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Reimbursement and Practice Management

Morale — Twelve Steps to Success

Excellent managers and medical group leaders realize that it takes an active, engaged and motivated workforce to achieve desired financial targets, as well as engender patient and referring physician loyalty.

After reading this article you will understand how to:

  • Discover effective ways to reward employees without a significant investment of time or practice funds
  • Formulate activities that recognize outstanding employee teams
  • Develop an effective exit interview process

View related pearls

A medical practice is one of the busiest work environments possible for a business; employees must simultaneously manage data, messages, forms, tasks, and most importantly, patients, all the while providing caring personal service. To avoid employee burn out in such a stressful environment, managers must do more than give orders. Good managers help the bottom line of a medical practice in many ways. Excellent managers realize that it takes an active, engaged and motivated workforce to achieve desired financial targets, as well as engender patient and referring physician loyalty.

Along with crunching the numbers and attending to daily contingencies, effective managers must take action every day to build rapport and foster respectful relationships among team members. Here are 12 strategies today's high-performing managers are using to boost employee morale — and retain their best employees:

Recognize Positive Results. A little bit of sincere praise goes a long ways — and it doesn’t cost a dime. Find ways to recognize employees for their hard work. Ask each team — front office, nursing, business office, etc. — to list their group's most significant accomplishments during the previous year or quarter. Share those lists at meetings and on bulletin boards in the staff area. The team approach to commendations makes sure that everyone feels included, not just the star players on the team.

Share Feedback. Everyone wants to feel that his or her work has a higher purpose. Ensure that your employees really get the sense that they are contributing by encouraging and sharing the positive feedback you get from patients. Consider asking a patient who has had a particularly great experience with your practice to come and speak at a staff meeting (offer that person a small token of your appreciation, such as a $25 gift card to a local retailer, for taking the time to do so). Post notes, letters and emails from patients in the staff break-room. Because medical practice employees often see patients at their sickest, sharing the real-life stories of how they have succeeded in helping a patient will reinforce that sense that their daily duties, no matter how mundane they appear, have a higher purpose and are appreciated. Don't skip annual employee performance reviews, which are essential to provide positive feedback, as well as offer suggestions for future performance improvement.

Staff Properly. Are you expecting one nurse to room 60 patients, triage 100 calls and meet you at the surgery center by noon? Morale is sure to plummet when employees feel like they are always falling short of expectations. You don’t have to lower your standards, but do take a realistic view of what’s possible. Give employees the tools and resources they need to get their jobs done, but also ensure that you have enough team members in the first place. Pay at or above market rates, and place a priority on asking every employee this important question at least once a year: “What can I do to help you do your job more effectively?”

Develop Teamwork. Developing a team is essential because employees tend to flourish when they have co-workers whom they can count on for support. Develop cross-training opportunities so that team members can effectively support one another.

Be a Leader. Be a leader, not a pal. Even great employees can’t function without a leader– someone who establishes boundaries, sets priorities, administers protocols, and ensures compliance with rules and regulations. One of the most important tasks of the leader is to provide feedback; both positive and critical (emphasize constructive criticism).

Encourage Professional Development. However much employees enjoy their jobs, they may be looking for more challenges or more variety. Some will seize upon opportunities to advance professionally. Help employees expand their skills by training them on new tasks, encouraging them to be part of a task force with a special assignment (such as choosing a new piece of equipment or software).

Pause to Have Fun. Although the nature of the work in a medical practice is extremely serious, it’s important to find opportunities to inject a little fun into the workplace, too. Incorporate small pleasures into the regular schedule. Try holding an ice cream (or frozen yogurt, or fresh fruit) social with all of the fixings at lunchtime one day. Hold fun contests among employees, such as Tacky Holiday Sweater Day in December. Involve patients in the fun, too. For example, post photos of the top three tackiest sweaters on your practice’s Facebook page, and give patients a week to vote. Traffic to your site will likely soar.

Motivate. For the majority of staff, positive energies foster positive performance. Make small-but-effective morale-boosting efforts that inspire your employees to be their best. For example, share a motivational video like this one from John VonAchen at the beginning of each staff meeting. You can find a host of similar two-to-three-minute motivational videos for the workplace at no cost on YouTube. Promote community service activities: take on a volunteer project as a practice or allow employees a small amount of paid time per quarter – perhaps four hours — to volunteer for the charitable initiative or organization of their choice.

Eliminate Viruses. Most medical practices are like families, which can be great but also bring significant challenges when cannot bring yourself to let go of the employee whose poor performance or attitude is bringing everyone else down. People who are not team players, spread gossip, and never accept responsibility for their mistakes are like a virus: their bad attitude spreads throughout the workplace. The impact can even hit your bottom line if declining morale leads to lower work quality and higher turnover. Although often painful, don't let a virus bring down your entire workforce; say goodbye.

Counsel Wisely. When employees make serious errors, pull them aside and deal with the issue in private. Public embarrassment can only serve to make an employee humiliated and, potentially, scornful.

Conduct Exit Interviews. If you have the misfortune of losing a great employee, take the time to perform an exit interview. Avoid becoming defensive or dismissive when you hear criticism. Ask open-ended questions such as, “What were your best and worst experiences here? Is there one thing about our workplace that you would change if you could? Listen carefully and, above all, give the employee enough space and security to speak with candor about their experiences while working at your practice. Even if the employee is leaving for a reason you can’t control — relocation to another state, for example — the facts and impression gained through an exit interview can provide valuable knowledge about the work environment at your practice.

Show Appreciation. Staff incentives need not come in the form of annual bonuses or other costly perks. The real gift – the one that is most effective in building and sustaining morale — is your appreciation. Often, all you need to do say "thank you" frequently and with sincerity.

Good employees are like the most valuable players on sports teams: they excel in their own areas but also seem to raise the quality of everyone’s game, day in and day out. You might not need to ratchet up salaries and benefits to keep your workforce’s best employees. Many of the things that employees value the most — respect, teamwork, fun and rewarding work – don’t cost a dime; it’s just takes a little imagination and few minutes of your time each day.

Pearl 06/01/14

Proven Winners
Express your appreciation to employees in creative, low-cost ways such as these proven winners:

  • Thank Families. Take the thank you note to a new level by writing a card to the employee’s spouse or entire family to explain how much you appreciate your colleague.
  • Make a Video. Record a short video that recognizes your employees – simply speak into the camera and thank them by name, or try something more creative. Post the video on YouTube for employees to see and share with others.
  • Leave Sticky Notes. Post a sticky note on the employee’s monitor to saying thanks for a good job or completing a special project. It’s simple, but effective when it's authentic.
  • Write ‘Thank You’ Notes. Saying thanks about something specific may be the ultimate reward. If you do it selectively yet authentically, you’ll see those notes of appreciation on your employees’ desks or walls for years to come.
  • In the News. Tell your local paper about your employee’s success. Also tell the paper in the town where your employee lives. Run a press release too. Then, when it gets printed in the paper, get the article framed and give it as a gift to your employee.
  • Recognition Circle. Ask each employee to write something positive about the person you're recognizing on a piece of paper. Either give them the box of collected sayings or frame them for the person.

Motivating employees is great, but the real secret to an effective workforce is to keep them happy.

Pearl 06/09/14

What Do I Do?
Job descriptions are critical to an effective workforce. They help employees understand how they fit in the practice and how their work contributes to achieving the practice's goals. In addition to the job summary — the answer to the question, "Why does this job exist?" — job descriptions should include the job title, department name, reporting relationship, duties and responsibilities, working conditions and job specifications for the position. Finally, incorporate a disclaimer that the document is not created to be comprehensive; expectations are that the employee will be a contributing team member beyond the technical scope of the description.

Pearl 06/16/14

For the Health of It
Positive work environments have proven to contribute to an organization's bottom line. While there are many ways to motivate an employee, positive reinforcement is one of the most successful strategies. Programs that recognize employees are both effective – and low cost. Issue certificates for passing training programs or achieving certifications; publish positive comments about employees from patients and referring physicians on a board in the staff break-room, and ask employees to nominate co-workers for "teamwork" awards.

Don't forget the cheapest and best motivator of all – showing your appreciation. Put a thank you note on the chair of an employee you wish to recognize for a job well done, and you'll see that note posted at their workstation for months, if not years, to come.

Pearl 06/23/14

Making a Difference
According to the American Society for Training and Development, corporate surveys report that over half of all employees don’t care too much about the business' mission or even their jobs, for that matter. Take advantage of the fact that your practice is no ordinary business. Remind employees of their influence on people's lives. Every smile, every gentle touch, every door held open – these all truly make a difference for patients who are often sick and suffering, and nearly always anxious.

Bring in a photographer to take pictures of your employees aiding patients (of course, seek patients' permission to be photographed); use these photos to post in the employee break-room, as well as the nurses' station, telephone room and business office. Ensuring that your employees recognize their role in caring for patients translates into an engaged workforce that provide countless rewards for your practice.

United States