Getting through to the boss

Are you a practice manager who's struggling to communicate with your practice owner? You're not alone. I get calls every week from managers who feel like owners don't respect them or listen to them. They're having trouble "managing up."

Take Julie, a practice manager at a six-doctor practice in Ohio. She was upset because the owner rarely asked for her opinion or input. He'd just show up in her office and tell her what he wanted her to do. He also undermined her decisions. Team members would ask Julie for something, and if they didn't get what they wanted, they'd go to the owner and persuade him to let them have their way. So it's no surprise the team members didn't respect Julie—she didn't have any authority. If you were Julie, how would you manage your practice owner?

Get the details on paper

The first step is developing a complete job description. As a practice manager, you need to know what your roles and responsibilities are. You can't manage employees without a job description; the same holds true for "managing up" to the boss. The owner needs to know and acknowledge your responsibilities. To get started, try customizing a generic job description like this one. Or, to start from scratch, write down all of your responsibilities and present the document to the owner, who'll amend it and approve it. Once your job description is set, the owner needs to share it with the other team members so they know your role.

Know the boss's style

To communicate effectively, you need to learn your practice owner's personality and preferred communication style. Some owners, such as Julie's, hate confrontation and don't want to be seen as the bad guy. On the other end of the spectrum are aggressive owners and micromanagers who want to be involved in every decision. Knowing your boss's personality will help you work with him or her more effectively.

I'll use myself as an example. My employees know I don't respond well to aggressive communication. If you come to me and say, "Mark, you have to do this," you probably won't get what you want. I also don't like long-winded explanations or lots of detail unless I ask for it. I'd rather you get to the point. If you give me the bullet points on why you want to make a change and let me ask a few questions, I'll probably respond positively.

Some people prefer to communicate face to face; others prefer e-mail or memos. I have some clients I talk to only through e-mail; others hate to be denied their phone time. Some people want to see charts and graphs; others do better when you talk them through a problem and its solution. Similarly, knowing the communication style of your practice owner is imperative.

If you're struggling to figure out your boss's communication preferences, schedule a discussion at a neutral location, such as a restaurant. Ask your practice owner how you can collaborate together most effectively. But don't take all the responsibility for figuring out what communication style works best for your boss. It's the practice owner's job to tell you what style he or she prefers. I tell all my employees to be succinct and that I don't want long explanations. I also tell them never to approach me until after I've had my second cup of coffee. See? I'm an open book.

If you need more information, there are lots of books about communication available at any bookstore. There are also classes you can take to better understand how you and others communicate and how to modify your communication to be more effective.

Set a hierarchy of authority

Within a practice, communication can become a snarled mess if you don't delineate a hierarchy of authority that everyone in the practice knows and follows. A typical hierarchical chart can be seen as below. Using this basic example, if a receptionist were to encounter a problem, she would talk to the office manager. If the office manager was having trouble with another team member, she'd talk to the practice manager, and so on.

Starting point: Sample hierarchy of authority

The hierarchy works in the other direction, too. If the owner sees the receptionist making mistakes, she talks to the practice manager, who then talks to the office manager, who then talks to the receptionist. And vice versa. If the receptionist can't do her job because of the owner's interruptions, she goes up the chain. It's crucial that everyone in the practice be aware of the hierarchy of authority and follow it. Team members should feel free to voice concerns to the owner, but the owner should take those concerns to the team member's superior to resolve.

Bad things happen when people don't follow the practice hierarchy of authority. Communication breaks down, resentment festers, and misunderstandings run rampant. So the practice leadership needs to enforce the hierarchy. If, for example, a receptionist were to go directly to the practice owner with a problem, bypassing her own boss, the owner or manager would need to tell the receptionist to bring that problem to her immediate supervisor. If the practice owner or manager tried to resolve the problem directly, he or she would undermine the supervisor's authority and render that team leader ineffective.

To avoid this, I suggest you put a big copy of your hierarchy on a wall in your practice, perhaps in the employee lounge. When it changes, let everyone know and update the chart.

Meet regularly

If you're going to be successful at managing up, you need to talk regularly with the practice owner. I suggest you schedule monthly meetings between yourself and the owner to make sure this happens. Meetings over breakfast work well for many owner-manager teams. Once the day starts, it's too easy to delay or cancel meetings.

Prepare an agenda in advance of these meetings and present it to the practice owner for any additions. Naturally, the minutes from the meeting will need to be recorded, and that will probably be your job. What's the point of holding an important meeting if you're not going to keep track of what you discussed and set in motion?

As the practice manager, you also need to meet at least once a month with the office manager, the head technician, and the kennel manager. And to keep the whole team informed of policies and procedures, schedule a full team meeting at least once a month. Attendance must be mandatory. Distribute the minutes of that clinic meeting as soon as possible, while new ideas and important issues are still fresh in everyone's minds.

Keep track of projects

If you want to manage up and communicate successfully with your boss, you also need to let him or her know what you're working on. Practice owners often don't know what their managers are doing or what projects or problems they're dealing with. In fact, when managers do their job well, the practices run so smoothly that owners might wonder if the managers are doing anything at all.

That's where a project board comes in. This is typically a dry-erase board hung in your office, with columns designated for "project," "status," "intended date of completion," and "completion date." Write any projects delegated to you on the board along with the intended finish date. Then update the status as the project moves toward completion. This helps everyone see what you're working on. When new projects come along, add them to the board. If you're overwhelmed with other tasks, ask the owner to work with you to determine what projects take priority, then note those decisions on the board.

You and the owner must work together to create a management structure and ensure it's followed. This structure fosters practice-wide respect, trust for the manager, and trust among all team members. If you're a practice manager and all of this sounds a little daunting, don't worry. Start by buying a brand-new dry-erase board. I guarantee you'll feel more ready than ever to tackle the next project that comes your way.

The bottom line

5 steps to managing up

To manage owners, practice managers need the following items and bits of information:

1. Clear job description

2. Knowledge of the owner's communication style

3. Hierarchy of authority

4. Regular meetings

5. A project board.

Mark Opperman, CVPM, a Veterinary Economics Editorial Advisory Board member, is owner of VMC Inc. in Evergreen, Colo. Catch "How to Keep Your '10' Employees" and his four-part talk "Help! I'm in HR Hell!" at CVC Central Aug. 23 to 26 in Kansas City, Mo. Send questions or comments to ve@advanstar.com

Mark Opperman, CVPM