Getting Staff Out of a Rut

Alicia Mitchell was a relative newcomer to Physicians Group of Utah when she asked her staff to create a personal profile - one that included an updated resume. Needless to say, she had everyone whispering at the water cooler.

“It was a threatening thing at first, but I explained that I wasn’t asking any of them to look for a new position,” says Mitchell, operations efficiency manager for the Salt Lake City-based physician recruiting division of IASIS Healthcare and a long-time practice administrator. Her purpose, of course, was not to intimidate, but to encourage her employees to recognize their contributions to the team. “Even the best employees get stuck in a day-to-day rut where they no longer recognize what they’ve accomplished during the year,” she says. “I focused first on the employees who were burned out. Some honestly felt they hadn’t learned anything new, but when I opened their profile I could say, ‘Look. You learned Word and you implemented an Excel tracking program for our chart release that the entire office now uses.’ They’re often surprised.”

As part of the profile, each employee was also was asked to set four goals for the upcoming year - for personal, business performance (for the overall practice), customer service, and best practice for their specific jobs. “I have them set measurable and realistic goals and keep that in their portfolio and we review it every quarter when we meet,” says Mitchell. “I always ask them what tools they need to help them do their job better or improve workflow, like new equipment or training, and I make sure they get it.”

Boost pride

Such techniques that underscore self-worth are an excellent tool for reenergizing your troops, says Jeffrey Denning, practice management consultant for Practice Performance Group in La Jolla, Calif. Employee fatigue, he adds, is an occupational hazard in any field, usually setting in after the four- or five-year mark when staff members show up for work, but check out on creativity. The remedy, he says, is instilling a sense of pride. “If you get people who are proud of themselves and proud of the place they work you don’t get people in ruts,” he says. “It doesn’t happen.”

It’s not a difficult goal, but it does require managerial prowess - and an understanding of Maslow’s hierarchy of needs, says Denning. The popular psychological framework that seeks to define human motivation maintains that workers seek first to fulfill their basic need for survival (food, clothing, and shelter), which is met in the workplace by collecting a steady paycheck. The next level of motivation is safety and security, which is satisfied by working in an environment where trust is established and the employer is financially stable. Then comes social motivation, says Denning, whereby employees enjoy being with their coworkers and feel part of the team. The highest level is self-esteem, in which employees are motivated to perform because they value their own contribution.

“What every manager wants is to for their employees to be motivated at the self-esteem level, with an attitude that says, ‘I know what I’m doing and I’m good at it, and I know that because my performance reviews say I’m good and my boss tells me I’m good,’” says Denning. To get them there, however, you have to make whatever is keeping them at their current low level of motivation disappear. “You may have staff feeling insecure because they know your practice is struggling to make payroll, or because you assigned them a new task without sufficient training, which is a very common scenario in a medical practice,” he says.

A manager who is sensitive to Maslow’s hierarchy would instead say, Denning notes, “‘I’m going to give you a new task. I know you don’t know it yet. I barely know it. We’ll learn it together and when I’m confident you can do it alone, I’ll leave you to it.’ That’s a safe environment.”

Keep it fresh

Ironically, the challenges facing healthcare providers today, including pay-for-performance reimbursement and new delivery models for patient care, make it easy for managers to light a fire under their staff. “The health insurers are telling us they aren’t going to pay us for sick patients anymore; they’re going to pay us to keep them healthy and that’s what’s so exciting,” says Mary Ann Tyler, administrator for family practice Lawrence Park Medical Management in Broomall, Pa., and a board member of the Professional Association of Health Care Office Management. “The patients need help managing their own healthcare and it takes every part of our team to do it. We’re retraining everyone on staff.”

Indeed, there’s nothing like continuing education to help clear out the cobwebs. “I have a responsibility to know my staff is properly trained and certified before they start educating the patients,” says Tyler. “The staff is the core of our success and I need them to be engaged and enthusiastic about their work.”

The easiest and least expensive training method, of course, is to ask your employees to cross-train each other. That keeps things interesting and provides the added benefit of enabling your staff to pinch-hit for each other when someone is out sick, on vacation, or otherwise swamped. You can also outsource training for IT seminars, customer service workshops, and certification classes through your state medical society, training academies, or your professional association.

There are other ways, too, to recharge your team - and the best part is they cost less and work better than offering a raise. Try delegating projects to those who seem bored in their current positions to help cultivate a sense of ownership. Start small and work together until you’re sure the employees are up to speed, doling out greater responsibility as they accomplish each task. You can also ask employees who are skilled in their departments to train new recruits, which helps instill pride.

And don’t forget to reward employees for a job well done. Small denomination gift cards to the movies or local mall cost little but make a big impact. You can also simply write a note on the back of their paycheck, or better yet, praise them publicly for going above and beyond in front of their peers. Such gestures help motivate employees who have been with you for a while to keep bringing their A game. “You have to make sure your employees own their position,” says Mitchell. “Make sure you empower them to make decisions and that you don’t punish them if they don’t have the resources or training to make the right decision. It’s all about giving them a chance to be involved so it’s not all being pushed down from the top.”

Shelly K. Schwartz, a freelance writer in Maplewood, N.J., has covered personal finance, technology, and healthcare for more than 12 years. Her work has appeared on CNNMoney.com, Bankrate.com, and Healthy Family magazine. She can be reached via physicianspractice@cmpmedica.com.

This article originally appeared in the July/August 2010 issue of Physicians Practice.