Everybodys a critic!

Sept. 1, 1996
Expecting better job performance from a dental assistant is certainly within your responsibilities. The question becomes: How do you criticize your subordinates? Are you really trying to improve productivity, or is it a matter of belittling a colleague?

Expecting better job performance from a dental assistant is certainly within your responsibilities. The question becomes: How do you criticize your subordinates? Are you really trying to improve productivity, or is it a matter of belittling a colleague?

Kent Davies

Hygienists are well-trained to delicately criticize their patients` oral hygiene habits. As anyone who has faced the formidable task of criticizing an aide or colleague can testify, criticizing poor on-the-job performance is much more complicated. Unfortunately, dental colleges provide little or no training in basic supervisory skills. So you are often left to your own devices when administering constructive criticism to an assistant.

In a dental office, positive on-the-job criticism cultivates more effective and efficient subordinate competencies. Although constructive criticism is remarkably productive, improper or negative criticism is extremely destructive to already delicate workplace relationships. To complicate matters further, inflexible and tight schedules make constructive criticism in dental offices especially difficult.

Phebe Blitz, an associate professor at Northern Arizona University`s Department of Dental Hygiene in Flagstaff, Ariz., has found in her experience that "criticism is something most people don`t want to deal with in dental offices. Some of the least productive offices I have seen had managers who do absolutely no criticism because they don`t want to deal with it, even though it is one of the most critical things you do towards building an effective team."

Anita Jupp, an international speaker and dental consultant with her company, Anita Jupp & Company in Burlington, Ontario, Canada, finds that most dentists "run their practice on a too-nice basis. Not a business basis. They don`t want to offend their dental team members so a lot of times people are frustrated."

When rendering criticism, a few simple rules will simultaneously enhance interpersonal relationships, improve job performance and, most importantly, improve patient care.

Be pro-active

Jupp believes that most problems can be prevented with a more "pro-active" approach towards hiring and supervising dental office employees. Before starting the hiring process for a dental assistant, Jupp recommends that the "dentist and hygienist discuss the personality type that best complements their team approach as well as the ideal candidate`s qualifications and experience." Do they want to hire a new graduate, for example, or a more experienced hygienist who can talk dentistry and reinforce treatment plans.

To help ensure quality patient care, Jupp strongly believes the "hygienist should also be part of the process when listing an assistant`s duties, hygiene communication skills, and what they can legally delegate to an assistant." Fewer problems will develop down the road if the hygienist also participates in "the interviewing process when hiring an assistant." After all, the hygienist will be the person supervising and working most closely with the dental assistant.

Jupp also stresses the importance of the hygienist, the doctor, and the assistant taking time each morning to take a look at the schedule to:

- See who is coming in during the day.

- Identify new patients who need X-rays.

- Determine which patients may be a little apprehensive.

- Decide who the assistant needs to spend more time with so the hygienist doesn`t feel rushed or frustrated.

This team-oriented, pro-active approach reduces the need for any constructive criticism by improving communication and anticipating problems.

As the hygienist, you have the responsibility for the day-to-day supervision of your assistant. Since the dentist pays the assistant, though, she is ultimately responsible for an assistant`s hiring, supervision, evaluation, and training.

Jupp has found that "90 percent of the time a problem can be worked out between the hygienist and her assistant. But, ultimately, there may be a need for the dentist to be involved." If a problem develops that potentially affects the whole office or patients` welfare, it is probably a good time to bring the dentist into the matter or at least keep her informed.

When anger doesn`t work

Losing your cool is detrimental to constructively criticizing a subordinate`s behavior. Never let anger control your response, no matter how bad the situation may appear. Exasperation is especially tempting when facing situations seriously impeding quality patient care. When all is said and done, though, you will pay dearly for your passionate overreaction.

Although, at times, it is a very human reaction to want to immediately identify and correct especially egregious behavior, Blitz recommends "taking some deep breaths and letting them out slowly to refocus your mind. I will also, if I find that I am very emotionally upset, leave the room and walk up and down the hallway, or get a drink of water." When she is emotionally involved in a situation Blitz "won`t handle it until I have controlled my emotions."

Blitz`s golden rule is to "praise in public and criticize in private." Although space is always at a premium in dental offices, Blitz recommends going into the dentist`s private office during a break or, better yet, taking a few minutes at day`s end to discuss the situation in the reception room which Blitz "finds less threatening." Under no circumstances should criticism be administered in front of patients or colleagues.

It`s also important to remember that criticism voiced angrily and cruelly becomes an emotional and self-serving exercise for the accuser intent on punishing the guilty and generating shame. It is quite rare that inappropriate criticism accomplishes anything of lasting value.

Create win-win situations

Constructive criticism creates win-win situations for everyone. It is most effective when conducted in a sensitive manner that doesn`t hurt a subordinate`s feelings or make her perceive she is being unfairly singled out.

Blitz believes constructive criticism "can turn out to be very powerful learning experiences." Your overriding goal, when applying constructive criticism, is making everyone (and especially the patient) a winner. The person receiving the constructive criticism will learn more about professional conduct, the patient will receive better quality care, and you will have turned a frustrating situation into a positive learning tool.

Constructive criticism must be sensitive to everyone`s psychological needs. It accomplishes clearly defined goals that improve patient care, such as accountability for seating the patient on time.

Jupp stresses that these goals should be scrupulously delineated upon hiring an assistant and reinforced during performance reviews. Constructive criticism should also be viewed as an unique opportunity to learn new skills and develop more positive attitudes.

Meeting these goals results in more pleasant working conditions and more professional patient care. Positive criticism also psychologically opens the person receiving constructive criticism to additional helpful suggestions, as needed, in the future.

When criticizing subordinates, it is important to consider that dignity and positive self-worth are universally important. This is especially important in team management situations. Destroying a subordinate`s self-image accomplishes nothing. In fact, such behavior only results in the subordinate harboring a deep preoccupation for sweet revenge or even considering a move to a more empathetic supervisor.

Blitz recommends offering positive, non-tangible rewards for improving one`s behavior. After first identifying the behavior in question, Blitz tries to motivate a positive change in the person`s behavior by "identifying an opportunity, a goal, or a reward for them changing their behavior." In other words, a reward for a more positive resolution of the situation.

Listen to the accused

Jupp recommends it is up to the hygienist and dentist to "actually listen to the dental assistant" when talking about a need for improvement. By asking, "What are your concerns? What are your frustrations?" the person facing constructive criticism is allowed to have meaningful input. After all, there is always two sides to every story.

Blitz always asks a person needing constructive criticism, "How would you like to have resolved the situation?" Her goal is to give ownership of the solution to the person receiving the constructive criticism by getting them to come up with a better way of handling it. If that doesn`t work, then Blitz "might give them some suggestions."

A week or two later Blitz will provide praise in a similar situation by saying, "Wow! That is what I was talking about last week and look how well you have done with it." This reinforcement, according to Blitz, "is very important."

Constructive criticism is essential to maintaining a professional dental office. Ignoring a problem ultimately makes a situation worse and destroys any semblance of true team work. Everyone suffers, including the patients, when, in the naive assumption that problems can be truly swept under the rug, festering problems are ignored.

"People who feel good about themselves," Blitz finds, "produce more and are happier and less frustrated because they have learned to deal with frustrating situations. Some of the least productive offices I have seen have had managers who do absolutely no criticism because they don`t want to deal with it. And everybody is miserable and everyone is undermining everyone else. No one feels good about themselves or works together as a team. I see criticism as a critical piece in helping empower each individual and the team."

In negative work environments, Jupp strongly believes, "Patients can see, hear, and feel the tension between dental team members." Ultimately, patients will feel even more uncomfortable than usual in a tense dental setting. "They don`t miss much," she said, and, ultimately, they will seek a more congenial atmosphere for their dental needs.

Constructive criticism may, at first, be uncomfortable to administer. In the long run, though, it is a necessity if you want to increase your income while providing high quality patient care. And the best benefit may be the joy of working with a quality dental care team who have all benefited from constructive criticism.

Kent R. Davies, MBA, is a freelance writer living in Anacortes, Washington. For nine years, he taught business management at Central Washington Univer-sity and the University of Puget Sound. His articles have appeared in more than 75 publications, including Entrepreneurial Woman and Executive Female.