November 2002

Rock the Boat – Don’t Tip It Over
Creating a Strong Team Sometimes Requires a Diplomatic Shake-Up
By Michelle Geller-Vino

We are so used to following trends in our society, that they often blindly lead us. For example, popular music styles change every few years. Fashion reinvents itself even faster than that. Professions like chiropractic, however, rarely have a quick metamorphosis. Gradually, though, another common question is being asked in addition to the age-old: “How do I get more new patients?” That question is, “How do I hire a great staff and keep the team motivated?”

Typically, doctors love to work with patients, but administrative tasks leave much to be desired. Staff members often are hired out of desperation, with little or no concept about how the individual fits into his or her role in the office. Then, there might be no formal training, leaving the employee to figure it all out on his or her own.

Finally, if the practice is flat or in decline, the doctor frequently blames it on the staff members. One of two possibilities usually follows: either the staff member gets fired and the process repeats, or worse, the doctor leaves the weak link to stay and infect the other team members and the practice itself.

There are five aspects to creating what I refer to as “The ‘A’ Team.” They include:
1. Proper Hiring Techniques
2. New Staff Member Training
3. Weekly Staff Meetings
4. Probation
5. Dismissal and Replacement

1. Proper Hiring Techniques: Undoubtedly, the most important characteristic of a great teammate is personality. I would rather hire someone with no experience and a fireball attitude than the other way around. Look for traits like coachability, punctuality, and enthusiasm. These will always go farther than typing speed and a long resume.

Next, outline a clear job description for that employee. Print a list of the requirements so there are no surprises. That way, the employee is well aware of what is going to be expected of him or her before starting.

Be precise about the things you will not tolerate, such as lateness and personal phone calls. In essence, you are creating a strong commitment up front.

This is very similar to doing a report of findings with a patient. You are outlining the care plan before they begin. Finally, begin with a 30-day window to see if you like each other and if the new kid on the block gets along with the other members of the team.

Remember that one bad apple can spoil the whole bunch. Don’t allow it to happen. A tree can take hundreds of years to grow, and one lightning bolt can burn it to the ground.

2. New Staff Member Training: New staff member training is vital. You would never draft an athlete into the professional ranks and not show him or her the playbook, would you? Well, the same holds true here. You must work with the new team member weekly in private to get him or her up to speed.

You cannot expect expert performance without extra practice time. Role-play with the new employee yourself. Go over new patient procedures, telephone procedures, paperwork, communication skills, and whatever else you think this person needs to excel.

Chiropractors are notorious for having staff members filter in and out. This creates frustration for the doctors and staff, and for the patients as well. You cannot blame an employee for lackluster performance if he or she is not trained to your specifications. New staff members are lumps of clay. It is up to you to mold them the way you want them. Otherwise, stop complaining and accept mediocrity.

3. Weekly Staff Meetings: Weekly staff meetings are sorely misused in the chiropractic profession. These weekly meetings are excellent ways to “gather the troops” in order to reflect on the past week’s performance, as well as upcoming events. Each department should prepare a report to be introduced at the meeting.

Does the insurance department need more cooperation from the front desk? Are collections where they should be? Have certain patients missed coming to the health-care class?

Often, each of you has a completely different interaction with the patient. Patients tell staff members some things that they forget to tell the doctors. You should all be on the same page.

Remember that the insurance office staff does not often get to meet the patients. It is nice to go through all of the new patients for the week and describe the patients’ care plans, their chief complaints, what their personality types are, and any other information you think could be useful in caring for these patients.

Also, make sure to review your weekly and monthly goals at this time. Each staff member should be crystal clear on what the goals are for office visits, new patients, services, and collections.

4. Probation: Let’s say that things aren’t going as planned. You might suspect that one of the teammates is slacking off, or not showing full commitment. I am a firm believer in praising staff members when they are exhibiting the behaviors that you desire, while addressing improper behavior as well.

If you do not let the person know that something is wrong, he or she will continue to act in the same way. Likely, the other staff members will resent you for allowing it, especially if it is clearly detrimental to their success. This is possibly the most difficult thing for many doctors, but the earlier challenges are confronted, the smoother things will run.

The best way I have found to handle serious issues with a staff person is to privately meet with the individual. Do not embarrass him or her in front of the rest of the team. At this meeting you are to tell the person what you believe to be unacceptable. There is no reason to make this conversation antagonistic. Contrarily, you can open the conversation by letting them know that you are trying to help them meet their highest potential.

If the behavior is something severe, or a repetitive problem, place that employee on “probation.” Be sure to clearly document the conversation and have the staff person sign it. By documenting the interaction, you are letting this person know that you are serious about your practice. Do not expect perfection out of each member of the team, because it is not attainable; however, you can expect excellence. Strive to be such a powerful leader that your staff knows it without you having to say it.

5. Dismissal and Replacement: Finally, there is a time to cut your losses and let someone go gracefully. No one likes to fire people. In fact, some would rather keep a staff member around, even if he or she is hurting the practice, rather than develop the strength to dismiss and replace.

Letting a weak staff member go is not always easy. However, there are three main reasons why it is an amazing way to spark growth in your practice. First, you will instantly raise your self-esteem. This is invaluable. You are telling yourself that mediocrity will not be tolerated. By facing difficult challenges, you are saying, “I care too much about chiropractic and my patients to allow an uncommitted person onto the team.”

Second, you are creating an opportunity for the rest of the team to know that certain behaviors will not be tolerated. Again, perfection is not necessary, but excellence is essential. Lastly, the sheer fact that the “rotten apple” is gone will spark some comments from the patients. You’ll be amazed that once the employee is gone, the patients will want to know what took you so long.

This is a great time to tell the patients that you care too much about them to allow for anything less than an expertly trained staff. Mind you, patients won’t speak up while the person is still employed, but once he or she is let go, all of the negatives will be shared.

The reason why many of you opened your own offices is because you wanted the control to practice your way. Hire people with winning personalities and educate them as to how you would like them to act. Give new employees the attention they deserve. Continue to hold team trainings; there is no end to growth.

Weekly staff meetings ensure that each member is being held accountable. Each department should report so you are all on the same page. Every staff member is of equal importance, including the doctor. Hold yourselves to a high standard and you will see the growth.

Confrontations arise; do not let them fester. Instead, nip them in the bud, handle the issues and simply fix what needs to be fixed. Remember that this is business, and contending with weaker areas is not personal.

Emotions such as fear, indecisiveness, and guilt hold you back from building a great practice. Nothing less than full commitment can be accepted. If you impart that message on a regular basis, starting with a long look in the mirror, excellence is attainable. Shaking the tree makes weak leaves fall; what remains is a strong foundation for the fruits of your labor to blossom.

Ms. Geller-Vino is the president of MGV Marketing, Inc., based in Boca Raton, Fla. Her company’s specialty is new patient acquisition through lectures, screenings and health fairs scheduled throughout doctors’ communities. Ms. Geller-Vino offers both on-site and home-based marketing programs and can be reached at 561-392-5206, or visit the company’s website at www.mgvmarketing.com