Provide Staff Position Definitions

Without a specific assignment of duties per staff member, your practice will suffer.


Provide Staff Position Definitions

Without a specific assignment of duties per staff member, your practice will suffer,

Sheldon H. Kreda, O.D., F.A.A.O., Lauderhill, Fla.

Good business managers know the importance of providing their employees with a clear assignment of their job responsibilities. Such managers determine these duties based on both the organization's needs and the related skill set of each employee. Doctor, it's your job to clearly define an employee's job. Vague job descriptions limited to just a title, such as tech or receptionist, can result in lost orders, misfiled insurance claims and fewer patient visits. Allowing staff to run on autopilot can result in errors and omissions that at the very least can jeopardize practice income and at the worst cause patient harm and leave you vulnerable to malpractice.

You can eliminate potential problems by pinning each and every office task to a designated individual. To accomplish this, follow these steps:

1 Create a job description chart

Pooling office chores can disproportionately bog down your most talented employee or push an important task on to the wrong individual. Therefore, compose an organizational chart that details the specific job duties of each of the positions in your practice. (See the organizational chart, above.) This chart provides an objective tool to organize staff and distribute work.

All of us have strengths and weaknesses that we bring to our jobs. That said, it's up to you, the doctor, to recruit and position staff members just as a coach would organize a team. Assign your players according to their talents to maximize their productivity. For example, your receptionist may lack the technical skills required to perform meticulous data collection. So, placing him/her in this position would not be an optimal fit.

A carefully thought out division of labor will marshal your staff into a cohesive team that limits duplications and omissions. Such a chart acts as a guideline and helps employees do their jobs better, especially when their jobs are better aligned with their natural abilities. Because this chart clearly defines who is in charge of a task and ultimately responsible for its completion, an absence of personal involvement created when duties are shared or delegated is no longer an excuse for substandard results, and stops finger pointing.

Note the area on the chart where all circles overlap, which I've labeled “everyone's job.” If it's “everyone's job,” it becomes “no one's job.” Watch out for tasks that have no owner. A job can, in actual fact, become an orphan, and orphan jobs are not done often. Yes, it's tempting to load up overlapping areas with vital tasks, such as patient recall, in the false hope that assigning more people will get the job done faster and better. But, I've discovered that this is equivalent to having your staff pull chores out of a hat as free time becomes available. Recalls and confirmations are the lifeblood of a practice, yet if this is allowed to turn into a round robin staff activity picked up by whoever has the time, the work will not be done with the attention and timeliness it deserves. This will cause the practice to suffer.

Take for example the simple task of locking the front door at the end of the day. We all know it needs to be done, but who does it? Yes, it gets done most of the time, but is it someone's specific responsibility to make sure the door is locked? Who do you blame when you get the afterhours phone call from your alarm company? You can clearly see the obvious benefit of assigning this responsibility to a single trusted employee, but this same oversight needs to be applied to everything you need accomplished within your practice.

To recap: A task that falls to all hands can easily fall through the cracks. Allowing this will almost guarantee essential work will not be done because no one person has to take personal responsibility for it. Therefore, overlapping areas define a “no man's land” that must be avoided.

Overlapping duties and cross training are a necessary evil that you cannot avoid. A tech should be able to relieve a busy optician, and an optician should be able to book an appointment. We can see that the greater the area of overlapping duties, the greater is the loss of personal responsibility. Thankfully, the organizational chart clearly defines who is in charge of the task and ultimately responsible for its completion.

2 Bring the chart with you to interviews

Managers, in general, tend to favor job candidates who have similar personalities and abilities to themselves, often overlooking the diversity of skills needed to round out the entire staff. There are abilities needed for the specific position for which the job candidate is applying and by extension, the person who ultimately gets the job must bring the most to the job. By hiring without regard to a clear definition of the open position, the result can be an incompetent employee and create weak areas of staff coverage.

Take, for example, an organized, diligent and deadly serious interviewee but one who lacks the outgoing and gregarious personality needed to be an effective front desk receptionist, the position needed to be filled. Although he/she possess fine qualities, these are not what are needed for this particular job. This person should be removed as a candidate for this position.

Similar to the adage about the chicken and the egg, the job determines the employee, and the employee determines the job. It's best to put the right person into the right job to start. To accomplish this, bring your organizational chart with you to interviews, so you are reminded to refer to it when questioning prospective employees. In addition, provide a copy to the potential hire, so he/she knows exactly what is expected of them, should they get the job.

3 Give it to the staff

Defining responsibility is a sure fire method to keep your staff focused and on task. So, be sure to provide your organizational chart to all staff members. You may have two circles or ten. You can caption each circle by employee name rather than job title, or mix and match job descriptions.

In addition to enabling you, the doctor/manager, to control your staff's job responsibilities, an organizational chart can also provide an invaluable measure of job performance. That is, the more closely each staff member stays within their respective circle, the greater their competence. This translates to fewer mistakes, enhanced efficiency and, therefore, a healthier practice. OM

Dr. Kreda practices in Lauderhill, Fla. He's a frequent lecturer and author. E-mail him at, or send comments to