Studies over the years have shown that–believe it or not–what staff want more than sex and money are two things: one is acknowledgment and sincere appreciation by the boss for a job well done, and two is the opportunity to influence and/or participate in management decisions that affect the practice and their jobs. My feeling is that in the times in which we currently live, both of those desires are superceded by the necessity for healthcare insurance.

We all know that it is not possible to attract quality staff members without providing healthcare as a benefit of employment. But the cost of medical coverage is skyrocketing! Ten years ago the premium for single person healthcare was in the neighborhood of $300/month. Currently that cost–even with higher deductibles and larger co-pays–is closer to $600/month. As a dentist owner, there is no other overhead item that is rising faster and with apparently no end in sight than the cost of health insurance. Supplies, staff salaries, lab, occupancy–nothing else has even come close to doubling in that same time period.

There are many reasons for these continuous cost increases. Physicians are forced to practice medicine defensively, necessitating the ordering of every test under the sun because of the litigious society in which we live here in the United States. So until limits are placed on malpractice judgments–or a change in our legal system occurs that will prevent an attorney from taking a case on contingency– I don’t see costs going down. Another contributing factor to escalating healthcare premiums are the heroic costly hospitalizations of terminally ill patients. End of life medical costs need to be controlled in some humane fashion with greater integration of hospice care.

Unfortunately, we as dentists have little control over these issues. So much of the discussion about health care is political, and a lot of smart people have failed in their attempt to make improvements. Meanwhile we dentists as employers just continue to pay increasing premiums for health care. So what to do? My recommendation is to cap the dollar allotment that you pay as a benefit. Whatever you are currently paying for single person coverage–whether that is a percentage or a dollar amount–announce to your staff that as of January 2014–that dollar amount is the maximum that you will pay, and staff members will be required to pay the increase. Give your staff the better part of the year to prepare–you don’t want to announce this new policy in November.

Staff surely understand this dynamic of continuous rising costs of health coverage. In many dental practices, staff have been affected with no or minimal salary increases because of this upward pressure on medical costs. Unfortunately, you as the doctor cannot continue on this path. It is time to take a stand.

I constantly hear clients complaining about how they don’t have enough time to go to the bathroom – let alone all the other substantive things they want to accomplish – both in their professional lives and their personal lives. Doctors these days just seem flat out overwhelmed. Yet I continue to observe other doctors – albeit a much smaller segment – who seem to have figured out how to achieve the balance we are all seeking. These are very successful, creative and innovative professionals who have achieved– or are on their way to achieving –
their dreams.

I believe these doctors have mastered the art of delegation. They are the polar opposite of the micromanager. They revel in the old saying “if you want to get something done ask a busy person.” They allow competent staff to take responsibility for tasks or projects and then let them run with them. These successful doctors are also smart enough to know what NOT to delegate. As someone once said, “I can give you the sheet music for Blowin’ In The Wind, but you ain’t gonna be Bob Dylan.”

Of course, this means you need to have trusted, responsible, talented and motivated people working for you. During my monthly meetings and telephone calls, I am always hearing about staff issues – immature behavior, lack of appreciation, always asking for more, not understanding the concept of team, etc. The list is endless. In fact, I’ve said repeatedly that the most significant roadblock to success in any dental practice is the failure to assemble and retain a great team. So why do we continue to employ ineffectual people? Why do we continue to tolerate mediocrity when there are so many talented people available?

I think it may be the ultimate catch-22: you are so stressed and so busy that you don’t have the time or energy to solve the problem. Unfortunately it seems easier to just live with what you’ve got. Seth Godin eloquently discussed this very problem a few days ago. So you need to re-define your vision. Almost like a New Year’s resolution – even if it is already March. Simply stated, identify the areas that only you can do – the areas that create the most value in your life – and agree to assign or delegate everything else. Obviously this is easier said than done – or I wouldn’t be writing this post.

John Wooden, the iconic basketball coach of UCLA, might have said it best. He attributed his coaching success to “getting my players to do what they don’t want to do in order to get the results they want”. I couldn’t offer better advice.