Hey Dental Team, Who’s The Boss in the Dental Office?

I frequently ask dental team members a disarming question: “Who’s your boss?” Almost all the time I get this unfortunate answer: “the doctor.” It is probably the correct answer but still not a good answer, because in so many dental practices, the doctor wears too many hats: clinician, manager, and CEO. The manager hat has to go.

This problem is seldom seen in medical practices. When a surgeon is in the operating room, he or she is not likely to be interrupted by someone saying that another employee wants Tuesday off and that is not going to work; team members complaining that the workload is not fair; or pleas for help dealing with a patient who insists on coming in tomorrow even though there is just no room in the schedule.

In dental practices the multi-tasking doctor is always under siege. Team members stalk him or her in the hall, the private office, and sometimes the treatment room. Decisions need to be made and only the doctor has the authority.

It is revealing that the organizational chart of most dental practices consists of the doctor at the top, with a flat line listing of all employees below. Everyone other that the doctor is on the same level on the chart. In business parlance, this means that the doctor has many “direct reports”—a small army of employees who need to get the attention of the boss/doctor throughout the day.

The solution is for the doctor to designate a true office manager, someone with the authority—not just the responsibility—to manage the practice and make day-to-day decisions. The office manager reports directly to the doctor, who of course oversees decisions, but the rest of the team all report to the office manager. In this way, the doctor can focus on treating patients while the office manager handles administrative matters.

No practice is too large or too small for a manager. Whether the practice has four, forty, or four-hundred employees, there needs to be a designated office manager to rescue the doctor from most managerial tasks and ensure that the doctor is kept busy cranking out dentistry, which is the way the business generates revenue.

Too many management tasks sap production time and wear down the practice’s greatest asset—the doctor. Years ago, when the pace of life was slower, offices were not bulging with technology, and patients were not in such a hurry to get back to their over-scheduled lives, the doctor could run the business and treat the patients. Now, however, the practice of dentistry is becoming more complex by the day and the overhead monster is threatening to eat the profits. To ensure continued practice success, the doctor needs to concentrate on dentistry, while the office manager does the rest.

For many practices, particularly small ones, having an office manager is a change of culture, and I help often practices with this transition. When the organizational chart is redone and team members are trained in new roles and responsibilities , everyone benefits from a more logical distribution of duties.

Next week: The political clash that occurs when team members want to go around their boss (the office manager) to talk to the “real boss” (the doctor).