Leading and Managing a Strong Medical Practice Team

April 2, 2014

Medical school taught you to practice medicine, not how to manage your staff. Here's a crash course.

You became a physician to care for patients, so leading and managing your staff may not be among your top priorities. If you have a manager or administrator at your practice, it may be even more tempting to rely on them to take on all of the team-building and leadership tasks. But that's a big mistake.

"You can't just say, 'Well I'm the doctor and my whole role is to deal with patients in the clinical setting, I don't need to worry about any of the other things,'" says Judy Capko, consultant and founder of Capko & Morgan, a practice-management consulting firm in San Francisco. "The doctor is the ultimate leader in the practice, and he or she is the force that sets the vision of how we treat the culture, how we treat the patients, whether or not we're ready to stay long term."

Those may sound like big responsibilities, but don't get too overwhelmed. A little effort from physicians goes a long way toward cultivating a strong and healthy staff. Here are some simple ways medical practice consultants and former practice administrators say you can lead, foster, and manage a strong team at your practice.

Lead by example

Since you are the leader of your practice, your staff (if you have hired well) will strive to follow your example. If you are on time, they are more likely to be on time; if you are passionate, they are more likely to be passionate; and if you are detail oriented, they are more likely to be detail oriented, says Dallas-based Audrey "Christie" McLaughlin, a registered nurse and founder of Physicians Practice Expert, a medical practice consulting firm, and contributor to Practice Notes, Physicians Practice's blog. "The more that you can model the behavior and performance that you want to see from your staff, the more that you can really influence your team in a positive way."

Be part of the team

Another way to cultivate a strong team: Be a strong leader and teammate. Those roles can be difficult to balance, but showing that you value your team and are engaged with them can help, says Capko. Be respectful, be considerate, and be polite, she says. If a staff member returns from vacation, ask him how it went; if someone new joins your practice, spend a few minutes getting to know her; and if you have some unexpected free time, walk around and ask staff members how their days are going. "If you take that time to be with them, they're going to be much more loyal and dedicated to you," she says.

In addition to engaging with staff on a daily basis, attend staff meetings whenever possible. That will send the message that you support your staff and care about the challenges they face, says Capko.

Establish boundaries

While fostering a strong team mentality is critical, be careful not to get too friendly with your staff. Failure to establish strong professional boundaries could jeopardize your ability to command respect and authority, says Capko, adding that this often occurs in practices when young doctors relate more easily to staff members than their physician colleagues.

Remember, there is an important distinction between getting personal with staff and being personable with staff. "They don’t need to know your personal problems; you don’t need to know theirs," says Capko.

Other boundary-blurring topics to steer clear of include talking critically about one staff member to another, and discussing personal finances with staff, says Carol Stryker, founder of Houston-based medical practice consulting firm Symbiotic Solutions. "Never ever get to talking about things that point out the income disparity between you and them," she says. "For instance, you don't complain, 'I just can't believe how expensive it is to put a new roof on my house,' because typically your staff won't relate to that and it just raises issues."

Play fair

Establishing strong professional boundaries also reduces the likelihood that you will start playing favorites with certain staff members, which can crush staff morale and destroy teamwork, says Mary Pat Whaley, a practice administrator for more than 25 years and founder of Manage My Practice consulting firm in Durham, N.C.

In fact, Whaley says that physician favoritism toward certain staff members is one of the most "poisonous" problems that crops up in practices. "As soon as staff sees that one person doesn't have to toe the line or follow the rules, then nobody [else] feels like they have to either," she says.

For that reason, it's critical to hold all staff members to the same standards, and avoid socializing with staff outside of work unless you invite the entire team, says McLaughlin. Also, focus on cultivating strong relationships outside of your practice so that you won't be tempted to form them within it, says Stryker.

Hold accountable

A fundamental aspect of a strong staff team, of course, is strong performance. As the leader of your practice, you play a pivotal role in holding staff accountable for poor performance, and in encouraging strong performance.

When a staff member is performing well, be generous with compliments and praise, says Whaley, noting that physician praise, especially public praise, means a lot to staff members and increases the likelihood that they will continue to perform similarly in the future.

The hard part of encouraging strong performance, of course, is holding staff accountable for poor performance. Still, don't shy away from it when necessary, says Whaley. "If something happens on the clinic floor and nobody tells the manager, then there becomes sort of this whole conspiracy," she says. "It's very important that the staff understands that the physician ... is not going to sort of bypass the rules and be like one of the kids instead of the dad."

How you react to poor performance may change depending on the circumstances, though you should always discipline staff privately, says Whaley. If you see a performance problem, consider taking note of it quietly and later asking your practice manager to speak with the staff member about it. Or, consider getting directly involved. "One of the best things that a physician can say is, 'I think that you and the manager and I may need to have a talk,'" says Whaley. "That really gets staff's attention."

Managing the manager

True or false: You have a practice manager or administrator, so it's OK to turn over all the practice-management responsibilities to her. False!

While you may not want to believe it, some managers really are bad apples, and physicians are easy targets for embezzlement and fraud, says Mary Pat Whaley, founder of Manage My Practice consulting firm in Durham, N.C.

"As is very popularly quoted these days: 'Trust but verify,'" she says. "If you as a physician don't understand the business details, you always want have to have a CPA or a consultant kind of looking over your administrator's shoulder. The administrator, if they're worth their salt, should appreciate that."

But keeping an eye on finances is not the only area of medical practice management that physicians need to oversee. For more tips on how to effectively manage your manager, visit bit.ly/Managing-Manager.

Whose responsibility is it?

When physicians and their managers or administrators are on the same page, they are not stepping on each other's toes, and practices run much more smoothly. But when it comes to practice-management responsibilities, it can be tricky to identify what responsibilities should belong to the physician, and what responsibilities should belong to the manager. Visit bit.ly/Responsibility-Quiz to see if you've delineated practice management responsibilities correctly in your practice.

Aubrey Westgate is senior editor for Physicians Practice. She can be reached at aubrey.westgate@ubm.com.

This article originally appeared in the April 2014 issue of Physicians Practice.