fix this practice

Avoid the Carnival Ride With Staff

Without strong leadership, you're likely to experience staff turnover.

RICHARD S. KATTOUF, O.D., D.O.S.

Q My practice is a "merry-goround" of employees. They feel I am too demanding because I insist they fill my patient schedule and sell optical goods at a high rate. I am the doctor and as I pay well, I feel it is my right to demand productivity. Yet how do I solve high staff turnover?

Dr. R.B. Tait
via e-mail

A: You are the doctor, but realize that you are the owner of a clinic and a retail optical department. You experience staff turnover due to the following issues:

► Limited involvement in the management of the practice. Keeping the schedule filled is a team effort, including all staff and the doctor(s). It entails internal marketing by owner and staff. The annual recall system requires the doctor to have a "pulse" on the timing and methods of recall. The owner must have checks and balance systems in place to assure that the recall techniques are implemented properly.

It's common that staff tell me they haven't done recall due to a "lack of time." This is a great example of employee behavior when owners refuse to monitor their practices.

Here's another example: Upset with the low percentage of optical sales, the owner calls an emergency staff meeting to get answers. My first response to this dilemma is to determine if the doctor is ordering-directing and prescribing at chairside. Most doctors don't recognize their obligation to use the power of the doctor with the patient. This is the biggest problem in selling eyewear. Leave the total responsibility to the stylist/optician and you'll struggle with low eyewear profits.

In addition, the lack of the doctor's involvement leads to stress, confusion, embezzlement and most of all, employee turnover.

► Staff training. Too often, I discover inadequate training. Employees submit vision and medical claims without proper instruction. Staffers are thrust into situations where they have no knowledge. This creates a disaster in collected income and patient care.

Many doctors adopt the attitude that the new employees will simply learn from observing. Often, those whom they observe are not trained properly. This puts tremendous stress on staff to "fake" skills or knowledge. This is dangerous to the reputation of the practice and creates huge patient dissatisfaction.

► Constant negativity from the owner. When the doctor complains about his/her income they do not get pity from the staff. Silent employees with think, "How can the doctor complain. Look at his house and his car. I make $13 per hour and he is complaining to me?" No employee should hear the doctor complain about accounts receivable and accounts payable. Placing this burden on the employee will cause constant turnover.

► Doctor knowledge. When the owner does not understand managed care vision and medical insurance plans and coding, he is unable to properly oversee the staff performing these duties. I often observe staff incorrectly billing and coding. This leads to lost income, delayed payments and adds to the overall stress in the practice. The same thing applies to knowledge of the office's computer software. It's common that employees have better computer skills than the owner. This can inhibit the owners ability to monitor performance.

Your staff seeks strong and enthusiastic leadership. If you don't display this leadership and set the example, you will continue to experience staff turnover. OM