Let's face it – we all make wishes, and more to the point, we all hope our wishes come true. But where is a star or an Aladdin's lamp when you need one? Since the definition of a wish is the desire or hope that something could happen, how many of us are willing to do what it takes to separate hope from reality? 

It would be interesting if a genie suddenly appeared and allowed us to grant three wishes. By each of us, I mean doctors, staff, and patients. Endless wealth aside, what would you wish for?

If you're planning the "wish for more wishes" strategy, you are straightaway in defiance of the genie's wish-granting rules that clearly state: "Three wishes, to be exact. And ixnay on the wishing for more wishes. That's it. Three. Uno, dos, tres. No substitutions, exchanges, or refunds." In other words, DENIED!

No, these perceived wishes could only be granted under one condition – that they help to improve said relationships at work. And, if they also prove profitable thanks to a deeper understanding of one another, so much the better.

Of course, I am still determining what each group would wish for, but I imagine it would be something along these lines. 

Doctors: 

#1 – Increased practice efficiency and productivity.

#2 – Less disruptive staff turnover. 

#3 – More patient compliance with medical care.

Staff:

#1 – Better management and appreciation.

#2 – Doctors who are more mindful of the schedule. 

#3 – Patients who follow office policies.

Patients:

#1 – More value and respect for MY time.

#2 – More quality time with the doctor; feeling less rushed through my visit.

#3 – Better communication between doctor and patient.

While I'm not a Genie, the above "wishes" are all granted (well, achievable) merely by making simple changes and implementing fundamental practice management strategies. It is also well noted that the wants and desires of each group tend to overlap. Therefore, one can effectively tackle two or more 'wishes' with just one swipe of the genie lamp. BONUS!

Doctors, since you know that "it all starts at the top," there are certain things you can start on today that will make you the hero who turns many of these wishes into reality! So let's begin with the call for better management.

Management. Do you know where you fall on the management scale as an employer? If you recognize that your management skills could help, why not give staff an anonymous management survey? Get into their heads and learn where you potentially need to catch up. Then be open to making some changes. Any effort (small or large) does not go unnoticed and will be appreciated. 

Appreciation. Try not to let a day go by where you don't offer a simple and genuine "thank you." It's not complicated; sometimes, that's all it takes to build a more gratifying work culture. What's more, it just might be the thing that prevents staff from leaving. Feeling more satisfied and appreciated daily often leads to increased productivity. Worth a try! 

Patient waits. Long wait times can make patients feel disrespected and their time undervalued. Remember to consider the role that you can play in keeping an on-time schedule. Stick to appointment times, observe how and when backups occur, limit excessive chit-chat, and #1 - arrive and start on time. Briefly review each day's schedule with your staff and implement effective protocols and policies to improve poor scheduling habits. Please don't dismiss their insight – they are on the front lines; hear the patient's gripes and know things you don't know! 

Some areas that may need new focus; late arriving patients, appointment reminder notifications, realistic treatment-time alignments, overbooking, no-shows, and interruptions. Monitor progress made and modify as required. Do nothing, and guess what? You will accomplish that - nothing.

Patient communication. Patients don't expect more time than necessary, but they expect adequate QUALITY time with their doctors. This includes better communication, time for questions/answers, active LISTENING, and understanding of their concerns. In addition, they want empathy and compassion for their pain and clear, doable orders they can follow. Delivering a higher, more influential level of communication will also positively affect compliance—better outcome – better for everyone. 

Staff communication. To improve staff communication – hello, communicate! Converse with them, learn about them, and try to meet their employment needs. Treat them fairly. Schedule routine team meetings and listen to their ideas/concerns. Perform on-the-spot and annual performance reviews that support their career advancement. Have an open-door policy that inspires back-and-forth dialogue, not just your monologue. Don't ignore their grumbles. The respect you give them will come back tenfold.

Office efficiency. Efficiency-minded practices start by having consistent Standard Operating Procedures in place. Simple, whole systems can turn a chaotic practice into one that runs on autopilot. Also, prioritize structured, educational training programs (telling is not teaching) so staff can confidently and effectively participate in hands-on patient care. Incorporate one-on-one demonstrations, scripting aids, conferences, mentorships, webinars, etc. Make it your goal to develop STAR employees, not mediocre ones. Share with staff the big picture (your practice mission), and set goals to help achieve practice efficiency and success that benefits the entire team. Then watch what happens.

And there you have it. Quoting Antoine de Saint-Exupéry, from his book Le Petit Prince - The Little Prince, "A goal without a plan is just a wish." Without actionable steps, your dream/wish is a wish. Don't stop. Pursue your dream. Dream it, create a goal, develop a plan, and implement that plan. Your wish will come true.

Dr. William L. Goldfarb would insist that you call him Bill.

Bill's wish for incoming students would be that in addition to private study, students should be active in fostering and creating a community that facilitates open dialogue and learning from one another.

Bill was the type who would have loved and embraced the technological advancements so critical to the improvement and advancement of society, science, and medicine. He would be so proud to celebrate 50 years of the Goldfarb Foundation.

Podiatrists starting a new practice or continuing to grow an existing one are accepting and seeking new patients.

Marketing to attract new patients is vital. Creating a strategy to attract new patients can be nerve-wracking, especially when dedicating most work hours to patient care and office management.

Marketing agencies may knock on your door, pitching campaigns that sound good. Often the costs seem steep, and you may be uncertain what works. Fortunately, you are a part of an association here to support your career by offering opportunities to network with other podiatrists and obtain relevant news!

Many techniques and strategies could work for you.

Here are three ways to attract new podiatry patients.

1. Create and maintain a robust digital presence.

If you do not already have a website, you will want one. The website should include bios, office hours, contact information, location information, and information about conditions treated.

If you are a podiatrist that does not have your practice, you can still benefit from getting an updated headshot or updating your bio online.

Patients choosing a podiatrist will want to see your face and know a little about you and your qualifications before making an appointment.

2. Get involved in your community.

What opportunities are there to network to get your name out there?

Perhaps you could join your local chamber of commerce. Consider hosting an event and inviting potential referral partners to see your location and learn more about your services.

Consider sponsoring a 5K and distributing literature about your practice.

3. Leverage the opportunity to increase referrals through existing patients and other reputable sources.

Your existing patients can be your most significant source of referrals. Prospective patients often do not seek a podiatrist because they don't know about the treatment of podiatry and conditions. Existing patients aware of the conditions you treat can then refer loved ones to your practice. Ensure your office has adequate signage, brochures, and materials that incorporate all your offerings.

Some podiatrists have found a strategy and a budget that works well for them!

When meeting with an advertising agency, one should ask questions when you are unsure. If you don't know what questions to ask, perhaps you have a friend or mentor, such as another podiatrist or business owner, who can give you some advice!

Keep working hard to get your name out there, and your practice will achieve growth,

PPMA is an association dedicated to the greater good of podiatrists in Pennsylvania. To learn more, visit PPMA at www.ppma.org. 

It is no secret that the cost of everything has significantly increased over the past two years. We see it daily when we fill up our gas tanks, go to the grocery store, go out to dinner with our families, and go on a vacation. It is evident that hotel costs doubled in rates from the previous year, and the list continues. 

Inflation continues to affect not only our personal lives but also our professional lives as private practitioners/business owners. 

The big difference between us as private practitioners/business owners and the examples I gave you is that we cannot adjust our prices to compensate for the increased cost of supplies/equipment in our offices. 

For example, restaurants can increase the prices on their menus to make up for the difference in their increased cost of items/goods.

On the other hand, we can not increase our copays or reimbursements from the insurance companies because we are on a controlled fee-based schedule set by Medicare and the insurance companies. 

In my private office, the cost of medical supplies, office supplies, and equipment has increased significantly compared to 2020. 

Something has to be done! 

As many of you know, there is a national injectable lidocaine shortage. I read some information online about why we have difficulty finding and buying one of the most used injectable anesthetics in our practices. 

According to https://www.ashp.org/drug-shortages/current-shortages/drug-shortage-detail.aspx?id=88, Pfizer has lidocaine presentations on shortage due to manufacturing delays and increased demand. 

According to https://pipelinemedical.com/blog/why-is-lidocaine-in-shortage/

“there was an increase in the demand for anesthetics during the pandemic. Many hospitalized intubated patients required anesthesia to avoid the discomfort and pain associated with it. This increased demand, resulting in a less obvious but anticipated shortage of local anesthetics such as lidocaine.”

As we all know, what happens when there is a supply shortage and increased demand? Prices will skyrocket. I’m anticipating this is what we’ll see happen with this lidocaine shortage and the other medical supplies that have significantly increased.

I also recently saw an article about our state representatives and their salaries in our local paper.  

One sentence captured my attention. 

“State representatives serve two-year terms with the salary this year set at $95,432.14 and raised annually by the inflation rate.”

It got me thinking that we, as healthcare professionals, who worked through the beginning and most challenging stages of the covid pandemic, ironically, are the ones who are unable to get our reimbursements adjusted due to inflation, unlike the previous examples mentioned in this article. 

My goal is to help our medical professionals/business owners continue successful practices by increasing our reimbursements from Medicare and other insurance providers based on the current inflation rate. 

I request that our PPMA members have your accountants put together a cost of supplies report from 2020, compare it to 2022, and email it to our executive Director Michael Davis. I would also like to have the APMA pair up with the AMA and fight for our private practitioners/business owners of all medical professionals & specialists, from primary care doctors to dermatologists, neurologists, cardiologists, etc. 

Any recommendations or suggestions would be helpful from our PPMA members. 

I appreciate your support of PPMA, and we will continue to do whatever we can to keep our profession thriving and responsibly working together!

“Staff Attitude?! Whatever!”

Staff attitudes and behaviors most definitely have a direct impact on the attitudes and behaviors of our patients. In fact, studies showing over and over again that their attitude alone can play a major role in patient satisfaction, and that’s got to make you wonder just how adversely a patient is affected when exposed to a staff person who rarely smiles or one who thinks that an irritating, nail-scraping-chalkboard “whatever” response is ever appropriate! I’m sure that any malpractice insurance company would agree that an employee’s confrontational attitude is enough of a reason to turn a patient’s unanticipated surgical scar or unexpected (surprise) bill into a full-blown malpractice lawsuit; whereas, a more attentive (caring) attitude can actually help to smooth things over and prevent one from happening. 

While staff cannot be expected to carry the ball alone through these types of conflict, everyone must stop and realize that (just like the doctor), their individual attention and handling of each patient is impressionable and even pivotal in “what might happen next.” In short, the attitude of your staff can make or break your practice.  

Make no mistake. The attitude of the practice starts at the top…with the doctor. And you’ve heard this before…it’s not the doctor’s job to make staff happy, only to provide an environment that allows them to be happy. So, if ongoing quality patient relations and providing exceptional customer service are important to you; and taking measures to improve the overall attitude of your practice is something you want to seriously take hold of, here some suggestions to get you started:

1. Be very particular when hiring staff and trust your gut-instincts. If they project a warm, caring personality during the interview, most likely they will carry that through to your patients. If you see them as unfriendly, non-caring and inattentive, so, too, will your patients. Thinking that you will “just hire them temporarily” (in a pinch) until someone better comes along…or expect that their attitude will approve in time is risky. Could be their “temporary” employment can cause some long-term damage.

2. Once developed, do not take your employer/employee relationship for granted. Whether your staff is there for 30 days or 30 years, it should always be one that is built on mutual respect…with plenty of open communication, including making the time to listen or hear them out.

3. Encourage them to achieve a greater knowledge of their work and profession – through certification, association membership, educational and motivational seminars, in-house training, webinars, etc.  Don’t underestimate staffs’ personal and professional growth. It is an important piece of feeling good about themselves, which in turn motivates self-esteem, job satisfaction and a positive job attitude. Stagnancy does the complete opposite.

4. Schedule regular employee evaluations to ensure that everyone’s needs and expectations are being met. Evaluations are needed to help staff improve and move the practice forward. Sadly, too many staff complain that they never get evaluated. Their gripe? “I just want to know how I’m doing and if I need to improve in any area.” Step up to the plate and do evaluations for your staff. Do them for the practice. 

5. Openly and honestly discuss their salary and/or benefits on a regular basis. I suggest doing this during their annual evaluation. Make sure increases are based on a variety of qualifying factors (including job performance); not just longevity. If anyone would like to receive a copy of our Compensation and Benefits Statement to help employees understand their full compensation package…please email me at lynn@soshms.com. 

6. Help build their self-worth through consistent doses of praise for jobs that are “well done!” Verbal appreciation (a simple “thank you”) is as good for the soul as it is music to their ears and can surely increase the quality of an individual’s work performance.

7. Everyone makes mistakes. Point theirs out in private; NOT public and remember that mistakes are also opportunities to learn and improve. Especially do not ridicule, admonish or embarrass them in front of your patients or their co-workers. Take into consideration that these insensitive (sometimes impulsive) actions not only point out their weaknesses to uninvolved observers, but it makes you look like a bully employer.

8. Make an all-out effort to include staff as part of your practice “team” with the understanding that what benefits the whole of the office ultimately benefits them individually. Listen and be open to their ideas. Doing so not only makes them feel valuable, but their ideas may actually enhance practice growth and success.

9. Help them brush up on their communication (and attitudinal) skills when dealing with different types of personalities by insisting they attend seminars focusing on this very important aspect of their job. You might even consider going with them, for it truly is a financial investment that benefits everyone and pays back every single day…ten times over!

I am reminded of Robert Fulghum's "All I need to know I learned in Kindergarten," whose core life principles can (and should) be practiced daily. You know, share everything, play fair, do not hit people, put things back where you found them, clean up your mess, do not take things that are not yours, say you are sorry when you hurt somebody.

But life's lessons do not stop there. With knowledge and experience as teachers, we can learn something new every day. Or at least we should! Sometimes the best management lessons are found when we least expect them and in the most specific and unpredictable settings. Simplicity is where the true genius lies. Let me explain.

What I learned from going to my hairdresser:

Some people do not belong in the receptionist's chair. As I sat in my stylist's chair, it was painful to my management consultant's ears to overhear how the receptionist answered her phone. Her welcome opening was hardly welcoming. There was no greeting, no inflection in her voice, and her response to what I suspected was a request for an appointment became a missed opportunity. "No, there are no openings." Period. No offer to look ahead in the schedule, no recommendation to accommodate this customer, no thank you for calling! Barely a goodbye. Does the owner even know that her "style" is turning customers away? As the assigned receptionist of a beauty salon OR a doctor's office, they are the "Director of First Impressions"; good manners and a pleasant, polite, engaging, helpful personality should be mandatory. Their attitude can make or break a business (or a practice). Some off-hours training is crucial, where role-playing and appropriately overseeing phone calls and turning them into appointments can be taught. Sadly, it is not.

• A confident professional can work and talk at the same time. 

I have been to some hairstylists who think that they need to stop working to have a conversation with their customers. This standstill approach to hair cutting involves stepping away from the customer's head, poised with scissors and comb in hand, to tell (or listen to) a story. Being a good listener is one thing, but, no joke, it turns a one-hour appointment into two. Similar complaints have been made against podiatrists who wield a scalpel or nail clipper until they finish their conversation. Little wonder that patient schedules sometimes run behind.

What I learned from going to my dentist:

• A patient's fear and trepidation can be minimized, and adherence optimized. 

Introducing scary needles and instruments or not fully understanding WHY a procedure is necessary can be a frightening experience for a patient. However, the dentist (or doctor) who takes the time to explain what will be done thoroughly communicates what one can expect to feel during and after the procedure can put the patient more at ease. What is more, patients seem more willing to adhere to associated recommendations when they understand the consequences of non-compliance.

What I learned from going with my mother to her doctor:

• Doctors need to manage their time with their patients. 

Patients love when doctors take an interest in them and engage in personal stories and conversations. Patients DO NOT love when they become prisoners of these personal stories and discussions for over an hour. OMG, in this case, TWO hours! Many patients will walk out if they are kept waiting due to mismanaged time. Building customer relations does not mean talking incessantly. It means mutual respect and knowing how and when to draw the line between enjoyable conversation and long-winded rambling. Oh yes and staying on schedule is a big plus.

What I learned from going to a restaurant:

• Hiring people who love what they do pays off. 

A restaurant experience has so much to do with the served food. It is also about the people who serve the food—employees who love what they do exceptionally reflect strongly on the business. Excellent, efficient service combined with good-natured personalities are substantiated reasons for customers to return and refer friends and family.

What I learned from being a management consultant:

• If you do not change anything, nothing will change.

I applaud doctors who want their practice and staff to be more efficient, productive, and consistent in their standard protocols. They acknowledge that a pair of outside eyes can offer new perspectives and ideas, help create an on-board team mentality, and often recognize what is working well. Yet, when it comes to implementing recommended changes, there exists a reluctance. Usually, the desire for immediate outcomes dominates the recommendation to slowly eat the elephant, one bite at a time, turning efficient changes into a time-consuming and overwhelming project and landing them right back to where they started. Elephants aside, Dr. Albert Einstein responds: "If you always do what you always did, you'll always get what you always got."

Darco provides foot and ankle products to various markets, including podiatrists. This includes post-operative shoes, walking boots, products designed to help patients suffering from plantar fasciitis, wound care offloading products, and ankle bracing products.

   Darco headquarters are here in Huntington, WV.

   Darco’s products provide a healing platform for patients as they adjust from the acute phase to rehab, and finally back to their normal footwear. 

FOUNDER STORY

   The provider has been serving the podiatric community since 1985! Darco was founded by a podiatrist by the name of Darrel Darby, DPM. Dr. Darby was a graduate of the Ohio School of Podiatric Medicine. He was president of APMA in 1976.

   Dr. Darby created the first modern-day post-op shoe after seeing many patients being given various kinds of shoes to use when recovering from surgery or foot trauma. He listened to patients’ complaints about being uncomfortable. Like many small business owners, he started the company out of his home garage. Darco’s first run of the shoe was successful. His efforts eventually led to Darco becoming the largest manufacturer and distributor of foot and ankle products in the world! 

   Dr. Darby’s solutions have a reputation for innovation and high quality. This has led the company to expansions that include an international presence. International locations include Suffolk, UK, Raisting, Germany, Shang Hai, China, and Darwad, India.                                  

PHILANTHROPY

Dr. Darby was a big advocate for podiatric education and as such, Darco has donated over $500,000 to the podiatry schools for scholarships!

DOING BUSINESS DURING THE PANDEMIC

   Podiatrists interested in learning more can contact us by phone or email. We often set up a Zoom session to help podiatrists learn about our products and answer any questions they may have. We also can provide product training for the application and use of our products via Zoom. 

   All companies have been impacted by COVID-19. Representatives from Darco are not able to attend as many professional conferences. The in-person interactions with clinicians or our distributors have been replaced with virtual sessions held via conference calls or Zoom sessions. 

   The transportation issues experienced at many United States ports have delayed product shipments resulting in a lean inventory at times. The increased transportation and raw material costs have impacted our business resulting in us raising prices to keep up with the increased costs.

    Darco accepts direct calls from patients regularly that need advice on what shoe to use for recovery or what size product to get. Most patients are not familiar with these types of products. The employees take pride in servicing the customers explaining the ins and outs so that the patient is satisfied.
GOING THE EXTRA MILE

   There have been instances in which a patient may be facing financial hardship and Darco has sent products at no charge just to do good and it has resulted in a positive experience for both the patient and the employee.

Expressing Gratitude – A Step in the Right Direction

By Lynn Homisak, PRT

Whatever happened to gratitude in our world?

Sadly, our country has always known inequality; but it's become worse, and as a nation, we are more divided than ever.

Have we forgotten, amid our differences, how to be kind, civil, or tolerant of each other?

Has it come to the point that we don't even want to share the planet with someone who doesn't share our views? Is "thankful" something we only feel obligated to think about once a year in November? Does everything we do have to end up with the finger gesture from the car or a scornful comment to someone without a face-covering during a crisis? What is it that stokes the mean spirit in us, to the point in which destroying the lives of fellow citizens by any means possible has become just another day?

Someone, quick! Please get me a pair of much-needed rose-colored glasses to see the good in people again.

I know it's there! It may be that I am too much an optimist, but I think we need a boost in compassion and a little more understanding; show a little more gratitude towards each other.

I've been feeling this way for a while. It became clear to me the other day as I sat in the reception area of my doctor's office, awaiting my appointment.

I happened to overhear a patient expressing her gratitude to my doctor as she left the office. She pointed out how appreciative she was of the care she received that day.

My eavesdropping on their conversation was unavoidable as this very vocal patient was within earshot of where I was seated. Her comments were flattering and mainly focused on her experience with the medical assistant. "Karen was so great," she said. "She took excellent care of me, made sure I was comfortable, and kept poking her head in the room while I waited to let me know how much longer you would be and to make sure I was comfortable. You might not realize it, but little things like that make a difference to us patients. I hope you recognize what a good nurse she is and thank her for being so caring."

I smiled publicly and cheered silently!

I always love hearing some good employee feedback.

The doctor's response, however, was not what I expected. Nor was it, in my opinion, professional. A simple acknowledgment was all this patient looking for. Instead, what she (and everyone else in the reception room) heard was, "Well, I don't have to thank my staff for being nice to my patients. That's their job. That's what they get paid for. If they weren't (nice), however, they would surely hear about it from me!"

As a patient, witnessing this unfortunate scenario allowed me my interpretation. He would undoubtedly point out to his staff all unsatisfactory conduct and silently ignore their generally excellent behavior. Are these qualities of a successful practice?

My viewpoint might be better explained by sharing Sam's story.

Sam was a little league baseball coach. From the dugout, he heard one of his players complain to another. "Coach only sees what he wants to...he only sees the times I miss the ball!" The coach turned to his player and assured him that coaches do see everything! "Then why, Coach, do I only hear it when I do something bad or outstanding. What about all the stuff I regularly contribute that helped make ours a winning team? Don't you ever notice the little thing we do? Don't they matter too?" 

The coach still argued that he saw everything but shamefully admitted that the "expected" things are sometimes just taken for granted. He thanked the young player for bringing this to his attention. He needed to hear it. From that point on, he vowed to be more aware and recognize his players, even at the "un" expected times.

Similarly, the patient I described made a point of sharing her experience, and it was something the doctor needed to hear.

It is not uncommon for doctors to be unaware of daily activities while busy treating patients.

After all, they can't be everywhere all the time. However, as managing physicians, they need to be aware of staff responsibilities; the inadequate, the exceptional, and everything in between. Where to start?

For one, it would be helpful if doctors did self-awareness checks and occasionally noticed what may appear routine activity, yet vital to the efficiency of the practice.

When they do, let staff know that these everyday tasks are appreciated. Show well-deserved gratitude to the staff. Not only because "it's their job," but because it will lead to repeat behavior, higher morale, job satisfaction, and if that wasn't enough…greater productivity.

Two, start a new habit of beginning or ending staff meetings by saying nice things.

It helps by balancing gripes or complaints that may arise in our practices with positivity every day. Managers can go around the room and suggest each employee verbalize some gratuitous words of encouragement about a co-worker, their manager, or doctor, even a brief uplifting patient story.

Go for the smile!

Receiving compliments at the beginning of a meeting can help break the ice and encourage participation, leading to new, more constructive ideas.

If you choose to do so at the end of the meeting, everyone leaves on a high note, feeling a positive boost.

And three, it would help to make gratitude a routine occurrence.

You will see a change in staff attitudes simply by saying thank you. Not just a contrite, "let's get this out of the way, thanks," but a sincere "thank you" for a specific act of service.

Employees can tell the difference between a nondescript pat on the back vs. a true expression of gratitude.

Expressing gratitude is something you can do every day. Do it three times every day. It doesn't cost a thing!

Indeed, an ambitious doctor who can express gratitude to staff is purposeful.

Employees are not exempt from this exercise. Gratitude works both ways. Put your heads together and start the ball rolling by making simple changes to create a more gratitude-contributing climate.

Your internal efforts may not change the way people treat each other outside of the practice, but if we all aim a little higher, we just might set a great example.

That would indeed be a step in the right direction!

Homisak, PRT

Some of you may recall a very dated (1965) TV commercial “Mother, please! I’d rather do it myself!” The message of course was to get relief from a particular aspirin, rather than suffer the headache-induced stress brought about by (in this case), an interfering mother. Undoubtedly, many of us are “I’d rather do it myself” people, and while our intent is not to grouch on those around us, there is a refusal or resistance to change our ways. Enter Effective delegation. The answer to the “DIY” cry!

To clarify – delegation is not just about unloading tasks because you don’t want to do them or because they are too difficult or boring. It is about carefully selecting, empowering, and trusting capable individuals to take on specific tasks. Then transferring the decision-making responsibilities to the assignee in such a way that they are granted full ownership of it. It’s intention? To help reclaim your time, reduce your stress, and increase efficiency and productivity – all of which can lead to added practice value.

While there are tremendous advantages to delegating, the push-back (or barriers) by naysayers are not far behind. Of course for some, it’s nothing more than benign habit (“I’ve always done it myself”), an unwillingness to change, or fearing a loss of control. Others believe “I’m the best; no one else can do it like I can!” And include the standard refrain, “it’s easier just to do it myself.”  

Many doctors, by their own admission, have found it particularly difficult assigning hands-on tasks to their staff. Perhaps because they feel a duty and obligation to their patients, or a combination of reasons listed. Additionally, there is the fear they could risk malpractice. Others that might consider delegating do not want to take (or claim not to have) the time to train. My favorite though, is the worry of patient disapproval. (“Patients expect ME to treat them, not my staff.”) I don’t doubt that a handful of patients may prefer the doctor’s attention; however, the ability to convince them ultimately rests on how the doctor presents. If a physician is confident that his or her well-trained staff are capable of performing a particular task, it follows that patients will too. Few would question a dental assistant prepping for a root canal. In fact, you would be surprised if the dentist was the one who cleaned your teeth.

Every successful endeavor has a form of this hierarchy. The auto shop has ‘Bud” the seasoned mechanic who takes on engine repairs and assigns ‘Jimmy’, the young new hire, oil changes and flat tires. The Executive or Head Chef manages the kitchen while sous chefs, line cooks, and prep chefs work many jobs to prepare restaurant meals. The bank president rarely if ever works the teller position. Brad Pitt has a stunt double; and as good as he may be, you will never see Tom Brady kick a field goal.

To be clear, some resistance is valid because not everything can (or should) be delegated. There are indeed limits and stepping over that line is unacceptable. However, no one is suggesting that staff perform bunion surgery, suture-close capsules, administer injections, or deep wound debridement, all which of course, would define unprofessional, even unlawful conduct. There are tasks, however, that can be considered suitable.

Conscientiously select those jobs that can be directly trained/learned and are personally comfortable for you to let go (administrative or patient hands-on). Once staff have become capable and confident in their performance and can prove that they are able to handle more, they’ll need one-on-one instruction and guidance. For example, show them and explain how to prep a patient for a procedure, apply pads post-palliative, acquire preliminary patient history, assist in surgical procedures, and with adequate training and supervision are achieved, take orthotic impressions. Being able to delegate such tasks allows for simultaneous revenue streams. While you are giving an injection, they can productively apply and instruct a patient in proper night splint use.

Proper delegation requires three critical steps:

1. Choose the right person when delegating assigned tasks. Expect some initial mistakes, remembering that mistakes (recognizing and correcting them) are part of learning and development. Keeping in mind, that too much leniency or mistakes unchallenged will result in YOU re-doing the work - accomplishing nothing.

    

2. Be sure to clarify and manage (not micromanage) the job. Detail the reasons why and how something needs to be done and insist on quality as an end result. Remember, people are not mind-readers, so unless you successfully communicate your expectations, they cannot possibly understand how best to meet them. If you are vague, they are left to their own interpretation and that is a set-up to fail. Then review and supervise their progress.

    

3. Provide Incentive; praise, and reward the action – especially for a job well done.  Everyone likes to feel their work and efforts are appreciated.  Spell out what in particular they are being commended for by saying, “Sue, the patient history you took today was very thorough…made my work much easier!”  Rewards (not for simply doing the task – but excelling at it) are a great morale builder. In fact, self-confidence, appreciation and rewarding good behavior often results in repeated good behavior. 

If the barriers that prevent us from letting go are self-induced, so too are the remedies that can allow us to reverse course and welcome the help of others. Just think of it. Reduced demands of your time. Increased efficiency and productivity. Additional revenue opportunities. A more fulfilled, confident, reputable and devoted staff. Less stress; less headaches. All because of the decision to put that “do it yourself syndrome” to rest. And without the use of any OTC medicine. Plop, plop, fizz, fizz – Oh what a relief it is! 

Written by Lynn Homisak, SOS Healthcare Management Solutions, LLC

I’ll admit. I commiserate with doctors (employers/parents/coaches/teachers) or any leader when they hear the words, “It’s not my job” after asking why an assigned task was neglected or incomplete. To be fair however, I have similar compassion for staff when they hear, “That won’t work here!” after offering a new suggestion for improvement. Both sound like nails screeching on a chalkboard or a fork grating across a china plate! Eeeccchhh! Both expressions are toxic from auditory, motivational and common sense perspectives. Instead of the traditional face crunch every time we hear these words, we would do much better to understand why they are said and how to prevent hearing them ever again.

It’s usually implied (if not stated) that job descriptions are the culprits of the phrase “It’s not my job”; however, it is generally the product of an unsupportive work environment or an employee’s poor work ethic. If the employee is not team-oriented, does not align with the practice culture or sees their employment as just a “j-o-b” as opposed to a career, every job-related thing they do is a struggle.

Similarly, if the employee has a decent work ethic at the onset but turns bitter once on board, it’s likely due to an uncooperative culture. For example, maybe they were getting a disproportionate number of extra jobs dumped in their laps that prevented them from getting their primary tasks done – while other co-workers seemed to always get a pass. Perhaps they were continuously assigned tasks that they were not properly trained in, or not within their skillset or comfort range. Finally, bad performance could simply be the result of bad management. How can you avoid all of this? Three simple guidelines: hire for personality, build a positive work environment and manage staff the way you’d like to be managed.

In order to address the mind numbing, “That won’t work here!” comment, we have to talk about change and why that typical first reaction to a new idea is to resist it. Truth is, many times it is simply the WAY people are approached, rather than the change itself that causes resistance. Let’s say a practice sends the staff to a conference where they are exposed to many new efficiency strategies. When they return, staff are eager to implement the new stuff they learned so they enthusiastically approach their doctor with several pages of things they “need” to do differently. Unfortunately, the doctor was not there and doesn’t share their enthusiasm and in fact, feels a little threatened by change. As a result he/she pulls back and without even hearing what’s involved or knowing the potential outcome, the automatic response is “That won’t work here!” Ouch. Talk about an energy killer!

If the approach was less overwhelming; if the staff presented just one or two top ideas; and if they had laid out what was involved along with the potential outcomes…the doctor would be able to process it much easier and resistance levels would drop significantly. When offering up a new idea, avoid going in like gangbusters. Instead, take a more reasonable approach:

“Doctor, thanks for sending us to the conference. There’s one thing we learned there that we are eager to share with you and feel it would benefit the practice. (State the idea and the benefits) I’ve done some research and the costs to make the change are minimal-to-none. (Present anticipated costs, if any) Basically, here’s what would be involved. (Outline x,y,z actions needed)  Susan (or whoever will be responsible) has already offered to do (x and y) to get things started and I’ll tackle (z). If we try it for about 2-3 weeks, we’ll have a good indication of whether or not it will work for us (Point out that it takes approximately 21 days for any change to take effect.) I’m pretty confident this will make our practice more efficient, however, if it doesn’t work to your satisfaction, we’ll agree to go back to doing things the way we did before.”

By the way, this strategy works in reverse too; e.g., if the doctor plans to implement new policy and needs staff to be on board.

If you are absolutely, positively 100% satisfied your office is flawless, perfectly fine-tuned, and couldn’t be better… there is no need to make changes and you have already spent too much time reading here. If however, you want to continue improving your practice, well then, change needs to be part of that process. Whether the doctor initiates some new ideas or the staff does…for the sake of progress, have an open mind, lose the de-motivational “It won’t work here” and consider an “Ok, let’s try” response. You won’t be sorry.