Practices Benefit From a Culture of Accountability

Mistakes happen — but when mistakes occur or there’s an oversight, are employees owning responsibility? Are they accountable? Developing a culture of accountability within a dental practice can improve productivity and employee morale, and have a healthy impact on the practice’s bottom line.

Staff members will treat patients the way doctors treat their staff members.

Accountability is defined by Merriam-Webster as “an obligation or willingness to accept responsibility or to account for one’s actions.”

Sounds simple enough. But according to a survey conducted by AMA Enterprise, a division of the American Management Association, one out of every five business leaders (21 percent) believes the percentage of unaccountable employees ranges from 30 to 50 percent.

That’s a lot of people who don’t take ownership of their on-the-job responsibilities. And dental practices are not immune.

However, by developing a culture of accountability within the practice, that percentage of responsibility shirkers could be dramatically reduced.


Dianne Watterson, RDH, MBA, a Lexington, North Carolina-based dental management consultant, says that if a dentist hires competent people, and makes sure they have the proper training to do their job, he or she won’t have to stand over them holding their feet to the fire to ensure accountability.

But that doesn’t mean dentists should maintain a complete hands-off policy.

“The dentist is accountable for the success of the practice, and has to have systems in place to at least check for accountability, and know when people are doing their job well,” Watterson says.

Doctors also need to be aware of, and take seriously, complaints from patients about a particular staff member. It may not always be legitimate and could be a result of bias on the patient’s part, but it could also be substantial.

“Doctors need to have their staff members’ backs too,” Watterson says. “But if one patient complains about something, and the doctor then receives a second complaint along the same line, he or she needs to take that very seriously.”

Many doctors, she says, glaze over at the thought of having staff meetings — but such meetings have a way of bringing problems to light. And in a group practice, even better than a general staff meeting is holding department meetings. For example, hold one meeting with hygienists, and a separate meeting with the assisting staff.

“With department-type meetings you can focus on specific things,” Watterson says. “And you can do that with a number. If you’re looking at the efficiency of a particular schedule coordinator, then you can examine the downtime percentage, and there’s a number for that.”


One way to improve accountability is to offer incentives in the form of setting goals that staff has to work toward, and then rewards for achieving that goal. However, Watterson cautions that if the practice is experiencing significant problems with downtime, improvement needs to be shown before bonuses can be distributed.

“Sometimes the system is broken in a practice and you’ve either got to come up with a new system, or train people to do what they’re supposed to be doing,” she says. “And then if you don’t see improvement, it might be time to replace that person.”

Incentives, of course, need to be realistic. If, for example, a practice is experiencing 25 percent downtime, a good initial goal would be to reduce that to 20 percent over the next several months.

“It’s better to incrementally make improvement than to say we’re going to drop this to 10 percent in three months,” Watterson says. “That’s just not easy to do.”

Fostering a team concept is important, Watterson says. In dental offices where staff function like a team, peer-to-peer accountability becomes a natural outcropping of the team concept.

“Among healthy teams, accountability is a natural thing that occurs,” she explains. “They want to help each other. And if there’s a goal to work toward with a reward, most of the time people will get on board with that.”


Watterson believes that when dental practices foster a culture of accountability, good things happen — morale goes up, productivity improves and the practice bottom line reaps the benefits.

“Most staff members want to do a good job,” she says. “Most want to know that their doctor approves of their performance. So it can definitely affect the bottom line in a healthy way when there’s good peer-to-peer communication and oversight.”

The benefits trickle down to patients, who can sense when staff members are happy doing their job versus fussing and competing with each other.

“One of my mentors used to have this expression: Staff members will treat patients the way doctors treat their staff members,” Watterson says. “There’s probably some truth in that statement.”

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