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The streetwise rules to management

By Judy Capko & Rebecca Anwar, Ph.D.

Managing effectively, holding on to good employees and creating the best work teams to get the job done is becoming increasingly difficult. This holds true for those in solo or small group practices. It has become particularly challenging and more critical with the advent of managed care, the ratcheting down of reimbursement and a shrinking labor pool. It is time to throw away some of those past management habits and move into the future. Here’s how to begin.

Work smarter. Get a grip on the things you do that can and should be done by someone else. Know when to let go! Too often physicians and their managers get caught-up in tasks that take time yet have little value or significance to the overall running of a successful practice, improving operations, increasing the level of patient satisfaction and improving outcomes. Let’s face it, ordering supplies, calling the photocopy repair service and calling the hospital records department for copies or dictation doesn’t cut it when other members of the office team could more appropriately perform these tasks.

Physicians and managers also get caught-up in trying to perform tasks in areas where they have no expertise or training. It’s not uncommon to see practice administrators taking on the role of office designer, strategic planner, marketers, interior decorators and accountant. The practice and the administrator would be better served by outsourcing services that require expertise outside expectations typical for an administrator or physician.

Give your employees opportunities to grow. It is common for employees to be the victims of poor delegation from the top down. This does little to strengthen their skills, provide job enrichment, show your support and increase their confidence and morale. What a shame. Inevitably, this affects turnover, as employees seek jobs that are more rewarding, sometimes leaving healthcare employment opportunities altogether.

Learn to hand it over. Knowing when and how to turn work over to someone else is an art. It requires a good understanding of your employee’s strengths, the ability to express confidence in them and finding a way to let go without compromising the end result. Some fundamental principles include:

• Identifying resources: Who is available to do the job?

• Analyzing strengths: Who is the best one to do the job?

• Getting agreement on the purpose, the desired outcome.

• Getting a commitment on when it will be completed.

• Accountability: Monitoring performance and result.

Here’s a few ways you can learn to let go of the details and create a better work experience for your employees.

First, lift the myth of vulnerability. Traditionally, managers have feared that if they reveal to their employees that they cannot be all things to all people, they will be seen as weak and will not be seen, as a leader staff will want to follow. This is simply not true. When you admit you need help, you are viewed as more human—a real person they can relate to, someone who has strengths and weaknesses. They see you as someone who needs them, wants their help and makes them feel important!

For example, Keeping track of referral sources so you can measure the effects of your marketing efforts can be a burden. Why not ask those in the front office for help? After all, they are the ones that obtain the information in the first place. They may suggest a completely new method of tracking referral sources and even offer to design a new tool that gives you better information for data analysis.

Second, be on the same team. Start by open dialogue with staff to share your vision for the practice. This will help them to understand where you want to go and help you get there. Support this by conducting regular staff meetings. Follow some basic rules for effective staff meetings: proper planning, prepared agenda, soliciting employee input and feedback, and facilitating an open exchange that includes all staffers.

Require physician and management teams to attend and participate in the staff meeting. This means physicians don’t sit on the sidelines or pontificate about what they want. It means open discussion and finding out what employees want and need to support you! It may be as simple as another fax machine or changing service vendors.

Finally, pay for talent. There’s no free lunch and you get what you pay for. Those two statements hold true when setting staff wages. Obviously, you need a prudent salary budget so you don’t break the bank, but pay employees what they are worth. Qualified, motivated employees free you up to do the things that generate revenue for the practice. Setting competitive salary strategies that recognize an employee’s value is an investment in the practice and your future.

Take the first step to letting go. This is a matter of defining the tasks and proper assignments. For a period of one week, write down all the tasks you do in a day that do not really fall under the umbrella of your title, whether your title is physician, administrator, business manager or clinical supervisor. You will be amazed at the number of tasks that do not require your skill and take you away from important clinical or business responsibilities. For example, if you are a physician, do you still hunt for charts, call for lab reports, schedule surgeries or sort and open your mail?

Now it’s time to take these tasks seriously. Physicians and managers need to write down the steps required to accomplish the various tasks they have assumed in the past. Decide who it is that should be doing these things. Then it’s simply a matter of providing the appropriate instruction or training and support. You might be surprised at the results they achieve. Usually the problem of delegation isn’t that there is no one else that can get the job done. It’s usually a matter of taking the time to train someone to do it correctly, providing needed support and obtaining feedback to be sure the expected result is achieved.

Don’t sabotage your efforts. Once an employee has been provided with the proper training and instruction, you must trust them to get the job done. It is better to give more general instruction than to bog down an employee with every detail of how “You” want it done. Give employees the flexibility to accomplish tasks with their own methods, in their own way—as long as the result is not compromised. If you have confidence in your employees and trust them, you will be amazed at what they can accomplish. They will learn to be self-starters, solve problems and want to improve their performance. They will be interested in helping you succeed.

Judy Capko is based in Los Angeles and Rebecca Anwar is based in Philadelphia. Both are senior consultants with The Sage Group, Inc.

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