Part 3: What Defines a Successful Practice?

This is the third blog post in this series. (If you missed the first two, go back and read them; I will see you in a couple of minutes.) 

OK, we have been talking about success. In the first blog post in this series, I talked about my opinion of what success means: being happy in your job. I don’t equate success with money. Although, I think if you love your job and are happy, you are going to work in a way that attracts people and probably make a great living.

In the second blog post, I talked about how I thought I wanted a big practice (much like everyone), but I found I am much happier being in a small office. I love the people with whom I work, and I truly like most of my patients. I talked about how my office is fee-for-service. And to survive as a fee-for-service practice, you have to separate yourself from the rest of the dentists. We try to be a warm and friendly staff who focuses on the patient.

Today, I want to talk with you about my management style. First, I want to say that I want to be the dentist who I know I should be. But after 22 years, I realize being a leader doesn’t come easy for me. I am the guy whose leadership style is to not micromanage. I am a guy whose employees have been with my office for years. (I have employees who have been with me for 39, 21, 18, 11, 10, nine and five years.) I believe that at this point, everyone should know how to do their jobs, and they should know how to do them well. When someone does something that should be pointed out, I do this — but only then. Theoretically.

What usually happens is that I think about how I should talk to this employee after the patient leaves. (I don’t want to talk to him or her in front of the patient because that looks bad.) But sometimes, I get busy, and then it never seems like the right time to talk, or I just don’t want to get into it. Or I don’t want to create drama during the day, so I tell myself I will initiate the talk before the employee leaves for the day. But then I get busy and never actually say anything. Then, by the next day, it has been more than 24 hours since what seemed like an insignificant detail actually happened, and I have forgotten about it. Problem solved.

Not having a “sit down” with someone has some benefits. There are no tears. There is no attitude from that employee for the whole day. There is no argument about how it “wasn’t my fault.”

Let’s say you don’t talk about that fairly insignificant thing. The next thing you know, it has been a week, and the issue has long been forgotten. Everyone wins. How about that leadership?

I know some of you are probably thinking, “This guy is a total wuss.” I know, I know. But I also know I am talking to dentists who probably do the same thing as me. It is far easier to ignore than to deal with every little thing that comes up. I mean, we don’t have personality conflicts in our office, thank goodness. Everyone really gets along, and drama is almost nonexistent.

If the assistant doesn’t have the bonding agent ready before the etch is taken off the tooth, is that really a big deal? From a big-picture perspective, no. I feel like I am fairly critical, and I find if I just marinate on a particular issue, something that seemed like kind of a big deal yesterday becomes not that big of a deal the next day.

There is some leadership, by me, when it comes to doing dentistry and how people should be treated. I know what I like to do. I know how to treat people, and there is no compromising this.

I just finishing reading another blog post about the way The Ritz-Carlton approaches leadership. I know that taking the easy way out or not “rocking the boat” is not the leadership philosophy of most CEOs, but micromanaging is not my style. I guess my philosophy is to hire the right people and let them do their jobs. Then, every month, we get together and have lunch and talk about ways we can improve or make each other’s jobs easier.

Look, this philosophy works for me. I love my job and my team. We have production goals that get met almost every month. We do a lot of laughing around here, and I think most of my employees/team members like to come to work. Maybe because I don’t nitpick everything they do. I don’t nitpick about supply costs or lab costs. I don’t complain about how the manufacturer raised the cost of its composite. (One hundred and fifty dollars’ worth of composite could possibly make me $3,000; what do I care if they raise their cost $10?) I don’t even look at my lab bill. I like my ceramist, and he does great work. Am I going to complain if he charges me for a reduction coping or a custom shade? So his fee goes from $225 to $239 for one case; I charge $1,300. We have a great relationship. I am not going to change this because I want to complain about $14.

I do my best to keep costs down. I shut the air conditioner off at night. I turn the lights off when I leave. I ask the staff member who handles ordering to do his or her due diligence. If the hygienists need new scaler tips, I say, just buy them, no question. If they can’t do their job well because they need X, then just buy X, I say.

This is my management style. I know I am not alone when it comes to disliking confrontation. I know I am not the only one who dislikes micromanaging people or working with numbers. Think about how much time I save because I don’t read spreadsheets to find out how I can bring the hygiene-per-patient average up from $124 to $128. Think about how much better my life is because I don’t care that my expenses are 2 percent higher this month than they were last month. Pennies, I tell you.

Compared with having a patient who loves coming to your office and feels so comfortable at your office that he or she keeps coming back. Compared with patients who trust you when they want to make their smile prettier. Compared with a grandmother who loves you as her dentist so much that she wants to send their grandkids to see you and doesn’t care how much it costs. That is really what I care about it. All of those other things? I will worry about them tomorrow.

Tell me about your management style. Am I alone in offering this type of “leadership”?



John Gammichia, DMD, FAGD