Most practices don’t fail for lack of systems—they fail because accountability shows up late, tense, and inconsistent. We unpack a practical way to fix that with the CVI method—curiosity, validation, and invitation—so your team follows through without fear, defensiveness, or drama. You’ll hear why “laminated” SOPs stall, how delayed feedback normalizes noncompliance, and how reframing protocols around patient outcomes and team fairness wins real buy-in.
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Episode Transcript
One day I was talking to my personal trainer
and he was telling me about thegyms, what he called the silent
quitters.
Now, these are the type ofpeople that hire the trainer,
they get the meal plan, they getall the supplements, and they
tell everybody, hey, I'm all in,I'm going after it this year,
I'm gonna lose all this weight.
And then they do none of thework and they start getting
frustrated because they're notgetting results, even though
(01:18):
they signed up for everything,but they didn't do any of the
work.
Meanwhile, you've got anothergroup where it's the people who
show up every day.
They sweat, they try hard, butthey don't watch their diet.
And they're frustrated toobecause they're not getting any
results either.
Same gym, different habits, sameoutcomes.
Okay.
(01:38):
No progress.
Now I see the same thinghappening with dental practice
owners.
Some have zero systems, they'vegot zero structure, they got
zero accountability in theiroffice, and others have really
good systems.
They've got the SOPs, they gotthe meetings, they got the
checklist.
They even bought a laminator offof Amazon and they laminated
(01:59):
everything, but they still can'tget their teams to follow any of
it.
And both of those groups end upin the same place, practice
chaos.
So today we're gonna talk aboutwhy accountability fails, even
with great systems, and how tofix it with my CVI method
curiosity, validation, andinvitation, accountability
(02:22):
without anxiety, calmconfidence, and the
follow-through that actuallysticks.
Now you are listening to theDental Practice Heroes podcast.
I am your host, Dr.
Paul Etchison.
I'm the author of two books ondental practice management, a
dental coach, and the owner of anearly$6 million practice in the
south suburbs of Chicago.
(02:43):
If you want a team-drivenpractice that runs without you,
that allows you to take aninsane amount of time off and
still be highly profitable, allwhile taking great care of your
team and your patients.
Well, you've come to the rightplace.
All right, let's dive into ourtopic.
Now I want to talk a little bitmore about these two different
types of owners.
I worked with one doctor, Dr.
Scott.
(03:04):
He was over on the West Coast.
When we started workingtogether, he had no systems.
Everything was like verbalinstructions, nothing was clear,
everything was driven by memory.
There was nothing written down,there's no clarity, there was
very little consistency.
And the result, well, it was alot of the times it was chaos.
There was very littleconsistency there.
(03:25):
And why?
Because there were no systems.
I mean, you can't haveconsistency without systems.
I want to talk to you about aclient that I just started
working with, and she's tellingme about how she's a bad leader.
She doesn't believe in ourleadership skills.
She's telling me how I havethese meetings, I do it with my
team, I create what I want, Ispend a lot of time, like almost
like developing lesson plans forthe meetings.
(03:46):
So she's being very intentionalabout what she wants to
communicate to her team and thesystems that she wants to
create.
So she has the systems, but thething is, is that the team
doesn't follow them.
They got the binder, they gotthe SOPs, they got the meeting
agendas, they hold the morninghuddles, but nothing sticks.
So this person who's putting allthis energy into their practice
(04:07):
is getting the same results asthe first person who is kind of
putting in not a lot.
So the key principle here isthat systems create a way of
doing things in your practice,but they don't create
accountability.
Conversations do.
So why does accountability failin so many practices?
The fact of the matter is, isbecause when accountability
(04:28):
happens, it often happens waytoo late.
Delayed accountability willalways kill your system.
And this happens so often.
You tell your team what you wantthem to do.
And then one day, when you havea few cancellations, you start
picking apart everythinghappening at the practice
because you're kind of mad thatyou had some cancellations and
you're sitting on your butt inyour office, and you notice a
(04:50):
problem.
You decide that it bothers youtoday, even though it didn't
bother you the past three weeksthat it was happening, and then
you bring it up, and the teamfeels blindsided by you because
why is this something soimportant to you today?
Oh, Doc's having a bad day.
And then you, as the owner, youfeel resentful to your team
because you're looking at thesethings that you told them you
wanted to get done and they'renot doing it.
(05:12):
Everybody feels defeated, nobodywins.
And this happens in so manypractices.
They have a monthly meeting,they talk about what they're
going to do, and then they comeback the next month and they
talk about it again.
And there's no follow-through inbetween, there's no checking in,
there's no accountability.
Because when you, as the owner,delay accountability, you
normalize the behavior.
(05:33):
You make it okay for your teamto not follow the system.
Now let's talk about theaccountability that a lot of
practice owners use.
I call this accountability withanxiety.
This doesn't work either.
This is when you're leading froma title.
This is when you're trying toget your team to do things
because you think that theydon't want to be criticized by
you, that they don't want to getin trouble.
Owners like this are oftenoperating from tension, uh,
(05:57):
leading with frustration.
We talked about this before.
What the heck?
You know better, things likethat.
And that type of leadership isgonna trigger shame in your
team.
It's gonna trigger avoidance,defensiveness.
They're gonna start hidingmistakes, they're gonna become
disengaged.
When you correct people in thisway, essentially what you're
doing is you're justguaranteeing that they're not
(06:19):
gonna tell you the truth.
They're gonna hide theirmistakes.
We do not want our teams to dothings because they're scared of
getting in trouble.
Sure, we want them to be heldaccountable, but we do not want
to lead on the basis of fear.
We want to lead on the basis ofwhy we do the right things for
the patient, why we're doing theright things for the team.
We want to lead on the basis ofwhy what we do, it's the right
(06:42):
thing for the patient and it'sthe right thing for the team.
And let me give you an example.
Just simple one, closingchecklists.
Okay, closing checklists.
Why do we have a closingchecklist?
Well, because these are thingsthat need to happen at night so
that we can take awesome care ofour patients.
Now, also, I said it's got to begood for the team.
Why do we have closingchecklists?
So that everybody knows what theresponsibilities are and so that
(07:05):
it's equitable.
So everybody is responsible forthe closing task.
It's not one person putting inmore work than the others.
Everybody is accountable forthat checklist.
So that's why we have thatsystem.
That's what we're focusing on.
That is the kind of stuff wewant our team to follow that
protocol because it's the rightthing for the team and it's the
right thing for the patients,not because if they don't,
(07:26):
they're gonna get in trouble.
So, how do we createaccountability in our practice?
Well, first of all, we've got tobe timely with it.
We've got to be on top of ourteam.
If we're gonna tell them to dosomething, we have to check on
it and make sure it's gettingdone.
And we've got to point it out assoon as it doesn't get done, and
we've got to get curious.
So, this is what we're gonna do.
This is what I call my CVImethod of accountability.
(07:48):
C stands for curiosity, V standsfor validation, and I stands for
invite.
Okay, here we go.
Curiosity.
You are going to get curiouswith your team when they don't
do something.
You're gonna start askingquestions because you need to
understand why that didn'thappen.
So you might say something likethis, you know, hey, I noticed
(08:09):
that this didn't happen.
Help me to understand why it,why do you think that didn't get
done?
Like, you know, we talked aboutthis before.
I really want to understand likewhy it's not getting done.
Help me understand that.
So it's a very neutral way ofapproaching it, it's very
non-threatening, and it opens upfor the real conversation that
you're about to have with yourteam member.
Now, they're gonna tell youtheir version of why it's not
(08:30):
happening.
And that might be like, I didn'thave time.
It might be that I forgot aboutit.
It might be that I don't see whywe're doing it that way, or I
think it could be done adifferent way.
Whatever it is, and whateverthey tell you, you have to
validate their experience.
So this is the V and C VI.
It's the second step.
Validate their experience.
And that means you're you'reshowing empathy, you're showing
(08:52):
that their perspective, that yourespect it.
Okay.
It doesn't mean that you'reagreeing with them.
It just means that you'reexpressing understanding of
where they're coming from.
So, oh, that makes sense.
Or like, I could totally see whyit's so overwhelming.
You got so much to do and youdidn't get to it, or I can see
why you forgot about it.
There's so many other thingsgoing on.
I don't know.
Just you want to validate theirexperience because this creates
(09:13):
safety.
I mean, you think about likemarriage consulting, you know, I
read a lot of books about a lotof different things, one of
which is I read about how tohave a better marriage.
And it's all aboutcommunication.
And the communication is allabout the relationship.
I want you to think about, say,like you go home from work, you
start complaining to your wifeabout something, something that
happened at the practice, andshe immediately tells you, you
(09:34):
know, I think you overreacted,or maybe you should try to be
more forgiving with your team.
Or maybe, like, maybe what youthought it wasn't really what
happened, and she starts sidingwith the other party.
How open are you to listen toanything else that she says?
You're not.
You shut down, you getdefensive, you start defending
your position, you defend yourexperience because someone is
(09:57):
telling you that the way thatyou acted wasn't reasonable.
So you immediately go on thedefense.
And that doesn't lead toanything constructive.
It's the same with your team.
If they tell you something orthey give you a reason why
something didn't happen, and youstart telling them that their
experience was wrong, theyweren't too busy, they knew the
system, they understood it.
I don't know.
If you don't validate theirexperience, you're dead in the
(10:19):
water.
Now let's let's go back to thisexample.
How about if my wife, who I justexplained to, I was complaining
to, she said something like, Oh,I totally see your point.
That really sucks.
That must be really frustratingfor you.
I totally see where you'recoming from, something like
that.
Now your guard is down.
Okay.
You're ready to move forward.
You're ready to come up withsolutions or next steps if
you're with depending on whatyou're talking about.
(10:40):
See, the thing is thatvalidation allows the
conversation to continue.
It lets people's guard down.
And it is such a killer ofculture and dental practices
when we don't validate theexperience of our team and we
tell them that they're wrong.
Okay.
So curiosity, C, we're gettingcurious.
V, we're validating theirexperience.
(11:02):
And then the I, the invitation.
We are inviting participation.
Okay, we're inviting them togive a solution to help us come
up with a solution so that wecan meet our goal.
So I noticed this didn't happen,and they tell you why, you
validate their experience.
And then you're saying, Well,what do you think we should do?
Give me some input.
You're inviting them to givesome solutions here to help you
(11:23):
with fixing the problem.
Because if you don't invitethem, you know, you've had these
systems happen at your practicewhere you just show up, you tell
people that we're doing it thisway.
And sometimes your team will tryeverything they can to poke
holes in your system to show howit doesn't work, how you're
wrong, and how this isunreasonable.
But if you involve them, youinvite their participation, you
(11:46):
involve them in the creation ofthe solutions, creation of the
systems.
Now they have something, they'vegot something invested in the
game and they want to figure outa way to make it work.
So we're inviting participation.
So we're showing up, we're usingthis CVI technique, and we're
being consistent with it.
And what I mean by beingconsistent is every single day
(12:08):
we're checking on these thingsto make sure that they're
getting done.
Now, when you build a largerpractice, you're leading your
leaders, your leaders areholding people accountable in
this way.
Obviously, you can't check onevery single thing, but you can
build a practice that'ssystematic, that has
accountability built into it.
So we want to give same-dayfeedback.
It has to be timely.
These little 30-secondconversations, they're not
(12:31):
confrontational, they're reallyquick.
We're just making sure our teamknows that it's important to us
and that we're watching.
We're being very calm, we'rebeing direct, we're not getting
emotional.
And every time we have theseconversations, we're using that
CVI technique.
And no one should get upsetbecause accountability, it's not
a confrontation.
(12:51):
It's just a checking that we'realigned still.
We're checking for alignment.
We're not confronting anybody.
And this is what my coachingclient was doing, the one that
had all the systems, but nobodywas following through with it,
is she was setting up thesystems.
And when I asked her, I said,why do you think that system's
not being followed?
And she said, I don't reallyknow.
And I said, Have you ever askedyour team?
She goes, No.
(13:12):
So she never got curious.
And the thing is, is if youbring something up at a meeting,
you bring up a system and itdoesn't get followed for the
next month, and you bring it upat the next meeting, that's
still too long of time.
That's still 30 days that wentby.
You need to be timely.
It needs to be, we're going todecide as a team what we're
doing with the system.
We're going to hold everybodyaccountable to it every single
(13:34):
day.
So whether your practice has nosystems like the first example,
or those beautiful systems thatnobody follows, accountability
is the glue.
And the way that you deliverthat accountability determines
whether your systems live ordie, CVI, curiosity, validation,
invitation.
It is the difference betweenchaos and clarity.
(13:54):
And these are the sort of thingsthat we teach our coaching
clients that work with usone-on-one.
This is why I think DPH is superspecial compared to other
coaching programs, because we,myself and Dr.
Henry and Dr.
Steve, we have large teams.
We have seen it all.
We have the experience and thewisdom to get the results versus
maybe like a consultant that'snot a dentist.
(14:16):
I mean, they might have thesystems, but they've never
personally gotten a team to dothese things.
And that's the challenge.
The systems, I mean, we couldtalk about best practices all
day, but whether or not you canget your team to do these
things, that's what's going tomake the big difference.
So here are your tacticaltakeaways for this episode.
Address the issues the same day,not someday.
(14:37):
Don't save accountability forthat weekly meeting or the
monthly meeting.
Don't wait until you have time.
Don't let it slide and hope itfixes itself.
Tackle it today.
If you see it, say it.
30 seconds of curiosity beatsthree months of resentment.
Trust me.
Takeaway number two, use thatCVI script.
Curiosity.
Hey, I noticed what got in theway.
(14:58):
Validation.
Yeah, I get it.
It makes sense.
Invitation.
So what can we adjust?
What do you think we can do tomake this easier or more
consistent?
This removes the conflict.
It adds the clarity.
And takeaway number three, Iwant you to separate the person
from the pattern.
If you get frustrated, it is soeasy to attack the individual.
But the real win is in attackingthe pattern.
(15:21):
I want you to say this isn'tabout you, it's about the
process.
Let's fix the system.
Grace over guilt.
You get to keep the dignity andyou get to get the results.
And the more you have thesecalm, little accountability
conversations every day, theless dramatic they're gonna
feel.
You need to normalize this typeof culture, normalize checking
in, normalize asking how's itgoing, normalize clarifying
(15:44):
expectations, things like that.
It's a steady drip.
You don't want to bring the firehose like so many of us doctors
do.
We have one day where we get alot of cancellations and we have
a bunch of time to go poke holesand find out what our team's not
doing just to get us even morepissed off because we're really
just pissed off about theschedule.
And as the leader, it's so easyto notice when things aren't
happening.
(16:04):
Let's try to notice when thingsare happening.
When you see something good,call it out, celebrate it,
reinforce it, celebrate thewins.
We don't do it enough.
People repeat what getsrecognized.
So this week, I want you to tryto have one of those CVI
conversations with your week andreally pay attention to the
(16:25):
energy of the person you'retalking to as soon as you
validate their experience.
I promise you, it's one of thestrongest communication tactics
I have.
Validate their experience.
Doesn't mean you're agreeingwith them, you're just
validating their experience.
So have one of thoseconversations this week around
something that's not happeningin your practice.
Try it out, see how it works.
(16:46):
And if you want a practice wherethings run smoothly and a team
that actually follows throughwith everything, go check out
our coaching options atdentalpracticeheroes.com or set
up a free strategy call with meat dentalpracticeheroes.com
slash strategy because a smoothrunning practice is exactly what
we help you build.
Thank you so much for listening.
(17:06):
I really appreciate it.
If you've got a second, pleaseleave us a five-star review on
Apple Podcasts.
It means a lot to me and I couldreally use some new reviews.
It's been a bit.
Thank you so much for listening.
Take care.
We'll talk to you next time.
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