Last updated on June 15th, 2022 at 02:46 pm

“How can I get my staff to take more responsibility?”

I’ve been asked this question a lot, and I mean a real lot, over my career.

It might be asked in those exact words or in some variation with relation to a specific position, e.g. “How can I get my hygienist to help me more with case acceptance?” or “How would I get my Office Manager to take more initiative or be more willing to handle ____________ (insert task) in the office?

Now, obviously I get asked these questions because the doctor is trying to solve a problem – and I understand. Why? Well, in the service business you’re really only as strong as your team. And your team consists of individuals. So, if your individual staff don’t take initiative and hold down their areas, it tends to all float up to the top; and you (the doctor – or manager) wind up overloaded and stressed. It’s also not a workable formula for growth.

To create systems in the office that encourage individual initiative and responsibility can be a lot of work. And to that end, it’s why companies like MGE exist to begin with. We teach doctors and their managers how to be executives, provide staff training both live and online (Note: if you haven’t already seen it, our online training platform is up and pretty darn cool if I must say! You can find it at www.DDSSuccess.com). We also put systems in place so that you have an organization where everyone is accountable and handles the respective duties in their area of responsibility.

With all of that said, what could I tell you right now – what can YOU do right now – immediately after reading this post that could help you improve your staff’s willingness to show initiative and take more responsibility?

Well – let’s start simple. First thing you can do is…

ASK them to!

I know that it sounds silly, but you’d be surprised how many people will hire a new employee without ever laying out what the expectations are, what it is they’re supposed to do in detail, why they’re doing it, or what the expected outcome is.

They don’t know any of this stuff to begin with – yet I see it all the time where a doctor hires somebody and doesn’t really lay out what they want – and then they expect the new employee to miraculously know what they want through osmosis or telepathy or something.

And then when the person doesn’t perform, it’s, “oh that was a bad employee.”

I would be laying this stuff out during the hiring process. “Here’s what is expected…” This helps on two ends:

  1. It sets expectations right from the beginning and
  2. If the applicant doesn’t like what they hear about what the job entails – they won’t take the job. It’s a great way to avoid wasting your time and theirs.

Now, if you don’t make what you expect clear – from the beginning, you create a problem. Why? Well, generally speaking, most people are good and will TRY to meet expectations, do a good job not just for personal satisfaction – but to make you as their employer happy as well. So, if you don’t tell them what is wanted or what you need them to do, how do most handle this? They will try to figure it out themselves.

Where this becomes ultra-problematic is when what THEY THINK you want (since you didn’t tell them) and what YOU ACTUALLY DO WANT are vastly different.

The How and the Why

So now, assuming you’ve asked your staff member, i.e.

  1. To do more, take on more initiative, etc.,
  2. They’re willing to take that bigger bite of job responsibility, and
  3. You have their attention,

It now breaks down into two issues:

  1. The HOW,
  2. And the WHY.

Most formal or on-the-job training is focused on the HOW. How do you answer the phone? How do you greet a patient? How do you do this or that?

If you’re teaching the HOW without the WHY, you’re going to end up with problems.


Let me give you an example.

You hire a receptionist and teach them how to answer the phone, “It’s a great day at ABC dental, my name is _______, how can I help you?”

You tell them you’re supposed to smile when they answer the phone and you give them scripts, etc. You give them the HOW, but you don’t explain WHY they should do it this way. You don’t explain why it’s important to greet a patient like this. So eventually you’ll go back to the front desk and discover that they’re no longer handling calls the way you told them to.

Why does this normally happen? Well, it has to do with the concept of “understanding.”


The definition of understand is, “to grasp the meaning and significance of something.” In other words: What does this mean and (even bigger) how important is it?

If someone doesn’t understand why they’re doing something, what the motivation is behind their actions, the how (portions of a person’s day-to-day duties) can drop out.

Imagine instead that, right from the get-go, you explain to your new receptionist something along the lines of: “You’re the first person that any patient sees or hears and as such, create the virtual entirety of the ‘first impression’ for our entire practice. With this in mind, it’s important to me (the doctor/OM, etc.) as a part of your job to remember this in all of your actions. You’re also a huge part of our marketing plan. If a patient calls our office and their experience is anything less than positive, they may decide to go elsewhere!”

Now, instead of “smiling while they answer the phone,” because “you told them to,” they’re able to associate WHY they need to do it and how it affects the business!

In effect, they start to understand why it’s important that they do the things they’re supposed to be doing.

Now, add a little something else: expected outcome(s). You could explain it something like this: “What the office would look like if a receptionist was doing a great job would be: communication flowing quickly and efficiently, patients would never hold for more than _____ time, the reception area would always be neat and well-kept, patients would feel welcome, etc.

You explain what the outcome of great job performance would be; along with the hows and the why.

Now a person has an idea of what they should be shooting for.

You could do the same thing with a hygienist. You could tell them, “When patients see you for a recall appointment and they’re missing a tooth you might want to point out that we can treat that. And if you see something wrong with a crown you might say the doctor will want to look at that.” Obviously, they can’t diagnose but it should be clear if you want them to help you with case acceptance.

Now that’s the how, but WHY? Why is it important?

“Our office is all about restoring full dental/oral health, function and aesthetic to all of our patients. We want to help eliminate or at least control dental disease in our patient base, and this is a big factor. They get the dentistry done and they see us for regular hygiene visits.”

Again, this is something you can start discussing during the hiring process.

Let’s say you interview a prospective hygienist and tell them that you expect a hygienist to assist with patient education and case acceptance.  They respond with something along the lines of: “Oh I don’t do that!” Well then maybe they’re not the right hygienist for you. That just sets the tone right there so that you don’t waste their time or yours.

That’s the summary, along with what you can do right now. If you want them to take on more, ask them, and then explain to them how and why it is you want them to do the various parts of their job a certain way, as well as give them a little info about expectations and outcome.

And I’ll wrap this up with four simple points:

1. Employment decisions should be based on performance

If someone is doing their job, they should feel secure on their job.

Contrast this with cases where you have explained the how, the why, and you’ve trained this person and they’re still not performing their job up to expected levels; well there is a possibility that they are just not a good fit for your office.

It’s not a bad move to make decisions with regards to employees (i.e. who to promote and who not to promote, who to keep and who not to keep and things of that nature.) based on job performance.  Too often it’s not. It has to do with “who you know,” or other such things.

That said, I’m not an employment attorney and there is no “one-size fits all” solution to employee related issues. And with that in mind, I strongly recommend consulting an employment attorney when questions of this nature arise. It can save you considerable time and expense in the long run.

2. What if you can’t explain the “how” and the “why” to the staff? In other words – you don’t know them! (or haven’t clearly defined them).

If this is the case, you’re going to have problems. I’ve seen this happen before. Doctor hires an office manager and then asks, “What’s an office manager supposed to do?” You’d better find out! This is something we teach on the MGE program.

If you can’t explain to an employee what they are supposed to do, then you’re not even going to know whether they’re doing it right or not.

3. There has to be a degree of oversight and supervision.

You don’t want someone floating out in the ether with no degree of interface or correction. You need to know how to keep those things in place and that’s why you need an organizational system.

4. You want employees who want to grow with the office.

This is something that’s important to me. I want somebody who’s ambitious – in a positive sense. You sometimes hear the word “ambitious” with the connotation that they’re “willing to do sketchy things to get ahead.” That’s NOT what I mean.

What I mean is you want someone who wants to grow. So, if you have no space for this person to grow into, then you’re possibly going to lose them to other opportunities.

You hire a receptionist and this person is upbeat, competent, does a great job and is getting better and better – you want to have a position to promote them into. If you have nowhere to promote them into because of no growth, they’re going to be looking for greener pastures elsewhere to fulfill their own destiny and dreams.

Think about it, how would you feel as a doctor — you get an associate job and you’re never ever going to make more than a certain amount per day. You produce $5,000 you get paid $400 per day; you produce $10,000 you get paid the same $400 per day. And this will never change. There’s no growth associated with that. There has to be room for growth.

If you’ve made it this far, I know it was a little long, I apologize. And thanks for sticking with me through the whole thing. Ultimately, I hope it helps.

If you want more information about MGE, come check us out at www.mgeonline.com. We’re just a phone call away, at (800) 640-1140, to help you improve organization and profitability in your practice!


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