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Every organization has a culture unique to that organization and a doctor’s office is no exception. The culture determines how patients, staff and doctors feel when they walk in the office. The ophthalmologist plays the key role in determining the culture of his/her office. If we want our office culture to be one of excellence, competence and friendliness, we must work to set that tone. Various aspects contribute to the culture we might find in our own office.
Say No to Negativity
When something goes wrong, we sometimes ask or search till we find out who is responsible so we can set them straight. Unfortunately, this spreads fear throughout the office and leads to an inordinate focus on avoiding mistakes. Everyone becomes hesitant to tackle difficult problems or make changes. If something goes wrong, staff is quick to blame someone else and cover their own mistakes. An atmosphere of distrust and suspicion pervades the office.
Alternatively, we need to constantly remind our staff and ourselves that we are the best and most talented people in the world. When something goes wrong, we should assume the problem is in the process or the system, not the individual. We need to realize that since we have the best people, if one person made a mistake, others would have made the same mistake in similar circumstances. We need to work to change the circumstances, not punish or reprimand any one individual.
There are many negative attitudes that can work their way into the culture of an office, such as frequent complaining, unhappiness or gossip. We need to constantly make sure our own attitude and behaviors are positive. We need to focus on and encourage staff members who foster positive attitudes.
Studies have shown that kind words and personal attention from the physician often mean more to an employee than a raise. On the other hand, any negative words seem to be magnified in the minds and feelings of the staff. Some things physicians should try to convey to the staff in word and action include:
- Thank you. We appreciate your hard work and realize that you are continually doing your best despite circumstances that are often difficult. We want you to enjoy working here. We all spend the biggest percentage of our waking hours here, so we have chosen the best possible people to be our employees.
- We are all fortunate to be working in an ophthalmology office where our goal is to provide the best possible eye care for people. Studies show that people value their eyesight more than anything else, next to life itself. We can all go home at night knowing that we have spent our day providing the highest form of service to the public.
- We all enjoy working in a practice that has the reputation of being thriving and successful. We all want to do everything we can to enhance that reputation.
- Honesty and fairness are always pursued without question in this office. If it is not right, we don’t do it.
The Three A’s (plus one E)
An effective office culture constantly focuses on the traditional “three A’s” of a successful medical practice:
Availability: We want to make sure we are always available to our patients and referring physicians. Answer the phones quickly. Always know how to get our doctors on the phone immediately if necessary.
Always have room for emergency appointments. Remember that some emergencies are “social emergencies” that occur, for example, when a referring doctor’s friend or relative wants to be seen today for whatever reason.
A culture of availability is necessary to thrive in today’s competitive world.
Affability: Always be kind to everyone. Remember that for some people, the severe eye problem that brought them to our practice is the worst thing that has ever happened to them in their life.
If patients are mean or unreasonable, we need to see if we can melt their hardness with kindness. A friendly smile does more to build a practice than almost anything.
We need to remember this true story:
As a 10-year-old boy, I loved my dog. The most horrific experience of my life was to see him in terrible pain after he was run over by a truck. As I tried to comfort my dying best friend and cuddled him in my arms, he bit me hard — for the first time in my life. It took me many years to finally understand that when people or dogs are in great pain, they sometimes bite those who are trying to help them.
When the “dog bites,” don’t bite back.
Ability: We need to remind our staff that we have the best doctors and the best staff.
We also need to let the patients know it by being professional in dress and language.
We should avoid chewing gum, eating or even talking about food in front of patients.
Coffee cups, Coke cans and food don’t belong on our desks where people can see them. I have had more than one patient question our focus on his sight-threatening problem because we discussed lunch within earshot. The same is true for any personal conversation, such as upcoming travel or other personal distractions that lead patients to think their eye problems are not getting our full attention and best efforts.
Conversely, attention to things of personal interest to the patient, such as their families or travel, show that the physician is focused on them and their interests. Office attention to holidays, such as dressing up for Halloween, builds a personal bond and increases loyalty with patients.
Patients assume that precision and accuracy are the earmarks of a quality physician. Patients question our ability if we misspell their names or lose their charts.
When people call on the phone, we need to let them know by the confidence in our voice that they reached the right place and we can help them.
Efficiency: In these times of increasing overhead and declining reimbursement, we need to establish a culture of efficiency.
The day is much more enjoyable for our staff as well as ourselves when everyone is busy and productive. A day when we don’t accomplish much is a slow, painful day.
We must also continually remind ourselves that the products of our business are doctor services. They are what we bill for. Doctor time is what brings income into our practice, so we must constantly think of ways to conserve that limited commodity.
One of the most important things we can do to make the office more efficient is to train the staff to constantly look for even small ways to save time for the physician. We can set the example by keeping focused on the work of the office and limiting personal phone calls or other personal distractions. We need to delegate every task possible to other staff members.
It is often said that any institution is the lengthened shadow of its leader. As physicians, we automatically become the leaders in our practice. We lead by setting the proper tone or culture in our office. Patients and staff correctly and intuitively know that they can best understand our quality as a physician and a person by looking at the culture in our office.
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About the author: Gregory S. Brinton, MD, MBA, is a retina specialist in private practice in Salt Lake City and a member of the board of the American Academy of Ophthalmic Executives.