Compliance vs. Commitment

I’m sure you have seen them! The slew of “what should I do” or “help me” posts when scrolling within dental social media forums. I see them, and I applaud those who seek help from their peers. But some of the problems introduced in these posts also concern me greatly. Because often, there is so much more that needs to be unpacked. The few details that are shared online rarely give us enough context to truly respond rationally and intelligently. Sadly, many of the scenarios shared suggest poor leadership or a lack of communication from the leader. They also point to cultural mismatches between the author’s expectations and what is actually occurring in the practice. Unfortunately, more and more, I see that many of these posts are met with two (very brief) polarizing responses that truly do not attempt to solve these complex leadership issues. Let me share what I mean.

Polarizing Perspectives

In one example, the author of a Facebook post had brought her concerns about their newest employee’s behavior. To her it was blatantly obvious that the behavior should be addressed and did not feel it was “her place” as a team member to correct her teammate. She felt strongly that this specific individual’s behavior fell outside industry norms (and perceived practice values) and expected that her employer would immediately correct the behavior by interceding. When her employer failed to react or share her concern (and simply ignored her), she opted to seek advice in this particular Facebook group imploring what they thought she should do next. When I scroll through the comments, I discovered these two distinct styles of responses:

“It’s NONE of your business, so just do your job and don’t worry about it”

OR

“RUN, NOW! You deserve better! Go find another job!”

Both of these responses are on opposite sides of the spectrum, and frankly neither one really is helpful to the author of the post. But, each speaks volumes as to what is going on in our field and our practices. Ignoring issues in the practice leads to key team members to basically run out of options. They are left to either accept what is going on (comply with the status quo) or walk away. Obviously, the author of the post felt that it was “her business” to approach her employer because the behavior of her new teammate had crossed a line that may impact the practice. I am finding all too often that flippant responses in social media are simply just symptoms of the bigger problem. There are times to consider leaving a job, but let’s at least better understand what is happening before walking away. There could be multiple underlying factors that could be going on here. Let’s take a closer look at one factor in particular: Compliance vs. Commitment.

The Deficiencies of a Compliance Culture

Let’s look at what it means to be compliant or committed. It’s not easy distinguish as to where they cross over and there can be gray areas, but I’ll try to keep it simple. Compliance means we do what we are told or we follow the rules that are set in motion by upper managment, at least until someone else changes them. Now, I want to share at this juncture that there are “rules in dentistry” that we must comply with such as the Dental Practice Act and OSHA or CDC guidelines. I want to set this aside for a moment, because I want to go a bit deeper. When we create a culture that is “rules based” or grounded in only compliance, we are only asking the bare minimum of those who work with us. Team members aren’t taking initiative and most of the time they are barely treading water (and so is the practice). There is no forward movement. Everyone is basically going through the motions. When the workplace is in a state of compliance, employees may follow rules and regulations but they do not share information or willingly help others to reach their targets. They don’t work together — instead, each person works independently with little concern for how their efforts impact other team members. As such, the entire group operates inefficiently because no one takes accountability. Thus, the first response to the facebook post—a “mind your own business and do your job” attitude.

There are a few team dysfunctions that may stem from a culture of compliance. Most of the time, compliance just requires us to take take limited actions. If we do take some form of initiative, then it causes confusion. Others in the practice might feel uneasy since they are unsure how to follow the new regulations. Some employers lean towards being non-confrontational in these scenarios because they want to avoid conflict and they don’t know what changes will come with the new initiative. So, team members work in silos often just “staying in their lane.”

Compliance also implies less confidence among teammates and between management and staff members. This lack of confidence may lead to micromanagement because the supervisor feels obligated to monitor compliance all day and ensure that everyone performs their tasks. It may also lead to an inability to plan for the future because no one knows what changes are coming next, so they cannot prepare. A blame game may erupt as a result of a lack of organization or preparation. You do not want the blame game!

In other practices, resentment can build among employees who are waiting for their manager or employer to provide the structure or systems. When, in fact, the leadership might be overburdened or underskilled. In this unfortunate scenario, we may then end up with a stressed manager that disregards team members’ concerns due to having too much on their plate.

All of these factors can lead to a culture that breeds apathy and negativity among team members. When there is no communication within departments, individuals will have little contact with their coworkers; this lack of communication frequently results in a lack of team cohesiveness. And, in the end, it can result in a high turnover rate.

Compliance Summarized

A dental practice can’t get where it wants to go if its workers are simply clocking in and out, performing the bare minimum. Compliance can be an important first step during onboarding and setting the rules of operation, but it absolutely must grow to a deeper level of commitment for three main reasons:

1. Patients want care from a dental team that is committed to their oral health

2. The practice needs to grow and flourish

3. Employees desire job fulfillment and want to be a part of something greater than themselves

Commitment Cultures

Commitment on the other hand involves giving our best effort at all times to move forward and make progress, even if it’s hard or uncomfortable. It means we do what it takes to reach our personal and collective goals, even if that means making sacrifices. It is a work ethic—a personal dedication and willingness that pushes us forward in the workplace and our careers. Team members work toward the practice’s vision in order to set it apart from the competition.

It’s easy to get caught up in the day-to-day activities of managing a dental practice, but it may be worth considering how you might formalize the core beliefs and vision of the practice. It might mean that you develop better structures for communication between your team members to integrate ideas that emerge from the ranks. You could also consider how you can model the actions that you want to see implemented in your practice. This may mean showing up on time every day and taking initiative on projects or tasks that need to get done. It could mean staying late one night a week just to ensure that you are prepared for that one special patient scheduled tomorrow who will need a seamless experience. Providing an example to your teammates helps them understand how to raise their bar and commit at a higher level, which is useful for keeping them motivated and engaged.

In general, employers look for employees with both traits: compliance plus commitment. They want people who will follow their rules without question but also take initiative when needed. But, I am going to go out on a limb here and state that the more dedicated the employees are, the more they trust one another and trust the systems that are in place. So, lean more towards a culture of commitment to support that trust. Compliance should only come into play when a rule, or standard is being put in place. Then, lean away from that minimum mindset to build engagement and trust.

The more trust and confidence a team has in one another, the more productive and creative they will be in their efforts to collaborate. Trust is a fundamental building block for commitment.

Consider the uniformity of the team. If there are disparities among the group in terms of commitment levels, it can have a negative impact on morale and progress. If some of your team members are not fully committed and responsible for their actions in the dental workplace, others can lose confidence in the process and become despondent. Consider these questions about those who aren’t devoted: They may be showing up each day, but do they truly think of themselves as part of a team? Do they have the ability to make sacrifices on behalf of others? Are they willing to go above and beyond for your patients? Commitment is the key difference between compliant and exceptional employees. It also distinguishes a good practice from an excellent one.

So, let me briefly return to the two distinct responses I found in the Facebook post. I believe we’ve already recognized that individuals who are operating from a compliance mentality are more likely to express feelings of apathy and noninvolvement with “It’s none of your business, so just do your job and don’t worry about it.” And, those pressing the author of the post to “Run, NOW! Go look for another job!” recognize that her present job and workplace climate may not provide her the opportunity to start a conversation to improve standards. Far too often, key employees who are committed to their practices are left without options when it is not clear as to what the culture represents. And, leaders within those practices “turn a blind eye” or “bury their heads in the sand” instead of addressing concerns head on. Leaders should provide environments that enable and encourage the growth and development of our employees, which will have the most impact on the perceived shortage of quality team members. Developing a culture is far easier than constantly hiring for compliance. A workplace that promotes a culture of commitment is more likely to have long-term team players who help the practice expand and serve patients for life.