Soothe staff anxiety, build teamwork in challenging times

To keep a relaxed and focused atmosphere during this bad economy, practice owners must show leadership, effective communication and optimism.

Issue: January 10, 2009

ByJohn B. Pinto

John B. Pinto

Nearly 40 years ago, when I was in high school, a gang of us boys in the then-wild rural outskirts of Los Angeles were into falconry — you know, hawks, hunting and the whole medieval scene. Mostly, we caught rabbits, helped to feed our families and learned how to manage the performance of the birds we kept by carefully monitoring their mood and condition. We weighed each bird to the nearest gram and would palpate their sternums for how fat or lean they were before our trips afield.

The core lessons learned then still stick as I help clients manage their vital staff resources: Fat and happy falcons do not fly with much vigor, whereas starving or nervous birds are too weak or frantic to be successful doing their job. It is the relaxed-but-hungry birds that catch all of the rabbits.

We called these healthy, eager, hungry birds “sharp set.” They were the ones ready to go into the field to work hard.

That was several economic recessions ago. But the seemingly oblique lessons learned back then are still useful when applied to ophthalmic practice management in the present national doldrums:

It is calm, well-led, keen-to-toil staff — staff who understand that times are a bit tough, but not impossibly so — who are the hardest and most effective workers.
Sassy workers in the middle of fat economic times do not value their jobs much and know they do not have to work hard to keep them.
Staff members who are freaked out by the economy (and who are not much helped by your running around and saying how the sky is falling) are not at their best on the job.

Let us explore what you can do to cultivate the best your staff members have to give while soothing their understandable anxiety.

Be a leader

Remember that good economic times can paper over poor leadership habits. If your style as an owner has veered in the past to the gruff and the negative, you may now no longer be in a position to exchange endless pay raises for love and inspirational leadership.

Scrupulous leadership, which takes honesty and frequent situation updates, is the key right now. If you have been the somewhat shy, invisible leader of your practice (letting an administrator be your proxy), now is the time to circulate the office often, learn everyone’s name and learn how they are each contributing to your success. And then keep it up. If this works at times such as now, just imagine what a great leader you will be after “The Great Recession” is over in a couple of years.

Staff morale can be more positively affected by their interaction with you as a physician and by your specific positive comments about their performance than by any other single influence in the workplace. Do not just praise the technicians you see every day but also the billing staff and front desk clerks. In practices in which surgeons go overboard with this — and do so sincerely — we could readily drop wages and not lose a single staffer.

Now is the time to communicate avidly. Hold plenty of meetings (all-hands, departmental, even quick “team spirit” huddles in advance of each clinic session).

Invite and answer questions about “how it’s all going to work out.” Do what you can to counter the negative daily news feeds, which have now reached the fevered pitch of what could be reasonably called “recessionary pornography.” Let your staff know why a career in medicine — and especially a career in eye care — is so valued at times such as these. Tell your people that the perceived threat of nationalized health care, if President-elect Barack Obama reads from President Lyndon B. Johnson’s playbook and expands Medicare, might have the same net positive outcome experienced by eye care professionals since 1965.

Steer toward the positive

Emphasize the positive in every staff communication. Be especially careful about the things you put in writing. As a doctor or manager, it is easy to dryly write about the practice’s misfortunes in a way that feels good to you — getting things off your chest — but that will absolutely freak out the troops.

Balance anything negative you feel you must report with the silver lining: “It appears that we are down 7% in patient visits and 9% in collections this year. However, because of our new flex-staffing program and the way we’ve been able to trim the cost of supplies, I’m happy to report we’re only going to be trimming about 5% of staff hours over the balance of this year, starting with voluntary reductions. And as soon as the economy turns around, we hope to rapidly restore everyone possible to their former hours.”

Although we may be in the midst of a national recession, this is not hitting everyone equally. If you work in Michigan or Ohio, your practice numbers may have been softening for a few years. As your community or practice comes out of this, announce and celebrate these successes.

Now is the time to reassure your best staff, the core of your business, that their jobs are secure. Although you might

reasonably hold the line on raises and even roll back some hourly pay rates a tad for non-essential personnel, you want to tangibly continue to motivate your top performers for one very practical reason: It is more profitable to keep these stars pulling hard and helping your practice survive and succeed than to risk their loss to competing practices or industries.

Learn from the experience

Educate your staff about the core causes of the present recession (lax lending oversight, the ruptured housing bubble, unsustainable consumer spending, excessive leverage by institutions, etc.) so they can read the signs next time around. Clip out articles and bring in guest speakers for all-hands staff meetings on family budgeting. Is this being a little paternalistic? Perhaps, but if staff members feel you care about their financial future, they will work harder to guarantee yours.

Avoid overt, outward displays of your relative prosperity. You may be bummed that your normal European vacation this year has been canceled and you are not trading in your car on the accustomed schedule, but staff will not understand how a five-star retreat in Sedona and the same “old” Mercedes represent disappointing consolation prizes.

If you need to downsize and have a choice, trim hours a bit across the board, rather than cutting positions. Let your staff know in advance that this is your affirmed company policy, so they will not be so anxious about their all-or-nothing status and can be prepared to taper family expenses accordingly if the time ever comes.

Make sure the entire team stays top-line focused. Profit enhancement in the largely fixed-cost business of eye care is more a matter of revenue enhancement than cost containment. Just three more patients per day will increase profits by $100,000+ per year in the typical practice.

In the fortunate majority of practices biased toward general, geriatric, less-elective eye care, none of these approaches will be obliged as you sail smoothly through the next year or two (or three or four) of market tumult. But many of these staff management and leadership pearls apply in good times and bad. Apply them liberally, and your staff and your practice will fly high, no matter the environment.

John B. Pinto is president of J. Pinto & Associates Inc., an ophthalmic practice management consulting firm established in 1979. Mr. Pinto is the country’s most-published author on ophthalmology management topics. He is the author of John Pinto’s Little Green Book of Ophthalmology, Cashflow: The Practical Art of Earning More From Your Ophthalmology Practice, The Efficient Ophthalmologist: How to See More Patients, Provide Better Care and Prosper in an Era of Falling Fees, The Women of Ophthalmology and the new book, Legal Issues in Ophthalmology: A Review for Surgeons and Administrators. He can be reached at 619-223-2233; e-mail: pintoinc@aol.com; Web site: www.pintoinc.com.