fix this practice

When Staff is Insubordinate

We can value staff input, but must never forget who is really in control.

RICHARD KATOUF, O.D., D.O.S.

Q Since my cost of goods is extremely high, I decided to start an in-house finishing laboratory. My staff say they refuse to participate. What do I do?

Dr. G.R. Norton
via e-mail

A: For years I have posed the question, "Who controls your practice?" The answer should be you. In reality, however, I often observe the patients or staff in control. It's certainly a great management tool to bring the staff into the process of discussion of matters concerning large concepts, techniques or equipment purchases. Yet some successful O.D.s never ask for employee input and function at a high level. I, personally favor developing a dialogue with staff, as it motivates them.

Every organization needs a strong leader. At the end of the day, it's your duty to make the final decision. G.R., it appears that you haven't developed that leadership behavioral pattern. You have enabled your staff to maintain a "controlling" influence.

Mr. Nice guy

Dr. N. S. Kortrell (not his real name) hired my company several years ago to increase efficiency, productivity and profitability. Dr. Kortrell is truly one of the nicest individuals I've ever met. He couldn't be more accommodating to his staff, and his pay scale far exceeded others in his region. I made N.S. aware of the negative consequences of enabling his staff.

Dr. Kortrell and staff reaped the rewards from his consulting and management program. Yet N.S. continued to enable his staff. Four years later, N.S. decided to invest in an in-house finishing, lens-casting and anti-reflection coating system. The staff told him they refused to use the system. They claimed the out-of-house lab used quality products, which couldn't be matched in-house.

Financial analysis projected that out-of-office lab bills would be cut 50%, and the practice would achieve monthly savings of at least $4,000. Because N.S. had lost control of his staff, he requested I return for a consultation.

The solution

In Dr. Kortrell's staff of five, Dixie, an optician for 20 years, was the self-appointed leader. Some staff followed her, while others feared her. During meetings with individual staff members, only Dixie had a strong negative opinion about the in-office lab. Yet N.S. was led to believe that the entire staff was against this project — a demonstration of Dixie's control.

Confronting refusal

I met with Dixie and Dr. Kortrell. I told Dixie that she was an excellent optician and that N.S. appreciated her work. I educated her in lens casting and provided her with a list of clients who used this system so that she could speak directly with opticians who were thrilled with the results. In addition, I stated that the practice was Dr. Kortrell's, and as such, he expected all employees to follow his lead.

I ended with a loud, clear statement: "Dixie, if you continue to act as an anchor in the doctor's decision making, you'll be placed on probation. And, if you don't cease in your intimidating behavior, you'll be terminated." Dixie complied. The system is now in place. N.S. nets a much higher income than before, while his cost of goods has plummeted.

Doctors, you've had the formal education, taken the financial risks, put in countless hours in building your practice. Take control. Your staff and patients want and appreciate a confident and strong leader/doctor. OM