Meeting of the Minds

"There’s nothing so exhausting as the management of men, except the management of women." -- Disraeli

In the early days, practice management was such an obscure subject that dental schools summarily dismissed it with the advice: "Don’t spill silver nitrate on yourself or the patient, and be sure to turn everything off before departing at night."

After World War II, however, it became obvious that dentistry was no longer a "drill, fill and bill" cottage industry, but rather a candidate for the Fortune 500 list. We learned this because a new breed of dental entrepreneur in the personae of Brahe, Levoy, Barkley et al. emerged to fill the void left in our dental education. A relentlessly ebullient couple made their debut in what became known as "The Rhode Show" featuring riveting information on everything from interpersonal relationships to the intricacies of dental thank-you notes.

Out of all this came one of the greatest disasters ever visited upon the dental profession -- the concept of the staff meeting. Originally promoted by practice management gurus who had exhausted their bag of useful suggestions, it was purported to be a method of forming a happy, cohesive group whose team efforts would raise the level of production and self-fulfillment to unprecedented heights.

As envisioned by various dry-fingered business promoters, the staff meeting should be held in the morning on company time so that the paid help would suffer no loss of benefits that would otherwise render them restive and surly. The dentist, as the titular head of the practice, encourages round table participation by the staff, who, the theory goes, would offer constructive criticism and propose innovative ideas to enhance the daily grind of earning a crust. The doctor, in turn, would offer his or her ideas of increased performance in lieu of pay raises, submit whining requests for staff to be in place no later than 15 minutes after the first patient of the day is seated, and propose a special five-minute break every other month for personal phone calls.

In theory, the staff meeting idea should have worked. With all the little differences ironed out, personnel should have been purring like a basketful of cobras in no time at all. Except for one fact: The average dentist would no more willingly chair a second staff meeting after his initial convocation than undergo amputation of his personal parts without anesthesia. The staff, likewise, would sooner submit to bamboo slivers driven under their fingernails than attend a meeting where the only expected benefit is to decide when the next meeting will take place.

In our office, this potential for dissension has been solved by what has become known as the "Unilateral Compromise Device." Based on the fact that dentists are easier to replace than good staff and fortified by our 58 years of experience as a dentist and 54 years as a husband, we have incorporated the art of complete capitulation. In other words, just let the staff run the office, a practice they instinctively follow anyway. This functions as well at work as it does at home and avoids unpleasantness in both places.

It’s not that we don’t have staff meetings; we do, but they are informal and take place throughout the working day.

Staff: We need Kleenex, paper towels, more turn-around time and an assistant’s stool with a cup holder for coffee.

Me: OK.

Staff: We’ll be late on Thursday. We have to have our nails done.

Me: No problem.

Staff: We don’t like the computer, so we’re going back to pegboard. Also we’ll be shutting down between Christmas and New Year’s.

Me: Whatever.

Staff: It’s 4:30. Don’t even think about starting a crown prep now!

Me: Okey dokey.

For dentists weary of trying to manage what is essentially an unmanageable profession and tired of feeling guilty for lacking the qualities of leadership advocated by practice seminar gurus, take heart. Following the precepts of Unilateral Compromise, you, too, can simply show up in the mornings, do your job to best of your ability and go home.

George Bernard Shaw, a nondentist but eccentric enough to qualify otherwise, pointed out: "Except during the nine months before he draws his first breath, no man manages his affairs as well as a tree does." He later died, offering no explanation.