Practice managers – are they obsolete?

She (L) is one-half of a husband and wife team. He (M) is the dentist and she has been the “practice manager” for some years – they are just about to complete the sale of the practice to two associates. When the sale is concluded and after a sabbatical year, they will be creating a new single-handed practice from scratch.
L was chatting to me yesterday and bemoaning the fact that, during the whole of her time as practice manager she never felt “accepted” by the rest of the team because:

  1. She had no previous experience of dentistry before this “job” and no clinical experience and
  2. The rest of the (female) team in the practice regarded her as “the boss’s wife” and, therefore, excluded her from their camaraderie.

L & M have been clients for nearly 4 years now and I know that this problem has been ongoing and a source of considerable upset and stress. L has now, finally, given up working at the practice and is so pleased to be free of the pressure.
Her question to me “Chris, when we begin our next practice, what tips have you got for me to avoid falling into the same trap with the next team we recruit?”
My answers:

  • Let’s look at the history. The term “practice manager” evolved when some dentists realised that the pressures of clinical work left them no time to fulfill three important obligations
  • financial management
  • personnel and
  • clinical supplies
  • So, looking around for help (and with zero skill in recruitment and limited funds) they either promoted their longest serving nurse to embrace these duties as well as nursing or they asked their spouses to come and help them out.
  • In the case of the “senior nurse”, she already had the relationship with the rest of the team and was considered “one of them” who had slightly gone over to the dark side by becoming the boss’s confidant. Mind you – no such thing as a secret in a place like that!
  • In the case of the “boss’s wife” – we often see the problems manifested by L – with the team whispering “why on earth should we do what she asks – she knows nothing about dentistry.”
  • And, of course, some “boss’s wives” (L excepted I hasten to add) didn’t help themselves by swanking in on a part-time basis, in their new car, flashing their new jewellery and explaining that they could only work part-time because of social, sporting and children’s committments.

It’s not always like that, of course, and I’ve worked with some fabulous spousal partnerships over the years. Interestingly, in the last few years, quite a few female dental principals with husbands as practice managers – I think that works realy well. The husband can often become father confessor to the team as well as a steady and unemotional hand on the tiller.
The conclusion I reach is a semantic one – that it’s the term “practice manager” that creates some of the problem, because it is so steeped in clinical tradition.
The solution?
Don’t call yourself a “practice manager”, call yourself a “business manager”.
I know that sounds too simple but I think it will really work – and create the distinction that we are not describing a promoted nurse or a part-time wife but an all-round business manager with influence in finance, marketing, sales, team-building, customer service, time management and business strategy.
Almost to the extent that the clinical supplies and audit could be allocated to a separate individual who might be called a “clinical manager?”


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Chris Barrow

Chris Barrow has been active as a consultant, trainer and coach to the UK dental profession for over 20 years. As a writer, his blog enjoys a strong following and he is a regular contributor to the dental press. Naturally direct, assertive and determined, he has the ability to reach conclusions quickly, as well as the sharp reflexes and lightness of touch to innovate, change tack and push boundaries. In 2014 he appeared as a “castaway” in the first season of the popular reality TV show “The Island with Bear Grylls”. His main professional focus is as Coach Barrow, providing coaching and mentorship to independent dentistry.