Article Submission Guidelines for Practice Management, EHR, Glaucoma, and Managed Care

Exclusive Date: April 17, 2013

Want to Implement Change? Hire a New Employee First.

 Sponsor: Alcon® - DAILIES® AquaComfort Plus®

Do you ever feel paralyzed about making changes in your practice? Perhaps you have an idea for a new service or a new marketing strategy. Maybe you want to delegate more tasks to your staff so you can see a few more patients per day. Whatever the new thing is, you may feel frozen because you just can't ask any more from your staff. Or you're concerned that if you do bring up the idea, it will meet with a resounding rejection from the staff.

When any of us make a change in our practice operations, there are many moving parts. This is important to consider because a good idea may fail if it is not introduced properly. Even if you know some of the major items that need to happen, it can be difficult to decide what to do first. Here is a guide to implementing change.

Gaining support for change
There is a natural resistance to change among most employees. It springs from fear over what the change may bring. It is simply easier to just continue to do things the way we have been doing them. The only problem is that if businesses don't change, they will eventually die. It may take many years, but businesses must keep pace with changes in society and must grow financially or they will stagnate and then decline. Even better than just keeping pace is to lead change in a positive way. Highly successful businesses offer new services and products to customers, delivered in unique ways. These changes create great customer experiences.

The first step to introduce a change in procedure is to discuss the reason for the change and ask for input. This may be in a staff meeting or you could talk to staff members one-on-one. Start by reviewing the very simple reasons why you are proposing the change. This most likely revolves around the need to increase revenue or profit, or patient demand. Your staff should have an interest in the business aspects of the company, but you may need to remind them about that side.

Many ODs and staff members are so focused on patient care that profitability takes a back seat. But a short presentation about how important it is for the practice to make a profit quickly reminds employees that if their career is going to grow, the practice must grow.

We want staff input because people support what they help to create. Staff members often have excellent ideas that can help the project and they may see legitimate obstacles that should be considered in advance. Start with a statement about a business problem (i.e. "We need to create more revenue and profit.") and ask for ideas on how to achieve that goal. Eventually, work in your new idea and get help in developing it.

Anticipate and head off fear
The next step is to think in advance about what some staff members could be concerned about if the changes are implemented and then reassure them about how you will prevent or remedy those problems.

Here are the main fears staff members have about changes and what you might do about them:

  • They may have to work harder. Reassure this worry by saying you will hire more employees if the new concept proves successful. Remind employees that you do not want anyone to feel stress and that customer service is extremely important to your vision of the practice. On the other hand, you expect everyone to work hard and if that creates increased profit, some of that can be paid out in salary increases.
  • They may be asked to perform tasks they don't know how to do. Pledge that you will provide plenty of training and that you realize the new skills will take time. Encourage staff that new responsibilities are a way to create advancement in their career. As the practice does better, life in the office can be better.
  • They may not like the new tasks. This is not likely, but you should consider it. Most changes do not involve a different type of work. If I'm asking an employee to take on a much different job than she is used to, I usually have a one-on-one chat with her first. I explain the new job, why I think she would be good at it, and then ask if she is willing to take it on.
It is often reassuring to test a new idea and call it a pilot program. Tell staff in advance that you can't predict every aspect of the new program, but you will all adapt and learn as you go along. If the pilot is successful, more resources and funds can be allocated to make the changes permanent.

Hire first
If your staff already seems very busy with patient care and administrative duties, consider hiring a new employee before a change is started. This relieves a great deal of pressure on staff and it counteracts any negative staff response that is more fear-based than real. In many cases, a new employee motivates existing staff members to perform better and try harder, because they realize that someone else could replace them.

Don't worry about the increased cost of the additional employee. You are making an investment in growing your practice and the new idea should increase productivity far more than the additional wages. The first step of adding to the staff demonstrates your confidence in the new program. The new staff member will provide some breathing room for all employees to learn new techniques.

Who is in charge?
In the end, the optometrist/owner should lead the practice. Inspire your employees to support your vision. Make decisions for the good of the practice and proceed. It is possible to make the office culture overly collaborative, where all employees have an equal vote in every decision and if you do not have unanimous approval, nothing happens. If that describes your practice, take steps to change that practice. Listen to staff input and then make the decision as you see fit and announce the change.

If some staff members resist all change, in spite of your best efforts to be inclusive, then you really learned something important about them. Those employees are not as great as you might have previously thought. They are really not team players. That is an important part of your ongoing employment review process. In the worst case, you could be better off in the future replacing that employee with someone with a positive attitude.

Best wishes for continued success,

Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week