Article Date: 8/1/2009

10 Best-Practice Strategies For Managing Staff
staffing

10 Best-Practice Strategies For Managing Staff

Rather than rely on "gut instincts," take your cues from top-performing practices.

BOB LEVOY, O.D. Roslyn, N.Y.

Of all the practice management decisions optometrists make, none are as important as those that pertain to the hiring and management of support staff. Not only do they have more "face time" with patients than you, they're also critically important to the productivity, profitability and growth of your practice. Ironically, many optometrists underestimate the importance of staff management tasks — relying instead on "gut instincts" and guess work to hire, lead and retain the right people for their practice. Predictably, this process often goes awry, resulting in poor staff morale, teamwork and turnover.

I learned the following 10 staff management strategies from my studies of high-performance professional practices and incorporated them in my recent book, 222 Secrets of Hiring, Managing and Retaining Great Employees in Healthcare Practices (Jones & Bartlett, 2008). Hopefully, they will provide a helpful template for your practice.

1 GET THE RIGHT PEOPLE ON BOARD

Most optometrists focus on knowledge, skills and experience when hiring new employees. However, a good skill fit doesn't necessarily guarantee that a person will be happy or energized about a job or a practice. Two additional criteria are critical for getting the right people on board. These are job fit and culture fit.

Job fit describes the match between what a job offers and what a candidate for that job desires in a position.

Practice culture refers to the way things get done in a practice, how management treats its staff and how people work with one another. It shows up in how patients are treated and whether they return to the practice.

O.D.s who recognize the critical impact that culture has on job performance go out of their way to select people whose knowledge, experience, abilities and motivation fit with the culture of their practice.

Recommendation: Remember that everything that really matters starts with you, at the top: a commitment to excellence, outstanding service, kindness, courtesy, punctuality, ethics and enthusiasm. And, by the same token, employee engagement — the emotional connection that people have to their jobs and to the practice for which they work — also starts at the top.

2 LET EMPLOYEES KNOW WHAT YOU EXPECT

One of the major causes of diminished motivation among newly hired employees is a failure of doctors (or office managers) to clearly explain their expectations regarding the job itself, overtime, dress code and a host of other pertinent topics. After some time on the job, reality sets in, and employees' initial enthusiasm often turns into dissatisfaction.

Recommendation: Make sure job candidates know your expectations in the beginning, in order to help them decide whether the position is one in which they'll be happy. Two crucial tools for this purpose: written job descriptions and an employee handbook.

3 PROVIDE STAFF WITH THE ACTUAL TOOLS AND RESOURCES THEY NEED

A common complaint from disgruntled employees is that office or optometric equipment that they use on a daily basis is out-of-date, frequently needs repair or worse, needs to be replaced. The inference: "You and your work are not important enough to remedy the situation."

Recommendation: Empower the employee who actually uses the equipment. Allow her to recommend (or buy outright) what's needed. Allowing this "ownership" will make a difference that you won't believe.

4 PROVIDE OPPORTUNITIES FOR EMPLOYEES TO DO WHAT THEY DO BEST

"Letting top performers do what they do best excites them and increases their productivity," says John Sullivan Ph.D., professor of management at San Francisco State University. "Now, you might ask, who will do the unwanted tasks? Maybe someone else would like to do those," Sullivan suggests.

"If so, the problem is solved," he says. "If not, then give those tasks to low performers or parttime employees, outsource them, give them to interns or even hire temps to do them."

Recommendation: As a start, ask employees: "What interests you most?" And "What do you do best?" Their answers may surprise you.

5 PROVIDE COMPLIMENTS, RECOGNITION AND PUBLIC PATS ON THE BACK

Many staff members whom I've interviewed feel most thwarted and frustrated about their work because of a lack of appreciation. Included are those who do above-average work but receive no special recognition or appreciation. The bottom line: Unnoticed and unappreciated good work tends to deteriorate almost without exception.

Recommendation: Systematically start thanking your staff members when they do good work — whether it's one-on-one in person, in the hallway, at a staff meeting, by voice mail, through a written thank-you note, by e-mail, or at the end of each day at work. I guarantee it'll make their day.

6 MAKE YOUR PRACTICE A "GREAT PLACE TO WORK."

Among the benefits: Your practice will be more attractive to prospective employees if you show them it's a great place to work. Not only will you have more applicants to choose from, but the overall quality of applicants will likely be better. In addition, your practice will have higher levels of staff morale, motivation and productivity, loyalty, patient satisfaction and less absenteeism and turnover than before. The result: greater profitability.

Recommendation: Consider such alternative work arrangements as flextime (flexible work hours), compressed work weeks (work longer days in exchange for a shorter week), job sharing (divide one full-time job, for example, into two part-time jobs) and telecommuting. These arrangements help ease the conflicts many employees have between home and work.

The possibilities to make work more enjoyable are endless.

7 SEEK STAFF MEMBERS' OPINIONS ABOUT PRACTICE-RELATED ISSUES

Rudolf W. Cisco, DPM, of Gainesville, Ga., says he makes it a point to listen intently to his staff's input. He says he works hard at cultivating a "safe-tosay" environment, where employees are not afraid to be open and honest at all times.

"I have found that 99% of the time that my employees are right on target when they bring a problem to my attention," he says. "Patients often provide candid feedback to my staff, which means my employees know more about the 'real issues' than I do. It may be hard to hear, but it would be foolish for me not to take heed of what they say."

Recommendation: Schedule a "no-holds-barred" staff meeting, and ask: "What compliments about the practice do you hear most often?" "What complaints do you hear?" "Is there anything that patients have been consistently asking for that we should consider doing?" Again, the answers may, surprise you.

8 SHARE YOUR PRACTICE MISSION WITH EMPLOYEES

"What matters most in this practice?" is a question I've posed to countless optometrists and staff members. What surprises me is the variety of answers I often receive from people within the same practice. Lack of agreement sends mixed messages (and results in mixed behaviors) with patients. "People need to know what matters most to the organization where they work; otherwise they become frustrated, distracted, bored, cynical and otherwise unproductive," says management consultant Craig R. Hickman in Management Malpractice: How to Cure Unhealthy Management Practices That Disable Your Organization (Platinum Press, 2005).

Recommendation: Schedule a staff meeting around the topic of "What in your opinion matters most in this practice" Have everyone first write their answers to the question, then discuss them, and reach consensus on the topic. It'll keep everyone rowing in the same direction.

9 PROVIDE FEEDBACK TO EMPLOYEES ABOUT THEIR JOB PERFORMANCE

Studies show that a high percentage of employees are in the dark about how they're doing on the job or how they can do better — simply because they've never been told and have no way of knowing. One result is that exceptional employees are unaware of their strengths and may (or may not) be consistent in what they do or how they do it. Another consequence is that marginal employees tend to become complacent and may think your silence means approval (i.e. "If the doctor doesn't like the way I do things, she would tell me."

Recommendation: Schedule periodic performance reviews with a discussion of the following topics: clarification of job responsibilities, priorities and performance goals; recognition of good work; and strengths and weaknesses of which the employee may be unaware. Such discussions (properly documented) also provide you with important legal protection should a disgruntled employee file a wrongful termination lawsuit.

10 INCREASE STAFF SALARIES FOR THE RIGHT REASONS

Many O.D.s agonize over when and how to give raises to their employees and as a result, frequently do so for reasons that in many cases, they later regret. Examples include: giving a raise to an employee who asks for one and/or has completed another year with the practice. Such reasons have merit but require further justification.

Recommendation: At a minimum, staff members deserve periodic cost-of-living increases. Offer additional raises if staff members assume additional responsibilities, acquire new skills, progress to the next level in their positions, go the extra mile or garner positive feedback from patients. This compensation model recognizes and rewards achievement — making a statement that you want employees who are hard-working, strive for excellence and take your practice to new levels.

These 10 staff management strategies will pay huge dividends in terms of improved productivity, profitability and practice growth. OM

Dr. Levoy's newest book, "222 Serets of hiring, Managing and Retaining Great Empolyees in Healthcare Practices," was published by Jones & Bartlett Publishers. You can contact him at b.levoy@att.net.


Optometric Management, Issue: August 2009