How a "control freak"
ruined a group practice

Running a clinic is exactly like running
any other business. Are you up to it?

By Madeleine Partous

A Toronto IM recently recalled his first couple of years in group practice. "It was hell, quite frankly," he admitted. "We were all pals in university -- and I've learned that working with your friends is a pretty good way to lose them."

One of the issues doctors face when they start up or join a group practice is that their training doesn't prepare them to run a business. Needless to say, most doctors don't have either the time or the inclination to get an MBA. And as the internist discovered, it can be risky to partner with "pals" since personal issues can often cloud the business side of things.

The fact is that it's extremely important to treat your clinic as a business like any other. For many doctors, this can be as simple as investing in an experienced office manager. It's easy to assume that all you need is a secretary, especially at startup when costs are high and overhead is a big concern. But a good office manager can take a lot of the burden off your shoulders by ensuring the smooth operation of the clinic, including dealing with appointments (Should you overbook? Can you handle it?), phones, patient files, computers and so on. Let's face it -- not all physicians are perfectly organized and the time to learn just isn't always there.

An Edmonton family physician, now in solo practice, described what finally drove him away from his clinic. "I never really knew what was going on. We'd hired this young girl who was really great, a whiz with computers and filing, but we found out eventually that she was completely overwhelmed." One of his partners also tended to be very controlling, not letting let her make any decisions on her own. "But then he'd get busy and not give her any guidance either, so the work piled up and the chaos grew. And then he'd yell at her about it."

THE SECRET? DELEGATE
A good business runs on good business relations: treat your staff and your colleagues with respect. If some of them are personal friends, make sure you keep the business end of things distinct; keep it out of the office. Most importantly, though, approach the running of the clinic as though you were a CEO -- let other people do the non-medical work.

For many doctors, it's very difficult to let go. While those in business and many of the other professions learn management techniques on the job or by attending "coach" seminars, doctors don't often have room in their busy schedules. (If your clinic is large enough, you might consider reading the occasional book on the subject -- find one that deals specifically with small businesses.)

HERE ARE 10 PRACTICAL WAYS TO PROMOTE A GOOD CLINIC ATMOSPHERE:

1. Listen: expressing your opinions is easy -- it's a lot harder to really hear what other people have to say. They may even teach you a thing or two.
2. Delegate: try to see how a need to control every aspect of the clinic can make your life and that of others difficult, even impossible.
3. Hold on to good staff: it's worth spending a little money to keep someone who's already trained and competent.
4. Compliment employees: sometimes a few kind words go further than a bonus cheque.
5. Trust your people: allow them to make decisions, even if they might make a mistake every once in awhile. It's how they learn, and how you get better staff in the long run.
6. Take time off whenever you can: that's why you have staff. Stress and fatigue are the two worst enemies of any smooth-running business.
7. Meet with your colleagues and staff: weekly or biweekly meetings can help morale and are indispensable for revealing problems in the office.
8. Don't let resentment build up: if you have issues with staff or colleagues, take them aside and talk to them. It could save your practice.
9. Respect yourself and others: that golden rule says it all --treat others the way you'd like to be treated.
10. Be humble: no one knows it all -- not even you.