How strong leadership influences your entire practice

Key Points

Top-down attitude

Don't fall prey to a hierarchy mentality that has physicians and managers making all the decisions. It's important to involve those affected by a potential change in the decision-making process. Their input is an invaluable contribution to understanding a situation, making a wise choice, and ensuring the buy-in to change-an essential ingredient to achieving the best results.

Poor communication

A busy doctor often assumes that staff members know what is expected of them and that they feel appreciated. Wrong! Feedback is critical. It helps staff understand what they are doing well and where they can tune up their skills. It makes them feel appreciated and valued. The result of great feedback is a highly motivated and productive team and a practice that runs better. It's in your power to make this happen.

Details are critical when it comes to practicing medicine, but on the business side of medicine, they often result in a failure to look at the big picture and the practice's vision for the future. I've seen it many times, and it impedes success. Take the urologist who becomes overwhelmed by new, unfavorable edicts handed down by Medicare. If he gets angry and reacts, the outcome is likely to be negative. Instead, when something happens that has a short-term effect on the practice, take time to analyze what the long-term impact might be and what proactive action management can take to make it better.

The same is true for problems that emerge during the day. Better to focus on errors that repeat themselves than to get off track and dedicate too much time to an isolated problem that is unlikely to recur. Also, ask yourself if you are the right person to take on the problem. If you can turn it over for someone else to solve, do so. Delegating responsibilities will free you from getting bogged down unnecessarily.

Certainly, there are times when looking at problem-causing details is important. In such instances, examine the processes that can be fixed to improve results over time, rather than looking for someone to blame.

Poor hire and fire decisions

It's a common mistake to rush to judgment when it comes to hiring. When a staff member gives 2 weeks' notice, we feel pressured to fill the position before it is vacant. Sometimes if the "right" candidate hasn't come along, we settle for less, and we live to regret it. Hiring is an expensive process that takes lots of your time and your staff's. So pick a candidate who is a good fit, even if it means waiting. Be fair, consistent, and objective in how you measure and evaluate potential new hires. Take your time when searching for new employees.

By the same token, hanging on to an underperforming employee can be disastrous, especially if you've given him the opportunity to improve and he hasn't. When it's obvious an employee isn't cutting it, it's your job to sort through the possible reasons and find out which one applies.

Give him the training, tools, and support needed to succeed. Set realistic expectations and goals for improvement. If he does not achieve the expected results, it's time to consider termination. Don't let emotions rule the day and cause you to be over-sympathetic. Base the decision on objective, measurable results and do it swiftly with sensitivity. It's not fair to the physicians, staff, or the individual employee to drag it out.