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    What to do when the clinic has taken you hostage

    Remedy dysfunctional clinic environment by directly addressing common complaints


    3 common complaints

    Complaint #1: "I always thought they worked for me—but I now think I am the one working for them."

    One day, after I was done teaching and relaxing in the sun at lunch, I visited a physician and his office manager. They stated because of the area they live in, they could not find qualified people to work in their general ophthalmology clinic.

    Because of the lack of qualified people, they were in the routine of taking in anybody who applied and then train them in-house and “on the fly.” When the new hires began to develop skills, they started paying them more and more to keep them with the group.

    It did not take long for the staff to see this. Soon their intensity levels began to go down exponentially as their salaries went up. The physicians made sure they stayed happy by giving bonuses and salary bumps occasionally. Staff soon realized that the physicians would not be able to get anyone to replace them. So they demanded more and more money—as well as other perks.

    Eventually, the teeter-totter of power swung into the employees’ favor. The physicians are being held hostage by undisciplinable (they threaten to leave if poor behavior is called out), overpriced staff who will only give them a marginal day’s work.

    They wanted help and ideas from me, but when I gave them the solution I would use—and have used in the past—the practice manager had to catch a fainting physician.

    I told them to fire the one that was the “ring leader” in order to send a message to the rest of the group that no one was irreplaceable.

    Yes, I know—this is cutting your nose off to spite your face, but a message needs to be sent that even though it will be very hard to replace that person, no one is sacred. The reason employees are there is to work for the group—not the other way around.

    Complaint #2: “This really is my practice—I just let you work here!”

    A different physician spoke to me about her office administrator after a class I had just given called “Scary Tech.”

    The class is about how an outstanding technician with excellent skills, giant work ethic, and loyalty to the practice to a fault, could ever be thought of as scary.

    These are the monster technicians or administrators who have managed to cull their power into such a position that even the physician worries about having to go up against them because they are so integral to the practice.

    These employees are often quick to launch, “passionate” in how they treat others (“my way or the highway”), are unapproachable in their work habits so no one can match up to them, and consider themselves the “silent partners” who are actually on a peer level with the physician.

    This physician found herself tip-toeing around the administrator because she did not want to make the administrator mad and did not “want her wrath coming down on me, and couldn’t afford to have her leave the group.” The administrator had been with the group 25 years, and was felt by all to be irreplaceable. They just needed to know how to survive working with her!

    When I asked the physician, “Who thinks they are irreplaceable?” she said, “That’s what they tell us all the time.”

    I advised her that when she got back, she needed to sit down with the other partners and have a serious discussion regarding the administrator and whether this is the person they want to manage their business.

    When I emphasized the administrator was working at the pleasure of the physician, she smiled and asked how much it would cost to have me come and tell that to her!

    Complaint 3: 'Pet' technicians

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