Is Your Work Force Still Viable?

Single practice physicians are the most vulnerable to the curse of "The Corrupted Employee."   Often these docs have practiced in a framework that is somewhat disorganized and without set policies and procedures for the performance of daily tasks.  In addition, the physician may be prone to cancel office hours or reschedule his patients based on his or her personal demands.  Vacations and sick days happen and while the staff needs to be paid and to work a sufficient number of hours to assure that their paychecks are viable, the office sometimes becomes a free for all.

When the cat's away, the mice will play is an unfortunate fact of life that you can count on if your staff is left without proper supervision.  Many senior staffers fall into the role of office managers, often without the skill set or authority to enforce the rules of the day when the doctor is not in the office.  The greater freedoms that are allowed, the more the rules will be broken, and many times they are broken to the point that they really cannot be repaired.

I have seen situations where staff clocks in, then goes to the deli for something to eat and drink, then sits for forty minutes, eating and drinking.  These are the first employees who will claim,"I don't have time," when you suddenly expect them to follow any new policy.  You will find paperwork in drawers, files or notes everywhere, and a general lack of accountability in these offices.  What becomes the norm when the physician is away, then becomes more the norm when he or she is in the office.

You can try your best to change these situations, unfortunately, many times to no avail.  There comes a point when even the greatest consultant or practice manager can no longer inspire the corrupted employee.   Doing as little as possible becomes the new job description and employees resent having to change their style and attitude.  

You should of course do your best to rectify this type of situation, but it is not beyond the realm of possibility that cleaning house becomes your only option.  If you have promoted a practice without a daily routine or reasonable expectations, you may not be able to salvage your present staff.  It is essential that employees have a job description that keeps them busy for their entire day.  They must complete a number of tasks and have an hour by hour routine, day after day, that promotes organization.  If you have employees with too much time on their hands, then you have too many employees.

Work is a privilege and in the current economic situation, there are people that would wait outside your office door for the chance to earn a paycheck each week.  If your present employees are not meeting your expectations, then it may be time to train a new set of employees and expect that they will be grateful for the opportunity to work and be productive each day.

Don't fall into a pattern of laziness where all your employees are still on the job when you are away.  Paying people to do nothing is ridiculous as well as a tremendous strain on your payroll revenue.  If you are away on vacation, or need to cancel hours for the day, make sure you only keep a skeleton crew in the office to answer the phone and make future appointments.  You will see how fast your employees want to become essential, whether or not you are there.

You cannot change from an easy breezy individual who lacks the ability to discipline your staff to someone who now wants total compliance to the rules that were never enforced in the past.  Change takes time and effort and change must first begin with the physician.  Put in the effort to speak to your staff and to tell them what you expect and the changes you want to put into play.   Make sure that the principles of change- the desire for organization and assured revenue - start first with you.

If after a time, you find your staff cannot make the proposed changes then you must take steps to replace these individuals with others that are vested in your practice mission statement and goals for the future.