fix this practice
Can You Over-Delegate?
Giving one employee too much power can put you in a desperate situation.

Q: know that you are a proponent of delegation to ancillary personnel. The owners of our practice feel as if we have overdelegated to our office manager and relinquished control of the practice. Do you have any suggestions?

   Dr. J. R. Hanilin via e-mail

A: Many ophthalmology practices retain a manager with an M.B.A. to control staff and oversee day-to-day operations. The manager of an optometric practice is usually appointed based on time in the profession and past work history. These appointed managers have no formal education to handle the rigors of operating a clinic and retail optical department.

Too much of a good thing

The O.D. then charges that person with human resources, employee reviews, scheduling, implementing new techniques, opening mail, answering staff questions, making bank deposits, balancing day-end receipts, accounts payable, staff discipline and handling some of the doctor's personal affairs. Let's be realistic. Can one person perform all of these tasks? Many very good employees reach a point at which they do nothing well simply because the owner has given them too much responsibility. I have seen numerous negative consequences from the above scenario: 

•   Physical health problems. The negative stress of overload can create debilitating systemic conditions.

•   Mental breakdown. Emotional stress can lead to depression or other behavioral episodes.

•   Owner held hostage. Manager makes demands of salary, paid sick leave and excessive paid vacation. This scenario is almost always coupled with embezzlement of time, money or products.

•   Management meltdown. The staff is not overseen sufficiently. As a "leader," the manager sends the wrong message to the employees. Staff start to mimic her habits.

Delegation gone wrong

A group practice came to my consulting company with similar issues. Dr. J. Solen, the spokesman for four owners, explained that the owners had delegated all management duties to Sally. Her total compensation package was just over $80,000. Sally was responsible for yearly staff reviews, so she approved unwarranted raises to many employees to "buy their favor." Sally was very upset when she learned the owners had retained me to perform on-site consulting services for the practice.

I found the percent of salaries to gross was 30%. In that state, it should not exceed 20%. The day I arrived, Sally had an "emotional breakdown" and was unavailable for the three days I was on-site. I set up one-on-one interviews with each of the fifteen employees and uncovered all of the above scenarios. The owners were shocked. In contacting a human resources attorney in the state, I developed a new structured job description for Sally. She immediately took a six-week, unpaid sick leave to figure out how to "deal with it."

Back to basics

I appointed each doctor to oversee one department. I developed a commission system that they could use in lieu of annual raises to control payroll. With my mentoring, the doctors became excellent owner/managers and actually enjoyed controlling their own practice and destiny.

The lesson: Control your practice and control your life.

DR. KATTOUF IS PRESIDENT AND FOUNDER OF TWO MANAGEMENT AND CONSULTING COMPANIES. FOR INFORMATION, CALL (800) 745-EYES OR E-MAIL HIM AT  ADVANCEDEYECARE@HOTMAIL.COM. THE INFORMATION IN THIS COLUMN IS BASED ON ACTUAL CONSULTING FILES.