Management Essentials

Machiavelli: Your New HR Manager

By Farrell “Toby” Tyson, MD, FACS

Niccolo Machiavelli, one of the founders of modern day political science, authored the political survival book The Prince during the renaissance. Best known for his saying, "It is far better to be feared than loved," Machiavelli actually produced some practical insights for managing human resources in your ophthalmology practice.

No Good Deed Goes Unpunished

Machiavelli states, "Hatred is gained as much by good works as by evil." This is never truer than when dealing with pay raises or bonuses. When performing financial compensation evaluations, approach with objectivity — rather than emotions — and be prepared for raises and bonuses to go unappreciated.

"Benefits should be conferred gradually," Machiavelli says, "and in that way they will taste better," This approach allows for staff to grow slowly in both financial compensation and responsibility. If either is granted too quickly, the employee will come to expect the same rate of growth to continue. When that is no longer possible, the employee will become disgruntled and less productive.

Dangers Inherent in Change

Change is necessary for further development of your practice, but change can lead to human resource nightmares. Machiavelli wrote, "There is nothing more difficult to execute… nor more dangerous to administer than to introduce a new order to things; for he who introduces it has all those who profit from the old order as his enemies; and only lukewarm allies in those who might profit from the new." When instituting change, an administrator needs to evaluate how that change will affect all parties. This allows anticipation of resistance and a plan of action to alleviate it.

Staff that was once truly loyal can become obstructionist if they feel threatened. This became evident when we went from vacation and sick days to a paid time-off system, which required us to reevaluate how all staff were affected. It follows Machiavelli's belief that people "are ungrateful, fickle, liars and deceivers, they shun danger and are greedy for profit; while you treat them well, they are yours. They would shed their blood for you… but when you are in danger they turn against you."

The lesson: always count the votes before calling the question. This tactic preserves the view of consensus and maintains the staff 's respect.

These statements may seem brutal and cold, but over time all practices will see extremes of both good and bad in their employees. Minimize your negative exposure through good hiring practices. Machiavelli understood this when he wrote, "The first method for estimating the intelligence of a ruler is to look at the men he has around him." He knew that to be successful, you needed to surround yourself with successful people. You cannot succeed if the support you rely upon is fractured and weak.

In addition, all practices need to learn to document human resource issues correctly and efficiently. Most practices shun confrontation and wait to document deficiencies and achievements until it is too late. Machiavelli commented that a "prince who bases his power entirely on… words, finding himself completely without other preparations, comes to ruin." There is a great deal of power in writing something down. Words help convey a sentiment, but documentation preserves and reinforces it. Our rule of thumb on chart documentation for billable services applies just as much to human resources: if something isn't documented, it didn't happen.

Forewarned is Forearmed

In life, most individuals are out for themselves or their own ideas. The workplace requires awareness of that reality and vigilance for personal agendas, as employees seeking a certain outcome provide you with selective information needed to come to only one conclusion — theirs. Without all the necessary information to come to a fully educated conclusion, the search for facts is problematic.

The employee will usually push for you to take a position and act upon it immediately. In these scenarios, always buy some time. Reply in a fashion like, "I will take that into consideration" or "I understand your position. I will have to look into it." Never be rushed. Remember, it comes down to you. I leave you with one last word from Machiavelli: "He who wishes to be obeyed must know how to command." OM

Farrell C. Tyson, MD, FACS, is a refractive cataract/glaucoma eye surgeon at the Cape Coral Eye Center in Florida. He may be reached at tysonfc@hotmail.com.