Beyond Practice Management: Accountability

2009 06 04 14 09 47 485 Drb How To Bug

It's the Holy Grail of all who run a business or try to help a business: teaching people to be accountable. It's equally -- if not more -- important in our personal lives, too. Yet it remains as the one area that honest people struggle with all the time.

Accountability is defined as being responsible, being able to be explained. Think about that for a moment, because I want to start with your accountability. Why? Quite frankly, how can you expect the people who work with you to be accountable if you're not?

As a coach, I see this problem of accountability way too often. Somebody doesn't do this, someone gets mad about it, fingers start pointing, gossiping heats up, and soon there's a real mess. And none of it needed to happen. Where did it start? With your example, I'm sorry to say.

Being accountable means that we do what we say we are going to do. Let's start with a simple example every dentist or dental team member experiences.

Keeping clinical notes

At the last team meeting, everyone -- including you -- agreed that all clinical notes would need to be completed for that day by the end of that day, for logical medico-legal reasons. The discussion came about because clinical notes had been missing on some patients, and the notes had been sorely needed. So since everyone saw the sound reasoning to do it, it was agreed and the discussion moved on to the next topic.

The next few days, clinical notes were kept as agreed. But less than a week after the agreement, you had to run out at the end of the day to take your son to soccer practice. You thought to yourself, "I'll get them done first thing tomorrow morning before I forget." And you secretly say to yourself, "... and before anyone notices."

You get to your office the next morning, look at the day's schedule, and you're off with your morning huddle with your team. Yesterday was, well, yesterday, and you're focused on getting through another day: today. You completely forget about getting your clinical notes done. Because you're "the doctor," no one is checking up on you. Or are they?

The following week, a patient returns for treatment. The patient had just received hygiene care the week before. You had spoken to the patient about their somewhat complicated situation, and in your mind you were clear what was to happen and you felt the patient was, too. The problem is that you go to look at the clinical notes, and there's nothing there. That hygienist! She was supposed to do her clinical notes! Now what?

You don't have time right now to talk with the hygienist, so you make a mental note that at the next team meeting you will again bring up the agreement about making clinical notes each day before leaving the office. Another week passes, and you're getting ready for the meeting, and you remember about that scenario in which no clinical notes were made by the hygienist. Not wanting to single her out in front of the rest of the team, you have your office manager look at the past few weeks of appointments to check if clinical notes had been made on each patient and, if not, who wasn't doing their part.

Guess what your office manager tells you before the team meeting? Yes, you are the one who has been very hit-or-miss about getting the clinical notes done, not the team. You're a little miffed at yourself, but the discussion about the clinical notes is on the agenda, so it's going to be discussed. You bring up the issue of clinical notes, and the room falls silent. Everyone knows you have the worst track record for making those clinical notes, without fail. Your position as a leader is compromised; everyone knows you're not being accountable. Now what?

Leading by example

Let's step back from this scenario for a moment. I want you to think back to when you were an employee. You likely had a boss or supervisor who wasn't always accountable, and you recognized it. You likely thought, "Well, if they don't have to do it, why do I?" Yet you often tried to make sure you did it so you wouldn't lose your job, although it didn't help your opinion of your boss. And what was your opinion of that boss? In this situation, what do you think your employees' opinions are of you? Truthfully, it's probably not much different.

Teaching accountability to your team isn't possible unless you first are accountable for ALL you do. Yes, I mean ALL. You are in a position that demands the highest accountability if you are going to succeed as a leader and CEO of your practice. Even your patients will know if you're accountable or not, and many will leave when you're not accountable to them. It happens all the time, and no one wants to talk about it.

How do you start becoming accountable? You start by becoming accountable to yourself. You must be brutally honest with yourself, including when no one is watching. You must break your habits of excuses, whatever they may be. Doing all of this may require some major reworking of your life, whether it be "coming clean" with people to whom you have not told the truth, living your life in complete integrity, even getting organized in a way you have never done before. Whatever challenges you face to becoming completely accountable, you must face them. There is no way around this one. Perhaps it is for this reason that so many businesses produce less than what they could, CEOs lose their jobs, teams underperform, there is dissension in the workplace, and the list goes on.

The good news is this: Being accountable in all you do is a rewarding and heart-warming way to live. Your example will touch all the people who look up to you throughout your life. Your team will be inspired by your example, and they, too, will either become accountable for all they do -- at least while they are at work -- or they will find it so uncomfortable to come to your practice that they will leave on their own, and you will have the opportunity to replace them with someone who can be an accountable team member.

There are no monitors, consultants ragging team members, or threats of insubordination or loss of job that will make the biggest difference other than you. Take that path starting now, and reap the satisfaction and benefits that are waiting for you.

Don Deems, DDS, FAGD, is known is The Dentist's Coach and is actively engaged in private dental and coaching practices. His latest book, The Dentist's Coach: Build a Vibrant Practice and the Life You Want, is available via his website, along with a book he co-authored with Stephen Covey and Ken Blanchard, Roadmaps to Success: America's Top Intellectual Minds Map Out Successful Business Strategies.

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