Management Essentials

Is Your Practice Just Like “Survivor”?

By Farrell “Toby” Tyson, MD, FACS

In the past few years, reality TV has totally transformed television programming as we know it. Despite a lot of seemingly worthless content, there are actually a few valuable lessons we can apply to ophthalmology practice. Take, for example, one of the shows that started it all — “Survivor.” The series illustrated the calculating and backstabbing nature of individuals, with the less-scrupulous contestants usually advancing over the moral individuals.

In life, like in our practices, it seems that the nice guys finish last. This only will happen in your ophthalmology practice if you let it. We are often confronted with situations in our practice that involve innuendo, gossip and he said/she said, making it hard to get to the bottom of the truth. Like in “Survivor,” you may respond to your staff 's consensus view about a problem, only to later be second-guessed and betrayed.

To prevent this from happening in the future, a new course of action and policy should be set in place. First: no gossip can be tolerated in a practice. It seeds disruption and contempt, which can lead to a mass defection of valued employees. If a problem arises, accusations must be documented — once someone puts pen to paper, the hyperbole ceases to exist. When everyone is presented with the same information, they usually come to the same conclusions, allowing for quicker resolution of the problem with less aftershocks.

Cast Offs

Sometimes, termination of an employee is inevitable, but letting someone go can trigger much questioning around the practice among coworkers. To mitigate, it is beneficial to involve the other employees in voting the individual off the “island.” Any concerns and observations from fellow employees should be documented prior to termination.

When termination is necessary, it is best done quickly and professionally. Many practices try and try and try to make an employee “work.” Donald Trump probably expresses it best on his reality series, “The Apprentice,” saying that when it comes time to fire someone — they are going to dislike you just as much if you fire them immediately as if you spend months trying to rehabilitate them and still end up having to fire them. Many practices feel it is not necessary to fire with cause, but that is doing the individual a disservice. A terminated employee needs to know how and why they got to this place in order to — hopefully — avoid a similar fate at the next job. In addition, a termination should come as no surprise to the individual. As a first line of action, progressive discipline should be applied.

Voting off the Island

If you have ever watched “The Apprentice,” then you have probably noticed that the decision to “fire” a contestant is not done by a single person. Instead, an entire committee comes to a conclusion, presenting the united front of the organization with the added benefit of multiple witnesses of how and what was said during the termination. With more than one individual present, there is less chance for a dramatic scene, leading to a more civil and professional separation. Mr. Trump says not to feel guilty — you hired them at a fair wage, for fair days of paid work and now it's simply time to part company.

In both “Survivor” and “The Apprentice,” you eventually have a winner. During “Survivor,” at times it seems that only the sneaky will win. This all gets turned around when the past contestants get to vote on the two finalists, bringing karma into play. Having multiple individuals involved in the decision-making of your practice allows fair and just decisions to evolve.

In “The Apprentice,” the winner is not just the contestant, but also the Trump organization, which gains a competent new employee. This winwin scenario is possible because the best and brightest thrive in a well-structured and challenging environment. The retention of these types of individuals raises the bar for the organization, perpetuating the success that built it in the first place. While we know these shows contain as much fiction as reality, the overarching themes can still affect our practices in a positive way. 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.