Too often, I see doctors and their practices struggling to find a solution to overhead, productivity, and patient marketing and retention. In most cases, I see a high turn over of staff, few new patients and an out-of-control overhead spiral. The Doctors response is taking more continuing education to improve his clinical skills. As it turns out, this strategy misses the true causes of their problems. Overhead, productivity, staff unrest, and poor team performance are usually just symptoms of a lack of leadership in your practice.
We have all been pushed by so called practice management gurus to “delegate” the day-to-day “management” of our practices to an “office manager”. I can hear those same “experts” say: “Just do the clinical and let the office manager take over everything else”. If your consultant is saying this, fire them. It demonstrates a complete lack of understanding of group dynamics and purpose driven management skills.
Far too many office managers exist by “positional authority”. In other words, their title or position gives them the authority to dictate policy. At best they follow orders, at worst they alienate the staff through intimidation and poor people skills and run off patients. Add to this, that the doctor does not train them, give them an adequate job description, measure their performance, create consequence all the while never really giving them any real authority to hire and fire, change processes, and see the data that would really help them actually keep a hand on the management side of the practice. The problem is you (Doctor) don’t want to “manage” the practice but are reluctant to let go. By abdicating your leadership and management role you set yourself up for failure and poor productivity with high staff turn over. When there are problems in a practice, it is always caused by the Doctor. By your decisions or lack of them, you own the results. Your systems are precisely designed to give you the results you are getting. The buck stops with you. If you want different results, then change the systems. Do something different.
Doctor, you need more than an office manager. You need to “partner” with a TEAM LEADER.
A Team Leader is someone who provides guidance, instruction, direction, and leadership to a team for the purpose of achieving results. A group of staff members do not necessarily constitute a team. Teams are developed and grown. It is no longer good enough to have “good” staff members. You need excellent team members. Your practice will never go any further than the person with the lowest level of commitment to the vision for the practice. It is the responsibility of the team leader to add feet to your vision. It is reasonable to expect your team leader to manage your office and your team during working hours, but you are responsible to define “reality” in your practice and monitor their progress. The team leader will create the systems and help the staff develop the vision on a day-to-day basis.
The team leader fulfills a team role similar to that of captain in a team sport. They hold equal responsibility and accountability for the group’s performance with each of the other team members. Ideas, options and collective decisions on how best to accomplish the purpose and goals of the team are encouraged and supported by the team leader. When a person accepts a position as a team leader, he or she accepts the challenge of becoming both an exceptional leader and an exceptional person. In effect, the team leader becomes accountable to the team for his or her leadership performance as well as the final results of the practice. They become more than an office-manager, they become a partner in the leadership and execution of your vision for the practice. There is a litany of mistakes that most offices make in hiring an “office manager”:
1.They hire from outside the office and hire them as “the office manager”. This creates that positional authority with a title, but is not supported by actually earning the title or authority. For the best strategy, you should always try to hire people that could grow into elevated positions so that when there is a vacancy in any area of management, you can consider someone already in your employ.
2.Offices fail to adequately train for the position with well designed office policy manuals, job descriptions, measured performance, and consequences for not fulfilling each of these. How could you? You yourself have not actually held the position nor even have the skill set to perform it. It’s difficult to hire for a job you don’t understand.
3.You pay them more than anyone else in the office. An office manager’s pay should be no more than a front desk staff member’s salary as a base. Any other pay would be based on the performance that they actually oversee and you can measure.
4.They should actually have a job and not just a private office where they “hide out”. Your office manager could be a hygienist or assistant but is most likely tied to the front desk positions. They need to work hand-in- hand, side-by-side with the staff. Actual team leaders rise to the top to occupy that position of authority and leadership. They earn the position and don’t actually need a title. Consider every hiring and training in the light of how do we build a “team” rather than a group of people that work together.
5.Whatever the job description, make sure that you figure out a way to measure their performance and reward excellence. Dedicate yourself as an owner to make sure they receive ongoing training and consistent feedback of how they are doing.
6.Never hire from desperation. Hire slowly and fire quickly. Never hire someone you cannot let go.
7.The ultimate goal of leadership with a team leader is to create an office with committed team members, not just compliant employees. Do this and you will see that there is no need to manage anyone. You merely need to cast a vision to let them know what you want done. This type of commitment means that the team will self-police themselves by not allowing a mediocre member stay on your team.
If you are a doctor or office manager and you are reading this, go back and ask your team:
1.What should I stop doing?
2.What should I keep doing?
3.What should I start doing?
Few leaders are successful unless a lot of people want them to be. Every success comes through the assistance of many other people. Conversely, many people whose success stops at some point are in that position because they have cut themselves off from everyone who has helped them. They view themselves as the sole source of their achievements. As they become more self-centered and isolated, they lose their creativity and ability to succeed. Continually acknowledge others contributions, and focus on appreciating and thanking others, and the conditions will always grow to support your increasing success. You will never get ahead until people are behind you. A leader can give up everything but final responsibility. Becoming accountable is how you Summit.
Michael Abernathy, DDS