Who’s really running your practice: you or your staff?

To run a successful practice, managers must be able to discipline behavior that doesn’t align with company procedures, even when it may be uncomfortable.

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

Take-home message: To run a successful practice, managers must be able to discipline behavior that doesn’t align with company procedures, even when it may be uncomfortable.

While visiting with an administrator at another practice a while back, a long and arduous discussion regarding staffing, and their various behaviors, began.

More from Dianna: (Eavesdropping at a major medical meeting)

She had many concerns, frustrations, and questions: Did I see these behaviors in the other locations I visited? How can you “teach” (instill) teamwork, and unity, into the staff when these are actually ingrained qualities that they either have or don’t (like empathy and sympathy)? And, what tactics could she use to “get them to understand” how disruptive their behavior was actually being to the office and their fellow co-workers?

Finally, somewhat of a lull occurred and she exhaled, sat back in her chair, and said softly: “Really, what is it with these people? – I just don’t get it.”

Editorial from Peter McDonnell, MD: Giving weight to worrisome reports

Smiling, I said: “If I knew that answer, I’d be retired on a remote island, counting starfish on the beach. I would have bottled that knowledge, sold it on late night TV for 19.99, and then BOUGHT the island!”

I don’t think there is a manager around that at some time hasn’t muttered those very same words and/or invested a lot of money in self-help books regarding staff motivation and had the latest pundits visit their clinics for staff “therapy”, as well as to teach everyone the words to Kumbaya!

Editorial: Beware venom ophthalmia!

They would learn how to help their staff and would give them the space to “be happy” in their work environment. After all, staff is so hard to find and retain. Managers go sometimes overboard trying to ensure their staff is happy. And herein lies the rub.

Because most managers/administrators/supervisors don’t understand the dynamics of their staff, the staff ends up in the driver’s seat.

Bad behavior is allowed by turning the other cheek, poor work habits are not disciplined-lest we offend someone-and the “rules” of your clinic society are overlooked so your staff can feel comfortable and “be themselves”.

Well, here’s how I see it: Sometimes you need to put on your stomping shoes!

Example: Dealing with a child


Since most of us have had to deal with a child (age five through twenty), it’s actually quite similar behavior.

Example: It is 9 PM on a school night. Your 10-year-old wants to start a movie that will go until 10:30.

When you advise them it is a school night, the 10-year-old begins to argue, refuses to head off to bed, begins discussing your parenting skills, and eventually storms to their room, where their TV turns on and they begin to watch the movie.

Editorial from Dr. McDonnell: Are medical students happy?

You are exhausted, and rationalize that at least they are in their room and in bed, so you let it slide. Good luck in the future with bedtime, curfew, or ever being the boss again.

Example: Your 10-year-old comes racing down with barely enough time to make the school bus and looking like they are a stand in for a Miley Cyrus concert!

You, and she, have addressed the issue of school dress before, but you have a bad day ahead of you and can’t handle another dress code struggle at 6 AM. So you let it slide. Guess what she will be wearing tomorrow!

Editorial: Do you know these African American ophthalmic pioneers?

I am in no way calling your staff children-but I am calling the behavior issues childlike, referring to how the process occurs and the behavior is learned, versus the actual age of the employee. By allowing the poor behavior, or dress code infractions to continue, you are “teaching” them that their behavior is alright.

Most managers I come into contact with are in their 40s-50s category. But, most of their staff is in their 20s and 30s. What this means is managers have a whole different set of criteria, values, and beliefs than their staff!

Blog: 6 steps to boost your practice with content marketing

Each “generational group” adheres to a code of behavior, beliefs, and ethics. The issues that bother, worry, and set a behavioral standard for a 50-year-old, is archaic, punitive, and out of touch to a 20-year-old.

As an outsider, I watch these dichotomies and role-play: “What would I do in my office versus how this manager is handling this situation in theirs?”

Feeling the pain and frustration in her question, I handed her a notebook off her desk and said: “Take a note….”

5-step approach


             1. Do you have an employee handbook?

Every office I visit has one that they labored over. Each employee is given one. Rarely are they enforced even though most offices have every staff member sign a sheet stating they received it!

Recent: Remembering Kenneth Greenberg, MD, catalyst in development of excimer laser

Use it, enforce it, and refer back to it on issues such as: dress code, attendance, what their job is defined as, and behavior that is expected in the work place. Do not only ensure each employee received, put it on your group/clinic personnel site so they can refer to it if needed.

2. Stop tap-dancing and avoiding poor behavior because you don’t want to upset anyone

If they are being aberrant, then they need to be yanked back into line immediately and firmly so you are not reliving Ground Hog Day over and over. Stop letting poor behavior slide-it opens the door for more, and worse, behavior to continue. And if one “gets away with poor behavior” you have set the stage for multiple exhibits of poor behavior by others.

3. Make the rules equitable-the same for everyone!

When you allow poor behavior, now you not only have a problem with that employee, but with other employees watching. Since it's alright for them to do it – then it is alright for me to do it! And you cannot let something slide for one, yet discipline someone else, for the same infraction. This behavior by you will undermine you faster than anything an employee does.

Editorial: How myopia shaped the attitudes of Theodore Roosevelt and Ronald Reagan

The staff that does comply will stop viewing you as a viable leader if you have multiple variations of the rules.


Steps 4-5


4. Your younger staff does not “think” like you!

You need to try and be aware of what “drives” them-what their goals are and use those characteristics to teach, discipline, and lead them to be strong team members. In most cases, your younger staff doesn’t need, or want, to be a family unit with their co-workers. This is a job–not a life to them.

5. Call it like it is!

If someone leaves, what would have been the ramifications of allowing them to stay with their disruptive behavior? What would be the cost to you?!

Recent: Lee Nordan, MD, innovator in refractive surgery, remembered

She stopped writing and looked at me with a look of understanding, “I never saw it that way. I think you might be on to something. I am really going to think about this.”

At that very moment, as if rehearsed, a young 20-something technician walked by. She was wearing her blue scrubs, a grey hoody sweatshirt with an orange symbol of something, a bandana with a different symbol around her head, flaming orange sneakers with green laces, a diamond stud nose ring, and chewing gum at the speed of sound.

Blog: How to make your New Year’s resolutions last the whole year

My jaw dropped and I said: “What the hell is that?!”

She looked up and said: “I didn’t even notice her”. This was at 3 in the afternoon.

I nudged her black dress heels and said: “Tomorrow, leave these home, and wear your stomping boots!”


Dianna E. Graves, COMT, BS Ed

E: dgraves@stpauleye.com

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.

Related Videos
Related Content
© 2023 MJH Life Sciences

All rights reserved.