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.

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!