(LISTEN, Physician SPOTLIGHT) “I can do more in one house call than I could ever do sitting in a box at a clinic, being told I have to see patients every 10 minutes.” ~Dr. E.B.
By Michael Tetreault, Editor-in-Chief
Employee wages and staffing are usually the number two or number one expense for most medical practices year after year. Leasing space is the other.
As one of your primary expenses, you want to hold onto your staff, especially when they’re “good” for as long as you can.
But understandably, managing your team, your patients, your expenses, your practice comes with a lot of headaches, sleepless nights, so-so days and rewards.
If you manage your team and “they like you” … their labor and your return on investment is a match made in well, medicine.
So whenever we talk to Doctors who recently go through a staff change we often echo the old adage, “People don’t quit their jobs, they quit their bosses.”
And, it’s true.
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Managing the puzzle that is managing people is like an Indiana Jones adventure in that cave of wonders in the jungle. Sometimes you’re on solid ground and other times you’re falling into people’s problems you know or wish you hadn’t asked. Sometimes the barrage of needless interruptions makes you want to pull your hair out (if you have any left).
So when faced with those people who sometimes know us the best at work, their our co-workers, our teammates … they usually see us more than our family. In some cases, they know us better than our close friends do. They know what you need to hear to keep you focused and happy. They know when to present you with bad news. They know how to manipulate you. They also hear your kindness towards others and learn about your closed door philosophies and musings on politics and patient care, religion and more as the months and years go by.
Your staff sees you as their boss. They respect you and they want to be respected as well.
So it’s a fine line being a Doctor-Boss today.
Here are two short cues you might want to lean into or identify about yourself that can help you become a better “Doctor-Boss” and retain those team members longer and at the end of the day, maybe have a little less stress when it comes to managing your staff.
TYPE #1 – The Burden Carrier
We talk with a lot of Physicians both in and outside of Concierge Medicine, Direct Primary Care, Hospital jobs, and the like and for the most part, every Physician feels compelled to be overly responsible. While this is a great character trait, it also has a downside.
Fatigue. Exhaustion. Working more and more hours than you should. Ultimately leading to that dreaded end, burnout.
If you are parked in your own parking lot and dread walking into your office, it’s time to make some changes. Take a step back and get some input from experts that can help you enjoy your work again. Walking into your medical practice or the four walls of the exam room should not be seen the same as walking into the penalty box each day. If at some point in your day you think to yourself … “I must do everything or it won’t get done …” then you fit the mold or typecast of “The Burden Carrier” Doctor-Boss.
So what can you do to overcome these feelings?
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It’s not always easy. Some cases are tougher than others, right?
First, understand that you’re not alone. This isn’t just a problem in healthcare. It’s a problem that ails most small business owners, big, medium and small. But in healthcare you are often so busy that these caution cones are bypassed so quickly that you might not realize you’re at a dead end until it’s too late.
Unless you’re one of the rare Doctors out there who got your MBA and your MD/DO degrees … we know for a fact that medical schools aren’t business schools. It’s more like … “Don’t worry about it [eg. the business of medicine]. You’ll learn on the job. You’ll pick it up as you go. We trained you to be a Doctor, now go figure it out on your own.”
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Second, take a breath.
Realizing you have a problem with your team or inside your practice is important. If you don’t exercise good judgment when it comes to identifying you even have an issue with your staff, you’re on the road to burnout and potentially financial collapse of the practice.
“If my patient experience can be improved, it starts with a walk from the parking lot to the office front door,” says Doug, a Patient who spoke with us recently. “When I walk by one of your staff and their vehicles, am I going to see clean dashboards or papers, trash and wrappers on the dashboard. Is your teams private life a mess? Yes, I think about these things as your Patient. It signals to me that there is a good chance that if the staff has a messy personal life, your staff is going to mess up my paperwork, my insurance, my file, my labs/tests, etc. It’s a reflection on the Doctor too. It tells me that maybe he/she isn’t making very good management decisions. That’s a red flag for me. My visit to the Doctor needs be more about just collecting a prescription and a co-pay.”
TYPE #2 – The Insulated Doctor-Boss
The Insulated Doctor-Boss often doesn’t know the full story.
Maybe you’ve got a great Operations or Office Manager that you’ve hired. He or she knows what you need, when you need it, often before you even know you need it.
Things are clicking. However, there are few things you would like to know more about and asking that person for accurate intelligence is maybe a little scary to you.
No member of your staff wants to deliver bad news to the Insulated Doctor-Boss, so maybe they hide it. Maybe they delay it. Maybe they wait until that one day when you’re really happy and finally let you know about something that happened with that patient (you know the one).
What can you do?
Well, you do have options. First, create a culture within your medical practice in which the messenger isn’t shot. We all know the old age, “Don’t shoot the messenger.”
But what do we do? We do just that. We take out frustrations, show a little extra emotion and maybe say things more sternly than we should. That’s on you. That’s on the Insulated Doctor-Boss.
Case in point, an article entitled The Insulated Leader unmasks what leaders (ie Doctors) can do to overcome this challenge with their team.
Adi Ignatius wrote in the Harvard Business Review that CEOs know less than their employees about what’s really going on in the business? That’s one of the provocative questions raised this month by Hal Gregersen, executive director of the MIT Leadership Center, in “Bursting the CEO Bubble.” Gregersen, whose article is based on interviews with more than 200 senior executives, says that status and authority often insulate CEOs from critical information that might challenge their assumptions and strategies. No one wants to tell the boss bad news, so the CEO may be the last to hear it. It’s a common problem. But it’s not insurmountable. Some of the world’s most innovative leaders have found ways to avoid this trap—but those tactics require executives to break out of their routine.
Your staff should be applauded for bringing important information to you forward.
So how can you foster a culture in which your team, your employees, nurses, PAs or colleagues can feel free to speak openly to you, the Insulated Doctor-Boss? What can you do specifically today to become less insulated and/or more in control?
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HBR write Ignatius says “One technique is simply to be quieter. Instead of going into broadcast mode, executives should relentlessly ask questions of their colleagues, and they should carve out space to reflect deeply on the challenges they face. Above all, they should go on “listening tours” to identify weak signals that might be early indicators of looming threats and opportunities.”
Walt Bettinger, the CEO of Schwab, requires his managers to write “brutally honest reports” that candidly address, among other things, what’s “broken” in the company. He even invites employees who raise consequential issues to visit headquarters.
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There’s no such thing as the perfect practice. All you can do is learn and pursue it. But please, don’t look at your medical practice like a penalty box. You’re more valued to your community and to us than that. We don’t have all the answers. But what we do have, we share with you. We interview and speak with a lot of Doctors year after year in this space and others. Their stories are often your stories, just in a different part of the globe. We hope that by pointing some of these management traits out, Physicians are able to keep moving forward. Without your team on board, it’s easy to see a Doctor fail. No matter how smart the Doctor is, where the degree on the wall is from or how great the service is you provide, without a great team you can trust, your practice is at risk.