Dos and don'ts for a happy practice

It's been a few years now since I worked in an office with other (fully grown) people, so when I read a recent Medscape article about dysfunctional medical practices, my initial reaction was to be grateful that I don't need to worry about office drama, and that nobody else here is tall enough to put fish in the microwave.

But for those of you who do spend so many of your waking hours with coworkers, this piece should be required reading. If anything, it gives plenty of sound advice on the kind of dynamics you don't want to see in a work environment, especially a physician practice in existence to serve patients.

On the other hand, the average office employee can only truly be responsible for the attitude he or she brings to work (and to life, for that matter). For that reason, this piece from the Huffington Post offers indispensable lessons for every individual striving to bring comfort, service and usefulness to relationships and work responsibilities. In other words, anyone in the business of helping patients has a responsibility to nurture their own happiness and positive energy to bring to their work.

While I do recommend you read both articles in their entirety, here's an overview of the lessons managers, physicians and employees should take from their advice:


Celebrate the small wins. In a physician practice, you don't often see the immediate impact of saving lives or of even improving them. In the ambulatory setting, your work mostly involves improving patients' health incrementally, often amid frustration and setbacks. But when you take a step back and see what you accomplish when you answer a patient's seemingly simple question, when you foster the career growth of a hard-working employee or catch a billing error before it turns into a catastrophe, you'll be reminded why you show up to your practice every day. And if you feel more satisfied with the work you're doing, that attitude can be infectious.

Speak up about problems. Most people don't want to be the squeaky wheel, the one who rocks the boat or whatever cliché they prefer. But silence can create even bigger problems, so you've got to overcome your discomfort and express your concerns, which takes trust. "If you don't trust people, you can't engage in healthy conflict, so you create this artificial harmony," Melissa Stratman, CEO of Coleman Associates, a Boulder, Colorado-based practice consultancy, told Medpage. "Everyone pretends to get along until something happens or someone blows up."


Rely too much on technology for communication. "There's a deep need to have a sense of belonging that comes with having personal interactions with friends," John Cacioppo, Ph.D., the director of the Center of Cognitive and Social Neuroscience at the University of Chicago, told the Huffington Post. The same concept can apply to coworkers. You may not in fact be friends, but you do have a relationship that requires personal attention. Even on the busiest of days, don't overlook the power of eye contact, an understanding tone of voice or a hand on a person's shoulder to help foster people's sense of belonging and diminish anxiety.

Make 'profitability' a negative. "In a dysfunctional organization, there are things you can do that will get you in trouble, and nobody will tell you what they are until you get in trouble," Albert J. Bernstein, PhD, a Portland, Oregon-based clinical psychologist and author of Emotional Vampires at Work, told Medscape. "In a medical setting, the written rules emphasize that we're here to deliver the highest-quality medical care, but the unwritten rules may emphasize profitability, protecting reputations, and billing for as many services as possible," he said. Rather than permitting a punishing tone in the interest of protecting your bottom line, be clear in your mission that keeping your practice in business is essential to patient care.

Our friend Brandon Betancourt, administrator of Salud Pediatrics in Chicago, addresses this topic well in a recent blog post. "In the private practice world, mentioning profit or revenue is almost prohibited as if it was a kind of taboo," he wrote. "We are very upfront with both patients and our staff about the need to be profitable. We believe so strongly in this, that in our practice, we discuss profitability in practice's core values document. Here is an excerpt from our company's charter:

In order to carry out our mission, we recognize that every staff member must take every opportunity to decrease cost, to increase efficiency, and earn revenues that support our team, our practice and our patients.

In today's health care climate, practice employee must be comfortable with talking about money. They need to know that not only is it okay, but a necessity."

As always, please let us know in the comments what you think of these ideas, and any more you have to add. -  Deb (@PracticeMgt)

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