gott-episode-factory-system-vs-pa-dentistry

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Most dental practices are unwittingly mimicking outdated Factory System organizational design and management practices. The emerging work world of the Participation Age is demanding a much different approach and great practices are racing to embrace the Participation Age.

The hallmarks of the Participation Age are: 1) participation – people want to participate WITH you in building a great practice, not FOR you, and 2) sharing – they want to share in the rewards of that participation. One without the other is hollow.

To get everyone to participate as “Stakeholders” (not share holders necessarily), we need to rehumanize dentistry by giving everyone their brain back. How do we do that? The central practice of the Participation Age is universally Distributed Decision-making (DDM) through universally Distributed Leadership – everyone is a leader.

Why does DDM work? Because Input=Ownership – the more input I have in a decision, the more I will own carrying it out and improving on it. There decisions should be made locally (universally distributed) whenever possible, and it’s almost always possible.

What do we do instead? We mimic a 19th century Factory System model borrowed from the military with its roots in slavery; the classic top-down “pyramid scheme” hierarchy of management. It’s emotionally satisfying – everyone knows exactly who has a bigger gun than whom, but it destroys engagement and participation at every level, and dehumanizes work like nothing that came before the factories other than slavery, serfdom, and indentured servitude.

What should we do instead? Become a Mission-Centered Practice, where we all work to get our patients the result we have committed to. We all serve the Mission, not our department, a human boss, or a job description. And we all make every decision by how it relates to our Mission. We also help each other stay focused on the Mission, and use functions, tools, methodologies, processes, equipment and relationships to accomplish that mission. The effectively flattens the organization in an extremely healthy way and makes us all accountable to the Mission itself.

How do we see the differences between Factory System Dentistry and Participation Age Dentistry worked out? The podcast goes deep on these; following are a few differences:

Classic Factory System Dentistry emphasizes command & control management, assuming people want to be codependent, childlike, task-oriented workers, centralized decision-making, time-based pay, and silos/fiefdoms that create competition and division between functions.

Participation Age Dentistry rehumanizes by emphasizing localized (but not independent) decision-making, inclusive leadership by everyone, adult Stakeholders who are self-managed adults, universally distributed decision-making, results-based pay and incentives, and being Mission-centered, not department or boss-centered.

There are nine practices outlined in the podcast that reflect the above emphasis on Distributed Decision-making; things like DDM Teams, turning Practice Managers into Practice Leaders, roles vs jobs, process mapping & metrics vs. frantic work, much higher standards for team members, hiring completely differently, and full transparency. These nine, along with some others provide the transition from Factory System Dentistry to Participation Age Dentistry.

There are a lot of myths about Participation Age Dentistry:

MYTH                                                                        TRUTH

  • Chaos & Anarchy w/out Management                      – Tighter processes, less chaos
  • It’s different, not better                                                – Higher profits & staff retention
  • It’s a new fad                                                                   – Return to pre-Ind. Age practice
  • Will cause a dip in performance first                         – Better performance right away

Practices are racing to embrace the emerging work world of the Participation Age. What is the first thing you can to move your practice in that direction. Eat the elephant one bite at a time.