Where is Your Net Profit?

You’ve worked hard all week; the office atmosphere is rife with discipline and brisk efficiency. The staff have been getting along with one another and you are proud of the team spirit they’ve both individually and collectively demonstrated. In fact, your staff has almost read your mind and anticipated your every need. All of the patients have arrived on time for their appointments, and the majority of them have even heeded your advice and accepted your treatment plans!

Now it’s Friday afternoon; the staff has received their paychecks, which reflect production bonuses that you’ve doled out in appreciation of their contribution to the overall increase in production. But then you look at your bank balance and you’re surprised and sorely disappointed at the lack of funds left over for you. What happened?

Where is your net profit? Did you work hard all week just to earn less money? The bank balance should be going up, not down!

You wonder if it’s worth all the effort. All of that increased production might just have landed you into a “higher office-overhead/higher tax-bracket” situation. It’s that frustrating income vortex — the place where, despite producing and collecting more, you take home the same amount or less. And following a few of these “successful” weeks, you shake your head and realize that if you endure much more of that kind of success, you’ll go broke! So, what should you do?

Let’s start by taking a look at the myriad of possibilities of what might have occurred that resulted in your not having any profit for yourself:

Management Issues:

  • Could you consolidate loans for equipment and/or your practice into just one loan, in order to reduce your monthly loan payment and possibly the interest amount?
  • Can you reduce the amount of inventory the practice maintains?
  • Are you collecting your Accounts Receivables with minimal aging? Do you collect at least 97% of the amounts billed?
  • Do you have any sort of monitoring system that helps you to know at a glance, statistically, who is productive and who isn’t?
  • Do you have written office policies that are known and enforced?
  • Does each position in the office have a fully delineated job description?

To learn the 8 staff-related issues that can plague you and adversely affect your net income read the final half of this article by filling out this form (Highly Recommended).

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Leadership Attributes and Management Qualities

As a practice owner, you should be asking yourself the following questions objectively:

  • Am I a good leader?
  • Do I run from conflict?
  • Am I able to motivate my staff?
  • Is my office harmonious or is it filled with conflict?
  • Does my staff “own” their jobs, or do they just punch in and out?
  • Do I ever feel that my staff is “holding me hostage”?
  • Am I running my practice? …or is my practice running me?

Did you answer any of those questions favorably? If you’re like the average practice owner, the answer is no. That’s because, like most doctors, you were not trained in leadership and executive skills. Consequently, you will often find yourself in management situations in which you lack certainty about what to do. Insufficient leadership could easily result in poor staff performance, unhappy patients, needless stress and lost income.

Maxim: The Morale of the Staff Is Based Upon Their Individual and Office Production.

Believe it or not, most staff members want to do a good job. They want to improve and they like being acknowledged for a job well done. When one produces a good product, it’s a reflection of his competence. Demonstration of competence raises anyone’s morale. As a leader, you have the opportunity to foster an environment that can bring about ever-increasing competence and morale.

So, how does one become a good leader? Is leadership a personality trait with which only a few are blessed? No! Leadership skills are taught and, with practice, can be put successfully into daily use.

The first quality a good leader has to have is the ability to confront situations, i.e., to face up to them. If you are the type of owner who runs and hides from conflict and staff problems, then you need some improvement in this area. First, decide that you are going to face up to the problem. Simply take a moment and make the decision; this is very helpful.

Next, grab someone — a friend, your spouse or a colleague — and roleplay the problem. Have that person play the part of the troublesome individual, hitting you hard with backtalk, new problems, can’t-be-dones, etc. Be sure to do the drill until you find that you are more confident and even feel somewhat excited to try out your new skills and presentation. You will be surprised at how easily the situation will resolve once you do this. Keep in mind that your staff can’t and won’t follow if you don’t lead.

It is very important for you to maintain excellent communication with your staff and to provide demonstrable leadership.

To learn Six Key Actions That You, As An Executive, Should Take fill out this form.

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How to Write a Mission Statement

The owner of a veterinary practice recently asked us about how a mission statement should be written, what it should focus on and what the final objective should be. This example is for this particular veterinary practice, but all of the concepts we will cover apply equally to any other private healthcare practice.

Their current mission statement is below:

“To honor our patients, (our) Animal Hospital ensures that each client is confident in the care they are receiving for their animal companion, comfortable with all aspects of the hospital and staff, as well as engaged in all areas of their pet’s health and wellbeing.”

The idea of this mission statement is good. My only concern with it is that it is somewhat limited. Here’s what I mean.

The effectiveness of a mission statement is that it creates the goal towards which the practice strives. The goal, once stated, is what is called an ideal scene, meaning what the practice would look like to the practice owners if it was functioning at an ideal level. This ideal scene is then compared to the existing scene. The differences are the corrections that need to be undertaken.

Let’s use your mission statement as an example. Let’s say when you compare this mission statement, this ideal scene, with the existing scene you find what’s missing is that the clients aren’t as engaged in all areas of their pet’s health and wellbeing as you would like. Let’s say too many of them view their pets as a bit disposable. This can be a problem in more rural areas where pet owners often feel that if something is wrong with the pet, rather than fix it, they’ll have the pet put down and get a new pet….in other words, the pet is viewed as discretionary or disposable.

So, how does this missing ingredient to the mission statement affect the doctors? The doctors have to compromise their treatment of the patients to align with the clients’ wishes. While it’s a bit optimistic to think that all clients will do everything that is best for the pet and not take their pocketbook into account, when the pendulum swings too much in that direction, the doctor’s work satisfaction declines. I’ve seen this really crush the morale of the doctor. So, assuming this was indeed a true mission statement, now we have the existing scene not lining up with the ideal scene and the result is the doctors are not happy.

To see how to resolve this issue in your practice read the final half of this article by filling out this form.

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How to Properly Correct Employees

It would be wonderful if employees never make mistakes and always do a perfect job. But we’re all human; on-the-job errors are part and parcel of working in a practice. That begs this question: What do you do when a staff member messes up and how do you correct him?

Here are some suggestions on how to properly correct your staff:

As part of this overall process, you must have written job descriptions and office policies that clearly delineate which tasks a person is responsible for on his/her job and the overall working guidelines for the office, respectively. The reason that proper, written job descriptions and office policies are so important is that you should use them as part of your correction procedure. Unfortunately, very few practice owners have them in place.

For starters, if you need to correct a staff member, make sure you review any specific disciplinary policies that you have issued, so that your actions are consistent with them. For example, if your policy states that proven theft results in an automatic discharge, you would not utilize a gradient approach to termination by merely reprimanding someone guilty of stealing.

Typically, the first step in correcting a staff member is to direct his attention to the specific item he violated, as delineated in his job description or in your written policies, indicating the appropriate action that he failed to take or the inappropriate action that he did take. Direct the staff member to reread the policy and/or job description. Ensure that he understands it and clear up any confusions or misunderstandings. This corrective action is usually sufficient to handle the first offense.

If the staff member commits a second offense involving the same issue, the office manager or practice owner should review the situation with the staff member and have him sign a copy of the policy or procedure that covers what was violated, as an attestation that he understands it and agrees to abide by it. We then recommend that you put a copy of the signed document in the staff member’s personnel file and give him a copy to put in his staff binder. One may consider that this constitutes a warning.

To learn how to apply these policies in specific situations, such as;  How many warnings should be issued? What if the employee is an excellent producer? Read the final half of this article by filling out this form.

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Resolving Negativity in the Office

Some time ago, I read this article in the Wall Street Journal – which discussed dealing with feuding employees. There is good information in this article on feuding employees, and anyone having staff-conflict issues should check it out. Since dealing with staff bickering and personality conflicts can be a major source of stress in an office, knowing how to deal with it can be extremely useful.

As the Wall Street Journal article points out, when you let employee situations linger too long, bad things happen, and you can end up losing not only the problem employee but other good employees as well. So, when you encounter two or more employees feuding, our recommendation for you is to find out as quickly as possible who seems to be instigating the problem, as well as determine which of the two employees is the most productive, and to quickly nip it in the bud.

Normally, when a feud is going on, other staff members have either been involved or have observed it in one form or another. It usually bothers them as well, even if they are not directly involved. What we recommended to practice owners is to interview these peripheral staff and get a more neutral opinion of what’s going on and who is really causing the problem. Also, interview the staff involved and get their respective sides of the story. From this you should be able to find out who the real problem employee is.

ACT FAST! The longer you let something like this linger, the greater the odds that you will lose not only the problem employee, but the good employee and possibly other staff members who are sick of being involved in that type of work environment. If you act swiftly on such matters, you will keep your employees happy.

There’s another very important point: the longer this kind of thing is allowed to continue in your office, the more likely it is that other staff members will start to feel that their workplace is not safe. They will also feel that the owner is not in control of the office and that they may want to find a better environment to work in. You could end up losing a really good employee because you didn’t confront the problem and act swiftly and appropriately.

Having the right office policy and job descriptions in place to govern acceptable and unacceptable behavior in the workplace will give you an important foundation to stand on when handling this kind of situation. Lack of such policy can make the workplace less than harmonious. And don’t forget to document, document, document the non-optimum issues in writing and what was done to handle the people involved. Without documentation, you can open yourself up to potential legal issues.

The “staff infection” is a term that I came up with long ago to discuss the effects that a negative employee can have on a team and how fast it can spread. Similar to how the “Staphylococcus Infection” is dangerous to the body.

The “staff infection” starts in various ways, such as with a staff member that often rolls his or her eyes at staff meetings. This staff member engages in rumormongering and can be counted on to “stir the pot” in the office. This can be the idle staff member or the person who always seems to be busy but gets nothing done. You get the idea. This is the employee that you are “just not sure about.”

What would you think of a doctor that did not practice good sepsis control and permitted Staphylococcus germs to fester in or on his or her equipment? It simply does not make sense, does it? Nobody would do that. Preventing any sort of infection in a patient is more than second nature to any doctor. What would your opinion be of a doctor that was aware that his or her patient had an obvious staph infection but did nothing about it? Enough said.

How do you handle the “Staff Infection”? Read the final half of this article by filling out this form.

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Did You Hire the Wrong Person?

A recent survey conducted with practice owners across the US revealed that the number-one management problem they have is personnel issues. Among the problems mentioned by hundreds of owners surveyed were:

  • Procuring qualified personnel,
  • Getting employees to perform competently once hired,
  • An inability to hold staff members accountable for their work,
  • Turnover and handling disputes among employees.

Correctly isolating and debugging non-optimum practice situations is a skill that every doctor finds he needs. Oftentimes, a manager who is seeking solutions overlooks some administrative fundamentals which, left undetected, cause a problem to appear larger or more complex than it really is. Moreover, failing to discover the real source of a problem leads to poor decision-making. In the case of managing employees, this type of failure is not only frustrating, it’s expensive.

The real work begins after the hiring process ends, for each employee must be well trained for his/her position in the practice. Lacking thorough training, an employee will not perform to the expected standard. That will inevitably lead to either the employee quitting or the doctor firing him/her.

There is an exact technology for finding and hiring good staff members. Assuming the hiring techniques are sound, the most devastating managerial mistakes are made during the training period. During that time, an unskilled manager might make assumptions that lead to incorrect reasons for poor performance, and those conclusions, in turn, lead to bad decisions regarding personnel. All too often, a suitable person who is both willing and trainable fails to receive the information needed to do the job. As a result, turnover occurs and doctors and office managers spend their time dealing with personnel problems rather than treating or servicing patients.

Written job descriptions are a must for each position in a practice. More importantly, those descriptions need to include fundamental data that are often omitted because the manager assumes that the employee already knows what is needed from him. Common sense, or common knowledge, to one person may not be so to another. Verbal instructions are much less effective than thoroughly written job manuals.

Every job description in an office should include the seven following sections:

  1. The responsibilities that the person holding the job position has to the patients,
  2. A general description of the position, which includes its purpose,
  3. A statistic that quantifies, and thus objectively measures, the production of the position,
  4. A list of specific duties that one in the position is expected to perform,

What are the final three sections that a job description should contain and the four things to examine when employee problems arise? Read the final half of this article by filling out this form.

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A Functioning Office Manager

Your Key to Success

The primary function of the office manager is to accomplish the goals and purposes of the practice as determined by the owner of the practice. The OM should assist the owner in developing policies that forward the purpose of the business as a whole. It is the OM’s job to see to it that all members of the group are fully contributing to the expansion of the practice, and that a high level of communication exists between the group and the owner.

The OM should run the day to day activities of the office and keep the daily distractions off of the owner/doctor’s plate. This would be accomplished by ensuring that the OM, first of all, was trained in the handling of staff and felt comfortable with the hiring, training and correction of all staff members.

The OM should be a person who understands the importance of communication and the power that open communication can generate within any group. The OM should energetically lead the group toward accomplishment of the established goals. The OM should be someone with good communication abilities and someone who can really care for the staff.

The OM would ensure that all internal communication systems are strongly in place and operational, and that the staff is taking responsibility for keeping all unnecessary “traffic” from and within their own posts to a minimum.

To affect the above, the OM should have a strong working understanding of the management tools such as statistical management, the establishment of a communication system that really works for the office, written communications, job descriptions for each position, written policies for the practice, and personnel management.

The OM is in charge of seeing to it that all areas in the practice are running smoothly and producing the desired products of each respective area. This would require her/him to have an understanding of organizational structure and function. They would ensure that all functions in the organization were being firmly held by someone and that they were trained in the skilled handling of their assigned posts.

The OM should have a very strong working knowledge of statistics and their use in strengthening the practice. The OM would be in charge of posting statistics and going over those statistics with the staff in the staff meeting to determine the appropriate steps to take in order to improve, maintain, or increase practice production statistics.

It is the OM’s responsibility to obtain compliance from all staff in regard to the owner/doctor’s wishes and any program or project steps that are being worked on.

The OM would be responsible for the hiring and firing of personnel and for conducting performance evaluations on a regular basis with all staff.

The OM is responsible for the preparing and implementation of programs that would take the group through the needed steps toward the accomplishment of company plans.

Fill out the form to read the rest of this article which includes: 5 key objectives of an OM, the results the OM must obtain for the practice and how to select an OM (highly recommended). Scroll to top

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Fill out the form to read the rest of this article which includes: 5 key objectives of an OM, the results the OM must obtain for the practice and how to select an OM (highly recommended).