Eyeworld

T he typical practice spends about 8% of cash flow on brains. A minority of the brains you buy are out- sourced on a thankfully in- frequent schedule, given their cost: accountants, attorneys, consultants, and the like. But the majority of your prac- tice's brains dwell internally: the managing partner, the office man- ager, administrator, or executive di- rector. Then there's the unheralded brain trust of your practice. They collect your charges, pay your bills, and directly oversee the moment-by- moment actions of every lay staff member on the front line. These are your middle managers. After more than three decades spying on the planet's best ophthalmic front-line supervisors, I've learned 17 pearls for selecting, cultivating, and lavishing praise on these vital cogs in the ma- chine. 1. Leadership candidacy obliges a desire to lead. Great leaders in- nately desire a leadership role. Em- powering hesitant leaders rarely turns out very well. When you are considering two roughly equivalent staff members to elevate to the same middle-management position, pick the one who wants the job the most. 2. Technical skills and job knowledge, while being important prerequisites for mid-level leader- ship, are not enough. There are plenty of great techs and billing clerks who have been elevated to be- come so-so department heads. You probably have one or two of these present in your practice today. The kindest thing is to gently demote them back to their comfort zone and select replacements who balance their technical ability with a desire for leadership. 3. It's difficult for a rank-and-file staffer to give up his or her peer-to- peer relationships and rise to leader- ship of the work group. It's lonely at the top. Make sure that a promotion is indeed welcomed by your supervi- sory candidate and explain how his relationship with peers will necessar- ily change. Just as important, make sure that he doesn't overplay the new role, snubbing and lording it over his former peers. 4. Any work group with two or more people needs a formally desig- nated leader supported publicly by management and by the board. Absent clear reporting lines and a department leader, an under/unsu- pervised cohort of equals in a de- partment will peck at each other, like chickens in a barn yard, to es- tablish a dominance hierarchy. The person they pick through this bully- ing, organic process is rarely the per- son you want in the role. 5. Speaking plainly, the chief job of every leader is to help the or- ganization extract as much eco- nomic value as possible out of the company's costly staff resources. Every effective supervisor does this not only actively, by assigning and overseeing workloads that are chron- ically at the outer limits of group ca- pacity, but also passively, by observing and gently guiding any laggards back up to their potential— a dimension of the so-called "sen- tinel effect." 6. Having all the lay staff— techs, receptionists, billing staff, and the rest—report up to the adminis- trator without one or more interme- diate department leaders, in a practice with any more than eight or 10 lay staff, breaks down. This excess span of control is commonly seen in practices of every size where the ad- ministrator or doctors are inhibited to select middle managers—either as a misplaced cost-saving measure or because they are stuck about whom to choose. 7. Naming junior department heads "team leaders" or "acting de- October 2011 www.ASOA.org I trust my business to ASOA. In today's economic climate... The Physician's PERSPECTIVE day o In t onomic clima c s e 's e day ... e t onomic clima continued on page 96 View Ophthalmology Business online at www.OphthalmologyBusiness.org 94-99 OB_EW October 2011-DL2_Layout 1 9/29/11 4:26 PM Page 95

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