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When Does Empowerment Become Entitlement?

Do you sometimes feel that some of your employees exhibit a sense of entitlement? Have you questioned whether it’s you or them? Did you do something to cause it, or are they just inherently that way? Or do you just chalk it up to the nature of the current generation? All of these generalizations might be missing the point – I’d like to posit that it might be your fault!

Let’s start with a simple analogy. Imagine a sausage factory with two kinds of jobs – sausage-stuffing jobs and sausage-counting jobs. Sausage stuffers come to work every day and are told to stuff sausages working on this machine or the other for eight hours. They take breaks when they are allowed to and stop for lunch during their lunch hour. At the end of the day, they go home and don’t think about stuffing sausages. When they take their allotted vacation time, they expect that somebody else would’ve stuffed those sausages when they were gone. They really don’t care who was stuffing them. It isn’t their job. They expect to come back and stuff new sausages for the new week.In contrast, sausage counters have to count the sausages, make sure they are making enough to meet the demand, ensure that the stuffers are stuffing enough sausage to meet the specifications (but not too much to drive down the margins), and the like. Sometimes they have no time for lunch, and sometimes they have plenty of time to discuss the previous night’s ballgame. When they go home at night, they take their job home with them, worrying whether they had ordered enough casings for next week’s sausages, whether they have too much capacity for the slowing demand and what they should do about it, etc. When sausage counters return from a vacation, all of their sausages are piled on the floor to be counted. Nobody counted them when they were gone. They have to count the previous week’s sausages and the current week’s sausages. I suspect you get the point.

Most companies have both sausage-stuffing jobs and sausage-counting jobs. However, identifying which is which might not be as simple as it may appear. A common misconception is to equate this distinction with workers and management. For example, a software developer, who is considered a worker-bee at a digital design shop, might still take her work home and be brooding over a menacing software bug all night long. Conversely, a shift supervisor at a construction site might leave his work at the construction site when he goes home. Additionally, two individuals with the same job description might treat their job differently: one as a sausage stuffer and the other as a sausage counter.What does sausage stuffing and counting have to do with entitlement? A lot. Sausage stuffers are committed to doing a very good job of stuffing sausages. They don’t want more responsibility. Sausage stuffers expect that for a job well done, they will receive their negotiated slate of compensation, including their pay, benefit plans, vacation and sick time, etc. If they are due five sick days in a year, and by the end of the year they have not utilized all five, a sausage stuffer is likely to find a way to use the remaining sick days they’re entitled to. After all, they do a good job for the employer and they expect to receive the entire slate of compensation they were promised. You might view that as entitlement, but the sausage stuffer views it as their implicit contract.

Sausage counters view their jobs differently. They’re committed to the success of the business and are willing to do whatever it takes, whenever it needs to be done. They look for increased opportunities to contribute and view their compensation beyond that of monetary and benefit plans. For them, part of the compensation is the challenge in the job, growth of themselves and their career, and the freedom to operate independently rather than be supervised. Sausage counters value the freedom of independence and associated empowerment. They also recognize that with it comes an obligation: the success of the company.To illustrate this, imagine one of the machines in the sausage stuffing plant is leaking sausages. The conscientious sausage stuffer working at that machine might yell out to his supervisor, “Hey, Counting Boss, this machine is leaking sausage grind. You need to do something about this.” After simply reporting his observation, the sausage stuffer feels that he has completely discharged his responsibility. In contrast, the Counting Boss is up all night thinking about whether the machine can be fixed, or if she needs to buy a new machine, how much the new machine would cost, whether there is room in the company’s capital budget for the new machine, and so on. Does the sausage stuffer want to deal with the headache? Absolutely not. Does the sausage counter like the challenge and independence of being able to make that decision? Absolutely.The ownership of the company might want to empower and provide greater autonomy to their sausage counters in terms of how they manage their time, when they take breaks and if they can go to their child’s afternoon soccer game. But, afraid to label people as either sausage stuffers or sausage counters, they might provide that autonomy to their entire staff. Lo and behold: for the sausage stuffer, this is now part of the overall slate of compensation – their ability to manage their own time. A few months later, ownership looks at the behavior of their sausage stuffers and complains that they seem to feel entitled. Of course they are entitled: the owners enabled them.

So how do you solve this distinction? In the old days, manufacturing companies had a clear demarcation – hourly employees and salaried employees. In fact, the U.S. government then defined the concept of non-exempt and exempt employees (other governments have similar concepts). This worked well as long as we had sausage factories where the stuffing jobs were distinctly different from the counting jobs. But with the decrease in manufacturing companies and the increase in automation, most of the employees in your companies are now either service workers or knowledge workers. In other words, they are either serving a customer or using their thinking to create value. Both types of jobs appear to be sausage counting jobs. But are they really? Even if they are, do the individuals behave as sausage counters?

Interestingly, most new-economy companies have taken the position that all jobs are sausage-counting jobs and expect their employees to operate with the associated level of autonomy and obligation.

Now look at it from the employee’s point of view. If you gave them a choice, what do you think they would want to be? Of course, you would have to explain the limited responsibility and authority that comes being a sausage stuffer and the broader privileges and obligations that are associated with a sausage counter. What would likely happen is that everybody would want the privileges of a sausage counter, yet not everybody would sign up for its obligations.

Here is an illustrative example. At Think Shift, we have a simple vacation policy: “Vacation is good, take some. End of policy.” Is this a privilege or an obligation? It’s both. Yes, the employees get to decide when and how much vacation they take. However, their job remains their responsibility even when they are away. So before they go on vacation, every employee makes sure that all of their tasks are either completed ahead of time, or negotiated with a colleague to complete while they are gone. Even after that, do you think they have full peace of mind that they had covered all the bases? No. During their vacation, they worry that they might have missed something. Every employee checks their email when they are on vacation. Management doesn’t ask them to do so. The employees feel a sense of obligation to do so. Is our vacation policy a privilege or an obligation? It’s both. We find that this policy works well as long as all employees view themselves as sausage counters – with the attendant authority and obligations. But if you administer such a vacation policy to a group of employees, some of whom behave like sausage stuffers and others as sausage counters, it might be ill-advised.

At the end of the day, your desire to give people authority and to empower them requires that they rise up and accept certain obligations. Have you communicated those obligations? Have you empowered the right kind of people? Or are you unwilling to distinguish between sausage stuffers and sausage counters, and have thus empowered a few who will never rise up to fulfill their responsibilities? Has empowerment led to entitlement?

We welcome your comments on our Food for Thought mailings and encourage you to explore the Food for Thought archive. We hope your business is doing well. We’re happy to chat about the content in this article or anything else with which you’d like assistance.

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Build a Stronger Dental Team with 5 Simple Steps

An efficient dental care team is theBaseball Team backbone of a successful clinic, improving its day-to-day operations as well as patient satisfaction. If your team works together smoothly, the benefits affect every aspect of your practice in a positive manner, thus reducing time and enhancing performance.

If your team has any shortcomings with motivation, productivity or efficiency, follow these 5 simple steps.

1. Focus on Strong Hires – To build an incredible dental team, put in the time and effort to find the best talent possible. Research dental offices hiring and recruitment strategies, and make a list of essential skills and characteristics you want in your staff. Where possible, raise motivation by promoting existing team members.

Advertise even when you aren’t hiring, and build a network of passive candidates who may be a good fit someday. Remember, the best people won’t be willing to work for peanuts, so make sure your clinic’s pay scale is at par with (or better than) the competition.

2. Train Your Staff – For your dental care team to work effectively, they need to be trained on the systems you use (e.g. scheduling, hygiene, equipment maintenance, financial management, etc.). Document every step to build awareness and minimize “holes”, and train existing staff as well as new hires.

Customize these processes according to your practice, and use the 3-month probation period to its fullest by guiding new team members through the systems you use. Even experienced people will not get the hang of “how we do things here” unless you’re clear about your expectations!

3. Take Performance Reviews – Regular performance reviews can do a lot when it comes to motivating your dental team. Set up an agenda for review meetings, where you discuss each person’s progress and contributions to your practice, as well as their strengths and areas where they can make improvements.

Encourage them to bring up any issues, expectations, feedback and opinions they want to share. This raises morale, team spirit and ownership, as each person on the team feels more included. You could do this twice a year with seasoned team members, and every month for new hires.

4. Encourage Ownership – Simply giving your team members certain responsibilities and expecting them to do their best may not be enough. If you really want to boost productivity, offer a bonus system that rewards performance. Set up a system of weekly or monthly goals, both for individuals and the team as a whole.

Hold a quarterly or bi-annual team meeting (outside the office, a fun diversion from the daily grind) where you share results and rewards. Ideally, bonuses should be awarded based on a collection model, i.e. revenue growth. This helps create a sense of challenge and excitement while also boosting your clinic’s earnings.

5. Help Them Grow – To motivate your team and reduce turnover, offer continuing education or skill enhancement programs that helps them stay up-to-date with advancements in the industry. In fact, this can help reduce your stress too – the more your team members learn, the better they will be at their jobs.

Dental skills tend to become outdated every 3-5 years, so helping your staff also helps you. Work with core team members to offer in-house coaching or brainstorming sessions as well, where you or other doctors guide staff through new systems, innovations and leadership opportunities.

When you’re hiring a dental assistant or other staff, look for team players who want to grow within your practice. It’s the best way to set up a strong base for success!


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Three things to keep in mind about your reputation

More wisdom from Seth Godin:

Three things to keep in mind about your reputation

  1. Your reputation has as much impact on your life as what you actually do.
  2. Early assumptions about you are sticky and are difficult to change.
  3. The single best way to maintain your reputation is to do things you’re proud of. Gaming goes only so far.

Source: Seth’s Blog: Three things to keep in mind about your reputation

In dentistry reputation is everything. Read the linked post, it is short and worth the effort.

New technology, especially the Internet and social media have accelerated the age old word of mouth process. Your reputation can be tarnished in the click of an eye. Because our reputations are so valuable dentists are especially concerned about online reviews and other social media.

Godin reminds us (as stated in #2 above) first impressions are still very powerful. If a patient comes away from a first visit with a positive first impression it is unlikely he/she will be persuaded you are a jerk based on an online review. However if the first impression the potential new patient gets of you comes from a negative online review it will be harder for you to overcome the impression and win them over. In fact it is probable that the potential new patient will simply go elsewhere and you will never get a chance to win them over.

The second big take away is that a good reputation comes from doing good things.

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If Your Hygienists Aren’t Doing This, You’re Cheating Your Practice and Patients

Ok. I am going to make a bold statement. Well, it’s not really that bold.

My hygienists are the lifeblood of my general practice.

I use the term ‘general’ practice very intentionally in that statement. I don’t have exact stats, but my guess would be that 75% of my general dental practice care is driven through the hygiene department.

If you don’t have your hygienists taking photographs on your patients then you are cheating yourself and your patients. Photographs speak a thousand words. They communicate in a way that words simply can’t communicate.

Now I don’t believe in intraoral cameras. In my opinion, they are 1990’s technology and promote single tooth dentistry. I prefer to utilize extraoral digital camera with mirrors and retractors.

In our practice we have a simple rule. Every visit in hygiene there must be a photo taken. I don’t care what the picture is of – just that when I walk in the room we have a photo taken and on the patient education monitor.

Now we start having regular photographs to show patients how things are progressing.

Here’s a perfect example.

LS RDH photography

Lauren has been our patient since 2013. In 2013 we took our baseline series of new patient photographs. At this visit in 2016 our hygienist noted some recession on the upper premolars.

No patient believes or wants to hear they have recession and need a tissue graft. But – a picture speaks a thousand words.

This simple picture and the comparison to 2013 allowed us to talk to the patient about several things.

The true need for a tissue graft. We have an active area of recession that needs to be corrected. The patient sees the difference and ‘owns’ the problem.
The need for some type of occlusal treatment. Likely the need for some equilibration and a guard to protect the teeth. We know that usually this type of isolated recession is related to occlusal trauma.

So there you have it. The value of photography! And to me the beauty of this is that all done by my hygienist. I walk in and the patient is prepared and all I have to do is agree and answer any lingering questions.

Are you taking photographs in your practice?

What holds you back from taking photographs?


T-Bone Speaks is a podcast dedicated to helping you achieve clinical, financial, and personal balance. You’ll love the entertaining demeanor and down to earth approach to dentistry.

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Culture is What You Walk Past


I generally try to avoid politically-motivated topics in this Food for Thought series. Even though it has been particularly difficult to resist this election season, this month’s topic is more inspired by a news story than the current political climate and should be viewed as such.

We have all heard, or heard of, the lewd comments that Donald Trump made about women in a leaked tape from 2005, which have been explained as simply “locker room talk.” My wife asked me if such comments are typical in men’s locker rooms, and my response inspired this article.

I told her no, those comments fall totally outside my experience — in the locker rooms I’ve been in and with the company I’ve kept. So, the natural question is am I the exception? Are the locker rooms I’ve spent time in, or the men who were there, unusual? Is it just me? Quite immodestly, I am going to claim it is just me. I told my wife I can think of people I know who might make those kinds of comments under certain circumstances. However, they know me well enough to not say such things while I’m around. I don’t promote prudishness, but I don’t walk past lewd comments either. That ensures the culture around me doesn’t include that kind of “locker room talk.”

For example, in my own company – of which I am not the CEO and do not have operating authority – I do not like the use of foul language in the workplace. I am told, much to my chagrin, that it used to be, and might still be, in common use. However, I do not walk past it. As a result, nobody uses foul language in my presence, and on occasion when somebody slips up they apologize immediately.

Let me use a more national example. All of us occasionally break the speed limit. It’s not uncommon for someone to come rushing into a meeting or to a social event and brag about how quickly they made it across town, implying they broke every speed limit in the process. Does anyone reprove? Of course not. Yet, you’ll never see anyone rush into a meeting and brag about nabbing the handicap parking spot. “It’s right outside the front door! How convenient!” If they did, they wouldn’t brag about it. And if they did brag, someone would say something. As a society, we walk past speeding violations but not stealing handicap privileges.  Both violations are written in the code of law.  But, where is it written in the code of culture that one violation is permissible and the other is offensive?

My friend Carolyn McKnight tells a great story. She went to Azerbaijan to run a multi-day meeting. People from many different countries, mostly from that part of the world, were in attendance. And, as Carolyn found out, the culture in that part of the world – probably in many parts of the world – is not fastidious about punctuality. Yet, Carolyn wanted to set a culture of accountability. On the first day, when the first person walked in late, she politely said, “We are sorry you could not be here on time. But we are glad you are here now. Please join us.” As each person entered late, Carolyn repeated, in her slow, soft and inimitable manner, “We are sorry you could not be here on time. But we are glad you are here now.  Please join us.” The refrain continued with each late entrant. Lo and behold, every attendee was on time from that day forward. Carolyn did not walk past the tardy.

In the February 2008 Food for Thought article, I told a number of stories to illustrate the fact that people are more accountable in organizations where everybody – even a bystander – undertakes an obligation to hold others accountable. I called this obligation co-accountability. Staying silent when faced with a lack of accountability is a failure of co-accountability. It’s walking past when you should be speaking up. Cultures that accept the obligation of co-accountability reach a higher level of accountability. To walk past a violation is failure of co-accountability.

Culture is not defined by what you condone or even what you promote. Surely, it’s not defined by undisputable phrases printed on a poster board and plastered on the wall. Rather, culture is best defined by what you will or will not walk past.

So, next time somebody in your company behaves in a manner that gives you pause, ask yourself, is this a speeding violation or a handicap parking violation? Should you speak up or stand silent? Should you or should you not walk past? Your action – at that moment – helps define your company’s culture. By being intentional about your action, you will create an intentional culture.

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