One of the toughest employee issues facing a doctor is the task of finding the right person to fill a specific administrative role in the office. We are constantly faced with the choice between finding a competent person and then tailoring the job to her strengths or defining the job and then finding the person who fits that mold best. There are positives to both approaches, explored below.
Lean or redundant organization?
A generation ago, almost all organizations were redundant. This means that there were multiple pathways to get something accomplished. Back-ups and substitutes were easier to com by because the technical training necessary was less in general, and the labor market was less fragmented. Most organizations have become leaner over time, with an individual’s productivity greatly enhanced by workflow software, remote connectivity, etc. So, one person can do more, but as organizations, we become more dependent on individuals rather than systems.
Now, the training necessary to fill a role such as front desk coordinator is significant and daunting. Can you simply hire a temp to run your front desk if your primary employee resigns or even goes on vacation? For most clinics, this is not possible on short or no notice. It becomes even more difficult if the primary doctor does not know how to operate the practice management software or even the telephone systems!
Cross training
What the solution? A partial solution is to be sure that other admin personnel in the office know how to perform the basic functions of a different position. Cross training has some protective elements, but at a cost. Simple training is not enough, you have to have practice in order to do it well. If we train our front desk employee how to send patient statements, for example, and she does not do it for 6 months, will she remember how when the time comes? Probably not, even with an instructional manual.
Cross training has the negative side effect of having employees work in their areas of weakness at times. In larger or redundant organizations, this is a cardinal sin, but in smaller organizations it becomes a necessity. Think of the simplest division of labor in a typical office: front and back desk duties. The critical characteristics of a front desk person are: uptone, charismatic, people skills, language and communication skills, and ability to multi-task in a live, people-oriented context. For the back desk we have attention to detail, completion of cycles of action, numbers, finance, rules, compliance, etc. Can you find all of these characteristics in the same individual? Perhaps, but that’s a rara avis indeed.
If there are two separate employees with separate skill sets, then cross training makes it so that you at least have someone to fill a breach. So it’s a decent temporary solution. The trap arises when the manager allows the staff to fall into “next available”, meaning that all personnel do all jobs and the staff is by definition operating outside their strengths.
Playing to strengths
The ideal makeup of a support staff is one composed of personnel assigned to what they do best. As soon as you are large enough to require more than one admin person, you need to find compatible, but differently skilled employees. The ideal model I push is that of Interdependent Adults.
- Interdependent means that even though we are doing different jobs, we have to rely on each other to get the final work product completed and with good quality. We’re not working in isolation in a silo or in secret.
- An adult in this context is someone who knows what is supposed to be done, and actually does it without being asked (reminded), told or forced.
There are many methods of getting to this set-up, which I will explore in future posts. Suffice it to say that your managerial skills will be tested and there’s a multiple path learning curve involved in getting there.