Juggling Managers

May 1, 2008

We have a busy gynecology practice with a staff of 10. When my office manager of 19 years left, I made the mistake of hiring from within. In retrospect, she wasn’t really up to the bigger job, and she just is not performing to our needs. In the last five months I hired another woman that used to manage an eight-physician practice. We were only hiring for our front desk, and she was fine with that. This new worker obviously has the managerial skills that we have been looking for, but I can’t figure out how to promote her to manager and demote the present manager. One of the best parts of this practice (aside from its financial success) is the close working relationship of the entire staff. I am looking for any way to accomplish this with the minimal amount of pain. Suggestions from other practices included creating a new position above manager.

Question: We have a busy gynecology practice with a staff of 10. When my office manager of 19 years left, I made the mistake of hiring from within. In retrospect, she wasn’t really up to the bigger job, and she just is not performing to our needs. In the last five months I hired another woman that used to manage an eight-physician practice.

We were only hiring for our front desk, and she was fine with that. This new worker obviously has the managerial skills that we have been looking for, but I can’t figure out how to promote her to manager and demote the present manager. One of the best parts of this practice (aside from its financial success) is the close working relationship of the entire staff. I am looking for any way to accomplish this with the minimal amount of pain. Suggestions from other practices included creating a new position above manager.

Answer: Sorry to hear about your situation.

There may be pain no matter what, but keep your eye on the goal.

Having an inexperienced manager will not help your practice financially or from the perspective of the working relationships. I’d hazard a guess that you currently are not only losing revenue opportunities, but that there is discord among the staff that has simply become so normal you hardly recognize it anymore. Ten staff people need to be managed. And have no doubt: They all know that the current manager isn’t up to the task. That creates a vacuum of leadership that makes things directionless, at best.

You have to act from either perspective. How to do it least painfully? How about a frank talk with the current manager? Point out that the practice is billing, I assume, more than a million dollars. Would she be up for managing any other million dollar business? Don’t be afraid to point out the kind of things you think a manager should be doing that she isn’t doing. Acknowledge your mistake in advancing her to a role that, in retrospect, is less than ideal for anyone. Ask what role she’d really like to have. Perhaps she’d love to simply oversee the billing staff, for example, or take charge of patient accounts. Present it as an opportunity to work in her dream role.

She can’t feel happy knowing she is in over her head; hone in on that.

Also, separate her role from the role of the other employee (the new hire). Your current manager needs to find a new role, regardless of whether you have a potential replacement sitting at your front desk.

When you are ready to hire a new manager, you sure can consider the new employee, but I’d also encourage you to open the search to other experienced managers so that you take a full look at the field instead of settling for what’s in front of you again. Your new hire may or may not be truly ideal. The only way to know is to check out many applicants.

I think that creating two managers by inventing a “new” position will just mean no one knows who is in charge. You also end up paying two people to do work that should be done by one. Plus, it doesn’t fool anyone.