Promote staff without defeating the point

For many medical practices and other businesses, January means performance reviews. The whys and hows of this annual exercise are another matter; but once the process is over and done with, some of your employees will be trying new titles on for size, often with too little consideration as to whether they actually fit.

A recent piece in the Harvard Business Review explores this problem. See if the following explanation gets you nodding, too: "Organizations often assume that a promotion should involve giving star performers responsibility for managing more people and developing--rather than just executing--strategy. 'Yet, these are not areas of genius for all,' says Susan David, co-director of the Harvard/McLean Institute of Coaching, founding director of Evidence Based Psychology LLC. 'Many organizations lose some of their best operational people because of creating single pathways to organizational success.'"

In other words, an entry-level widget maker who proves exceptional at making widgets rarely gets promoted to super-duper widget-maker--or a similar position that aligns with his or her strengths--but rather becomes a chief widget designer or manager of the other minion widget makers. He or she leaves work one day feeling confident and on top of the world, and returns the next feeling lost and unworthy of the new reality into which he's been thrust. Because of poor planning on the manager's part, the entire purpose of the promotion is undermined, often leaving the employee believing that he or she is at fault.

Although medical office career paths don't track quite the same as in the corporate world, a version of this phenomenon certainly occurs in practices. For example, how often is a stellar receptionist, with excellent listening skills and a sparkling personality, rewarded for her achievements by being relegated to the back office? While a position in the billing office or similar may offer a higher salary or more prestige than sitting at the front desk, the move is a recipe for all-around disappointment.

Fortunately, there are ways to avoid this troubling paradox. Consider the following tips from HBR:

1. Talk to those who see the employee in ways that you don't. Gather opinions from peers, team members and people he or she manages about how the individual would perform in the new role you envision for him or her. In some cases, you may find that the employee is already doing parts of the new job.

2. Keep people working "at the edge of their abilities." That is, find the right balance between overwhelming employees with new responsibilities and letting them get bored and disengaged with doing the same old thing.

3. Consider whether the employee will like the new role. Just because a person is capable of carrying out a set of duties doesn't mean they'll be enjoyable or fulfilling. Have honest conversations with staffers about the appeal of what you're offering to have them do (not just the raise or other perks they will get).

4. Try short-term experiments. "It gets tricky when performance in a current role is not a good predictor of performance in a new role," says Herminia Ibarra, the Cora Chaired Professor of Leadership and Learning and Faculty Director of the INSEAD Leadership Initiative. Before committing to a major change, set up a trial to gauge the employee's ability and satisfaction in the new role. Be clear that it's just an experiment, and outline clear success criteria and an evaluation timeline. There's also an opportunity to combine these efforts with regular cross-training exercises.

5. Know when (and how) to say 'no.' If an employee approaches you about a possible promotion, have an honest discussion about why both of you think it may or may not be the right time. Once you ascertain your employee's goals, help him or her create an action plan to reach them. Whenever possible, provide the individual with the tasks and assignments needed to acquire the appropriate skill set. If the reasons you have to decline a raise or promotion have more to do with practice finances, be sure to put more emphasis on intrinsic motivators, such as recognizing contributions, providing opportunities to gain new experiences and supporting autonomy and choice within a job. According to HBR blogger Amy Gallo, employees who feel valued are more likely to wait out the hard times.

Have you implemented any of these strategies in your practice? What other advice do you have to share with managers and administrators about how to avoid common promotion-related pitfalls? - Deb