Fairness on the team
When a team member says it isn't fair
"Why does she get a course when I don't?"
That is one of those sentences that can turn an ordinary Tuesday at the clinic into hard work.
A clinic owner told me recently that she had paid for a course for one of her dental assistants. Maiken had been responsible for sterilization for more than a year, she had asked for the course herself, and she had asked twice. Good decision, capable employee, no doubt anywhere.
Two days later another assistant stood in the office with her arms crossed. The owner explained herself. Then she explained a little more. And she ended up promising the other one that she could go on a course too, just to get some peace. She never got lunch that day. Now she had two courses she hadn't budgeted for, and a feeling of having done something wrong without being able to define what.
The uncomfortable part of that story is that she did everything right. She rewarded the one who had taken responsibility. She listened to the one who was upset. She solved the conflict the same day. And she still ended up in a worse place than if she had done nothing at all.
I have seen the same thing happen in clinic after clinic. The sentence shows up around pay, schedules, bonuses, days off, who gets the new patients, and who gets to leave at three on a Friday. The owner reacts almost the same way every time. She explains herself, and she gives in to get the calm back. The explanation does work. Just never for very long.
Fairness on the team isn't the same as treating everyone alike
It is rarely about the course itself and it is almost never about the amount. What the employee reacts to is that she can't see how the decision was made.
There is usually a principle.
The owner uses it every single time, she could explain it in her sleep and it is often a perfectly sensible principle. It just lives in one place only: inside her own head. Invisible decision principles are far more common in the clinics I visit than actual unfairness, and they do more damage, because nobody can put a finger on them.
When the criteria don't exist anywhere outside your head, the team fills the gap themselves. People (read: employees) are not known for filling information gaps with the most generous explanation. They fill them with the worst guess they can think of, and that guess is almost always favoritism. It says nothing bad about your team, it is simply how our brains work when they are missing information. And it does very little for the feeling of fairness on the team.
What I want to challenge you on is the kind of leadership most of us fall back on when the appointment book is full: we judge each situation on its own. It feels flexible, responsible and a little generous. From the employee's side it looks different. She only sees the outcomes and never the math behind them. When every decision is made from scratch, every exception starts to look like a personal preference. You may be treating everyone exactly the same inside your head. That just doesn't help anyone who can't see in there.
The three-employee test
Here is an uncomfortable but useful exercise.
If I walked into your clinic tomorrow and asked three of your employees separately how someone gets a course paid for at your place, would I get the same answer three times? In most of the clinics I visit, I wouldn't. I would get three polite guesses.
The test works on all sorts of things: the schedule, the pay review, and who gets asked first when a course seat suddenly opens up. If you get three different answers to the same question, you have found an area where your leadership feels random to the people working for you. Your decisions may well have been right every single time. The only question is how many of them are visible to anyone other than you.
This is worth a moment of your time as a leader, because it explains something a lot of clinic owners wonder about: why the same discussion keeps coming back even though you solved it last time.
The problem is that you didn't solve it.
You paid your way out of it.
You don't need more rules
You can handle this with three sentences.
A 40-page staff handbook actually makes it harder, because nobody reads it and because it covers everything except the things people are quietly annoyed about.
Write down which principles decisions about courses are based on at your clinic. No numbers, no amounts, only the criteria. It could look like this:
"Courses here are prioritized by three things: what the clinic needs in the coming year, what we agreed at your annual review, and what responsibility you have already taken for an area."
Say it out loud at a staff meeting. Let people ask questions, including the annoyed ones. It is uncomfortable the first time, because it takes away your room to improvise, and improvising is one of the things most of us like best about being our own boss. That is also exactly why it works.
And then you have to use it. Out loud. The next time someone gets a course, you say it in the room where the others are standing:
"We have chosen to pay for Maiken's sterilization course, because she has had responsibility for that area for a year, and because we agreed on it at her review in March."
Notice what happens to that sentence. The decision stops being "I chose Maiken" and becomes "Maiken's situation matched what we agreed". That is a bigger difference than it sounds. It moves the conversation away from your feelings and over to your agreement, and it means the next person who gets unhappy doesn't have to convince you that she deserves something too. She has to look at the list and work out where she stands.
That is the biggest win for you personally, by the way.
You no longer have to invent a new explanation every time somebody gets upset.
You already said it, and you said it before anyone was upset about anything.
The principles have to point at something
There is a trap here worth knowing about, because you can write down three perfectly clear principles and still not move anything. It happens when the principles don't point at something the team agrees on.
If nobody in the clinic can answer what you are trying to get good at this year, then "what the clinic needs" just becomes a new word for "what the owner thinks". Then you have moved the arbitrariness down one level and wrapped it in a principle. That holds for about six months.
A team without a shared purpose spends their best intentions in different directions.
Three capable people, three different ideas about what matters most today, and none of them are wrong from where they are sitting.
When there is no shared why, fairness turns into a ledger between colleagues: who got what, who owes whom, who was overlooked in March. When there is a shared purpose, the question in the staff room changes into something else entirely. Are we all contributing to the same thing?
That is also why this isn't a job you can finish on a Friday afternoon and put behind you. The principles have to be said again. And again. People remember the last decision far better than they remember the rule behind it.
The step you can take this week
One step is enough.
Pick the one area where "it isn't fair" comes up most often at your place. Maybe it's the schedule. Maybe it's the courses. Write down the three principles that actually govern your decisions in that area, including the dull ones, because "whoever asks first usually gets the seat" is also a principle, and it is worth knowing if that is the one you are really using.
And then test them with one question:
If my employee had known these three principles in advance, would she be able to understand the most recent decision, even if she still disagreed with it?
If the answer is yes, you have a system, and you are further along than you think.
If the answer is no, you have just found the place the unrest comes from. That is a far more interesting problem to work on than the question of who got the last course.
Which area at your clinic would give three different answers if I asked three of your employees how the decision actually gets made?
Schedules and pay reviews
This is one of the places where "it isn't fair" shows up. The others are the schedule, the pay review and how the patients get divided up, and I'll be writing about those over the fall.
Would you like a friendly reminder when there is a new post? Sign up below and I'll send you a link one to four times a month, and if you get tired of reading about clinic optimization, patient communication and marketing, you can unsubscribe with one click without me taking offense.
Facebook and LinkedIn rarely show two of my posts to the same person, so the list is really the only way to get all of them.
Thank you for reading.
Kind regards
Jesper Hatt
Dentist, advisor and advocate for clinics where safety, community and balance are a natural part of everyday life.
T: +41 78 268 0078
"At Hatt Consulting we know how demanding it can be to make the clinic and your private life work together. Many clinic owners don't really dream of working more, but of creating more calm, energy and balance in everyday life.
We help you and your team find small, practical ways to make the days easier. That can be through personal sparring, joint training at the clinic or simple tools online.
Our goal is that you can feel secure in the role of owner and leader and still have the energy to be present, with patients, with your team and at home.
Would you like to hear how we can support you and your clinic? Write to us at Mail@HattConsulting.com, and together we will find the solution that gives you the most calm and energy."
