Not long ago timeservers expected a salary bump every year for doing nothing. Public sector workers thought of it as their human right, and private companies bought into it, although not as generously, being, as they are, sticklers for performance related pay. Dental nursing is a hard job for low pay. Many jobs — probably most — are like this. It’s the way of things that nurses will jump from job to job to gain a 50p an hour raise, neglecting the question of what it’s like working for different dental practices.
Yet I know nurses who are paid well. They support their clinical teams in a way that makes them run better and they do some of the selling for the dentists. These nurses aren’t following instructions. They break through by making an intuitive, creative sacrifice that pulls their colleagues up around them. On some level they decide: “I’m going to put more of myself into this, with no guarantees of reward, and do it long enough that it begins to change things around me for the better.”
This kind of behaviour manifests so obviously in a sales team because if you sell more the business grows faster and more people get recruited under you ergo you’re paid more. Actually, everyone is part of the sales team: the receptionists, TCOs, dentists, nurses and back office. The patient journey is the product you are all selling every day. The common feeling among dentists that if they sell more they are just creating more work for themselves won’t be around for much longer. There’s no space left for it.
The patient journey has to improve and efficiencies have to be made to pay for salary bumps and new recruitment and all team members have the potential to help the business grow faster. Dental practice leaders need to communicate to their teams that people probably won’t get career progression unless the business grows.
The mindset needed for this is the opposite of waiting passively for that annual bump. To use a phrase coined by the business consultant and former Navy Seal Jocko Willink, it’s extreme ownership. Extreme ownership is about looking around you and taking on responsibilities to make things better without being asked. So you take on your superiors’ responsibilities to make them look better without needing praise or recognition, and you support colleagues rather than faction fighting. As a leader you encourage this mindset by encouraging decentralised command. You give the green light to initiative and creative thinking.
Sooner or later, says Willink, even if it takes longer than a worker would like, the truth will out: it will be so obvious at various levels of the business that they are indispensable that they will get more back than they thought was possible. They will have created a special role for themselves outside of the unimaginative structures that were producing mediocrity. This will be so obvious they won’t need to crow.
The bitter pill is that no one, especially not the great mass of workers in all the hardest jobs — tough, exhausting jobs that are repetitive, gruelling and consist largely of drudgery — is going to break through to a better place until they make a sacrifice. It doesn’t work the other way around. I’ve seen this realisation among managers who were doing a good job but then, when they suddenly got it, their careers and prospects transformed.
It’s never gift wrapped for you, you have to create this transformation from the inside, but the opportunities are extraordinary. The only rules are that you have to do a good job first, and you’re only as good as your last job. If you’re working for a small company you have a lot of clout if you are very good at what you do.
I can’t tell you how often I encounter hostility to these facts, coming from a sense of entitlement. There are 2.3m university students in the UK, all making a significant sacrifice of time, money and effort for their prospects, with no guarantees, so isn’t it a paradox that when most people reach the career ladder they expect the rules to change? They never do, you always have to make your sacrifice first, and with no guarantees, otherwise it isn’t a sacrifice.
If you’re leading a team of people you’ve got to normalise this process and make it explicit and transparent. You might use a bonus scheme to conspicuously reward staff who go above and beyond their paygrade. Naturally you will want to promote those who add value and fuel everyone’s growth and prosperity. Just make sure you stand by what you say — I’ve seen businesses torn apart where good faith is lost. Whenever you encourage your people to step up you’re asking them to enter a contract of trust with you. Don’t break it. Look after them.
