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How to be a strong manager even when dealing with over-controlling physicians

The sad truth about working in a medical office is that a manager often has no real job description and not much authority either. Here are examples of situations that come as a result. They are outlined by Ana McGary of PeopleFirst Enterprises, a human resource management consulting firm in Powder Springs, GA.

    The doctors never seem to agree on my role as manager. Many times they give me individual assignments without taking into consideration all the basic work I have to do. How can I remedy this?

Go to the original hiring doctor and ask for help. Make it an honest discussion, not a complaint session:

I love my job here. But I think some of the other doctors have expectations of me that you don’t. I want to do the right thing and meet everybody’s full expectations, so could you give me some guidance?

Then outline the problem – that it’s not always possible to do the regular work plus the special assignments. Keep it business related, and emphasize that the goal is to do a good job, not to get out of work.

Expect a good answer. Quite likely, the doctor will tell the others what the manager’s role is and set up some system for making requests.

The doctors put me in charge – sort of. They promoted me to manager, but they didn’t give me any authority. What should I do?

That’s an all-too-common problem, McGary says. The doctors promote a staffer to be “the in-charge person” who is accountable for how the office runs, but they don’t grant any decision-making authority. Then when there’s a directive, staff go over the new manager’s head to the doctors and reverse it.

The only solution is to ask to meet with the doctor or doctors who assigned the new role as manager and lay out the problem.

Draw up a list of all the duties, show it to the doctor and say “Here are my responsibilities. Do you see them this way?”

Also point out any growth that has taken place: “You hired me for this, and this is what my job has turned into during the last two years.”

And then the big question: “Are these the things you want me to do?”

Whether the doctor agrees, disagrees, or wants to discuss the list with the other physicians, finish with one more question: “What’s the best way for me to keep you informed on what’s going on in my job?”

The answer will show how much that doctor wants to micromanage the manager. And it may be the manager really has no authority at all but has to get approval for every decision. But whatever the answer, that’s the authority level the position carries.

From there, lay the cards of the table. Cite some of the problems that have arisen as a result of the lack of authority. Mostly, those will be management and discipline issues, the worst being that staff take the manager’s directives to the doctors and get them nullified.

Don’t complain. Don’t whine. Instead, show the impact the situation is having on the office’s operations. McGary gives this example:

Last week Staffer A asked you for the afternoon off. However, I had given her a project that needed to be finished by the end of the day. It didn’t get done, and as a result we were late getting the bills out. I believe she bypassed me because she knew my answer would be no. So may I ask you to direct staff to me when they request time off?

Point out that the doctors’ role is to practice medicine and the manager’s role is to take on the administrative work and give them more time to do so.

Unfortunately, one meeting probably isn’t enough to change the behavior entirely, so expect to be talking again about the issue in the future. But at least the groundwork has been laid.

McGary adds that it’s also appropriate to ask the doctor to meet with staff and explain that “Manager A is taking on more responsibilities. She will be doing X, Y, and Z. If you have a request, it should go through her. It’s not that I’m not available, but I need to have more time to spend with the patients.”

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