Have you ever caught yourself saying: “No one can do this the way I can, so I’ll do it myself.” “If I can do it myself, I probably should.” “This is too mundane a task to delegate.” “I could complete this task faster than it would take me to explain and delegate.” If you answered “yes” to any of the above, you might consider implementing a delegation process.
Why do we avoid delegation? If you respond immediately, you are instantaneously satisfied and get a dopamine rush. What if you wait to respond, taking time to instead focus on what you are doing now? So, you table the task, promising to return when you have time to respond more thoughtfully. What was I doing? And therein lies the rub: Regardless of whether you respond now or later that task has already set up shop — rent-free — in your psyche and has disrupted your focus. So, what can you do?
Start by admitting there’s a problem. You’re a doctor, and you are a big-idea person. When you start out, you are convinced you can wear all the hats and juggle all the balls. And that approach does work in the beginning. But in the long term, it isn’t sustainable — not if you want to provide outstanding patient care and micromanage every aspect of the practice. However, with increased administrative responsibilities, such as completing medical records when you go home and the demand from the bean counters to see more patients, we quickly become burned out, because there aren’t enough hours in the day. Instead of delegating some of those tasks, you take them all on. You quickly find that you can’t possibly do more than you already do; try as you might to convince yourself otherwise. You soon discover that you are drowning in work. Why do we subject ourselves to the idea that we must do everything? Maybe because we are uncomfortable asking for help. Maybe we can’t give up control. Perhaps we try to convince ourselves that it is quicker and easier to do it ourselves than to teach someone else how to do it.
This is the road to burnout that is affecting nearly 50% of all physicians. One practical solution for burnout prevention is to consider delegation. Maybe you answered emails during your daughter’s soccer game. Maybe you told your loved ones you couldn’t take a vacation this year. Maybe you spend more time and energy reacting throughout your day instead of being proactive. Maybe you spent your weekend completing your medical records instead of being with your family. Perhaps you went out to celebrate your anniversary, but you were so distracted by intrusive thoughts about work that you couldn’t remember what you ate or you pulled out your cell phone to answer a non-urgent email.
The work–life balance conundrum. Let’s get honest: how long has it been since you were fully present? How long has it been since you have been able to fully disconnect from work? I’ll answer for you: too long. You know how I know? Because I have been there. In fact, if we are honest, we’ve all been there. Life has a sneaky way of getting in the way of our best intentions: being present, establishing healthy boundaries, self-care, and putting family first. We know what we are supposed to do, but often, we can’t quite figure out how to do it. This is when delegation proves helpful. However, as with any struggle or obstacle in life, the first step is admitting you have a problem and that you may not have everything under control.
First, let me state what delegation is not. Delegation is not a last-minute dump of responsibility onto someone else’s plate because you didn’t plan or prepare appropriately. Delegation is not simply a way of unloading your duties; it’s how efficient physicians can benefit from the powerful, multiplying effects of asking others to do that for which they were hired.
With effective delegation, you free yourself from mundane activities and develop employees who grow your practice. Delegation is a skill that benefits everyone in the practice. It also develops employees by sending a powerful message to them that they are trusted, competent, and valued.
Why Does Delegation Matter?
Most physicians need to improve their delegation skills. The first time we try to delegate an assignment to others, we think “it would be quicker for me to do this task myself.”
We hang on to every task because we think we can do it better or faster. Why? Because it makes us feel good and accomplished. We micromanage out of fear. But we must use others to accomplish our goals and enable us to take better care of patients.
You cannot grow your practice if you are bogged down in administrative functions. Delegating isn’t easy — it takes practice and commitment. It can be the difference between the status quo and the practice’s growth. Begin by investing the time to teach someone how to handle one task. It will take longer; still, the long-term result is that you are no longer obligated to do that one thing in the future. For example, suppose you are spending several hours a week dictating prior authorization letters. In that case, you can train a nurse, NP, PA, or MA to create a prior authorization letter using AI. And imagine how much time you would save if you could do that with 10 things!
It is time to delegate if your inbox needs to be more organized and is woefully neglected. When was the last time you reached inbox zero? Months? Years? Never? Delegation can help you quickly achieve that elusive inbox zero and then keep it organized.
There is one thing that, if cultivated and nurtured properly, can change the course of your practice. There must be an element of trust. Develop a guiding philosophy starting with one small approach to trust that yields a huge impact. This does come with a caveat: you must recognize that mistakes will happen. Be honest and recognize that everyone makes mistakes. And if you need a reminder, think of the Golden Rule: we forgive because we, too, want to be forgiven for errors that we have made.
Building a culture of trust is the single most important goal you can have as a physician. Employees in high-trust organizations such as medical practices are more productive, energetic, and collaborative; stay with their employers longer; and take ownership of their work and the outcomes. Employees in high-trust workplaces report that they are 106% more energetic at work, 76% more engaged with their jobs, 74% less stressed, 13% less likely to take sick days, and 29% more satisfied with their work–life balance.(1) With work–life balance, we must note that every aspect of our lives is connected and interwoven. Our professional lives and personal lives don’t exist in vacuums. So, take that leap of trust — trust in your ability to hire first-class employees and their ability to do exactly what you entrust to them. At work and in life, trust is better than currency. And just like a currency or our reputations, it can be earned and saved over time — and depleted with a few clicks in seconds.
Leaders can show their trust with delegation. It is not the dumping-busy-work-on-someone-and-micromanaging kind of way, but the kind of delegation that entrusts people with key projects, offering support when needed. This, incidentally, also benefits from the same compounding, multiplying effect as currency — the more you invest and entrust, the more you equip your employees to take your practice to the next level.
When you teach an employee how to do a task, including equipping them with the necessary tools, skills, and information and delegating responsibility, you show them that you trust them; your actions say, “I trust you to do a good job.” Ask yourself the following questions to earn the trust of your employees:
Do you treat employees like valued members of your practice? If not, ask for their input — and listen to their responses.
Can you keep your word? If not, make sure that if you say you’ll do something, you do it.
Are you proactive in delivering your contributions? If not, start anticipating your responsibilities that impact how others do their jobs and deliver on them — without being asked or hunted down.
Do you ask for help? If not, consider asking as needed to let your employees know that you value how their role and input contribute to the business’s success.
If you answered no to any of these questions, consider your next improvement steps.
Implement the 70% Rule
Physicians should consider adopting the 70% rule. The 70% rule says that if the person you would like to perform the task can do it at least 70% as well as you can, you should delegate it. It may be difficult to accept that the task won’t be done exactly as you would and that you could accomplish it faster, but you are confident it can be done. After you’ve asked, can this person do this task 70% as well as I could? Then, proceed to the next step of delegation: practice at the top of your license and delegate the rest.
The 70% rule will take time to accept and, in the beginning, may be difficult to adopt. However, something completed at 70% of your standard is still complete. Another benefit of early delegation is getting that dopamine hit as you cross that task off your to-do list. We didn’t go to school for 10+ years to input data for insurance companies into the EMR or to call medical supply companies to find the best price for tongue blades and microscope slides. These and many other tasks can be accomplished by others, and the physician should only do what others can’t do — and that is to care for patients.
Getting Your Mindset Right
The more you prepare, the more success you can expect later. Five preparatory steps will help you start an effective delegation program(2):
Admit there is a problem. Be candid with yourself and admit that you need help, want help, and are willing to ask for and accept help.
Accept that it will take time. Learning to delegate is like exercising muscles to increase strength. At first, it is uncomfortable and hurts. The more you exercise those muscles, the stronger they get. Suddenly, what used to hurt now feels good, and lifting those weights gets easier. It just takes practice and consistency.
Be a teacher. The best delegators are willing to invest time in proper onboarding and training. This requires some heavy lifting on the front end but will result in incredible efficiency and even patient satisfaction and will prove to be one of the most profitable investments you could make for yourself and your practice.
Have a plan. Successful delegation involves a plan for task management. Without a system for monitoring projects and tasks, you are buried in sticky notes — great for grocery lists but not for medical practices. You must have a system to track tasks and projects once delegated.
Shift the mindset. Instead of thinking you must do it all, consider delegation an opportunity to empower others on your team to grow. Lean into your team to discover ways you can improve. Be open to suggestions and receptive to feedback. Delegation requires discipline, consistency, and patience.
Putting the Pedal to the Metal
One of the most mission-critical steps is deciding what you should and shouldn’t delegate. It is easy to delegate to tell someone to return a phone call or order toner, but can you delegate important tasks to them, such as buying a printer–fax machine? How do you know if you are delegating the right tasks to the right person? This is when the 70% rule — the one that says that if the person you like to perform the task can do it at least 70% as well as you can, you should delegate — comes into play.
Importance of Communication
A recent survey found that 38% of respondents named communication their key issue.(3) Calls, texts, and voicemails work fine for casual conversations, but to emphasize a deadline or celebrate an accomplishment, try to cater communication to the style employees prefer to help them stay connected in the manner that best suits and motivates them. Some may prefer face-to-face meetings, while others may prefer written communication. Therefore, it is necessary to recognize those individual preferences to let them know you are listening and that you care.
Trust those to whom you delegate a task. This step is essential but also the most challenging. From this point on, it is imperative to have faith in your delegation process and people. It may be hard to let someone else take the responsibility, because if you commit to the first three steps, you and your team should be primed for the next moment to celebrate the wins, no matter how small. Some wins will be small, but even imperceptible wins merit recognition. Even the smallest gesture, such as a verbal pat on the back with a “great job,” can motivate your team.
Similarly, always appreciate the power and impact of manners. The “please” and “thank you” that your parents instilled in you go a long way. There are times when things don’t quite go as expected. Then, think of a mistake as a diamond-in-the-rough opportunity to continue building trust through open, honest communication and repeated efforts. There is no winning and losing here, just winning and learning.
Offer constructive feedback whenever possible. It is always best to give immediate feedback so no one is left wondering if they are going in the right direction. Weave feedback into your communication so no one must guess where they stand. Frame feedback as a positive experience by discussing it often at staff meetings and during performance reviews.
If possible, provide feedback frequently. Give more in-depth feedback or coaching on regular, scheduled one-to-one, or quarterly review time.
Feedback needs to be actionable with time-bound follow-up. Inspect what you expect. Check and review the progress regularly until you see improved results, then pull back and avoid micromanaging your employees.
Feedback goes both ways. Encourage your team members to give you feedback, too.
Bottom Line: Physicians think they must do everything, and everything must go through them. Delegation means changing that mindset and trusting your staff. Empower your staff to solve problems independently so they can be the hero. After all, most mistakes are paper mistakes, so try not to worry about mistakes. Sure, mistakes have consequences, but most of the time, they are relatively insignificant. If we learn from mistakes and commit to improving, delegation will enhance the practice. Our mistakes aren’t life or death unless others make diagnosis and treatment decisions. They happen, and we can recover from them. You want employees who aren’t afraid to make a mistake or decision so that nothing is delegated back to you. I admit this isn’t easy, but your practice will improve once you become comfortable with delegation.
References
Zak PJ. (2017). Trust factor: The science of creating high-performance companies. AMACOM.
Lichtenstein BJ, Reuben DB, Karlamangla AS, Han W, Roth CP, Wenger NS. Effect of Physician Delegation to Other Healthcare Providers on the Quality of Care for Geriatric Conditions. J Am Geriatr Soc. 2015;63(10):2164-2170. https://doi.org/10.1111/jgs.13654 .
Ratna H. The importance of effective communication in healthcare practice. Harvard Public Health Review. 2019;23:1-6. https://doi.org/10.54111/0001/W4