A tall order filled, and then some

Leaders wanted new staff. But new wasn’t the answer to this problem: everyone needed to relearn sandlot rules.

By Whitney Hauser, OD

I recently helped out a practice that has been in business for decades, whose employees, and management, needed to relearn how to work with one another. It was a tall order.

Here’s what happened.

The founding surgeon was more boss than leader. His management style was to direct subordinates to perform a series of tasks rather than train them to competently do the job for which they were hired. The practice manager told me this surgeon would direct staff but never explained the why to his orders. For these employees, “Just do it” had a whole new meaning. The result was an unmotivated, disinterested staff, detached from the clinic’s purported mission of serving patients.

Peculiar ways

This surgeon also had a peculiar way of treating his patients. While considered a top-notch surgeon, he routinely performed procedures into the wee hours of the morning. The reason: He didn’t consider keeping a patient’s appointment a priority — however, he did provide sandwiches for exhausted and hungry patients who lingered in the waiting areas.

While the surgeon was a taskmaster who garnered more fear that respect, some staff were not blameless in the clinic’s turmoil. They soon figured out that bad behavior was tolerated. Arriving late became the norm for many, rankling those who did arrive on time. Medical recording errors were made with regularity. The practice’s seas were never calm, and patient care and customer service were the first things to be tossed overboard.

A new flag

Then came the day the founding surgeon left. New managers wanted to turn the existing ship around by putting the old ways behind them and recommiting to customer service. But though the former surgeon was gone, many staff members, their attitudes and bad habits remained.

The current partners decided, “We want to be more than good, we want to be great.” They were determined to move into the upper echelon. The doctors fostered education and a sense of pride into their staff.

And new expectations. Management established rules for employee attendance, patient wait times and made paying attention to the “patient experience” a priority. It worked. The practice cut wait times to a fraction of what they had been. Patient satisfaction became a driver. For their efforts, the practice was rewarded with exponential growth. Annual patient encounters grew 35% in a few years and surgical volume in the affiliated surgery center more than doubled.

Why was I hired?

The established location had such a transformation that it inspired management to expand. A new office, replete with an interior designer overseeing all its inner spaces, was built in an affluent suburban area. The only question that remained was who would staff the new location.

While the partners were committed to training and mentoring the existing staff, ambivalence reigned. Besides the tardiness problem, there were even issues with well-intentioned staffers, unwilling to consider the ramifications of their dealings with patients.

For example, refractive counselors focused on LASIK surgery risks rather than the benefits. Rattled by the occasional ranting patient, counselors felt compelled to provide a laundry list of potential side effects. Naturally, their conversion rate was abysmal, as they often talked patients out of the procedure, not into it.

On the fence

So, the partners were torn between their concerns that existing staff’s habits would die a slow and lingering death, and the new staff’s untried and untested talents. With opening day approaching, management assessed the strategy for staffing one last time. Ultimately, they decided that a new influence was necessary to set the right tone for the new office.

I was retained in January to help the practice hire the new staff for the new location — the partners had decided that no one was to come to the suburban oasis from the original clinic. Instead, new employees whose focus was on patient care and customer service would man it.

The art of the possible

I was told to hire about 10 new people who should be ready to hit the clinical floor running in patient care and surgery. After a decade as a clinical director, I knew this was not doable. The partners wanted a state-of-the-art office plucked from a plum market in the region and dropped into their space, employees and all. But their city offered a shallow talent pool. If someone showed promise the practice couldn’t compete with pay or lost the individual to another field.

Potential candidates were interviewed for available positions; all were pleasant and polished, but none had ophthalmic experience. I then suggested that we might rehab some of the existing employees. I expected reluctance, but none was given. Management accepted my suggestion.

We opened the field up but were surprised to find only a few applied for positions they held at the original location. When I asked those who hadn’t applied what held them back, several mentioned that they were insecure about the direction that the practice was heading. They felt like they were being left behind — the red-headed stepchildren. Each side had lost faith in the other.

To renew that faith, I engaged the current employees in role-play. I pretended to be the anxious patient, the angry patient, the skeptical patient and so on. As we dug deeper into each personality that they regularly encountered and then discussed how to best address that patient, light bulbs came on. Several employees realized the difference between informing and intimidating. The staff learned to size up patients and mirror them. They mastered the concept of word selection — for instance, that “new” connotes unproven technology while “innovation” says cutting-edge.

Quickly, the reluctant applicants jumped in with both feet. They got it. And the partners watched as their enthusiasm set in. The red-headed stepchildren had value to add after all.

In the end, some new employees were hired and expectations regarding attendance and job performance were clearly established and enforced. The older employees provided the experience and knowledge the new employees lacked. Ultimately, both groups adopted the better characteristics of the other. Older staff became punctual and new staff learned the skills necessary to perform their jobs.

When the suburban location launched, a joyful marriage of old and new took place. Existing employees felt like valued mentors to junior staffers, and the fresh blood brought renewed enthusiasm to all. The physicians were pleased with the integration of zeal and knowledge.

When I returned to speak to the practice, it was delightful to see its cohesion. Everyone had a sense of purpose. While the practice manager didn’t get what he had envisioned, he got what he needed — no doubt, to his, and everyone else’s betterment. OM

About the Author
	Whitney Hauser, OD, is founder and senior consultant for Signal Ophthalmic Consulting, which specializes in developing premium practices and increasing elective procedure volume. She can be reached at whauser@signalophthalmic.com