Fear and loathing of the performance review

Many of your colleagues shun them or dismiss
them as time wasters. More fool they

By David Elkins

Two words that can rattle a medical practice to its core: Performance Review. Consultants insist that you do them. Your employees both look forward to them and fear them. You become near catatonic at the thought. Problem is, the consultants got it right. In the interest of a smooth-running practice, you just have to do them. Not me, I hear you say. I'm in solo practice. Sheila is my only employee. It would be embarrassing and it wouldn't accomplish anything. Embarrassing it might be -- a little at the start of the review -- but you're wrong if you think it wouldn't accomplish anything. Practice after practice has shown that both employee (Sheila et al) and employer (you) invariably come out of reviews stronger and better able to cope with the everyday stress of running the small businesses that medical practices are. At best, they keep you and your staff dealing with each other in an honest and professional way, and that can't hurt.

If you're still fighting the idea of formal employee reviews, remember your staff looks forward to them as a chance to be rewarded for good work and to be given constructive criticism about how to do better. It's all about self-improvement and as the most casual glance at the bookshelves of the nearest Chapters/Indigo bookmart will show you, this society goes for self-improvement like a dog for a bone.

A HOPE AND A PRAYER
Not doing a review is a tremendous disservice to those who work for you. Everybody wants to know where they stand, they know you have expectations but they can't be certain what they are unless you tell them clearly. Many doctors live on a hope and a prayer that their employees will somehow know by osmosis what is expected of them. Osmosis works no better at the office than it does in a marriage. One of the reasons humans learned to talk is so that we could tell others of our needs and expectations. The ears, of course, are so we can listen to the needs and expectations of others. Performance reviews were built for this kind of interaction.

There's another reason why regular performance reviews are necessary -- a legal one. Consider the woes of the Calgary dermatologist who hired an assistant who was as attractive as she was incompetent. When a mistake was discovered she just turned on the charm and promised to do better. She might still be working for the poor doctor if a patient record file she permanently "mislaid" hadn't almost landed him in court. He lost his temper and fired her on the spot. Her wrongful dismissal suit did wind up in court -- and cost the practice six months worth of salary to resolve it. Why? Because he hadn't done regular performance reviews. At the very least they would have provided a paper trail that showed chapter and verse of her shortcomings. At best, he would have dismissed her without consequences at the first review.

Here are the reviews that are the most important:

• Ninety-day probation. New employees must always be put on a three-month probation. This should be made clear in writing, in their initial the interview. Make it clear that the new employee's work will be evaluated at the end of the period and if it's acceptable -- and they still want to work with you - the job will become permanent. If not, you simply part company with no hard feelings. You may want to include a raise in pay to celebrate their permanent status.
• Yearly reviews. These are the big ones. The consensus is that they should be done at the same time every year for all employees -- not, as some suggest, on the anniversary date of employment. When review time comes around, prepare a list of duties and go through it item by item. Do it in writing. At the end of the interview, which need only take 15 to 30 minutes, provide the employee with a copy and keep one in his or her file. Another tip: plan to give raises only during the annual review. This prevents employees from asking for them at often inopportune times during the year. It takes away much of the anxiety of the process for both of you.

Don't confine your meetings strictly to these annual affairs. It's a good idea for you, or your manager, to have an informal practice chat with employees every couple of months just to make sure everything is on track.

Next issue: how to conduct the best performance review possible.