October 10, 2018
4 min read
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Surgeons can help themselves by helping their management staff thrive

Establish your practice as a learning organization, stay involved in training staff and ask frequently for feedback.

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“Investing in management means building communication systems, business processes, feedback, and routines that let you scale the business and team as efficiently as possible.”
– Fred Wilson

“A good teacher must be able to put himself in the place of those who find learning hard.”
– Eliphas Levi

“Manage others the way you would like to be managed.”
– Brian Tracy

On the way to becoming an eye surgeon, most ophthalmologists put in a lot of time not just learning but also teaching, either as formal teaching assistants during their university years or less formally as the smartest student in the class who helps fellow students with difficult subjects.

The best and most successful surgeons, who go on to be the owners of vibrant practices, embrace a continuing role as a generous teacher and mentor. They obviously do this at several levels:

  • As clinicians, helping their patients make important treatment decisions;
  • As supervising physicians, helping younger doctors in a group practice polish their craft; and
  • As business leaders, helping their administrator and mid-level department managers improve their skills.

There are numerous, conscious ways of being a better educator:

Be involved with all new staff hires and promotions — and demotions. If you are too busy to interview the finalists for head tech or lead receptionist, you have weak grounds for complaining when the manager selected does not rise to your standards. Go beyond a perfunctory “hello” to deeply interview any new management staff and any senior staff who are moving up the ladder. And every time a manager fails, do not leave it to your administrator alone to conduct the demotion or exit interview. Join the discussion. It is a splendid opportunity to improve not only the company’s collective skill at picking leaders, but your own skills as a business owner.

Set the right tone, establishing your practice as a “learning organization.” What does that mean? It means you take the time to patiently answer staff questions. You attend staff meetings and present topics that will help staff better help your patients. Encourage that protocols and policies are not just passed along orally, but memorialized in writing, and periodically reviewed for potential improvements and clarifications. Objectively, the average department manager or administrator in your practice should be spending about as much time on formal continuing education as you do — about 3% to 5% of their professional time, or roughly 1 day per month. Readings, group discussion of focused management topics germane to the company’s challenges, formal conferences and workshops — all apply.

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Stay personally involved in training senior management staff. There are numerous outlets for this, starting with your administrator. Your practice manager may be skilled at accounting or billing or marketing or human resources. But they are probably underinformed about the nuances of the products and services your practice sells (even if they came up the ranks as a technician before they became a manager). Help your administrator understand the most common eye diseases and their treatments. Collaborate to discover the economic impact of one course of treatment vs. another. Help your billing manager learn how to conduct more thorough chart audits. Help your tech supervisor make a training video when a new piece of equipment is purchased.

Be generous with continuing education funding. This goes beyond sending senior staff to the national meetings. Encourage your administrator to scan for local community college courses in bookkeeping, HR management and facilities management. Set up a tuition subsidy program for promising managers who could be more valuable to you if they finished college or picked up an advanced degree. Every manager should have an individual or group subscription to publications relevant to their specialist area. Consider setting aside shelf space and obliging each manager to buy (at the practice’s expense) one germane book per month, read it, report a pearl or two they learned at a manager’s meeting, and then have the book go into the practice’s reference library. This can go beyond printed books. Audio management, executive effectiveness and similar courses can make good use of morning and evening commuting time and of trips to the satellite office if you have a hub-and-spoke practice.

Provide abundant encouragement whenever you catch senior staff leading their staff effectively. As a surgeon you were probably trained in a “gotcha” environment, jumped on by professors every time you missed a step or made an error. As a result, you quite likely apply the same method to your administrator and middle managers: silence when their work is well done, and stern reproach whenever a small error is discovered. The fastest way to turn around management’s morale (and frankly, the morale of all lay staff) is to praise early and often, pointing out even the smallest performance gains you notice.

Develop a deeper level of strategic intimacy with your management staff. We often perform this exercise with physician clients and their managers sitting together around a conference table: We hand out pens and paper, and ask everyone to, “Write down a description of this practice 5 years from now.” The all-too-common result is that managers and doctors write down very differing visions of where they see the practice is heading in the future. Strategic planning is a board-level responsibility that should be pursued in collaboration with the practice administrator and mid-level managers (who can help assure the feasibility of your operational goals).

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Ask for feedback. Ask each of your senior staff at frequent intervals: “Is there anything I could be doing to be a better practice owner? To back you up? To support your role as a leader here?” And then take their advice. Along the way, be humble; when a manager fails, ask, “How much of their failure was my responsibility?”