Your Responsibility to Your Staff

Just as your staff has responsibilities to you and your practice, you likewise have several responsibilities to your practice and staff.

The complexity of active leadership can be best understood by breaking it down into its essential and integral parts:

1. Communication: It is vital for the owner of a practice to maintain excellent communication with his/her staff and to provide active and visible leadership. The following are key elements involving communication that you, as an executive, should implement:

a. Communication of Goals.
Determine the purpose of your practice (most often presented in the form of a mission statement) and communicate that to your staff. Impart the goals of the practice to the staff and keep them informed of the projects that you intend to implement to achieve those goals. The better informed your staff is and the greater understanding they have of such matters, the more likely they will be working in tandem with you.
b. Communication Tools.
There are some fundamental communication tools to implement in the practice; see to it that your staff uses them. These tools can be established and maintained by your office manager; but, as the senior executive and leader of the practice, you must reinforce them. Examples of those tools are: written requests or proposals, written office communications, written office policies and the use of an effective communication relay system.
c. Responding to Communication.
It is vital that you and your staff respond swiftly to written communication. When people do not receive a reply to their memos or emails within an appropriate and reasonable period of time, thereafter they become less willing to communicate. As a result, the business can have more problems on its hands. (Keep that in mind when reading the second part of this article.

2. Staff Meetings: It is also vital that you ensure that the practice holds staff meetings once per week. This is one of the most valuable opportunities available to you for educating staff, setting goals and targets, and handling problem areas that should be addressed by the staff as a whole. The communication lines within the business will strengthen considerably too.

You, as the owner and leader, in addition to your office manager, should continually strive to establish strong coordination and leadership for your staff. Any problems or disagreements between the owner and office manager should always be sorted out OUTSIDE of the staff meeting and should never be addressed in the presence of any staff.

Staff meetings run most effectively if the owner and office manager meet prior to the staff meeting to plan and coordinate those matters to be addressed with the staff.

Fill out the form on this page to read the rest of this article and find out why writing and implementing Policy in your practice, as well as setting Goals and Targets successfully, is so vital to achieving expansion. (highly recommended). Click to scroll to the top of the page.

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Turn a 40 Hour Week Into 30 and Stay Profitable

Do you ever get to the end of the day and realize that you didn’t get half of the things done that you intended to get done?

Do you find yourself giving endless streams of orders and then having to spend time following up to make sure everything was really done?

Do you often have to redo work because it was not done correctly the first time by someone else?
Is scheduling a problem?

Managing time in a healthcare practice is an art. Unique problems arise because, as the doctor, your main priority is treating patients. But, how are you supposed to keep your full attention on patients and at the same time stay on top of the crucial administrative work that is paramount to maintaining a thriving practice? The essence of successful time management is the attainment of a level of organization which facilitates the goal of a healthcare practice, a high quantity of well and happy patients.

Simply stated, how well you organize determines how many hours you work and how productive you are during those hours.

If you are having difficulty managing your time, the first action you should take is to keep a time log during a typical work week. While this may be arduous at first glance, you will find it well worth the time and energy you put into it. Carry a small notebook with you throughout the day and log everything you do along with the amount of time you spent doing each. This is best done by logging the events as they happen and avoid trying to reconstruct the information at a later point in time.

At the end of the week, you will be able to look over the information and tabulate how much time was spent on the various activities you engaged in. This exact record will help you isolate areas of the practice that are not being competently handled by your employees and/or are problematic to the point of requiring much of your attention.

The next action you should take is to have each one of your employees keep their own time log, just as you did yours. At the end of the week, you can gather the logs and review the activity of each staff member.

Read part II of this article and find out the key questions you should be asking yourself when you have completed your log. Request “Turn A 40 Hour Week Into 30 and Stay Profitable – Part II” (highly recommended). Scroll to top

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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 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

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. 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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Putting New Employees on the Job

Practice owners bring on new employees for a variety of reasons. Often, when practices are undergoing expansion of production and income, they require increased staffing. Or, due to poor past hiring procedures practice owners find that they have to replace some employees who are poor performers. There is a natural attrition rate as well when a staff member moves out of town, gets a higher paying job, etc.

Many past Practice Solution articles have been written on numerous aspects of our successful hiring procedures, including testing, how to conduct proper interviews, how to weed out non-qualified candidates, legally acceptable and unacceptable questions to ask, etc. You’ll find some of those articles in this issue of Hot Tip.This article will go over some of the best actions to implement when putting new employees on the job.

Once you’ve decided to hire a new staff member, the first thing to do is have them complete all appropriate paperwork. This would include signing whatever employment contract you use as well as having them read all of the appropriate office policies and attesting to having read them.

Personnel File

A personnel file is vital for maintaining proper documentation on every employee. You can set yourself up for legal problems in the future if you don’t have this properly in place. Therefore, creating a personnel file for the new employee is one of the first things you should do after hiring the person.

The office manager should create a personnel file for the new employee which contains:

  • The full job application and the resume turned in during the hiring process.
  • Any other forms used in the hiring process.
  • Any tests taken.
  • Any interview notes, write ups, etc.
  • Employment contract.
  • A copy of the policies the new employee read and signed.
  • A checklist of everything the office manager will be doing with the new employee to bring them onto the job. Make sure the checklist is filled out as each item is done.

As the new employee becomes a regular employee, the personnel file should be constantly updated with job reviews, disciplinary warnings, commendations, etc. The personnel file is your key management tool for documenting everything having to do with that employee, from the time they are hired until the time they leave, for whatever reason.

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Termination Series:

A Constructive Face-to-Face Termination

This article is a continuation of our termination series. To view the previous article, click here. This series will go over how a termination decision should be made, how the organization handles problems before making a termination and how to convey the news for a constructive face-to-face termination. There are specific guidelines when terminating because all of these factors will impact strongly on the employee’s perceptions, their consequent motivation to act on their emotion negatively and the way your current employees will view how you handle these and following situations. It’s up to you to make a termination something that is going to aid you and your practice or something that could collapse it.

The person doing the termination will be less likely to get distracted by emotions if the goals are kept in the forefront during the process. Concentrate on what is being attempted, not just the fact that you have to convey bad news, then anticipated fear and discomfort can usually be minimized.

Five goals can provide a direction for communication when announcing the termination:

  1. Convincing Them That It’s Best for Everyone: If the guidelines for making a termination decision are followed, you will probably have a good termination. Most employees who are in trouble know that there is trouble, but for economic reasons they just can’t admit that a termination might be justified. They are usually quite unhappy in their work, and were another job to be readily available, might thank you for the termination (at least in their own minds). In short, they know it’s a bad relationship that is extracting costs that are probably even more troublesome. Your goal is to try to help them understand the larger perspective; the relationship isn’t working out and should be terminated.
  2. Minimize Possibility of Legal Action: How the employee is treated during communication of the termination makes a significant difference in his or her state of mind immediately following the announcement. In short, how employees are handled can encourage or discourage them to “fight back” or move on with their lives. You want them to “move on.” Treat them with respect and understanding yet firmness throughout the process.
  3. Provide a Positive Exit and Build Self-Esteem: Few people are total washouts. Termination represents ending a relationship as opposed to indicating that the employee is a failure. Focus on this fact in an effort to make him/her feel worthwhile. Avoid anything that smacks of humiliation since you don’t intend to decrease his/her self-esteem.
  4. Minimize External/Internal Adverse Impact: Employees who are terminated usually have friends left behind. so how you handle the termination can impact on the morale of those people. Your goal is to minimize damaging that morale. How you convey the bad news can demonstrate a caring, sensitive organization or one that is arbitrary, uncommunicative, and insensitive. The employees left behind will have perceptions one way or another. You want them to have a positive one.
  5. Facilitate Orderly Departure: Tools, uniforms, etc., have to be turned in and various documents must be processed and signed. The employee’s cooperation is needed to do this; therefore, communication must not give the employee an additional motive for obstructing an orderly departure.

The Face-To-Face Termination

Knowing that this is a “good” termination does not make the face-to-face encounter less difficult. It is intense. It is a task few people want, much less perceive as a constructive learning and growth experience for the employee. A reasonably humane, sympathetic attempt to end the painful encounter as quickly as possible is tempting.

However difficult, termination can be a relatively productive experience if handled properly, with finesse, tact and directness. Some situations will make the attempt at being positive, forward looking, and constructive out of the question. But the attempt should be made.

The ideas listed below offer ways of making the difficult encounter a reasonably productive one:

  1. Indicate Intent – Be Direct: “Sally, the practice has made the decision to terminate your employment here (don’t say, ‘terminate you’). The decision has been reviewed, but we need to discuss a number of issues. I hope we can do so in a reasonably friendly manner. You have a right to be upset, etc., and I will understand.”
    • Don’t Apologize: Don’t say, “It’s hard for me to do this,”
    • “I really hate to have to tell you this,”
    • “We have tried to help you, but it just hasn’t worked,”
    • “You have left us no choice,”
    • “I’m sorry,” or
    • “The doctor is making me do this.”
  2. All of these phrases just make matters worse and make the practice look cheap and blameless. They add fuel to the emotions already operating and serve no constructive or situation-strategic purpose.
  3. Allow Ventilation and Catharsis: If the employee starts swearing, yelling, bad-mouthing, crying, etc., just sit there and don’t respond. He/she needs that emotional release for any constructive discussion to take place later on. Do not be tempted to put your arm around their shoulder, pat them on the back, etc. These innocent actions could be misconstrued as sexual harassment, even female to female.
  4. Explain Reasons Specifically: Don’t say things like “poor attitude” or “insubordination” unless you can cite the specific behaviors. Generalized statements leave too much room for interpretations and argument. You don’t want that now, so have the hard evidence or documentation on hand.
  5. Avoid Counseling: Trying to help him or her understand “where he/she went wrong” is productive if placed in the context of how it could be avoided elsewhere in a future position. Anything short of such a context not only won’t work, but it will probably add to the employee’s emotional upheaval, or even begging for another chance, saying they’ll change.
  6. Discuss Remedial Actions – Offer Direction: Tell him or her how to apply for unemployment compensation, vocational training for skill development – anything that gives the employee hope for the future. Indicate that although the relationship hasn’t worked out, you still feel a social/moral obligation to try to help the person adjust to the situation.

The above are guidelines intended to help you in this area. It is not intended to be, nor is it, legal advice. You should consult an attorney on any specific legal problems that might come up with employee discharge.

If you are a practice owner and are in the middle of or have questions about a particular employment concern, please schedule a 1 hour complimentary call with one of our experts now!


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