10 ways in which leadership will impact your dental practice and how to measure them

By Jamie MorleyDecember 7, 2023

A question I often get asked when I am talking to both dental and orthodontic practice leaders is what will be the impact on my dental practice of developing our leadership and how can I measure that impact?

This article will give you 10 ways in which it will impact your practice and it will also give you some ways in which you can measure that impact. Click above to watch the video, click below for the audio or read on!

Hard endpoints for a dental practice that leadership impacts

1. Engagement levels of team members

Engagement in the dictionary is defined in different ways. It can be used in a black or white way, meaning that people engage in or do not engage in doing something. It can also be defined as feeling part of something or wanting to contribute to something broader. I have had conversations will multiple dental leaders saying that the average nurse doesn’t care and just wants to get paid and go home. This to me is an example of not being engaged in the overall practice and only engaged in the specific task they are required to do. Great leadership will lead to individuals really feeling connected with and engaged with the overall group of people in the practice and what the overall practice is looking to achieve. They will want to contribute to this broader purpose and will go above and beyond to do so.

To measure this is relatively straight forward. There are multiple tools out there to measure engagement levels in a team, some of which are very sophisticated whilst a relatively simple survey will also do the job.  As with any measure, the key is about consistency. Agree on the measure and then take that measure on a consistent basis to track progress. I would suggest that for the average dental practice a short survey every 6 months for staff members and associates to complete anonymously would be a good starting point. You must ensure it is confidential and not use any of the information from the survey against somebody.

There is one specific measure called Employee Net Promoter Score (eNPS) which has been used by some organisations as the sole indicator of employee engagement. The question is as follows:

'On a scale of 0 to 10, with 0 being “not at all likely” and 10 being “very likely” how likely are you to recommend working at (name of your practice) to a friend or colleague?'

You then need to put the answers into 3 categories as follows:

Promoters: Employees that gave a score of 9 and 10, which means they are happy and satisfied with your company 

Passive or Neutral: Employees that gave a score of 7 and 8, which means either they’ll promote the company or say something bad about it 

Detractors: Employees that gave a score between 0 to 6, which means they are dissatisfied and unhappy with the company 

eNPS = % promoters – % detractors

As an example, if you have 10 people who work in your practice and after answering the question you get 4 Promoters, 4 Passive and 2 Detractors then your eNPS is 40% - 20% which is +20. Scores range from -100 to +100. Anywhere above zero is ok. A benchmark for healthcare is -6.5 according to the following article which is also a good read for more information about Employee Net Promoter Score (eNPS). More important is to measure the progression of this score.

It is potentially suggested that this sole measure is too one dimensional. Click here for a good article on this to read further.

2. Reduced staff turnover

One of the biggest reasons that people leave is because of their manager. Another huge reason that people leave is because of the culture of where they work. See my other article on why do staff leave? The culture that is created is down to leadership. Create a culture (defined as the values and beliefs of the practice) that people feel comfortable in and people are much more likely to stay. Create a toxic work culture that people don’t feel comfortable in and nurses, receptionists, TCOs, associates and practice managers will leave. The impact of a person leaving on a dental practice is considerable. The time and money lost to get the new person up to speed is highly significant, not to mention the disruption to the level of service provided.

Measuring staff turnover is easy. Take a measure of the number of people who have left over the last 12 months and divide that into the total number of people in your team. Importantly I would include associates in this. You have to include everybody. Also, what about where people left for legitimate reasons? You could have an overall measure where you include everybody who left no matter what and then you could have a sub-measure where you exclude situations where people have legitimate reasons. The problem with this is what is a legitimate reason? I would be very narrow with this. This is about brutal honesty. Don’t come up with excuses for people leaving. It is a measure for you to track. You can do this monthly on a rolling 12 month basis

3. Reduced staff sickness

If people are not engaged in their work at your practice, they are not interested, they don’t like the culture of the practice, they don’t like how they are being treated at the practice and they find the job boring this will make it much more likely that they be off sick, in other words they are more likely to ‘pull a sicky’ which has significant impact on other staff members and an even bigger impact in having to rearrange patients. I also think that there is a direct link to people’s health and wellbeing which will also affect staff sickness levels, again further impacting the service provided to patients. This is down to leadership.

Measuring sick levels is easy. Take a measure of the number of sick days taken in any one month and divide by the number of staff based on a full time equivalent. So, if somebody is working 3 days a week this counts as 0.6 of a Full Time Equivalent. Track how this moves.

4. Ability to make change happen

If you can galvanise your team behind a critical change that you want to make to your practice it is highly likely that the change will happen. If you cannot, it is highly unlikely the change will happen. There are many, many stories of failed change on many different levels. You only have to think of the number of courses you went on and came back with a plan to make a change to your practice, only for it not to materialise. Recent examples might include your intra-oral scanner being sat in the corner for half the day not being fully used.  This is about influencing motivating and inspiring your team to contribute to that change which will ultimately enable your practice to realise it’s goals and dreams.

Measuring this is a little bit more tricky, but can be simplified. Have clear measures of success for the changes you want to make and start setting success measures for 6 months after starting. Based on this measure were you successful in making that change? If you were then you made change happen. If you weren’t, then you didn’t. How often have you been successful versus unsuccessful?

Behaviours in a dental practice that leadership impacts

The following are more observed behaviours that great leadership will lead to, whilst a lack of leadership or poor leadership will mean these behaviours either don’t exist or with be the opposite of these. In terms of measuring these, it is definitely more difficult and based on observation, but we can still approach this in a way that makes it less subjective. I will cover a way of doing this for all these behaviours at the end.

5. High levels of positive energy

When there are high levels of positive energy people have significant energy that is positively contributing to the success of the business. They will be able to overcome barriers that come along without having to wait around to be told what to do. They will be proactive and give real effort to making the practice a success through doing their own jobs with real energy and contributing positively to every aspect of the business when required.

6. People going above and beyond

When people are highly engaged in the business you will see people going above and beyond what they are required to do. They will go above and beyond with doing something that is outside of their job role. A nurse takes time to speak to a patient who has enquired about a specific treatment, before then passing them onto the TCO. They will go above and beyond the standard that is required of their job role. An associate takes time to help another associate with a difficult case. They will go above and beyond in terms of the time and effort commitment that they put in. A staff member helping a frail patient to the chair. When you are regularly witnessing this from team members this is down to great leadership. When you don’t see this at all this is due to poor leadership.

7. Effective conflict

Creating a culture where you can have effective conflict is down to great leadership. If you have a culture where there is artificial harmony with people not speaking up about things that concern them this will mean that you cannot progress as a practice. When a nurse sees something that is really limiting the experience for the patient but doesn’t speak up about it. If you have a culture where there are mean personal attacks on people. Those people will leave. When an associate or a principal dentist attacks a nurse and makes it personal. Effective conflict is how creating a culture of feedback that goes throughout the organisation but is based on what is noticed and what happened, not individual attacks. This will happen when there is great leadership.

8. Clarity of what’s important

Team members and staff know what is most important. They are clear on the key priorities for the pctice, as well as understanding the values of the practice, where it is heading and it’s purpose. When staff members understand these and see them as genuine and real it has a major impact. They are aligned in getting behind these so that the practice can progress in the way it wants to. It ensures the practice moves forward in the most effective way possible. This is an impact of great leadership.

9. High levels of trust

People will trust each other. What do we mean by trust? Patrick Lencioni talks about vulnerability based trust where people trust each other in a way that allows them to be vulnerable with each other. They can admit mistakes, they can challenge each other, they can recognise when they do something great, they can ask for help. An associate can ask his principal for help with a case. Brenee Brown also talks at length about the importance of vulnerability within organisations. Alongside this runs the concept of psychological safety as outlined by Amy Edmonson in the Fearless organisation and spoken about in the research done by Google called Project Aristotle. This environment will allow your team to perform to the highest level and is a consequence of great leadership.

10. Improved decision making

Improved decision making is the impact of great leadership. Being able to understand how you make your decisions, to reflect and learn from the impact of those decisions, as well as to understand the biases that may be at play, is great leadership. If we don’t do this we will continue to make bad decisions, rather than continually improving the number of good decisions we make. This is down to great leadership.

How do you go about measuring these? The only way you can measure these is to reflect on these yourself, along with members of the team. When you have noticed these behaviours? Based on what has been noticed what is an appropriate overall rating. Whilst this is subjective it breaks it down so that you can hopefully be a little less subjective or biased in your scoring. It is about being honest. If you are more of an optimistic person then be aware of this when answering the question. If you are more pessimistic then again be aware of this.

The impacts of leadership on a dental practice are significant. Take some time to focus on your leadership and to measure the impact.

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