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What can you tell us about your background?
I was born and raised in Baltimore, Maryland. I attended college, dental school, and my postgraduate endodontic residency at the University...
What can you tell us about your background?I grew up in southern Orange County and earned a bachelor’s degree in biology at San Diego State University in 1983. There I met my future wife, Kim, at the...
Focus on family, patients, friends, growth, and community
What can you tell us about your background?
For as long as I can remember, I wanted to make people smile. I always loved getting the class laughing in grade school. Looking back, I am sure...
Dr. Robert Slosberg facilitates accurate mapping and obturation of the resportive defect with CBCT imaging
AbstractA patient presented with advanced internal root resorption of tooth No. 9. The prominent location of this tooth...
Drs. Brian Shaughnessy, Margaret Jones, Ricardo Caicedo, Joseph Morelli, Stephen Clark, and Ms. Jennifer Osborne review the occurrence of teeth presenting with condensing osteitis and their associated pulpal diagnosis over a 2-year period.
Dr. Andrei Zoryan dispels some of the common myths surrounding carrier-based obturation
Carrier-based gutta percha
Carrier-based obturation (such as Thermafil®, GT® obturator, ProTaper® obturator [Dentsply Tulsa Dental Specialties]) is one...
In part 2 of his series, Dr. Ace Goerig suggests ways to reduce stress in the practice
Almost all endodontists could be completely out of debt and on the way to financial freedom within 5 to 7 years if they only knew the secret. But the secret is...
Dr. Robert Fleisher ruminates on how to prepare for retirement
There are so many articles about everything that you become pretty much overwhelmed and can never expect to read them all. So you pick and choose. You like to learn about the latest and...
Dr. Roger Levin presents the 10 top ways to help create a perfect dental team
With the changes brought on by the economy, top companies are bringing in the best resources they can find to evaluate where their organizations stand. They want to know...
Dr. Joel C. Small explains how default leadership limits practice owner’s success and how you can build your business around trust
“Default leadership is the greatest obstacle in our practices transformation from good to great. Without purposeful leadership, our practices are like a caterpillar that never experiences what it means to be a butterfly….” Excerpted from Face to Face
Imagine, if you will, what life would be like if nothing that you did mattered. How would you feel if your words or your actions were so inconsequential that you were disregarded by others, and you became powerless and unable to alter your existence? Now consider what we do when we micromanage our staff. Is there really any difference between micromanaging people and making them inconsequential? If we deny them the ability to contribute and utilize their minds and their creativity have we not made them insignificant?
Without confidence that their actions matter, our staff will develop paralysis that is manifested by an absence of spontaneity and creativity in our practice culture. B. F. Skinner, a social psychologist, in a classic experiment, demonstrated that rats that were conditioned to believe that their actions were useless in altering their environment exhibited paralysis and failed to act when placed in a life-threatening situation. Conversely, rats that were conditioned to believe that their actions made a difference would act defensively when placed in a similar situation.
Micromanagement is the result of leadership by default. It is a means of compensating for our deficiencies as leaders. Disengaged leaders are like plumbers who fix leaks with duct tape because they have no tools. Micromanagement has become our leadership duct tape. We use it because we have no other tools in our bag.
Default leadership is arguably the greatest limiting factor for transforming our practices from good to great. For many of us, micromanagement is actually default leadership in disguise. We mistakenly believe that by overseeing and directing our staff and everything they do we are actually leading, when in reality we are unwittingly destroying our ability to provide effective leadership. This is because a professional practice that is micromanaged is by necessity burdened with excessive rules and regulations that demand compliance, and a compliant culture suppresses creativity and participative decision making.
Numerous studies have investigated the effect of micromanaged cultures versus participative cultures on a corporation’s bottom line. John Zenger, in his book The Extraordinary Leader, cites a study which found that CEOs who stressed effective communication, accountability, and the empowerment of people were able to provide a much higher profit margin for their companies than their counterparts who emphasized performance monitoring. A research study conducted by Success Profiles found that companies who encouraged participative decision making had an overall 11.1% rate of compounded revenue growth compared to an overall 2.3% growth rate for those companies that did not encourage participation by their employees.
Another provocative study, cited in Daniel Goleman’s book Primal Leadership, offers convincing evidence that our staff is the best and most accurate source for assessing us as leaders. In this longitudinal study of the effectiveness of leaders, the staff’s assessment of the leader proved to be the most accurate in predicting the leader’s success and effectiveness when compared to the assessment of the leader’s peers and bosses. Even at 7 years after the assessment, the staff’s prediction of the leader’s success was shown to be the most accurate. In the final analysis, the accuracy of the staff’s prediction of the leader’s success was equal if not superior to an elaborate battery of performance simulations performed in assessment centers.
What a profound irony! The very people that we unknowingly make insignificant by diminishing their role in our practice are the ones who possess the insight to make us better leaders. Considering this revelation, perhaps we should begin to listen to what they have to say, or better yet, we might consider adopting a 360-degree performance evaluation that includes their assessment of our performance.
So what’s to be learned from all of this information? First, we must promise ourselves and our staff that we will honor and respect their choice to adopt our culture and participate in our practice. This is best done by making them relevant—by becoming passionate advocates of a participative culture.
Second, we must promise ourselves that we will no longer lead by default. The argument for purposeful leadership is too strong and the consequences of default leadership are too significant. We must quit wasting our time and precious energy on trivial matters and instead concentrate our efforts on matters of greater importance to our practices and our professions. And last, it is time for us to seek partnerships with institutions of higher learning so that we can focus our energy on teaching industry-specific leadership qualities that will enable us to eradicate leadership deficiencies in the health-care community.
Leadership: strength through vulnerability
“The deeper our faith, the more doubt we must endure; the deeper our hope, the more prone we are to despair; the deeper our love, the more pain its loss will bring: these are a few of the paradoxes we must hold as human beings. If we refuse to hold them in hopes of living without doubt, despair, and pain, we also find ourselves living without faith, hope, and love.”
Parker Palmer—A Hidden Wholeness
As Parker Palmer states, it is through our vulnerability to doubt, despair, and pain that we are able to fully experience the joys of faith, hope, and love. Imagine how shallow life would be if we were unwilling to accept the risk inherent in our vulnerability.
I would venture to say that most people define vulnerability as weakness. If we consider the term in the context of warfare or even business, vulnerability would imply that we have somehow failed to protect ourselves from harm. Whether harm comes in the form of a hostile business takeover or an enemy attacking an unprotected flank, the final analysis is that we, as business or military leaders, have failed. If we look for synonyms for the word vulnerable in a thesaurus, we find that they include the words weakness, defenselessness, and helplessness.
Contrary to this standard interpretation, vulnerability can also be a source of great strength, if we are willing to see it differently. Recall the vivid image of an unidentified, unarmed, Chinese student standing alone while blocking the path of a Chinese military tank in Tiananmen Square during the Chinese worker and student uprising in 1989. This was a display of ultimate defenselessness and helplessness, but the message was one of incredible strength for people around the world. Other great people like Martin Luther King and Mahatma Gandhi have changed the course of nations by the strength derived from their willingness to be vulnerable.
Vulnerability is seldom discussed in relationship to leadership. Yet, a leader who refuses to be vulnerable will never fully achieve the strength and depth of his or her leadership potential. There is no doubt that vulnerability, as displayed by the student in Tiananmen Square, involves risk. At times it involves great risk. As a business leader, being vulnerable may even put your professional career at risk. Some of us may be unwilling to suffer the harm that risk can bring. Others understand that the rewards derived from our vulnerability far exceed the potential risk. For exceptional leaders, it is their commitment to their core values and purpose that enables them to seek these rewards while enduring the risk.
Consider the issue of trust as it relates to leadership and vulnerability. Books on leadership mention trust as one of the critical factors in the leader-follower relationship. Most authorities would agree that without trust, leadership is at best ineffective, if not nonexistent. But trust involves a considerable degree of vulnerability on the part of a leader and follower. Trusting others can be potentially harmful, particularly if it proves to be unwarranted.
Those of us who have been emotionally harmed by trust feel violated. Our natural tendency is to disappear within our emotional selves and never to trust again. With time, as we recover from our deep cynicism, we ask the key question: “Will I ever again know whom to trust?” The answer is a disappointing “Probably not”! This may be a bitter pill to swallow, but if we are to develop a culture of trust, we, as leaders, must willingly trust others so that they may, in return, trust us. This is one of the paradoxes that, as Parker Palmer states, we, as human beings, (and leaders) must resolve. There are other, similar examples of the strength of vulnerability. Choosing to no longer micromanage others is a great leap of faith that requires vulnerability on the part of the leader.
Intuitively, we may understand the negative effect that micromanaging has on staff motivation and creativity. Letting go is still a frightening experience because we have, in our own minds at least, placed the success of our organization in the hands of someone other than ourselves.
It is interesting to note that in cultures characterized by a command-and-control mentality there is a continuous downward spiral in staff morale and productivity. At the core of these cultures is a deep-seated lack of trust on the part of the leadership. Values are replaced with stringent rules and regulations. The team members, perceiving the scarcity of trust and lacking the guidance of values, are often immobilized by their inability to determine the right thing to do. Ironically, this inability to act results in loss of productivity, which the leadership views as a lack of adherence to the rules, and, consequently, more rules and regulations are created. Punishment for further disobedience becomes more severe.
How do we resolve this obvious contradiction, or cognitive dissonance, between our perceived need to trust and our fear of trust? The solution lies in our belief that never to trust again would be to deny ourselves the many meaningful experiences that trusting others can provide. In the final analysis, we are willing to trust in spite of the potential harm because we value the positive aspect of trust more than we fear the potential negative.
When trust is present within a business atmosphere, the employees are empowered to make decisions that will benefit the entire team. Trust can be felt. And it’s an element that has the power to transform almost any individual and business. Try adding trust as a core value to your business today. Watch how things change. Say “I trust you” often to your employees and loved ones through your actions and words. Build your business around trust.
This article is an excerpt from Face to Face — A Leadership Guide for Health Care Professionals and Entrepreneurs. You can learn more about why and how leadership is different in small organizations, like our dental practices, and why we must lead rather than manage our practices to greatness. Visit www.readfacetoface.com.
Dr Joel C. Small is in private endodontic practice in Plano, Texas. He received his endodontic training at the University of Texas at Houston, and his Masters of Business Administration, with an emphasis in health care management, from Texas Tech University He lectures throughout the United States on the topics of leadership, practice management, and specialty practice transitions. He is a co owner of Phase Two Associates, LLC, a specialty dental practice brokerage firm in Dallas, Texas. Phase Two Associates deals exclusively with practice transitions for the dental specialist. He can be reached at
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