Originally published in the April 2002 Dental Practice Report. Copyright 1999-2002 Medec Dental Communications.
If your practice suffers the "it's-not-my-job" syndrome, you may need to more clearly spell out each team member's role. Below are guidelines
for writing a thorough, effective job description.
by Deborah Odell MBA
"I'm so frustrated," reported a client recently. "Every night before I go home, I walk through the office and find trash left in the trash cans. I've told the staff over and over that it's everyone's responsibility to make sure the office is cleaned and ready before anyone goes home."
"Who is specifically responsible for taking out the trash?" I asked.
"Everyone knows it's supposed to be taken out! They just refuse to do it and I end up taking it out!"
"Let me ask this another way: Which job description has taking out the trash as a primary responsibility?" With that question came a long pause.
Taking out the trash may seem like a silly thing to get upset about, but the fact of the matter is, this doctor, along with many others, is struggling because of unclear job expectations. Without clearly defined roles, the attitude of "It's not my job, someone else should be doing it," has the potential to spill over into other areas of the practice. And it can lead to frustration. In this case, the doctor believed no one cared about the practice. After all, if they cared, wouldn't they make sure the trash was taken out?
In truth, if "everyone" is responsible for the trash, "everyone" will think someone else will take it out. This type of conflict occurs in practices regularly, and it's just one of several reasons to develop and implement clearly defined job descriptions for each position in your practice.
It clearly defines the job you are trying to fill. When you are recruiting and screening candidates, you can compare the candidate's experience, education and other qualifications to the position requirements outlined in the job description. It can guide you as you write a "help-wanted" ad. The job description also establishes a standard definition of the position so that you can more accurately determine the "going rate" for an equivalent position in the marketplace. For example, in today's competitive labor market, a candidate for a front office position may be looking at administrative assistant positions in other industries. If the two job descriptions have similarities, which they do, you now can determine a compensation package that will attract a broader range of candidates.
A job description helps determine training needs. It identifies the skills needed to accomplish the job tasks. You can use the list of skills to determine areas in which your employee needs to improve and build an effective training program based on specific skills and tasks. X-ray certification is an excellent example. In order for an assistant to satisfy the requirements of the position she must either enter the job with X-ray certification or begin a training program to gain certification in a pre-determined amount of time.
It helps determine the essential and non-essential components of the job. In order to remain in compliance with the Americans With Disabilities Act (ADA), "reasonable accommodation" must be made for individuals with disabilities. That means if an employee can perform the essential job functions, with or without reasonable accommodation, that employee is qualified for the position. Written job descriptions clarify each position's components, thereby reducing the risk of discrimination claims based on non-compliance.
It defines the criteria against which an employee's performance is measured. Performance appraisals should be based on the measurements of task accomplishment. If you don't know exactly what an employee is supposed to be doing, how can you measure whether she/he has been successful? Written job descriptions ensure that you and your employee are on the same page with regard to job expectations.
1. Position summary. This section outlines the key purposes of the position. For example, the appointment coordinator's description would explain that this position "is responsible for effectively and efficiently scheduling appointments to ensure patient satisfaction and practice profitability."
2. The key results expected of the position. The job description should outline four to eight results expected of the position. For example, operatories must be sterilized and stocked before each procedure 100% of the time.
3. Reporting system. Typically, a written job description includes a section defining the way in which the employee is expected to report to the supervisor. It often includes a checklist of specific tasks and indicates what tasks the employee has decision-making authority over and what tasks the supervisor must authorize. Ordering supplies is a good example. The responsibility for keeping inventory fully stocked and the decisions associated with accomplishing that task are often given to an assistant. However, if the amount of the orders exceeds the budgeted amount for the month, the doctor must OK any further orders.
4. Essential and non-essential parts of the job. This section ensures that the practice is in compliance with the Americans With Disabilities Act. Label each task on the task checklist as essential or non-essential to comply with the ADA. For example, the assistant job description may include stocking inventory. This requires the ability to lift 30 pounds or more and is "essential" to the position.
5. Measurements used in the position. Each job description must have clearly defined measurements of accomplishment. Using the hygienist job description as an example, measurements might include a hygiene production goal, daily procedure mix, patient of record case acceptance and unfilled hours, to name a few.
6. Working conditions. This section should define any possible unusual harm that might occur as a result of completing job tasks, e.g., lifting, exposure to hazardous materials, exposure to the elements or exposure to unstable clientele.
7. Necessary experience. Any relevant experience needed to successfully accomplish the job tasks, including required licenses, degrees or certifications.
The easiest way to write a job description is to begin with a laundry list of tasks for each position. At the beginning of a week, give each staff member a clipboard with paper. Ask them to write down each task they engage in during the week. At the end of the week you will have a list of tasks they feel responsible for accomplishing.
During the same week, you should generate a separate list of tasks you feel are the responsibility of each position. Remember, you don't have to know every task. That's why you're asking the staff to make a task list. And, most doctors have some idea of what each position is meant to accomplish. It's important you identify your expectations so that they can be communicated clearly to your staff members.
At the end of the week, compare lists. A couple of interesting things will happen. First, you'll quickly identify any duplication of tasks or task interdependence. Task interdependence is a significant cause of conflict in a dental practice. The job descriptions should identify primary and secondary responsibilities.
Second, you will see if the job being done is in line with the expectations you have for the position. The contradiction in lists is another area of conflict in a practice. Often staff members don't know what their doctors expect of them and don't understand why the doctor is always disappointed in their performance. Reviewing each list and creating a master by adding or removing tasks from the employee's task list will set the framework for clear communication about job expectations.
Once you've accomplished these steps you will have the foundation you need to fill in the remaining sections outlined above.