MANAGING EMPLOYEES

MANAGING EMPLOYEES IN THE MEDICAL PRACTICE/CLINIC Presented by: Maxine I. Collins, MBA, CPA, CMC, CMIS, CMOM

INTRODUCTION – SOME FAMOUS QUOTES ON MANAGEMENT • “If you pick the right people and give them the opportunity to spread their wings – and put compensation as a carrier behind it – you almost don’t have to manage them.” --Jack Welch • “Hire people who are better than you are, then leave them to get on with it…; Look for people who will aim for the remarkable, who will not settle for the routine.” –David Ogilvy • “Good management is the art of making problems so interesting and their solutions so constructive that everyone wants to get to work and deal with them.” –Paul Hawken

JUST A COUPLE OF MORE-- • “So much of what we call management consists in making it difficult for people to work.” – Peter Drucker • “The secret of managing is to keep the guys who hate you away from the guys who are undecided.” –Casey Stengel • “Surround yourself with the best people you can find, delegate authority, and don’t interfere as long as the policy you’ve decided upon is being carried out.” --Ronald Reagan

TRUISM • Are some of these quotations true? • What is a truism? – From the Free Online Dictionary – n. “A self-evident truth; an obvious truth; platitude” • From Wikipedia, the free encyclopedia – “A truism is a claim that is so obvious or self-evident as to be hardly worth mentioning, except as a reminder or as a rhetorical or literary device and is the opposite of falsism”.

EXPERIENCES • Facts I have observed from many years of management: • Employees need to know what is expected of them and understand the philosophy of the practice. • They need to be able to ask questions freely. • Everyone benefits from orientation and training. • Employee need goals to reach and exceed. • Individuals thrive with effective communication. • Everyone performs better when they are able to contribute with ideas, suggestions that are, at least considered. • Employees need to be rewarded for a job well done and receive constructive discipline when necessary. • And, sometimes – no matter how hard you try – it is impossible to be successful in dealing with some individuals. Some need to go elsewhere for the benefit of the Practice and for themselves.

YOUR EXPERIENCES • Think back a moment to your experiences: • Do you remember your 1st job? • What were your emotions on that 1st day? • Were you questions answered? • Did you leave that day feeling overwhelmed, but excited? • Were you still a little apprehensive the 2nd day? • How did you feel after being there for 1 month? • Could you have written down a concise description of your duties and responsibilities at that time? • What perceptions did you have about the attitude of the office staff and what you could hope to accomplish in the position? • What could have made that first experience a little easier – a little more productive – or what is perfect? • Did you learn any good lessons from that experience?

ONGOING DISCUSSIONS FOR THIS WEBINAR TOPIC • This webinar will be a little different than some you may have experienced. • You will be given an opportunity to continue to discuss some of the topics/issues by emailing me directly with your opinions and solutions to a few case scenarios that will be presented at the end of your PowerPoint presentation in the Appendix section. • As we gather your ideas and comments on possible solutions, I will calculate a consensus and then provide you with my opinion on the correct solution. • I think this will be a fun learning experience and keep us in contact for problems that we face on a day-to-day basis. • You will be able to respond to the scenarios for a period of 4 weeks post webinar. I will then provide the analyses to you by email.

THE LEARNING PROCESS • We begin learning at birth. • We had few fears to deal with at an early age. Do you remember any fear from taking that first step? We were adventurous; some more than others; but - barring an illness, we all ventured forward with enthusiasm and sometimes even laughter. • What are some of your earliest memories? • Do you recollect your first day of school?

THE LEARNING PROCESS • Do you have any memories of the first things you learned about “right” and “wrong”? • What type of child were you? • Did you love to look at pictures? • Did you love to read? • Were you a “loner” or did you love groups? • Was your family close? • Did you have a “few good” friends or “a lot” of friends? • Do you remember the best day of your life so far? • Do you remember the worst day of your life? • All of these experiences in our learning process determine the adults that we become and the type of employee that we may be.

IS YOUR ADULT LIFE TOTALLY DEPENDENT ON YOUR ENVIRONMENT? • No, not usually. • We are all born with innate characteristics, certain beliefs and attitudes that can be affected by our environment – but this is not always the case. • When we become adults and employees, we must “for the most part” put away childish things and determine for ourselves our own destiny.

WHAT DOES ALL OF THIS HAVE TO DO WITH MANAGING EMPLOYEES? • EVERYTHING! • As a manager, we must develop the quality of objectivity. • We can only do that by understanding ourselves and attempting to understand our employee’s perspectives. • It is still true that we must treat others as we want to be treated ourselves. • How do we accomplish these lofty goals?

1. SELECTING THE EMPLOYEE • Select the “right” employee for “the job”. • A manager can only do that if we: • 1. Understand the job. • Educational skills required. • Characteristics of individual needed for the job – is this a “people person” position; a research-oriented job, etc. • Experience needed, preferred or required • Responsibilities – including a detailed list of tasks • Reporting requirements • Hours required

2. WEAVING • “Weaving the job description” into the overall goals and philosophy of the Practice and relaying these aspirations to the employees. • Start them off in the right direction! Begin by establishing an appreciation of the job in relation to the most important goals of the Practice - the provision of compassionate, quality patient care and the support of the clinicians providing that care. • We all need a purpose and a plan.

3. THE HIRING PROCESS • Preparation • Organization • The telephone interview • The face-to-face interview • Thoughtful/”making it real” • Time requirements of the job • The legalities • The call-back • The selection • Follow-up

4. ORIENTATION • Preparation • The “first day” • Welcome and introductions • Completion of necessary forms • The Employee Manual • Policies and Procedures • A “day in the life of the job”

5. TRAINING • ‘Hands-on” Computer Training • Importance of cross-training • OSHA • HIPAA • FRAUD, WASTE AND ABUSE • STATE LAWS • COLLECTION LAW • MANAGED CARE CONTRACT LAW • ORGANIZED TRAINING FOR THE DETAILS OF THE JOB ALONG WITH EXPECTATIONS • TESTING WITH “REAL LIFE SCENARIOS” • EMPLOYEE COMMUNICATION AND TEAMWORK • INSTRUCTION FROM AN EXPERIENCED CO-WORKER • FEEDBACK • FOLLOW-UP

6. ON THE JOB • Necessary Tools for the job • Policies and procedures specific to job and updated • Continuing the Educational process • The daily “huddle meeting” - updating with newsletters, communication, etc. • Monitoring and follow-up • The “right attitude” – how to accomplish • Responsibility centers and “open door policy” with next in command • Rewards • Discipline

WHAT MOTIVATES YOU? • Is it the job itself? • Is it your work ethic? • Is it money and/or possessions? • Is it a “pat on the back” and acknowledgement? • Is it survival? • Is it success? • Is it fame? • Is it in your soul? • Is it a quest for education? • Is it someone in your life?

WHAT MAKES EMPLOYEES ACT DIFFERENTLY? • Where they come from? • How they were raised? • Their personality traits? • Their fears? • Their successes? • Their failures? • Their personal life? • Their circumstances? • Their dreams? • Their education? • All of the above?

TEAMWORK • I believe it is all of the above for each of us. • That is why we are either good managers or mediocre managers. • Do you want the person to succeed? • Do you feel you need to protect your own position and, therefore, don’t want to give credit where credit is due? We have all experienced one of those types in the workplace. It stifles teamwork! • Is it important to have a little fun and promote excitement about the job?

CAN YOU “WIPE THE SLATE CLEAN”? • After completing a session(s) with a difficult employee, can you really give them a second chance? • Does your personality just “clash” with an employee? • Do you disapprove of the employees personal life style and allow that to affect your decisions? • Do you expect any more of your staff than you do of yourself? Do you expect too much of yourself? • These are questions we each have to answer daily and the ones that impact our success as managers.

A FEW EXAMPLES • The employee who lacks confidence. • The employee who is just never happy. • The employee with a “chip on their shoulder” • The employee who develops the attitude – “things will never change”. • The “one with the “halo” effect” • The “one who loves turmoil and to stir up trouble” • The ones “who talk big, but accomplish little”. • The “know it all” • The employee with “problems at home” • The employee that cannot be “on time” • The quiet employee • The employee that gives 110%.

THE EXPERTS SAY-- • “10 Tips for Dealing with Difficult Employees” by Debra Condren, Ph.D.: • 1. “Separate in your mind, the person’s professional role from his or her difficult personality. • You don’t have to live with them, just motivate them to perform well on the job and contribute to the productivity. • 2. “Use ..humor”. This is very disarming, particularly to difficult personality types. The ability to laugh at oneself is a key indicator of emotional intelligence, or the ability to connect well with other people” • Connecting • Listening • Being a good communicator

“10 TIPS FOR DEALING WITH DIFFICULT EMPLOYEES” • 3. “Don’t take it personally. Recognize that this person is likely having difficulties with similar themes in many other professional and personal relationships. Remember that it’s not about you –it’s about the person’s prickly personality style; this will help buffer you from becoming emotionally reactive or stressed”. • 4. “When “issues hit the fan,” focus on first listening rather than on arguing. Use comments like, “It sounds like you’re very concerned about this aspect of the project”. Or “Do you mind filling me in on your thoughts on how we can better deal with this situation?” • 5. “Ask for clarification. Making sure you’ve heard the person correctly goes a long way in keeping communication clear”. • Clarify • Have them put it in writing.

“10 TIPS FOR DEALING WITH DIFFICULT EMPLOYEES” • 6. “In a stalemate, rely on the old standby, “We don’t have to decide this today”. Or, “Let’s sleep on it and get back to this later.” Or, “Hmm. Let me give that some thought and revisit the issue next week”. • 7. “Say your message in as few words as possible. The less you say, the more likely you are to be heard”. • 8. “Don’t repeat yourself. Even if you don’t get an acknowledgment from this difficult person that he or she agrees, don’t try to “drive your point home” by saying it again a different way (you could say it 50 times and be there all afternoon, but a stubborn person won’t necessarily meet your half way). Say it once and move on.

“10 TIPS FOR DEALING WITH DIFFICULT EMPLOYEES” • 9. “Periodically ask, “Am I making sense?” Asking for feedback as you are speaking lets the touchy employee know you are just as interested in that person’s reaction and creative input than in being heard or being right”. • 10. “Have an Open Door Policy. When people, and particularly difficult personality types, feel that you are approachable, they are more likely to keep the lines of communication flowing and less likely to let things simmer to crisis/boiling point. Conversely, employers who “table” every request to take with, “Let’s schedule a meeting for this on Thursday at 4:00” give the impression that they aren’t really interested in staying connected to their employees” concerns, insights and ideas. People shut down communication under rigid guidelines (and are then more likely to act out in a passive-aggressive or hostile way). Source: FrugalMarketing.com; “10 Tips for Dealing With Difficult Employees”, by Debra Condren, Ph.D., 2003. The steps are direct quotes from the article.

THE CONSENSUS? • Do you agree with everything the author has stated in this article? • Do you agree with most of it? • Do you agree with some of it?

HOW TO DEAL WITH THE GREAT EMPLOYEE - • “Great Employees Are Like Fine Restaurants” – • Mike Goldman, owner of Pridestaff of Paramus. The secret is in identifying the strengths and weakness of each employee. Guide them and lead them on how to improve their weaknesses. Encourage and reward; and guide them to further improve their strengths. We can all improve every day in some way. Make sure others don’t take advantage of them. Be fair and objective. Review your pay structure periodically. Is it fairly reflecting the job duties and performance?

THE TRUISMS REVISITED • The “right person” for the job • Individuals with talents, desire & goals • Give them the opportunity • Train and Delegate effectively • Make the job interesting, exciting and challenging • Provide the employee with your expectations • Remove complications that hinder job performance • Communicate, communicate, communicate • Listen – really listen • Make the tough decisions • Follow-up and make changes when necessary • Can you add a few of your own that you have found from your experiences?

MOTIVATION • There are ways to increase motivation • There are ways to diminish motivation • But, by and large, motivation comes from the heart and soul of the individual and is “watered and grown” by the effective manager. • Having a little fun occasionally and developing passion for the job can motivate most. • Feeling ‘worthwhile and appreciated” can motivate many.

LIFE • From the dictionary - “the condition that distinguishes organisms from inorganic objects and dead organisms, being manifested by growth through metabolism, reproduction, and the power of adaptation to environment through changes originating internally” www.dictionary.reference.com • Couldn’t have said it better myself! • Life is truly what you make it - as is the management of employees.

THANK YOU! • Have a great one!!!! • Contact me at: mcmcollinsco@aol.com, M Collins & Co, PLLC

APPENDIX • CASE SCENARIO #1 • CASE SCENARIO #2 • CASE SCENARIO #3

CASE #1 - • THE EMPLOYEE CANDIDATE THAT LACKS SELF-CONFIDENCE: • Once upon a time, I interviewed a young lady that had a degree in Medical Records Management from an accredited university. I was interviewing for two open positions – 1 in the billing department; 1 in medical records. I, naturally, had her in mind for the medical records department after reviewing her resume. • When asking her about this position, she responded, “Oh no, I am not interested in that position – I do not want that responsibility! I am applying for the position in billing. I know that I don’t really have hands-on experience in that area, but I feel that I could learn the duties and would like this position”. • Question/Discussion: How would you proceed with this interview?

CASE #2 • THE EMPLOYEE THAT RUNS TO THE DOCTORS FOR EVERYTHING – COMPLAINTS, IDEAS, SUGGESTIONS, CODING, MANAGEMENT, GOSSIP, ETC. HE/SHE DOES NOT SEEM TO KNOW, LET ALONE, FOLLOW THE CHAIN OF COMMAND. • You have surely had this happen to you – or will. One day the Physician comes to the manager’s office and is upset because an employee has approached the physician in the hallway (while busy between his/her seeing patients) with big ideas on specific problems in the office that she knows how to solve; or, has suggestions on how the office could better be managed and/or reimbursement improved. • The physician wants to know how you could allow these issues to continue and what you were going to do about it – asks if you are up to the tasks. • The employee seems to be better at complaining and talking “in the hallway” to whomever will listen than to perform his/her duties and you have been planning to have a counseling session to discuss some errors you have found as well as his/her productivity. • Question/Discussion – How do you respond to the physician and how would you handle this employee?

CASE #3 • THE EMPLOYEE THAT CANNOT BE TOUCHED – IN OTHER WORDS – HE/SHE HAS BEEN WITH THE PHYSICIAN FOR A WHILE AND IS ABOVE REPROACH AS FAR AS THE DR. IS CONCERNED. • However, you are experiencing constant interference and violations of the policies and procedures from this employee. He/she does not act the same in attitude or behavior in the office when the physician is not around. The entire office is complaining and wants to know why you do not correct the situation. • Question/Discussion – How do you handle this situation to prevent disharmony in the office and increase productivity and teamwork – while, at the same time, getting along with and achieving cooperation from the doctor ?

MANAGING EMPLOYEES