A Case Study on Employee Communication

In the dental office, open communication between practice owners and staff ensures an efficient workplace, reduces employee turnover and helps mitigate potential employment-related claims. Failing to communicate office policies and expectations properly or effectively can lead to difficult situations.

In one case reported to The Dentists Insurance Company’s Risk Management Advice Line, an employee was hired as a full-time registered dental assistant. She was instructed to write down eight hours on her time card, regardless of the actual hours worked. She was also asked to report 15 minutes prior to the start of her shift for a mandatory daily huddle.

Although the employee was not happy about these requests, she complied because she needed the job. Ultimately, the employee became fed up with not being paid for the actual hours worked. After a few months, she began to record her actual hours on the time card. The payroll program used by the dentist removed any overtime entries that were not marked as approved by the dentist. The employee questioned the dentist about the missing overtime on her paycheck and was told that his office policy is not to pay overtime unless prior approval is obtained. However, he had not previously informed her of his office policy regarding overtime.

To make matters worse, the office manager changed the employee’s schedule, resulting in a reduction of hours. The manager also changed her position from RDA to DA without prior notice or any discussions with the employee. The employee contacted the office the following week and informed them that she would not be returning to work. Two months later, the office received a letter from an attorney representing the former employee, who alleged a hostile work environment and failure to pay overtime. Eventually, the case was settled through mediation for a high five-figure amount.

When communicating with employees, TDIC recommends that practice owners be clear, direct and decisive. This should begin with employee onboarding and continue through the duration of employment. A good starting point is a comprehensive and up-to-date employee manual. In addition, new employees must clearly understand the practice's vision, goals, policies and procedures.

It’s also a leadership best practice to clearly outline each employee’s role and responsibilities. Each position should have a written job description and written expectations, and these expectations should be discussed with the employee in person to ensure understanding. This establishes accountability and increases motivation and performance for each member of the team.

Communication Climates and Your Practice

Communication and behavior experts categorize interactions in terms of climate. A confirming communication climate is one in which the receiver gets a sense of their value and worth from the messenger. Conversely, a disconfirming communication climate suggests to the receiver that they are devalued and unimportant. Disconfirming climates lead to negative behavior patterns that impede communication, such as defensiveness, embarrassment and conflict, while confirming climates lead to positive behavior patterns that support effective communication, such as honesty, appreciation and collaboration.

Defensive communication behaviors are particularly important to avoid, because as one individual becomes more defensive in a conversation, they become less able to accurately perceive the other individual’s messages. Both sent and received messages then become distorted. The opposite is also true: defense-reducing or supportive behavior fostered by a confirming climate lead to fewer distorted

Creating a Confirming Communication Climate

messages in a conversation. The resulting communication is clearer and more effective, supporting more teamwork and less conflict.

An environment in which patients feel safe, understood and willing to cooperate is one where both provider and patient can benefit. The same standard is true for interactions with dental practice owners and staff members. Learning and adopting confirming communication strategies is one of the best tools you have for reducing risk.

In 1961, communications researcher Jack Gibbs identified six patterns of behavior that create confirming communication climates. These remain the gold standard for developing positive communication skills that de-escalate conflict and foster feelings of support and cooperation. Below are examples from TDIC experts that apply to interactions within a dental practice.

• Description. Describe a behavior instead of evaluating it. A description provides detail about the person’s behaviors without passing judgement.

– Disconfirming statement: “It’s rude for you to arrive late to your appointments.”

– Confirming statement: “I’ve noticed that it’s been difficult for you to make it to your appointments.”

• Problem Orientation. Focus on the problem you are trying to solve, separating it from the person with whom you are communicating. Rather than exerting control over the other person, problem-oriented behaviors focus on finding solutions that satisfy both parties’ needs.

– Disconfirming statement: “You should floss every day.”

– Confirming statement: “Let’s talk about some ways that we could make it easier for you to remember to floss each day.”

• Spontaneity. In terms of confirming communication, Gibbs defines spontaneity as honesty or transparency. Instead of hiding an agenda, the communicator is simply honest rather than manipulative.

– Disconfirming statement: “What are you doing on your day off?”

– Confirming statement: “Next Friday, we need extra staff members on hand to finish purging paper charts. You could earn overtime pay if you are able to come in to help.”

• Empathy. This is the action of responding to another person’s feelings by trying to understand the situation from their perspective. Being empathetic demonstrates that you value another’s opinions even if you don’t agree with them.

– Disconfirming statement: “This crown just needs to be replaced. It’s not a big deal.” continued on page 8