Leadership is one of the most difficult aspects of practice management. However, when you get leadership right, you improve your practice for patients, employees, and for yourself. Here are a few big challenges I faced over the years, and how I had to show leadership to meet those challenges.
Terminating an Employee Who Then Filed a Wrongful Termination Claim
I don’t think anyone enjoys difficult conversations to terminate an employee. This one was with an employee whom I had inherited from the previous practice owner. The person simply could not do the job they were tasked with, no matter how much training and guidance I provided. I had no choice, but to sit down with the employee, point out for a final time (having had previous conversations) what wasn’t working in her employment with us, and then terminating that employment.
Patients loved this employee, but charts weren’t properly filled out, patient flow was an issue and other practice operations were suffering. No amount of remediation was going to improve the situation. Every person in the office was doing their own job plus hers, negatively impacting our service to patients and our efficiency.
I documented, documented and documented the employee’s work performance and failures, and fired the employee. The employee then filed a claim with the Equal Employment Opportunity Commission (EEOC) for wrongful termination due to age discrimination. There was a large cost financially to my practice in the fees paid to my attorney, even though I won this case.
The positive effect, however, outweighed those costs, as I was able to double the amount of patients I was seeing after terminating this employee, enabling me to increase net collections by 33 percent.
My recommendation for other practice owners, given this experience, is to consider adding a human resources rider to your business insurance.
Finding Time to “Do it All”
I own a practice, am a mom, I lecture to colleagues and I am the past president of our state optometric association. Time management is a huge problem we all face, but women in particular, and I am no exception.
I realized that I needed to be more present in everything I was doing. The way I was doing things wasn’t sustainable. I started scheduling self-care, including exercise and breaks, into my day. I hired a business coach and outsourced everything I possibly could, such as payroll, bookkeeping and billing. At home, I “outsource” cooking to my husband (who happens to enjoy it more than me), get meals delivered sometimes and hired a cleaning service to help with housekeeping.
Most importantly, I forgave myself for not being perfect. I am modeling the behaviors I want for my daughters. Many celebrate women for “coping” and having it all. But that is not the way forward for us. We cannot be our best selves when we are exhausted and depleted.
Finding better work-life balance has paid off for my practice and overall happiness. My practice has thrived, my speaking engagements have increased, and my relationships with my daughters, friends and husband are better than ever. I grew the practice 12 percent last year, while making more time for myself.
On average, I now spend 28 hours per week seeing patients, and am working on getting my schedule down to 24 hours per week of patient care. My time in the office is much more focused, and therefore, more efficient. On the administrative days, when I set aside time to handle management responsibilities, the entire staff thrives, as I’m able to engage with them in a meaningful way.
I recommend outsourcing everything you can. Let go of the notion that there is one best way to do your life. The way that works best for you is what is best. Do not compare yourself to other people, including optometrists. Instead, set your own benchmarks for success, so you are focusing on the work and goals that are most impactful for you.
Hiring can take on a life of its own, time and expense-wise, sifting through hundreds of resumes only to develop resume fatigue and then hire poorly. This is especially concerning, as an amazing team will elevate your practice, enabling you to deliver better care to patients.
My solution to this challenge was I stopped hiring for skill and results and started hiring for habits, cognition and attitude. I now focus and rely heavily on personality assessments to find the most qualified candidates, and then do 3-4 phone or Zoom interviews before an in-person interview.
Click HERE to see the emotional intelligence-gauging questions I ask during interviews with prospective employees.
The assessments are an investment, but considering that employee turnover costs ~3x an employee’s salary, it’s super important to get this right. The change in approach has paid off. Our patients receive more attention and better service, and leave our office with their expectations exceeded, contributing to a 110 percent increase in net production in five years.
My recommendation follows the old adage, “Hire slow and fire fast.” Develop a methodical system for hiring and utilize recruitment services that can help you with writing job descriptions and performing assessments.