You became a dentist. When did you become a leader?
Dear colleague,
You chose to become a dentist. Maybe you also chose to open your own clinic or take one over. I doubt you ever sat down and decided that a large part of your working life would go to sick leave, conflicts, budgets and performance reviews.
It is there anyway.
You became an employer without applying for the job of leader and without being promoted.
You became a strategist because somebody had to decide what the clinic lives on in five years, and an entrepreneur because somebody had to say yes or no to the next piece of equipment.
But nobody you know called to congratulate you.
Your clinic cannot be treated like a patient
Dental school taught you something that works clinically.
Find the problem
Make the diagnosis
Build the plan
Carry it out precisely
It is a good model, and it holds all the way through a treatment.
It just does not hold for a clinic.
You get no single diagnosis and no single plan. And if you built the perfect plan on Monday morning, it would be rewritten before lunch.
One employee calls in sick.
Another resigns.
A patient gets angry about a bill.
The new colleague needs help with a case.
And the appointment book is full three weeks out, so no time is left to adjust what did not work along the way.
That is the day-to-day.
And the day-to-day is unusually good at eating exactly the time you should have spent being a leader.
Four jobs in one clinic
A German colleague once told me he thought he had taken over one job as a dentist, which turned out to be four jobs at once.
As an employer you hire, you train, you handle conflicts, you hold performance reviews and you make sure rules and agreements are kept.
As a team leader you set direction and build the culture that decides whether the good people want to stay.
As a strategist you decide which patients the clinic should be best at helping, which treatments you offer, and what the clinic looks like in five years.
And as an entrepreneur you weigh investments, technology, premises and finances.
Four different sets of skills, and one person has to cover all four. That is you.
The role you cannot talk about out loud
One side of this is hard to put on a course program. It can be lonely.
You cannot walk into the staff room and say that you are worried about the finances right now.
You cannot discuss your doubts about an employee with the rest of the team. And when you are weighing whether she should get another chance, you cannot tell anyone how much it occupies you.
You are the one the others count on to have it under control.
You do not need to have everything under control.
You need somebody to think with.
I have had mentors and sparring partners across borders for many years, and they made a real difference, because they gave me a place where I could think out loud before decisions were made.
Five days without running a clinic
In early October I was in Umbria teaching at a leadership retreat for fifteen clinic owners. The most interesting part happened outside the classroom.
On Thursday, Johnny took the whole group out on a walk of a good two hours.
No watch.
No GPS.
No phone.
Fifteen people who normally have a phone in their pocket, an appointment book within reach, a dental assistant at their side and a receptionist who can pull them back into the clinic in seconds.
Now nobody could call, nobody could ask them to approve anything, and nobody could make the twenty small decisions an hour that a clinic day is built from.
That was the whole point.
When you can no longer react to the next thing coming, you start to think about where you are right now.
The decision that never gets made
On Saturday each participant had to write a vision for the clinic and turn it into a plan. Two or three things over three months, one thing a month, and who does what.
It sounds almost trivial. But try finding the time for it in an ordinary week. Between two patients? After the last one? When everyone has gone home and the phone is finally quiet?
That is where many clinic owners get stuck. It is rarely because they are unsure what they want. Time and room to think about it was simply never planned. The day-to-day wins every time, because the day-to-day has a slot in the appointment book and the direction does not.
You do not need Umbria
Half a day can do the work.
Set it aside.
Go somewhere the clinic cannot reach you, leave the phone in the car, and bring a piece of paper. Ask yourself: if the clinic is going to be a better place in three years, what has to be different? Find one thing. Then ask what has to happen over the next three months to get closer, and who does what.
That is not a strategy workshop, it is leadership, and it is probably the part of your work you have been given the least time for, because the time goes to making the clinic work today.
And it can be learned.
You can learn to hold the difficult conversation, to set clear expectations, to hand over responsibility without losing control, and to run meetings that lead to something.
All of it starts with you deciding that the leadership role is part of your job.
Nobody else is coming to decide it for you.
What have you not had time for?
Think back over the last twelve months.
What have you invested the least time in?
The difficult performance review, the strategy you have been carrying around for two years, the financial review, or your own development as a leader?
That is usually exactly where the frustration is biggest.
You know what ought to happen.
You just never got it done, because a patient was waiting at 10.20, a phone call HAD to be answered at 11.05, an employee at 13.40 and an emergency at 15.15.
That is how a year goes.
And another one.
You did not choose the leadership role
The leadership role arrived without you actively choosing it.
What kind of leader you become is up to you.
It does not take more hours, it takes some of the hours going to something other than the next patient and the next problem.
If you do not set aside the time to decide the direction, the day-to-day decides it.
And the day-to-day is really bad at strategy.
Think about when you last sat down and decided where your clinic is going.
Decisions that were never made
The clinic's direction is one of those places where something that matters a great deal gets settled without anyone necessarily having sat down to decide it. What the deliberate and the accidental direction each lead to, I will write more about over the fall.
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Thanks 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