Five Ways to Align Medical Practice Staff with Practice Goals

Setting your staff up to succeed in their jobs creates stable and compliant office operations that mitigate several types of risk and increase your net income.  Serendipitously, it also produces greater job satisfaction for physicians and staff, improves patient care and satisfaction, and promotes a collaborative environment focused on the common good. What's not to like? 

Try these five steps to set staff members up for success:

1. Tell your staff what you want the practice to be.
In business speak, what are the mission, vision, and values of the practice?  Only the physician can decide what these are.  Even in a large practice, or a practice owned by a large institution, each physician will have specific goals for the personality of her practice.   The staff needs a clear description of that personality so that they can reinforce the physician's values and make good decisions when facing unexpected situations. 

A prerequisite is that the physician has taken the time to articulate his goals and evaluate relative priorities. Clarity on goals and their relative priorities also prepares the physician to make necessary tradeoffs.  Except for the illegal and unethical, there are no wrong goals.

2. Give clear instructions on what you want your staff to do.
The devil is always in the details and the source of all frustration is unmet expectations. For example, the only time it is sufficient to say, “Part of your duties is to answer the phone,” is when you have an operations manual that describes exactly what answering the phone involves: greeting, elements of a complete message, handling instructions, etc.

If you do not already have an operations manual, the best time to develop one is when training a new employee. 

3. Encourage questions regarding how your expectations of staff are consistent with what you want the practice to be.
If you have made a reasonably good hiring decision, you can assume that your staff wants to meet and exceed your expectations.  You can also assume staff lacks the context to always fit the pieces together as you would. 

For example: Two values of a practice are to meet the patients' needs in a way that respects their time and minimizes their costs.  The practice has instructed staff that the practice will not call in a new prescription without seeing the patient first. A busy patient calls in to report a strep throat and requests an antibiotic prescription. From the staff's perspective, requiring an appointment seems to conflict with practice values.  Only if staff asks the physician to resolve the apparent conflict will the physician have an opportunity to say that the highest priority is effective medical care, and that the physician cannot rely on the patient's self-diagnosis.

4. Hold staff accountable for their job performance.
When staff fails to perform an assigned task, or does it incorrectly, tell them what is wrong and let them correct it.  That turns the mistake into a learning opportunity and diminishes the likelihood of a recurrence.  Being aggravated and doing the job yourself has no long-term benefit and increases the likelihood of a recurrence.

Pressures sometimes make it impossible to stop everything and let staff correct the situation.  In those situations, make a point to have a later conversation with staff to point out the failure and provide instruction for future events.

5. Support staff when they have, in good faith, followed what they think are your instructions.
When you believe staff has been inappropriate with a patient or in error in anything, ask them what happened and why they did what they did.  You may be surprised to learn that they performed in exact concurrence with their training.  That deserves at least a word of praise.  You may also learn that the training was incomplete or unclear, or that the situation presented them with a dilemma.  Any of these issues is a good opportunity to resolve the misunderstanding and update the operations manual. 
Criticism is appropriate only if they knew what to do and chose not to do it.

Setting your staff up to succeed pays lots of dividends, worth far more than the investment it requires of the physician.