How essential is performance appraisal to dental practices?

In a modern, well-managed dental practice, performance appraisal is the single most important management tool.

No other management mechanism has as much influence over individuals’ careers and working lives.   Performance appraisal can be the most powerful instrument that dental practices possess to mobilise the energy of every employee toward the achievement of strategic goals.  Used well, performance appraisal can focus every individual’s attention on fulfilling the company’s vision and values.  But used poorly, the procedure may quickly become an ineffective administrative process and in some cases can have a counter-productive effect on employee performance.

So what is performance appraisal? It is too often seen as merely an annual drill mandated by the practice principal, yet another routine administrative duty that needs to be completed as part of the process of CQC compliance.  But in practices that understand the power of performance appraisal and use it effectively, this can be used to facilitate an ongoing process as opposed to a one-off annual event.  In companies which pursue this modern approach, performance appraisal follows Planning, Execution, Performance, Assessment and Performance Review (See figure).

PA in dental practices

With the introduction of CQC compliance protocols, there is much more pressure on dental practices to demonstrate appropriate policies and procedures to CQC inspectors, showing how these are implemented and helping them to operate as an ethical and professional organisation that continuously strives to improve its standards.  One of the key challenges for dental practices is to overcome the industry’s prevailing tendency to underestimate the value of professional management and sophisticated administration processes even though this is critical to profitability.  Unfortunately, this role is too often filled by a receptionist or a nurse or even the practice principal who tends to get burnt out from too much multitasking as they end up trying to finish onerous duties in between seeing patients.  While there is nothing inherently wrong with promoting a receptionist or a nurse to this role, they have to be sufficiently qualified and trained to understand  how to conduct professional performance appraisals, not only for support staff , but  more importantly, for dentists who are generally perceived as being above and beyond performance appraisal.

I often hear practice principals use words like “we are a family and we treat our patients as family” but if you scratch below the surface of these claims, long-term employees’ motivation is not to be a member of a ‘family’, it is rooted in something outside the practice and they are likely to be deeply frustrated about their lack of career development.  Retaining employees who are only motivated by factors beyond the practice is organisationally hazardous for many reasons: unhappy employees will become instrumental employees, that is to say they will ‘work to rule’ with minimal physical and mental effort, even taking short cuts.  If these short cuts were to involve something like cross-infection control, the consequences could be disastrous for patients and the practice.  

It is important to remember that nobody goes to work to do a bad job, it is the way in which employees and associates are managed and motivated that determines how much they deliver and how effective they become.  This goal is easily achievable and requires many skills such as knowing how to deliver feedback effectively; but if you incorporate a professional strategy-based performance management system you have far more chance of success.  This is a vital tool to keep employees engaged in their work and support them to continue to develop in the way that suits each individual employee and align their individual aspirations with the practice’s overall objectives.  It is only then that the dental practice can truly claim that they operate an ethical and professional organisation and have given their employees and associates the opportunity to achieve their full professional potential.  It goes without saying that this would be highly CQC compliant.

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