Building Your Practice through Stakeholder Relationships, Part VI

Thomas E. Cavanaugh, DC, MBA

Developing the Employee Stakeholder Relationship

As defined in Part 1 of this series of newsletters, “stakeholders’ are individuals or groups who can influence or are affected by a corporation´s activities. In our field of chiropractic this would be staff, community, patients, attorneys, the insurance industry, Chamber of Commerce, local charitable clubs and any other organizations pertinent to your business. In Parts II, III, IV and V we established the importance of “Patient’, “Supplier’, “Community’ and Political stakeholder relationships. In this issue, I will address the “employee’ stakeholder relationship.

Employee Relationships

Management of people in the work place is certainly the most challenging task for an owner/manager of any business or practice. Each person comes to their work environment with a complexity of different experiences, unique personalities and varying value systems.

To give you a better idea of this complexity, consider the human face. With about 6,430,000,000 people in the world, and excluding the most identical of twins, each face is unique. If there are so many different and unique physical features in such a small surface area as the face, imagine the magnitude of individual differences developed as a result of a lifetime of different environmental and social experiences, plus the accumulation of developmental thoughts and actions of each person. All of these factors and more, become the “make-up’ of the individual. Such complexity is almost unfathomable.

Now, put this convolution of personalities in one work place and allow them to interact with one another. We begin to see synergy or confusion in the making! Fortunately, society has placed some common ground rules in our lives pertaining to courtesy, respect, communication, service, kindness and the like, which make it possible for us to live in peace with each other.

The question for the owner/manager is ‘how do you manage each person?´ What is the best way? Centralized or Vertical management (from the top down) is something of the past. I was recently talking with a doctor who said he couldn´t seem to keep staff. When I asked him about his management style he said he took full responsibility as the boss and told his staff what to do and when … much like a ‘General´ or ‘dictator.´ He gave the orders and did not invite or encourage any other input. He did it so well that he was constantly replacing lost staff members. This is a clear example of vertical management. It might work well in war but it doesn´t work at all when you´re trying to build a practice.

Over the last 15 years, companies have long changed their management to a more horizontal style. This means delegating and spreading out the responsibilities to team leaders and other departments. Budgets, benefits, bonuses, vacations, peer reviews and awards of such are now handled on a more local level. For employees, this has brought about a greater trust, more self-esteem, personal growth, innovation, creativity, decreased absenteeism, and a desire to make their organization profitable. Most chiropractic offices are not large enough to have such teams. But doctors can still find ways to bring this type of horizontal management into his office.


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The “Situational Leadership/Management’ style works best in most practices. Depending on the “situation’ the doctor would use the following management approaches:

• Directing: This is a one-on-one type of management. You can compare it to giving directions to an out of town person looking for a particular destination. You know exactly how to get to where the person wants to go so you either verbalize or write down the specific directions for him – you are thorough with the details including how far to go in which direction, where to turn and what to watch for. With your new employees you also need to provide clear directions, helping them acquire the skills that will make them feel competent and accomplished in their position.

• Delegating: Delegate or assign certain projects and responsibilities to your self-motivated and learned staff members. You simply give them the assignments and they´ll know what to do. Receiving an assignment without much direction shows your confidence in their abilities, which becomes a great motivator for your peak performers to want to excel even more.

• Coaching: Coaching employees individually on achieving specific goals within their scope of job responsibilities, should be a learning, and motivating experience for them. Allow employees to use the skills they learn, motivate them to master those skills and encourage them to learn others. Take the time to “coach’ because when your employees achieve goals, you and your practice are the big winners.

• Supporting: You can have one of the best human beings working for you in your office but yet this employee seems to struggle at their work. Whether it´s training, proper equipment or encouraging words, be obviously supportive of employees striving to do their best. Have faith that through your guidance, patience and positive feedback, they will grow into their position.

Employees along with patients make up the lifeblood of your practice, and should be treated as such. Your employees have families just like you. They want quality and quantity time with their spouses, children, parents, etc., just like you. They want to experience and have all of the things that you as a doctor want for you and your family.

As much as you want perfect employees - employees that think and believe like you - it just isn´t going to happen. Remember the magnitude of individual differences that we discussed earlier in this newsletter and you can easily see why you will never have employees just like you – they will never treat your office the same way you treat it – they will probably not appreciate any extra patient load that forces them to work overtime – they will not be concerned about practice building when they are not in the office – no doctor, your practice will never be the priority in your employees´ lives that it is in yours, but happy employees will do their best while they work for you. So doctor, learn to live with the acceptable differences between you and your employees, and work on keeping employees happy and productive.

What can you do different in your office to make things better for your employees? What is it that can make you the best boss they have ever worked for? How can you motivate employees to reach their greatest potential? How can you earn more of their loyalty? These are just some of the questions you need to ask yourself in order to develop the management style that will make your staff want to stay and work their best for you – a vital element in you being able to maximize your patient volume, enhance the quality of patient service and increase profits. Follow the Golden Rule and treat your staff the way you would expect to be treated if you were working for someone else. Make happy, be happy!

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