In smaller offices, communication from the doctor to other staff members, whether administrative or technical, is fairly straightforward. Everyone is close in proximity and there is ample opportunity to clear up anything that might be unclear.
In a larger practice or particularly a multi-disciplinary practice, this is not as straightforward. Many doctors who are directors of or participants in larger practices developed their managerial habits in smaller practices, and then find that the small-scale approach is no longer effective. You will know this in your practice when you have to repeat instructions, your directives are not consistently carried out, or you end up doing administrative tasks yourself.
This is a pattern where the doctor thinks procedures or instructions are delivered, but they are not received or executed. This can come from incomplete or faulty training of new employees or just plain sloppiness. When you see this in the clinic, especially on a repetitious basis, specific verbal and practical training is required. The context of the procedure, the “why” remains critical to proper understanding of policy and procedure.
This is a habit pattern of the doctor giving verbal instructions to the staff in between patients. This is fine if the instructions are to execute normal procedures (mostly for a new staff member) and also to cement the instructions in the patient’s mind. When the instructions are particular to that patient, the doctor must stay present until the instructions are clearly received and acted upon.
Formalization of procedures
An administrative procedural manual is essential to consistency in procedures across different personnel. A text-based manual is a universal starting point. Screen captures of common software navigation are helpful, along with any video-based instructions supplied by your software vendor. In general, anything that is outside normal communications should not be verbal unless time does not allow any other method.
Electronic media for communication
It’s a good idea to have standards of communication in the office for non-verbal communication. Text, e-mail and shared files are the most common pathways.
Text should be used for very simple ideas, primarily logistical. Avoid multiple threads in most cases, because your text reader will become flooded, and the chances of information going to the wrong recipient increases. You will need to establish the expected response time to standard business texts. This is typically the range of hours, <4.
E-mail should be used for more complex ideas that would require collaboration or attached documents. A good convention to use is to direct the e-mail to whoever is expected to take action and to CC those who should know about the information but are not expected to act. Use reply all if there are multiple recipients. Avoid using BCC, as this tends to undermine trust.
For longer e-mail threads, avoid letting the content migrate away from the subject line. It’s generally better to have a single topic contained within the e-mail and complete that than to have multiple topics within the same thread.
If the e-mail is instructional in nature, the recipient should respond to the sender noting completion of the task.
Generally, the response time is one business day, even if just to say that the task is in progress.
Shared files are useful for information shared over multiple recipients, without being too task oriented. This can be used for policy documents, tracking forms, etc. There are multiple, easily accessed formats for doing this. Microsoft OneDrive, Google Docs or more flexible formats such as Trello work well for this need.
Office communications grow more complex over time, due to the volume of information increasing and the pipelines available proliferating. Rules and conventions within the office help to make sure that tasks do not get neglected or mishandled.
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