"My best producing doctor butts heads with others"

Dear Editor:

I’m a practice owner with a 4 doctor practice. More than half of the staff has been here over 10 years.

My best producing doctor constantly gives things away or discounts them and acts like she owns the place. As you can imagine, this behavior creates resentment in the other doctors. She also has a habit of changing the schedule and tends to shorten appointments and switch things around without telling anyone. The front desk has often made the schedule for a reason and yet she keeps going behind their backs to manipulate it.

Additionally, my front office team leader butts heads with her at least once a month and I am forced to continuously intervene. Both are alpha people, but the FO lead should know her time and place for confrontations. When this veterinarian is on her game she’s an A, but when she’s butting heads with others the whole place tips toes around.

Please help…(no I don't want drugs)!
 

Dear Reader:
First of all, although the issues you described may necessitate some bitter medicine (no one likes to have difficult conversations), I promise…I will recommend no drugs!

The difficulties you are having with two of your high performers are frustrating and unfortunately, very common in medical practices. The way, you as the practice owner, work to solve these impasses will set the tone and climate for your office now and into the future.

First of all, as your turnover is low and because you are reaching out for assistance, I want to compliment you on all that you are doing right! You obviously care about how your team functions and you put time and energy into improving the overall interpersonal environment. This leadership attitude positions you well for success. Secondly, the acting out of your two employees requires a systemic solution as well as individual coaching. My ideas address both the short term and long term solutions for these types of difficulties.

Dr. Jeff Thoren’s article in July’s EVT (Ask, Don’t Tell) would be an excellent starting place for you. It provides a helpful mindset for you as the practice leader to adopt. The premise is that telling people to change doesn’t work. As a matter of fact, it often brings about the opposite effect of triggering rebellion or passive frustration, and the problem could therefore intensify rather than improve.

Guidepost number one to having an exceptional veterinary team asserts that teams do not form themselves into a best practice structure, nor do most individuals on a team understand how and when to modify their behaviors or work habits for the good of the team.

As the practice leader, it is imperative that you help your team see the goal of becoming a high functioning team as a vision that all share. Doing some upfront discussions with your group at team meetings surrounding the “what kind of a team do we want to be?” and “what do we want to work towards as our team culture?”, would be helpful to set this new tone of shared leadership and responsibility throughout your team. This underscores the concept that creating an excellent team is everyone’s responsibility and provides a foundational expectation of how the team expects to work together.

It is also helpful to instill consistent and frequent feedback into your team culture. If there are set times, say quarterly meetings, when employees sit down with their reporting manager to explore how work and team processes are progressing, it is not as anxiety provoking as only meeting with employees when problem behaviors have become significant and destructive. This would be a healthy “go forward” plan for you and your team.

Now, let’s look your high producing colleague. She sounds like an excellent clinician and probably serves her clients and patients well. She is not, however, working as a self-aware member of the veterinary team. She is functioning as if she were in a solo practice, without recognizing that her behaviors and actions have a negative impact on the rest of the team.

Set up a time to review practice processes with her. The goal of this meeting is to help her identify what is not working rather than you providing it for her. Ask her how she thinks the practice is working for her. Listen carefully for what she appreciates and what causes her frustration in the daily functioning. Most likely, some of her current behaviors are her way of attempting to make systems that don’t work for her fit her needs. Once you have a clear picture of her viewpoint, complement her on her hard work and dedication, and let her know that it is your job as the practice leader to make sure everyone on the team has the best possible working environment. Let her know, clearly and thoughtfully, where her needs and actions conflict with that of the office staff or the other veterinarians. Be specific and concrete with the changes or systems you see necessary for this to happen. Ask her to give some thought to these ideas and to meet with you in a few days (set the meeting before she leaves) with her thoughts. In this way, rather than encouraging a “tug of war” with this autonomous clinician, you have engaged her as your colleague in making the practice a better place.

Along the same line, invite your front office head to meet with you to explore the practice culture. Ask her what she perceives to be the strengths and difficulties of her team interactions. Most likely, she will mention something about the behavior you describe which has the rest of the staff walking on eggshells around her. As you respond to her description, praise her assets as well as explore and define what she perceives as her challenges. Validate those issues that you believe need to be addressed, and ask her to consider how she might tackle these challenges differently. Perhaps she, too, might benefit from some time to do some self-exploration before providing her solutions. Always set a time to follow up on this type of discussion and make sure it happens.

With the coaching/questioning model of working with employees, you, as the leader, are helping them increase their self awareness and their understanding of the interpersonal network in which they function. Rather than you attempting to solve everyone’s problems, you are inviting them to work with you as fellow problem solvers. The benefit of this model is that team members are more likely to attempt new behaviors if they have had a stake in defining them and likely take ownership in the outcomes.

Most of us would just as soon our “people problems” work themselves out, but unfortunately this usually isn’t the case. Taking a proactive stance, and inviting employees to be part of the solution rather than continuing to create problems is always the wisest action. As you adopt and practice this leadership model, I think you will see great improvements in the functioning of your team.

My best as you move forward!

Dr. Ruby
editor@myEVT.com