Three Reasons We Struggle to Influence and Inspire Team Member Performance

Author: Ross Vera


As challenging as ever, leading and training an orthodontic team requires focus, sensitivity to individual differences and structure. The good news is that the survey responses gathered from the Pride Institute’s Practice Opportunity assessment illustrate that orthodontists are eager to become better leaders and provide more effective team training.

Perhaps it’s a risky statement, but there is no topic, more neglected in the practice management industry, than employee training. While you can learn about the characteristics of effective leaders, there is lack of support for orthodontists that help them understand how people learn, how to facilitate truly effective behavior change, and thereby promote effective performance and continuous improvement. I know this is true because I constantly encounter orthodontists and managers who are frustrated in their ability to train their teams effectively. Regardless of the leader, regardless of the system being taught, regardless of the practice management firm guiding them, there is something glaringly missing. Teams both desire and deserve to be coached to new levels of success. So what are we doing ineffectively and how can we be more effective?

In our culture, the term “learning” is generally associated with the acquisition of knowledge. Your kids might come home and blurt out “I learned about pollywogs today!” Great! However, in the field of psychology, it is defined as “the process leading to relatively permanent behavioral change or potential behavioral change.” Permanent behavior change. That’s what we want! So, in spite of our best efforts and most animated fits of discontent, why aren’t we getting it?



I recently had a Pride client say in regards to an employee issue, “She knows how to do it. I’ve seen her do it! What is the problem?” Sound familiar? I totally appreciate her frustration. The solution starts with turning her frustrated, rhetorical question into a curious question. What is the problem? Her initial statement suggests motivation, doesn’t it? Since she “knows how to do it,” she must not be motivated to do it. But wait….what if the employee has a moral or ethical objection to the task? Or maybe there are nuances in the circumstances of particular tasks that impede her? Is this a task requiring creativity, or repetition? And if it is motivation, is she lacking confidence or is she bored to tears by the task? Maybe there is no accountability mechanism, or worse, she has lost respect for the leader or the process. If you misdiagnose any of the root causes of undesirable performance, you will get more of the same. It’s just like diagnosis with your patients. You wouldn’t try to correct an overbite with a root canal would you?

So how can you learn to diagnose your team member’s performance challenges? At Pride Institute we train all of our clients in Situational Leadership, based on a collaboration with Ken Blanchard that provides a practical framework for matching the employee’s level of development with the appropriate training approach. The process features a 2-day interactive course and ongoing coaching. The situational theory is, that you can diagnose a staff members readiness level based on his/her competence and commitment levels in association with a specific goal, task or skill. Of course there are many ways to gain proficiency in these skills, but realize that it can’t be easily achieved by reading a book or listening to a podcast. Get support from somebody that can assist you in applying theory and method to your unique situation. It will change the way you experience your role as a leader and change your relationships with your team members.



Let’s assume you have accurately diagnosed the reason for a lack of ideal performance. The next step is to select the appropriate coaching/training solution and implement it. Another exemplary quote from a client “I took the form out with Gina, I highlighted each part she is expected to complete, and she has it taped to her desk. Can it be any more clear?” Again, a perfectly understandable sentiment. But human nature is finicky. Gina is not exactly the best match for the task. She has excellent people skills and a wonderful way with words, but is very difficult to train. She is intuitive, operates according to natural feel, but what we were able to uncover was that she really does not do well with repetitive “mindless” tasks, as she described them. You can see that the challenge is not only capacity or skill set, but also of attitude. Highlighted forms will not quite do the trick. What did do the trick was a healthy dose of empathy for an employee whose natural skill set was far more sophisticated than the task, followed by an old-fashioned form completion drill. As a side note, if a task is performed too infrequently, it is very hard to master. In this case, Gina was paid to complete the form 20 times in a row. Not kidding! This was not a punishment. It was the result of a sensitive approach to Gina’s learning style and skill set. With a playful roll of the eyes, she played along and no longer has a problem with that particular form. She and her doctor now have a basis for interpreting her performance challenges, as well as a heightened appreciation for the priceless people skills she brings to work with her every day. These are highly nuanced points but a great coach can help you develop the skills necessary to respond to most of your team’s performance obstacles.



“Accountability? Seriously? How cliché’?!” I really, really wish you were right about this. It’s one of my biggest frustrations and probably the biggest reason we at Pride Institute get to make a living in the field of practice management. The most over-utilized accountability mechanism in an orthodontic practice is the statement “I’ve told her 100 times!” In all likelihood, you have resorted all too often to micromanagement in your efforts to affect behavior. It’s business as usual for me during my first 6 months with a client. Another thing “they didn’t teach you in dental school” is that there is a little known part of an employee’s brain called the “Blah, blah, blah filter.” Often used in marriages, the “Blah, blah, blah filter” unconsciously filters out unimportant information, from important information. In the presence of a micromanaging style, this filter detects when actual deadlines are approaching based on the manager’s behavioral cues. This is why my clients say “I have to tell them a hundred times to get something done.” I’m obviously being playful about it, but I’m absolutely serious. A person’s brain will unconsciously utilize environmental cues to prioritize work. If you function as a natural alarm clock, equipped with snooze button, your employees will calculate your degree of urgency and respond accordingly. You are training them not to respond to 80% of your requests!

To change this dynamic, you must institute structural accountability. At Pride Institute our clients must engage in regular team meetings and daily huddles, which are to be carried out in very specific fashion. If I learn that one of my clients has ceased conducting meetings or begun down the slippery slope of allowing personal schedule changes or emergency patient scheduling to impact the integrity the team meetings, I will immediately consider putting coaching on hold. That is how important this time commitment is to producing change for our clients.

In conclusion, this material would appear to be very basic. Yet somehow, almost every practice we consultants work with, is struggling with these issues. The frustration of orthodontists on office administrators is undeniable. The financial cost of employee underperformance to practices is irrefutable. So the practice management industry needs to be accountable and view this as a challenge. Though offerings at this level are somewhat scant, orthodontists would benefit from being accountable to their own best interests by seeking the help they need.




  • A significant 63% of orthodontists identified team management/ training as a top practice management priority
  • Only 16% of orthodontic teams surveyed engage in regular feedback and coaching sessions
  • Only 29% of orthodontic teams surveyed conduct regular and effective team meetings to: analyze statistics, problem solve and train team members


  • Only 52% of orthodontic team members surveyed had an up-to-date job description and coaching plan for continuous improvement
  • Only 43% of orthodontic team members surveyed reported having been recognized for doing a good job during the previous 30 days
  • Only 58% of orthodontic team members surveyed were given sufficient coaching and feedback to help them do their jobs and grow

image21Ross Vera has 15 years of experience Dental Practice Management and serves as a consultant at Pride Institute. He specializes in Leadership, Human Resources, and Specialty Dental Practice Building. Ross can be reached via e-mail at


This article was first published in OrthoWorld 2012.

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