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If the Staff Ain't Happy . . .

Over the 25 or so years I have been in practice, I've come to divide my days at work into four categories. These were developed in an entirely unscientific manner, based on a daily routine that grew out of 30 years of marriage. When I get home in the evening, my wife has always asked, "How was your day?" In the early years, I found myself giving rather lengthy answers to that question, but I've noticed that, as time passed, my replies have become shorter and shorter. It's not that my wife has lost interest in how my day went, or that I have lost interest in conveying that information to her; it is simply what I refer to as an "economy of communication" that inevitably evolves within a lifelong, loving partnership.

The first classification I use, Category 1, is a great day. On a Category 1 day, everything goes right, the patients are all happy, the staff gets along well, and I feel I have made a positive contribution to the physical and emotional well-being of both myself and humanity. Category 2 would be an OK day. There are probably a few negative experiences such as minor staff squabbles, late lab deliveries, temporary equipment failures, and annoyed (or annoying) patients or parents, but overall, the outcome is generally favorable. These days are probably the most common, when everyone is functioning at a comfortable, baseline level of happiness and job satisfaction. Category 3 is a "yuck" day. There may be some major staff disputes, crippling equipment breakdowns, or entirely unreasonable parents or uncooperative patients. It is not uncommon for these days to be accompanied by inclement weather or, given that I practice in downtown Los Angeles, major traffic snafus that delay my trip home by hours. The last type of day, Category 4, really doesn't have a name. When my wife makes her routine inquiry, I respond by frowning, raising my left eyebrow, shaking my head in a disgusted and exhausted manner, and rapidly changing the subject. Everyone knows what I'm talking about here--it's just "one of those days" when nothing goes right. Category 4 days are the diametrical opposites of the great days in Category 1.

At home, no factor has more to do with whether a day will be a Category 1 or a Category 4 than my wife's tone and mood. In acknowledgment of this fact of life, a plaque hanging over our fireplace proclaims, "If Momma ain't happy, ain't nobody happy!" An entirely analogous situation occurs at the office: If the staff ain't happy, ain't nobody happy. And if the staff ain't happy, I ain't happy! No other factor is more important in determining whether my workday is a Category 1 or a Category 4.

While I have the egocentric illusion that I am in total control of my environs, the truth of the matter is that for the office to flow smoothly, the staff has to be happy and functioning well as a team. It was just that premise that led to the survey published in this issue of JCO. The most interesting result is that in all but one of the categories surveyed, the factors that the staff reported were most important to them in determining their job satisfaction and happiness differed from the doctors' perception of what contributes to staff satisfaction and happiness. The one area where both staff and doctors agreed was, of course, salary. Anybody has to make enough money at work to support a family and to feel genuinely recognized for value contributed, and doctors seem to know that. In all other areas we surveyed, however, the orthodontists and staffs disagreed about relative importance. I don't want to spoil the ending by recounting all our findings here, but it would behoove our readers to pay close attention to what influences their staff members' happiness at work. I also think it would be in every employer's best interest to talk to the staff openly about issues that are important to them, and not simply to assume that doctor knows best. Our survey indicates that such an assumption is not necessarily true. If you have a large staff--larger than would lend itself to one-on-one individual discussions about job satisfaction--you might want to consider conducting a survey of your own. After all, if the staff ain't happy, ain't nobody happy. Have a Category 1 day.



Editor, JCO. E-mail: rkeim@usc.edu.

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