Medical Practices Falter When Physicians' Roles are Poorly Defined

May 28, 2014
Carol Stryker

Physicians can play many roles in medical practices, but that doesn't mean they should take them all on.

One of the biggest challenges for a medical office is confusion between the roles of leader, manager, supervisor, and worker bee.  Each one is essential and most physicians are called upon to fill more than one of these roles.

Leaders have power, as do managers and supervisors.  What differentiates a leader is the ability to articulate a common, often abstract, objective and to enlist the willing support of others in its pursuit.  People follow a leader because they want to.  They have bought into his vision and want to be a part of it.  Being a leader takes a lot of time interacting with subordinates and helping them see the value of the objective.

Physicians do tend to see themselves as leaders, and they have a clear vision of their objectives in practicing medicine.  It is a challenge, however, to express that vision to staff because it is so intuitively obvious to the physician.

Managers are concerned with concrete objectives.  They are responsible for getting specific work done.  It is a manager's responsibility to define the job, understand its components, provide the resources to get the work done, and monitor progress, stepping in as needed to coach subordinates or provide corrective action.  The manager's job requires sustained attention, both to plan the work and to consistently monitor performance.

Supervisors are overseers.  They monitor the activities of subordinates to ensure that they do what they are supposed to do, as defined by the manager.  This includes adhering to attendance schedules as well as standards of productivity and quality.   An important role of the supervisor is to teach subordinates and advocate for them with managers.  The supervisor's role is often one of chastising and correcting.  Not alienating and discouraging subordinates requires good social skills and empathy, but it is not an intellectual exercise.

A worker bee can be the happiest of all, provided she has a clear definition of the job and the tools to do it well.  The worker bee is responsible for her work and is not expected to monitor, coach, or teach anyone else.

There is quite a bit of the worker bee in every physician. Most physicians I know want to take care of patients.  Keeping track of time and attendance is not a good use of their time and they have little patience with administrative detail.  They know what their support systems need to do for them.  They want those systems to function reliably but seldom have the time or the interest to design the work or monitor performance.

In too many medical practices, the roles of supervisor, manager, and even leader go begging.  Confusion and frustration are the result for everyone involved:  physicians, staff, and patients.

Physicians must decide which roles they are willing and able to fulfill and explicitly delegate the others.  And, once delegated, they must honor the delegation.  It is often difficult emotionally, and it is always difficult to find, train, and afford the delegates.  That said, it is an investment that pays big dividends in physician satisfaction, quality of life, and profitability.