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Three Team Decisions

by Steven Anderson

Decisions, decisions. We make them every day. Some more consciously than others. But we are always making decisions.

Why then do we make such poor team decisions?

They are different from individual decisions and we usually mess them up.

Here’s a quick example.

I was recently invited to observe a team meeting of a team we had never worked with before. They were looking for some suggestions as to how they could be more effective as a team and asked me to join them to get a feel for their team and the culture of their practice. I arrived early and waited for the meeting to start because when you are early, you are on time.

Early on the agenda was a discussion regarding a new initiative that the leader dentist had decided to implement in the office. The entire team would be required to be on board. I had some idea of the direction that the dentist had decided to take because he had shared a little about it with me before the meeting. He was excited about the direction he had decided to take and was looking forward to having the team share his enthusiasm.

To my shock, the dentist introduced the new initiative as follows: “We have been thinking about implementing a new system in the practice and I wanted to know what you think about it.” At that point, some basic parameters of the new idea were shared. Team members immediately began asking probing questions. Several of the more outspoken team members around the room shared strong opinions until the tide clearly turned against the new initiative. Before the discussion was over, all team members had turned visibly and vocally against the idea. It was dead in the water.

The dentist was deflated and infuriated. After the meeting we sat down and he began to berate his team in their absence. “This is how they always are. They are against everything I want to do.” After he calmed down, we discussed the situation and the fact that the dentist had set himself up for failure on the implementation of the new initiative because of one simple thing: He had not determined the type of decision he really wanted his team to make. Then he set the entire situation up for failure by virtue of the question he asked. There was only one person to blame for the failure of this team decision and it was the lead decision maker.

Why do we fail when making team decisions?

Two reasons:

1. Failure to identify the exact type of decision to be made.

2. Failure to set up the decision in the right way so that it is successful.

In the next few minutes, we’ll discuss three different team decisions and how to set them up for success. The three decision are:

The Implementation Decision.

A decision has been made and team involvement is required to implement the decision.

The Input Decision.

A decision is up for consideration and team input is desired before the leader makes a final decision.

The Democratic Decision.

A decision needs to be made and just about any direction taken will be OK.

Let’s take a look at each in reverse order and how to set them up for success.

The Democratic Decision.

Majority rules. In a true democracy, an issue will be discussed and debated, then a vote is taken and the majority rules. These types of team decisions include issues where the stakes are low and just about any direction will do. One example might be where to order out for lunch (with budget parameters). Let the group decide and adjust accordingly. The democratic decision is truly a “What do you all think?”type of decision with the preface that options can be discussed and then we will take a vote. Majority wins. Alternatively, the entire decision can be left to the team to decide in whatever way they want to make the decision. Just give a time limit so a decision can be made in a timely manner.

Unfortunately, too many decisions are presented as democratic decisions. “What do you all think we should do?” should be reserved for the few times when it really does not matter what direction is taken and each member of the group truly can voice their own opinions and have their voice heard.

Too often when an important decision is to be made, that will impact the success and direction of the practice. I hear well-meaning dentist-leaders say, “Well, let me see what my team thinks.” Once that road is taken—with the implication that it is a team democratic decision—it is difficult, if not impossible to take it back. Don’t ask the team what they think unless you are ready to hand over the decision to the team to make.

The Input Decision.

Many decisions involve those who are closer to the reality than the decision maker. Getting input from those who may be involved later down the line might be a good move. These types of decisions might include: The date for the next team retreat that might require childcare arrangements or…

• Where to have the next team retreat

• A new piece of equipment

• A new marketing campaign

• A potential new hire

How this type of decision is framed is critical. It goes something like this: “We are considering possible dates for our next team retreat and would like everyone’s input before we make the final decision. We realize that we may not be able to find the ideal date that will work perfectly for everyone, so we appreciate your input as well as your cooperation once the final decision is made.”

By framing the decision this way, you have made some things very clear:

1. You value their input upfront.

2. The leader will be making the final decision.

3. The decision may not be perfect for everyone even though you are asking for input in advance.

4. The leader expects everyone’s cooperation once the final decision is made even though it may not be the decision that would have been each person’s choice.

Everyone likes to be heard and know that their opinion matters. Asking for input in the appropriate way up front gives everyone who wants to the opportunity to weigh-in with the understanding of where the final decision will be made.

The Implementation Decision.

When a decision has been made but team involvement is needed for successful implementation, buy-in is crucial. These type of decisions might include:

• Going to mandatory CE together, like OSHA or HIPAA compliance training

• Installing a new piece of equipment

• New rules or laws implementation

• A new clinical direction or philosophy of care

Some decisions are the leader’s or owner’s right to make and many times they have to be made so the business can move forward.

In framing this type of discussion, you might say, “We have decided to implement a new philosophy of clinical care in the practice because of some new scientific discoveries that make total sense and are in the best interest of our patients and our practice. I would like to explain this new clinical direction and then work together on how we can all implement this new direction in our respective positions.”

The message is clear:

1. A decision has been made.

2. There is a clear reason why the decision has been made that will be explained.

3. It will take everyone to implement the change and we are all going to work together as a team to make that happen.

In other words, the decision is not up for debate. It has been made. What may be up for discussion is how we are going to implement it together.

In some cases, it may be appropriate to acknowledge the fact that everyone on the team may not initially agree with the decision that has been made. Disagreement is acceptable. We do not all have to agree 100% of the time. What is expected, however, is that everyone get on board with the successful implementation of the decision. That is what being a team is all about. In other words, “It’s not Burger King around here all the time. We don’t always do it your way!” If you are going to work here, sometimes you just have to do it the King’s way!

So there you have it, three team decisions:

1. The Democratic Decision, where the team can decide by vote or some other democratic way.

2. The Input Decision, where input is invited and welcome before the decision is made.

3. The Implementation Decision, where the decision has been made and team cooperation is needed for implementation.

Know what kind of decision it is and then present it to your team accordingly.

If there could have been a redo on our first example of the team meeting gone bad, it would have been for the doctor leader to have presented the decision not as a democratic one, but as an Implementation Decision, for which team cooperation was needed for implementation. Approached that way, the outcome would have been much different. After we got done working with that team and the leader-dentist, the outcomes were much different!

Democratic, Input, or the Implementation Decision has been made. Know what kind of decision you want your team to make and approach it in such a way as to produce the most effective—and beneficial—outcome.

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