This article was published in MedEsthetics May journal.
Developing behavioral standards and leading by example can help you bring out the best in your employees.
As the physician-owner of an aesthetics practice, no matter how effective your practice manager or administrator may be, your employees will look to you as the leader of the business. Your behavior and attitude can bring out the best—or the worst—in your staff. Therefore it is vitally important that practice owners embrace their roles as practice leaders and take time to consider the culture they wish to create for their teams and patients.
Creating a Culture of Respect
Medical providers tend to place a lot of focus on patient diagnosis, treatment and outcomes—and that is a good
thing. But what is often overlooked is the proven connection between a patient’s experience with her provider and
the quality of her result. Patients who have a great experience — from the front desk through recovery—are more
engaged in their treatment, leading to better outcomes. Creating a positive patient experience throughout the
continuum of care requires every employee to bring his or her “A” game to the offi ce every day. You can help your
staff accomplish this by creating a set of standard operating procedures for employee behavior.
Following are some examples of behavioral goals—or expectations—you can implement with your staff.
• We commit to respect and support each other.
• We will always greet patients with a smile and positive eye contact.
• We will always introduce ourselves by name to patients.
• We will always explain to patients our role in the practice and in their care.
• We will answer all questions and ensure that our patients understand the answers.
• We will be considerate and tolerant with one another.
• We will not engage in gossip or the spreading of rumors.
• We will bring concerns and problems to the weekly staff meeting to discuss and resolve.
In order to get the most buy-in from staff, I recommend creating a list of behavioral standards during a staff meeting—
with employee input—and having everyone agree to them. This way each employee has the opportunity to
contribute suggestions, share concerns and make a personal commitment to uphold the desired behaviors. You can then create a poster with your standards and have everyone,including the physicians, sign the poster on the wall.
Do be prepared for some pushback. Inevitably the question will arise, “Why do we need to do this when we’ve been working just fine for the last number of years?” Let your team know that your decision to introduce behavioral
standards is just one piece of improving the patient experience. It is not a reflection on their behavior or a punishment.
Setting an Example
As the leader of the practice, it is imperative that you follow all behavioral standards. This will affect the behavior
of your employees and help them fi nd their best selves to share with patients. How can you do this?
• Employ the power of enthusiasm. Enthusiasm is infectious. When your staff sees you enthusiastically embrace
the behavioral standards, they will follow your lead.Your example will lead your employees to become better team members and help them deliver the outcomes your patients seek.
• Engage with your staff every day. Take an interest in the work they are doing, thank them for their work and “round” the office once or twice each week. This will help you get to know your employees better—and vice versa.
• Use emotional intelligence. All people have distinct personality traits and are motivated by different concerns and outcomes. When you recognize each person as an individual, you can interact with each member of your team in the way that makes him or her most comfortable. For example, when a problem arises some employees may need an arm around their shoulders and a private discussion, while others relish a challenging conversation. Knowing the difference is key.
Addressing Problem Behaviors
Once your practice has established an agreed-upon set of standards, the physician-leader must be the first to exhibit
these behaviors because staff members will be watching.They will also be watching to see if you tolerate actions that
fall below the expected standards. Medical professionals have a tremendous capacity for empathy. Unfortunately, this can make them adverse to confrontation—a dangerous trait for a team leader. You may prefer that staff members work together and hope that difficult issues will simply go away. However, that will never be the case; these problems fester and ferment until they are addressed. The way—and the speed with which—you address employee behavior that falls short of the expectations will define how well these new standards become ingrained into the culture of your practice. It is important to confront the issue immediately. Do not wait until tomorrow or next week. As soon as there is a free minute, take the employee aside for a private conversation. Explain the shortcoming that you have witnessed,
and give the employee an opportunity to comment and/or explain.
A good example is when you hear someone being disrespectful toward a coworker. Take that person aside and say “I need to speak with you about the way you talked to Mary. Why did you roll your eyes and why were you so dismissive of her concern?” After you have listened to the employee’s response, help him or her understand why this behavior cannot continue and offer guidance on how to handle the situation in the future. For example, “How would you feel if I communicated with you in that way? In the future, if you are having a problem with someone, address it directly with them respectfully and in a private area.” It is important to confront the issue immediately. Do not wait until tomorrow or next week.Then ask the employee to confirm that the behavior will not be repeated. “I need you to not repeat this style of communication. Do I have your agreement that this is inappropriate in our practice?” Use the language “I need”
rather than “I would like” or “Please” to emphasize that you are serious about requiring the change in behavior.
After the problem has been addressed, reinforce that he or she is a valued member of the team and that you have
confidence that the shortcoming will not be repeated. This style of coaching will help to raise the bar for all team
members to the expected level.
Maintaining What You’ve Built
It is essential that everyone in the office is held to the same standards. If you allow leeway to certain employees or
administrators, you will create resentment among staff members, and the culture of your practice—not to mention
your own credibility with staff—will be damaged. A leader cannot have favorites in the office. For example,
you may have a long-tenured employee—maybe even your first hire from years ago when you started your practice—
who is used to doing things his or her own way. You may have even overheard staff say, “Oh yeah, he always acts like that, they’ll never do anything.” Once the new behavior standards are launched, all employees, including those who have been at the practice long term, must be in compliance with expectations.Another challenge may be a superstar employee whose less-than-stellar attitude has been tolerated because the practice depends upon that person’s performance. These superstars also need to be coached into compliance with the expectations using the previously mentioned approach. Every member of your staff plays a critical role in the patient experience, and your daily behavior guides your staff more than any other factor in the practice. In some cases, you may have a genuinely toxic employee
on your team. A toxic employee can sap the energy right out of your practice. These staff members tend to be overly negative; blame other people for their problems or shortcomings; have an “It’s not me, it’s you” response to all concerns; and may even withhold information or assistance that would help coworkers. The toxicity is insidious, and can drag you and your staff into an abyss of low morale and decreased productivity. If you can change a toxic employee’s behavior through agreed-upon behavioral standards and coaching, you will demonstrate your leadership to all your staff, and it will have a huge, positive impact on the patient experience.
Following are steps for working with a toxic employee:
1. Set clear expectations for the behavior modifications that are required, and provide a timetable within which
those changes must be implemented.
2. Document the discussion as well as your expectations, and email those notes to the employee after your
conversation. Be straightforward about the behavior(s) that need to change.
3. Have weekly coaching meetings with the employee to provide feedback on progress and give the employee an opportunity to discuss progress from his or her perspective.
4. Be prepared to terminate the employee if there is no progress and the behavior expectations are not met. “Three
strikes and you’re out” is a simple but effective approach. After the first discussion, give the employee a written warning. If the behavior is repeated, give a final written warning after your conversation. Termination follows a third strike.
Remember two things: Toxic staff members typically fire themselves because they are resistant to changing their unacceptable behavior; and your staff and patients will thank you for resolving problems with a toxic employee. Every member of your staff plays a critical role in the patient experience, and your daily behavior guides your staff more than any other factor in the practice. Your example will lead your employees to become better team members and help them deliver the outcomes your patients seek.
David J. Waldron is executive director of the Dermatology Business Accelerator, a business community dedicated to helping physicians develop their leadership skills and business acumen. Contact him at firstname.lastname@example.org.