Monday, April 19, 2010

Young Dentist, Disrespectful Older Staff - What Should She Do?

Background: I am a young female dentist (practicing 3 yrs). A year and a half ago I became a 50% partner of a very large dental practice. The practice is established in a small town and has some employees that have been there 20+ years. I really enjoy working with my partner; he is a wonderful mentor and we complement each other well. He is probably a few years away from retirement (in his late 60s), or so he says (I think it'll never happen but that's cool with me). His weakness is that he has gotten "soft" on his, now our, employees over the years. They get away with everything. When I started, I began to notice there blatant lack of respect towards him as a leader/boss. I began bringing examples to his attention, such as employees not performing job duties. For example, not updating health histories, giving excuses why the autoclave does not need to be cleaned out, failing to comply with OSHA recommendations that we enforce, etc. I am younger than the youngest staff member by 10 yrs. They treat me like their daughter rather than their boss. I also am not respected as an authority/boss figure. I am a pleaser and I know that my weakness is that I suck at being an authoritative person. I have a hard time "telling people how it is" or saying something that might hurt or offend someone. You know how most people have a fear of speaking in public-mine is "bossing" someone around. Yes, I know this is bad and I need to get over it--workin' on it) So this past week, we had some tough calls to make. Our production/collection ratio has decreased so it became time to cut salaries to be able to make ends meet. Here's the thing: we live in a state with the highest unemployment, and in a county with the state’s highest unemployment. It's lean. We have a staff that is very over paid- hygienist making an hour rate to equal about 48% of their production, DA's making b/t 38-50k/yr (this includes benefits). So the cuts were not unwarranted. We also decided that we were going to give each person a job description and let them know that we are going to start holding people accountable. My partner and I decided that I should deliver the news to each individual employee about the pay cut so that I am viewed as someone with authority, rather than a "sidekick." I did this and it went well on my part- meaning I was able to deliver the news without throwing up, profuse sweating or a trembling voice.

Situation 1: earlier in the week I politely said to my DA "I have noticed that you have not been updating the health history, I need you to do this for every and all patients prior to me coming to the room." She politely said "no I always take the blood pressure" ME: {dazed look thinking WTF?} replies "no not the blood pressure the health history." DA: "I always do that." ME: "go back through the last 3 weeks of charts and you will see you have not." I leave the room. Later in the day she comes up to be and starts yelling defensively about me nit-picking her and being unreasonable, how she's been an assistant for years without a problem on and on. I am freaked out and panicking, and respond "I need the health history updated" and walk away floored that she just yelled at me like this. I think about the situation over night and decide to give an oral warning for insubordination. So at the "cuts" meeting I give the oral warning and she again begins yelling at me and defending that she has done no wrong. My partner chimes in with "we know you’re busy and we still love you"--could've killed him for throwing me under the bus. We have discussed this and he says he was trying to get her to shut up so we could move on. At which point she responds how she has worked here for a long time with no problems.

1. Now what do I do? She clearly does not respect me.

2. Should partner clarify with her that he is in support of my position or let it rest. After all the cuts we do not want to hurt morale even more.

3. How do I continue to work with someone, let alone pay them, when I know they do not disrespect me.

4. I want to fire her, is this to harsh?

Situation 2: Another DA who I rarely work with says during the "cuts" meeting that I act "shady” towards her. The OM, partner and I look at her confused (as I might work with her 2x/month) and ask for her to explain. She explains how during a procedure we did together earlier in the day (add into sch. and she was available to assist) I belittled her in front of the patients parents (patient was 6) by asking her to remove the suction 3 times and allowing the parents to stay in the room when she had asked the parents to leave. Okay background: so I asked her to remove the suction 3x because the first 2x she did not listen-the suction was in the way. The parents were not supposed to be in the room to start, however, she failed to "remember" this. I was behind sch. I had 2 other patients and 2 hygienist checks I did not have time to argue/debate with parents who do not want to leave their child so I went ahead and did the extraction with the parents in the room. So back to situation: I grow a pair of balls (I think it was because she walked into the room with such an entitlement negative attitude) and respond "I am who I am, and Dr. and I will run this practice as we see fit and if my ways and our ways do not work for you, you should consider another place for employment." She had some smart ass comeback and partner chimed in with "in 30 days we will have a performance review" and the meeting was over.

1. I feel like she is making stuff up to like "get me in trouble" with my partner-- Does anyone else think this is shady? I really am not a shady person; I thought I was just asking her to do what I expect.

2. How do I go on with this negative Nelly? I really cannot stand her attitude. I want to fire her too. Would you?

3. To me, I feel as though she also does not respect me, or am I being super sensitive?

My main concern is that I do not know how to manage a staff of women older than me. I feel like I cannot win. Any thoughts/suggestions. I am not arrogant, I know that I need help with practice management and will take any advice I can, except hiring a consultant. Partner has been down this road many times in his 40yrs and he does not want to go there, I will respect his wishes.

So you've been a partner for 1.5 years. How long have you been with the practice in total? If you've been there awhile so you've already established yourself, it is time to take the bull by the horns. If this is going to be YOUR practice someday, it's never too early to start acting like it's YOUR practice. Hopefully your partner will agree. If that means getting rid of the deadwood you do it. Sometimes it'll send a message to the rest of the team that insubordination will NOT be tolerated.

This first appeared on Dentaltown.

Send your questions to Tim Lott, CPA, CVA at tlott@dentalcpas.com

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