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Every clinic has ‘characters,' how to manage them is key


Understanding that every office will have varying personalities and characters is important when managing staff members.



Understanding that every office will have varying personalities and characters is important when managing staff members.



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

It’s easy to get lulled into believing that the issues we face daily are unique to only our office-that we are the only managers in the world who deal with staff and physician concerns like ours.

But, have heart, for there is safety in numbers!

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If you look around, it will become abundantly clear: Every office has the same characters, curmudgeons and souls as you do. You simply have to observe how they go about their day and it becomes glaringly clear.

I recently went with a friend to have new tires put on their car. We went to a good sized tire chain store that we were sure was going to relieve all the perils of another Minnesota winter by replacing the treadless pair currently on the car with new tires that would handle loose pavement, snow and all assortments of road peril utilizing their super road hugger, efficient tires you could almost see in small print.

“You’re safe with our tires little lady!” written on the side of each tire.

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Our first encounter was with “John Wayne.”

While we were quietly pricing and comparing tires/brands, he sauntered up to us, smiled a grandfatherly grin (by the way, he was all of 28 years old) and said, “Can I help you young ladies today?”

If he had been wearing a Stetson, I am positive he would have tugged on the brim of the hat and nodded his head.

In our office we call this person “the Schmoozer.”


The Schmoozer-best described as the one feigning extreme interest-comes across as over fawning and is ingratiating to a fault. Someone who after 3 minutes, you want to escape but very often cannot.

It’s an Oscar-award winning performance, but the care that is provided is subpar at best.

Personal experiences

Now, in Minnesota, we have a regional saying for when something needs to be done: “Well, if I were going to (insert the chore), I’d get ‘a guy’ to do it.”

Or, for a question about plumbing, we would say: “Well, a guy would put another elbow in there and it will flow better.”

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Not that it has to be a male, but it’s just a phrase that is used regarding everything that needs fixing.

‘The guy’ is never named, but evidently it is a tried-and -rue saying, so I responded to Mr. Wayne by saying:

“We are looking to talk to a guy about tires.”

He beamed his largest smile and said, “It’s your lucky day. I’m your guy.”

After 20 minutes of tortuous bartering, we agreed to the tires he was recommending. Not because we had faith in them, but more to escape and move along with the process.

Having sealed the deal, he quickly called for another other guy who was going to be the tire installer.


Elvis has entered the building

Enter “Elvis.”

He swaggered into the lobby wearing a gleaming outfit, including a clean, red, grease rag hanging from his pocket. The towel was grease-free.

I asked if he was just starting his day, and he advised me that he had started 3 hours ago.

We were placed in the bullpen area where we could watch the tires going onto the car. It is then that I saw why he was so clean.

Elvis was the office diva. He was the lead over the grease-smeared worker bees who were now efficiently working on the car.

He watched as the two assistants removed the snow-covered tires, put the new ones on the rims, and balanced/ aligned the whole group. He did this with a watchful eye as he sipped his coffee and recorded their progress on a clipboard.

With the car still on the lift, Elvis put on gloves and checked each tire pressure, marked it suitable on his clipboard, and determined the job was done to his approval.

The final stop was with mission control-time to ensure all systems were go for departure.

A very attentive controller sat us down to discuss tire pressure, when to rotate, the difference between plain air versus nitrogen when filling tires.

She was officious, and even though she had obviously been through this discussion a million times, she listened well, allowed questions, and answered them in people talk. We understood what she was telling us and promised to comply to ensure happy, safe tires.


While my friend was settling the final bill, I thought about my own office and how we appeared to others.

I soon realized that not only did we have the same cast of characters we had just met, we had a few more morphed into multiple roles!

Clinic characters

John Wayne: We had “the guy” who was going to take care of the whole process and make sure you were taken care of before he dumped you on someone else. He was very willing to show us the tires, etc., until the front door clanged and the next sale entered. When this occurred, we were quickly and obviously moved along to the next attendant in line.

This occurs in offices when staff-who are kind, patient, and helpful so they can get their portion done-quickly move to the next person in line or looking to buy glasses, etc. when another sale hits their view.

Elvis: I have more than a few divas. The key to divas is twofold:

·      Get them to understand they are a diva, and that at times this may not be a popular role for them.

·      Get others to realize that yes, this person is a diva, and why would anyone in their right mind want to be them?

Divas need to be watched as they often can turn into bullies if they are not getting the recognition they seek. They can drift in and out of this role and when they morph into the bully role, they can become periodically disruptive to the rest of the clinic.

We also have bullies. The key to bullies can be hard to figure out, but primarily it is this:

You need to let them know you are onto them, and since you are managerially over them, you are up for the challenge. Bullies do not like to be backed into a corner because then they lose the upper hand.


Bullies are one of the hardest types of staff to control in your office. They create a type of chaos that is hard to rectify as they often prey on another’s insecurities and these are often hidden by the staff being preyed upon.

They know their prey’s weakness and will attack them when they have the opportunity to, or simply because they are bored and are looking for a little excitement.

When a bully is on the prowl, make sure you counter equally and swiftly. They need to be aware you are on it, aware of it, and will not tolerate the behavior. No matter what their ranking is in your clinic.

As I have mentioned in the past, bullies are often in an elevated position, a position of presumed power due to their role with the doctor. Many people, even the managers, will avoid confronting them because they feel the doctor will protect them. When this is the case in a practice, there is not much a manager can do regarding a bully.

What you need to do in this case is to talk with the doctor letting them know the impact this person, by using the doctors stature and cover, is doing to the rest of the staff, and even the doctor, without his/her knowledge. You need the doctor’s help to get this handled quickly.

Elvis went from diva, to bully, to diva all in one visit and probably did so all day.

Lastly, you have mission control. These are the go-to folks in your office that listen, follow through, and do everything they can to ensure that the patient receives an excellent experience. They usually are the worker bees in each role (front desk, technicians and optical) that do their job everyday with minimal fanfare.

Here I was in the tire shop watching “my staff,” but the only difference was the uniforms.

That Monday, I went to the office and watched a morning of encounters with patients. Later that afternoon, I sat down and listed who was what character and then pondered what to do with this behavior.


After a bit, I realized that there wasn’t much to do about it except the following: Be sure that these various roles were well balanced and insulated between the worker bees and the go-to people in the office. To ensure I was on the right track, I went online to see what a guy might say about this.

The response was a referral to the tire store where I had spent my Saturday!


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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