Article Date: 9/1/2003

fix this practice
Learning How to Work Together
One key to practice success is getting your staff to work as a team.
By Richard S. Kattouf, O.D.

Q A doctor has multiple departments in his main independent practice plus satellite locations. He wants all departments and locations to operate in the same manner, but they compete with each other. What can a doctor do to solve this problem?

Dr. A. L. Diamond, via e-mail

A: One of the key ingredients to success for department stores, restaurants and many other businesses that have multiple locations is the uniformity with which they operate every location.

Zeroing in on the problem

In comparison, most doctors who I've consulted with get a failing grade in setting up a standard operating procedure and enforcing it on a daily basis. This universal problem in the solo and branch practices is caused by lack of staff training, poor ownership awareness of staff performance on a day-to-day basis, no defined consequences to negative behavior by staff, owners not exhibiting a strong leadership role and the absence of a current code of behavior and performance that all team members must abide by.

Jealousies, cliques and gossip are major causes of competition between departments and locations. Many skilled workers are "territorial" even though they complain about being over burdened with work and patients and employees always coming to them with questions and problems. They resist sharing their knowledge because they enjoy being depended on and/or are threatened by any new person learning what they know.


Developing a program

Every office must have a training program (that includes checks and balances) that the doctor/owner can administer easily to each new employee. Test the trainee's knowledge as she takes the course to ensure that she's absorbing the material.

It's critical to allow the newer staffers who have completed the course to instruct the workshops in the subject areas where they have achieved the highest scores. As the teacher, they learn more and perceptually close the knowledge gap between themselves and the varsity employees.

The subject matter must include ocular anatomy, pathology, data collection, instrumentation, technical skills, medications, optical and contact lens dispensing. If each employee receives this knowledge base from the beginning, then the skill and knowledge gap are almost non-existent.

To break down the common territorial behavioral pattern, the doctor/owner must continually stress to all employees that no one's position is in jeopardy. Develop team commission systems that enable the entire staff to earn monetary rewards for reaching defined targets. Without all members of the team pulling their load, the extra money will not likely be earned.

Know what's going on

Consistent awareness on the part of owners and managers is key. Staff needs daily repetition of proper language skills, fee collection, phone scripts, intra-office communication, fee presentation and telephone techniques. Short daily organizational meetings will create a workplace that has continuity between departments and locations. When staffers know that ownership has a pulse on their daily behavior/performance, the results are amazing.

I'll wrap up the discussion on this topic next month. 

Dr. Kattouf is president and founder of two management and consulting companies.  For information, call (800) 745-EYES or e-mail him at The information in this column is based on actual consulting files.


Optometric Management, Issue: September 2003