The Administrator’s Desk: How to Build Teamwork

February 1, 2009

Building a team takes work, but it’s well worth the effort. Here’s how to avoid the “every-man-for-himself” mentality.


Teamwork - it’s one of those buzzwords that can be hard to define. When it’s missing from your practice, however, it’s even harder to ignore. Indeed, offices that operate with an every-man-for-himself mentality suffer higher levels of turnover, chronic morale problems, and lower productivity; a drag on profit that medical practices today can ill afford. “I know great practices the minute I walk in the door,” says Steve Adams, senior practice management consultant for MAG Mutual Healthcare Solutions in Atlanta. “The best practices don’t have accounts receivable problems, they don’t have morale problems, and they don’t get as many patient complaints because they have teamwork in place.”

Developing an effective and highly functional staff that puts practice performance first, though, is easier said than done. To a large degree, that’s because medical practices are comprised of a small group of people who work together but perform very different roles. Adams estimates up to half of all medical practices suffer from teamwork challenges. “This is one of the most common requests I get,” he says.

Lead by example

As practice administrator, you can encourage teamwork by modeling good business behavior yourself. That means meeting regularly with your physicians and shareholders to discuss financial performance and opportunities for growth, maintaining open lines of communication, and resolving conflicts as quickly and professionally as possible.

Leadership in your office also must present a unified front, making it clear to all layers of staff that teamwork is a top priority. Joey Roth, practice manager for Rocky Mountain Cancer Center in Boulder, Colo. says she went one step further by asking each of the 37 staff members who report to her to help create a values statement that keeps everyone focused on the single goal of patient satisfaction. “We’ve taken those values and try to live by them daily in our work environment,” she says.

Positive reinforcement

To keep employees accountable to their coworkers, Roth also asks her staff to conduct annual peer reviews. “We ask each person to highlight or bring to attention things we’ve witnessed our peers doing in the positive,” she says. “If you get your evaluations back and you notice that you didn’t have much positive feedback in one or two of the 10 categories you might say, ‘I think I do this well, but maybe I could do it better.’ It’s meant to be a positive to help you develop yourself professionally.”

Jacks of all trades

In the quest for better teamwork, the American Medical Association’s guide to “Managing the Medical Practice” notes it’s also important to crosstrain your staff to perform multiple jobs, making them more valuable to you and giving your employees the opportunity to walk in their coworker’s shoes. Train your medical assistants to answer the phones, use the computer, check in patients, make appointments, and file charts. Administrative employees should be taught to take vital signs, chaperone patients to the exam room, schedule lab tests or surgery, and prepare an exam room for the next patient.

“By working closely together to understand each other’s needs, both the clinical and administrative staff will develop an appreciation for the problems that exist on both sides of that invisible line that seems to exist between the clinical and administrative personnel,” the AMA writes. “For fully functioning teams to operate smoothly, employees must understand their own roles and how their roles interact with and affect others.”

Let them be heard

Another effective way to get your staff working together is to give them a little skin in the game. Roth says she empowers her employees with the tools necessary to effect change. “The people on the floor doing the job are the ones who come up with the best ideas,” she says. “Instead of being a dictatorship where decisions are top down, it comes from the bottom up and that tends to work much better. You get better buy-in.”

One of the biggest benefits of cultivating a functional work environment is that your staff won’t tolerate naysayers or underperformers, forcing less productive employees to step up their game. Call it positive peer pressure. Adams notes you can help tap the potential of all your employees by considering their personalities and whether or not they’re suited for the job they perform. “A lot of times in a practice you find folks whose personality is not conducive to their line of work,” says Adams. “You might have an overly extroverted person who can’t concentrate on a single task for long stuck in billing and coding when they’d perform better at the front desk. Or maybe you’ve got the quiet person at the front desk portraying poor customer service. She’d probably be happier filing claims all day.”

A few bad apples

That said, there are some employees, in every profession, who will never be team players. Practice administrators should dismiss them promptly, says Adams.

“I don’t invest a lot of time in bad employees,” he says. “Ultimately, you can’t change people, and for $12 or $13 an hour people just aren’t willing to change.” When searching for their replacement, be sure to screen job candidates carefully, checking references and using personality tests to ensure they fit with your corporate culture. And don’t forget to include a 90-day probation period in your employment contracts, giving you the right to terminate employment during that time for any reason. “What happens is that you’re the office manager with high turnover, so you run an ad and hire someone who you think is the best candidate,” says Adams. “You spend the first few weeks training them so you get backed up and you know it’s not working out but it’s easier to keep them than to fire them and get more behind. Cut your loss and move on.”

Your employees may work side by side, but it doesn’t mean they’re playing for the same team. You can help unlock your staff’s potential and give your practice a competitive edge by setting a positive example, telling each employee how they contribute to the practice’s mission, empowering them to make decisions, and hiring the right people for the job.

Shelly K. Schwartz, a freelance writer in Maplewood, N.J., has covered personal finance, technology, and healthcare for 12 years. Her work has appeared on CNNMoney.com, Bankrate.com and Healthy Family magazine. She can be reached via kellie.rowden-racette@cmpmedica.com.

This article originally appeared in the February 2009 issue of Physicians Practice.