Twenty-Four Things You Should Know About Managing Your Practice Before I Die

Before we start, let me put this right out there. I have zero plans to leave this earth anytime soon. However, since our fate is unpredictable, I thought now would be a good time to share some things I have come to understand over my podiatry-infused lifetime. If I do live forever, that would be great. if I don’t, I will have at least put these little nuggets of wisdom and experience out there. Otherwise, if I wait until the next deadline (so to speak), they may be forever lost. Some could come as a surprise (even spur an “Aha!” moment). Some you could say “Lynn mentioned that a time or two … bless her heart.” So, in no particular order of importance, here are some nuggets to consider. 1. No matter how well you think you communicate with your staff, you fall short. 2. No matter how well staff thinks they communicate with their doctors, they fall short. 3. A lack of communication is one of the most egregious of all management crimes. 4. Policies are useless if you do not enforce them or if there are no consequences for violating them. 5. Staff can make or break your practice. 6. Don’t bother hiring a consultant unless you plan to engage in the recommended change process. 7. Change is hard but if nothing changes … nothing will change. 8. Regardless of your forbidding staff from sharing wage information, they will share wage information. So be fair and you will have nothing to hide. 9. There are only so many ways to convince you that written job descriptions, employee manuals, staff meetings and performance reviews really lead to greater efficiency. You either get it or you don’t. 10. Forgo proper training and you cannot complain about incompetent staff. 11. You get what you pay for. Pay a low salary and it is best to set your expectations low. 12. Assuming is not the same as knowing. Facts are always important when making a credible point. 13. Patients can hear your overextended personal conversations in a connecting treatment room while you keep them inappropriately waiting … and waiting … and waiting … 14. Patients will not leave you for another doctor if you properly reschedule them to evaluate, diagnose and treat the three other conditions they bring to your attention during their reserved 10- or 15-minute encounter. 15. When you spend extra time accommodating a patient for unscheduled conditions, you are being unfair to your patients who came on time and are waiting unnecessarily (see #14). 16. Most patients are convinced that staff have the skills and competence to deliver appropriate/limited “hands-on care.” They sense that if their doctor has confidence in their staff, so should they. 17. Do not be your patient’s financial advisor. Offer care based on what is best for your patients, not based on the jeans they wear, the phone they carry, the car they drive or the insurance they have. Let them decide what they can and cannot afford. 18. Cheating on insurance claims only triggers an audit. 19. Embezzlement happens when a practice has absent security measures. 20. Rushing through the hiring process never ends well. Having the right staff starts with hiring the right person and retaining them requires good management. 21. Overall, doctors do not make the best managers and “playing it by ear” is mostly ineffective. 22. Employees who use cell phones, text, surf the Web, visit Facebook, visit Twitter or do online shopping, etc. are stealing company time, but the inconsistency of an employer or manager not leading by example dismisses the importance. 23. A negative workplace causes conflicts, kills morale, reduces productivity and lowers profit. 24. Staff motivation is not wrapped in a dollar bill as much as it is embodied in appreciation and respect. There you have it. These are just a few observations from the edge of reality. You can throw them out, learn from them, comment on them or share them. Just don’t kill the messenger. P.S. — Since I am still here, I reserve the right to amend this list at least until the day I die.