Forget Production Goals
Focus on Process

Tip 11: Forget Production Goals—Focus on Process

What you get by achieving your goals is not as important as what you become by achieving your goals.
- Henry David Thoreau

We all know how important it is to set goals, don't we? From the day I began practice, everyone advised me to set production and collection goals, after all goal setting makes perfect business sense. In the late eighties I was enrolled in a so-called "business school for dentists" with the main focus on establishing monthly production goals. Everyone on staff was focused on production. We set SMART goals. SMART is an acronym for specific, measurable, attainable, realistic and timely. We set up bonus systems when goals were reached. As time went on we really turned up the heat by setting
big "stretch goals." But then I noticed something happening: we kept raising the bar until we achieved some unintended consequences.

Goal setting is the standard of operations in the business world. There is a popular study that is cited from the 1979 Harvard Business School MBA program in which 3 percent of the students wrote down their future goals. Ten years later that 3 percent of students were worth ten times the worth of the rest of the class combined. The study never occurred! Can you believe it? The study was pure urban myth. Today that myth is being totally exposed by studies that reveal the downside of goal setting. According to a new study from the Harvard Business School, titled "Goals Gone Wild," there are many negative effects from goal setting including:

• Too narrow a focus that neglects non-goal areas.
• A rise in unethical behavior.
• Distorted risk preferences.
• Corrosion of organizational culture.
• Reduced intrinsic motivation.

This study confirmed what I was feeling during the eighties. I am a big fan of building culture, and when our entire culture centered on production, I became uncomfortable. Although I don't remember compromising my ethics, I certainly saw the possibilities. In the Introduction, I mentioned the importance of intrinsic motivation to our well-being. My focus on the extrinsic rewards was the reason I sought guidance for my burnout. This obsessive desire to focus on extrinsic rewards ended up being the cause of much of my unhappiness.

So what did I do? I turned it around…I focused on process over product. I still had an idea of a specific result I wanted to see each month, but I focused more on how to get there. In other words, I identified areas of focus that would get me to that destination if I diligently applied myself. This was how I developed and committed to my master systems of examination and case presentation. As you will learn later, these two processes are not even "productive," but they give us the capability to produce more dentistry…pretty counterintuitive.

Author Peter Bregman says, "A goal is a result; an area of focus is a path. A goal points to a future you intend to reach; an area of focus settles you into the present."

When I concentrated more on examination, diagnosis, treatment planning and communication, everything changed. Part II of this book explains more about these areas of focus. For now I want to get across that what we pay attention to is what gets rewarded. We become better, and build a better culture when we take our eyes off of production goals.

Not only will the dentist reach his destination, but also in the process, he or she will become better dentists. The culture will be built. Through repetition we can get better at preps and impressions but what about the skills that really matter, the ones that make or break the success of a dentist…the nontechnical skills…the soft skills.

By slowing down my exam process I was able to see how poorly I was doing at certain things, how well I did at others, what needed improvement and what made the biggest differences. In other words, the exam process is a compilation of many key skills that matter.

Legendary basketball coach John Wooden understood the role of extrinsic goals. Wooden held his drills without a basketball in the player's hands. Why? Because the ball tempted the players to take a shot—and not work on the drill. Scoring was so tempting. John Wooden called the basketball "catnip." Production and collection are the dentist's catnip.

But the goal is to win…to score a lot and grow. As long as the catnip is present we will never slow down enough to practice those sweet soft skills. Dentists who focus on the intrinsic rewards, the process over the product, create practices that are much more satisfying through the years.