Hands on or hands off? In the past 13 years, working in offices of all sizes as an orthodontic auxiliary, I have witnessed a variety of management styles. One thing to point out before we get going, is that orthodontists are brilliant science geeks. They are not always, or even often, the best managers and quickly find that office management is not as easy as it sounds.

Let's reflect on two Docs I have worked with. For fun, we will call them Dr. Jekyll and Dr. Hyde.

Dr. Hyde was not evil like the one from the popular story, but he was extremely authoritative. He couldn’t help but micro-manage every aspect of his practice, especially the staff ‘below’ him. Nothing could be done without his approval or his initiation. My co-workers were like sheep, unable to think for themselves. This made for a very depressing, resentful, miserable work place. The only fun anyone was having was when they were comparing criticisms about the doctor. Needless to say, the undertone in this office was Doctor vs. Staff. Can you even imagine what the overall office culture was like to patients?

Dr. Jekyll was the polar opposite of Dr. Hyde. He was very warm and supportive of his team. Dr. Jekyll was the kind of boss that makes you feel special, gave you freedom in your role, and lots of positive feedback. Sounds pretty great, right? He encouraged the team members to bring new ideas to the table, and almost depended on it. They would present a multitude of new marketing or policy changes, but he had a hard time ever actually acting on any of them. More frustratingly, Dr. Jekyll was the lovable guy, so he had a very hard time addressing office conflicts. When problems brewed between team members, it was nearly impossible for him to step in and mediate resolution. So instead, he ignored it and issues festered for weeks and weeks. You know that feeling that there is a giant elephant in the room, but nobody wants to bring it up? This also created a miserable work place.

So we have two extreme but applicable management styles. Neither is going to retain employees or provide a positive, attractive practice culture. So what is the solution?

I came across a great article in HBR (Harvard Business Review, March 2016 edition) this month by Ranjay Gulati, the Jaime and Josefina Chu Tiampo Professor of Business Administration at Harvard Business School and Alicia DeSantola, a PHD student in the Organizational Behavior program. The article is titled, “Start-Ups That Last”. Three points really standout and relate to orthodontic offices.

1. Incorporate Structure. It’s difficult for employees to stay focused and engaged without guidance and processes.

2. Implement Plans and Goals. Without a framework of the doctor’s plans and goals for the practice, the employees tend to improvise, which translates into aimless riffing.

3. Support the Practice Culture. Endorse and articulate the founding values in meetings and job descriptions. Make sure to hire and reward for cultural fit.

Orthodontists are constantly working on their clinical technique. Don’t forget to take a second to look up from the chair and evaluate your own management skills. Ask your team, “What kind of manager am I?”