At the end of last month’s article on professionalism in dentistry, I indicated how important it was to value every member of the team at whatever level they operate. As I write this, the non-dental press has had a feeding frenzy about two members of the England football team who, it is alleged, no longer get on with each other. As a result, one of them has currently withdrawn from the squad. While this has nothing to do with dentistry, it reinforces the point that has been made on many occasions, it is important one ‘has a team’ and that the team is made up of people who are aligned to a common goal and who work well together.
I’m sure you will all be familiar with the key elements that make up a team, as well as knowing the benefits of having a team. We are often asked, however, ‘how do I create a team?’, ‘what can I expect when that team begins work?’, and ‘how should I, as principal, be behaving towards my team?’ You may even believe that, as there are less than 10 of you in the practice, you are automatically a team.
Let’s assume you know what makes a team, leadership, common ‘smart’ goals, people working well together, excellent communications, appropriate skills and equal levels of commitment and no serious internal conflicts. Let us also assume you are comfortable with your role as leader, and you have set smart goals the team understand. Let’s assume you’ve had a meeting, you’ve explained the goals that you want to achieve this month or year and you have sent them on their way. What can you expect?
In 1965, the psychologist Bruce Tuckman identified four main phases in the development of a team, which he called ‘forming’, ‘storming’, ‘norming’ and ‘performing’. While we may prefer a more ‘British English’ combination, it is clear each phase can be recognised by the way individuals think and behave and as a result, they require different help from the principal.
1. Forming
In the forming stage you, as principal, will have discussed with your staff the key elements of teamwork as identified above and told them about your ambitious goals and the help you are going to need to achieve them. These goals will benefit you, your patients, and all members of the team. Assuming you have created a good introduction, each member of your team will want to be accepted as part of the group and there will be limited conflict. However each member of the team will also have their own personal feelings about being a member of the team, and if your behaviour has previously been non team oriented, they may be ambiguous or sceptical about your approach. As a result, you need to clearly identify the team’s goals and objectives, engage with them about their expectations, establish good guidelines and procedures; in other words you need to use a directing style.
2. Storming
In the storming stage, the team will start to work on the tasks you have set and, as a result, you may start to see some conflicts begin to surface; these may be interpersonal and there may be questions of leadership and authority. You have to help them move to a problem-solving mindset. You may have to help them listen effectively, understand and appreciate different personalities and needs in the team and work out how to resolve issues when people do not get along. As principal, you will provide more of a coaching role, clarifying, persuading and explaining.
3. Norming
As you might expect, in the norming stage, team members begin to trust each other, share the leadership roles in tasks related to their specific skills and you will hopefully see evidence of creative thinking to solve problems. As principal, yours is now a supportive role, encouraging, listening and collaborating; you may have minimal influence in decision-making and this is a great place to be.
4. Performing
Performing shows the team as being highly flexible, very creative and the team members modify their roles to meet the requirements of the tasks with which they have to deal. As principal, you are now playing a delegating role, observing, monitoring and providing little direction; you set the goals of the team, the boundaries within which they have to operate, and away they go and deliver.
This state of nirvana does not last forever. A team operating at this level is such a help to the practice owner, he or she may feel they can walk away and leave them. Indeed that might be possible if the goals and incentives for the team are set appropriately. Too often though, delegation becomes abdication; the principal goes sailing around the world, trekking in Nepal or some other extended absence and without the sense of leadership, the team can disintegrate and all your hard work and their commitment can be lost much more quickly than it took to develop.
I will leave it to you to decide at which of these four stages the England team is currently. How they fare in the near future will depend on the role Fabio Capello as manager plays and the determination of the team as a whole to perform.
For your practice, the key questions are: do I have a team, what stage are they at, what do I need to do to raise their game, if I don’t have a team, do I want one and how will I survive without one?