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Young Ophthalmologists
Team Building: An Essential Management Skill
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The passage of health-care reform and the change in workforce expectations after a prolonged recession will challenge any ophthalmology practice. To achieve operational success, you will need to become even better at creating and maintaining effective teams in the office.

No matter how talented individuals on a staff may be, unless they can function together efficiently and with excellence, the practice will not achieve the level of performance required in coming years to be successful — or perhaps even survive. 

undefinedWe can learn something about successful teamwork from observing symphony orchestras and sports teams.

A superb symphony performance requires excellent individual musicians and a talented conductor working together with precision. They must share the same goal and vision.

The conductor produces no music, but rather achieves his or her musical vision through directing others. Likewise, a practice manager or managing doctor must realize his or her vision through the motivation and coordination of everyone in the practice. The result can be harmonious or discordant, pleasing or stressful, depending upon the skill of the “conductor.”

The conductor must convey the vision and the mission. In an orchestra, everyone is performing the same piece, even though they are playing different parts, just as on a baseball team, each player plays a different position.

In a medical practice, everyone may play different roles, but they should all work together harmoniously so that the flow of the practice comes together as a beautiful symphony.

We have all seen sports teams that have a star player who isn’t supported by the team because he or she always seeks the spotlight. We have also seen how successful a team can be when the star player credits the team with the team’s success. In team efforts, the entire team must be psychologically and financially rewarded for their successes.

Obviously, hiring the best doctors and staff is an important step. The goal should be to hire all A players, but sometimes even the best teams don’t have all A players. What they do have is players who work together to spur each other on to achieve optimal performances. There may be times for solo performances, but the focus must be on what can be achieved as a team.

Team Dynamics

When a team is dysfunctional and staff is not supportive of each other, trust is lacking, deadlines are missed and quality suffers. This atmosphere causes customers to be frustrated and disappointed. And when customers leave, the business suffers.

Let’s look at what can we learn from a successful orchestra or sports team.

  • Set clear expectations. Members of a successful team know what the goal is. They know what their position is, they know precisely what is expected from each of them individually, and they know how they will be measured individually and as a group.

    In a medical practice, each employee should be cognizant of the ultimate practice goals and know how his or her role fits into the whole practice, why it is important and how he or she will be measured. These things should be made clear during the hiring process and throughout employment. Expectations may change, but when this happens, the change(s) must be communicated clearly and regularly. Training and practice as a team are essential.

  • Communicate the vision and mission of your team. The vision of a sports team may be to win a championship. It is a key role of the manager or coach to regularly and clearly communicate the vision and mission to the team. This is equally true for a medical practice.

    The vision or mission is the primary reason for the practice’s existence; all activities should support this vision, and the team needs to clearly understand what it is. Develop a system of regular evaluation to monitor performance of your team members — this helps the team members align their performance with the broad mission and vision of the practice.

  • Be conscious of the culture within the practice and personality differences. Every organization has its unique culture. The culture of a particular organization can change over time, but cultures tend to change slowly.

    It is important when hiring people to be clear what values are important to your practice and to hire people who share your values. Personality-assessment programs, such as DISC, Enneagram or Myers-Briggs may be helpful in evaluating compatibility.

  • Empower your team. Like a sports team, your employees should have the authority to make some decisions on their own within the framework of the overall plan. Develop a sense of trust in your team players so they feel empowered to make decisions when necessary.

    This not only enables the team to function efficiently as circumstances change, but also fosters creativity and initiative among the individuals. If everyone clearly understands the overall goals and objectives, they will make decisions appropriate to achieving the practice goals.

  • Build personal relationships. The orchestra conductor or sports-team manager must get to know each musician or player and work with each person so that he or she can excel individually and work together with the team.

    Likewise, each staff person needs to be mentored, coached, disciplined and motivated to excel in his or her role. You must understand what each individual desires to achieve and help that person understand how his or her goals can be achieved within the context of team success.

  • Give appropriate rewards. When a sports team excels and wins, everyone on the team wins. If we want to have a successful team in the medical practice, then we need to set team goals and provide team rewards.

    Just as on a sports team, everyone may not be rewarded equally, but there should be a significant reward for everyone. Such rewards are not easy to construct, and care must be taken to have a meaningful review process in place so that individuals who are not pulling their own weight can come to understand that they will not continue to be part of the team unless they “step up to the plate.”

  • Be flexible and adapt as teams change. Even the best sports teams experience change among players. Quality managers are always scouting for new players and anticipating change. Managers prepare their team for roster changes.

    In a medical practice, it’s important that team members be cross-trained for different positions. Cross-training helps the team gain appreciation for the work of other team members and makes the team more resilient to change.

This new era of health care will require practices to deliver high-quality, low-cost, personalized eye care. This goal will necessitate teams of high-performance individuals who are motivated to work efficiently and cooperatively.

Ophthalmic practice teams must be prepared by leadership to understand excellence as the alternative to reductions in compensation or benefits. Such teams will be led by managers who understand how to build and maintain champion teams.

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About the author: This article has been adapted from the June 2011 issue of Coding Bulletin. It was written by Walt Underwood, who has worked with physicians, managers and community leaders to successfully develop and manage medical practices and managed-care organizations for more than 35 years. The former CEO at Thomas Eyegroup in Atlanta, Walt is currently a medical practice-management consultant at Corcoran Consulting Group. He is also a former member of the AAOE board and presents several courses at the AAOE program of the Annual Meeting.

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