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Issue: 36 - Dec 15, 2011
By: Amanda L. Donnelly, DVM, MBA
ALD Veterinary Consulting, LLC
Practice managers are supposed to be effective at human resource management or in other words-keep the staff happy and keep owners out of trouble with any regulatory organizations.  In addition,  managers are expected to ensure client satisfaction,  resolve client complaints, keep the business running smoothly, keep the schedule hopping, contribute to marketing initiatives, control expenses, and be the owner’s go-to person for any number of other issues or concerns.  On any given day, the manager’s agenda is likely to be derailed by someone or something that requires attention.  Being an effective practice manager is challenging but there are specific actions that will help ensure your success.  Take the following steps to increase your job satisfaction and enhance your job performance. 
Define Your Job Roles and Expectations
Establish reasonable and agreed upon job duties and expectations for your position.  This starts by having a written job description that outlines major areas of responsibility.  There are multiple resources for writing a job description including AAHA, VHMA and veterinary consultants.  Generic job descriptions are a good starting point but need to be edited to tailor them for your specific practice.  Next, meet with practice owners to define specific job expectations and areas of accountability for job performance.  For example, if the job description states one of the duties as “Maintain major practice expense categories within target goals” the owner(s) and manager need to agree on appropriate expectations and action steps for the manager to fulfill this job responsibility.  Otherwise, the job description is only words on paper, the manager may or may not be accountable for controlling expenses, and there is no plan and timeline in place to respond to increases in expense categories if they occur.  Once job roles and expectations are defined, communication is enhanced because owners and managers are clear about what duties are to be fulfilled by the manager. 
Clarify Goals and Priorities
Clarify goals and action plans to meet the goals.  For example, if one of the hospital goals is to grow the business by 10% and marketing plans have been drafted to meet this goal, then the manager knows what the owners want and has a roadmap to achieve success. Since managers have to juggle multiple job responsibilities, it is imperative to define and agree upon the priority for job tasks.  Otherwise, managers may risk owners assuming they will get everything done that they request in a short period of time which may be unrealistic.  To avoid miscommunication and the perception of ineffective job performance, it is incumbent upon managers to let owners know when they have too many job duties to complete in a reasonable time period.  Managers need to ask owners which duties to prioritize first rather than assuming they know what the owners want or what they think is best.  Moreover, setting timelines for completion of tasks helps everyone on the leadership team have the same expectations and knowledge regarding the manager’s job duties.
Manage Your Time Wisely
If time management is a problem for you, read one or two books to gather information and practical tips to help you become more organized.  Talk to other practice managers in similar practices to see how they have conquered their time management challenges.  The list serve or discussion forums for the Veterinary Hospital Manager’s Association (VHMA) or the Veterinary Emergency & Specialty Practice Association (VESPA) are excellent resources to ask questions and connect with colleagues.
Most managers find it works best to set aside specific hours or time slots for employees to come to their office with questions or concerns.  Obviously, emergency situations or serious concerns must be addressed as needed but having set hours for employees eliminates being interrupted by an employee that wants to talk about something that isn’t time sensitive.  When working on important projects or activities close your door and strive to maintain focus for a defined period of time such as one to three hours.  Ask the front office not to interrupt you with phone calls if they are not critical and avoid the temptation of checking email which can be distracting and time consuming.
Provide Effective Leadership
One of the critical roles of leaders is to make sure the team knows the mission, vision and core values of the organization.  If your practice doesn’t have a written mission or vision and core values, work with the practice owners to develop these guiding statements so the team knows where they’re going and how they’re going to get there. 
Build trust with employees by sharing information and being true to your word.  Keep team members informed about business activities that may affect their job and follow through on promised actions.  For example, if you tell an employee you will consider a change in their work schedule or send them to a continuing education seminar, you need to stick to your promise.  Otherwise, staff begins to adopt an attitude of thinking management doesn’t care or take action on employee issues and morale may suffer.
Being a great leader doesn’t necessarily come naturally to everyone.  But leadership skills can be learned.  Part of being an effective manager is taking the time to learn more about positive leadership and devoting time to honing your leadership skills. 
Learn the Art of Managing Up
Managing up refers to the ability to work effectively with your boss to achieve the best results for you, them and the organization.  Managing up is really all about creating win-win work relationships so you can be effective and help drive the success of the practice.  The art of managing up involves improving communication with owners and understanding their management or leadership style.
Be sure to schedule weekly leadership meetings to enhance communication and feedback.  Weekly meetings ensure managers have the tools and information to do their jobs and avoid the need for marathon sessions which tend to occur when practice issues are not addressed on a weekly basis.  Managers need to let owners know if they require any resources to do their job effectively and they need to give owners relevant feedback about management issues.  Remember also that those sticky management problems, many of which may directly involve the owner and their actions, won’t go away just because you don’t talk about them.  When problems arise, tackle them head on by letting the owners know how their actions or specific situations have an effect on your job performance.  For example, if you work for an owner that undermines your authority, diplomatically let them know how their actions result in negative consequences for the business.
Enhance Staff Productivity with Feedback
Feedback helps you work better with your team because employees appreciate knowing how they are doing and how they can improve.  Don’t forget to solicit feedback from staff as well which further assists in efforts to improve hospital operations.  Take the following steps to establish effective feedback protocols.
Communicate clearly:  Sometimes inefficiency or lack of accountability exists because managers are unclear when communicating with staff about their job performance or when delegating job tasks.  Communicate and clarify expectations to employees in a direct, straightforward manner.  Be sure to assess for understanding from employees.  Ask them if they have any questions about their assigned job tasks.  Don’t forget to give employees deadlines when delegating job tasks.  Rather than asking an employee “Can you please file these records and enter these invoices?” instead say “I need these records filed and the invoices entered by the end of your shift.  Can you complete this job task by 5pm?” 
Know when and how to deliver feedback:  Feedback is more meaningful when it is specific and timely.  Rather than saying “Thanks for doing a good job” or “We need for you to do a better job”, give specific feedback about what behavior you want to continue and/or what behavior is unacceptable.  While it may seem nit-picky, not everyone has the same definition of what is an “exceptional, good or poor” job performance, what is “on-time” or what is “clean”.  Be aware of appropriate times and places to give feedback.  Follow the old adage, “praise in public and criticize in private”. 
Focus on the behavior not the person: Focus on employees’ behavior not on intangibles such as their attitude or intention.  We cannot measure, quantify or see an employee’s attitude or intention.  We can witness behavior and actions.  Rather than telling an employee they need to have a better attitude or they need to be more efficient checking in clients, tell them specifically what words or actions demonstrate their poor attitude or poor job performance.  When you focus feedback on specific behavior and actions, employees will know what they need to do differently as well as what they need to continue doing well.
Relate job duties to the practice’s vision and core values:  Everyone’s job role in the practice has a purpose and helps to further the vision of the business.  Employees benefit from understanding how their individual job roles and assignments fit into the “big picture” or vision of the practice and how they help to achieve business goals.  Additionally, how you want team members to act and do their job tasks relates to the practice’s core values.  Remind employees that their actions need to be consistent with your core values. 
Coach Your Team to Problem-solve
If you feel like you get mired down dealing with inefficiency or fixing problems brought to you by team members then you may need to do a better job coaching your employees to be problem-solvers.  One of the biggest drains on practice efficiency occurs when team members have to seek out supervisors for assistance or approval before taking action.  Assess the problem-solving capabilities of your team.  Do some of your employees continually come to you seeking approval or direction before they take action?  Could they have been trained to make the appropriate decisions or solve problems on their own?  Answering these questions is critical if you want to maximize the efficiency of operations and promote teamwork.
Employees often need to be coached to make good decisions and become problem-solvers.  Encourage staff to propose possible solutions for how they think a problem should be handled rather than just asking how they should proceed.  In time, employees will learn to present one or more possible solutions when they come to you with problems and will feel comfortable making decisions on their own about minor variations in daily operations.  With proper coaching, many issues that previously had to be resolved by managers or doctors will be taken care of by the staff.
Amanda L. Donnelly, DVM, MBA
ALD Veterinary Consulting, Rockledge, FL