Guidelines versus policies

The bigger and thicker your policy manual is, the more you may be choking the health and growth of your practice.

Here's another example of a policy, for products sold at a practice: "Refunds are only given within 30 days of purchase." A guideline might be: "Whenever patients request a refund, use your judgment as to what's fair and equitable; in other words, do for patients what you would think is appropriate if you were in their shoes."

Policies are most commonly found in practices that use a directive management style. When a practice is run using this style, you need policies because you're directing staff members on exactly how things should be done.

I'm a fan of management by delegation. In my practice, my office manager and I didn't direct employees; we made sure that the employees were skilled enough to handle the tasks and responsibilities. Sure, we had a few specific rules that needed to be followed, but I'd say we were 80% delegation and only 20% directive. We simply made sure that employees managed their time well and accomplished all of their responsibilities. That's why guidelines were more effective.

I discovered this principle in the early days of my practice-but not because some wise person shared it with me. I discovered it because I didn't know any better.

When I started my practice, I didn't have a lot of ideas about what to direct people to do. That was the bad news. But the good news was that I had to rely on people to figure things out on their own. I quickly learned that if they could figure out what they were doing, then they could do that without me standing over them.

Many practices tend to regularly encounter employee issues: turnover, dissatisfaction, or dissent. I believe a guideline-driven workplace and a delegation-focused style create a happier, more productive team.

You promote happy employees when you challenge them. The happiness factor diminishes if you're constantly directing them on their specific tasks and requiring them to follow detailed guidelines. By giving them greater responsibility, you create more valuable and valued employees.

As sure as you put a policy into place today, you'll have to make exceptions tomorrow. That adds stress and responsibility to the person creating the policies. But if you manage by guidelines and delegation, staff members can focus on what they're producing rather than on the individual tasks that it takes to make it happen. This approach also fosters greater flexibility, which is essential to growing a practice.

And those happy employees will produce happy customers, which is essential to the growth of any practice.

This article first appeared in the author's blog ( http://www.practicemanagementacademy.com/blog/) . Since 2003, he has shared his success principles through his program, Pulse Points of the Million-Dollar Practice, in which he teaches the fundamentals of successful personal and practice management, with a focus on helping doctors create a practice they enjoy and a life they love.

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