The role of the director of operations in managing clinicians for success

By Ann Rabinovitz
The number one issue facing any company, of any size is human resources: staffing problems, compliance issues, and motivational concerns. Among the common reasons that employees fail are that they are wrong for the job, poorly trained, uncertain what is expected of them, or not given consistent feedback about job performance. Low productivity and poor motivation are management-driven problems. As a result, according to an October 2004 article in Human Resources Magazine, two out of five of your employees may be actively job hunting within the next 12 months. And often the reasons are human resources lacks: lack of career development or promotion prospects, lack of feedback, lack of recognition, lack of a good working relationship with the manager, and a lack of opportunity to be creative. A Lore International Institute survey found that most employees want their managers to have integrity and be fair and honest, engender trust, show appreciation, and listen, understand, and communicate effectively with them. Successful employee management, then, comes from conducting the business side of your practice with a focus on integrity, processes, and structure. It benefits from developing a performance-oriented culture, understanding that what gets measured gets managed. Good managers also maintain regular communications with their employees and confront problem situations and employees immediately as they arise.
HIRING A DOO

DOOs first tasks, then, is to make sure that all staff members understand and accept that they are in a service business, helping patients resolve hearing impairments that diminish their quality of life. This is a noble, worthwhile service. An important ingredient in making the practice successful is for the DOO to add a performance-oriented component to its culture. All employees must clearly understand their job expectations and goals and know that they will be held accountable for meeting them. One definition of accountability is the pursuit of excellence in execution. As Larry Bossidy and Ram Charan wrote in their book Execution: The Discipline of Getting Things Done, Execution is the great unaddressed issue in the business world today. Its absence is the single biggest obstacle to success. Lack of execution is the cause of most of the disappointments that are mistakenly attributed to other causes.1 The DOO should communicate regularly with employees about their goals and objectives; assess their performance; provide feedback, coaching, and counseling; address problems head on; and offer recognition and rewards.
HIRING AND TRAINING THE RIGHT STAFF

Someone has to manage the business side of a practice. Often this is the owner. But, in many cases, the owner hires a director of office operations (DOO) to oversee day-today operations. This person need not be a practicing audiologist or dispenser. When a practice has a DOO, it is critical for the owner to make it clear that the director is in charge of all decisions and has the owners full support. This message is best conveyed at a meeting where the owner introduces the DOO to the entire office staff and explains what the person will be doing. At the same meeting, the DOO should outline his or her objectives. The director will emphasize that he or she will be managing the numbers, not the technical side of fitting patients. The DOO must be a good leader and manager because the culture of a practice is determined largely by how the staff are treated, motivated, and managed. Customer service is paramount to success and must become part of the culture of the practice. One of the
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Recruiting the right staff is critical to meeting a practices goals and objectives. While an in-depth discussion must be saved for another article, suffice it to say that successful hiring starts with creating a job description for every position. Doing this allows the DOO to determine who the right person is for each job and to focus on attracting suitable candidates to interview. In the interview, the DOO must present realistic job expectations. He or she should also search for performance facts that may not be apparent from the rsum. This can be done, for example, by asking questions that require candidates to explain rather than give a simple yes or no reply. Ask candidates to discuss results, not merely recite a list of actions taken. When an employee is hired, he or she needs to be properly oriented from day one. Doing so reduces stress and turnover among new staff. Many DOOs meet daily with new hires to share their vision and get feedback from them. It is important for newcomers to learn every aspect of the practice.
ADVOCATING FOR THE PROFESSION

In managing the staff, the successful DOO presents himor herself as an audiology advocate. The DOO helps create an effective marketing plan, which attracts top-quality leads for appointments. My company, American
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The role of the DOO

Hearing Aid Associates, gives high priority to having an effective marketing plan. One of AHAAs primary services is helping practice owners/managers create them. The DOO must be attentive to the process of front office scheduling, ensuring that when a potential patient calls with a hearing problem, whoever answers the phone motivates the caller to schedule an appointment. The DOO must establish good rapport with the staff, letting them know that he or she is focusing on their numbers, not necessarily on their techniques unless their techniques are preventing them from being successful.
STAFF MEETINGS

counseling as well as provide feedback and recognition for good performance.

COMMON STAFF OBJECTIONS

Regular meetings with staff, both one-onone and as a group, are essential to successful practice management. Both types of meeting offer the DOO an opportunity to continuously share his or her vision, solicit feedback from employees, and discuss the progress of the practice compared to its goals. The best meeting moderators ask questions rather than make statements because questions require active participation from employees. Effective questions often seek to resolve a problem, improve processes, or elicit information and insight, such as: How can we do this better? What did we do right/wrong? Does anyone have an idea? Or they can ask for specific, focused, factual responses, such as What do you think about? How will this help? Tell me why we shouldn't... In meetings, the DOO reminds staff of the practices financial goals and discusses how actual sales compare with the goals. If they are ahead of budget, the DOO offers praise. If they lag behind, he or she asks questions to determine how improvements can be made.
COMMUNICATIONS/EVALUATIONS

Of course, ours is not a perfect world with perfect employees. Hence, some staff members will object to the process. One complaint may be that the DOO is not a clinician and therefore does not understand the difficulties of their jobs. If this happens, the DOO should acknowledge that he or she is not a clinician, but rather is focused on managing the numbers, not the technical side of fitting patients. This complaint will most likely come from a clinician who is underperforming, so it is imperative that the DOO determine the reason. Once the cause is identified, the director can show the clinician how to improve performance. Another common complaint is I cant sell all these units. Again, the DOO must determine the root cause. Was the goal truly unrealistic? Do the persons skills need improving? Along with skills, look at the employees closure rate. If the percentage is high, the problem may be insufficient time to see enough patients, which gets back to a goal issue or a time-management problem.
CONCLUSION

The keys to effective staff management include ensuring that staff members know who is in charge, whether its the owner or a separate DOO. That person needs to hire and train well, create a service- and performance-oriented culture, set clear expectations, communicate regularly, praise often, counsel when needed, and treat all employees fairly and consistently. Above all else, remember that your employees want certain things from you, including: integrity, recognition for their work, regular communication, and fair compensation for their good efforts.
Ann Rabinovitz is Associate Regional Business Manager, Framingham, MA, for American Hearing Aid Associates, West Chester, PA. Readers may contact her at arabinovitz@ ahaanet.com. REFERENCE 1. Bossidy L, Ram Charan R: Execution: The Discipline of Getting Things Done. New York: Crown Business, 2002.

In a performance-oriented culture, its up to the DOO to ensure good communications. Along with staff meetings, another important communications tool is the performance evaluation. Individual meetings should be scheduled with each staff member at least quarterly, and more often with employees who are having problems meeting goals. These sessions are an opportunity for the DOO to offer
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