When it comes to running a clinic, lack of communication is not an option. Mark Opperman reveals the best ways to keep your employees in the loop.
The "Management Matters" blog features the writing of veterinary practice management consultants Monica Dixon Perry, Mark Opperman and Sheila Grosdidier. Come back every month for their unique take on current and future trends in veterinary practice as well as tried-and-true tips for improving patient care, team member morale and practice revenue.
Recently, I spoke with a client who had an associate veterinarian coming up for contract renewal, and he had some complaints about this employee. The associate veterinarian took too long in the exam room, performed surgeries without preanesthetic bloodwork (even though this was hospital policy) and didn't charge his own favorite clients the full cost of services. Now, the practice owner wanted to add penalties to the associate's contract so that, if these behaviors continued, the associate veterinarian wouldn't receive his production bonuses.
When I asked the practice owner if he had ever sat down and discussed these problems with the associate, his response was that he had "mentioned them." You may not be surprised that, when I addressed these issues with the associate, I found he was completely unaware that these were problems for the practice owner.
I'm always amazed how often these types of situations arise. I know that many veterinarians prefer to avoid confrontation with employees, but talking out problems is a responsibility of ownership. It's not fair for practice owners to penalize associates for issues they haven't even directly discussed. (And, by the way, it would be illegal to not pay them bonuses under these circumstances.)
Veterinary practices need direct lines of communication between the practice owner and the associate doctors. Here are my suggested best practices for open communication at a veterinary practice:
Keep your door open. I suggest that practice owners maintain an open-door policy with their associate doctors. Associate veterinarians should feel free to talk to the owner about any problems or issues they have and, in turn, the owner should be able to directly talk to the associate about any issues, good or bad, going on in the practice.
Don't make associates try to read the practice owner's mind. A practice manager or hospital administrator can discuss management issues with associates and other team members, but issues pertaining to veterinary medicine still need to be addressed by the practice owner. Associates shouldn't find out at their annual review or contract renewal that the practice owner is unhappy with their performance—the associate should have been made aware of such problems long before that time.
Hold meetings. Many practice owners hold weekly or monthly meetings with their associates to cover both medical and management topics. Breakfast is a good time, because once the workday starts, there's always some excuse to postpone or delay these meetings. Set a specific day and time beforehand, such as the first Wednesday of each month at 6 a.m. at a breakfast spot in town. To make these meetings truly effective, the practice owner will need to create an agenda. Be open to suggestions before the meeting from associates to ensure their issues are heard. Ask one attendee at the meeting to keep notes and distribute them afterwards to the doctors.
Regularly review performance. This last suggestion is a big one. Every associate needs formal, timely performance reviews. And, as I stated before, a review is not the time to unload on the associate all of the problems and concerns the practice owner has stored up over the course of a year. A review is not a time for surprises. A good practice owner will have already communicated issues during the year. Instead, the performance review is a time to reflect on and discuss both the good and bad things that have happened over the year and, most importantly, discuss a strategy for continued success in the year to come.
When it comes to performance reviews, I like task-specific evaluations. For example, a task-specific evaluation form for an associate veterinarian might ask the question, "How well does the doctor review his/her physical exam findings with the client in the exam room during wellness visits?" Another question might be, "Does the doctor maintain his/her appointment schedule and see appointments in a timely manner?" There may also be medical questions such as, "How well does the doctor keep up on new medical and surgical procedures and share that information with other doctors within the practice?"
I also encourage associates to perform a self-evaluation using similar criteria at their review as well. Then the practice owner and associate sit down to compare notes. Naturally, the differences between the two evaluations will need to be highlighted and discussed. The associate might think he or she does a great job keeping up with new trends and concepts in medicine and surgery, but the practice owner may not agree. At the end of the evaluation, the owner and associate should set goals for the year ahead. For example, if the issue is keeping up with the latest medicine, the practice owner may send the associate to a veterinary conference in return for the associate's commitment to share CE lessons at a meeting upon his or her return.
I suggest that formal performance reviews be done after the initial three months of employment and at least yearly thereafter. Whenever I talk to associates, they usually say they really do want to know how well they're doing in their bosses' eyes. They welcome performance reviews done right.
Of course, meetings and performance reviews do not replace open, honest interaction and discussion throughout the year. It’s not fair to associates—or any employee—for practice owners to bottle up concerns then passive-aggressively penalize associates at year's end. If you are a practice owner who has a hard time confronting employees when there are problems, make sure you hire a practice manager or hospital administrator who can help.
Mark Opperman, CVPM, is a certified veterinary practice manager and owner of VMC Inc., a veterinary consulting firm based in Evergreen, Colo.