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Horizontal versus Vertical Thinking in Dentistry


Why do some people react to business problems with conventional solutions, while others imagine innovative, unusual possibilities? In Alan Cohen’s, Spirit Means Business: The way to prosper wildly without selling your soul, I learned that there are two thinking styles: horizonal and vertical.  If you’re facing a seemingly intractable problem, it may be time for a different approach.

What is Vertical Thinking?

Most of us think vertically.  We experience a problem and then we identify a solution to fit that problem. This solution is usually based on what others have done or conventional knowledge.  If you feel ill, your doctor computes your symptoms and proscribes a medicine to treat those symptoms.  You do this as a dentist: you diagnose a problem and suggest a procedure to resolve that problem.  

Most dentists also apply vertical thinking to other areas of their practice. You have a job opening; you place an ad. There’s nothing wrong with vertical thinking; in fact, it’s a useful and effective response to many types of business problems.  But it’s not sufficient to solve every issue, so let’s compare it to horizontal thinking.

What is Horizontal Thinking?

Artists, innovators and creators think horizontally. If vertical thinking focuses on solving a problem, horizontal thinking asks why this problem occurred in the first place. It is a lateral thought process that synthesizes seemingly disparate ideas and facts to come up with a whole new idea. Steve Jobs didn’t set out to create better iterations of a personal computer. He asked wild, literal out-of-the-box questions about how people could use technology in their everyday tasks. What if you could have a computer that was the size of a slim book? What if mobile phones could do more than make calls? What if they could fit in your pocket? Airbnb didn’t want to create nicer hotel rooms. They combined the idea of couch surfing with hostels and created an alternative to hotel rooms.

Let’s take this analogy back to medicine. What if the proscribed medicine didn’t solve your problem? And what if the next 3 didn’t work either? Wouldn’t you want your doctor to engage in horizontal thinking to determine the underlying causes of your distress to find a creative solution?

The Limits of Vertical Thinking

A huge pain point these days is finding and retaining good employees. Day after day I listen to dentists complain about the dearth of good job candidates and how it’s impossible to find anyone who has the necessary skills and who wants to work. Dentists insist they can’t attract anyone because:

  • There’s no one looking for work in their area
  • The people looking for work don’t have any experience in dentistry and the practice doesn’t have time to train newbies
  • Candidates demand a salary level the dentist doesn’t want to pay

I acknowledge that these are real factors but are these insurmountable barriers? When dentists think vertically, they post the same type of job ads in the same places as everyone else.  Maybe they refine the wording of the ad or extend the geographic area, but they stick with the conventional method of finding new staff.  The short definition of insanity is doing the same thing over and over and expecting a different result. If posting ads on Indeed has not netted you good candidates in the past, is it really wise to stick to the same method over and over?  

Finding Your Next Employee with Horizontal Thinking

Horizontal Idea #1 The non-job-ad, “job ad”

What if instead of spending hundreds of dollars posting ads on Indeed, you promoted your practice as a great place to work. What if you used your local paper for a “non-job ad” that simply thanked your team?

Imagine the people in your community opening their paper to see a picture of your happy team.  In the copy, you express your appreciation and gratitude for how well they work together to serve patients.  At the very bottom could be one line that says the practice always welcomes new employees who want to become part of the magic.  Let’s imagine what could happen. Because this ad isn’t in the Help Wanted section, it would be read by many different people in your community. And who would this appeal to specially? Local, dental employees who don’t feel appreciated by their dentist. They might not be actively looking for a new job, but seeing your words inspires them to seek you out because they perceive you as warm and appreciative.

Who else would take note of this ad? Potential patients who want to go to a practice where the dentist loves his/her team.

Horizontal idea #2  Become the best known and best liked dentist in your area

Instead of passively waiting until there is a job opening in your practice, create a pipeline of potential employees who all know you and like you. Why would they like you? Because you offer to help them.  Even if you’re an introvert, you can become a master networker by:

  • Hosting CE opportunities after work – in your facility, showcasing a technique or a speaker. 
  • Organizing social events such as happy hours or picnics.
  • Sponsoring a monthly newsletter or a Facebook group.
  • Starting a book club.

By creating opportunities to meet local dental employees, you build a network of people who can either refer someone great to you or apply themselves.  You can bypass Indeed entirely because you already have local people who will help you recruit.

This idea of horizontal thinking can help us all create innovative responses to daily problems. It aligns with an article I wrote about hiring candidates with a growth vs fixed mindset.

Abraham Maslow said, “If the only tool you have is a hammer, you tend to see every problem as a nail.”  To popcorn off this insight, horizontal thinking may help you see more than just a world full of nails.

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“As an Office Manager, I’ve seen a great difference in my practice since starting with Sharyn. Three years ago our staff was in turmoil with a lot of infighting and gossip and some jealousy directed towards me.

I had given up because everything I did was judged. Now I have learned to have more one-to-one communication and by being more vulnerable with individuals I found my leadership voice. As a team, we’re all focused on the same goals.

Last year, in August we produced $88,000. This year we’re on track to produce $111,000 this month. I know it’s because we learned how to follow through with patients and communicate our expectations while building our systems.

Sharyn has gotten us out of our comfort zone and inspired us to dream bigger and it works.”

–Sharon St Pierre, Sperbeck Dental Care

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