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MANAGING THE OFFICE

The 8 best management tips from our readers

Managing the people with their problems and personalities is the most formidable part of a medical office manager’s job.

So here for our readers is a long list of ways to make the job easier. They come from the many consultants and managers MOM has talked with over the years.

1 Hiring the right people

Interview tactics

Before hiring a job applicant, look carefully at two points:

The first is attitude. Listen for positive, enthusiastic, and solid answers to questions such as these:

Tell me about your experience in medical offices.

Tell me about a situation where you were able to help a patient.

How did you interact with (the physicians – patients – manager) at your last job?

How would you handle a telephone call from an irate patient?

The second is teamwork. Ask about personal accomplishments and listen for me-me comments versus comments about interacting with other people. A team player says a former boss was helpful, gives other people credit for an accomplishment, and mentions the good things peers in other jobs have done. The candidates who will never join the team are those who toot their own horns, complain about their other jobs, and criticize former bosses and peers.

Give staff the final word on a hire

Before making a job offer, have the candidate spend the morning shadowing one or two other staffers and going to lunch with several staffers. Afterwards, ask the others if they would like to work with that person and whether they think that person will be an asset to the office. Besides getting a good view of the candidate, having staff participate in the evaluation creates a sense of teamwork and ownership in the practice.

2 Understanding personalities

Seven basic types

All employees fall into one of seven basic personality types, and the manager has to know how to deal with each one.

  • The commander. Has to be in control, is a perfectionist, can be domineering, aloof, and abrupt. Even so, commanders know their jobs, inspire confidence, and get the job done. To make them happy, put them in charge of things such as reorganizing the files or tracking the vacation and sick days.
  • The attacker. Grouchy, cynical, argumentative. Two keys here. First, what the attacker wants is respect; second, don’t back down. When the attacker attacks, come back with, “That’s an interesting point.” (respect) “Can you explain why your method is more effective that the one we’re using?” (counterattack)
  • The pleaser. Warm, kind, good-hearted. Can’t say no. Takes on every request. Pleasers want approval and are crushed by criticism. For them the sandwich technique actually works: “You did A+ on this. Next time, you need to watch the typos. You are a good worker.”
  • The drifter. Creative, artsy, disorganized, short attention span, daydreamer. Drifters need sensation and constant change. Don’t give them long, ongoing projects. They’ll lose interest midway. Break the job into different tasks, and dole the tasks out one by one.
  • The performer. Likes the spotlight, is entertaining, is fun to be around. This person wants stardom and will take on a lot of work to get it. Stroke the ego, give praise for work well done, and the performer will perform well.
  • The avoider. A wallflower, doesn’t talk much, tries to be inconspicuous, is insecure. Don’t yell at avoiders. That only scares them. Point out their mistakes, but let them know mistakes aren’t fatal. Also, give precise directions. Avoiders are so fearful of making mistakes that if they find a misspelled word in something they are transcribing, they’ll put the same misspelling in their own work.
  • The analyzer. Precise, detailed, diligent, nerdy, double-checks everything. Give the analyzers examples and details. Give them explanations. But don’t let them kill a deadline. Say, “I don’t have time to wait for more data. Go ahead and finish it with what you have.”

3 Motivating staff

Four motivation personalities

What motivates one person doesn’t necessarily motivate another. To get the best from staff, the manager has to hold out the right carrots. There are four groups of people here.

1 First are those who are motivated by feelings. What spurs them on to good work is personal recognition: “Finish this by the end of the day. I know I can count on you.”

2 Second are the process people. They want to know every step the job requires: “Finish this by the end of the day. You need to do A, B, and C.”

3 Next are the results-oriented people. They want to do everything their own way: “Finish this by the end of the day. You figure out how.”

4 And fourth are the power people. They want to hear what needs to be done and get the authority to take over from there: “This has to be finished by the end of the day. Let me know when you are done.”

Business cards as motivators

A good motivator for the entire office – and also an inexpensive marketing tactic – is business cards for staff. Tell staff to give out their cards whenever they have an opportunity to leave their names and the name of the practice – in the grocery store, in the car repair shop, or when meeting with, say, an accountant.

The benefits are threefold. The cards advertise the office. They give potential patients a personal contact. And they give staff a sense of professionalism and pride in the job, because few people making an hourly wage have them.

4 Building morale

Morale at staff meetings

Use staff meetings to build morale. Before the meeting, have staff write anonymous comments about one another, good or bad. The manager collects them and reads them aloud during the first 15 minutes of the meeting.

There will be compliments. There will also be complaints, and often those complaints identify problems such as, “The front desk people don’t always get such-and-such right.” The manager can then address those problems without citing anybody specifically.

Similarly, at each meeting have one person explain what his or her job entails. Over time, cover all the positions. That makes staff appreciate how difficult and time consuming everybody’s job is. It also makes them aware of how the office runs and shows them where to turn for help and explanations.

5 Improving performance

An office-wide monthly incentive

The most effective financial incentive is an office-wide program that ties a bonus to the bottom line. The purpose of an incentive is to increase profits, and by itself, one staffer’s extra work can’t do that. It requires an office-wide effort.

Set a threshold of what the physicians want to earn after expenses. Then give staff a percentage of anything in excess of that, with each person’s share depending on salary. So suppose there are two physicians and each wants to have $10,000 a month after expenses. Give staff perhaps 10% of anything over that.

How much does each staffer get? Pay by salary percentage. If there are three staffers and one earns 28% of the total payroll, another 37%, and the third 35%, those are the percentages they get. So suppose the after-expense revenue this month soars to $30,000. There’s $10,000 profit, and the three staffers get to divide up 10% of that, or $1,000. That makes their bonus amounts this month $280, $370, and $350, respectively.

To keep the incentive going, pay the money each month. Do it annually and people forget about it. Also, if one month shows a loss, don’t carry that into the next month. Staff will have to work just to get back to zero. And if the next month also shows a loss, they’ll never catch up. The incentive will die.

The watchful eye

People perform best when they know they’re being watched. Staff need to know the manager is aware of what they should be doing and what they are doing.

A good way to be a watchful manager is with daily rounds. In a very small office, talk with individual staffers; in a larger office, talk with the supervisors. Every morning, talk briefly with each staffer (or supervisor). Ask what work will be done that day and if there are any problems. If one area is short handed, the manager can assign other staff to help out. Or if supplies are low, the manager can place an order. If a problem patient in coming in, the manager can prepare staff for the visit.

Make another short round in the afternoon. Ask how the work is coming along and if any new problems have arisen.

Besides keeping the manager in the know, and besides addressing the problems, the rounds eliminate the interruptions throughout the day because most issues – including the petty ones – get solved on the spot.

Encouraging the stars

Give staff a chance to shine. Encourage them to grow in their jobs by designing and completing projects that benefit the office. The manager can offer a list of projects or can let staff design their own for approval. Either way, the staffer presents it to the manager in writing. Then manager and staffer together write out the goal, how the performance will be measured, what excellence will be, how the staffer will achieve the goal, the completion date for each step, and the final completion date. At completion, the staffer writes up the results. Put the documentation in the personnel file and consider it at review time. The manager can also reward the effort immediately.

Make the projects voluntary so people aren’t penalized for sticking to their jobs. Present it as “you can just do your job or you can find time to do extra things and be rewarded for it.”

6 Perks that go a long way

Hours instead of days

One way to accommodate staff and at the same time reduce full-day absences is to replace the personal leave days with personal leave hours. So instead of getting, say, two days leave, staff get 16 hours. People like the programs because they can take a full day or just use the hours here and there however they want.

There are two restrictions, however.

First, staff have to get written approval. Do that with a form showing the requested date and the departure and approximate return times. The manager signs the form. When the staffer returns, the manager notes on the form the actual number of hours taken.

And second, because it’s too much of a hassle to track minutes, everybody has to take full hours. Thus, a 90-minute absence counts as two hours.

Staff can use the hours for anything they want and don’t have to explain the reason to the manager. Where the hours are most helpful is with doctor appointments for children. Instead of having to take an entire day for a short appointment, a parent can be out only a few hours. That gives her or him time for several appointments throughout the year.

The manager gets some benefit too. Covering an absence for a few hours is far easier than covering for a whole day.

7 Productive reviews

Reviews with no money attached

Another way to improve performance is to review staff three times a year without tying the results to money.

A useful review isn’t tied to money but to performance. It shows the staffer what’s good, what’s bad, and what needs to be done better. And it shows the manager where education and training are needed.

Thrice annual reviews are admittedly time consuming, but they can make a manager’s job a lot easier, because performance and behavior never have a chance to get out of hand. If there’s a performance or behavior issue, it gets addressed quickly. It doesn’t slide for 12 months.

Spend about 30 minutes with each employee and write a few sentences summarizing the meeting. Keep the notes in the staffer’s personnel file.

Reviews for better performance

At review time, the best rating system is a narrative plus a numerical scale.

The narrative is what the staffer remembers – not the numbers. Be specific. Instead of “does a great job,” cite what’s great about it, perhaps “always extends personal courtesies to patients” or “collects complete and accurate data.”

Do the same with criticism. Where there’s a low rating, make it clear what the staffer is doing and lay out what improvements are needed.

Raises to recognize growth

Instead of basing the entire raise on how well a staffer performs in the job, make a part of it dependent on growth, or how well the staffer has grown in the job during the review period. The growth can come from professional education and certification. It can also be acquired at no cost by learning new jobs from other staff or from personal research or study. As they grow in their jobs, staff become more competent. They do more and better work. And self-esteem and job satisfaction increase.

Start with some staff input

Ask staff to fill out the evaluation form on themselves before the review. It often makes the discussion of the shortfall areas easier, because most people grade themselves much tougher than the manager does. What’s more, when the staffer comes in admitting to the shortcomings, the manager doesn’t have to be the attack person who brings them up.

Don’t kill it

No matter how bad a review is, end it with a positive note. Express confidence in the staffer’s ability to do the job.

8 Knowing how to manage

Getting attention and respect

How does the manager command respect from the staff – and the doctors? Here are seven ways:

  • Before giving a directive or stating an opinion, think it through. Figure out what the consequences could be. People respect and listen to what’s been carefully considered.
  • Look professional. Don’t get so friendly as to stand too close to another person. Never touch anybody. With dress, err on the side of conservative and formal. And stand up straight. That shows confidence.
  • Speak with conviction. Make eye contact. Use hand gestures to emphasize a point or to count off points being presented. Show animation. If on a stage, walk around a bit.
  • Match the speaking style of the other person. When talking with a staffer who is quiet and deliberate, talk slowly. With somebody who wants everything done yesterday, talk faster. People relate to other people who look and talk the same way they do.
  • Don’t use slang. Don’t try to get personal with staff by using casual language such as “like,” “you know,” “stuff,” and “junk.” Slang undermines a manager’s credibility.
  • Listen. That calms anger. It says, “I hear what you are saying.” It helps the staffer get collected. By contrast, interrupting says the other person isn’t important.
  • Be enthusiastic. Speak with passion. If the manager doesn’t show excitement about the topic, don’t expect anybody else to get excited about it.

A better response from listening

One of the main things employees want from a boss is to be listened to. There are seven points to being a good listener.

  • Set aside time to talk. When a staffer comes in to talk about a problem, hold the phone calls and interruptions. If that’s not possible, tell the staffer so and set a better time. The staffer will appreciate the fact that the manager wants to give the matter full attention.
  • Don’t interrupt. Focus on what the staffer says. Don’t make comments or give opinions until the staffer has finished talking.
  • Ask open-ended questions. Those are questions that begin with “tell me,” “describe,” or “explain this to me.” For example, if the staffer says it’s difficult to work overtime, respond with, “Tell me what problems you’re having with that.”
  • Use listening body language. Make eye contact. Staring at the wall or glancing around the room indicates lack of interest. Lean forward and nod occasionally. And mirror the staffer’s emotions. Smile when the staffer uses humor or frown when there’s a serious matter.
  • Paraphrase what the staffer says. That ensures there’s no misinterpretation, but it also shows the manager is paying attention to the staffer’s concerns.
  • Use reflexive statements. Those are statements that recognize the staffer’s feelings without passing judgment — “you seem worried about being able to meet the deadline” or “you sound upset about not getting your requested vacation.” By reflecting what the staffer says, those statements show the manager is listening, isn’t criticizing, and respects what the staffer is saying.
  • Summarize the conversation Lay out who’s going to do what, for example, “I’ll talk to Staffer A tomorrow about filling in for you during lunch.” That sends both sides out on the right foot. It’s also a nice way to tell the staffer that time’s up.

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