Managing Office Staff: What Podiatry Can Learn From The Airline Industry

Lynn Homisak, PRT

   Based on my years of experience in healthcare, it is fair to say that communication is the number one issue in the majority of offices. This was evident when I visited a large multi-doctor practice on the East Coast. Part of that consult was to meet with all the staff managers and discuss where they felt efficiency breakdowns occurred. As we worked through issues, one manager asked, “I’m confused. Did our doctors actually fly you across the country to ask us what the problems were so you could tell them what we said? They are here with us every day … Did they consider asking us that question?” If their communication skills were modeled after air traffic control, this practice could have concentrated on improving patient care and efficiency systems, but they could not get past their communication roadblocks.

   Teamwork and communication compliment and feed off each other. Through active listening skills, mutual effort and commitment to a successful outcome, shared responsibilities toward a common purpose/goal, clear accepted procedures, dedication and sacrifice (“taking one for the good of the team”), this combination can increase trust and performance.

Why A Hasty Run-Through Won’t Cut It When Training Staff

Another underutilized tool in the shed of success is proper training. While many jobs at the onset appear daunting, airlines make certain their pilots are fully trained. No shortcuts allowed. The level of training that one receives turns that fear into confidence. It is easy for an employer to criticize an employee for not doing his or her job right, but it is often the result of improper or no training, something employers fail to take responsibility for.

   I had the privilege of sitting in the actual cockpit of a Boeing 737-800 simulator to see and feel firsthand what is involved with flying it. As I took my seat among the hundreds of knobs, handles, dials, buttons and levers in front of, above and below me, I could not help but feel intimidated. I got a quick “run-through” from the pilot, who parked himself in the co-pilot seat and began rattling off what he said I needed to know before takeoff. Pull this, check this, lower that … it seemed his instructions were endless. He basically touched on some key points, like how to start the plane, pull back on the throttle, put it in autopilot and drop the landing gear.

   When he completed his 15-minute tutorial, he asked if I had any questions. Even though I knew I was not prepared, off we went. This was an eye-opening event. Even though I (we) landed the plane (thanks to the co-pilot), we crashed as I taxied to the gate. Had it been a real flight, 162 passengers plus crew would not have made it.

   Needless to say, a hasty “run-through” just did not cut it. Yet this is too often how we train staff in many offices. Circumstances are different but the reasons for failure are the same and while hundreds of lives may not be at stake, reputations are.

   Telling is not teaching. Teaching requires much more effort than that. I did not understand a fraction of the requirements to pilot that aircraft. Even though I received a primer of the “hows” of starting and stopping the plane, I did not know the who, what, when, where and whys, let alone the ifs. The bottom line is I could no more fly that plane with any success than a staff person (experienced or not) could be expected to perform his or her duties in the office without the necessary training.

   My philosophy of working in a podiatry practice is and always has been to teach staff how to do everything, even if they are hired to work in one particular area. This does not mean that all staff must be perfect at all roles but they must be proficient. If needed, they can help with all office duties and support co-workers who are out due to illness or vacation.


Ms. Homisak has only touched on a small portion of what has come out of aerospace engineering. The Crew Resource Manual (CRM) was used as a resource for the writing of Atul Giwandi's The Checklist Manifesto. Many of us are aware of the use of checklists in the OR prior to beginning a surgical case.

The CRM has also been used in developing heuristics and algorithms for anesthesiologists in dealing with OR crises. Doctor Gaba et. al. at Stanford have developed a simulation program (think flight simulation) for anesthesiology residence programs at Stanford and Mass General for instance.

Another resource developed from CRM, Operations Management and In Extremus Psychology is the text, Crisis Management in the Acute Care Setting. It is quite comprehensive and helpful in improving quality of care and patient safety.

Thank you Ms. Homisak for your interesting article.

Jim DiNoivs

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