Share the Joy

Successful delegation depends on finding partners who complement each other -- where one is weak, the other excels. This prevents the practice from suffering from an individual's weaknesses while simultaneously benefiting from each partner's strengths.

Case in point: I was once the sole owner of my practice. We had three physicians and two mid-level providers, but I was in charge of running the whole show. So it was my decision back in 1996 that caused us to become one of the first practices to adopt electronic medical records. With evangelical zeal, I firmly believed that the future of medicine was electronic, and so I pushed for computerizing the office wherever possible. I even became president of our EMR's user group and subsequently I have risen to some fame -- at least within EMR circles. (Amazingly, despite my best efforts to impulsively drive our practice in directions never seen before in primary care via my ADHD management style, we never went bankrupt.)

Such single-minded focus is an asset for projects like EMR. However, it's less good for running a practice. I remained frustrated with our lack of financial progress. But everything turned around when two of my employed physicians became partners two years ago.

We divided our work based on our skills: I am the CEO (motivated leader and dreamer) and CIO (computer geek). Mike is the CMO (develops clinical guidelines for the practice and works with the nursing staff). Chris is the CFO/COO (runs the office's day-to-day activities).

Our practice grew rapidly and our finances improved, with our income now far above the national mean for primary care. And, our technology and our clinical quality are nationally recognized.

Here are some points to consider when delegating roles and responsibilities:

• Someone in the practice must have a leader's vision. This person must not only believe in "something bigger," but also be able to motivate others to embrace the dream.

• Offset these dreamers with practical nuts-and-bolts people who can run the practice's daily activities. Liken this to having an accelerator and brakes in a car. Obviously, you need both to avoid the equally undesirable prospects of crashing and going nowhere.

• Those who don't want to run the business can still find a useful place in a practice. A CMO can do much to bring in new physicians, deal with clinical issues, and help set guidelines. If a new immunization comes out, for example, you can trust your CMO will be ready with the clinical data, while the CFO handles the financial side. Both are critical.

• Employ good politics. Make sure you have someone on board to act as a trustworthy mediator. One of my personal strengths is that I am able to overlook the weaknesses of others if I see strengths -- a real asset for keeping peace.

The process of delegation is ongoing. Crises will come and go -- as in any business, marriage, family -- but with proper delegation you'll work from a position of maximum strength that will move the practice forward. And although it can be initially hard to let go of some power, in the end, things will be far better for your staff, your patients, and you.

Robert Lamberts, MD, is a primary care physician with Evans Medical Group, in Evans, Georgia. He is board certified in internal medicine and pediatrics and specializes in the care of adults, pediatrics, diabetes, high blood pressure, asthma, preventative medicine, attention deficit disorder and emotional/behavior disorders. Dr. Lamberts serves on multiple committees at several national organizations for the promotion of computerized health records, for which he is a recognized national speaker. He can be reached at rob.lamberts@gmail.com.