Joseph Capko

Nearly all practices can benefit from improved communication.  In this column, I’ll be sharing some tips on forms of group communication.  Reaching out to groups within your practice can improve morale, invigorate and encourage problem solving and generally make your work life more pleasant and profitable. Reinforce what is important and solidify culture. Any opportunity to communicate with a group is an opportunity to build a common understanding of the goals and challenges facing the practice. Without this holistic understanding, how can you expect staff to show any initiative beyond their narrow job description? Accordingly, be sure to point out how staff’s activities advance your strategic objectives and how the practice is moving towards these goals together. Insist on engagement. Leadership can actively and consistently seek feedback from the entire staff in the most welcoming way possible. Staff is generally delighted to be consulted. Recognize any ideas they contribute as broadly as possible to help build cohesion. Along with asking for feedback, it’s critical to demonstrate a positive and receptive attitude to feedback - especially when it’s feedback that reflects critically on the management. This is precisely the information you need to hear most, because it’s likely in your personal blind spot. In the majority of practices we’ve visited, at least a few valuable ideas from staff go unrecognized and untapped. Occasionally, management even has a know-it-all or even a belittling attitude summed up well in a line from the Honeymooners – “I’m the boss and you’re nothing!” The response of “Congratulations, boss over nothing!” reflects how the healthy functioning of the practice relies on the competence and goodwill of all its contributors. Encourage accountability and reward commitment. Staff meetings and group memos present an opportunity to acknowledge accomplishments in full view of others. We strongly urge management to take every opportunity to thank staff in group contexts. A heartfelt thank you and even a modest gift, such as a $10 Starbucks gift card, can be surprisingly meaningful to staff that can feel invisible unless they make a mistake. Build and reinforce positivity. Since it’s unlikely a demoralized staff is

Since administrators play such a critical role in practices, recruiting a new one for your practice may provoke a fair bit of anxiety. If you’ve been left with little time, you may feel rushed. If your previous practice manager was a flop, you might even be feeling dread. Addressing the challenge head-on and systematically can help get you the result you desire. One familiar mistake we see is failing to define your needs thoroughly. This is not just a matter of “minimum of five years experience” – it’s a matter of understanding your practice’s mission, goals, and culture. It’s a matter of identifying what success looks like with the right administrator in place. Without mapping your practice’s needs and culture to a candidate’s qualifications and characteristics, you’re left merely hoping for a good outcome. Considering the lost time, productivity and general disruption that comes along with a poor hire, you need the odds in your favor. If you have infighting among your staff, which isn’t uncommon unfortunately, you may need a no-nonsense administrator with more of a hands-on approach as opposed to a spreadsheet genius who prefers to stay locked in her office all day. On the other hand, perhaps you have a mature and well-functioning staff and feel that you need a candidate with particularly strong financial management skills—for example, if growing your practice by adding a new office or even acquiring a competitor is on your agenda. Whatever you decide, you may want to create a spreadsheet table so that you can rate each candidates on the dimensions you think are most important - a simple 1-5 rating is a great start. You may want to use weighting as a tool to further refine your analysis. The old management saying of “be slow to hire and quick to fire” is useful to keep in mind along with some caveats. While it’s certainly important to find the best possible candidate, the cost of stop-gap management can be high. We see many practices where some staff is “temporarily” filling in as the practice administrator – often poorly attending to many

Many administrators and physicians struggle to find the optimal staffing level.  When patient volume is especially high or an employee has called in sick, it can seem like you’re horribly short-handed.  On the other hand, seeing staff idle can make physicians feel as though they are paying for nothing at all – hardly a comfortable thought when profits are being challenged in multiple fronts.   Evaluating your ongoing staffing needs in a methodical, evidence-based manner can be a challenge, but it’s well worth the time and trouble. While it’s natural to look to other medical practices to see how you compare, don’t give undue weight to such comparisons.  While staffing levels typically fall between 3-6 FTE staff per clinician, it’s underappreciated that the strongest, most profitable practices often have more staff per provider.  To the extent staff assists the physicians in working efficiently, they increase the revenue potential of the practice.  Every task that a physician does that a staff member could do is a lost opportunity.  When we visit our medical practice clients, we almost always notice productivity gains that could be made with existing practice staff.  If your practice is like most, you can benefit from looking carefully to see if more tasks can be done by staff generally.  And here’s a great little secret: if you have staff who sometimes feel a little bored or underappreciated, simply asking them how efficiency can be improved can yield immediate results. Even after decades of experience, we’re still surprised by how many excellent ideas can come from even the most junior staff.  But more than that, staff feels more valued, engaged, and committed to the practice when you recognize their knowledge by asking their opinions. Also keep in mind that there may be tasks staff would be motivated to do during brief down periods that are beneficial to your practice. For example, many practices fail to update their websites and social media on a regular basis. This type of work can be a perfect fit for slow times at the front desk if you have a person who has the enthusiasm