Improving the Performance of Medical Practice Staff

The first spring after planting peach trees, I was thrilled to see bees pollinating the hundreds of blossoms that appeared. When clumps of little green peaches developed, I started gathering recipes for pie and cobbler.

Unfortunately though, few peach baked goods came out of my oven that year. Why? I didn't get the yield I was hoping for because I didn't understand the concept of "thinning" - picking off some of the small or too-clustered fruits so that the larger and healthier ones could mature.

The practice team is like my peach tree. You must tend to it regularly, give it nutrients, and thin it when necessary. It might be hard for some managers to face that last one, but it's true. And it's important for the overall health and success of the team.

As you look ahead and plan for 2016, ask yourself these questions:

1. Are you actively cultivating your high performers?

The key word is actively. Just as my peach trees needed water and nutrients, your strong performers need inputs to thrive. Are you taking the time to teach and mentor them so they can ultimately assume more advanced roles (maybe even yours)? Do you give them opportunities for learning? Not just the annual CPT code changes, but skill building that results in them bringing you innovative, new ideas? Are there projects that your star employees could take on next year? This is the time of year to ask these questions and factor the answers into next year's budget, so your top performers don't stagnate.

2. Is there a plan for training and coaching your average performers to go from good to great?

If the answer is no, it's time to develop one. And it doesn't have to be complicated. Start by considering each employee's current knowledge and what you feel would build it. Assigning self-paced learning such as journal articles, e-newsletter reading, or webinars is a good start. Then, meet with each employee to discuss the kind of additional training, knowledge, or support he feels is needed, and set some goals and a budget for this in 2016. You'll find this conversation can be a great motivator, especially for staff who are less likely to take initiative, and those who may feel the need for your "permission" and a nudge to further their learning.

3.Is anyone on the team struggling?

Admit it: You know who these people are. Maybe you've been too busy juggling multiple priorities to schedule time to talk with them. Or, maybe you're giving these folks some time - hoping things will get better.

Before the year draws to a close, confront these employees, tactfully, of course, to determine what's going on. Finding out the "real story" behind lackluster performance is the first step toward motivating employees to do better. Don't assume anything. Boredom, fear of change, overwork, stress at home, lack of sleep or exercise, or some story the employee has in her head that you don't think she's doing a good job. All of these things can affect productivity. Your first action is to identify those who have been slipping, and schedule a meeting to find out what's up.

4. Could some employees benefit from coaching?

Coaching is a one-on-one empowerment process that can build employee confidence and improve performance, enabling employees to think differently and assume new roles. Coaching is different from training and it's useful when you are grooming employees to move into supervisory positions or when you are expanding someone's role. A coach acts as a sounding board, and supports employees by helping them to take action and improve.

Whether you conduct the coaching meetings, or you hire an outside coach, it's an employee benefit that bodes well for both productivity and profitability. It can also create a succession planning process that develops front-line staff into supervisors or managers.

5. How well is your "old growth" performing?

Not old by age, but old by tenure. It's common for medical offices to have long-term employees who remain in the same or similar job roles for what is often too many years. On the one hand, this can be perceived as loyalty. But in many cases, long-time employees get stuck in the "this is the way we've always done it" mentality and aren't motivated to learn new things, and rarely come to the manager or physicians with innovative ideas.

We recently guided a client to conclude that it was time to let go of a manager who didn't have the education, skills, initiative, or interpersonal abilities to be an effective administrator. The physician had realized it nearly three years before, but felt that firing her would have been "traitorous." So the practice hobbled along with high turnover, disempowered employees, and flat revenue as the physician became increasingly unhappy.

When the administrator was finally let go, it was like a shot in the arm for the employees, all of whom stepped up and began to blossom. Although there were a lot of pieces to put back together, the "thinning" was a huge relief for the physician as well, who said, "I should have done this a long time ago. Now I can move forward and build the kind of practice I've always wanted."

Cheryl Toth, MBAis a consultant and trainer with KarenZupko & Associates, Inc. She brings more than 20 years of consulting and executive and technology product management experience to her projects.