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Practice Development | May/Jun '14

Ten Things Every Doctor Should Know About Managing A Practice

Some of the most important skills for practice success are the ones they don’t teach you in medical school.

Young ophthalmologists come out of medical school and residency with a wide range of clinical abilities. However, the business skills needed to run a practice—financial oversight, technology acquisition, employee training and management, staff motivation—aren’t taught in medical school. This can make the transition from largely passive medical education to active management of a practice a real challenge for young doctors.

I am fortunate to be part of a dynamic practice with a great team of physician partners, a chief operating officer, and clinical and administrative staff. Below are 10 lessons I’ve learned during my career that have helped me to be a better practice manager.

Earn the respect you want. It can be daunting to contemplate managing staff with years of experience in the practice you’ve just joined. Your education and the fact that you were chosen to join the practice are an important foundation, but you’ll need to earn the staff’s respect. The best way to do that? Take excellent care of patients. Also, do not have too much pride to let the staff teach YOU. Don’t ever discount the knowledge and experience they have from years of working in the profession. I learned many important tips in the clinic and the OR from technicians and other staff members.

Cultivate relationships. In the rush to build a patient base and hone your clinical skills, don’t forget to take the time to talk to your patients and enjoy getting to know them. The way you treat people is what builds your word-of-mouth reputation. In addition, spend time getting to know referring doctors in your community. As your practice or caseload grows, you will depend more on these referral sources and on your ability to work collaboratively to best serve patients.

Make good hires. Getting it right the first time is a much better strategy than trying to get rid of a problem employee. Although you may require candidates to have certain skills for the job, it is even more important to choose people with the right personality for the practice and for the role you are trying to fill. Skills can be taught—attitude and work ethic cannot.

Remember your role. Some of the best advice I have received on managing people is: “You can be friendly, but you aren’t their friend.” As a young doctor, and especially one new to the community, it is common to feel that you have more in common with staff members your age than with, for example, a senior partner. But strike a careful balance. Getting too chummy with staff can invite some to take advantage or even just be perceived as taking advantage of the friendship to shirk duties or get special treatment.

Keep it positive! Fostering positive communication in the practice starts, of course, with a healthy relationship among the partners, and that filters down to interactions with staff. You will spend more time with your partners and staff than you do with family—so treat them with respect, kindness, and a positive attitude.

Don’t act too quickly. It’s natural to want to be decisive and nip problems in the bud. However, employee conflicts and complaints always have more than one side. When someone comes to you with a problem or comment concerning another person, reflect back that you have heard his or her concern, but don’t immediately assume the information is accurate and act on it. Gather intelligence, consult other parties to the dispute, and make sure you have all the facts before making a judgment call. I’ve witnessed completely false accusations made against staff that were very unfortunate and destroyed relationships. As a physician in the practice, it behooves you to act in a mature, reserved, and respectful manner to all parties involved. And don’t forget to redirect the problem if a staff member has inappropriately tried to jump over a department manager or other supervisor.

Say it in person. Email is absolutely NOT the forum for serious discussions, no matter how convenient it may seem. Whether it is a disagreement with a partner over how to handle something or bad news for an employee, make the conversation face to face when possible or by phone if that’s the only alternative. Also, beware of the “reply all” button. Negative comments sent to a group of people about an individual could be considered slanderous and defamatory.

Build a culture of practice success. It is important for everyone in the practice—from the receptionist on up—to realize that two fundamentals drive all else: excellent patient care and practice success. When you have a thriving practice, you can adapt to changing needs and external pressures, you can provide income security to doctors and staff, you can conduct cutting-edge research and acquire new technology, and, most importantly, you can take the best possible care of your patients. It is important for staff members to feel invested not just in getting what they want as individuals but in doing what is best for the practice.

Delegate. As ophthalmologists, we are “detail people,” so it’s very tempting to micromanage the staff members around us and to look over their shoulders when they create the clinic schedule or pick out a new paint color for the waiting room. Not only is this a waste of your time, but it also stifles creativity and the sense of ownership you want the staff to have in the practice. Learn to delegate, trust, empower others, and let people do their jobs—even if they do things differently than you might.

Know when to seek help. There’s a lot to be said for learning by doing, but our practice has certainly found that periodically bringing in needed legal, financial, or other expertise is warranted. Additionally, the impartial advice of a practice management consultant can be well worth the money.

With these tips, I hope that young doctors, even as they continue to build surgical acumen, can take the time to occasionally turn that internal focus outward in order to also build a practice environment based on excellence, teamwork, and profitability.

Elizabeth A. Davis, MD, FACS

Elizabeth A. Davis, MD, FACS, is a Managing Partner at Minnesota Eye Consultants and an Adjunct Assistant Clinical Professor at the University of Minnesota. This article is based, in part, on her contributions to the 2013 Future Leaders Meeting, supported by Abbott Medical Optics. Dr. Davis may be reached at (952) 885-2467 or eadavis@mneye.com.