Best Practice Management
WHO and WHAT is Killing Your Productivity? (Part 2 of 2)

Overlooking Poor Performing Staff – “(S)he’s been with me since I started! I can’t let her go!” “Sure, the other staff are having difficulty getting along with her/him, but I just tell them to deal with it. They don’t have to go home with her/him.” “I could never replace him/her…(s)he’s the only one that knows my practice inside and out!”

This problem is very commonplace. If you are not among those who feel stuck in the middle between say, a longtime employee/manager and the rest of the staff, consider yourself lucky. To be clear, poor performance is legally defined as 'when (any) employee's behavior or performance (duties of their role) might fall below the required standard'. That in itself is enough to warrant a one-on-one discussion with them – likely some additional guidance, possibly a write up. What’s worse is when doctors fail to recognize the cultural as well as the occupational damage that these employees have on the practice and make excuses for them to “carry on” in spite of it – resulting in the loss of good staff, ongoing disruption from frequent staff turnover, a plummeting morale, and an unhealthy dose of resentment towards management for not putting their foot down and taking charge. Of course, it’s when there is no policy in place or certain people appear to be exempt from following the set rules and regulations that things get out of hand. Every practice should have an employee manual that states such rules – including a clearly outlined disciplinary policy to make sure that they are carried out fairly across the board. No exceptions. Policy avoiders get very good at what they do – if they are continuously allowed to get away with it!

Unclear Expectations – If tasks or projects are not completed to your satisfaction, there’s a good chance your message is not getting through to staff. Are outcomes clearly defined? Do you teach rather than “tell”? Are your high standards, too high? Does their job description match their skill level? Is the timeline realistic? If not, possibly start with setting the bar slightly lower and you may find yourself more surprised, even pleased, at the actions they take. Do this not by shouting orders and assuming they will follow through; rather, ask questions and let them participate in the process. For example, you might ask, “Do you have a suggestion for improving this task?” Often, if you ease up and modify expectations, a good employee will work hard to meet the goal; perhaps even supersede it. PS- it also helps if you are the kind of “boss” who doesn’t micromanage at every turn. Employees put more energy into their work and are infinitely more productive if they enjoy what they’re doing and who they’re doing it for! Proficiency will come with time, we all learn to crawl before we run.

Flawed Staff Meetings – If there is inadequate follow up or you are not achieving specific outcomes after your scheduled staff meetings, I’ll be the first to agree, they are a total waste of time. However, by routinely carving out a small slice of your schedule when the entire office can participate in open communication, shared ideas, solutions, responsibilities, results, and accomplishments…you can pretty much hand your staff the keys necessary to ignite productivity. A structured (written) Action Plan and pre-planned agenda offer direction and necessary follow up and should be the basis of each meeting. They help to define and outline goals, build a culture, and stimulate the power of collaboration. You can request a complimentary copy of an Action Plan template to help keep your meetings on track by emailing me at I’m happy to send you one.

Manual Appointment Reminders – Letting go of “the way we’ve always done it” can be difficult. Understandable. However, if you’re not committed to moving your practice forward, it’s either standing still or going backwards. While many offices still cling to having staff manually call each patient to remind them of their appointment, it is a time consuming process. Especially in those offices whose daily schedules are substantial. Still, they prefer this method claiming “patients like it better” and “it’s more personal”.  All agree that appointment reminders are critical, yet having a professional, automated system do it, for some, remains inconceivable. Given the time that staff typically spend on this single task, anywhere from 30-90 minutes (some confess more), automation is far more cost effective. There are other, more productive ways staff can use that chunk of time. Of course, even with an automated system, manual calls can still selectively be made to new patients or to those who require additional instruction; however, most patients these days have adapted to computerized calls, texts, or emails as a way of receiving their reminders – especially since most of their other doctors are already doing it. As far as that personal touch? Ask your staff how many patients they personally connect with vs how many of their “personal” reminder calls go directly to the patients’ voicemail where they are prompted to leave a recorded message. If they are honest, staff will tell you that voicemail wins by a landslide! Yes, even our elderly patients have it. So, think again. Who’s automating who these days?

In this two-part article, I’ve presented some common productivity killers. (And in the process, feel a Part III brewing!) If you’ve been putting off change, now’s as good a time as any to evaluate and determine what you can do differently to increase efficiency levels in your practice. Not every point made may be immediately doable in your office, so just start by taking one or two…or three that will! “The most important step of them all is the first step. Start something.”