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October 1, 2021

How to Encourage Accountability! Part 1

Just hearing the word accountability often results in a big sigh, rolling the eyes and that ugh feeling.  Let’s face it cultivating accountability can seem like a daunting task.  What usually pops into mind are the words babysitter or micro-manager from past failed attempts at trying to get others to be accountable. We often give up after two or three attempts to hold the person accountable.  We feel that the effort isn’t worth the frustration.



However, without accountability, execution suffers.  Performance deteriorates when we don’t hold ourselves or others accountable to getting work done well and on time. The more we let things slip the more acceptable it becomes to let them slip again.  A day becomes a week, a week a month and finally not at all.

I am often asked by my clients and audience members; “how many times do I have to ask or remind someone?”  My response is always until they do it or you let them go.  Otherwise, your culture reaps the result of lower performance.  Culture always starts with the leadership team.  It is either what leadership does or allows which becomes viewed as accepted by the team.

There are always consequences when there is lack of accountability to the patients, practice, and team.  Therefore, there must also be consequences to the person who is not being accountable.

Without it, it is difficult to get people to assume ownership of their own actions because they believe they will not face any consequences.

Here are ways leaders can demonstrate and encourage accountability.

Establish clear job expectations.  What are the daily, weekly, monthly, and yearly expectations?  I like to use S.M.A.R.T. Goals

  1. Specific
  2. Measurable
  3. Attainable
  4. Relevant
  5. Timely


Communicate daily and address any concerns immediately.  We often let things go a few times before addressing.  The concern is once something is allowed (not addressed) it is considered acceptable.  Nip things in the bud as soon as they happen.

Have constructive conversations.  Notice I did not say constructive criticism.  I have yet to find anything constructive about criticism.  A constructive conversation starts out with what you appreciate.  For example, “I really appreciate, or I really like that you did ____…And I would add ______ to make it even better.”  Notice I used the word and not the word but.  The word but negates what was previously said.  The word and builds on what was good.  Three positive comments to one growth opportunity make a good conversation.  Five positive comments to one growth opportunity make a great conversation!  We want to build our team up and make them feel more confident.  Confidence helps nurture accountability.

Read November’s Show Your Shine for Part 2 of How to Encourage Accountability!

October 1, 2019

Your Team Is Your Greatest Asset… When You Invest in Them! Part 2

In Part 1 we covered how YOU can get your team aligned and engaged to become your greatest asset.  In Part 2 we will cover how to empower them so THEY can become your greatest asset!

Have team meetings and discuss with your team the core values of the practice.  Together define what it means in words in actions.  Make agreements as a team that support the core values on how you will communicate, work together to serve each other and the patients.  Establish as your number one standard that the team treat each other as well or better than how they treat their patients.  It is vital that you do not set double standards for how the team treats each other versus how they treat the patients.  Print the standards and store them in a binder accessible to the team.  Keep them alive by reviewing them at huddles, team meetings or when hire someone new or when someone’s behavior deems it necessary.  Everyone helps everyone support the standards by holding each other accountable once the agreements are in place.

Some examples of standards:

  • Greet and smile at each other in the morning
  • Ask for help
  • Ask don’t assume
  • Offer help
  • Say please and thank you
  • Don’t gossip
  • Be kind



Empowerment happens with clear training and implementation processes.  We need to let go of perfection and instead strive for excellence.  Proficiency comes after mistakes and leads to excellence.    “Unless we try to do something beyond what we have already mastered, we will never become what we might have become!”

  • Set high standards not impossible standards
  • Learn from mistakes and move on
  • Share what will be done differently

Have a clear and consistent training process.  Which means the team does tasks the same way.  So often times I see team members choosing how they will complete a task based on what they think is right.  Or because it’s how it has always been done.  Or it’s just someone’s opinion…usually the most vocal team member.  Often times there hasn’t been a formal team meeting discussion defining and agreeing on how the system or process will be done.  Utilize the R.I.S.E. Process to successfully implement new ideas and create clear and consistent systems and processes.

Set realistic weekly training goals for you and your new employees to measure their progress.  Base training expectations on the average time it took for an employee to learn instead of the quickest time.  It will help lessen new employees feeling overwhelmed and allow them and the team to measure their progress.  Have a constructive conversation weekly with the new team member discussing goals, expectations and accomplishments instead of criticizing what they are doing wrong.  Catch them doing things right and highlight them at a minimum of 3 positives to every 1 growth opportunity.  Exceptional relationships are built on a 5 to 1 ratio.

Our life, the people in our life and our circumstances continue to change.  Therefore, it is necessary to continue to invest in learning and training to continue to grow.  Where are you in your growth process?  What is working what has changed?  What investment would make the biggest impact in your team being your greatest asset?  Your team will be your greatest asset when you invest in them.

Email Judy Kay at to learn more!

February 1, 2018

Say Bye Bye to Fly-Bys!


Say Bye Bye to Fly-Bys!

This message is focused on developing a We Team decision strategy to avoid fly-bys! Let’s by start by illustrating a fly-by.

Foundation of a Fly-by!

It’s another busy day! Doctor you just stepped out of treatment op 1 and are hurrying to hygiene ops 3 and 4 to do checks that have been waiting for at least 10 minutes. The hygienists have buzzed, messaged and are now tapping their feet with impatience. You avoid eye contact with the three team members (office administrator, assistant and hygienist) lining the hallway as you know they are all waiting for you. A blur of questions assault you as you pass by them. “Doctor can I…, Doctor what do…, Doctor how would…!” All you want to do is get to the hygiene rooms before the hygienists get more upset. So without lifting your head you mutter responses on the fly…yes…no…do this starting now. You’re not even sure what you said or to who. All you know is that you cleared a path to get to the next room. You have just successfully completed another fly-by.

Fly-bys may seem like an effective and efficient resolution but can be very toxic to the team and practice culture.   There is no time to process benefits and consequences, get team feedback and input or discuss with the entire We Team (leadership team).   A new standard or process is put into place with a few sound bites of discussion with the one lucky or unlucky team member who happened to ask the question. Everyone else on the team including the other members of the We Team are unaware of the decision and new process. In a short time, the We Team will no longer be cohesive and the team will start to doubt what the standard is for the day. The team will no longer fill confident or empowered to take even the smallest action without asking questions. This will result in consistently fueling an even longer line in the hallway. If you hear your team say ask each other; “do you know if we are doing it this way today,” you know fly-bys are happening. Fly-bys fuel incompetence, uncertainty and divide the team. Doctors, fly-bys are neither effective nor efficient.

I would like to introduce my W.O.W. Decision Making Strategy.

W.O.W. is an acronym for weed out weeds. A weed is anything that does not benefit the patients, practice or the team. W.O.W. Decision Making gives the We Team a positive, practical and proven decision making strategy. The results are decisions that are consistent, fair and support the team, the patients and the practice.

The W.O.W. Decision Making Strategy is based on the following concept questions:

  • Patients, Practice & Team
    • What’s in the best interests of Patients, Practice and Team – not any individual (including doctor)
  • Practical
    • Does it make common sense
    • Is it realistic with resources available regarding Time, Money, People, Or are you willing to invest
  • Precedent
    • What precedent is being set? If it is done once for one team member, it becomes the expectation for entire team. If it is not across the board, it will feel like favoritism or inconsistency and, therefore, it will be unfair. Only say “yes” to what you want to set as a precedent.
  • Passionate
    • Is the We Team passionate enough about the decision to defend it – even to the point of possibly losing a patient or a team member? I suggest not implementing anything that the We Team thinks it is just a “nice to do”! “Nice to do” won’t be worth defending if the practice could lose a patient or team member. On a scale of 1 to 10 with 10 being high does it rate 8 or above. Don’t implement anything that does not rate at least an 8 or you will not be willing to sustain the change.

Team Behavior Decisions

When we don’t see the results we desire from a team member we get frustrated and tend believe it is a behavior issue that warrants consequences. However, before we take any action we need to identify whether their lack of performance was truly a behavior issue. Maybe it was an issue with training, expectations, or communication that caused the problem. It is critical to not just react to what you think it is because you really don’t know. This is why it is so essential to meet with the team member and ask questions. The reality is that we could clear the majority of our team problems if we just asked questions. Schedule a time to meet with the team member and ask them questions to verify if:

  • They have been trained to do the task
  • They were clear on what was expected
  • They were clear on what was communicated

In many cases you will find it is either a lack of training, expectations or communication and not behavior that causes the performance problem. If that is the case the ownership lies on the person delegating and not the receiver of the task.

Utilizing W.O.W. Decision Making Strategy will help you say good bye to fly-bys and cultivate a happier, healthier and more cohesive We Team, Team and Practice Culture!

March 1, 2016

How to Prevent 3 Communication Pitfalls!

Our level of success in life is in direct relationship to how successfully we communicate. Communication can often be difficult and sometimes very frustrating. When we don’t say anything, an assumption is made – and in most cases, it’s negative. If we do say something, it may be perceived incorrectly. If that is not enough, there are all the “shoulds” from others – their comparison expectations on how we should do something, or be something or live our life a certain way. In other words, their way!

Because of assumptions, perceptions and comparison expectations we often make commitments to either do things we don’t want to do or don’t have time to do. Just writing this makes me feel exhausted! Wouldn’t it be nice if we didn’t have to worry about communicating? But that is not reality.

Our success in life depends on our ability to communicate. Therefore, it is necessary to learn how to communicate and overcome these pitfalls regardless of how frustrating or difficult they may be. I have found from years of coaching dental teams nationwide that the best way to get good at something is to remove or overcome the obstacles.

Let’s start with assumptions. This one is a biggy! We make assumptions every minute of every day. Something happens and we instantly assign meaning to it. It may be correct or it may be incorrect. We won’t know unless we take the next step. That step is asking. Sounds easy but it’s not. We often fear that if we ask, we may open ourselves up to an emotional reaction. We can’t let fear stop us from asking. We don’t know what someone meant by their actions or words or the way they said something. Sometimes even what they say or the words they use can mean something different than what we believe them to mean. Ask with care, concern and respect. Continue to respectfully ask questions until you understand the other person’s true intent. If you are still thinking “I think they meant…”, you are assuming and it is important ask more questions to achieve a clear understanding.

Perceptions are just as dangerous as assumptions. Both the person speaking and the person listening play a role in perceptions. I often hear team members say, “I didn’t mean it that way! They just took it wrong! So it’s not my fault!” If you are always being misunderstood, it is important to reflect on how you are communicating. It is not just what you say that counts in communication. It is also how the message is being perceived. The listener often bases their perception on their past experiences they had with you as well as your words, body language and tone of voice. They often assign meaning based on what it would mean if they said or did that same thing, which in many cases does not accurately reflect the other person’s intent. Inaccurate perceptions also happen when we don’t hear the entire story or all the reasons or steps. It is important to take the time to clearly explain your intent to avoid false perceptions.

Comparison Expectations create negative expectations! They are the “shoulds” that guilt us into doing things we aren’t comfortable doing or feeling terrible about ourselves when we don’t. We have all heard and even said, “You should….!” Comparison Expectations happen when we compare ourselves to others…or when others compare us to them. The comparison is what creates the expectations for who, what, when where, why and how we should do something based on what others do. Comparing is toxic; someone always loses. We may even believe that others are wrong when they don’t do something our way. Comparison expectations can make us feel or do something out of guilt. Guilt creates shame and shame inhibits communication because if we feel shameful about something, we are less likely to communicate openly and honestly. Stop the comparison noise! Quit allowing the “shoulds” from yourself and others to dictate your actions AND quit expecting others to do things your way. Instead together as a team create clear standards and support them!

(If you would like to receive the white pages for Team Communication Guidelines please email me at and write Team Communication Guidelines in the subject line.)

Our success in life will depend greatly on how well we communicate in our personal and professional lives. Communicate clearly, ask questions to avoid false assumptions and perceptions and for goodness sake…stop “shouldng” on each other!

December 1, 2015

5 Core Culture Characteristics that Nurture Change!

December 2015

5 Core Culture Characteristics that Nurture Change!

You may have heard the quote; “The only thing that is constant is change!” It is true, change is inevitable but not always positive or successful! The reality is that some work cultures support positive and successful change, while other cultures sabotage change. There are many factors involved, such as team workload, other current changes in progress, team beliefs about change, clear communication about the change, benefits of the change, appropriate training, coaching and support provided during the change, etc.

I help dental teams nationwide successfully embrace change. This month is dedicated to learning how to create a culture where change can be a more positive, successful and sustainable experience!



Change requires us to have courage to face our fear of the unpredictable unknown! Regardless of how dysfunctional, unhappy, unproductive or toxic the current culture may be it often feels safer to keep the status quo. The known almost always feels safer than the unknown. That is why the value of the change must be clear to those expected to make the change. It is important for the value and benefits of change to rate an 8 or above on a scale of 1 to 10 with 10 being high. Otherwise, the chance for the change to be sustained is limited.

After working with dental teams for many years I have found 5 consistent characteristics in the cultures that support positive and successful change.

  • Trust in leadership
  • Clear and consistent direction
  • Structured plan
  • Adequate training and practice time
  • Realistic workload

The number one core characteristic that supports change is trust in the leadership. If the team members trust their leader(s) they will be more willing to step into the unpredictable unknown. Leaders can build trust by embodying the following traits:

  • Model the waddle is the number one leadership principle – in other words lead by example
  • Have a clear and consistent direction
  • Be transparent and keep the team in the loop as much as possible
  • Be open to suggestions and feedback
  • Address any obstacles, fears or concerns the team may have

The second core characteristic is to communicate a clear and consistent direction. It is important to use a decision strategy to avoid emotion driven decisions in the heat of the moment. I teach the following four strategic steps:

  • What’s in the best interests of the patients, practice and the team – not any individual and long term
    • Think about 10 months and 10 years instead of next 10 minutes or 10 days
  • What is practical and realistic based on time, people and money currently available
  • What is the precedence being set – if we can’t do it across the board for everyone on the team it will feel like favoritism and divide the team
  • What is the level of passion which we are willing to support the decision – will we support it when push comes to shove even if it may result in losing an employee or a patient

Set your team up to succeed by delegating the change clearly and concisely. I suggest the following delegation process:

  • Clarify expectations
  • Ask questions to make sure everyone understands
  • Write objective down in bullet points if more than a couple of things
  • Set expectation of completion time and date
  • Under promise and over deliver
  • For more involved longer tasks schedule a check in

The third core characteristic is for leadership to work with the team to develop a well-structured plan. If you want the team to embrace a change ask for their suggestions and feedback on how to implement the change. If you want the team to have ownership give them authorship as well. A well-structured plan is well thought out and clearly defined. I teach teams the R.I.S.E. Implementation Process to help them work together to create a well-structured plan. R.I.S.E. is an acronym for Review, Implement, Sustain and Evaluate.

  • Review
    • What is it we are currently doing
    • WIIFTT – What’s in it for the team if we make the change
      • It is important for the value/benefits to rate an 8 or above on scale of 1 to 10 or it is difficult to sustain
  • Implement
    • What are we going to change
    • Who is going to do it
    • Who are we going to do it for
    • When are we going to do it – including time, sequence and flow
    • Where are we going do it – very specific location
    • Why are we going to do it – WIIFTT if we make the change – there must always be something in it for the team for the team to sustain the change
    • How are we going do it
      • Practice verbal skills
      • Practice role playing – yes I know it’s weird but it’s effective
      • Practice the entire physical walk through – never test it out for the first time on a patient
    • Create standard operating procedures
    • Schedule the roll out date
  • Sustain
    • In order to sustain it is important for the new change to become a habit
    • It takes a range of anywhere between 17 to 257 days to form a habit depending on the difficulty with the average being 66 days
      • Give any new change at least 60 days to get comfortable before considering any changes
    • Be precise and consistent to make the change become a habit much sooner
      • Same sequence and steps for every team member every time
    • Support the change positively in words, actions and attitude
  • Evaluate
    • Is the process still working effectively
    • If not what is the value and benefits in a change
    • Any change takes ongoing tweaking

The fourth core characteristic is to schedule appropriate and adequate training and practice time. I have found that the most positive and successful changes happen when the team has time to train and practice.

Team meetings are the perfect opportunity for training and practice time. Utilize your team meetings to:

  • Update systems/protocols
  • Implement new ideas
  • Monitor yearly goals
  • Practice, practice, practice
    • Verbal skills, role playing and physical walk through

Team meetings are more effective when you:

  • Schedule often enough
  • Schedule time enough
  • Schedule when most can attend
  • Get feedback from the entire team
    • Encourage solution focused suggestions on how to overcome potential obstacles

The fifth core characteristic is to be realistic with the workload. It will be very difficult to get the team excited about embracing something new if they are already swamped and consistently running behind. It is important to evaluate whether there is enough time, money and people to implement the change successfully. Even the most committed employees will become resistant to change if they are consistently overwhelmed.

Embodying these 5 core characteristics will nurture a culture where change becomes a more positive, successful and sustainable experience.

October 1, 2013

The Cost of Trust

One of the biggest signs of low trust is when the leadership team has difficulty getting the team on board and excited to follow their lead.

Imagine a culture of trust where:

•             Leadership was by example

•             Everyone could rely on each other to work together for the greater good

•             Co-worker’s didn’t question each other’s intent

•             Open communication was the standard

•             Gossip ceased to exist

•             Accountability was self-maintained

•             Honesty was the only policy

Trust is the foundation of a happy, healthy, and high producing culture.   There is a cost to low trust! 

How much more productive would your practice be if your team truly trusted each other?

The dictionary defines trust as instinctive unquestioning belief in and reliance upon something.  The culture of trust I am suggesting is not one of blind faith but instead one of confidence!  Confident trust is based on good reasons, definite evidence or past experience.

 Think about the people in your life that you trust the most.  Why do you trust them?  Confident trust does not just happen overnight.  It takes time to nurture and grow.  However, breaking one’s trust can happen in a heartbeat.  The great news is that building trust is a skill set that can be learned.  Once we can learn how to build trust we can prevent trust breakdowns!

I would start by having a team meeting to talk about the level of trust in your practice.  Discuss the benefits of having a culture of trust.  It is also important for the entire team to understand how much a low level of trust affects the practice and the bottom line.  Such as having to add steps to compensate, extra staff to cover for lack of accountability, and redundant systems and processes.

 Let me give you an example of low trust with patients.  You may have some patients that no show or cancel last minute.  Therefore, you decide to implement the following protocol:  All patients must sign a form that states they will owe $ if they don’t show or cancel last minute unless it is an illness (with a doctor note) or death in the family.   The cost is that now all patients are subjected to a protocol that shows you no longer trust them and makes them feel unwelcome…which could ultimately destroy the relationship resulting in them leaving the practice.  It is an insult to your patients who are responsible and accountable and the ones who are not will just ignore it!  The same holds true with your team.  When you add extra steps for everyone to compensate for the inadequacies of the team members you can’t trust…you may end up losing your good team members.

The next step is to ask the team to share what they feel they need from each other to build trust.  Use a large easel pad and write down all the answers being shared by the team.  Cross out any duplicates.  

Some examples might be:

•             If you have an issue with me talk to me first

•             Help me when you see I need help

•             Finish what you say you are going to do

•             Focus on the greater good instead of WIIFY

•             Tell me the truth but be compassionate

•             Don’t be late or absent for trivial reasons

 Put your list together and label it Trust Culture Guidelines.  Next print it, frame it and put on display for future reference.  It will be important to review whenever you hire someone new or…because old habit die hard; whenever someone’s behavior deems it necessary!

Ta-dah…your team has just established their guidelines on how to build the level of trust in the practice!  The awesome part is that when people create it they own it!

The bottom line is that trust is not just a social virtue it greatly affects your bottom line!