commit . . . watch out! They are on! And as a clinician, you had better be on as well! Are you as committed to their personal health as they are? The committed patient will expose your commitment as a caregiver every time.

Committing to the team creates the conditions for lasting change. It is about bringing your all to the task: your focus, your creativity, your drive, your desire to uplift the entire organization, and your willingness to put your personal agenda aside for something bigger than you. It is carrying the mantle, passing the torch, and winning the race.

Gallup’s long-running polls on engagement tell us is that people have a deep need for meaning and that we feel great distress when this need is not met. Researcher Jane Dutton of the University of Michigan believes this need for community grows more acute as we spend less time with friends and family and more time with our devices. “Our connections with colleagues have a significant effect on our experiences at work, but also in our lives as a whole,” Dutton says. “If we don’t feel a sense of belonging on the job, both our jobs and our lives will feel meaningless.”4

Peer accountability, when respectfully and skilfully orchestrated, will raise commitment. This connects us with our coworkers and unites us. A person-centered team is the result - a win for the office, the doctor, and the staff! RDH


1. 360-degree feedback. Wikipedia. Updated January 9, 2017.
2. 360 feedback toolkit. The Booth Company website.[NAME]&gclid=CM-BhbLu1dICFcm2wAodukcE2A.
3. Lencioni P. The Five Dysfunctions of Teams. New York, NY: John Wiley & Sons Inc.; 2002.
4. Crowley MC. Why a happy career can still feel unfulfilling. Fast Company website. Published March 14, 2017.

Dorothy Garlough, RDH, MPA, is an innovation architect, facilitating strategy sessions and forums to orchestrate change within dentistry. 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] or visit