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Addressing issues in the clinic to improve office morale


To improve morale, managers need to have a pulse on the dynamics of the group and work on the issues that can cause daily frustration.


Take home

To improve morale, managers need to have a pulse on the dynamics of the group and work on the issues that can cause daily frustration.



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

Recently a friend of mine, Donna, stopped over on her way to work. She works at a company that some might say is fairly rigid in its office protocol. To say that her desk is somewhere in the middle of a “cube farm” would underemphasize what little privacy any of its inhabitants have while trying to manage million-dollar accounts. But, they are “uniform” in their appearance and office setting. So when I heard that their office project this quarter is the book “Who Moved My Cheese?” it seemed very appropriate for them.

Dressed for success?

Donna dropped down in a chair and seemed out of sorts. She was definitely dressed out of sorts for her office.

“Aren’t you going to work today?” I asked, eyeing her baseball shirt.

“Oh, yes. This is the dress of the day to help inspire team unity,” she grumbled.

Donna was dressed in jeans, a turtleneck, and a Boston Red Sox Jason Varitek team shirt. She had on her black dress shoes-some habits die hard!

“Oh,” I smiled. “I would kill to wear jeans to work. No offense, what do jeans and baseball shirts have to do with team unity?”

“Exactly,” she yelled. “This is what the bosses came up with after meeting for 3 hours on how to improve office morale.”

And then off she went to the cube farm with a jaded view of her uniform of the day.


During the day, I kept drifting back to our discussion about improving morale by changing a dress code for the day, or having breakfast delivered once a year, or giving everyone another clinic tote bag and key chain. Though most of these gestures can mount dollar-wise, they usually are not all that appreciated by the staff. This often causes hurt feelings from the giver because the response of the staff can be less than lukewarm.

If done too often, the staff begins to expect these treats. Conversely, when management does not have “Ice Cream Bar Thursday,” the staff will become angry because something was taken away from them.

Unfortunately, giving staff members something to improve morale eventually leads them to:

1.              Expect it to continue

2.              Become angry if it does not continue

3.              Feel that no matter what you give them, they deserve more

4.              Actually decrease morale due to #3, or worst of all

5.              Irritate the staff because you do not understand what the issues really are in the office. They see it that you are trying to “buy them” with token gifts.


Pulse on the daily issues

To improve morale, managers need to have a pulse on the dynamics of the group and work on the issues that can cause daily heartburn. Some examples might be:

1.             Does the office layout, or current equipment, bog down the staff so that they are waiting in lines for equipment?

I visited a general ophthalmology practice a while ago. None of the technicians (there were seven) knew how to use a retinoscope, but they were all responsible for getting their patients’ readings using one autorefractor. They needed to refine the patients’ readings in the refractor room, and then move the patients again to their room to finish the exam. There were three technicians working with each physician, having 25 patients per shift. Technicians and patients were queued in the hallways all day. The physician was constantly waiting and could repeatedly be heard complaining about the poor clinic flow to anyone within hearing range.

I recommended they purchase two smaller-sized autorefractors, and advised them where to place these devices strategically to improve the clinic flow. They did this, and on the next visit, the technicians were visibly happier, the physician was less grumbly, and the patients’ waiting times had decreased-much better than a $10.00 gas card.

2.             The physician has a favorite technician.

If I were a physician, I would want to make sure that I surrounded myself with the best technician in the office, the best scribe, and the best float person (to direct traffic). The other technicians could work with the other physicians. The physician “favorites” are well known to the group, and the rest of the technicians feel they have no chance to move forward and grow into a better position in the practice. They see this as the physician not liking them.

Advance all the technical people in the office so they are all quality and skilled staff members. If the physician is out of the office, then “their” technician should float in with another physician. They need to be part of the group-not placed above the group or doing jobs they feel as necessary while the physician is out to avoid being the “other” technicians.

3.             “Death on legs” is the technician everyone wants out of the office.

They are in most cases the “favorite.” They are entitled, blatant, lazy, and privileged. They are also openly vocal that they can go elsewhere and make more money. They are this way because they feel they are protected and no one will call them on it, especially the manager.

Here’s a thought. Help them “out” and let them go. They are killing the office and are toxic to morale. Remove them from the office and watch morale improve.


Setting and achieving goals

My epiphany that “no one in management got it” occurred after I had worked at a clinic for 11 years. This revelation always occurred when my annual review rolled around.

Every year my manager would dutifully ask: “What can we do for you to make you continue to feel fulfilled?”

This question was only asked once a year, because it was listed on the review sheet. I always answered it the same way with the same two or three ideas:

·      I wanted to help increase community education in an increasingly international community.

·      I wanted to obtain and specialize in more advanced equipment versus the old, antiquated equipment we had.

·      I wanted to increase in-house education and to share ideas with other clinics about what we, as an eye department, had to offer to their patients.

My manager always dutifully wrote down these ideas. I would receive my increase and off I went for another year. Not one goal was ever discussed or approached with me throughout the year.

My last year there, I waited for the question during my last review. I silently prayed not to be asked again. We were almost done, almost safe, and then, my manager looked at me with earnest and asked the question.

I smiled sadly and said: “I was praying you wouldn’t ask that. I need to resign-thank you for my increase.”

I left my job to go to a place where they not only listened, but they also helped me achieve my goals as well as the clinical goals I had set.

Every time I conduct a review, I ask that same question of my staff. Then we work on it throughout the year. And we revisit it again to ensure they are working on their goals.

Much better, I have been told, than a clinic T-shirt that says: “I love my patients.”



Dianna E. Graves, COMT, BS Ed

E: dgraves@stpauleye.com

Dianna Graves 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.



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