Dennis Hartlieb

How to define practice core values

Defining Your Practice's Core Values

Welcome back to your our series about practice leadership. In my last conversation with Geri Gottlieb, practice coach and dental consultant, we discussed creating and defining you practice culture. In my latest conversation with Geri, we discussed why and how defining core values for your practice and making those values actionable is integral to creating a corporate culture in your practice.

Dr. Dennis Hartlieb: So, I want to get some useful take home things that dentists who are reading this can take home and start doing so to improve their practice. Part of improving their practice is creating your corporate culture.

How do you how do you create your corporate culture? What is the first thing or what's the beginning in the process of creating a corporate culture?

Geri Gottlieb: Well, the very first thing is you need to know is why you're doing what you're doing.

Dr. Dennis Hartlieb: Well that’s easy: I want to help people.

Geri Gottlieb: Great. But we need to dig a little deeper. Tell me why. Where does that come from? How do you think you're helping people? Dig down deeper in that answer. And then, define your vision. If you sit there and think “Wow, if I could show up to my practice tomorrow and it could feel like anything I wanted it to be, what would that look like?”, what is the vision for your practice, for your dentistry, for your life, for your team, for your…whatever!? You must get clear on where you are headed and why you're doing it. Then, you start to ask, “How are we going to get there?” If my vision is for the practice to be like Disneyland, what needs to be in place culturally value wise? What are the steppingstones that we're going to measure against and that we're going to make our decisions against every day to get us to where we want to be and keep us there?

Dr. Dennis Hartlieb: I think a lot of dentists have difficulty narrowing down what their “why” is? Why are they a dentist?

Geri Gottlieb: Right.

Dr. Dennis Hartlieb: You know, and I had to dig really deep for mine because it was very superficial. You help me work through this. Ultimately, I realized my reason for doing dentistry, my “why”, is about dignity. I grew up with parents who had really poor dental health. I would watch them not be able to have comfortable partial dentures and be very self-conscious. I saw when my mom was treated by one of my professors at a dental school, and it was almost like she became this better version of herself. Then, as I dug deep into it, I realized my other “why” is about giving. Giving people dignity. People can be who they truly are inside. And where I really felt this is when I treat teenagers, a patient group that I never thought I would ever want to treat. However, I do a lot of cosmetic work on kids who have peg laterals, missing laterals, and malformed teeth. And boy, we've seen how people have changed when they have a smile they are comfortable and proud of. I think deep down, it's about dignity because they can go out and they can smile. They can be themselves. They don't have to hide their face or hide their mouth when they're talking and laughing. It took me a long time to dig down that deep and then and had to pull off these layers. But it helps so much. I often have to remember to take myself out of the equation. Maybe their dignity is just about filling in a space and their dignity is not about how the teeth look. Maybe their parents lost their teeth. Maybe they don’t really care about how it looks. But to them, their dignity is that they have that tooth replaced. That was an issue for their parents, and I need to take my objectives out of it and understand that dignity for other people is different. It could be cosmetic, but it could be functional, or it could be some other thing that I may not completely understand. However, I can understand It's making them fulfilled and making them have the dignity that they desire. So, that helps me when I when I'm wrestling with treatment that patient wants that may not be along the lines of what I was thinking.

Geri Gottlieb: Right. And so a couple of things on that, too, Dennis. I remember when we when we dug into that and you used the word “dignity” for the first time. I loved it. However, everyone’s “why” can be different. So there's no judgment on whatever your “why” is “Dignity” became your “why”. That dignity is for the patient, for forgiving someone, and even for your team. Once you have your “why”, you take it and start thinking about the vision for your practice: What is the practice supposed to look like if we're here to give dignity back to people? What is the level and type of dentistry that you want to do that gives people back their dignity? What does the practice look like? What does that practice look like? Well, it looks like this: great. So how are we going to make it every day look like this? Well, every day we're gonna have to adhere to some values. What are some things that have to be in place every single day for every single one of us so we can promote dignity?

Dr. Dennis Hartlieb: It’s hard to get your core value crystal clear where it’s not just some fluff. It’s been helpful. I did it previously, but that was without the help of a coach, which was difficult. Who is going to make you dig deeper and get through the fluff? To our dentists who are reading this, once they settle in on their core value, which is their “why”, then they can start drilling in on operational core values, right? Would that be the next thing for them to concentrate on getting.

Geri Gottlieb: So, it's the vision piece. That “What is this practice thing to look like in order for me to do that?”. Now sometimes, I find if people are struggling to verbalize or come to the vision or even the ”why”, I will flip it and say, “Well, maybe you can answer a few key questions that helped to formulate core values, and that might then lead you to be able to articulate the vision.”

Dr. Dennis Hartlieb: Can you give us those key questions?

Geri Gottlieb: Yes, one of those key questions are “Why do we exist?” and “Why do we, as a practice, exist?”. We can say “We exist to bring people dignity.” That's simple.

Dr. Dennis Hartlieb: Right. So, it wouldn't be appropriate say we exist to do dentistry for our patients. Is that too superficial? Do you have to dig down deeper into why?

Geri Gottlieb: Yes, that’s too superficial. Right. And this is like asking, as Patrick Dempsey defines it, “Is the organization or the practice core purpose beyond making money?”.

Dr. Dennis Hartlieb: So making money is fine and important. We make money to exist.

Geri Gottlieb: Yes because you are a for profit business.

Dr. Dennis Hartlieb: So then why and how is my individual “why” the corporate “why”?

Geri Gottlieb: That’s a tough one. Your individual “why” might not be the leading “why” if you have a practice partner. But even for your own practice, your individual, “why” is going to be different than every person on your team. We all have a “why” for what we do. Your “why” drives the bigger purpose and the vision. So, it's definitely a part of it, but “why” is more individual to you and the practice you lead.

Dr. Dennis Hartlieb: So number one is again, “Why do we exist? Why do we exist corporately?”.

Geri Gottlieb: Yes, the next one is “How do we behave?” And this is the tough one because this is where the core values come into play. As Patrick Dempsey puts, there are limits of diversity that can exist within an organization or what's called a practice. There need to be core values that all employees must share, and this goes back to the kind of culture you have. So in my own practice, coaching and development, you know, my “why “is one thing in my vision for my business. Your why can be a certain size, feel a certain way, or engage in the world a certain way. But then you must define you are going to make your why actionable? For example, I put growth and development as a core value. That means myself, and anybody on my team, better absolutely love learning, growing, and being challenged to be better and think differently all the time. It's going to look like going to continuing education. It's going to look like reading books and listening to podcasts. It's going to look like honing our skills at what we do. That's a way that we behave.

Dr. Dennis Hartlieb: So the behavior or the way we're going to behave is based on the core values that the dentist or the leadership team has defined for a good practice.

Geri Gottlieb: Correct.

Dr. Dennis Hartlieb: Now, the one thing that I learned that I think was super valuable for me as an owner was letting somebody move on to their next opportunity, i.e. firing them. That was always difficult for me until I understood that it wasn't about me and that person. It was about that person's values and how they fit into the practice’s core values.

Geri Gottlieb: Yeah.

Dr. Dennis Hartlieb: And that realization made it so easy. It's like saying “Your values, the way you behave, the behaviors that you're demonstrating are not in line with our core values.”

Geri Gottlieb: Right.

Dr. Dennis Hartlieb: Personally, in my practice, it has taken us a long time in our practice to work through our core values. And we've had to redo our core values to make them even more clear. And we're still working on them. And we've been doing this for a year now. We've sort of been digging through everything else that we have to do.

Geri Gottlieb: Right. Because it's really easy to especially early on, because this is not the work that dentists all love to do. Tell me how much fun you had with this?

Dr. Dennis Hartlieb: I don't enjoy it.

Geri Gottlieb: Right. But we have to be willing to do this work. Otherwise, you're going to continue to get frustrated with your practice. If you're frustrated with your team, you're going to continue to feel that way. And certainly, we're never going to be perfect. But when you're able to have conversations that aren't about yourself, but they're about the core values and the work that we're doing here, it’s a choice to take on this work. It's OK if you don't want to. This work is hard, and it's easy to get stay on the surface. So, often, you hear things that people's core values are things like “You got to have integrity,” or “You've got to be nice,” or “You got what it's like.”

Dr. Dennis Hartlieb: “We want it to be fun.”

Geri Gottlieb: Right, well, what does that mean? What does that look like? Let's define your core values. Let's define your vision. But these core values have to be true and actionable. And defined by you and by the business. So, what I might think is fun might be very, very different than what you think is fun. So, if I say that fun is one of the core values of GG Consulting, what does that mean?

Dr. Dennis Hartlieb: Ping pong tables and foosball tables.

Geri Gottlieb: No, that's not what it means for me. Even if I don't define that and I bring in ping pong tables and foosball tables, my team is saying “But we want a pool table. But you said this was fun?”. This is my definition of fun. That's why it has to be defined as to be defined by you, not what the Webster's dictionary says. What does “We will have fun,” mean to you? And then what does it look like when you're doing it?

Dr. Dennis Hartlieb: One of the things that we learned was that we need the team to sign off on these. They have to say, “Yes, our values are in line with the corporate values and the office values.” Once they sign off on that, then people are accountable to those values, correct?

Geri Gottlieb: Correct.

Dr. Dennis Hartlieb: That was an important thing for me to learn: the process of creating the values, defining the values, and then having people sign off on those values. You have to say “Do you buy into this or not? Because if you don't, then you're not going to be a good fit for us and you’ll be unhappy.”

Geri Gottlieb: I had a related experience not too long ago. It was actually super refreshing. I had a team that had been practicing a good 10 years or more. The doctor had never talked about any of this. He had a lot of ideas, but he had never done the work to make it become reality. Then he made a clear vision and defined his values. Some of the people on his team were like “Oh, whoa, I never knew that’s what you wanted.” There was a newer hygienist who he had hired who and thought was going to be a rock star in his practice. She was smart, fun, young, and energetic. She took in all of the new information from the dentist and said, “Thank you so much for clarifying your vision. I actually had no idea that that's what you were looking for. So no wonder we were clashing from time to time. I would think I was operating within your vision, but I wasn't. What I've also come to realize is I actually don't want to operate within that vision. Like, I don't actually want to be that invested. I don't want to. I went into dental hygiene to have an easier career, make good money, and work part time and. So, I realize I'm not a fit for you and you're not going to be a fit for me.” There were no hard feelings. The dentist was disappointed that he has to find another hygienist, but otherwise it was great. Because he had never clearly defined his values, these clashes with a hygienist were occurring.

Dr. Dennis Hartlieb: Yeah, interesting. So tell me what the third thing we need to consider while defining our core values is.

Geri Gottlieb: Number three is “What do we do?”. So, we know for we do dentistry. But what does that mean? Because maybe how you do dentistry, Dennis, is different than how the person down the street is doing dentistry. We do dentistry. We take care of people we know. We do ‘A’, ‘B’, or ‘C’.

Dr. Dennis Hartlieb: A lot of people say, “Well, we do great dentistry,” or “We do excellent dentistry.”

Geri Gottlieb: How would anybody know?

Dr. Dennis Hartlieb: Right. So, at my practice, we looked at terms like “precision” or “precise”.

Geri Gottlieb: Yes.

Dr. Dennis Hartlieb: We talk about engagement and things like that. So, again, trying to stay away from the fluff and dig in deeper because, you know, superfluous words like “excellent”-- what does that word mean to me and what that means to somebody else? But when you talk about precision, that’s something measurable and actionable. Going through this process of defining the core values is really challenging because you've got you have to get to the true essence and not the not the superficial stuff. And that's really tough.

Geri Gottlieb: Well, absolutely. It is tough. It's hard. It's hard for me. It's hard for me as a business. And I coach this. I think another mistaken idea is that our vision and our core values are meant for the public’s eyes. This is what we're telling patients or potential patients that we do. This is what we're telling other people that we are. So, we've put mission statements and vision statements and core values statements out into the world on our Web sites. And we don't actually pay attention to them, live them, and don't even talk about them. We made them because some consultant or coach made us do this assignment. And then we never look at it again. The process we are discussing today is different. What makes this very different is this is internal. Now, you might have some of this on your website. As do I. But it's defined a little bit differently. It’s better at being lived out. This process is internal because every conversation that we need to have should be shaped by these core values and the vision. Whether it's about performance improvement, whether it's about are we going to paint the walls or not, the type of equipment we're going to buy, the way we're going to engage when there's conflict in the in the practice or we can't decide on something. We use our core values to guide these conversations. In our practice, it's not a flowery statement. That’s why we dig deep.

Dr. Dennis Hartlieb: I think I didn't believe is that the team members need structure. They need to understand the boundaries. So, I was I was always afraid of having sort of these behavioral boundaries and stuff like that. But we need that culturally. People are just doing this or doing that and doing that. Next thing you know, you have a business where who knows what you're going to expect when someone walks in.

Geri Gottlieb: Absolutely. B we all define things from our own interpretation, our own background, our own upbringing, or any number of variables. So even a word as simple as “fun”, as we discussed earlier, might mean something totally different to different people. So you've got to be clear about what your values and vision mean to you. Then the next piece is “How will we succeed?”. So we're going to take these core values and combine it now with strategy. What are those strategic things that we're going to do and how? Make sure that our strategy aligns with our core values. That’s where policies and systems come in. That's where strategic things that we're going to decide to do. Like marketing and how we’re going to market? Or maybe we won’t do any marketing? How are we going to define who our ideal patients are that we want to treat? How are we going to engage in the community? How are we going to handle our finances? How are we going to control our overhead? What are the metrics? We're going to be looking at some of these things that we talked about before. That's the strategic pieces. But we're not going to do any one of these separately and succeed the way that we probably want to.

Dr. Dennis Hartlieb: I think most businesses just go right to how will these talks succeed without having the groundwork done to make sure that the vision is clear or that the values are accepted. Everyone just jumps into that.

Geri Gottlieb: Absolutely, because that's what you've been taught. That's what you know. I think one of the most important things that I want to reiterate to you and every other dentist and business owner out there is that this stuff is hard. It sounds like it's the soft stuff, but this is actually the hard stuff. You know, the other pieces like “How am I going to do the dentistry? What equipment am I going to buy?” are actually easier dentists to do. That's what you went to school for. Then you were given a loan and opened a practice and told to put humans in it. And it's just these are these two pieces, the visionary piece and strategic piece, have to go together. That's why I don't cookie cutter coach. I always start with this foundational piece. And your core values have got to be really clear for me to coach you because I would just tell you “This is the system that you need to have. This is how those systems need to look. This is how you should do all of your financial arrangements. This is the type of equipment you should buy.” I would never coach you on the equipment. Instead I will ask you “Why?”. Then try to understand how you might carry out your “Why?”. Dennis, I will use your “Why?” as an example. If your core values are to bring and restore dignity to patients, I would ask you how you would do this. I would never advise you on equipment without understanding your “Why?”, but when I understand that dignity is part of your core values, we can have a conversation about interoral cameras and the use of them and why you would use them to align with your values. You can have that conversation with your team when they're pushing back. For example, if your hygienists say they don't have time to pull up the interoral camera or feel that it gets in the way, you would revisit your core values. You would say “We're here to restore dignity. One of the things that moves people forward to make choices that will bring them dignity are visuals.” So that's why the foundational piece is the harder work. Then we have the strategic side of things.

Dr. Dennis Hartlieb: This is fantastic. You know, we want to sort of close it up, but one of the things we keep coming back to is the “Why?”. One of the one of the best books that I've read on businesses, Simon Sinek’s book, Start with Why: How Great Leaders Inspire. This is a great book for young dentists or any dentist who's sort of struggled with the culture in their practice. Another great book is The Advantage by Patrick Lencioni, which complements Simon Sinek’s book. I think these books were very instrumental for me even though I read them after I had been practicing a long time. I still needed to learn how to make a culture healthy. And we are still working at it. So I don't want to I don't anyone out there to think, “Oh, doctor, Hartlieb’s practice is going to be awesome!”. We're still working on it. So I would I would encourage dentists and dental students to pick up both books I mentioned.

Geri Gottlieb: Yeah, absolutely. Students if you start your practice or are going into an establish practice, it is good to be pretty clear on why you want to do it, what is important to you, and the vision that you have for that practice. You also need to know what values you're going to need to have in place for almost every other decision that you have to make about your business. This will make leading your practice so much easier. And it’s way easier to do it before the train is already full speed ahead. This work is even harder when I'm making you pull back.

Dr. Dennis Hartlieb: Thank you again for chatting with us Geri! We look forward to our next discussion about how to build a team and making a fresh start in a post-COVID practice.

Dennis Hartlieb, DDS, AAACD

DOT Founder

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