Managing a Team of Former Peers

Many medical practice managers are promoted from within the practice. They are individuals who have worked hard as a member of the medical practice staff for many years and have demonstrated their talents, value, loyalty, and management capabilities. Ultimately, their contributions and abilities are recognized and they earn the promotion to management. If this is your story, congratulations! You have landed a big promotion, and you deserved it.

However, over those same years that you worked so hard and developed your skills, you also established friendships with the other members of your medical practice team. No doubt, you participated in a variety of staff social events over the years, such as lunch outings, birthday celebrations, picnics, holiday parties, and baby showers. You may remember times when you chatted happily with your coworkers over lunch or a cup of coffee in your breakroom or when you offered support to a coworker who was going through a bad time. Perhaps you relished feeling part of such a wonderful team and considered one or more of your coworkers to be among your closest friends and confidantes.

Once a staff member is promoted, the social climate in the practice almost invariably changes.

Things are probably different now that you’re the practice manager. Once a staff member is promoted, the social climate in the practice almost invariably changes. According to Salemi,(1) “Even if others in your group weren’t going for it [the promotion], they may inevitably feel resentment that you’re rising through the ranks and they’re not. After all, isn’t their hard work noticeable and rewardable, too? And if they were vying for the same role you pursued, that’s another issue. They didn’t get it and you did, end of story. Resentment, anyone?” Gallo(2) agrees, adding that promoted managers are the subject of extra scrutiny. She says, “The dynamics completely change. People start to watch you more than ever before . . . You need to establish your credibility and authority, without acting like the promotion’s gone to your head.”

Some promoted practice managers experience a profound sense of loss.

Medical practice managers who are promoted from within the practice must therefore combine the challenge of the promotion with the additional challenge of having to recalibrate their relationships with their coworkers. It is common to feel isolated, or even purposefully excluded socially, from the rest of your team. Some promoted practice managers experience a profound sense of loss, as they have, in fact, lost their place in the practice’s social structure. As Davey(3) puts it, “Your good fortune means disappointment for your coworkers who didn’t get the job. When you’re promoted over people who have always been friends (or rivals), the power relationship is inevitably altered . . . The one thing I can almost guarantee is that there will be awkward moments as you transition from team member to team leader.”

Expect Things to Change

The very first thing that you must do when promoted to practice manager is to anticipate and accept that things will be different now. It will do you no good to cling to or pine for your previous social position with the members of your team. As Quast(4) suggests, “Realize that your previous personal relationships with coworkers will need to be moved to a different level because you’re no longer a peer—you are now the person who assigns work, analyzes productivity and provides performance appraisals.” Gallo says that no matter what you do, the change is inevitable. She says, “You can no longer have close, personal friendships with your former peers. You can’t continue to have relationships in the way you did before. This is a loss for everybody but it’s part of the deal.” In fact, if you try to maintain the status quo socially, you may appear to be playing favorites. Instead, Gallo suggests that you remove yourself from many of your usual social interactions with your former peers. If team members go out for happy hour, for example, it may be better for you to stay behind. You don’t need to become aloof and unavailable, but you may want to attend fewer social gatherings, Gallo says. Quast agrees, urging newly promoted managers to “eliminate any water-cooler or break-room gossip and venting sessions with employees.”

If your personal support and social activities to this point have come mostly or entirely from your coworkers, now is the time for you to strengthen supportive relationships outside of your practice. Think about the people you already know who can be better friends to you as you move forward. Put more effort into those relationships. Have lunch with those friends; seek their insights and support. And build and foster relationships with new friends, especially with individuals who can relate well to what you’re going through and support you. You will need a new social network to replace the one that’s about to change.

Finally, Adenle(5) urges you to seek a mentor who can coach you to manage your former peers effectively. She suggests, “Find another manager with lots of experience and ask the manager to help you transition by coaching and mentoring you. Set up a reoccurring meeting with your mentor and be proactive at managing the relationship. This will gain you considerable esteem and boost your confidence in the new role.” Adenle suggests that you also join a good leadership networking group. There are lots of leadership groups and courses available online that can give you the tools you need to manage your peers, she says. Through any of these groups, you can connect with thought leaders, learn best practices, and have access to useful tools and information. In a leadership network, you can ask experienced managers how they deal with the complicated leadership issues you are likely to face now that you’re managing your former peers.

Announce the Transition

In most medical practices, it is someone else’s responsibility to announce your promotion, but occasionally the task of making the announcement falls to the promoted practice manager. Either way, it usually is best to gather everyone together for the announcement and to do it face-to-face. That way everyone will hear the news the same way and at the same time. Schedule the announcement at the end of the day so everyone has a chance to process the news without the demands of the workday in front of them.

The exception to the general announcement approach is if you know that you have one or more staff members who may find the news particularly challenging. For example, if you won the promotion over another team member, it will be best to tell him or her in private that the job went to you, before your general announcement. That way, the individual will have time and space to process his or her disappointment privately, not in front of the rest of your staff. Just be sure that the individual has no opportunity to share the news with the other members of your team before your general announcement.

Prepare a very brief response to the announcement. Express your gratitude and excitement, but focus mostly on how much you’re looking forward to working with everyone. Accept the inevitable congratulations you receive graciously, but be mindful that all eyes will be on you from now on. A short, modest, and humble response will be best.

Discuss Your Expectations

You will need to make it clear right away that you own your new role, especially if your new direct reports include peers who feel slighted or were passed over for the job. Step decisively into the role from the first day by letting the team know that things have changed, and that you are now their manager. A great way to do this is to schedule a one-on-one conversation with each member of your team the day after the announcement.

Salemi suggests that you can begin your discussion by acknowledging the elephant in the room, saying something like this: “I know this can be a little awkward and feel unfamiliar because we were so close and now I’m your boss.” Use this opportunity to discuss how expectations have changed and what this new relationship will look like. Talk through what you expect of your former peers and what they expect of you. Negotiate and, if necessary, re-negotiate those expectations. Ask: “What can I do to help you be more successful?” If you do this with openness and professionalism and show that you’re sincere, quickly backing up your words with action, you’ll be well on your way to gaining your staff’s trust and respect. That said, your former peers may go through more growing pains than you do as they see you step up to the challenge of your new role. As Salemi cautions, “The need to get over it is more their issue than it is yours.”

At the end of each one-on-one meeting, enlist the support of each employee by asking for specific help in areas where he or she can add value. As Davey says, “Everyone knows that you went from being a peer to being the boss overnight, and pretending that you suddenly have all the answers will damage your credibility.” Ask for assistance in a genuine way that makes your direct reports feel valued and engaged.

Your transition to management will probably be a lot more complicated when a former peer is also an extremely close friend. It makes sense to honor that friendship by devoting extra care, openness, and time to your discussion of how the relationship will be changing, and to talk through the implications both inside and outside of work. Be candid about how your own responsibilities and priorities have changed and ask how your friend sees his or hers changing as well. Tell you friend that you have valued your friendship and that you want him or her to be happy and successful. Let your friend know he or she can count on your continued support. Ask for your friend’s loyalty in return. But make it clear that there won’t be and cannot be any special treatment.

You may be able to keep your special friendship intact. But you may not be able to, at least not in the same way. Be very careful that you are not be perceived by others as playing favorites. Accept that you will not be able to share everything you know with your friend as perhaps you did. And accept that even if you can maintain the friendship, the nature of that friendship will change if for no other reason than that you are now your friend’s boss.

Finally, if one of your peers was in competition for the job, you will have an added layer of complexity to address. He or she has suffered a loss and is most likely disappointed. In some cases, you may need to give the person some space and time to let him or her adjust to the new situation. But it’s important that you do what you can to keep him or her from sabotaging you in your new role. Make it clear that you value him or her as an employee and that you plan to advocate for his or her development. Gallo suggests that you say something like: “I understand you’re disappointed. You’re an important part of this team, and I’m going to make sure you have what you need to succeed.”

Hold Your First Team Meeting

Once you’ve completed your one-on-one meeting, schedule your first team meeting. Create a special format for that event. Ideally, make your leadership kickoff meeting longer than your usual staff meeting, preferably in a unique setting such as a conference center in your community. The event can work even better if you can plan to spend an afternoon meeting with your team and then go out with them socially afterwards.

Start by discussing the purpose of your team. Of course, you’ll have your own take on this because you’ve been a part of the team. But seek your staff’s input, too. Bring in some of the ideas you collected from your one-on-one conversations. Engage in a discussion about where you need to continue on the same path and where you need to make changes. This will demonstrate that you’re not just a steward of the former practice manager’s plan, but a leader in your own right.

Next, share your early vision for your team and any priorities that you will tackle right away. Leave room for comments and questions so your team members feel like coauthors of the plan. Then discuss the ideal meeting schedule for your team. What are the different types of meetings you’ll need and how frequently and how long do you need them to be? This is another good way to usher in a new era under your leadership.

Finally, spend some time explaining how you like to operate and what your rules of the road are going to be. Davey suggests that it will be most useful if you can distill your philosophies into two or three guiding principles or ground rules. For example, if you know that some of the members of your team tend to be passive-aggressive, be explicit about your expectation that they address their concerns directly. For example, Davey suggests that you say something like this: “I want to be very clear that all issues need to be shared openly so they can be resolved. Please don’t come to me with an issue you haven’t addressed directly with one another first.” By stating your ground rules, you’ll manage your team’s expectations and establish how you’re going to handle things.

Be sure to end your meeting on a high note. For example, this would be a good time to initiate a new ritual for your team and to tell them what it means to you to have their support.

Tread Lightly at First

You probably have tons of ideas about how to lead your team, and you may be chomping at the bit to make sweeping changes in your practice. But don’t introduce any major overhauls right away. You’ll need to demonstrate your new authority without stepping on toes or damaging relationships. Gallo suggests that you make a few small decisions fairly quickly, but that you defer bigger ones if at all possible until you’ve been in the role longer and have time to gather input.

In the meantime, seek volunteer opportunities that will demonstrate your leadership. For example, volunteer for a committee for your professional organization and become more actively involved. As Salemi suggests, “As you take on leadership roles [outside your medical practice], former peers begin to see you as just that – a leader. An added bonus? You’ll start seeing yourself as a leader, too.”

Clean House If You Need To

Your medical practice has demonstrated confidence in you by making you its manager. Continue to deserve that confidence by balancing the humility to listen and learn and serve your team with the courage you will need to assert your role as a leader.

Your former peers will have to accept and support your leadership, or they will have to go.

Make the best effort you can, but recognize that you and each member of your staff have a two-way relationship. Your former peers must be willing to come around, too. If they’re not meeting you halfway despite your best efforts over time, tell them. And if resistance continues after you’ve addressed the issue directly with your former peers and given them opportunities to come on board, handle the matter as you would any serious performance issue. Clearly state your expectations, explain where they’re falling short, and warn them what the consequences will be if you don’t see improvement. Then follow through. Ultimately, your former peers will have to accept and support your leadership, or they will have to go. As Davey suggests, “Valuable team members will adapt. Those who don’t may need to find another place to contribute.”

References

1. Salemi V. How to manage a team of your former peers. U.S. News & World Report MONEY. June 10, 2014; http://money.usnews.com/money/blogs/outside-voices-careers/2014/06/10/how-to-manage-a-team-of-your-former-peers . Accessed January 27, 2016.

2. Gallo A. How to manage your former peers. Harvard Business Review. December 19, 2012; https://hbr.org/2012/12/how-to-manage-your-former-peer . Accessed February 1, 2016.

3. Davey L. What to do first when managing former peers. Harvard Business Review. September 16, 2015; https://hbr.org/2015/09/what-to-do-first-when-managing-former-peers . Accessed January 27, 2016.

4. Quast L. 8 Tips to transition from co-worker to manager. Forbes. September 30, 2013; www.forbes.com/sites/lisaquast/2013/09/30/8-tips-to-transition-from-co-worker-to-manager/#5f6ee966575f . Accessed January 28, 2016.

5. Adenle C. Manage your peers: see 12 tested ways. Catherine’s Career Corner. http://catherinescareercorner.com/2014/01/16/12-tested-ways-manage-peers/ . Accessed January 31, 2016.

Prepare to be a Practice Manager from the Start

According to Miller,(1) the most successful transitions start long before a promotion takes place. If you want fewer challenges after you get promoted, establish a high level of character and integrity early in your career and keep it consistent, Miller says.

Imagine how hard your job as practice manager will be if you have voiced your frustrations about your most difficult patients to your former peers, shared gossip, or cut corners. It will be doubly hard if you showed yourself as uncaring toward other members of your team. As Miller suggests, “If you’ve shown your peers that you aren’t supportive of their success and team cohesion, they will brace for the worst when they find out you’re becoming their boss—rather than showing you their best. Their reluctance to trust you in the new role, and your inability to regain their respect, could quickly derail your transition.”

Therefore, if you’re not already promoted to the practice management position you want, consider the management style you’d like to be known for and demonstrate those skills while you are still working side-by-side with your peers. That way, when you are promoted, there will be no surprises. Your team will already know what to expect from you, based upon their experience of your planning, decision-making, communication, and collaboration skills.

Reference

1. Miller J. How to manage former peers. Be Leaderly. www.beleaderly.com/manage-former-peers/ . Accessed January 28, 2016.

How to Handle Oversharing

Part of the process of growing out of your old role and into a new one as practice manager involves detaching yourself from the old day-to-day routines and conversations. Of course, your door should remain open, and members of your team may stop by to say hello. But you should do what you can to avoid conversations that are too personal, unless they are relevant to work. For example, if a staff member’s child has a health issue and he or she needs a flexible work arrangement, that’s an example of when to listen and to show continued compassion and support. But, as Salemi(1) suggests, “Knowing how they unknowingly butchered their tuna casserole recipe at the latest block party? Too much information.”

You’ll need to walk a fine line when a team member tries to continue sharing the intimate details of his or her personal life with you that are not relevant to the job. Of course, you won’t want to be perceived as rude or uncaring. But be mindful that as the practice manager your relationship has changed, and that the individual may be trying to curry favor with you. Gently bring the conversation back to work. As Salemi(1) suggests, you can do this by saying something like, “That’s an interesting story! I hate to cut it short but we have a very tight schedule until noon today. How’s that coming along?”

Be mindful of how much time you spend engaging in light conversation with each staff member, and the quality of that conversation. All eyes will be on you and if you are inequitable, you may be perceived as playing favorites. Avoid inside jokes and banter to which only some of your employees are privy. For more information on keeping your relationships equitable, see the sidebar, “Don’t be Perceived as Playing Favorites.”

Reference

1. Salemi V. How to manage a team of your former peers. U.S. News & World Report MONEY. June 10, 2014; http://money.usnews.com/money/blogs/outside-voices-careers/
   2014/06/10/how-to-manage-a-team-of-your-former-peers . Accessed January 27, 2016.

Handling Four Common Challenges to Your Leadership

Some of your former peers are likely to test your authority and leadership. Davey(1) describes four common challenges you may face and how you can handle them:

Reference

1. Davey L. What to do first when managing former peers. Harvard Business Review. September 16, 2015; https://hbr.org/2015/09/what-to-do-first-when-managing-former-peers . Accessed January 27, 2016.

Rethink Your Social Media Settings

Are you connected to your former peers through Facebook and other social media? If so, you may not want to share your personal life with your staff as you’ve done before. As Salemi suggests, “Start thinking if you really want your team to know you caught up with a college buddy last night at the local watering hole.”(1)

If you were vigilant about your social media all along, you won’t need to backtrack to change access to photos and more. But if you shared more than you want your staff to know in light of your new role, change your privacy settings. And from this time forward, be extra mindful about everything you post.

Reference

1. Salemi V. How to manage a team of your former peers. U.S. News & World Report MONEY. June 10, 2014; http://money.usnews.com/money/blogs/outside-voices-careers/
   2014/06/10/how-to-manage-a-team-of-your-former-peers . Accessed January 27, 2016.

Don’t be Perceived as Playing Favorites

If you worked in a medical practice that has 20 or more employees, you’d typically associate closely with only a handful of them. That’s not necessarily because you have a dislike for everyone else. Rather, there are simply some people to whom we more naturally gravitate than others. As a member of the staff, you no doubt had coworkers you knew and liked better than others.

Now, as the practice manager, you’ll still have some employees you prefer over others. However, you’ll need to make a concerted effort to spread your attention more evenly among your entire staff. Continuing to have a closer relationship with some employees could potentially make others feel as though you value them less. That can fuel a host of problems, not only for your leadership but for your team overall. Employees who believe that they are valued less may make life more difficult for those they perceive as having the boss’s favor.

If you have an employee you’d prefer to avoid, fight that inclination and give him or her a fair share of your attention. Also do your best to be equitable with everyone on your staff in your tone, facial expressions, and body language.