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    What I learned from turning over my office staff

    Today was a good afternoon – no, actually, it was a great afternoon! We had a productive staff meeting, cared for our patients, addressed several clinical concerns, and successfully completed a Novasure endometrial ablation procedure with an all new staff that had never seen the procedure and had never assisted on one before. The patient left extremely happy and grateful. This is what I consider a successful team effort.

    Three months ago, I turned over my entire full time staff all at once and asked for their keys immediately. I did not beg anyone to stay nor did I want them to stay. It was daunting and overwhelming for me, but it was absolutely the best thing to do for me and my practice. Luckily, I had a few part-time employees who were my saving grace. Why did the full-time employees go? Well, they thought they were indispensable and every day was full of negativity and drama. They became apathetic, disgruntled, and did not recognize that anyone is replaceable. These were people who were not capable of being happy in their lives and especially at their jobs. That type of attitude affected patients adversely, created immense patient dissatisfaction, and even made it so that I did not want to come to work myself. How could that be? I love my patients and my job! The staff negativity, lack of dedication, inertia, and complaining started to wear me down. One person was the real cancer and then it just spread from there as nobody would own their shortcomings or support one another. I tried talking to those involved, demonstrated empathy and understanding for their life situations, tried band-aid fixes by working with their limitations, enacted performance review measures, and eventually proceeded with disciplinary action, but nothing worked and nothing changed. So, it was time to start over with new people.

    I’m sure many of you have experienced similar staff challenges. If you are in private practice, you have control over your staff, but it is hard to find good people and time-consuming to train them, so you just keep the status quo. I’ve certainly been guilty of this in the past. If you are an employed physician then you have minimal control and have to jump through HR (human resources) hoops, which can be even more frustrating.

    Let’s face it. Being medical office staff is an under-appreciated, stressful, and hard job trying to balance administrative and clinical needs with demanding patients and sometimes demanding providers. Typically, many of the people who fulfill the roles are of a certain economic and educational background unless you are lucky enough to find someone with greater aspirations, a magnanimous personality, a thirst for knowledge, and a dedication to build a strong practice.

    More: 7 simple ways to find joy in medicine

    As I conducted my search and interviews, I took a radically different approach this time. Over the years, I have not had luck with Millennials as I found they had a sense of entitlement and lacked dedication and diligence. I was fed up so I told myself that I would not hire another Millennial, but I did not listen to myself and hired all Millennials again. Thankfully, they have worked out great! In the past, I would always try to sell myself and my practice to potential new hires by letting them know how great it was to work here and how we had a patient-focused philosophy. This time, I was much more realistic. Although I told them my practice was great and shared my vision, I told them my expectations, laid down ground rules, shared stories of the past staff behavior and how I would never tolerate that again. I told them I was looking for people who could be positive despite any personal or professional stressors and work cohesively as part of a team, supporting one another. I wanted them to have ambition and initiative to thrive personally and professionally and assured them I would support them. Well, it worked. I found 3 new full-time employees who are fantastic, despite being Millennials. I’m also indebted to my part-time employees who welcomed the new team members and weathered the storm with me to finally see the sun shining again.

    In the past, my MBA (Masters of Business Administration) business friends have wondered why we refer to the medical team as staff. They were always taught you are a team and only as good as your weakest link. Well, I never felt like my old staff was a team as I built a foundation, but they did not help nurture or support that foundation to grow. But now, I have learned what it means to have a true medical team.

    The people currently on my team are loyal, committed, diligent, driven, compassionate, smart, skilled, motivated, and supportive. They are simply good, kind people who have the ability and desire to learn, take initiative to problem solve, and take responsibility for their actions. They are not perfect, but learn and grow daily and strive for excellence. They love their jobs and are excited and enthusiastic to be here every day. They make me smile and care about me as a person. They inspire me to be a better leader and doctor. I admire and respect them. I am grateful and blessed to have them by my side and appreciate them daily.

    We have all heard from practice management gurus that your staff can make or break your practice. That is certainly true, but what I learned is that they can also make or break you as a healthcare provider. They can suck the life out of you, take the joy out of caring for patients, compromise patient care, increase patient complaints and dissatisfaction, break down the office infrastructure, destroy team morale, and cause an unhappy environment for everyone. I will never let that happen again. My current team is cohesive, supportive, positive, nurturing, and dedicated to me, patients, and the practice. I know we are a rock star team and my patients and I could not be happier.  

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