Article Date: 12/1/2011

How “Engaged” Are Your Employees?

How “Engaged” Are Your Employees?

How your employees can improve productivity, profitability and patient loyalty

Bob Levoy, O.D., Roslyn, N.Y.

Can you guess how your employees might (honestly) rate the following six statements on a scale of one (never agree) to five (always agree)?

► Time passes quickly when I'm at work.
► I'm enthusiastic about trying to exceed patients' expectations.
► I'm willing to “go the extra mile” in order to perform my job well.
► At work, I have the opportunity to do what I do best.
► I strive on a daily basis to achieve practice goals.
► I'm proud to tell others that I work at this practice.

The numbered answers to these questions measure “employee engagement,” one of the hottest healthcare topics today.

What is engagement?

“Engagement is the extent to which people value, enjoy and believe in what they do,” says Mark Phelps, senior consultant for Development Dimensions International, a Bridgeville, Pa. firm specializing in talent management.

“Engaged employees,” he adds, “are committed to the bottom line, have tremendous pride and job ownership, put forth more discretionary effort in terms of time and energy and on average, demonstrate significantly higher levels of performance and productivity than those who are not engaged.”

Organizations should seek engagement because “conclusive evidence from dozens of studies confirms that organizations with a high percentage of engaged employees outperform others in their industries,” says Mr. Phelps. “Engagement predicts such critical outcomes as customer satisfaction, employee retention and growth in revenue.”

Engagement: You know it when you see it

You sense an engaged practice the moment you walk through the front door. The most noticeable engaged characteristic is the level of energy and emotional commitment that employees exhibit. Even the casual observer can feel the difference. People move faster, interact with more visible animation, communicate with more palpable emotion and enthusiasm, listen more intently, respond more vigorously and really enjoy themselves in the process. Moreover, this energy seems to persist throughout the day, day after day.

Reality check: The Gallup Management Journal's semi-annual “Employee Engagement Index” puts the current percentage of “engaged” employees at only 29%. A slim majority, 54%, fall into the “not engaged” category, which they define as: “Essentially ‘checked out.’ They're sleepwalking through their workday, putting time but not energy or passion into their work.”

The remaining 17% are classified as “actively disengaged,” meaning these employees aren't just unhappy at work. They're busy acting out their unhappiness toward co-workers, and in some cases, patients.

Top ways to engage your employees

Here are some of the ways that high performance practices engage their employees:

They don't hire clock watchers. High performance practices don't simply look for skills and experience in potential employees, they also look for signs of intrinsic motivation that identifies candidates who have a high probability of being fully engaged. To identify these candidates, they include interview questions in which the answers can be most revealing, such as:

► In your last job, in what accomplishments did you take the most pride?
► In your last job, when you finished your work ahead of schedule, what did you usually do?
► In your last job, if you were asked to do something that wasn't part of your usual duties, how did you feel about it?
► Do you prefer a job in which you are given a lot of responsibility or a more highly structured job with more supervision?

They get them off to a good start. High performance practices 1) make new employees feel welcome and comfortable in their new surroundings and 2) get them up to speed as quickly as possible to achieve long-term success.

“How new employees are treated on their first day,” writes James B. Miller, author of The Corporate Coach: How to Build a Team of Loyal Customers and Happy Employees (HarperCollins, 1994), “makes an indelible impression that affects long-term performance.”

“Quite frankly,” he adds, “it is the most important day in an employee's career. It sets the tone for everything that will follow. How employees are treated on their first day is something every manager should make a top priority.”

They have reasonable expectations. To foster engagement, “companies need to reduce drains on employees' energy,” concludes a report by the Accenture Institute for High Performance, a Chicago-based global management consulting firm. “Unreasonable expectations — in the form of excessive workload, time pressures or conflicting demands on their time are powerful predictions of low engagement. Reducing physical stressors, such as excessive hours and work/life conflicts can help.”

They maintain open communication. Good communication between management and staff builds trust, motivates and fosters an all-for-one mentality. High performance practices always practice an open-door policy in which staff members can feel free to voice concerns and suggest new ideas.

“Office managers should have coffee with each employee, one-on-one, every month or so, so they get to know the employee better and understand what's going on in his or her life,” says Prashanthi Sylada, a board member for the Society of Human Resource Management, an Alexandria, Va.-based organization devoted to human resource management. Perhaps the person is recently caring for an aging parent in which case, flexible hours may be helpful.

They allow employees to do what they do best. When people do what they do best, they have more intrinsic motivation, energy and fun at work than those who just go through the motions. They love coming to work, and the day flies by.

In many cases, staff members in that “not engaged” category (i.e. bored) are mismatched for their jobs. In the worse case scenario, they're performing tasks below their level of training.

Action step: Use the one-on-sessions discussed above to learn what staff members like most or least about their jobs. Use this information to find or create a better job fit. In other words, if the demands of the job don't energize the person, it's best to help him or her find another job or role. Fortunately, the variety of tasks in the typical optometric practice is almost limitless.

In his seminal book, Flow: The Psychology of Optimal Experience, (Harper Perennial Modern Classics, 2008), author and professor Mihaly Csikszentmihalyi writes that people are most effective and happy when they have the exact level of skills to meet the challenges they face. To progress in an activity, he writes, people must have challenges that are just beyond the level of their skills and abilities. They will be motivated to grow just a bit to enjoy the perfect balance of skill and challenge, which gives them a feeling of exhilaration and achievement (and results in a high level of engagement).

They use a collaborative style of management. Another way to raise the level of employee engagement is to ask for, and actually use, employee ideas. Solicit employees' opinions on collections, office décor, etc. Follow up these conversations with action to demonstrate you value employees' ideas and will take them into consideration.

When you genuinely seek out employees' ideas, listen to their ideas and get them involved in decisions that affect how they complete their work, they feel valued and respected. This in turn, leads to a high level of engagement.

They care about their employees. “You must show you care for your people,” says Marcus Buckingham, author of The One Thing You Need to Know … About Great Managing, Great Leading, and Sustained Individual Success (Free Press, 2005). “I would like to be able to replace this skill with one that is more hard-edged, more tangible, but there's no getting around the data. A multitude of research studies confirm that employees are productive when they feel someone at work cares about them. Actually, the research confirms more than the causal link between caring and productivity. It reveals that employees who feel cared about are less likely to miss workdays, less likely to quit and more likely to advocate the company to friends and family. No matter how you choose to measure performance, being cared about seems to drive it.”

Buckingham's research is confirmed by the optometric assistant who told me, “My first job was in a practice that focused on efficiency and profits. Employees were only a ‘means to an end,’” she said, “This practice is totally different, one that puts people first and manages from the heart. I love working here.”

Action steps:

Consider the following steps to further develop employee engagement:

► Take an interest in the lives of your employees outside work: hobbies, sports, family events, such as anniversaries, birthdays, graduations, etc. Even a brief remark, such as “I hope your daughter does well in tonight's gymnastic competition” lets the person know you cared enough to remember. (Asking “How's it going?” or “How's the family?” doesn't cut it.)
► Provide training to give employees the skills they need to advance their careers and increase their value to the practice. Such training sends the message that your employees are valuable enough in which to invest.
► Time off — particularly around the holidays — is highly appreciated. If your practice is busy during the holidays, arrange if possible, alternative work schedules to give people additional time for holiday-related tasks and responsibilities.
► When you tell an employee why you're thankful he or she is on your team, that person is what I call, “emotionally rehired.” For example, when you say, “Amy, your incredible attention to detail makes a huge contribution to our efficiency and patient satisfaction. I'm glad you're here,” you have emotionally rehired Amy in just seconds. Amy understands the statement is sincere, and it will contribute noticeably to her level of engagement.

Hard learned lesson: Optometrists interested in improving the productivity, profitability and staff morale of their practices should make engaging employees a key component of that strategy. OM

Dr. Levoy is the author of 7 books including 201 Secrets of a High Performance Optometric Practice (recently reprinted and available at and 222 Secrets of a Hiring, Managing and Retaining Great Employees in Healthcare Practices. Contact him at, or to comment on this article, e-mail OM at

Optometric Management, Issue: December 2011