Teaching Medical Staff to Act Like Owners

Chances are you have a wide variety of staff working at your medical practice — nurses, receptionists, billing and coding staff, and the like. Do you treat them like staff, or do you expect more? If you expect them to act and treat patients as though the practice was their own, that is no small task.

“It’s something that every business and every industry struggles with,” says Todd Rodriguez, co-chair of the health law practice at Fox Rothschild LLP. “That being said, I certainly think you can create a culture that engenders that kind of thinking.”

The key is starting at the top and working your way down.

Trickle down effect

Rodriguez explains that it’s important for physicians to lead by example. If there are physicians in a practice who don’t pull their weight, or who hold up the process by not completing their records on time or returning phone calls promptly, that sends a message — a negative one.

“It sends a message that being on time is not that important; that returning phone calls and being responsive is not that important,” Rodriguez says. “If you’re a leader in the practice, establish a culture of ‘everything we do matters;’ that everybody’s responsible for their own job, and people are held responsible. No question about it, the culture has to start from the top down.”

And it continues with the interviewing process when hiring new staff and selecting candidates who already possess a quality-oriented mindset. Rodriguez explains that he recently toured a hospital that has new hire candidates interview with current staff, and then gets feedback from staff as to whether or not they feel the candidates would fit in with the practice’s culture. He also recommends finding incentives for encouraging employees that aren’t necessarily monetary-based.

“It may sound silly, but sort of like a gold star kind of thing, or a preferred parking space,” Rodriguez suggests.

If people or departments are consistently meeting certain quality or patient satisfaction objectives, then they should be shown recognition.

“If you build in those incentives, [it] helps to support that quality-oriented culture,” he says.

Talk to and challenge staff

Gabriela Cora, MD, MBA, a Miami-based physician, says there are times when it may be necessary to explain to staff that the “ownership” mentality is important because they would want the same care, courtesy and consideration for themselves or their families.

“That works for some staff,” she explains. “For others, it’s easier to point out the monetary aspect. Help them understand that the service itself, the level of attention to the patient and to detail, is directly related to the patient’s satisfaction and their willingness to continue to invest their money in further treatments or in further services.”

Rodriguez is a big proponent of actively reviewing staff performance and documenting those reviews. Whether it’s the front desk, the nurses or the clerical and billing staff, he suggests making them accountable by charging them with the responsibility of developing the criteria for those reviews.

“Tell staff, ‘If patient satisfaction is critical, we’re going to identify the ways to improve it, and I’m going to ask you guys to do it, because you’re the ones on the front lines,’” Rodriguez says. “And then you work with them to develop those criteria. And hopefully, by having them involved in that process, you’re getting their buy-in.”

Business mindset

Rodriguez says he regularly recommends to his physician practice clients that they start thinking like a business and acting like a business. Are they listening?

“Some are,” he says. “Many are simply throwing up their hands and saying, ‘All right, if I can’t do it, or if I’m not qualified to do it, I’m going to sell to a hospital, and let the hospital worry about it.’ But I think the ones who are serious about [thinking like a business], they’re doing it. They’re looking at the marketplace and saying, ‘What are we going to need to do to not only be successful this year, but five years from now?’”

A big part of that, Rodriguez says, is having a good staff; a staff that has been vetted, and is good at what they do.

“If you have staff who are doing their job efficiently, then whether it’s selling to a hospital or merging with another practice or negotiating with a managed care payer, you are going to be in a better situation than a practice that has not reviewed it’s staff for a long time, or that has a lot of marginal staff and patients who are not happy,” Rodriguez says. “I mean, its just part of being ready to take what comes. Having a good staff is critical.”