Practice managers and physician owners might look at the media attention focused on Yahoo! CEO Marissa Mayer’s decision to end work-from-home at her company and think, well, that doesn’t apply to me.  And it’s true, with only a few exceptions (say, billing), medical practice staff members are unlikely to be able to do their work from home — not just because they need to be where the patients are, but also because of the privacy risks of bringing documents out of the office.

That doesn’t mean, though, that the controversy and discussion that Mayer’s decision engendered (and now Best Buy CEO Hubert Joly‘s as well)  are completely irrelevant to physician practices.  Because even though working at home is an option that won’t often make sense for medical office staff, the media frenzy about one company’s HR decision does illustrate how challenging it can be to make management changes without unintended consequences, even when the need for the change seems obvious.

Change sparks fear

One of the theories that immediately emerged about the Yahoo! telecommuting ban was that Mayer was simply implementing “backdoor layoffs” — i.e., that she’d determined that forcing everyone into the office would be an easy way to encourage telecommuters to quit to achieve needed cost reductions.  Naturally, this theory provokes fear in all staff — what if there aren’t enough quitters to bring costs down, and my job ends up on the chopping block?

There are mixed reports of how the end of telecommuting is actually playing with Yahoo! employees — despite the ongoing outrage of bloggers, there are also reports that many current Yahoos understand the need for and actually support the change.  But, certainly the situation is a good reminder about how important it is to communicate effectively with employees, to help prevent unnecessary fears from taking hold — otherwise, you risk losing  your most valued employees, who will begin job hunting in earnest when they sense trouble.  (I have seen changes as small as eliminating free coffee to save a few bucks lead to swirling rumors that bankruptcy is imminent!  When communication is missing, rumors move in to fill the vacuum.)

Perks become business-as-usual

If you’ve never worked as a telecommuter, it might seem strange that people are crying out so desperately about losing something that seemed like a rare, situational benefit and not a right due to workers.  But, once implemented, benefits have a tendency to become perceived like rights — and, their value can be overestimated, partly because fear of loss (related to the ‘endowment effect’) is a powerful, natural human reaction.

Which brings me back to how people react to losing their free coffee … and other perceived endowments.  Ever tried to reduce overtime in a practice?  Routine overtime is expensive, and is usually a sign of suboptimal job structuring or sometimes inadequate staff.  When we encounter it in struggling practices, it’s one of the first things that catches our attention, and it needs correcting.  But, when employees have been routinely racking up extra hours for months or even years, it can be very disruptive to just shut off the spigot, because those employees are now depending on that income. “Over”time becomes synonymous with standard pay when it becomes expected.  If you can’t afford to lose those employees, you’ll need to find a way to soften the blow — whether by slightly raising hourly rates, switching schedules to allow for more meaningful time off (perhaps a morning a week), or offering the employees bonuses for recommending ideas that help streamline workflow and reduce costs. Other unpopular changes can be phased in gradually to lessen their impact on employee morale.

Tend to culture

Ms. Mayer’s challenge at Yahoo! includes turning around a culture that has been in decline for about a decade.  As the fifth CEO in as many years, she can hardly be held accountable for the poor morale and pessimism among staff that she inherited. Her move to bring everyone back into the office to reset the culture has been deemed drastic — but, she is responding to a drastic situation.

Mayer couldn’t have prevented the culture erosion that she now needs to so urgently correct — but, most practice managers and physician owners do have that opportunity.  Instilling teamwork, fostering communication, and creating a sense of shared mission are all essential to keeping employees motivated and everyone moving in the same direction — and, they’re much easier to maintain than to rebuild.  Too often, these ‘softer’ issues of practice management get short shrift — but, a little attention to team health (whether through regular meetings, shared goals or conscious feedback to staff) goes a long way toward avoiding a crisis that is much harder to manage and correct.


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