A journey into Corporate Middle Management – 11.07.2018

Today was a good day.  I feel like there may have been a breakthrough of sorts.  To give a brief background on the breakthrough that I speak of, I must take you back to the fact that I just took a multi-faceted position with a large multi-specialty health group.  I am heading up a new division within this group, and our new Medical Director of the developing division has an outside practice that we are slowly migrating into our system.  My job…manage the division by not only starting two clinics around the city, but also take on this albatross of a private practice and mold them into Company ABC.

The Physician is excited about the Migration.  The Physician’s Wife is excited that she won’t have the stress of trying to hold everything together anymore, but she is also terrified of letting go of the Practice almost as if the Practice were one of her kids.  The Trusted One is excited because he recognizes the absolute future potential of the Migration, and then there were Core who knew virtually nothing of the Migration.  Me?  Well, I was worried because I am solely responsible for whipping the Core into shape in preparation for the Migration, and that was terrifying because how was I to roll out this migrant practice and make it profitable enough to roll out to many other practices within Company ABC.?

What I discovered today after spending time with each member of the Core, is that before I can even think about profitability, I must first completely overhaul the fundamentals of the Practice.  We have to go back to basics.

(1) Expectations:  Set appropriate expectations from your staff, and make sure that they are communicated to each person; this could be done by holding a 60-minute staff meeting to review the handbook together and answer any questions that they might have.

(2) Employee Relations:  This one is simple.  Pull them together in a staff drum circle where they sing Kumbaya and explore each others’ energy…while one would say this is the best solution, and while I admire it greatly, for this crowd…and I know my audience…that ain’t gonna work.  Nope.  This one, we’re going to have to go back to the basics.  Put them in a room together, and hand them a handful of identical index cards with questions on them, and have them answer them…anonymously, of course.  Next read the questions and answers to the entire room.  Each staff member will have no choice but to learn about their co-workers.  They won’t know who wrote the responses that they were so inclined to “like,” so they would have to pretend like everyone wrote them.  This, I promise, will lead to teamwork.

(3) Regulation and Compliance:  Think OSHA.  As a group, walk through the clinic with them.  Encourage them to open their minds, listen to their gut, and keep their eyes locked on the out of the ordinary things…the things that could produce disaster.  Each member of the staff, or the Core, will contribute. Someone will picked up expired medications.  Another will notice fall/trip hazards.  Others will point out various other important issues regulated by OSHA such as how to handle water/mold damage, TB/Hep B regulations, Bloodborne Pathogens Trainings, etc.  The point is…they are working together as a team…for the cohesive success of the Practice.  Now, think HIPAA…and NO, it’s NEVER spelled HIPPA, and it’s never pronounced as HIPPO.  Take them through a series of role playing events, and use feasible, realtime examples.  Let them experience a HIPAA breach from all perspectives (the Company, the Provider, the Staff, the Patient and the Government).

Now, you ask why Regulation and Compliance came in 3rd Place…well this is why…you can never be completely OSHA or HIPAA compliant with equal effort from ALL parties.  This means T-E-A-M-W-O-R-K.

(4)  Financial Health:  For this one, we’ll need to focus on teaching the team how the “bottomline” directly effects their life.  You may think they would balk at this and think it condescending, but when you talk to them about this in terms of benefits (health insurance, STD/LTD, life insurance, legal aid, paid-time-off and 401(k) contributions), they will come around.  It may take some convincing, but if you pay them for what they are worth, and you offer benefits such as the above, you  will get them to all work together to make the Practice profitable.

Ok.  Breathe.  Now I have my agenda:

1 — Shadow each team member for a day and get them to confide in me;

2 — Convince each of them individually the prospects of the future and get them excited to finally open up and discuss the issues in a rational way;

3 — Book and plan the staff meeting day with an awesome catered breakfast and even more awesome catered lunch;

4 — Train. Train. Train.

It’s the perfect strategy.  Now, stay with me as I enter into this new journey of balancing corporate ideals with private practice feels.  MUST conquer this.


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November 8, 2018

It sounds like you have a very solid and progressive plan – good luck with your reform, I think you’ll do great!