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How to Manage a Challenging and Diverse Staff
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In the eyes of most managers and administrators, one of the most difficult aspects of management is human resources. No two people are the same, but the key is not to let a difference of opinion or personalities evolve into an antagonistic relationship. 

AAOEHow do you effectively manage diverse and sometimes difficult personnel? Here are some suggestions for optimizing your staff-management skills.

Challenge status-quo staffers. We’ve probably all heard the line, “But we’ve always done it this way.” Status-quo staff members believe that if it worked before, there is no reason to change it now. Staff members who view their employment as “just a job” rather than a career and those who have difficulty seeing the bigger picture will often fall back on the status-quo argument. I call these people “skaters” — staff who punch a time clock, do enough to satisfy their job description and then race out the door at 5 p.m. to get on with their “real life.”

With such employees, I have found that it is best to start with small changes and then work up to more complex ones – this gradual process does not overwhelm them. Once they have successfully tackled a few minor alterations in work policy, they are more receptive to further change.

Know your management style. This requires a hard, honest look in the mirror. Management styles can run from micro managing every employee and job description to refusing to set limits for fear of an employee responding negatively. Yet, evidence shows that neither of these extreme styles makes for successful management. Supervisors who adopt these extremes tend to pay with high turnover or total lack of control. As in all things, balance is the key.

Identify staff strengths and optimize staff skills. To successfully manage people, you need to assess the types of personalities that make up your team. Most people have their own individual combination of traits. It is easy to label a staffer as “passive/aggressive” or maybe a “negative Nellie,” but things are usually more complex than that. Also, staffs often include a mix of Baby Boomers, Gen X, Gen Y and Millennials, all of whom work and communicate in different and seemingly conflicting ways. A good way of addressing personality differences is to determine the strengths of each team member and then work to optimize those strengths to meet the goals of the practice.

Empower your staff. Making your employees feel empowered and more skilled than when they arrived builds a strong team and creates loyalty to you and to the practice. This can easily be achieved by giving each staff member the authority to make decisions to resolve issues and by supporting those decisions after the fact. This could be as simple as allowing them to validate the parking of a disgruntled patient or to swap a shift with another employee to accommodate a personal appointment. Respectfully reviewing the decision with the employee and providing advice or examples to improve their decision-making process not only improves their critical-thinking skills, but helps them feel invested in the success of the practice.

Create a transparent, fair and equitable policy for conflict resolution. This starts with having a solid employee manual reviewed by a labor attorney in your state. The policies in the manual should reflect the mission and culture of the office. It should let employees know what is expected of them and what they can expect from the practice. Such a manual also mitigates conflict with regard to basic codes of conduct like tardiness, absenteeism, job descriptions and social media. There should also be a discipline action plan that explains the process by which conflicts will be resolved.

Communicate respectfully. Often times, problems can be resolved with a quick conversation alerting the staff member of the issue. A simple word will put them on notice that you are in fact paying attention. You should always observe the old maxim “compliment in public and criticize in private.” When the situation is more egregious, a tiered policy is advised. This can range from a documented conversation, verbal warnings, written warnings and final warnings. It is very important to make sure that the employee understands the problem and what is expected in correcting it and to give them ample support and reasonable time to improve.

This sometimes requires re-training or review of office policy. If the employee fails after the allotted time, then the discipline escalates to the next level. I always like to include in the final warning that a future violation of any office policy may result in termination. This makes it clear that the employee may be terminated for a violation other than the one for which they were originally disciplined.

Create a strong support network. Because management is often a solitary position, it is important to have a strong network of peers for advice, support and a scale of relativity. Managing people can often be frustrating and emotionally charged. Taking that moment to regroup and look at a conflict objectively is invaluable. The American Academy of Ophthalmic Executives has a listserv called eTalk where you can ask questions, review scenarios and get immediate advice and support from hundreds of other administrators and physicians across the country. Membership is free for Academy members in training or their first year of practice.

Human resource management can be challenging, especially with our diversified employee pool, but it can also be incredibly rewarding and inspiring. Creating and maintaining a team and watching staff members not only succeed but thrive are worth all the trials that come with the job.

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About the author: This article is an adaption of the original version, which appeared in the July 2011 AAOE Executive Update. It was written by Nancy Baker, who has more than 20 years of experience in medical administration. Before transitioning to ophthalmology in 2004, she worked for a variety of medical specialties, including ob/gyn, general surgery, family practice and internal medicine. She specializes in revitalizing underperforming practices and is currently the administrator for Elander Eye Medical Group in Santa Monica, Calif.

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