Article Date: 10/1/2003

fix this practice
Learning How to Work Together
This month's column completes the discussion that began last month.
By Richard S. Kattouf, O.D.

Last month, I answered Dr. Diamond's question about getting the staff of multiple offices to work together so that some degree of uniformity existed between them. In closing the discussion on that topic, I'll use this month's article to give you some general tips on getting all of your employees on the same level of performance and behavior.

Deliver consequences

As a doctor and a businessperson, you must have defined consequences to negative behavior. For example, if an employee is late for work or he abuses the length of his lunchtime, then he could expect you to dock him one quarter of an hour in pay for each lateness in a pay period. If this consequence doesn't improve the employee's behavior, then place him on a short probation period. If he's late during the probationary period, then you should terminate him.

The important point here is that your entire staff must know that you've established fair rules and that you've put them into action for all staffers. Such standard operating procedures are necessary for operating a successful practice and controlling employees. Many doctors have a policy manual but their staffers either haven't read it or they just don't adhere to the policies.

Owners/doctors must exhibit strong leadership. In practices that I have consulted for, I have noticed a filter-down phenomenon (if the doctor is shy about fees, then the staff exhibits the same problem. If the owner is enthusiastic, the employees follow the same pattern). Doctors who set an example on personal grooming can expect employees to follow suit.

When a doctor arrives at the office well before the first patient, she can expect her staffers to also arrive on time. For your practice to operate efficiently, the leader must follow the policies, procedures and philosophies perfectly. Consider the following scenario.

Case in point

Dr. Fisk (not his real name) called me about multiple organizational, stress, behavior, efficiency, production and financial problems. Once I observed his office on site it was obvious that he and his staff had no boundaries of behavior. Dr. Fisk was consistently late in the morning and in returning from lunch. The staff had to deal with irate patients caused by long waiting periods. Many times, patients would leave because of the frustration of waiting for a tardy doctor. Dr. Fisk also exhibited poor grooming.

The filter-down phenomenon kicked in and staffers who were late stressed out those who were on time. The appearance and personal grooming of Dr. Fisk's staff was heading south. Lack of written boundaries for behavioral and performance reap this type of result. What can a practice owner do?

Making some changes

People don't like change. But to progress in your practice, positive changes are necessary to meet the demands of an ever-changing marketplace. I established two policy manuals in Dr. Fisk's office: one for him and one for his staff. Once I taught them the new concepts and made it clear that there were no exceptions and that the practice wouldn't tolerate "anchors" (staffers refusing to implement), a complete transformation took place. The key was getting Dr. Fisk to take the lead. Once his arrival time and grooming were in order, the staff had a mentor to emulate.

Avoiding stress

Staffers often complain about the stress that patients cause. What doctors and employees must understand is that the greatest stresses in the workplace are self imposed by owners and employees. With proper and defined standard operating procedures that are implemented by management and employees, self-imposed stresses become nonexistent.

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: October 2003