It's Hard Being the Boss

July 6, 2010

One of the reasons I wanted to go into solo practice was the independence. The ability to make the decisions, to call the shots, to make the policies. In short, to be the boss. Of course, with power comes responsibility.

One of the reasons I wanted to go into solo practice was the independence. The ability to make the decisions, to call the shots, to make the policies. In short, to be the boss. 

Of course, with power comes responsibility. Not only to my patients, but to my employees. And to the referring physicians. And at the same time, my family.

Yes, I can decide if the office is open or closed. And if I choose to take Columbus Day off because my kids don’t have school, I can accept the fact that I won’t be able to charge for seeing patients, and in effect, won’t get paid for that day.

But what about my staff? It’s a small solo practice, so I have decided that holidays are currently unpaid days off. They both knew before they accepted the jobs that there would be about 10 unpaid holidays. Yeah, I know, seems like a lot, but I have two kids in grade school, they get a lot of days off, and I don’t have any one to watch them. Now, if I decide to close the office for some other reason, I do pay them. So they are not at the mercy of my every whim. And it’s not often that I close the office, because in reality, I can’t afford it.

On the other hand, I give my employees 10 personal days a year. That includes vacation, sick days, etc. My MA has planned her summer vacation. Fine. Well, she just injured herself playing softball, so now she’s been out for two days, and may be out more next week. In a big practice, or in a hospital, she may have additional sick days. But again, I can’t afford to be paying someone for days they’re not working, even if they have a legitimate reason.

At least, this is what I have been telling myself for the last two days. I have not reminded her of this yet. And I feel kind of bad about it. This is the part of being a boss I don’t like. I know a rule is a rule, and if I let her take extra days, then why wouldn’t the front desk person suddenly come down with some summer flu and stay out a couple of days, say the Thursday and Friday before Labor Day?

But I know she needs the money, and I believe she truly is hurt. I don’t know if it has occurred to her that this counts towards her 10 days off, and I hate being the bearer of bad news.

Speaking of being hurt, it also bothers me when I hear her complain about how much this trip to the dentist cost, or how this isn’t covered by our plan, or how this doctor doesn’t participate in our plan. She doesn’t say it to me, but I’m right there so I hear her. I tell myself (and try to keep myself from telling her), it’s a heck of a lot better than having no coverage at all, ain’t it?

I want to be able to provide well for my staff, but I could never compete with a large practice or a hospital practice. Hopefully, as the practice grows, that will change.