Effective Management Teams Begin With Leadership

Accepting a new job as the top administrator in a group practice usually means “inheriting” long-term, trusted managers and supervisors who are well established—entrenched—in their respective positions. During the course of my career, I have served as the first “professional” group practice administrator no fewer than four times. In three of those practices, the veteran office manager agreed to stay on in a modified role—answering to a new “boss.”

I was fortunate to work with good, conscientious managers who willingly put the organization’s success ahead of their personal agendas or instincts for self-protection. They proved cooperative, hard-working, and careful not to sabotage the new guy’s efforts to assume control of the administrative side of the practice. In every situation, the office manager had within her hands the power to “make or break” the new administrator’s success. I felt very lucky to have worked with quality folks of high character.

Great Leaders—Great Rules

I recently came across an online article on leadership originally promoted by SmartBrief (www.smartbrief.com) published by the Springfield (Missouri) News-Leader.(1) The author, Missouri State University President Clifton Smart, told about meeting General Colin Powell when he spoke at the university some years ago. Subsequently, he read Powell’s It Worked for Me: In Life and Leadership.(2) Chapter One, “My Rules,” inspired Smart to create his own “Clif’s Ten Rules to Live By.”

Whenever Smart hires a new member of his administrative team, he goes over his 10 rules to make sure his direct reports understand how they will interact as leader and team member. As I read through his 10 rules, I reflected on my relationships with members of the various teams I had led. As it turned out, there was more to my success than just dumb luck—I shared some of the same principles championed by the likes of Clifton Smart and Colin Powell.

In writing his article for other executives, Smart modified and adapted his rules so they can apply more easily in a variety of settings beyond the academic world in which he operates. With just a little more tweaking, we can apply these principles to the unique milieu of medical practice management.

A Good Starting Place

As an administrator or physician, you can improve the effectiveness of your management team by creating your own list of basic rules (and sticking to them). Here are Smart’s rules adapted for medical practice:

1. No surprises—let me know as soon as you are aware of trouble brewing or problems arising. The sooner I know about it, the sooner I can help you with it. Departmental managers in dysfunctional organizations tend to hide problems from their superiors. Such behavior indicates fear. Ask yourself how you can reduce or eliminate fear in your organization.

2. Don’t be afraid to share your thoughts with me, and don’t be afraid to tell me you think I’m wrong. After all, I may be wrong. You are helping me when you do this and won’t be punished—I promise. It’s difficult to come up with creative solutions when surrounded by nervous “yes-men.” Wise Solomon famously said, “Iron sharpens iron, and one man sharpens another” (Proverbs 27:17).

3. Cell phones are great business tools, but turn them off during meetings. Focus on the discussion at hand. Make sure that any rule like this goes both ways. How disingenuous it would be for the boss to lay down the law about cell phones, then interrupt a conversation to attend to a “quick” call or text message.

4. Use appropriate lines of communication. Limit your communication with my bosses, and inform me if it occurs. In turn, I promise to limit my interaction with your subordinates, and I will inform you if it occurs. Every medical practice administrator faces this problem to a greater or lesser degree. Personnel with long-term relationships with the physicians they serve think nothing of doing an “end run” around the new boss by reporting directly to the physician. The staff member may do it unconsciously—simply out of habit. But more often, it’s a direct attempt to dodge the administrator’s authority. Administrators and doctors have to face this challenge together. Doctors may unwittingly play into a manipulative employee’s hands, or they may actually encourage this kind of behavior in order to keep an eye on the new manager. If you don’t interrupt these patterns, you will always have a dysfunctional administrative process. (I would go so far as to advise an administrator working with doctors who encourage “back-door” reporting from favorite employees to look for a new job!) Corollary to this rule: communicate on your level with other organizations. CEOs talk to other CEOs, administrators talk to other administrators, doctors talk to other doctors—and so forth.

5. Advocate for your position and your unit, but when a decision is made, support it 100% (even if you disagree with it). Take ownership of the decision and defend it to your unit. That means you don’t even hint that you disagree with the decision. Change-resistant employees will see a weakness and go for the jugular every time.

6. I expect loyalty from people who work for me—no exceptions. In return, I will be loyal to them and give them public credit for achievements of their unit or of the organization when they are involved.

7. Don’t be afraid to take a risk. I will support you, even if it doesn’t work out—I promise. Don’t overstep your bounds or take risks beyond your delegated authority, of course, but if your (reasonably) risky decision is true to the practice’s vision, mission, and core values, I will support you. For example, if you step outside the strict boundaries of our policies in order to keep a patient satisfied, I will support you. If you went too far, I will clarify how you can do better in the future, but I won’t undermine the action you already took.

8. My team must work together, not in silos. That includes all departments and locations. Your department, your office site, or your area of responsibility doesn’t exist in a vacuum. Never make a decision without considering how it affects everyone in the organization. First corollary: no empire building. Second corollary: share information. Be inclusive and transparent. It’s better to share too much than to withhold vital information.

9. Kindness works. Love works. Said another way, I expect professionalism and civility at all times, in all interactions. In fact, I won’t tolerate brusque, rude, or dismissive behavior among staff members. We will get along, or you will need to “get along down the road” to another job.

10. Never lie to or deceive me or your peers. This is a terminable offense—I promise. Don’t hide behind half-truths and partial disclosures to try and get around this rule. Any attempt to deceive me or those who work with me will be treated the same as a bare-faced lie. Rather than lie or tell a half-truth, look me in the eye and say, “I’d rather not say.” We can deal with that answer much more effectively.

Make It Your Own—And Stick To It

My actual list of rules differs somewhat from Smart’s, but these examples can give you a good start for creating your own rules that reflect your values and your goals. Perhaps your own list will be longer or shorter. It makes sense, of course, to start with the most important values and those that your team already follows (more or less). You can expand the list as necessary to get everyone pulling in the same direction.

Finally, Smart cautions us with, “These rules are easier to set out on paper than they are to follow—at least by some managers.” Once you boldly state your “rules,” you will find it necessary to hold everyone accountable. Decide in advance how you will deal with infractions, but by all means: deal with them! Otherwise, you’ve just wasted your time and effort.

References

1. Smart CM III. Ten rules for a successful administrative team. Springfield News-Leader, January 8, 2017. www.news-leader.com/story/news/business/2017/01/09/ten-rules-successful-administrative-team/95964586/ .

2. Powell C. It Worked for Me: In Life and Leadership. Harper; 2012.