Since we are required to spend a good deal of our working lives managing people, becoming more skilled at it is something that will help us deliver our primary service much more efficiently. However, many doctors have little or no training in this vital area, and are not well disposed to increasing their skill levels. It becomes a vicious cycle, where the ideas of “I’m not good at this” and “I don’t want to spend my time doing this” feed on one another worsening the dysfunction and incompetence that already exists.
For doctors who do want to improve their managerial skills, this blog will help you identify common erroneous assumptions and thoughts that will impede your progress if they are left unchecked. Some of these arise out of misunderstanding, and some out of applying the doctor’s own personality and worldview to an employee.
High functioning people do not need praise.
There is a strong tendency to ignore what a high functioning person in your office does and to only focus on problems and conflicts. This is fine example of keeping your doctor hat on when you should be having your employer hat on. The operative concept here is “catch them doing something right”, noticing and giving feedback to the staff member. This can be a small thing, such as noticing a staff member artfully handling an unpleasant or uncooperative patient. The main thing is that she has to feel noticed and appreciated, or she will end up feeling used and resentful.
Asking is better than telling
This fallacy arises from an over-reliance on the teamwork and consensus concepts. These are fine in peer relationships, but in hierarchical relationships, you can easily go astray. The art form here is to be firm and consistent without being tyrannical or overbearing. Remember that chiropractic practices (or really any health care services) are rule driven businesses. The providers must follow rules, and so must employees. This can also stem from a desire to be “nice” by not being controllling or bossy, but often ends up with incomplete tasks and work-shifting, oftentimes to the shoulders of the doctor.
I do not need to understand the business side of practice to be successful
This stems from discomfort with and unfamiliarity with finances, economics and basic business principles. It also comes from confusion between the price of something and the value of something. The cost, or price of any service is set by larger scale, non-local entities, such as third party payers and governments. The value of the service is something that is judged on an individual basis but the consumer of the service (the patient).
There is regional variation in the cost of services but not much, especially as compared with the price of other types of goods and services. For example, you can buy a new Lamborghini for $3.9M, or you can buy a new Nissan for about $12,000. The former is 32 times more expensive than the latter. The price of a chiropractic exam is the same in a given locale, regardless of your experience and effectiveness as a doctor.
I’m not a good manager
Managerial skills are learned, not native. Nobody is born as a natural manager. For doctors, some key points are
- Create structure, such as handbooks and procedural manuals
- Be consistent in the application of all procedures and expectations
- Give regular feedback through meetings and reviews
- Ask for feedback from your staff about your managerial style and effectiveness
- Praise in public, discipline in private
I’m not a good communicator
While it’s true that some are more literary and verbose than others, all spoken communications can be improved with practice. For the speaking portion, I have found that a simple way to improve is through the use of dictation. This can be simply speaking a thought into a recording device, and then listening back. See if your thoughts are clear, coherent and are constructed like declarative sentences. Is your voice breathy or scratchy? Do you mumble or cut your own words off? Most times, your voice will sound higher pitched and tinnier when recorded than it does when you are speaking naturally.
For listening, practice the three levels of listening:
- Content level: This is letting the other person speak his thoughts and the feeding it back. “So, what I understand you to say is…”
- Internal listening: This means gauging your own responses to the other individual. Are you interested and engaged, positive? Are you looking for quick ways to end the conversation?
- Third party listening: This means gauging the quality of the conversation as if viewed by a third party. Are the words consistent with the postures, gestures and overall body language? Does one party appear to be looking for an escape? Is there any visible sign of scorn or distaste?
I can delegate parts of my practice to others and never pay attention to them again
Effective delegation is an art form, and one that must be constantly practiced in order to become skilled. A useful concept is as follows: successful delegation occurs when bottom line responsibility for a task, project or process is handed of to a fully functioning adult. What’s a fully functioning adult? Someone who knows what she is supposed to do and does it, on or before the time it’s due, without being asked, told or forced.
The biggest pitfall in effective delegation is handing the task off and then ignoring the outcome. This is different from inspection, which will be the topic of a future blog.