We sat with Dr. James and his office leader, Tina, and listened to their staffing concerns. Turnover was a little too high, not everybody was fully engaged all the time, and “Orin, the grumpy guy” was having a bad week again, bringing some staff down with him. None of it was unbearable, just a steady drip in the background that, over time, was slowly wearing them down. Dentistry was starting to feel more like a treadmill than a joy.
I asked how they attack these issues and they responded that they had always addressed every staffing problem quickly. If someone quit, they got a good replacement quickly. If Orin was having a bad week, they always helped him put Pandora back in her box. And if they saw someone not giving it their all, they addressed it, although that seemed to be a problem that just rotated around the office and was neverending.
They were frustrated. Even though they were always responsible and quick to fix each problem as it arose, the office had plenty of other bottlenecks besides staff. Every day seemed like a game of whack-a-mole, reacting to each new problem as it came up.
If their situation sounds familiar, it should. Most office leaders and dentists are quick to address issues and get the practice back to equilibrium. But that approach is exactly why every day feels like déjà vu. We’re solving problems, when we should be solving obstacles.
Problems vs. Obstacles
The difference isn’t semantic – it’s gigantic.
You know you’re dealing with a problem because when you fix it, your practice ends up right back where it was before the problem came up. This approach is entirely reactive. You have all the staff you need, then someone quits, and you react by rehiring. Voila, you’re right back to where you were. Then it happens again four months later, and again, three months later, and again, and again. It’s just a nagging drip in the background, so you just deal with it and assume it’s the price of owning your own practice. But the reality is you’re just one question away from solving the obstacle behind the problems.
You’re solving the obstacle behind the problems when two things happen:
1) True Change – Your practice is materially different, even in a very small way, than it was before you solved the obstacle.
2) Fewer Problems – You have a lot fewer related problems going forward. Solving the obstacle solves a lot of the problems.
How to Solve Obstacles Instead of Problems
We solve problems by asking who, what, when, where and how. Who caused it, what happened, when and where did it occur, or how did it happen? All great questions, but without one more question, you’re just solving problems that will come back regularly. The most important, least asked question in business is the one that changes the game and allows you to make true progress in eliminating issues: That question is, “Why?”
Who, what, when, where and how are great starter questions, but asking, “Why?” addresses the obstacle behind the problems. For Dr. James and Tina, asking “why” would lead them to a number of possible obstacles. Listing the possibilities is the first step in permanently solving the staffing problems: Is it:
1) Our pay scale?
2) Our location?
3) Our office infrastructure and equipment?
4) Our onboarding and training?
5) Our general office culture?
6) Our expectations of people (or lack of them)?
7) Our processes (or lack)?
8) Our leadership style?
9) Orin, or other “negative” people?
10) A combination of some of the above?
You can see from this list why some people never want to solve the obstacle. In the short run, it just seems easier to fix the problem over and over again every time. But Dr. James and Tina were finally experiencing the fatigue that approach always causes. So they took the time to ask, “Why?”, made a list, prioritized what would help the most, and put a simple plan of action in place.
They found that the issue was a combination of a few simple things: Their onboarding and training process was not written down as a process and, as a result, no one had clarity on the way in. Responsibilities weren’t well defined so people in the same job had different opinions of what was expected. Training was ad hoc, resulting in a wide range of inconsistencies in the way patients were handled in both the front and back office. And responsibilities weren’t well outlined – no one knew who owned what processes. They also found that Orin was a bigger issue than they had been willing to believe.
All of this pointed to a final issue, the true obstacle that had caused all the problems; their own leadership style. They had always led by trying to get the staff excited and being emotional and relational, but had ignored processes, metrics, and accountability. They didn’t stop building relationships, but added the missing elements and made the hard leadership decision to move Orin along. As a result, people were much more engaged and staff turnover went down significantly. Having dealt with the obstacle, their own leadership, they had dramatically fewer problems going forward, and were able to get back to the passion that had brought them into the practice in the first place – helping people.
Are you solving problems and finding you never come to the end of them? Ask, “Why are these problems happening?” Find the true obstacle, address it, and watch your problems go away. This approach is simple, it’s just not easy. But it is infinitely better than reacting to a never-ending list of problems.
Make dentistry enjoyable again. Address your obstacles, not your problems.