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Management—A selection process
EDITORIALS
Management -A
selection process
D
uring the course of selecting a vocation and then in the following years of education and training, few of us reflected upon our managerial capacity. Practice management was frequently offered to dental students as an optional evening course. Concepts and teachings of economics had low priority or were avoided. Economics is a foundation for management and, in its broadest sense, refers to the science of trade or an exchange of goods or services for their perceived values. People, time, motion, relative value, and exchange are key expressions here. One becomes aware of the inadequacies in our selection and education when consideration is given to the proportion of time devoted to management and economics. We are well trained in tedious hand-eye coordination and the diagnosis of dentofacial and other related medical conditions. Little, however, was said or done about our monumental task as business coordinator, communications expert, educator, manager, or economist. As a result, most of us survive with a stub of the toe and a course here and there, depending on our background, desires, and goals. The need for management courses is obvious from continuing education course listings and their attendance. The trend in our teaching institutions is changing but not without obstacles. A few orthodontic curriculums are simulating the traditional practice in most aspects, including management. Perhaps we should contemplate contemporary changes in management philosophies in order to cope with double-digit inflation and fluctuations in perceived values and needs. Orthodontic management encompasses administrative skills in four broad areas: people, treatment, business, and profession. People management emphasizes the interdependence of doctor, patient, and staff. Delegation, education, support, and reward are key words for people-managing. The management of people cannot come without effective communication. Productive communication includes the directing of open discussion with goal orientation. You can improve communications with this suggested system’: Plan what you are going to say; follow up on the communication and restate it with different verbage; support words with deeds; examine the true purpose of the communication and be explicit; be a good listener; approach communication efforts in a prompt, considerate and timely manner; focus on the relevant issues; avoid hostile labeling or name-calling; and avoid being judgmental, since this impedes the flow of communication. Treatment management can be measured by the result, whether it is actual and founded, philosophical or perceived. Thus, care must be taken to avoid a double standard: one for the doctor and one for the patient. The orthodontic patient is the major benefactor of a well-managed office. A better quality of result, reduction in stress, and less treatment time are the rewards to the staff and orthodontist for the efficiency that comes with goal OOOZ-9416/80/110575+03$00.30/0
0
1980 The C. V. Mosby
Co.
575
576
Editorid
Am. J. Orrhod. Nowmher 1980
setting. Goal-oriented problem solving, monitoring of treatment progress with controls, and the institution of midcourse changes are obligations of the orthodontist. They will enable him to keep the patient/parent continually informed of progress and improve the office environment in order to fulfill the investment exchange. Business management involves productivity, profit, and worth. The important objectives here are practice building, promotion, education, and exchange of values (services and goods). Small business functions, such as hiring, training personnel, keeping financial records, controlling inventory, and subcontracting laboratory and other work are mandatory in the orthodontist’s program, even though his training in these functions may be sparse. An awareness of the need for orthodontic care is provided through education of the public. This education can have considerable input by the government and third parties. The quality and interpretation of data to be used by the government and third parties depend on who gathers and analyzes the data. If the orthodontic profession is not in the position to gather data, others certainly will be. The managers of our profession are addressing this problem partly through our public relations program which you have wisely supported. The profession’s management is being capably handled by the officers, trustees, committees, and delegates of the AAO. Regardless of the area, management always involves the integration of planning, organizing, delegating, and controlling. The orthodontist as a manager must perform these four basic functions with a planned objective at the hub. PLANNING is that managerial function that involves preparing for the future by selecting objectives for the person’s care. Then programs and procedures must be developed to achieve these objectives. ORGANIZING involves the design of a framework necessary for delegation of responsibility to achieve these goals. DELEGATING or directing is the guiding function which involves the motivation of employees to improve future development. Encouraging your staff to participate whenever possible will result in better objectives, more commitment, and greater motivation. Staffing or selecting and educating new employees is also a function. CONTROLLING is the feedback function, where it is determined whether objectives are being achieved or corrective action should be taken. Avrom King2 speaks of “quantum success” as that measured far beyond incremental expectations. This exponential success comes to people involved in “developmental management.” His refreshing rendition comes from the perusal of many timely and pertinent publications. King’s health-centered Tier III practice has both managerial competence and clinical expertise. This merger distinguishes the venture manager from the bureaucratic manager and the traditional administrator. There is a beneficial, attitudinal difference. Some of the characteristics of King’s venture manager include sufficient self-esteem so that failure is not perceived as a threat to personal integrity. There is usually generalization and broad involvement with a reputation for being practical in terms of evaluation, including the propagation of “team” feelings rather than a concentration on role and job functions. He has the energy and ability to focus on single aspects of a problem for a short time and then return to the total picture. The venture manager does not regard labor as an expense but, rather, as an investment or an asset with talent that needs to be optimized. He perceives others in terms of level of expertise rather than role or pecking
Volumr 78 Number 5
Editorial
577
order and is task rather than time oriented. This manager has a strong sense of mission about work with an attitude of caring, warmth, and empathy. The traditional dental manager believes that conflict should be controlled while the venture manager and the Tier III dentist look upon clarification processes as a way of converting vulnerability into opportunity and conflict into creative material for achievement .2 Venture managers move away from the authoritarian concept of dental management. The dentist, staff, and patient integrate to clarify values. It is an ongoing clarification of values for discretionary services. . . people making choices and seeking valued relationships. The most productive attitude for professional activities is that of helping people. As soon as one demonstrates an attitude toward helping people, rewards will come as a generated byproduct rather than a primary objective. To manage a practice effectively, the orthodontist is required to work with precision in a sea of change. He must educate the patient, parent, and staff in order to instill a sense of value toward dentofacial health. At the same time, he must have the ability to calm anxiety with support, empathy, and care. If your justification for professional activities is to band or bond teeth, bend wires, or adjust headgears, then you are confusing the means of orthodontics with the end purpose-to help people. Contemporary management continuously redefines objectives in terms of the changing environment. Dentists are not in competition with other dentists but, rather, with other forms of the individual’s voluntary spending, even with obvious dental disease or dentofacial problems. Planning constitutes the key element in managing a dental practice, but first there must be a background in management, including economics. Plans represent the basic difference between letting things happen and making them happen. . a selection process. Wayne G. Watson REFERENCES 1. Scheetz, James P., and Feldman, Stephen: Dentist-staff communication, J. Am. Coll. 1980. 2. King, Avrom: Nexus growth processes in dentistry, Phoenix, 1980, The Nexus Group.
Dent.
47:137-148,
Management -A
selection process
D
uring the course of selecting a vocation and then in the following years of education and training, few of us reflected upon our managerial capacity. Practice management was frequently offered to dental students as an optional evening course. Concepts and teachings of economics had low priority or were avoided. Economics is a foundation for management and, in its broadest sense, refers to the science of trade or an exchange of goods or services for their perceived values. People, time, motion, relative value, and exchange are key expressions here. One becomes aware of the inadequacies in our selection and education when consideration is given to the proportion of time devoted to management and economics. We are well trained in tedious hand-eye coordination and the diagnosis of dentofacial and other related medical conditions. Little, however, was said or done about our monumental task as business coordinator, communications expert, educator, manager, or economist. As a result, most of us survive with a stub of the toe and a course here and there, depending on our background, desires, and goals. The need for management courses is obvious from continuing education course listings and their attendance. The trend in our teaching institutions is changing but not without obstacles. A few orthodontic curriculums are simulating the traditional practice in most aspects, including management. Perhaps we should contemplate contemporary changes in management philosophies in order to cope with double-digit inflation and fluctuations in perceived values and needs. Orthodontic management encompasses administrative skills in four broad areas: people, treatment, business, and profession. People management emphasizes the interdependence of doctor, patient, and staff. Delegation, education, support, and reward are key words for people-managing. The management of people cannot come without effective communication. Productive communication includes the directing of open discussion with goal orientation. You can improve communications with this suggested system’: Plan what you are going to say; follow up on the communication and restate it with different verbage; support words with deeds; examine the true purpose of the communication and be explicit; be a good listener; approach communication efforts in a prompt, considerate and timely manner; focus on the relevant issues; avoid hostile labeling or name-calling; and avoid being judgmental, since this impedes the flow of communication. Treatment management can be measured by the result, whether it is actual and founded, philosophical or perceived. Thus, care must be taken to avoid a double standard: one for the doctor and one for the patient. The orthodontic patient is the major benefactor of a well-managed office. A better quality of result, reduction in stress, and less treatment time are the rewards to the staff and orthodontist for the efficiency that comes with goal OOOZ-9416/80/110575+03$00.30/0
0
1980 The C. V. Mosby
Co.
575
576
Editorid
Am. J. Orrhod. Nowmher 1980
setting. Goal-oriented problem solving, monitoring of treatment progress with controls, and the institution of midcourse changes are obligations of the orthodontist. They will enable him to keep the patient/parent continually informed of progress and improve the office environment in order to fulfill the investment exchange. Business management involves productivity, profit, and worth. The important objectives here are practice building, promotion, education, and exchange of values (services and goods). Small business functions, such as hiring, training personnel, keeping financial records, controlling inventory, and subcontracting laboratory and other work are mandatory in the orthodontist’s program, even though his training in these functions may be sparse. An awareness of the need for orthodontic care is provided through education of the public. This education can have considerable input by the government and third parties. The quality and interpretation of data to be used by the government and third parties depend on who gathers and analyzes the data. If the orthodontic profession is not in the position to gather data, others certainly will be. The managers of our profession are addressing this problem partly through our public relations program which you have wisely supported. The profession’s management is being capably handled by the officers, trustees, committees, and delegates of the AAO. Regardless of the area, management always involves the integration of planning, organizing, delegating, and controlling. The orthodontist as a manager must perform these four basic functions with a planned objective at the hub. PLANNING is that managerial function that involves preparing for the future by selecting objectives for the person’s care. Then programs and procedures must be developed to achieve these objectives. ORGANIZING involves the design of a framework necessary for delegation of responsibility to achieve these goals. DELEGATING or directing is the guiding function which involves the motivation of employees to improve future development. Encouraging your staff to participate whenever possible will result in better objectives, more commitment, and greater motivation. Staffing or selecting and educating new employees is also a function. CONTROLLING is the feedback function, where it is determined whether objectives are being achieved or corrective action should be taken. Avrom King2 speaks of “quantum success” as that measured far beyond incremental expectations. This exponential success comes to people involved in “developmental management.” His refreshing rendition comes from the perusal of many timely and pertinent publications. King’s health-centered Tier III practice has both managerial competence and clinical expertise. This merger distinguishes the venture manager from the bureaucratic manager and the traditional administrator. There is a beneficial, attitudinal difference. Some of the characteristics of King’s venture manager include sufficient self-esteem so that failure is not perceived as a threat to personal integrity. There is usually generalization and broad involvement with a reputation for being practical in terms of evaluation, including the propagation of “team” feelings rather than a concentration on role and job functions. He has the energy and ability to focus on single aspects of a problem for a short time and then return to the total picture. The venture manager does not regard labor as an expense but, rather, as an investment or an asset with talent that needs to be optimized. He perceives others in terms of level of expertise rather than role or pecking
Volumr 78 Number 5
Editorial
577
order and is task rather than time oriented. This manager has a strong sense of mission about work with an attitude of caring, warmth, and empathy. The traditional dental manager believes that conflict should be controlled while the venture manager and the Tier III dentist look upon clarification processes as a way of converting vulnerability into opportunity and conflict into creative material for achievement .2 Venture managers move away from the authoritarian concept of dental management. The dentist, staff, and patient integrate to clarify values. It is an ongoing clarification of values for discretionary services. . . people making choices and seeking valued relationships. The most productive attitude for professional activities is that of helping people. As soon as one demonstrates an attitude toward helping people, rewards will come as a generated byproduct rather than a primary objective. To manage a practice effectively, the orthodontist is required to work with precision in a sea of change. He must educate the patient, parent, and staff in order to instill a sense of value toward dentofacial health. At the same time, he must have the ability to calm anxiety with support, empathy, and care. If your justification for professional activities is to band or bond teeth, bend wires, or adjust headgears, then you are confusing the means of orthodontics with the end purpose-to help people. Contemporary management continuously redefines objectives in terms of the changing environment. Dentists are not in competition with other dentists but, rather, with other forms of the individual’s voluntary spending, even with obvious dental disease or dentofacial problems. Planning constitutes the key element in managing a dental practice, but first there must be a background in management, including economics. Plans represent the basic difference between letting things happen and making them happen. . a selection process. Wayne G. Watson REFERENCES 1. Scheetz, James P., and Feldman, Stephen: Dentist-staff communication, J. Am. Coll. 1980. 2. King, Avrom: Nexus growth processes in dentistry, Phoenix, 1980, The Nexus Group.
Dent.
47:137-148,