Dr. Lee has more than doubled her practice, grown more confident in her leadership skills, and strengthened her team.
teamwork, production, systems, clinical efficiency, retention
Dr. Treva Lee felt overwhelmed trying to make her practice profitable by herself. She struggled to hire staff and found that inconsistency was causing problems with the patient experience. To add to her frustration, her team wasn’t incorporating her ideas. This kicked in Dr. Lee’s instinct to micromanage. The combination created turmoil inside her practice, leading to high turnover and low profitability. The stress was so great, she took the problems home and vented about them. There were days she wondered if all the hassle was worth it if she couldn’t turn a profit.
“I didn’t know how to step back and stop micromanaging,” Dr. Lee said. “And my lack of systems created chaos. Because of the turnover, I felt I had to take on a lot of the training, which is a distraction and used up my mental energy instead of focusing on my patients.”
But Dr. Lee wasn’t ready to give up. She’d worked hard to become a dentist and grow her practice. As a woman, she had to work twice as hard to even get into dental school, let alone start a practice. “Back then, when women were more of a minority, we had to be better than the men to get accepted into dental school,” Dr. Lee recalled. “I remember I had classmates that got in before I did. I remember this guy who got in before I did and had lower test scores, lower GPA, and fewer community activities. I’m glad to see that’s changed now.”
Starting her practice in 1987 near Fresno, California, she rented space and an assistant from her father, who was also a dentist. She built her bread-and-butter practice, made up of mostly bilingual patients, within his practice. “I didn’t inherit the practice,” Dr. Lee said. “My father didn’t develop the practice so that he could hand it over to me. We kept everything separate. Our bookkeeping was separate. We shared some expenses such as utilities, but as far as supplies, my supplies were different from what he was using. I bought out his equipment and took over patients who were willing to come see me, but as he was getting older, his patients began going somewhere else. I grew the practice to where eventually I expanded from a three operatory office into a five operatory office.”
In 2013, when Dr. Lee realized she lacked the leadership skills to turn things around, she enlisted the help of The Team Training Institute after a marketing consultant she worked with introduced her to them.
The Team Training Institute (TTI) provided her with administrative coaches and clinical coaches, which helped her achieve and maintain consistency within her practice. Since starting with The Team Training Institute, Dr. Lee has more than doubled her practice, grown more confident in her leadership skills, and learned how to build a team that not only supports her but is enthusiastic about helping her grow. She no longer brings work home either.
Despite her growth over the past ten years, Dr. Lee feels like she’s just getting started. That’s because when her two children were young, her role as a mom was her priority, with her practice taking a backseat. “I feel my practice’s trajectory has been delayed by about 20 years,” she said. “I’m presently where my male counterparts were in their forties.”
This flexibility to go at her own pace, while still helping her grow, is one of the reasons she has continued working with TTI for a decade. “Even though The Team Training Institute works with big practices that have multiple locations, they also work with all-size practices and never try to force you into doing things a particular way,” Dr. Lee said. “They adapt for any size practice, such as the smaller practice like mine. Over the last ten years, The Team Training Institute helped me hold things together, but now that I can devote more time to my practice and I have a team that is willing to implement the TTI strategies, I feel like I’m really hitting my stride.”
Here are lessons learned that helped Dr. Lee grow her practice, build her confidence, and create a solid team:
Teamwork Makes the Dream Work
Building a strong, dedicated team that works well together is one of the single most important concepts that has created breakthroughs for Dr. Lee.
“Before I kept thinking, ‘What’s wrong with me? Why can’t I duplicate what other practices are doing?’” Dr. Lee said. “Part of that is really being able to surround yourself with a good team. Because obviously, you can’t do it all by yourself. What I really appreciate about The Team Training Institute is its emphasis on teamwork. That has really reduced stress and worrying because I have people willing to help.”
Building A Good Team Is About More Than Hiring Good People
Three strategies that contributed to Dr. Lee building a strong team with reduced turnover are:
1. Developing her practice’s culture:
Developing her practice’s core values boosted clarity, which in turn created a culture where growth could accelerate. “Core values help identify your culture. It helps to identify whether a person fits or not into your organization, which has helped us build a better team.”
2. Investing in her team’s training:
“Bringing my team to The Team Training Institute retreats, I can see they are paying attention,” Dr. Lee said. “I can see that they’re participating. They come back with some good ideas and suggestions which is great. It’s nice to get that feedback. Instead of experiencing the feeling I’m putting out all this information and it just lays there, they’re absorbing it. They understand when I talk about certain ideas that this is different from maybe other practices, but with TTI practices, this is the norm or our standard, which is different, and a cut above what other practices are doing. They also understand that ultimately, these differences help benefit our patients, too.”
3. Trusting her team to make good decisions:
“I had a high turnover due to the chaos from lack of systems and then my own tendency to micromanage. That’s still my biggest problem. The TTI coaches remind me to delegate and trust that my team can do what they are supposed to do. It’s a fine line between holding people accountable and giving them enough freedom to do their jobs right.”
Improve Implementation with the Right Coaches
Dr. Lee has also found that with the right coaches, changes can happen more smoothly and quickly. TTI coaches are seen as peers to the team because they have relevant experience and expertise in a variety of areas. This creates more cooperation and acceptance in incorporating changes and new ideas which has eliminated frustration.
“It isn’t just an admin person trying to tell the clinical staff what to do,” Dr. Lee said. “I’ve worked with a previous consultant, where the clinical staff is thinking, ‘Who are they? They’ve never worked in the back.’ Wendy (Briggs) and the hygiene coaches are hygienists, so people relate to them. It’s great they split hygiene coaches to cover the clinical side and admin coaches to help develop the front office team members. This is also helpful for me in developing my leadership skills. Otherwise, people feel like the coaches don’t understand what their life is like.”
Training and processes from The Team Training Institute not only helped her to optimize production, but it also created lightbulb moments for Dr. Lee, which resulted in her making changes that have improved patient care.
“Our focus was more on worrying about if a patient’s insurance covered the work we were doing,” Dr. Lee said. Dr. Lee discovered taking the x-rays they need instead of depending on previous x-rays allows for fast, accurate detection of changes in a patient’s mouth. “A lot can happen in six months, or even three months,” she said. “Wendy also made me think about adult fluoride and sealants differently. If it’s good enough for kids, then why aren’t we doing it for adults? It doesn’t really matter whether or not the insurance covers this, it’s still a good thing to do. Receiving the verbiage from The Team Training Institute for how to talk to patients is also helpful.”
For Dr. Lee, optimizing production means practicing more efficiently and increasing the clinical skills she has in her toolbox. “I learned to bundle instead of just doing one tooth at a time,” Dr. Lee said. “Now I’ll go ahead and do the whole quadrant or half of the mouth at one time. The Team Training Institute also gave me the confidence to get trained on additional clinical skills which allow me to do more dentistry in one visit. I knew that if we had the systems on how to do it step by step, and we made sure that the assistants have everything that I need when I need it, then those can be very productive days. That was one thing I didn’t have as much confidence to try to implement until I got involved with TTI. They helped me realize that my staff can keep up with me. I know what I can do, I just need to help get them trained. And in the process, I help my patients. TTI helped with the overall workflow, whether it was turning over the room or the sequencing or making sure the room is set up and the instruments are sterilized. The simple little day-to-day things can bog you down during the day, especially when you’re doing a big case that’s taking four or five hours. That’s where the inefficiencies can really show up.”
Systems Help Retain Employees
Developing and documenting the systems in a training manual has encouraged employees to ask questions instead of assuming they already know the answers. Dr. Lee credits The Team Training Institute with ideas such as adding videos and checklists to their systems manual to make it more engaging for team members, especially younger generations, who are used to learning through video.
“We nicknamed it ‘the bible,’” Dr. Lee said, referring to their systems training manual. “We put a lot of time and effort into it, and it’s always getting revised, but to have things listed out, gives a good overview of how that procedure should go, or how they can recognize instruments, materials, and tools when there is a gap in their knowledge. We encourage them to reference the manual and teach them to ask questions because we don’t know what they don’t know. Videos along with photos make it more thorough and checklists are visible to help reinforce the systems. One of my team has really taken over monitoring and evaluating the training instead of me micromanaging it. That’s been nice to delegate.”
An incentive program not only encourages her team to support her efforts for same-day dentistry but also helps retain staff and even win them back. “We’ve put in an incentive system to help encourage team members to offer same-day-dentistry. TTI is always saying, ‘You’ve got to celebrate the wins.’ Even if you’re thinking, ‘Oh, why should I provide incentives for something that people should already be doing because it’s part of their job’, Incentives make it more fun, and they help team members to initially get into those good habits. They also help to retain good people. I had an assistant leave a couple years ago. She came back and is a part of our team again. She realized we’re developing, and she wants to be part of helping build the culture that is going to help us and help the patients.”
Training Your Team to Help in Case Presentation
Dr. Lee’s team is currently raising its case acceptance rate. Incorporating tools as well as language helps prep patients for procedures and allows Dr. Lee to spend less time explaining what needs to be done so she can focus her energy on dentistry.
“We’re in the process of getting all the team members to ‘preheat’ the patient, so to speak, so that I don’t have to spend as much time talking,” Dr. Lee said. “I’ve found that a lot of times, explanations coming from team members are more understandable, which means I avoid overwhelming the patient. Plus, the patients respond better if they hear the idea first from my hygienist. Because they’ve heard the same thing from me and the hygienist and I confirm that I believe it’s the right thing to do, they are more comfortable agreeing to it. We’re incorporating technology to help make diagnoses too. I’ve always encouraged my team to use it, but it sort of fell by the wayside. With The Team Training Institute encouraging its use, they see the value more and feel more comfortable and confident and see it is worthwhile to do. Adding all those pieces improves case acceptance.”
In the past, Dr. Lee did not have a qualified office manager. While she tried designating people, they were never willing to embrace a leadership role. Now she is developing a team member as her office manager, who is extremely willing to learn and lead.
“In leadership, you can’t be everybody’s friend,” Dr. Lee said. “As a result, people I’ve tried to put into leadership roles in the past kind of soft-pedaled or let things slide. But if you’re being the mini boss, you must realize sometimes you have to tell people things that they don’t want to hear. I’ve discovered you need someone with a little tougher skin. I appreciate that my office manager has calls with the TTI admin coach by herself. It demonstrates that she’s willing to grow and learn. I still have challenges, but now I know I have other people to help with those challenges instead of it just being me. I used to feel like I was solo, and everything was on my back. It’s been hard to delegate and let go because you think no one can ever do it quite like you could. A happy discovery is finding out that sometimes they do things better than you could.”
Dr. Lee is working toward tiger-proofing her business, so there is redundant coverage, and creating her 3-5 year plan. “I’m not tiger-proofed, but I’m working to develop and get to that point,” she said. “I’m working to bring in an associate, so I can step back a little bit more, or just do the stuff that I really like doing. The tiger-proofing concept really wasn’t brought home until I heard other people’s stories. It’s important to do because obviously, team members are relying on you.”
She is scheduled to attend the Executive GPS 2-day training program with Dr. Meis to help solidify her goals and come up with her long-term plan for the practice. “I’ve always held back on developing a 3-5 year plan,” Dr. Lee said. “But now I realize I’m ready. Before I didn’t have any team members that were in alignment with me or that were going to stick around. Now I have the team around me, which makes a big difference.”
Before The Team Training Institute, Dr. Lee was overwhelmed with constantly having to rehire new staff and trying to be profitable. Now that she is retaining employees, overwhelm has diminished, especially because team members are willing to take on additional responsibilities for preliminary processes. Since committing to re-focus on growing her business, she has experienced her best three months since before the pandemic. Her team is excited to grow with her and she’s finding more time to do things for herself outside work.
“Without TTI, I might have thrown in the towel, closed my doors, and gone to work for someone else,” Dr. Lee said. “Before The Team Training Institute, I was overwhelmed because I constantly had to find new staff. For the previous five to seven years, I was just coasting. Now that I have more time and the right team, we’ve really hit the ground running. Finding the right team members that are willing to implement so I don’t feel like I’m doing it all on my own has made a huge difference. The changes we’ve made because of TTI have given me time to incorporate things back into my life, like cycling. My weekends are no longer taken up with trying to brainstorm the next marketing campaign or whatever. I even have time on weekdays. I’ve rejoined an orchestra for people that used to play when they were in junior high or high school. The team supports that too saying, ‘Hey, remember Doc has her orchestra rehearsal, let’s make sure she gets out of here on time.’ It’s nice that besides me looking out for them, they make sure they’re taking care of and looking out for me as well. The Team Training Institute has helped build up my self-confidence. I’m not super ambitious as I’m not somebody that wants multiple locations, I just want to improve what I have. I like that TTI doesn’t try to make you be something you don’t want to be. If you want a big practice with multiple doctors, they can help you achieve that, but if you are a small practice and want to stay that way, that’s okay too. They help you improve what you have. And who knows, I may change my mind as things change, which is okay too, because I know they’re willing to help me in whatever direction I want to go. Whether that’s to improve, go to the next step, or open multiple locations.”