3 Conversations that Will Keep You from Repeating Yourself

You know the moment: you’re having the same conversation again, trying to stay calm, trying to protect psychological safety, but quietly wondering why the message still isn’t landing. When a team member keeps missing a checklist step, showing up late, skipping a pre-collect, or sending patients up front with the wrong codes, it stops feeling like a one-off mistake and starts feeling like a culture problem. That’s where accountability either strengthens your dental team or slowly erodes it.

We break down a powerful tool from Crucial Accountability called CPR: Content, Pattern, Relationship. First we talk about content, the single miss that needs a quick, timely reset of expectations. Then we move to pattern, where leaders must stop re-litigating “today” and name the repetition clearly, without getting dragged into whataboutisms or excuses. Finally, we tackle relationship, the level most practice owners avoid until it hurts: when the real issue becomes trust, and the team can’t count on someone to do their part in a system that depends on everyone.

You’ll leave with three tactical takeaways you can use immediately, plus a clear test for deciding which conversation you’re actually having before you open your mouth. If accountability is a constant bottleneck in your dental practice management, we also share how a trained leadership team can carry standards with you so you’re not the only person holding the line. Subscribe, share this with a practice owner friend, and leave a review so more dental leaders can find the show.

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Transcript

When The Same Mistake Repeats

Paul Etchison 1:08

Have you ever noticed as the leader of a practice that you're saying the same things over and over to people over and over again? And you just keep doing it and you start getting frustrated. Like, why am I still having this conversation about this issue with this person? Maybe it's them showing up on time. Maybe it's them forgetting to do a checklist, or maybe it's them missing something very important that is part of a system in your practice, but nonetheless, it gets missed. And you know, if you listen to this podcast, I am such a proponent of psychological safety. I think we've got to make it okay at our practices to make mistakes. But sometimes we get to that point where that mistake has happened over and over again, and you get tired of talking about it. So that's what we're talking about today. What are we supposed to do when we get put in those situations as practice leaders? We've had the conversation, we've had it a few times, and maybe it's not the biggest thing in the world that we're complaining about or we're giving feedback about, but at some point it becomes frustrating, and at some point feelings start to get hurt, and at some point it can really affect the culture at your practice. So, how can you handle this and what you can do when you're in that situation now so that your culture can improve instead of getting worse?

Psychological Safety Meets Frustration

Paul Etchison 2:26

Now, you are listening to the Dental Practice Heroes podcast, where we teach dentists how to be the CEOs of their practice, empower their teams, and to build a practice that runs without them. Now, I'm your host, Dr. Paul Etchison. I'm a dentist, I'm a dental coach, I'm an author, and I'm someone who is just a little bit obsessed with helping practice owners build teams that solve problems instead of creating more of them. So today we are talking about accountability, and I'm going to share three levels of accountability that make the difference so that when you have these accountability conversations, you get the results you want. Let's go. Now, I was reading a book recently, re I guess rereading a book recently. It's called Crucial Accountability. And it's one of those books, every time you read it, it means a little bit something different to you because you've come to a different point in your practice career. You've had some more of these conversations. And as we talk about on the podcast, you've got to have those conversations, right? It's the people that have these conversations that have the good practice. It is a necessary part. You cannot avoid it. Just because you're having them doesn't mean anything is wrong. It means it is right. That means you are in a normal practice with normal humans that make mistakes and prioritize sometimes the wrong things. But nonetheless, you're the leader. Get in there, start doing things. So I want to share this idea with you. And the big idea is that the reason that accountability conversations fail is that sometimes leaders, when we're having these, we're talking about the wrong issue. We're talking about an instance. We're talking about what happened last week, what happened yesterday, what happened this morning. And the real conversation needs to be about something bigger. And I'm going to share what I mean by that in just a

CPR For Accountability Conversations

Paul Etchison 3:58

moment. So there's this idea, CPR. It comes from crucial accountability. And we're not talking about resuscitating your patients and that thing you've got to renew every two years. We're talking about CPR. So what does this mean? C is content. P is pattern, R is relationship. Now this deals with accountability conversations. So first, let's talk about the C. Let's

Content Fix The One Miss

Paul Etchison 4:20

talk about the content. What does that mean? Content means handling today's problem. And most accountability conversations, they start here. It's one thing. Someone forgot to pre-collect. The room didn't have it, wasn't it stocked, it didn't have the things in there. We had a patient wait maybe 20 minutes and somebody didn't go out there to let them know that we were running late and they were starting to get flustered. Maybe the lab case wasn't sent. It is like the first occurrence, it is the one thing that happened. So you'll talk to your team member about it. You'd say, What happened? You say what was expected. You said what needs to happen. You're getting curious. You're asking them questions. What happened with this? Help me understand. It's calm and you typically move on. They're very short conversations. So this reminds me of a story a long, long time ago when we had our first employee, we've just opened our first employee show up relatively pretty stinking late. And I had to address it right then. Hey, like I don't want to have this conversation with you, but we've got to be here on time. I want that to be a standard that we keep and we always have it. So as soon as someone's late, like you were today, I've got to address it. Please don't make me have to talk to you about this again. Is that cool? I was talking about content. I was talking about this person showing up late and I addressed it right when it happened. Not after they did it like 10 times. No, I did it that one day, the day it happened. It was quick, it was timely. That's the way it's supposed to be. Now, let's talk about the P in CPR.

Pattern Name The Repetition

Paul Etchison 5:47

We're talking about pattern. We're not talking about today anymore. We're not talking about the content. Instead of saying you forgot to pre-collect today or the room wasn't stocked, we're starting to say, I want to talk about the pattern. There's a pattern of the you're forgetting this. There's a pattern of the room not being stocked. Like this is the fourth time this month. It's the fifth time this month. But what typically happens in practice is the leader is stuck in the content conversation. Hey, the room wasn't stocked today. Hey, you showed up late today. So it's like we're still stuck in that content thing, but we're not so much spiffed about the content anymore. We're more concerned that it's becoming a pattern. And we're expressing to that person that that is a pattern we don't want to continue. We don't want to get in there where we're really talking about a pattern and the person keeps bringing up content. They do those whataboutisms. Like, what about when the other person did this? What about when someone else showed up? Lave, what about this? And you're like, you know what? I'm talking not talking about that. I'm talking about the pattern I'm seeing in your behavior. You know, I don't want to talk about today. I'm happy to have conversations about those other things, but right now I'm talking about this. I've noticed this happening several times over the past few weeks, and I'm really becoming concerned about this pattern I'm seeing. So now everything changes. We're having a different conversation now. We're not sitting there and getting defensive about this happened one day. Today I got caught by the train. Well, yeah, I'm not really talking about today, talking about pattern. Now you see how this is a different conversation. We got to make sure before when we go into these conversations, we're talking about the correct thing. Now let's talk about the R in the CPR.

Relationship When Trust Breaks

Paul Etchison 7:17

And this is one that I had to learn the hard way not that long ago. Now, the R stands for relationship. And when we're talking about relationship, the real issue at the core of it is trust. You've talked to people about showing up on time. You've talked about the pattern already. You've done the content, you've already done the pattern. What is starting to happen if that behavior continues? Now, instead of talking about the content of the pattern, you're talking about the relationship and what this behavior is doing to the level of trust. Because of this, the rest of the team is starting to not trust that they can count on you to be here. Because of this, the rest of the team is starting not to trust that you will do your part in our systems so that their parts can be done. Look, like let's say that the we have a certain assistant with the doctor that isn't completing the right codes when they send the patient to check out up front. Well, it keeps happening. Let's talk about it one day. Let's talk about the pattern. And then we're having a third conversation. We're saying, because of this, when you bring a patient up to the front, our front us team no longer trusts that what you completed in the computer is correct. And that's a problem. And why this is effective is because it's talking about the right thing. We are allowing people to make mistakes. I am so okay with mistakes. I want to not blame the person. I want to talk about systems so they don't happen again. That's psychological safety. But at a certain point, when the same thing keeps happening, it becomes a pattern. And as that pattern continues, it starts to break down in trust. We need to have trust with our team members. We need to trust that we can count on each other. We need to trust that people will show up on time, they'll do their part, that their part was done correctly, so we can do our part correctly. So there are so many things in a Dell office, so many systems that are dependent on many different people. And every single step along the way must be done correctly. That is the way it is. That is the standard. So your team members start asking themselves, can I depend on this person? Can I trust this person to follow through? Or are they unable? Are they not competent to do this? If they are trying their best to get that done and they continually screw it up and it's a breakdown in trust, and there is just nothing else to do, they don't belong on the team, unfortunately. And what you're saying to the team member is, I need this to be this way for you to be on this team. It is your decision, team member. You get to decide you have 100% control over what you do. But what I have control over is what I'm willing to accept. And I'm not willing to accept a team member that the other team members cannot trust. Sometimes uh we need to come up with a different system. Sometimes we just needed that clarity. But what should never happen is it gets just swept under the rug and ignored. You should never just hope that it works itself out because man, I've been doing this a long time. It doesn't work itself out. It just gets worse. So great leaders, great practice leaders, great dental leaders, great dental owners, they don't just know how to give feedback. They should know what conversation they're having and what that feedback is actually about. Is it the content? Is it the pattern? Or is it the relationship? And the sooner you can recognize the level, the sooner you will stop spinning your wheels in these conversations with a defensive team member that keeps saying, Well, what about this? What about that person yesterday? What about that happened? Because, man, nothing is more frustrating. And you know, as a practice leader, it is difficult. It is so difficult to deal with defensiveness. Defensiveness shuts down all improvements. We cannot have defensive team members. So here

Three Tactical Takeaways

Paul Etchison 10:56

are your tactical takeaways for this week. I want you to try these three things. One, before every accountability conversation you're going to have, I want you to ask yourself, am I talking about today's mistake or the content? Or am I really concerned about the pattern? Okay, that one question is gonna be a different conversation based on what you're talking about. Two, when you're talking about a pattern, don't let the repeated issues hide behind today's excuse. We're not talking about today. We're talking about a pattern. When you notice that pattern, say it directly. I don't want to focus on today. I want to talk about what I've been noticing over the past few weeks. And three, you got to know when the issue has transferred from pattern to relationship. If a pattern continues for a long enough time, it starts to affect the relationship. You've you've brought these things up with your team, you've clarified expectations, you've addressed the pattern. You have to ask yourself, is this becoming a trust issue? And if the answer is yes, stop having the pattern conversation and have that relationship conversation. We're talking about what it's doing to the relationship between team members.

Coaching Help And Leadership Teams

Paul Etchison 11:59

And if you're realizing in your practice that accountability is one of the biggest challenges, well, you know what really helps with that? A leadership team and a leadership team that is trained in accountability, how to have these conversations. And that's what we do in our coaching programs. So if that's something that sounds like could help your practice, reach out to me, dentalpracticeheroes.com/slash strategy. I will have a call with you. I'll let you know what we have. And at the bare minimum, I'm gonna give you some advice for free to help you in your practice, whether you move forward with coaching or not. But that's exactly what we help our clients build a leadership team so they're not the only one holding people accountable. And we teach their teams how to have these conversations, so everything runs better as we systematize and set standards. And guess what else works better? You get more profit, but that's not our focus. We want to make things work better. Profit comes secondary to that. If you do the right things, you get the right result for the right reasons. Isn't that nice? And I've been

Reviews Shoutouts And Closing

Paul Etchison 12:53

asking everybody for reviews lately, and I just want to give a shout out. Now, I don't know who this is. I gotta find out who this is. They put their name as aggressive fun, but it says, everybody, I'm a coaching client of Paul's, and before I was with him, I was lost. He doesn't coach you on just the X's and O's. He develops you into a leader. Leadership is such a hard thing to do. It's the thing none of us want to do. But the only way you'll get to a place in your life where one plus one equals three is to get your team to want to do the things on their own and have fulfillment while they're doing it. This podcast is a wonderful resource, and if you're listening to it, you're doing the right thing. So thanks for whoever that was. I hope I can find out who that is. I also got one from Andrew Lund DDS. He said I'd listen to this even if I wasn't a dentist. Paul is hilarious and doesn't hold back. I look forward to each episode. Thank you so much, Andrew. Got another recent one with Rob Dennis. Great podcast with real life actionable coaching tips. Been listening to the podcast for years and it's transformed both my professional and personal life. That's awesome. You know, I I I love it. Thank you so much, Rob. Man, I really appreciate it. So if you could and you got time, I really appreciate the reviews. Happy to read your name on there. Make sure you put your name so I can read it. Otherwise, you're just gonna be you're just gonna be aggressive fun. And I man, that sounds kind of fun. Some aggressive fun. I'm in. And thanks for listening. Thanks for spending some time during your day or your drive with me. Hope you have a great day at the office today. Be the leader and the hero that your team deserves. We'll talk to you next time.