Minimize Frustration with Medical Practice Staff

October 22, 2014

Frustration goes way down when expectations are explicit and achievable. Frustration with staff provides a good example of the theory.

The root of all frustration is unmet expectations. Frustration can be avoided, therefore, by managing your expectations so that they will be met.  It requires consistently doing three things: Defining expectations explicitly; refining expectations so that they are consistent with what is achievable; and making short- and mid-term sacrifices so the expectations can become reality.

Mitigating frustration with medical practice staff is a good example. Here are three principals to follow when hiring, training, and managing staff members.

1. Define expectations

What do you want from a receptionist, nurse, medical assistant, or physician's assistant? Have you ever sat down with a notepad and described your ideal staffer? This requires much more reflection than specifying years of experience or requisite certifications. Do you want someone who really likes people and smiles a lot? Do you want someone who is self-confident and looks people in the eye? Do you want someone who understands her role as serving your needs? What is more important - efficiency or empathy?

Unless you make the effort to define your ideal employee and communicate it to recruiters, screeners, and candidates, neither you nor the candidates will have any way to predict successful performance. Everyone will have his own picture of the ideal candidate, and the pictures are not at all likely to be the same. The too-common outcome is that everyone feels mislead and mistreated. That leads to turnover and you get to do it all over again.

2. Be realistic

Once you have defined the ideal employee, evaluate the likelihood that the total package exists. I recently spoke with a plastic surgeon who had defined his ideal "Girl Friday." He wanted a mature, sophisticated, attractive person to manage his front desk as well as his office. She needed a lot of financial and billing expertise, and he thought $35,000 a year without health insurance would be more than enough compensation.

What was wrong with his picture? In the first place, "Girl Friday" is incompatible with mature and sophisticated, and $35,000 per year would not fund the wardrobe and general presence he expected. Additionally, anyone with all the desired proficiencies can command a significantly higher salary.

The surgeon clearly needed to rank his desires and decide what compromises he was willing to make. What is more important? Keeping the salary low or setting a particular tone in his front office? Is it more important to be an attractive hostess for the practice, or to keep on top of the financials?

I am not arguing that a physician or manager give up on her ideal. You may get lucky. If, however, you don't, it is essential that you have identified the deal breakers. It is also vital that you are aware of the tradeoffs you have made in hiring a particular person, so that you don't hold them to a standard you knew they could not meet when you hired them.

3. Invest in the future

No one you hire can know how you want your office to run unless you tell him. A new staff person will try to figure it out, but unless you are the one delivering an explicit message he is not likely to get your priorities straight.

An operations manual that lays out the what and how of each task is invaluable. And training a new staff person is an excellent opportunity to begin or update an operations manual.

Just as important is your communication of the practice's mission, vision and values. It would be nice if these were written down and easily referenced, but it is not necessary. Your behavior communicates your values and priorities more clearly than any document.

When something happens that seems to contradict either standard practice or stated values, take the time to explain what was different about that situation. Otherwise your staff will never be able to act independently or anticipate your wishes.

What you may have noticed is that all of this takes time and focused attention, both of which are in short supply for any physician. What may not be as clear is that all of this is an investment that pays big dividends by saving time, money, and frustration in the future.