Article Date: 9/1/2003

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Be Firm But Fair
Too much of a softy when it comes to staff? Learn to rely on your manual.
By Gary Gerber, O.D.

Wouldn't it be great if your staff performed like a well-run, mechanized assembly line? Tending to every patient perfectly, scripting every word flawlessly and executing each task smoothly every time. You'd never hear, "I'm sorry, I forgot" or, "I was too busy doing something else."

But perhaps the best byproduct of this robotic staff would be that if a complaint ever did arise, you'd have an equally standardized and effective way to deal with it.

"But Dr. Jones, you mean I don't get paid for July fourth because it falls on a Sunday? The last doctor I worked for paid me for Groundhog Day!" The typical response? "Okay, I'll pay you this time. But next time . . . ."

Get real

If you really had an android staff and a fully automated office, you could simply say, "Consult the file on our server called youaintgettingpaidforjuly4th.doc for an explanation."

I'm not advocating an assembly line practice but this example does however illustrate how having a better administrative system in place can help you deal with the day-to-day speed bumps that plague most practices.

Keep it professional

I counsel my clients that while it's okay to be friendly with your staff, you're better off not becoming their friend. It may sound harsh, but it generally makes for a more efficient, productive and ultimately happier workplace.

This is because you need to maintain a certain "distance" to uphold your authoritative edge. Because when someone is in control, a business runs smoother. As the owner of your business, you'll have to make tough decisions and it's easier to make them when there is less emotion involved. I'm constantly working with clients to help them achieve this fine balance between boss and buddy. Some doctors really struggle with taking the reigns of their own business and dread having to speak to staff members about everything from raises to vacations.

Consult the manual

To help you with this transition of personality from pal to principal, having a centralized, easily accessible policies-and-procedures manual can help take the place of your having to make every administrative decision.

While you can't possibly have a predetermined plan for every situation that arises, you can plan for most contingencies. A few examples are policies on eye wear for staff and their families, continuing education, jury duty, etc. Instead of having to deal with these issues with each staff member every time they come up, simply direct them to this central document.

The point here isn't so much to reinforce that you should have such a master manual but to alert you to its ability to excuse you from making certain management decisions because it contains the "company's policy." The same goes with the clinical side of your practice. For example, at what point during a returning contact lens patient's visit should you perform corneal topography? You should outline the answer step-by-step in your manual.

For the sake of efficiency

We should learn from the fast food industry and put the same systems and process management that they use into our own practices. Not for the sake of being fast, but for making our offices efficient, our systems reproducible and driven by a concrete set of methods -- both clinical and administrative -- not driven by the doctor.

You don't have to rule with an iron fist. Just be firm and fair and have a good solid procedural infrastructure in place to help you run your practice.

Dr. Gerber is the president of the Power Practice, a company specializing in making optometrists more profitable.  Learn more at or call Dr. Gerber at (800) 867-9303.

Optometric Management, Issue: September 2003