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Written by Efrain Coronado D.D.S.
In my 18 years of experience in working with DSOs, I have noticed a need for greater integration between the DSO’s corporate team and its dental practices. The specific nature of these two worlds, the corporate and the clinical, yield different visions and expectations within the organization. One can say there is an unspoken ‘tug of war’ that exists between the corporate side of the organization and its individual dental practices.
On one hand, the DSO’s corporate team must establish a vision for the organization, an efficient plan, and execute it well in order to sustain the DSO’s longevity and growth. Its very nature is different from the clinical side.
On the other hand, the dental practices that make up a DSO, headed by a clinical and non-clinical office team, have different responsibilities and a more local mission. It is the dentist that examines, diagnoses, and treats the patient. This autonomy develops a sense of clinical independence in the dental professional that spills over into other areas such as administration, personnel, equipment, supplies, and furthermore, may develop a local vision limited to the geographical practice where they work.
A tug of war is not necessarily negative. In fact, I would argue that to certain extent they are necessary and beneficial since constructive tensions can lead to improvement in performance, creativity, resiliency, and productivity.
However, an uncontrolled tug of war can become an obstacle to the healthy growth and integrity of the DSO as a whole. Unintentionally, clinical practitioners, and for that matter, even administrative personnel at the practice location, can develop a professional culture and vision that runs in opposite direction, at odds, with the overall corporate vision. It is these differences in views and belief systems within a DSO that can develop into an ever-growing, as I call it, negative ‘tug of war’.
There is a practical way to control and minimize the negative aspects of the tug of war. One way is to create a space where the different parties can come together in dialogue, discussion, and understanding. In essence, the DSO creates a bridge within the organization, promoting cohesion, integrity, and identity.
This space can come in many different structures, forms, and names. The one I will propose for our present discussion is an organizational workshop. The purpose of workshops is to bring together a community of dentists and provide them with a voice within the organization. Workshops serve as spaces where professional encounters can take place, where dentists can express their anxieties, cares, joys, frustrations, expectations, and hopes, among others. The emphasis here is to hear the voices of the dentists.
Dentists work independently and have autonomy at their individual offices at a given location. But coming together through workshops and engaging in dialogue and relationships with other dental offices of the DSO at a given territory, can sustain the organization.
The communities of dentists, built through workshops, give a face and a voice to the local component, which can then engage in dialogue with the corporate component of the organization. This benefits the corporate component of the DSO because they don’t depend solely on assumptions in their decision-making, but rather by receiving direct input from the trenches (dental practices) via workshops. Dentists cannot be hesitant to regularly discuss the health of their offices. It is the communities of dentists (workshops) that discloses those challenges in order to solve them. Their engagement in the process should be encouraged, appreciated and expected.
Corporate must place high value on these workshops, because in doing so, it can yield to greater empowerment, improved communication, motivation, loyalty, and productivity. A lack of cohesion can cause disintegration and loss of organizational identity.
Having the presence of organizational workshops can aid a DSO by becoming in itself a visible expression of the organization. Becoming a unified expression of many voices coming together.
Such integration between the parts (local practices) and the whole (company – DSO) is not easy, but it is crucial; constant integration is a continual effort. It is this holistic vision which needs to be in the minds of all dentists and leaders.
When examining the level of integration of your DSO, a good place to start is considering the following questions:
- What is the health of your DSO as a community?
- Where and how can you improve the integration and communication within the organization?
- Do you, as an organization, speak with one unified voice?
The dental service organization as a whole must develop a culture in which it identifies itself as a community that needs continued nourishment and support from both corporate and the dental practices.
It is the creation of spaces, such as organizational workshops, that will enable the coming together to share, to propose, and to listen, that will enable to control the ‘tugs of wars’ within DSO’s so these entities can unite and develop a more cohesive effort for growth and for providing great oral health.
Dr. Efrain Coronado is a general dentist who has practiced for 24 years. He is a graduate of the University of Maryland Baltimore College of Dental Surgery. After graduating in 1998, he moved to Florida where he owned a private practice. In 2004, he joined Sage Dental. He has worked for Sage Dental for the past 18 years. After Sage Dental expanded into Georgia, Dr. Coronado relocated there. He is currently an associate dentist for Sage in the Atlanta metropolitan area. Dr. Coronado founded and led an international dental missionary group for seven years. He has also served as a dental examiner and consultant. He can be reached at: contact@coronadodds.net and connect with him on LinkedIn: www.linkedin.com/in/
Read Dr. Coronado’s article Want to Achieve a Solid Employee Foundation in Your DSO? Develop Leadership Behavior First.
