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‘Like’ it or not, it’s the talk of the clinic


Nowhere does it state in staff contracts that they have to like everyone, but they will work together professionally and kindly.



Nowhere does it state in staff contracts that they have to like everyone, but they will work together professionally and kindly.

Dianna E. Graves

Putting It In View By Dianna E. Graves, COMT, BS Ed

This problem lives in your office in the form of a little “four-letter word.”

While the days blend into each other, and the seasons come and go, this little word continues to dwell in the corners-brewing and festering until it develops into that monster that cyclically rears its ugly head, again and again. It disrupts the everyday “ho hum” of clinic life, wreaking havoc with the physicians and the staff, and causing administrators and managers to run for cover.

Slowing growing larger than King Kong himself, we do not know this four-letter word in diabolical descriptors or horrifying adjectives. No, we have hidden its devastation in something so innocuous that we allow it to blend into our worlds and reside there in the shadows. We call this beast, “Like.”

There! Now that I have your attention, let’s talk about this devastating word.

Your clinic is rampant with it. If you pay attention for a week, you will hear it all over the place and in many different facets.

Remove the benignly thrown out comments: “I really like when I drive into work on Monday and the sun is shining-gives me hope for the rest of the week” or “I tried a pumpkin-and-prune latte this morning on special and did not like that.”

But circle the ones you hear regarding work in red. These are the mitotic early cells of the Like beast beginning to develop in your clinic.

How do I know that you all have this going on in? Because it’s the number one conversation I have when I visit or talk with other managers or go to their clinics to teach.

Surprise, this is coast to coast, even island to island. Yes, it lives here in Minnesota as well-even with our deep, dark, bone-chilling winters.

Let me give you some examples of what I am talking about.


1.              Physicians: “I don’t want you to schedule Suzanne in my clinics anymore. Yes, I know she is a good technician, but I just don’t like her as much as I do Amy. Put her into Dr. Smith’s clinic. They are a better fit. Make it happen!”

Recognize that one? Not many managers need a bright flashlight to shine under the stairwell to find this one brewing there.

With job security in mind, your first logical thought is to keep the peace and put Amy with this physician whenever they are in clinic and then switch Suzanne to the other physician.

But is it really that simple?

Let’s say this physician is a specialist with a high-patient volume clinic. Amy may be quirky and funny and flits around the clinic all day like a moth to a flame.

Suzanne gets in and gets the job done. She maneuvers her way through chaos and keeps the physician on task and gets everyone out at 5 p.m. But, she’s no “fun.” What wins? Function or fun?

Instead of having Suzanne and another technician work this physician’s clinic, I now have to add a third technician to make up for Amy’s quirkiness. By the way, don’t think it hasn’t gotten back to Suzanne in very subtle ways that he doesn’t like her.

2.              Technician A: “I refuse to work with Sarah anymore and don’t want to be scheduled in the same clinic with her. She thinks she is better than me because she is a COT and I am a COA and I don’t like her.”

This one is fun for a lot of the same reasons as the above, but we need to delve more here.

If a staff member knows or feels that the physician just doesn’t like him or her, there isn’t much they can do because the physician is in a position of power. So the presumed unliked employee trundles along and does the best he or she can in a no-win situation-or he or she leaves and joins your most feared competitor.

But when it is a fellow technician, the claws will come out. It is now preservation of the fittest and a catfight will soon ensue.

They will each gather support from the other technicians-we called this choosing sides in elementary school-and will start to drag the other office staff into it as well. Don’t be surprised if a physician or two isn’t dragged into the whole debacle.

You now have a giant game of dodge ball occurring-with you as the ball!

3.              Technician B: “Thanks for choosing me to train for diagnostics, but no thanks. I don’t like sitting in a dark room with the patient and listening to a machine beep all day. If I can’t do A-scans, then I don’t want to do visual fields. I don’t like those exams.”

This “like” beast is cagey and wily. It now has become a war of wits between you and an unforeseen hidden monster.

Is the technician shying away from diagnostics because of insecurity with knowledge and afraid of being in the spotlight too much? What if he or she makes a mistake? Or, is he or she the clinic social director who does not want to be out of the limelight too long, for fear of missing something that needs “attention,” such as a co-worker’s wedding pictures or the newest puppy pictures from the mailman.

Take the challenge

I challenge you to this simple study.

Put a piece of paper in your pocket and go live your life for a week. Every time someone comes to you and tells you they do or don’t like something or someone, make a hash mark and then a brief note of the context. At the end of the week you will have quite a list!

Now, here comes the hard part. What do you do with these hash marks?

My staff and I have quarterly technician meetings. It’s a time to discuss news, changes, and education and then a chance to give staff a time to vent creatively and discuss things together with the group.

Take your hash marks to the meeting and talk about it. I call it the “Like” conversation.

I remind staff of the following tenets with these caveats:

1.              Nowhere in their contract-they don’t have one but they understand the meaning-does it state that they have to like everyone, but they will work together professionally and kindly. I have from time to time reminded them that I am aware that not everyone likes me, and that I see this as a flaw in their character! By the way, while I am not fond of every person I meet, I will treat every person with kindness and respect.

2.              Stop worrying if the physicians like you. Physicians have enough of their own friends. They want you to do your job and do it well. If you do that for them, they will like you even if they don’t remember your name!

3.              If you have the skill to perform a diagnostic or special task, I am going to place you there unless you give me a real good reason not to. I once had a young technician who I wanted to place in diagnostics and she was immediately sad, sullen, and withdrawn. When I asked her what was up, she stated she loved completing patient workups, because she felt she was really good at expediently troubleshooting their concerns, doing a great job for the doctors, and ensuring the patient was treated well during the exam. I have to admit she was phenomenal at her job. Why rock the boat? I didn’t, and moved someone else into the diagnostic role.

You are never going to kill the Like beast. It will continue to morph and grow, then regenerate and morph into a sneakier beast. You are only going to be able to keep it at bay.

It will take time and more effort than this wily monster is worth. Left unguarded, it will grow and take over your clinic.

So, go home tonight, grab your lance and trusty steed, and sleep well. Tomorrow, you have Like windmills to slay in your clinic. Trust me. The beasts will be sleeping sound and waiting for you.

Dianna E. Graves, COMT, BS Ed, is clinical services manager at St. Paul Eye Clinic PA, in Woodbury, MN. Graves is a graduate of the School of Ophthalmic Medical Technology, St. Paul, MN, and has been a member of its teaching faculty since 1983. She can be reached at dgraves@stpauleye.com.


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