Question

Allison began her health care career with an established general dentistry
practice consisting of one dentist, Dr. Gable. Shortly after she started her
job, Dr. Gable decided to add a second dentist, even though his past
ventures with adding a partner had not been successful. Dr. Gable hired an
expensive consulting firm to handle all the specifics, such as developing the
contract with this new dentist, helping with hiring additional staff,
purchasing additional equipment, and helping the current staff adapt during the transition. Even though Allison was new to the dental field, Dr. Gable
kept her up-to-date with the process, but only to a certain point.
Furthermore, Allison’s input was not wanted, so she politely stepped back
and observed the process. Both dentists had big ideas for a successful
partnership and expected instant success. They even looked for land to build
and move the current practice because they expected the practice to double
or triple in size since there would be two dentists to serve their expanding
patient base.
Watching the beginning of the partnership develop was exciting for
Allison, and she was anxious for the partnership to succeed. The thought of
managing such a large, successful practice would certainly be good
experience for her. However, Allison noted a couple of negative factors that
made her question the wisdom of adding a second dentist. Those factors
included:
1. The new partner had just graduated from dental school and did not
have a patient base to bring to the practice.
2. The discussions between the two dentists and the consulting firm did
not indicate how the new dentist would market himself.
3. The new dentist would be paid a set salary, increasing each year,
without consideration of how much revenue he actually generated.
Furthermore, several issues quickly came to the surface:
1. Expenses quickly exceeded profits.
a. The new dentist wanted all the best and newest equipment, which
was very expensive.
b. Increased staff for the new dentist meant a larger salary expense (not
to mention the salary of the new dentist).
2. The new dentist was neither motivated to nor interested in marketing
himself. He was drawing a salary, which would increase each year, so he
was not motivated to seek new patients.
a. This meant he was treating the existing patients and, therefore,
taking away business from Dr. Gable.
b. In turn, little additional revenue was being generated, and expenses were going through the roof.
3. The morale of the office quickly deteriorated.
a. The tension between the dentists and staff was obvious. Due to the
increased expenses, the year-end bonuses for staff were eliminated
and employee hours were cut.
b. Allison was also feeling demoralized.
Now, after keeping Allison out of this process, both dentists expect her to
fix the situation. Allison feels like her job is on the line, along with the
morale of the staff and the outcomes of the practice. Plus, Allison is positive
neither dentist will be open to accepting responsibility for the situation. She
is trying to decide what to do and how to address these problems.

Questions:

1. How might she draw upon and apply the theories of management and
motivation to address these issues?
2. How might she approach the dentists?
3. What are the most urgent issues?
4. What actions might she suggest to improve the situation?
5. What strategies might be used to motivate the dentists and the
employees in working to begin to address the issues?
6. Should Allison be updating her résumé and looking for another job?
Explain your response.

Answer 1

1.  To address the new dentist’s disinterest in marketing, Allison could refer to the Scientific Management Theory. She could devise a deal that would reward the new dentist with commission for every new patient that he brings in. This deal also relates to positive reinforcement with extrinsic rewards. To approach the deterioration of the office morale, Allison could use Ouchi’s Theory Z. By taking genuine concern in the employees needs and complaints, she could make the employees feel more valuable. Undoubtedly, Allison would need to follow her concern with rectification towards said complaints. This method also presents intrinsic rewards such as healthy relationships and choice.

2. The meeting should be in a formal setting and a human resources representative should be present. It’s important for Allison to be honest and firm with the dentists, but it seems like that might provoke a negative response from the dentists. So, Allison shouldn’t point a finger and blame the dentists. Allison should only state the facts of the situation, such as make references to the expenses, failure to generate new patients, and employee dissatisfaction. She could even mention the consequences of the data. Allison should then have solutions ready for the dentists to contemplate.

3.  The most urgent issues are the morale and finances. The practice can’t improve if everyone is discouraged. The staff, including the dentists, has to be motivated to work to improve the situation. If the expenses continue to exceed revenue, then the entire practice could fail. The practice would have to let go of staff, have equipment repossessed, and ultimately go out of business.

4. Allison could suggest the deal that I mentioned in the first question: revise the salary agreement for the new dentist to be based on his generated revenue. Then, by encouraging the new dentist to market himself, the practice could generate more revenue. To initiate marketing, she could suggest advertisements, whether it be commercials or print ads. The practice should consider incentives to influence customers. When appropriate, it’s also important to start involving the employees in decisions. This would improve staff morale and show them that they are respected.

5. Positive reinforcement could be used as motivation. It could start with intrinsic rewards such as choice. Doing this would ensure that the practice is working towards the same goals. It motivates the staff because they feel more involved in problem solving and goal setting. This technique touches on Locke’s Goal-Setting Theory which alone could motivate some employees. Regarding long-term goals, extrinsic goals could be acknowledged. Once the practice is out of the financial predicament, they could afford to bring back year-end bonuses.

6.  It’s important to frequently update your resume. But yes, Allison should be looking for another job. She is aware of Dr. Gable’s previous failures with adding a partner. It is also just a precaution in case the business is unsuccessful or if they let her go. She shouldn’t necessarily apply for a new job without trying to fix the situation first, though. If she approaches the dentists and they prove to her once more that her work isn’t appreciated, then she should apply for another job. Because at this point, Allison has tried inaction and action and neither influenced the dentists. Allison deserves a work environment that will genuinely value her work and opinion.